bluuebunny/crossref_metadata_2025 huggingface dataset:
Occupational exposure to blood and body fluids among Turkish nursing students during clinical practice training: frequency of needlestick/sharp injuries and hepatitis B immunisation
Authors: Talas Melek Serpil
Published: January 2009

Aim and objective.  To describe the rate of needlestick/sharp injuries in nursing students, to estimate the rate of vaccination administration and to define nursing students’ status using universal precautions for protecting from blood‐borne infections.

Background.  Nursing students have a high risk of occupational exposure to bloodborne pathogens because they may have insufficient background knowledge to recognise the level of risk posed by a particular patient and their inexperience with procedural skills and infection control procedures.

Design.  This study was designed as a retrospective and descriptive survey.

Methods.  The frequency and mechanism of needlestick/sharp injuries and hepatitis B immunisation were determined retrospectively by surveying students in three nursing schools. In November 2004, 473 students were questioned about needlestick/sharp injuries that they had sustained during their clinical practice and hepatitis B immunisations.

Results.  Forty‐nine per cent of the students who responded sustained injuries; of these 74% were injured while on wards. The highest number (72·2%) had been injured by hollow‐bore needles; 65·2% who were injured were not wearing gloves at the time of injury; 27% of injuries were associated with recapping the needle; 43·9% reported their injuries to administrators and the rate of those receiving medical assistance after needlestick/sharp injuries was less than not seeking assistance; 67·7% had been vaccinated against hepatitis B.

Conclusion.  This study showed that nursing students frequently sustain needlestick/sharp injuries and hepatitis B immunisation rate was low.

Relevance to clinical practice.  Findings will help in designing more intensive education programs directed at the students to increase their awareness of and compliance with Universal Precautions and in instituting policies so that they are fully immunised against hepatitis B before beginning clinical practice.
Caregiver self‐efficacy for managing behavioural problems of older people with dementia in Taiwan correlates with care receivers’ behavioural problems
Authors: Huang Huei‐Ling , Shyu Yea‐Ing Lotus , Chen Sien‐Tsong , Hsu Wen‐Chuin
Published: January 2009

Aims and objective.  To investigate the relationship between family caregivers’ self‐efficacy for managing behavioural problems of older people with dementia and their behavioural problems in Taiwan.

Background.  Older people with dementia commonly have at least one behavioural problem, which caregivers complain is difficult to handle. To provide interventions that can help caregivers more effectively manage the behavioural problems of care receivers with dementia, caregivers’ self‐efficacy on managing behavioural problems must be assessed. However, it is not clear yet how these behavioural problems of older people with dementia may influence caregivers’ self‐efficacy for managing behavioural problems.

Design.  A prospective, correlational study.

Method.  Eighty dyads of older people with dementia and their family caregivers were recruited from neurological clinics of a medical centre in Taiwan. Care receivers were assessed for behavioural problems using the Chinese version of Cohen‐Mansfield Agitation Inventory, community form. Caregivers’ self‐efficacy for managing care receivers’ agitation was measured by the research team‐developed Agitation Management Self‐Efficacy Scale.

Results.  Caregiver self‐efficacy for managing behavioural problems was significantly and positively associated with more caregiver education, greater duration of caregiving and with care receivers’ less physically non‐aggressive behaviours. When caregiver characteristics were controlled for in hierarchical regression analysis, physically non‐aggressive behaviours explained 6% of the variance in caregiver self‐efficacy.

Conclusions.  Results of this study contradict the general belief that physically aggressive behaviours of elders with dementia are more difficult for family caregivers to handle than other behavioural problems. Clinicians need to address physically non‐aggressive problem behaviours.

Relevance to clinical practice.  Nurses could assess older patients with dementia for physically non‐aggressive behaviours and train less educated caregivers to improve their self‐efficacy for managing problem behaviours, thus enhancing the quality of life for both caregivers and care receivers.
What factors affect influenza vaccine uptake among community‐dwelling older Chinese people in Hong Kong general outpatient clinics?
Authors: Kwong Enid Wai‐yung , Lam Ivy Oi‐yi , Chan Tony Moon‐Fai
Published: January 2009

Aim.  This study aimed to identify the influenza vaccination rate among community‐dwelling older Chinese people in Hong Kong general outpatient clinics and to identify the factors affecting their vaccine uptake.

Background.  Community‐dwelling older Chinese people in Hong Kong underuse influenza vaccination. The first step to increase their vaccination rates is to understand the factors affecting their influenza vaccine uptake.

Design.  This was a retrospective and descriptive study.

Methods.  The sample comprised 197 subjects from five general outpatient clinics in the Kowloon East cluster of Hong Kong. A self‐report questionnaire was used for data collection via individual face‐to‐face interviews.

Results.  Out of 197 subjects, 64·47% reported having received the vaccine within the previous 12 months. The regression model revealed that perceived benefits including ‘vaccination prevents me from catching influenza (OR = 12·18, CI = 3·61–41·07, p < 0·001)’, ‘If I get vaccinated, I will decrease the frequency of medical consultation (OR = 8·12, CI = 2·70–24·38, p = 0·001)’ and ‘If I am vaccinated and still get flu, I will not be as sick with it (OR = 0·43, CI = 0·24–0·76, p = 0·004)’, perceived barriers, which are ‘the side‐effects of influenza vaccination interfere with my usual activities (OR = 0·04, CI = 0·01–0·13, p < 0·001)’, ‘influenza vaccination is painful (OR = 2·73, CI = 1·55–4·81, p = 0·001)’ and ‘I am scared of needles (OR = 0·43, CI = 0·23–0·79, p = 0·007)’ and recommendations from doctors (OR = 14·18, CR = 4·09–49·16, p < 0·001) and families (OR = 3·67, CR = 1·24–10·83, p = 0·019) interactively influenced the subjects’ vaccine uptake.

Conclusion.  Specific benefits and barriers affecting the influenza uptake of community‐dwelling older Chinese people in general outpatient clinics have been identified. Specifically, recommendation from families plays a significant role in motivating the uptake of this Chinese ageing group.

Relevance to clinical practice.  We adopt strategies including personal invitation and reminders of influenza vaccination by doctors and educating doctors, older people and their families on influenza vaccination to increase the uptake of community‐dwelling Chinese older people in general outpatient clinics.
Caring for children with complex emotional and psychological disorders: experiences of nurses in a rural paediatric unit
Authors: Reid‐Searl Kerry , Dwyer Trudy , Happell Brenda , Moxham Lorna , Kahl Julie , Morris Jodie , Wheatland Narelle
Published: January 2009

Aims.  To explore the experiences of general nurses towards caring for children with mental health issues and to identify strategies to improve management of these children.

Background.  There has been an increase of children and adolescents with complex emotional and psychological disorders being admitted to paediatric units of general hospitals due to a lack of specialist child and youth mental health facilities. The study is situated in a 16 bed paediatric unit of a rural public hospital. As the closest inpatient child mental health unit of this kind is more than 600 km away, the paediatric unit admits children and adolescents with a primary psychiatric diagnosis.

Design.  A participatory action research approach guided this study.

Methods.  Focus groups and individual interviews were conducted with a purposive convenience sample of all nursing staff (n = 20) working in the paediatric unit. Verbatim interview transcripts were analysed to identify the major themes.

Results.  Two main themes emerged from data analysis: (1) role preparation and adequacy; (2) lack of support and resources. Participants suggested several strategies to address these concerns including: improving relationships with mental health services, professional development, and developing a greater appreciation for mental health interventions.

Conclusions.  There is a clear need for an increased understanding of mental health practices, an improved relationship between general and mental health services and continuing professional development to ensure nurses possess the skills and confidence to provide quality care to children admitted to a paediatric unit with a mental health diagnosis.

Relevance to clinical practice.  Few general nurses have mental health training and, through no fault of their own, may be providing less than optimal care to children who are admitted with a mental health diagnosis. Through a desire to improve care, the following participatory action research project was instigated.
Herbal product use in a sample of Turkish patients undergoing haemodialysis
Authors: Kara Belgüzar
Published: January 2009

Aim.  To examine herbal product use among patients with end‐stage renal disease undergoing haemodialysis.

Background.  Herbal therapy is a very popular choice for many patients. However, little information is available about herbal product use in renal patients.

Design.  The study was designed as a cross‐sectional survey. The data were obtained from 114 end‐stage renal disease patients in two haemodialysis centres in Ankara, Turkey between June–August 2007.

Methods.  Data were collected through face‐to‐face structured interviews. Descriptive statistics and the chi‐square test were conducted.

Results.  Approximately one‐third of the patients (28·1%) used a herbal product after the diagnosis of chronic kidney disease. Of these, 13·2% reported currently taking herbal products. A minority of participants (12·5%) informed their physician of herbal product use. Marital status was the only variable significantly associated with herbal product use.

Conclusions.  The results of this study showed that many patients used herbal products, but most did not disclose this use to their physician. Herbal product use was more prevalent among the participants who were married.

Relevance to clinical practice.  Understanding the patterns and reasons of herbal use is beneficial in efforts to improve the care of patients with end‐stage renal disease. Nurses should be aware of the potential health risks caused by herbal products and should educate the patient and the family.
Demonstration of lipids in plastic resin‐embedded sections of skin material
Authors: MEYER W. , SCHMIDT J. , BUSCHE R. , JACOB R. , NAIM H.Y.
Published: January 2009

Two different fluorescence stains, green: 5‐hexadecanoylaminofluorescein, and red: BODIPY® 665/676 [(E,E)‐3, 5‐bis‐(4‐phenyl‐1,3‐butadienyl)‐4,4‐difluoro‐4‐bora‐3a, 4a‐diaza‐s‐indacene, produced good results regarding the demonstration of glycolipids, free fatty acids and triglycerides in mammalian skin material that had been embedded in a water miscible plastic resin (Technovit® 7100). In this way, functional aspects of specific structures (epidermal barrier region, sebaceous glands) could be characterized histochemically in the integument of five mammalian species with sparse or dense hair coats.
Measurements of the surface microroughness with the scanning electron microscope
Authors: PALUSZYŃSKI J. , SLÓWKO W.
Published: January 2009

A three‐dimensional reconstruction system for scanning electron microscope consisting of a quadruple scintillator detector, a four‐channel frame‐grabber and PC‐based processing unit was developed. The authors explored a method that takes advantage of the angular distribution of secondary electron emission to obtain quantitative topography contrast and surface profiles. Software processing algorithms were developed to carry out the reconstruction process and compensate for several types of errors, inherent in the method. After pre‐calibration, the system allows obtaining surface topography with calculation of microroughness and waviness statistical parameters. The roughness estimation procedure was tested on metal roughness standards for machining and etched silicon surfaces. The main advantages of the system are almost real‐time operation and reliable, composition‐independent reconstruction for a broad class of materials.
Aberration‐corrected microscopy for structural biology applications
Authors: ZIEGLER A. , ROCKEL B. , HEGERL R. , FREITAG B. , LÜCKEN U. , PLITZKO J.M.
Published: January 2009

This study explores the potential of a Cs‐corrected transmission electron microscope for structural studies of biological samples, in particular isolated macromolecular complexes. A 300‐kV transmission electron microscope, equipped with a Cs corrector was employed to record sets of images at different defocus and Cs settings. The experiments were designed to determine whether imaging with large defocus benefits from Cs correction. Defocus contrast in biological imaging has a stronger influence on image resolution than any other parameter. We find the results are in good agreement with theoretical framework, verifying that the typical imaging conditions required for biological investigations are not affected by Cs correction.
EBSD: a powerful microstructure analysis technique in the field of solidification
Authors: BOEHM‐COURJAULT E. , GONZALES F. , JACOT A. , KOHLER F. , MARIAUX A. , NIEDERBERGER C. , SALGADO‐ORDORICA M.A. , RAPPAZ M.
Published: January 2009

This paper presents a few examples of the application of electron back‐scatter diffraction (EBSD) to solidification problems. For directionally solidified Al–Zn samples, this technique could reveal the change in dendrite growth directions from <100> to <110> as the composition of zinc increases from 5 to 90 wt%. The corresponding texture evolution and grain selection mechanisms were also examined. Twinned dendrites that form under certain solidification conditions in Al–X specimens (with X = Zn, Mg, Ni, Cu) were clearly identified as <110> dendrite trunks split in their centre by a (111) twin plane. In Zn–0.2 wt% Al hot‐dip galvanized coatings on steel sheets, EBSD clearly revealed the preferential basal orientation distribution of the nuclei as well as the reinforcement of this distribution by the faster growth of <1010> dendrites. Moreover, in Al–Zn–Si coatings, misorientations as large as 10° mm−1 have been measured within individual grains. Finally, the complex band and lamellae microstructures that form in the Cu–Sn peritectic system at low growth rate could be shown to constitute a continuous network initiated from a single nucleus. EBSD also showed that the α and β phases had a Kurdjumov–Sachs crystallographic relationship.
Social Stress Alters Expression of Large Conductance Calcium‐Activated Potassium Channel Subunits in Mouse Adrenal Medulla and Pituitary Glands
Authors: Chatterjee O. , Taylor L. A. , Ahmed S. , Nagaraj S. , Hall J. J. , Finckbeiner S. M. , Chan P. S. , Suda N. , King J. T. , Zeeman M. L. , McCobb D. P.
Published: January 2009

Large conductance calcium‐activated potassium (BK) channels are very prominently expressed in adrenal chromaffin and many anterior pituitary cells, where they shape intrinsic excitability complexly. Stress‐ and sex‐steroids regulate alternative splicing of Slo‐α, the pore‐forming subunit of BK channels, and chronic behavioural stress has been shown to alter Slo splicing in tree shrew adrenals. In the present study, we focus on mice, measuring the effects of chronic behavioural stress on total mRNA expression of the Slo‐α gene, two key BK channel β subunit genes (β2 and β4), and the ‘STREX’ splice variant of Slo‐α. As a chronic stressor, males of the relatively aggressive SJL strain were housed with a different unfamiliar SJL male every 24 h for 19 days. This ‘social‐instability’ paradigm stressed all individuals, as demonstrated by reduced weight gain and elevated corticosterone levels. Five quantitative reverse transcriptase‐polymerase chain assays were performed in parallel, including β‐actin, each calibrated against a dilution series of its corresponding cDNA template. Stress‐related changes in BK expression were larger in mice tested at 6 weeks than 9 weeks. In younger animals, Slo‐α mRNA levels were elevated 44% and 116% in the adrenal medulla and pituitary, respectively, compared to individually‐housed controls. β2 and β4 mRNAs were elevated 162% and 194% in the pituitary, but slightly reduced in the adrenals of stressed animals. In the pituitary, dominance scores of stressed animals correlated negatively with α and β subunit expression, with more subordinate individuals exhibiting levels that were three‐ to four‐fold higher than controls or dominant individuals. STREX variant representation was lower in the subordinate subset. Thus, the combination of subunits responding to stress differs markedly between adrenal and pituitary glands. These data suggest that early stress will differentially affect neuroendocrine cell excitability, and call for detailed analysis of functional consequences.
Role of the Ventromedial Hypothalamic Orexin‐1 Receptors in Regulation of Gastric Acid Secretion in Conscious Rats
Authors: Eliassi A. , Nazari M. , Naghdi N.
Published: January 2009

Orexins play an important role on the central nervous system to modulate gastric acid secretion. The orexin receptors are distributed within the hypothalamus, and expression of orexin‐1 receptors (OX1R) is greatest in the anterior hypothalamus and ventromedial nucleus. Therefore, we hypothesised that ventromedial hypothalamic OX1R may be involved in the control of gastric acid secretion. To address this question, we examined the effects of orexin‐A and a selective OX1R antagonist, SB‐3345867, on gastric acid secretion in pyloric‐ligated conscious rats. Intraventromedial injection of orexin‐A (0.5–2 μg/μl) stimulated gastric acid secretion in a dose‐dependent manner. This stimulatory effect of orexin‐A persisted over 3 h. In some experiments, SB‐3345867 (10 mg/kg i.p.) was administered 30 min before orexin‐A or saline injections. We found that i.p. injection of SB‐334867 suppressed stimulated gastric acid secretion induced by orexin‐A (2 μg/μl). Atropine (5 mg/kg) also inhibited the stimulatory effect of central injection of orexin‐A on acid secretion. In conclusion, the present study suggests that endogenous orexin‐A acts on the ventromedial hypothalamus to stimulates acid secretion. This stimulatory effect is probably mediated through OX1R.
Physical intervention: a review of the literature on its use, staff and patient views, and the impact of training
Authors: STUBBS B. , LEADBETTER D. , PATERSON B. , YORSTON G. , KNIGHT C. , DAVIS S.
Published: January 2009

As a principal control measure, physical intervention is intended to be a skilled manual, or hands‐on, method of physical restraint implemented by trained individuals, with the intention of controlling the aggressive patient, to restore safety in the clinical environment. Physical intervention is however a contentious practice. There have been reports in the literature of negative psychological views from staff and patients on the procedure. Although formal structured training was introduced in response to concerns around patient safety during restraint, concerns remain that PI is sometimes construed as a stand‐alone violence prevention initiative. Its potential for misuse, and overuse, in corrupted cultures of care has emerged as a social policy issue. The following paper critically explores the literature on training in physical intervention in the United Kingdom.
Perioperative concentrations of catecholamines in the cerebrospinal fluid and plasma during spinal anesthesia
Authors: OEHMKE M. J. , PODRANSKI T. , MANN M. , FRICKEY N. , KUHN D. F. M. , HEMPELMANN G.
Published: January 2009

Background:Catecholamine release is a physiological response to stress. The extent to which perioperative stress provokes the central release of catecholamines, which modulate pain perception in the spinal cord, still remains unknown. The perioperative course of catecholamine concentrations in the cerebrospinal fluid (CSF) and plasma was examined.

Methods:A prospective study was performed in 25 patients (ASA III, 60–84 years) undergoing elective hip joint replacement in spinal catheter anesthesia. The concentrations of dopamine, epinephrine and norepinephrine in the CSF and plasma were measured before anesthesia, immediately after surgery, and 6 and 24 h post‐operatively.

Results:In most patients, dopamine and epinephrine were not detectable in CSF. CSF–norepinephrine concentrations decreased from median [interquartile‐range] 159 [124;216] pre‐anesthesia to 116 [79;152] pmol/l immediately post‐operatively and were slightly elevated 24 h post‐operatively (180 [134;302] pmol/l) (P=0.05). Dopamine plasma concentrations were not detectable or were barely above the detection threshold. Plasma epinephrine increased from 61 [28;77] pmol/l pre‐anesthesia to 112 [69;138] pmol/l 6 h post‐operatively and returned to baseline 24 h post‐operatively (P=0.001). Plasma norepinephrine concentrations increased intra‐operatively from 298 [249;422] to 556 [423;649] pmol/l and remained elevated 24 h after surgery (P=0.009). There was no association between changes in CSF or plasma norepinephrine or epinephrine concentrations and changes in heart rate (HR) or mean arterial pressure (MAP).

Conclusion:During spinal anesthesia for elective hip joint replacement, norepinephrine concentrations were greater in plasma than in CSF. CSF dopamine and epinephrine concentrations were essentially undetectable. The changes in CSF‐norepinephrine concentrations and the changes of plasma norepinephrine concentrations showed no association with each other; nor were there correlations between clinical stress parameters (HR, MAP) or visual analog scale pain, and the changes in CSF norepinephrine concentrations.
Multi‐detector computed tomography in critically ill patients
Authors: AHVENJÄRVI L. K. , LAURILA J. J. , JARTTI A. , YLIPALOSAARI P. , ALA‐KOKKO T. I. , SYRJÄLÄ H. P.
Published: January 2009

Background: There is a lack of studies showing the overall impact of multi‐detector computed tomography (MDCT) on the treatment of critically ill patients in a general intensive care unit (ICU) setting.

Methods: A prospective observational study on the effects of MDCT on the treatment of patients in a 12‐bed medical–surgical ICU in a university hospital providing tertiary care.

Results: During the 9‐month study period, there were 343 admissions with ICU length of stay longer than 48 h. Of these patients, 64 (19%) had had inconclusive findings with other modalities of radiological imaging, and they underwent altogether 82 MDCT examinations. Fifty examinations (61%) resulted in a change of treatment. The changes included 22 surgical interventions, 16 percutaneous or paranasal interventions, 15 changes of antimicrobial therapy, three withdrawals of active treatment, and four other changes of treatment. Eight patients underwent two and one patient underwent three changes of treatment. Twenty examinations (24%) were regarded as otherwise necessary for clinical decision‐making, although no change in the treatment was indicated. Twelve examinations (15%) failed to provide any additional information relevant to the patient's treatment.

Conclusion: Sixty‐one percent of the MDCT examinations led to a change of treatment, and 24% of them otherwise contributed to or supported clinical decision‐making, suggesting that MDCT examination is helpful in the case of general ICU patients, with inconclusive findings with other imaging modalities.
Evaluation of the antifungal potential of Brazilian Cerrado medicinal plants
Authors: E Silva Fernanda Melo , De Paula José Elias , Espindola Laila Salmen
Published: January 2009

Therapeutic limitations, development of fungal drug resistance, drug‐related toxicity, drug interactions and insufficient bioavailability of the currently available antifungal drugs have made the development of drugs necessary that would be able to treat the emerging fungal infections. The Cerrado is the second greater biome of Brazil and it was identified as one of the most distinguished biomes of South America, becoming an important source of innovative vegetal molecules to treat several conditions. Thus, the objective of this study was to evaluate the antifungal potential of Cerrado plants, mainly those used to treat infections and wounds. A total of 57 extracts were screened by the agar‐well diffusion technique against Candida albicans and Trichophyton rubrum. The most promising extracts were tested in smaller concentrations and their minimal inhibitory concentrations (MIC) were determined by microdilution method. Results were analysed statistically by anova tests. Extracts of Kielmeyera coriacea, Renealmia alpinia, Stryphnodendron adstringens and Tabebuia caraiba were very active against T. rubrum, presented geometric means of the MIC values between 170.39 and 23.23 μg ml−1. Extracts of Cerrado plants are of particular interest as source of new agents for the treatment of dermatophytic infections.
Laryngeal histoplasmosis in an immunocompetent patient from a non‐endemic region: case report
Authors: Ferrari Teresa C. A. , Soares João Marcos A. , Salles José Maria P. , Handam Júnia S. , Azevedo Rosana C. S. , Xavier Marcelo A. P. , Faria Luciana C.
Published: January 2009

Histoplasma capsulatum infection involving the larynx is a rare manifestation, especially in immunocompetent individuals and a high index of suspicion is needed to establish the diagnosis correctly. We report a case of a 50‐year‐old Brazilian man who presented with progressive hoarseness and throat pain for 4 months. Laryngoscopy showed a supraglottic vegetant lesion, and the biopsies chronic granulomatous inflammation without any specific agent. A second laryngoscopy with biopsies was performed and after 17 days of incubation in specific medium, H. capsulatum was isolated. The patient was successfully treated with amphotericin B.
Normative data on Benton Visual Form Discrimination Test for older adults and impaired scores in Clinical Dementia Rating 0.5 participants: Community‐based study. The Osaki–Tajiri Project
Authors: Kasai Mari , Ishizaki Junichi , Ishii Hiroshi , Yamaguchi Satoshi , Yamadori Atsushi , Meguro Kenichi
Published: January 2009

Aims:  The Benton Visual Form Discrimination test (VFD) is one of the non‐verbal tests to assess the capacity for complex visual form discrimination. The purposes of the present study were to investigate the effects of age and education level of the VFD in healthy elderly subjects, rigorously excluding participants with Clinical Dementia Rating (CDR) 0.5, and the characteristics of VFD patterns in CDR 0.5 participants.

Methods:  The 597 participants included CDR 0 (healthy elderly, n = 405), CDR 0.5 (mild cognitive impairment, n = 161), and CDR 1 and 2 (dementia, n = 31). The VFD, Digit Forwards, Digit Backwards and Rey–Osterrieth Complex Figure Test (RCFT) copying were used for neuropsychological assessment.

Results:  There were significant effects of age and education level on the VFD in healthy participants, and the CDR 0.5 group had a lower score on the VFD than the healthy group. Low performance on the VFD was associated with Digit Backward and RCFT copying in both healthy and CDR 0.5 participants.

Conclusions:  CDR 0.5 participants exhibit deficits of visual form discrimination related to attention, visual construction and organization.
Health impact of disaster‐related stress on pregnant women living in the affected area of the Noto Peninsula earthquake in Japan
Authors: Hibino Yuri , Takaki Jiro , Kambayashi Yasuhiro , Hitomi Yoshiaki , Sakai Akemi , Sekizuka Naomi , Ogino Keiki , Nakamura Hiroyuki
Published: January 2009

Aims:  The present study assessed the health impact of stress on women who were pregnant during, or immediately after, a major earthquake and were living in the disaster area. Inherent resistance against the stress induced by the earthquake was also assessed.

Methods:  The panel study consisted of 99 women who provided responses before and after delivery (response rate, 77.9%). Psychological impact was assessed on the Edinburgh Postnatal Depression Scale (EPDS), and stress resistance was assessed on the Sense of Coherence Scale (SOC).

Results:  In adjusted multivariate models, the significant earthquake factor that predicted postnatal depression (EPDS) was ‘existing anxiety about an earthquake’ (β = 0.27, P = 0.01) and ‘parity’ (β = −0.26, P = 0.02). The SOC during pregnancy significantly moderated between ‘existing anxiety about an earthquake’ and ‘EPDS’ (β = −0.21, P = 0.02). During pregnancy the EDPS was a significant predictor of a physical abnormality during pregnancy or childbirth (odds ratio, 1.21; 95% confidence interval: 1.04–1.41). The SOC during pregnancy did not moderate between a physical abnormality and earthquake‐related stress.

Conclusions:  Provision of an adequate support system and improvement of the SOC of young women affected by a disaster may be two ways of reducing the deleterious effects of disaster‐related stress on maternal well‐being.
Dopamine promotes striatal neuronal apoptotic death via ERK signaling cascades
Authors: Chen Jun , Rusnak Milan , Lombroso Paul J. , Sidhu Anita
Published: January 2009

Although the mechanisms underlying striatal neurodegeneration are poorly understood, we have shown that striatal pathogenesis may be initiated by high synaptic levels of extracellular dopamine (DA). Here we investigated in rat striatal primary neurons the mobilization of the mitogen‐activated protein kinase (MAPK) signaling pathways after treatment with DA. Instead of observing an elevation of the archetypical pro‐cytotoxic MAPKs, p‐JNK and p‐p38 MAPK, we found that DA, acting through D1 DA receptors, induced a sustained stimulation of the phosphorylated form of extracellular signal‐regulated kinase (p‐ERK) via a cAMP/protein kinase A (PKA)/Rap1/B‐Raf / MAPK/ERK kinase (MEK) pathway. Blockade of D2 DA receptors, β‐adrenergic receptors orN‐methyl‐d‐aspartate receptors with receptor‐specific antagonists had no significant effect on this process. Activation of D1 DA receptors and PKA by DA caused phosphorylation and inactivation of the striatal‐enriched tyrosine phosphatase, an important phosphatase for the dephosphorylation and subsequent inactivation of p‐ERK in the striatum. Interestingly, p‐ERK was primarily retained in the cytoplasm, with only low amounts translocated to the nucleus. The scaffold protein β‐arrestin2 interacted with both p‐ERK and D1 DA receptor, triggering the cytosolic retention of p‐ERK and inducing striatal neuronal apoptotic death. These data provide unique insight into a novel role of p‐ERK in striatal neurodegeneration.
ALK (Anaplastic Lymphoma Kinase) expression in DRG neurons and its involvement in neuron–Schwann cells interaction
Authors: Degoutin Joffrey , Brunet‐de Carvalho Nicole , Cifuentes‐Diaz Carmen , Vigny Marc
Published: January 2009

Anaplastic lymphoma kinase (ALK) is a receptor tyrosine kinase (RTK) transiently expressed in specific regions of the central and peripheral nervous systems. In this study, we focused on the rat developing dorsal root ganglion (DRG). This ganglion is composed of heterogeneous sensory neurons characterized by the expression of RTK for neurotrophic factors, such as the nerve growth factor receptor TrkA or the glial‐derived neurotrophic factor family receptor Ret, which are specifically detected in nociceptive neurons. In DRG, ALK expression reached a maximum around birth. We showed that ALK is specifically present in a subtype of neurons during DRG development, and that the majority of these neurons co‐expressed TrkA and Ret. Interestingly, we identified only one form (220 kDa) of ALK in DRG neurons both in vivo and in vitro. On the opposite, in transfected cells as well as in brain extracts, ALK was identified as two forms (220 and 140 kDa). The DRG is composed of neurons and glial cells, principally satellite Schwann cells. Thus, we hypothesized that the presence of satellite Schwann cells was involved in the absence of truncated ALK. Using two different cell types, HEK293 cells stably expressing ALK, and MSC80 cells, a previously described Schwann cell line, we showed that a factor secreted by the Schwann cells is likely involved in the absence of ALK cleavage. All these data hence open new perspectives concerning the role of ALK in the specification of nociceptive DRG neurons and in the neurons–Schwann cells interaction.
More than a matter of getting ‘unstuck’: flexible thinkers use more abstract representations than perseverators
Authors: Kharitonova Maria , Chien Sarina , Colunga Eliana , Munakata Yuko
Published: January 2009

Why do people perseverate, repeating prior behaviours that are no longer appropriate? Many accounts point to isolated deficits in processes such as inhibition or attention. We instead posit a fundamental difference in rule representations: flexible switchers use active representations that rely on later‐developing prefrontal cortical areas and are more abstract, whereas perseverators use latent representations that rely on earlier‐developing posterior cortical and subcortical areas and are more stimulus‐specific. Thus, although switchers and perseverators should apply the rules they use to familiar stimuli equally reliably, perseverators should show unique limitations in generalizing their rules to novel stimuli, a process that requires abstract representations. Two behavioural experiments confirmed this counterintuitive prediction early in development. Three‐year‐old children sorted cards by one rule, were asked to switch to another rule, and then were asked simply to continue their behaviour, with novel cards. Perseverators applied the rule they were using (the first rule) just as reliably as switchers applied the rule they were using (the second rule) with familiar cards; however, only switchers generalized their rule to novel cards. This finding supports an early link between active representations that support switching and abstract representations that support generalization. We interpret this synergy in terms of prefrontal cortical development.
Minimum Shareholding Requirements for Insiders: Evidence from Taiwanese SMEs
Authors: Hung Jung‐Hua , Chen Hsiang‐Ju
Published: January 2009

Manuscript Type: Empirical

Research Question/Issue: This study aims to evaluate the suitability of Taiwan's minimum shareholding requirement for small‐ and medium‐sized enterprises (SMEs), and to examine whether stewardship theory and both incentive and entrenchment effects can characterize the ownership‐performance relationship simultaneously.

Research Findings/Results: We apply new empirical methods to a balanced panel dataset including 496 firm‐level observations of 62 Taiwanese SMEs publicly traded from 1999 to 2006. The results show a nonlinear ownership‐performance relationship, first negative then positive, with a single threshold value of insider ownership (5.4 per cent). This indicates that both effects combine and that the current regulated minimum level of insider shareholdings for public SMEs may be too high.

Theoretical Implications: Our evidence supports both convergence‐of‐interests and entrenchment effects and suggests a better specification that prevents spurious relations obtained from traditional methods. The stewardship theory does work in Taiwan. Insiders behave as loyal stewards rather than motivated by desire for entrenchment. Our empirical evidence suggests an avenue of future research, specifically to form better strategies for those involved in corporate governance.

Practical Implications: We suggest that Taiwanese authorities should lessen ownership obligations, thereby leading to improved corporate governance by increasing the independence of the boards of directors. Emerging markets can learn from the Taiwan experience and then formulate their own regulations. Publicly traded SMEs could offer compensation to insiders such as stock options and performance shares. Asymmetric information problems often experienced by outside stockholders and foreign investors can be alleviated by these signals of insider ownership.
Fear Appeals in Political Rhetoric about Terrorism: An Analysis of Speeches by Australian Prime Minister Howard
Authors: De Castella Krista , McGarty Craig , Musgrove Luke
Published: January 2009

This paper explores fear‐arousing content in Australian former Prime Minister John Howard's political rhetoric about terrorism. We coded 27 speeches delivered between September 2001 and November 2007 for the presence of statements promoting fear‐consistent appraisals (Smith & Lazarus, 1993). Fear‐arousing content was present in 24 of these speeches, but the amount of fear‐arousing content varied markedly. In particular, rhetoric that raised doubts about the capacity of Australia and its allies to cope with terrorism was most strongly present in the lead‐up to the invasion of Iraq and at times of declining support for government policies. Textual analysis of three key speeches confirmed a marked difference between Howard's speech given immediately after the attacks on September 11, 2001, and the second and third speeches presented prior to and after the 2003 invasion of Iraq. These findings indicate that Howard has not consistently employed fear‐inducing rhetoric in his speeches about terrorism, but that particular speeches appear to take this form, raising the possibility that fear‐arousing rhetoric may have been selectively deployed to support his political purposes at those times.
Alienable Speech: Ideological Variations in the Application of Free‐Speech Principles
Authors: Lindner Nicole M. , Nosek Brian A.
Published: January 2009

Although freedom of speech is a Constitutionally protected and widely endorsed value, political tolerance research finds that people are less willing to protect speech they dislike than speech they like (Gibson, 2006). Research also suggests liberal‐conservative differences in political tolerance (Davis & Silver, 2004). We measured U.S. citizens' political tolerance for speech acts, while manipulating the speaker's ethnicity and the speech's ideological content. Speech criticizing Americans was protected more strongly than was speech criticizing Arabs, especially among more politically liberal respondents. Liberals also reported greater free‐speech support. Respondents expressed greater political tolerance for a speaker when he was an exemplar of the criticized group, but showed equal political tolerance for speakers whose group membership (as a White or Black American) was irrelevant to the speech. Finally, implicit political identity showed convergent validity with explicit political identity in predicting speech tolerance, and implicit racial and ethnic preferences showed variable prediction of speech tolerance across the two studies.
Jumping off and being careful: children's strategies of risk management in everyday life
Authors: Christensen Pia , Mikkelsen Miguel Romero
Published: January 2009

This article addresses the complexity of children's risk landscapes through an ethnography of 10‐ to 12‐year‐old Danish children. The data revealed how children individually and collectively engaged with risk in their everyday activities. The children assessed risks in relation to their perceptions of their health as strength and control, negotiated the conditions of playing, and attuned their responses to situations of potential social and physical conflict. In the paper this risk engagement is illustrated in a variety of contexts: children's decisions to wear or not to wear a bicycle helmet; playing and games and routine pushing and shoving at school. In looking after themselves, children negotiate rules of participation and they safeguard personal and collective interests. Gender differences in these processes are addressed and discussed. The article argues that risk engagement is an important resource through which children also learn from their own mistakes. This is a necessary learning process when children engage with their personal health and safety. The article critically discusses different sociological frameworks and shows the significance of the study for the growing literature on understanding the meaning of risk in childhood.
Autism and social movements: French parents’ associations and international autistic individuals’ organisations
Authors: Chamak Brigitte
Published: January 2009

The aim of this empirical investigation is to analyse the social movements brought about by autism‐related issues. It is suggested that both the autism‐category changes in the late 1980s, and the development of educational and behavioural methods in the United States, have given rise to a large‐scale mobilisation around the changes in the definition of autism and interventions in many countries. The present paper highlights the historical dynamics of the mobilisation of French parents’ associations and the engagement of autistic persons’ organisations. The role of the French parents’ associations has been studied over the last 40 years to show how they have contributed to shaping public policy in France and how they have favoured the American model of autism despite the French professionals’ resistance. At the international level, the newly‐born associations of autistic individuals have introduced new actors who sometimes reproach the parents’ associations for speaking on their behalf. These new associations, such as self‐help groups, have a political identity problem. Their members no longer want to be considered as patients but as individuals with a different cognitive mode of functioning. Their actions can be analysed in the broader context of the disability movement. If the disability movement is considered as the latest generation of social movements, the action of autistic persons can be viewed as the latest generation of the disability movements.
TRUE UPPER BOUNDS FOR BERMUDAN PRODUCTS VIA NON‐NESTED MONTE CARLO
Authors: Belomestny Denis , Bender Christian , Schoenmakers John
Published: January 2009

We present a generic non‐nested Monte Carlo procedure for computing true upper bounds for Bermudan products, given an approximation of the Snell envelope. The pleonastic “true” stresses that, by construction, the estimator is biased above the Snell envelope. The key idea is a regression estimator for the Doob martingale part of the approximative Snell envelope, which preserves the martingale property. The so constructed martingale can be employed for computing tight dual upper bounds without nested simulation. In general, this martingale can also be used as a control variate for simulation of conditional expectations. In this context, we develop a variance reduced version of the nested primal‐dual estimator. Numerical experiments indicate the efficiency of the proposed algorithms.
Penetrance estimation of TTR familial amyloid polyneuropathy (type I) in Brazilian families
Authors: Saporta M. A. C. , Zaros C. , Cruz M. W. , André C. , Misrahi M. , Bonaïti‐Pellié C. , Planté‐Bordeneuve V.
Published: January 2009

Background and purpose:  Familial amyloid polyneuropathy (FAP) type I is a severe autosomal dominant inherited neuropathy associated with mutations in the transthyretin (TTR) gene. Significant phenotypic variability is seen amongst families with distinct geographic origin, especially regarding penetrance and age of onset. The aim of this study was to estimate the penetrance of FAP in Brazilian families.

Methods:  Twenty‐two distinct families were ascertained through genetically confirmed index cases and included in this study. Genealogical and clinical data were obtained from a total of 623 individuals, including 126 affected by FAP. In 15 families, TTR genotyping was performed in all available relatives (n = 86), after informed written consent. Seven families did not consent for genetic testing, but agreed to provide clinical and genealogical data. Penetrance was estimated using a previously described method based on survival analysis and corrected for ascertainment bias.

Results:  Mean age of onset in our sample was 34.5 years, with a significant earlier onset in males (31.1 vs. 35.9, P < 0.0001). The penetrance of FAP in our sample was estimated as 83% (95% CI: 66–99) after 60 years.

Conclusion:  Our results provide new information on FAP in Brazilian patients and may be helpful in the genetic counseling of this population.
Detection and analysis of Borna disease virus in Chinese patients with neurological disorders
Authors: Li Q. , Wang Z. , Zhu D. , Xu M. , Chen X. , Peng D. , Iwata Y. , Xie P.
Published: January 2009

Background and purpose:  Borna disease virus (BDV) is a neurotropic RNA virus that is known to cause neurological disturbances in various animal species, potentially even humans. However, the association between BDV infection and human neurological disorders remains unclear.

Methods:  Between August 2005 and March 2006, 65 patients with neurological disorders were enrolled into our study. The presence of BDV p24 RNA from peripheral blood mononuclear cells (PBMCs) was investigated by using nested reverse transcriptase PCR (RT‐PCR) assay.

Results:  Borna disease virus p24 RNA was detected from PBMCs in six patients with viral encephalitis by using nested RT‐PCR assay. However, BDV p24 RNA was not detected in patients with multiple sclerosis or peripheral nerve diseases.

Conclusion:  There might be possible associations between BDV infection and human viral encephalitis.
The Expression of Iron‐repressible Outer Membrane Proteins in Helicobacter pylori and Its Association with Iron Deficiency Anemia
Authors: Lee Jee Hyun , Choe Yon Ho , Choi Young Ok
Published: January 2009

Background: Helicobacter pylori infection is known to be a cause of iron deficiency anemia (IDA) that is unresponsive to iron supplements. H. pylori bind iron to a specific receptor by iron‐repressible outer membrane proteins (IROMPs) under conditions of restricted iron.

Materials and Methods: We compared the expression of IROMPs from strains of H. pylori under both iron‐restricted and iron‐supplemented conditions to determine the difference between strains with and without IDA. One standard strain, two clinical strains, and three IDA strains were cultured; and then the IROMPs were extracted under iron‐restricted and iron‐supplemented conditions. We used SDS‐PAGE to compare the expression of the IROMPs from each strain.

Results:  IROMPs were found in IDA strains under iron‐restricted conditions and their molecular sizes were estimated to be 56, 48, 41, and 37 kDa. In the iron‐repleted media, the IROMPs were no longer present.

Conclusion: In the iron‐depleted state, specific H. pylori strains associated with IDA demonstrated an advantage in iron acquisition due to a higher expression of IROMPs. Our results can explain in part why some patients with H. pylori infection are more prone to develop clinical IDA under restricted iron conditions in the host.