bluuebunny/crossref_metadata_2025 huggingface dataset:
Carbon‐constrained health care enterprise
Authors: Gell Michael
Published: February 2010

Rationale  The health economy is a significant part of a national economy accounting typically for about 8% of GDP spent. As national economies respond to the dual challenges of severe economic turbulence on the global scale and climate change mitigation, the health economy is coming under increasing pressure to respond. Indications for sharp reductions in budgets and reductions in greenhouse gas emissions, such as carbon dioxide, are widespread.

Aims  In this paper an analysis is undertaken of the diverse forces acting on a typical health care enterprise. The forces, both economic and carbon related, are investigated in terms of their effects through the enterprise and across its boundaries on the supply, demand and waste sides. The overall aim is to show how the enterprise and whole supply chains may flip synchronously into a low‐carbon evolutionary pathway.

Objectives  By illustrating how different elements of the health care enterprise may respond to these developments, diverse opportunities for cost reduction, carbon reduction and product (goods and services) development are identified. These opportunities involve a variety of waste reduction and energy and materials conservation measures as well as new ways of collaborating with other enterprises going through similar transformations. The overall objective is to show that the carbon‐constrained health care enterprise and the low‐carbon health economy in which it sits may broaden its role in the coming decades to include a degree of responsibility for the health of the environment. This broader role is likely to supplement and entangle with the traditional role of the health economy, currently focused narrowly on human health, and lead to extensive organisational transformation, and infrastructure and product developments.
Implications of complex adaptive systems theory for interpreting research about health care organizations
Authors: Jordon Michelle , Lanham Holly Jordan , Anderson Ruth A. , McDaniel Jr Reuben R.
Published: February 2010

Rationale  Data about health care organizations (HCOs) are not useful until they are interpreted. Such interpretations are influenced by the theoretical lenses used by the researcher.

Objective  Our purpose was to suggest the usefulness of theories of complex adaptive systems (CASs) in guiding research interpretation. Specifically, we addressed two questions: (1) What are the implications for interpreting research observations in HCOs of the fact that we are observing relationships among diverse agents? (2) What are the implications for interpreting research observations in HCOs of the fact that we are observing relationships among agents that learn?

Methods  We defined diversity and learning and the implications of the non‐linear relationships among agents from a CAS perspective. We then identified some common analytical practices that were problematic and may lead to conceptual and methodological errors. Then we described strategies for interpreting the results of research observations.

Conclusions  We suggest that the task of interpreting research observations of HCOs could be improved if researchers take into account that the systems they study are CASs with non‐linear relationships among diverse, learning agents. Our analysis points out how interpretation of research results might be shaped by the fact that HCOs are CASs. We described how learning is, in fact, the result of interactions among diverse agents and that learning can, by itself, reduce or increase agent diversity. We encouraged researchers to be persistent in their attempts to reason about complex systems and learn to attend not only to structures, but also to processes and functions of complex systems.
Evaluating health management programmes over time: application of propensity score‐based weighting to longitudinal data
Authors: Linden Ariel , Adams John L.
Published: February 2010

Health management programmes are generally evaluated as point treatment studies in which only a baseline and outcome measurement are used in the analysis, even when multiple observations for each individual are available. By summarizing observations into two distinct measurements the evaluator loses any ability to discern patterns of change in the outcome variable over time in relation to the intervention. There are several statistical models available to evaluate longitudinal data that are typically regression‐like in form and designed to adjust for clustering at the individual level. Most evaluators of longitudinal studies tend to adjust for the effect of time‐dependent confounding by including these covariates as independent variables in the model. However, this standard adjustment approach is likely to provide biased estimates. In this paper we describe the application of the propensity score‐based weighting technique to longitudinal data to estimate the effect of treatment on an outcome. This method reweights each treatment pattern to represent the entire population at each time point and provides an unbiased treatment effect. We illustrate the technique using data from a disease management programme and demonstrate its superiority over standard analytical adjustments in correcting for time‐dependent confounding for each time period under study.
The Home Situations Questionnaire‐PDD version: Factor structure and psychometric properties
Authors: Chowdhury M. , Aman M. G. , Scahill L. , Swiezy N. , Arnold L. E. , Lecavalier L. , Johnson C. , Handen B. , Stigler K. , Bearss K. , Sukhodolsky D. , McDougle C. J.
Published: February 2010

Background  The Home Situations Questionnaire (HSQ) is a caregiver‐rated scale designed to assess behavioural non‐compliance in everyday settings that has been used in several studies in typically developing children. Currently there is no accepted measure of behavioural non‐compliance in children with pervasive developmental disorders (PDDs).

Methods  Investigators of the Research Units on Pediatric Psychopharmacology Autism Network modified the HSQ for children with PDDs by adding five items (making 25 total items), and used it as the primary outcome measure in a clinical trial. In the current investigation, we examined the factor structure and psychometric properties of the modified scale, the HSQ‐PDD.

Results  An exploratory factor analysis with oblique rotations yielded two factors: ‘Socially Inflexible’ (14 items) and ‘Demand‐Specific’ (six items). Item content of both factors appeared to fit well with the rubric of PDDs. Internal consistency, using Cronbach's alpha statistic, was 0.90 for ‘Socially Inflexible’, and 0.80 for ‘Demand‐Specific.’ The obtained sub‐scales and HSQ‐PDD Total score showed moderate correlations with selected sub‐scales of the Aberrant Behavior Checklist, Child and Adolescent Symptom Inventory, and Children's Yale‐Brown Obsessive Compulsive Scale, and low correlations with the Vineland Adaptive Behavior sub‐scales.

Conclusions  The HSQ‐PDD appears to be well suited for children with PDDs, although the Demand‐Specific sub‐scale may benefit from addition of more items. We provided sub‐scale means and standard deviations for this relatively severe group of children with PDDs, and discussed the factor structure with respect to previous research.
Intracellular Calcium Elevation Induced by Extracellular Application of Cyclic‐ADP‐Ribose or Oxytocin is Temperature‐Sensitive in Rodent NG108‐15 Neuronal Cells with or without Exogenous Expression of Human Oxytocin Receptors
Authors: Amina S. , Hashii M. , Ma W‐J. , Yokoyama S. , Lopatina O. , Liu H‐X. , Islam M. S. , Higashida H.
Published: February 2010

ADP‐ribosyl cyclase and/or CD38 are activated after oxytocin receptor stimulation in the hypothalamus and pituitary in adult mice, leading to facilitation of oxytocin secretion. Although cyclic adenosine 5′‐diphosphoribose (cADPR) primarily acts as an intracellular second messenger, it has been suggested that extracellular cADPR stimulates intracellular ryanodine receptors after internalisation via the nucleotide‐transporting capacity of CD38 in fibroblasts and astrocytes. However, little is known about whether extracellular cADPR activates neurones. To address this question, we used a model neuronal cell line, NG108‐15 mouse neuroblastoma × rat glioma hybrid cells possessing CD38 but not oxytocin receptors, and measured cytosolic free calcium concentrations ([Ca2+]i). Extracellular application of cADPR to NG108‐15 cells elevated [Ca2+]i at 35 °C. The elevation was significantly enhanced when measured at 40 °C. The cADPR and heat‐induced [Ca2+]i increase were blocked under extracellular Ca2+‐free conditions and by 2‐aminoethoxydiphenyl borate, an antagonist of melastatin‐related transient receptor potential channel 2 (TRPM2) cation channels. Reverse transcriptation‐polymerase chain reaction analyses indicated that TRPM2 channels were expressed in NG108‐15 cells. Application of oxytocin elevated [Ca2+]i in NG108‐15 cells transformed to transiently express cloned human oxytocin receptors. The oxytocin‐induced [Ca2+]i response was also enhanced by heat. These results indicate that the extracellular application of cADPR, together with heat, activates cation influx downstream of oxytocin receptor signalling in NG108‐15 neuronal cells, and suggest the possible involvement of TRPM2 channels in oxytocin release in the mammalian brain.
Molecular Diversity of Vasotocin‐Dependent Aquaporins Closely Associated with Water Adaptation Strategy in Anuran Amphibians
Authors: Suzuki M. , Tanaka S.
Published: February 2010

Anuran amphibians represent the first vertebrates that adapted to terrestrial environments, and are successfully distributed around the world, even to forests and arid deserts. Many adult anurans have specialised osmoregulatory organs, in addition to the kidney (i.e. the ventral pelvic skin to absorb water from the external environments and a urinary bladder that stores water and reabsorbs it in times of need). Aquaporin (AQP), a water channel protein, plays a fundamental role in these water absorption/reabsorption processes. The anuran AQP family consists of at least AQP0‐AQP5, AQP7‐AQP10 and two anuran‐specific types, designated as AQPa1 and AQPa2. For the three osmoregulatory organs, AQP3 is constitutively located in the basolateral membrane of the tight‐junctioned epithelial cells, allowing water transport between the cytoplasm of these cells and the neighbouring tissue fluid at all times. On the other hand, AQPs at the apical side of the tight epithelial cells are different among these organs, and are named kidney‐type AQP2, ventral pelvic skin‐type AQPa2 and urinary bladder‐type AQPa2. All of them show translocation from the cytoplasmic pool to the apical plasma membrane in response to arginine vasotocin, thereby regulating water transport independently in each osmoregulatory organ. It was further revealed that, in terrestrial and arboreal anurans, the bladder‐type AQPa2 is expressed in the pelvic skin, together with the pelvic skin‐type AQPa2, potentially facilitating water absorption from the pelvic skin. By contrast, Xenopus has lost the ability to efficiently produce pelvic skin‐type AQPa2 (AQP‐x3) because Cys‐273 of AQP‐x3 and/or Cys‐273‐coding region of AQPx3 mRNA attenuate gene expression at a post‐transcriptional step, presumably leading to the prevention of excessive water influx in this aquatic species. Collectively, the acquisition of two forms of AQPa2 and the diversified regulation of their gene expression appears to provide the necessary mechanisms for the evolutionary adaptation of anurans to a wide variety of ecological environments.
Maternal Behaviour is Associated with Vasopressin Release in the Medial Preoptic Area and Bed Nucleus of the Stria Terminalis in the Rat
Authors: Bosch O. J. , Pförtsch J. , Beiderbeck D. I. , Landgraf R. , Neumann I. D.
Published: February 2010

The neuropeptide arginine vasopressin was recently shown to be an important regulator of female social behaviour, including maternal care and aggression. A key brain site for vasopressin‐ as well as oxytocin‐mediated maternal care is the medial preoptic area (MPOA). Together with the adjacent bed nucleus of the stria terminalis (BNST), these brain regions are considered to form a ‘super‐region’ for maternal behaviour. In the present study, we investigated the vasopressin and oxytocin systems within the MPOA and the BNST during maternal care in lactating rats in more detail. Binding to V1a and oxytocin receptors in the BNST and to oxytocin receptors in the MPOA was increased in lactation. Furthermore, microdialysis revealed that vasopressin release significantly increased (MPOA) or tended to increase (BNST) during different phases of maternal care (i.e. with or without suckling stimulus). In support, manipulations of V1a receptors in the MPOA are known to alter maternal care. We now show that local injection of a selective V1a receptor antagonist bilaterally into the BNST did not affect maternal care, but reduced maternal aggression and tended to lower anxiety‐related behaviour. The release of oxytocin did not change in any of the brain regions during maternal care. The results obtained indicate that locally‐released vasopressin within the MPOA and the BNST is important for the maintenance of complex maternal behaviours, including maternal care and aggression, respectively.
Ageing and surface EMG activity patterns of masticatory muscles
Authors: CECÍLIO F. A. , REGALO S. C. H. , PALINKAS M. , ISSA J. P. M. , SIÉSSERE S. , HALLAK J. E. C. , MACHADO‐de‐SOUSA J. P. , SEMPRINI M.
Published: February 2010

Summary  The purpose of this study was to evaluate the influence of age on the electromyographic activity of masticatory muscles. All volunteers were Brazilian, fully dentate (except for Group I – mixed dentition), Caucasian, aged 7–80, and divided into five groups: I (7–12 years), II (13–20 years), III (21–40 years), IV (41–60 years) and V (61–80 years). Except for Group V, which comprised nine women and eight men, all groups were equally divided with respect to gender (20 M/20 F). Surface electromyographic records of masticatory muscles were obtained at rest and during maximal voluntary contraction, right and left laterality, maximal jaw protrusion and maximal clenching in the intercuspal position. Statistically significant differences (P < 0·05) were found in all clinical conditions among the different age groups. Considerably different patterns of muscle activation were found across ages, with greater electromyographic activity in children and youth, and decreasing from adults to aged people.
Synchronous hepatic, mesenteric and pulmonary Epstein–Barr virus‐associated smooth muscle tumors in a renal transplant recipient
Authors: Al Hussain T. , Haleem A , Alsaad K. O.
Published: February 2010

Al Hussain T, Haleem A, Alsaad KO. Synchronous hepatic, mesenteric and pulmonary Epstein–Barr virus‐associated smooth muscle tumors in a renal transplant recipient. Clin Transplant 2010. DOI: 10.1111/j.1399‐0012.2009.01206.x  © 2010 John Wiley & Sons A/S.

Abstract:  Epstein–Barr virus‐associated smooth muscle tumors (EBV‐SMT) are distinct lesions that occur in immunocompromised patients. EBV‐SMT following solid organ transplantation are rare and generally have an indolent biological behavior. Post‐transplant EBV‐SMT have been reported in various anatomical locations. This report describes a synchronous and multicentric development of EBV‐SMT in liver, mesentery, and lung of a 33‐yr‐old male patient, 10 yr after a deceased allograft renal transplantation. The hepatic and mesenteric tumors were available for study. These tumors were composed of bland looking, desmin‐positive, spindle‐shaped cells which showed a strong nuclear staining for EBV with in situ hybridization technique. A literature review of post solid organ transplant EBV‐SMT in the liver and lung, particularly regarding their pathogenesis, synchronicity and biological behavior would be provided.
Cost‐effectiveness of screening for recurrent hepatocellular carcinoma after liver transplantation
Authors: Ladabaum Uri , Cheng Shan L. , Yao Francis Y. , Roberts John P.
Published: February 2010

Ladabaum U, Cheng SL, Yao FY, Roberts JP. Cost‐effectiveness of screening for recurrent hepatocellular carcinoma after liver transplantation. Clin Transplant 2011: 25: 283–291. © 2010 John Wiley & Sons A/S.

Abstract:  The effectiveness of screening and treatment of recurrent hepatocellular carcinoma (HCC) after liver transplantation (LT) remains undefined. Our aim was to evaluate the potential cost‐effectiveness of screening for recurrent HCC after LT. We constructed a Markov model of the natural history after LT for HCC. We superimposed screening with computed tomography, alpha‐fetoprotein, and chest X‐ray every six months for 1–5 yr after LT, with resection for treatable recurrence. Screening only those whose explant pathology exceeded Milan Criteria (MC) for two yr cost $138 000/life‐yr gained, and the incremental cost of screening all patients was $340 000/life‐yr gained. Screening for longer than two yr incurred progressively higher incremental costs/life‐yr gained. The most critical variable in sensitivity analyses was the survival benefit of finding a resectable recurrence. With the most favorable assumptions for a two‐yr screening duration, screening those whose explant pathology exceeded MC cost $91 000/life‐yr gained. In conclusion, screening for HCC recurrence after LT would probably yield most of its benefit in the first two yr, but at a relatively high cost/life‐yr gained. Screening for two yr in only those whose explant pathology exceeds MC may be relatively cost‐effective depending on the survival benefit of resection.
The role of phenotypic plasticity in responses of hunted thinhorn sheep ram horn growth to changing climate conditions
Authors: LOEHR J. , CAREY J. , O’HARA R. B. , HIK D. S.
Published: February 2010

When phenotypic change occurs over time in wildlife populations, it can be difficult to determine to what degree it is because of genetic effects or phenotypic plasticity. Here, we assess phenotypic changes over time in horn length and volume of thinhorn sheep (Ovis dalli) rams from Yukon Territory, Canada. We considered 42 years of horn growth from over 50 000 growth measurements in over 8000 individuals. We found that weather explained a large proportion of the annual fluctuation in horn growth, being particularly sensitive to spring weather. Only 2.5% of variance in horn length growth could be explained by an individual effect, and thus any genetic changes over the time period could only have had a small effect on phenotypes. Our findings allow insight into the capacity for horn morphology to react to selection pressures and demonstrate the overall importance of climate in determining growth.
The effects of caudal or intravenous clonidine on postoperative analgesia produced by caudal levobupivacaine in children
Authors: AKIN AYNUR , OCALAN SERIFE , ESMAOGLU ALIYE , BOYACI ADEM
Published: February 2010

Background:  Clonidine is used increasingly in pediatric anesthesia practice to prolong the duration of action of caudal block with a local anesthetic agent. Which route of administration of clonidine is the most beneficial remains unknown. We compared the effects of caudal and intravenous clonidine on postoperative analgesia produced by caudal levobupivacaine.

Methods:  Sixty ASA I and II children, aged 2–8  undergoing inguinal hernia repair or orchidopexy surgery received standardized premedication with midazolam and general anesthesia. The children were randomized in a double‐blind fashion to three groups. Group L (n = 20) patients received 0.75 ml·kg−1 of caudal 0.25% levobupivacaine and i.v. 5 ml saline, Group L‐Ccau (n = 20) patients received 0.75 ml·kg−1 of caudal 0.25% levobupivacaine + 2 μg·kg−1 clonidine and i.v. 5 ml saline, Group L‐Civ (n = 20) patients received 0.75 ml·kg−1 of caudal 0.25% levobupivacaine and i.v. 2 μg·kg−1 clonidine in 5 ml of saline. Mean arterial blood pressure, heart rate, peripheral oxygen saturation, and end‐tidal carbon dioxide values were recorded. Postoperative pain [Children and Infants Postoperative Pain Scale (CHIPPS) score], sedation (Ramsay Sedation Scale) and motor blockade (Modified Bromage Scale) were assessed at predetermined time points during the first 24 h after surgery.

Results:  Caudal clonidine significantly delayed the time to first rescue analgesic and fewer patients required rescue analgesia in the 24 h after surgery. No motor block was observed in any of the three groups on awakening or during the study period. In Group L‐Ccau, the CHIPPS score was lower than in Group L at all times through 240 min (P < 0.05), while the pain scores were lower in Group L‐Civ only at extubation and at 240 min (P < 0.05).

Conclusions:  Caudal clonidine prolongs the duration of analgesia produced by caudal levobupivacaine without causing significant side effects and this is because of a spinal mode of action.
The Chronicles of Electronic Commerce: Reverse Domain Name Hijacking under the Uniform Dispute Resolution Policy
Authors: Zainol Zinatul A.
Published: February 2010

Reverse Domain Name Hijacking is a unique concept under the Uniform Dispute Resolution Policy. Its main purpose is to protect domain name registrants against unjustified claims of overreaching trademark rights by allowing domain name registrants, in some limited circumstances to retort against trademark owners.
Risk of high‐level viraemia in HIV‐infected patients on successful antiretroviral treatment for more than 6 months
Authors: Engsig FN , Omland LH , Larsen MV , Rasmussen LD , Qvist T , Gerstoft J , Obel N
Published: February 2010

Objectives

According to the Swiss Federal Commission for HIV/AIDS, HIV‐infected patients on successful antiretroviral treatment have a negligible risk of transmitting HIV sexually. We estimated the risk that patients considered to have an undetectable viral load (VL) are actually viraemic.

Methods

A Danish, population‐based nationwide cohort study of HIV‐infected patients with VL <51 HIV‐1 RNA copies/mL for more than 6 months was carried out for the study period 2000–2008. The observation time was calculated from 6 months after the first VL <51 copies/mL to the last measurement of VL or the first VL >50 copies/mL. The time at risk of transmitting HIV sexually was calculated as 50% of the time from the last VL <51 copies/mL to the subsequent VL if it was >1000 copies/mL. The outcome was the time at risk of transmitting HIV sexually divided by the observation time.

Results

We identified 2680 study subjects contributing 9347.7 years of observation time and 56.4 years of risk of transmitting HIV (VL>1000 copies/mL). In 0.6% [95% confidence interval (CI) 0.5–0.8%] of the overall observation time the patients had VL >1000 copies/mL. In the first 6 months this risk was substantially higher (7.9%; 95% CI 4.5–11.0%), but thereafter decreased and was almost negligible after 5 years (0.03%; 95% CI 0.0–0.2%). The risk was higher in injecting drug users, but otherwise did not differ between subgroups of patients.

Conclusion

The risk of viraemia and therefore the risk of transmitting HIV sexually are high in the first 12 months of successful antiretroviral treatment, but thereafter are low.
Reasons for Being Selective When Choosing Personnel Selection Procedures
Authors: König Cornelius J. , Klehe Ute‐Christine , Berchtold Matthias , Kleinmann Martin
Published: February 2010

The scientist–practitioner gap in personnel selection is large. Thus, it is important to gain a better understanding of the reasons that make organizations use or not use certain selection procedures. Based on institutional theory, we predicted that six variables should determine the use of selection procedures: the procedures' diffusion in the field, legal problems associated with the procedures, applicant reactions to the procedures, their usefulness for organizational self‐promotion, their predictive validity, and the costs involved. To test these predictions, 506 HR professionals from the German‐speaking part of Switzerland filled out an online survey on the selection procedures used in their organizations. Respondents also evaluated five procedures (semi‐structured interviews, ability tests, personality tests, assessment centers, and graphology) on the six predictor variables. Multilevel logistic regression was used to analyze the data. The results revealed that the highest odd ratios belonged to the factors applicant reactions, costs, and diffusion. Lower (but significant) odds ratios belonged to the factors predictive validity, organizational self‐promotion, and perceived legality.
Recruiting on Corporate Web Sites: Perceptions of fit and attraction
Authors: Pfieffelmann Brigitte , Wagner Stephen H. , Libkuman Terry
Published: February 2010

This study adopted a person–organization (P–O fit) framework to investigate job seeker attraction to organizations in the context of e‐recruitment. Recruitment information posted on real corporate web sites was presented to active job seekers (N=120) in order to better understand reactions to online recruiting. Participants examined one of three corporate web sites and completed questionnaires about their perceptions of web site usability, subjective P–O fit, and organizational attraction. In addition, occupational preference, internet experience, organization size and location were used as control variables. For female participants, perceptions of web site usability and subjective P–O fit were both positively related to attraction, with subjective P–O fit mediating the relationship between web site usability and organizational attraction. These relations were not found for male participants. Implications for future empirical research and recruitment practice were discussed.
Applicability of the Extended Theory of Planned Behavior in Predicting Job Seeker Intentions to Use Job‐Search Websites
Authors: Lin Hsiu‐Fen
Published: February 2010

Although use of the Internet for job searching is rapidly increasing, the motivations for using electronic recruitment (e‐recruitment) services by job seekers have seldom been addressed. Derived from the extended theory of planned behavior, this study develops a research model for the empirical examination of factors affecting job seeker intentions to use job‐search websites. Utilizing data collected from 174 participants in Taiwan, various relationships in the research model are tested using structural equation modeling approach. The results showed that job seeker attitude, subjective norm, and perceived behavioral control significantly affected their intentions to use job‐search websites. Also, perceived usefulness and perceived ease of use showed a significant effect on attitude, interpersonal influence on subjective norm, and perceived ease of use and self‐efficacy on perceived behavioral control. However, external influence was found to be an insignificant predictor of subjective norm. In addition to providing further insight into the factors that influence job seeker intentions to use job‐search websites, this study offers valuable suggestions for subsequent research and practitioners investigating the use of e‐recruitment services.
Emotional Intelligence in Selection Contexts: Measurement method, criterion‐related validity, and vulnerability to response distortion
Authors: Christiansen Neil D. , Janovics Jay E. , Siers Brian P.
Published: February 2010

Two studies examined aspects of the validity of self‐report and performance‐based measures of emotional intelligence (EI) relevant to their use in personnel selection. In Study 1, structural equation modeling indicated that a two‐factor model with separate factors for the two types of EI measures fit better than a one‐factor solution. The performance‐based EI factor was more related to cognitive ability (R=.38) than personality (R=.26), whereas the self‐report EI factor was more related to personality (R=.85) than cognitive ability (R=.09). Although the performance‐based EI factor correlated more strongly with job performance (ρ=.24) than did that of the self‐report (ρ=.05), it provided little incremental validity beyond cognitive ability and conscientiousness. In Study 2, participants were asked to complete the measures as if applying for a job, and mean scores were then compared with those of Study 1. Results indicated that self‐report EI measures were more vulnerable to distortion than were the performance‐based measures. Implications for the assessment of EI in personnel selection contexts are discussed.
Exercising choice and control – women with learning disabilities and contraception
Authors: McCarthy Michelle
Published: February 2010

Accessible summary

This project was about contraception. Contraception is the things people use to stop a woman from getting pregnant.

We spoke to 23 women with learning disabilities and 162 doctors wrote to us.

Sometimes women with learning disabilities made their own decisions, but mostly it was other people who decided for them.

We suggest some ways to help women with learning disabilities get more information and be helped to decide for themselves.

This research project used semi‐structured in‐depth interviews to ask women with learning disabilities about the experience of being prescribed contraception. It also asked general practitioners about their prescribing practices through a postal survey. A service user group was involved at different stages of the project. Most of the women reported that it was other people who made the key decisions about starting to use contraception and which method to use. Both the women and the doctors said they liked having a third party (staff member or relative) present for the consultations. Many of the doctors were unclear about responding to issues of capacity to consent to treatment. An accessible research summary was produced to make the process and findings of the research available to the women with learning disabilities who took part in the study, as well as to any others who were interested (see Disability and Society, 24, 357–371, 2009). In the interests of disseminating that accessible report as widely as possible, extracts are included in this article, and the full version is available from the author.
Structural brain abnormalities in adolescents with autism spectrum disorder and patients with attention deficit/hyperactivity disorder
Authors: Brieber Sarah , Neufang Susanne , Bruning Nicole , Kamp‐Becker Inge , Remschmidt Helmut , Herpertz‐Dahlmann Beate , Fink Gereon R. , Konrad Kerstin
Published: February 2010

Background:  Although autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) are two distinct neurodevelopmental diseases, they share behavioural, neuropsychological and neurobiological characteristics. For the identification of endophenotypes across diagnostic categories, further investigations of phenotypic overlap between ADHD and autism at the behavioural, neurocognitive, and brain levels are needed.

Methods:  We examined regional grey matter differences and similarities in children and adolescents with ASD and ADHD in comparison to healthy controls using structural magnetic resonance imaging (MRI) and voxel‐based morphometry.

Results:  With regard to clinical criteria, the clinical groups did not differ with respect to ADHD symptoms; however, only patients with ASD showed deficits in social communication and interaction, according to parental rating. Structural abnormalities across both clinical groups compared to controls became evident as grey matter reductions in the left medial temporal lobe and as higher grey matter volumes in the left inferior parietal cortex. In addition, autism‐specific brain abnormalities were found as increased grey matter volume in the right supramarginal gyrus.

Conclusions:  While the shared structural deviations in the medial temporal lobe might be attributed to an unspecific delay in brain development and might be associated with memory deficits, the structural abnormalities in the inferior parietal lobe may correspond to attentional deficits observed in both ASD and ADHD. By contrast, the autism‐specific grey matter abnormalities near the right temporo‐parietal junction may be associated with impaired ‘theory of mind’ abilities. These findings shed some light on both similarities and differences in the neurocognitive profiles of ADHD and ASD patients.
Thickened saliva after effective management of drooling with botulinum toxin A
Authors: ERASMUS CORRIE E , VAN HULST KAREN , VAN DEN HOOGEN FRANK JA , VAN LIMBEEK JACQUES , ROELEVELD NEL , VEERMAN ENNO CI , ROTTEVEEL JAN J , JONGERIUS PETER H
Published: February 2010

Aim  The aim of this study was to evaluate the rheological properties of saliva after submandibular botulinum toxin type A (BoNT‐A) injections.

Method  We enrolled 15 children (11 males and six females; age range 3–17y, mean age 9y 10mo) diagnosed with spastic (n=9) or dyskinetic (n=6) quadriplegic cerebral palsy (CP); Gross Motor Function Classification System level IV or V; and two children with intellectual disability (IQ <70) who experienced moderate to severe drooling. Salivary flow rate and drooling quotient were measured at baseline and at different times after BoNT‐A injections up to 24 weeks. The mucin concentration of saliva was analysed before and after BoNT‐A treatment.

Results  Both submandibular salivary flow rate (baseline 0.38mL/min; 24wks after injection 0.26mL/min) and drooling quotient (baseline 42.5%; 24wks 28.80%) were substantially reduced, with a concomitant increase in mucin concentration within 8 weeks after BoNT‐A injection (from 0.612 to 1.830U/mL). The parents of nine children observed thickened saliva. Swallowing and chewing were problematic in seven children. Two of these children needed treatment with mucolytics because of pooling of thickened saliva in the throat.

Interpretation  When making decisions about the use of BoNT‐A, the risk of problems with masticatory and swallowing functions as a result of thickening of saliva after BoNT‐A treatment should be taken into account.
Examining the link between working memory behaviour and academic attainment in children with ADHD
Authors: ALLOWAY TRACY PACKIAM , GATHERCOLE SUSAN E , ELLIOTT JULIAN
Published: February 2010

Aim  The aim of the present study was to investigate whether behaviours typical of working memory problems are associated with poor academic attainment in those with attention‐deficit–hyperactivity disorder (ADHD), as well as a non‐clinical group identified on the basis of working memory difficulties.

Method  Children clinically diagnosed with ADHD‐combined (n=31; mean age 9y 7mo, SD 12mo; 27 males) were matched with 44 low working memory children (mean age 9y 4mo, SD 15mo; 32 males) and 10 healthy controls (mean age 10y, SD 12mo; 5 males). Working memory behaviour was measured using the Working Memory Rating Scale (WMRS) and academic attainment was assessed with standardized tests of literacy and numeracy.

Results  The majority of children considered by their teachers to have problematic behaviours performed poorly in literacy and numeracy. When the whole sample were split into two groups on the basis of their working memory behaviour (on the WMRS), the ‘At Risk’ group performed significantly worse in academic attainment.

Interpretation  As children with ADHD and a non‐clinical group exhibit classroom behaviour typical of working memory problems, early screening to prevent subsequent learning difficulties is important. The use of the WMRS allows educators to draw on their expertise in the classroom for early detection of children with working memory failures.
Indications and effects of botulinum toxin A for obstetric brachial plexus injury: a systematic literature review
Authors: GOBETS DAVID , BECKERMAN HELEEN , GROOT VINCENT de , VAN DOORN‐LOOGMAN MIRIAM H , BECHER JULES G
Published: February 2010

Aim  To give an overview of indications for the use of botulinum toxin A (BoNT‐A) treatment for children with obstetric brachial plexus injury (OBPI), and to present the best available evidence of the effectiveness of this treatment.

Method  Searches were performed in Cinahl, Cochrane Library, Embase, PubMed, and Web of Science, using the keywords ‘botulinum’ and ‘plexus’, to identify articles reporting on the use of BoNT‐A as a treatment for children with OBPI. Studies found through the references of related articles were also selected.

Results  Ten full‐text papers and six congress abstracts were included, involving 343 children. Four groups of indications could be identified: internal rotation/adduction contracture of the shoulder, limited active elbow flexion, limited active elbow extension, and pronation contracture of the lower arm. Overall, positive results were reported for all except the indication for limited active elbow extension. However, only one study was comparative in nature; all others were classified as having a low level of evidence. There was a large variation in outcome measures.

Interpretation  To provide better evidence for the already partly promising results of BoNT‐A treatment for children with OBPI, multicentre randomized controlled trials are needed.
Mechanisms of disease and clinical features of mutations of the gene for mitofusin 2: an important cause of hereditary peripheral neuropathy with striking clinical variability in children and adults
Authors: OUVRIER ROBERT , GREW SIMON
Published: February 2010

Mitofusin 2, a large transmembrane GTPase located in the outer mitochondrial membrane, promotes membrane fusion and is involved in the maintenance of the morphology of axonal mitochondria. Mutations of the gene encoding mitofusin 2 (MFN2) have recently been identified as the cause of approximately one‐third of dominantly inherited cases of the axonal degenerative forms of Charcot–Marie–Tooth disease (CMT type 2A) and of rarer variants. The latter include a severe, early‐onset axonal neuropathy, which may occur in autosomal dominant or recessive forms, as well as some instances associated with pyramidal tract involvement (CMT type 5), with optic atrophy (CMT type 6), and, occasionally, with alterations of cerebral white matter. All individuals with a dominantly or recessively inherited or otherwise unexplained, chronic progressive axonal degenerative polyneuropathy should be tested for mutations of MFN2.
Precision and content range of a parent‐reported item bank assessing lower extremity and mobility skills in children with cerebral palsy
Authors: GORTON III GEORGE E , WATSON KYLE , TUCKER CAROLE A , TIAN FENG , MONTPETIT KATHLEEN , HALEY STEPHEN M , MULCAHEY MARY J
Published: February 2010

Aim  The aim of this study was to determine the psychometric properties, content range, and measurement precision of a lower extremity physical functioning and mobility skills item bank (LE85) in children with cerebral palsy (CP).

Method  Lower extremity functioning and mobility skill items were administered to 308 parents of children (169 males, 139 females; mean age 10y 8mo, SD 4y) with spastic CP (145 diplegia, 73 hemiplegia, 89 quadriplegia; [for one person type of CP was unknown]) classified using the Gross Motor Function Classification System (75 level I, 91 level II, 79 level III, 37 level IV, 26 level V). Additional legacy measures were administered to assess concurrent validity. Psychometric characteristics, differential item functioning, content range, and score precision were examined.

Results  The LE85 had acceptable psychometric properties. Content range matched the ability range of the sample population and exceeded legacy measures with minimal differential item functioning. The LE85 had good correlation with the Paediatric Outcomes Data Collection Instrument, Functional Independence Measure for Children, Gillette Functional Assessment Questionnaire, and Paediatric Quality of Life Inventory – CP module (range r=0.63–0.86). Precision of the LE85 and 10‐item simulated computer adaptive test scores outperformed legacy measures.

Interpretation  The LE85 appears to be suitable to administer as a computer adaptive test to measure lower extremity physical functioning and mobility in children with CP.
Moving beyond static species distribution models in support of conservation biogeography
Authors: Franklin Janet
Published: February 2010

Aim To demonstrate that multi‐modelling methods have effectively been used to combine static species distribution models (SDM), predicting the geographical pattern of suitable habitat, with dynamic landscape and population models to forecast the impacts of environmental change on species’ status, an important goal of conservation biogeography.

Methods Three approaches were considered: (1) incorporating models of species migration to understand the ability of a species to occupy suitable habitat in new locations; (2) linking models of landscape disturbance and succession to models of habitat suitability; and (3) fully linking models of habitat suitability, habitat dynamics and spatially explicit population dynamics.

Results Linking species–environment relationships, landscape dynamics and population dynamics in a multi‐modelling framework allows the combined impacts of climate change (affecting species distribution and vital rates) and land cover dynamics (land use change, altered disturbance regimes) on species to be predicted. This approach is only feasible if the life history parameters and habitat requirements of the species are well understood.

Main conclusions Forecasts of the impacts of global change on species may be improved by considering multiple causes. A range of methods are available to address the interactions of changing habitat suitability, habitat dynamics and population response that vary in their complexity, realism and data requirements.
Genetic risk perception and reproductive decision making among people with epilepsy
Authors: Helbig Katherine L. , Bernhardt Barbara A. , Conway Laura J. , Valverde Kathleen D. , Helbig Ingo , Sperling Michael R.
Published: February 2010

We investigated estimated offspring risk among people with epilepsy and factors important in the family‐planning process. Data were collected for 88 participants using a questionnaire assessing perceived risk of offspring to develop epilepsy, importance of factors in the reproductive decision‐making process, decision to have fewer children, and association between risk perception and family planning decisions. Thirty‐four percent of participants had fewer children because of their epilepsy. Concerns about the ability to care for a child (p < 0.0001) and passing epilepsy onto a child (p = 0.003) were associated with the decision to have fewer children. The mean estimated risk of offspring to develop epilepsy was 26%, a 4‐fold increase over estimated population risks. Genetic counseling may be beneficial for people with epilepsy, given the considerable overestimation of offspring risk.
High‐dose intravenous levetiracetam for acute seizure exacerbation in children with intractable epilepsy
Authors: Depositario‐Cabacar Dewi T. , Peters Jurriaan M. , Pong Amanda W. , Roth Julie , Rotenberg Alexander , Riviello James J. , Takeoka Masanori
Published: February 2010

We review our experience with high‐dose intravenous levetiracetam (IV‐LEV) for acute seizure exacerbations in nine children with medically intractable epilepsy. All children had acute repetitive seizures—while on chronic antiepileptic drugs—that either led to hospitalization (eight) or occurred during hospitalization (one), and received doses of IV‐LEV of 150 mg/kg/day or greater, with a mean dose of 228 ± 48 mg/kg/day. Eight of nine children had resolution of the acute repetitive seizures. Seizure frequency was reduced to less than baseline in seven children (seizure‐free in two, ≥80% reduction in four, and 50% reduction in one). Except for one child with increased seizures, IV‐LEV was well tolerated in all children without complications.
Duration of red blood cell storage and survival of transfused patients (CME)
Authors: Edgren Gustaf , Kamper‐Jørgensen Mads , Eloranta Sandra , Rostgaard Klaus , Custer Brian , Ullum Henrik , Murphy Edward L. , Busch Michael P. , Reilly Marie , Melbye Mads , Hjalgrim Henrik , Nyrén And Olof
Published: February 2010

BACKGROUND: Disquieting reports of increased complication and death rates after transfusions of red blood cells (RBCs) stored for more than 14 days prompted us to perform an observational retrospective cohort study of mortality in relation to storage time.

STUDY DESIGN AND METHODS: We conducted a cohort study utilizing data on all recipients of at least one RBC transfusion in Sweden and Denmark between 1995 and 2002, as recorded in the Scandinavian Donations and Transfusions (SCANDAT) database. Relative risks of death in relation to storage time were estimated using Cox regression, adjusted for several possible confounding factors.

RESULTS: After various exclusions, 404,959 transfusion episodes remained for analysis. The 7‐day risk of death was similar in all exposure groups, but a tendency for a higher risk emerged among recipients of blood stored for 30 to 42 days (hazard ratio, 1.05; 95% confidence interval [CI], 0.97‐1.12), compared to recipients of blood stored for 10 to 19 days. With 2‐year follow‐up, this excess remained at the same level (hazard ratio, 1.05; 95% CI, 1.02‐1.08). No dose‐response pattern was revealed and no differential effect was seen when the analyses were restricted to recipients of leukoreduced units only.

CONCLUSION: Although a small excess mortality was noted in recipients of the oldest RBCs, the risk pattern was more consistent with weak confounding than with an effect of the momentary exposure to stored RBCs. It seems, thus, that any excess mortality conferred by older RBCs in the combined Swedish and Danish transfusion recipient population is likely less than 5%, which is considerably smaller than in the hitherto largest investigation.
Parvovirus B19 infection transmitted by transfusion of red blood cells confirmed by molecular analysis of linked donor and recipient samples
Authors: Yu Mei‐ying W. , Alter Harvey J. , Virata‐Theimer Maria Luisa A. , Geng Yansheng , Ma Li , Schechterly Cathy A. , Colvin Camilla A. , Luban Naomi L.C.
Published: February 2010

BACKGROUND: Extremely high viremic levels of parvovirus B19 (B19V) can be found in acutely infected, but asymptomatic donors. However, reports of transmission by single‐donor blood components are rare. In this prospective study, paired donor‐recipient samples were used to investigate the transfusion risk.

STUDY DESIGN AND METHODS: Posttransfusion plasma or blood samples from recipients were tested for B19V DNA by polymerase chain reaction, generally at 4 and 8 weeks, and for anti‐B19V immunoglobulin (Ig)G by enzyme immunoassay, at 12 and 24 weeks. To rule out infection unrelated to transfusion, pretransfusion samples and linked donor's samples for each B19V DNA–positive recipient were assayed for B19V DNA and anti‐B19V IgG and IgM. To confirm transmission, sequencing and phylogenetic analysis were performed.

RESULTS: A total of 14 of 869 (1.6%) recipients were B19V DNA positive, but only 1 of 869 (0.12%; 95% confidence interval, 0.0029%‐0.6409%) was negative for B19V DNA and anti‐B19V IgG before transfusion and seroconverted posttransfusion. This newly infected patient received 5 × 1010 IU B19V DNA in one red blood cell (RBC) unit from an acutely infected anti‐B19V–negative donor in addition to RBCs from three other donors that cumulatively contained 1320 IU of anti‐B19V IgG. DNA sequencing and phylogenetic analysis showed that sequences from the linked donor and recipient were identical (Genotype 1), thus establishing transfusion transmission.

CONCLUSIONS: The 0.12% transmission rate documented here, although low, could nonetheless result in hundreds or thousands of infections annually in the United States based on calculated confidence limits. Although most would be asymptomatic, some could have severe clinical outcomes, especially in neonates and those with immunocompromised or hemolytic states.