bluuebunny/crossref_metadata_2025 huggingface dataset:
The Plight of Clinical Waste Pickers: Evidence from the Northwest Region of Cameroon
Authors: Mochungong Peter I. K.
Published: April 2010

The Plight of Clinical Waste Pickers: Evidence from the Northwest Region of Cameroon: Peter I. K. Mochungong. Unit for Health Promotion Research, University of Southern Denmark, Denmark

Objective

To present the pitiable working conditions of clinical waste pickers in hospitals in the Northwest region of Cameroon and associated exposure to health hazards.

Methods

Observe clinical waste pickers as they carry out their functions for three days and carry out informal consultations (discussion) with the waste pickers on their working conditions, possible health risks and avenues and resources to improve the current situation.

Results

Lack of immunization, protective equipment, and poor work postures, absence of support groups and lack of awareness on associated health hazards contributes to the current plight of clinical waste pickers in Cameroon. Improving hospital infrastructure and equipment is prioritized over safety and management of risks faced by the clinical waste pickers.

Conclusion

Clinical waste pickers in Cameroon certainly work in poor conditions which endanger their health and those of their families. There is an urgent need for the implementation of health and safety protocols together with an overhaul of equipment currently in use.
Updated Meta-analysis of Probiotics for Preventing Necrotizing Enterocolitis in Preterm Neonates
Authors: Deshpande Girish , Rao Shripada , Patole Sanjay , Bulsara Max
Published: April 2010

OBJECTIVE:

Systematic reviews of randomized, controlled trials (RCTs) indicate lower mortality and necrotizing enterocolitis (NEC) and shorter time to full feeds after probiotic supplementation in preterm (<34 weeks' gestation) very low birth weight (VLBW; birth weight <1500 g) neonates. The objective of this study was to update our 2007 systematic review of RCTs of probiotic supplementation for preventing NEC in preterm VLBW neonates.

METHODS:

We searched in March 2009 the Cochrane Central register; Medline, Embase, and Cinahl databases; and proceedings of the Pediatric Academic Society meetings and gastroenterology conferences. Cochrane Neonatal Review Group search strategy was followed. Selection criteria were RCTs of any enteral probiotic supplementation that started within first 10 days and continued for ≥7 days in preterm VLBW neonates and reported on stage 2 NEC or higher (Modified Bell Staging).

RESULTS:

A total of 11 (N = 2176), including 4 new (n = 783), trials were eligible for inclusion in the meta-analysis by using a fixed-effects model. The risk for NEC and death was significantly lower. Risk for sepsis did not differ significantly. No significant adverse effects were reported. Trial sequential analysis) showed 30% reduction in the incidence of NEC (α = .05 and .01; power: 80%).

CONCLUSIONS:

The results confirm the significant benefits of probiotic supplements in reducing death and disease in preterm neonates. The dramatic effect sizes, tight confidence intervals, extremely low P values, and overall evidence indicate that additional placebo-controlled trials are unnecessary if a suitable probiotic product is available.
Children's Hospitals Do Not Acutely Respond to High Occupancy
Authors: Fieldston Evan S. , Hall Matthew , Sills Marion R. , Slonim Anthony D. , Myers Angela L. , Cannon Courtney , Pati Susmita , Shah Samir S.
Published: April 2010

OBJECTIVE:

High hospital occupancy may lead to overcrowding in emergency departments and inpatient units, having an adverse impact on patient care. It is not known how children's hospitals acutely respond to high occupancy. The objective of this study was to describe the frequency, direction, and magnitude of children's hospitals' acute responses to high occupancy.

METHODS:

Patients who were discharged from 39 children's hospitals that participated in the Pediatric Health Information System database during 2006 were eligible. Midnight census data were used to construct occupancy levels. Acute response to high occupancy was measured by 8 variables, including changes in hospital admissions (4 measures), transfers (2 measures), and length of stay (2 measures).

RESULTS:

Hospitals were frequently at high occupancy, with 28% of midnights at 85% to 94% occupancy and 42% of midnights at ≥95% occupancy. Whereas half of children's hospitals used occupancy-mitigating responses, there was variability in responses and magnitudes were small. When occupancy was >95%, no more than 8% of hospitals took steps to reduce admissions, 13% increased transfers out, and up to 58% reduced standardized length of stay. Two-day lag response was more common but remained of too small a magnitude to make a difference in hospital crowding. Additional modeling techniques also revealed little response.

CONCLUSIONS:

We found a low rate of acute response to high occupancy. When there was a response, the magnitude was small.
Considerations for Using Sucrose to Reduce Procedural Pain in Preterm Infants
Authors: Holsti Liisa , Grunau Ruth E.
Published: April 2010

Preterm and critically ill newborns admitted to a NICU undergo repeated skin-breaking procedures that are necessary for their survival. Sucrose is rapidly becoming the accepted clinical standard nonpharmacologic intervention for managing acute procedural pain for these infants. Although shown to be safe in single doses, only 4 studies have evaluated the effects of repeated doses of sucrose over relatively short periods of time. None has examined the use of sucrose throughout the NICU stay, and only 1 study evaluated the neurodevelopmental outcomes after repeated doses of sucrose. In that study, infants born at <31 weeks' gestational age and exposed to >10 doses per day in the first week of life were more likely to show poorer attention and motor development in the early months after discharge from the NICU. Results of studies in animal models have suggested that the mechanism of action of sucrose is through opioid pathways; however, in human infants, little has been done to examine the physiologic mechanisms involved, and the findings reported thus far have been ambiguous. Drawing from the growing animal literature of research that has examined the effects of chronic sugar exposure, we describe alternative amine and hormone pathways that are common to the processing of sucrose, attention, and motor development. In addition, a review of the latest research to examine the effects of repeated sucrose on pain processing is presented. These 2 literatures each can inform the other and can provide an impetus to initiate research to examine not only the mechanisms involved in the calming mechanisms of sucrose but also in the long-term neurodevelopmental effects of repeated sucrose in those infants born extremely preterm or critically ill.
Lactobacillus GG in the Prevention of Nosocomial Gastrointestinal and Respiratory Tract Infections
Authors: Hojsak Iva , Abdović Slaven , Szajewska Hania , Milošević Milan , Krznarić Željko , Kolaček Sanja
Published: April 2010

OBJECTIVE:

The incidence of nosocomial infections, predominantly gastrointestinal and respiratory, in children in developed countries is high, ranging from 5% to 44%. There is no effective strategy for preventing these infections. The objective of our study was to investigate the role of Lactobacillus GG (LGG) in preventing nosocomial gastrointestinal and respiratory tract infections at a pediatric hospital.

METHODS:

We conducted a randomized, double-blind, placebo-controlled trial of 742 hospitalized children. They were randomly allocated to receive for their hospitalization LGG at a dose of 109 colony-forming units in 100 mL of a fermented milk product (LGG group, n = 376) or placebo that was the same postpasteurized fermented milk product without LGG (placebo group, n = 366).

RESULTS:

In the LGG group, compared with the placebo group, we found a significantly reduced risk for gastrointestinal infections (relative risk [RR]: 0.40 [95% confidence interval (CI): 0.25–0.70]; number needed to treat: 15 [95% CI: 9–34)], respiratory tract infections (RR: 0.38 [95% CI: 0.18–0.85]; number needed to treat: 30 [95% CI: 16–159]), vomiting episodes (RR: 0.5 [95% CI: 0.3–0.9]), diarrheal episodes (RR: 0.24 [95% CI: 0.10–0.50]), episodes of gastrointestinal infections that lasted >2 days (RR: 0.40 [95% CI: 0.25–0.70]), and episodes of respiratory tract infections that lasted >3 days (RR: 0.4 [95% CI: 0.2–0.9]). Groups did not differ in hospitalization duration (P = .1).

CONCLUSIONS:

LGG administration can be recommended as a valid measure for decreasing the risk for nosocomial gastrointestinal and respiratory tract infections in pediatric facilities.
Breastfeeding and Prolactin Levels in Lactating Women With a Family History of Alcoholism
Authors: Mennella Julie A. , Pepino Marta Yanina
Published: April 2010

OBJECTIVE:

Many motivated new mothers fail to reach public health goals for breastfeeding, highlighting the need to identify risk factors. Because having a family history of alcoholism is associated with blunted prolactin responses to an alcohol challenge in nonlactating individuals, this study aimed to identify associations in family history of alcoholism, prolactin, and breastfeeding behaviors in lactating women.

METHODS:

This was a 2-day experimental study that used within-subject alcohol or control beverage consumption and between-subject family history of alcoholism factors. The participants were non–alcohol-dependent lactating women; 7 were family history–positive (FHP) for alcohol dependence, and 21 were family history–negative (FHN). Consumption of 0.4 g/kg alcohol or nonalcoholic beverage occurred in separate randomized sessions, followed by use of a breast pump. Basal and suckling-induced prolactin, blood alcohol concentrations, milk yield, self-reported drug effects, neophobia, and breastfeeding patterning were measured.

RESULTS:

Although no group differences in alcohol pharmacokinetics were detected, FHP women exhibited blunted prolactin to breast stimulation after drinking the control and alcohol beverage and felt more of the stimulant-like effects of alcohol than did FHN women. FHP women reported more frequent daily breastfeeding than did FHN women.

CONCLUSIONS:

This is the first evidence that family history of alcoholism is associated with a blunted magnitude, rapidity, and duration of the prolactin response to breast stimulation and an alcohol challenge in lactating women. More frequent breastfeeding by FHP women suggests behavioral compensation for perceived and/or actual poor lactation. Alcohol did not enhance lactational performance, further disputing the lore that alcohol is a galactagogue.
A guide to the ATSM in Medical Education. Article 2: assessment, feedback and evaluation
Authors: Shehmar Manjeet , Khan Khalid S
Published: April 2010

Key content

Assessment drives learning.

Assessments should test learning achievement against agreed objectives.

Feedback is a teaching aid.

Appraisal considers the trainee's personal as well as educational development.

Evaluation forms a cycle of continuing improvement of training.

Learning objectives

To learn about the main medical education theories on assessment, feedback and evaluation.

For trainees to understand how to use the theory in practice.

For Advanced Training Skills Module (ATSM) in Medical Education trainers to be able to offer learning opportunities to their trainees and then provide feedback.

Ethical issues

How far should the trainer become involved when a trainee has personal problems?

How can the trainer give constructive criticism without discouraging the trainee?

Please cite this article as: Shehmar M, Khan KS. A guide to the ATSM in Medical Education. Article 2: assessment, feedback and evaluation. The Obstetrician & Gynaecologist 2010;12:119–125.
Website reviews @ TOG
Authors: Keay Stephen
Published: April 2010

In this issue we consider the websites that provide support for women at difficult times in relation to their pregnancy. This includes dealing with an anomaly identified prenatally, bereavement, miscarriage or the loss of a child and the uncertainty parents face with preterm delivery when the prognosis for their baby may be guarded. This is an immensely difficult time for patients and it can be challenging for staff, too. Although the loss of a child is very rare, the impact this has on the parents and family is profound. The individual patient narratives are both powerful and moving and indicate the need for good communication and support, which may be required for weeks or months.

Early pregnancy clinic information leaflets and bereavement midwives will often highlight these websites but an awareness of them for the obstetricians and gynaecologists looking after the couple should be helpful. These charities provide invaluable ongoing support for patients.
Treatment‐related morbidity in gynaecological cancers
Authors: Hadwin Richard , Petts Gemma , Olaitan Adeola
Published: April 2010

Key content

The National Cancer Survivorship Initiative recognises that all treatment modalities in cancer have potential long‐term physical and psychosocial implications for patients.

Prediction and early recognition can prevent or minimise treatment‐related morbidity in gynaecological cancer.

Learning objectives

To introduce the concept of survivorship as an essential component of gynaecological oncology care.

To understand the range of problems that women encounter following cancer treatment and the need for a multidisciplinary approach.

Ethical issues

Informed counselling prior to treatment includes a description of potential long‐term morbidity, which may contribute to decision making.

Please cite this article as: Hadwin R, Petts G, Olaitan A. Treatment‐related morbidity in gynaecological cancers. The Obstetrician & Gynaecologist 2010;12:79–86.
Advances in fetal therapy
Authors: Morris R Katie , Chan Ben C , Kilby Mark D
Published: April 2010

Key content

Fetal medicine is a rapidly developing subspecialty.

The mainstay of treatment for fetal alloimmune thrombocytopenia remains maternal immunoglobulin therapy.

Stem cell transplantation and gene therapy have advanced over the last decade but must still be considered experimental.

Laser coagulation is the best treatment for all stages of twin‐to‐twin transfusion syndrome presenting before 26 weeks of gestation.

Fetoscopic endoluminal tracheal occlusion appears to improve prognosis in severe congenital diaphragmatic hernia.

Learning objectives

To gain an overview of the recent developments in fetal therapy.

To understand the benefits and risks of different methods of fetal therapy.

To appreciate the importance of high‐quality research in fetal medicine.

Ethical issues

With the option of fetal therapy, the value and implications of prenatal diagnosis have to be reviewed.

The acceptability of fetal therapy to parents and to society should be investigated.

The consideration of the mother and fetus as individual people presents an inherent difficulty in implementing randomised controlled trials in fetal medicine.

Please cite this article as: Morris RK, Chan BC, Kilby MD. Advances in fetal therapy. The Obstetrician & Gynaecologist 2010;12:94–102.
Pretesting the Likely Efficacy of Suggested Management Approaches to Data-Poor Fisheries
Authors: Butterworth Doug S. , Johnston Susan J. , Brandão Anabela
Published: April 2010

The thrust of this paper is that decision rules for the management of data-poor fisheries cannot be based on expert judgment alone. Such rules need to specifically link management responses to the values of the indicators available for the fishery and their trends. Prior simulation testing is needed to confirm that the application of any rules suggested is likely to achieve the objectives sought for the fishery. The management procedure (MP) approach (also called management strategy evaluation), which provides a framework for such testing, is summarized briefly. How this approach could be used to develop a decision rule for a fishery for which the only indicator available is the mean length of the catch is presented as an example. The extent to which the ability to meet management objectives could be improved if an unbiased index of relative abundance were available, and an MP based on a fitted population model applied, is illustrated. An MP developed for the fishery for Patagonian toothfish Dissotichus eleginoides off the sub-Antarctic Prince Edward Islands is summarized. This illustrates how the MP testing framework can be used in circumstances in which the available indicators conflict, leading to considerable uncertainty about the present resource status. The information content of indicators is closely related to the extent to which they vary about trends in the underlying resource attributes (e.g., catch per unit effort and underlying abundance). The compilation of lists of the statistical properties (such as the coefficients of variation and autocorrelations) of the residuals about detrended time series of the indicators, together with their likely relationships to the underlying attribute, for fisheries worldwide is suggested. This would provide a sound basis for specifying error structure in the simulation tests advocated for both generic and case-specific decision rules for data-poor fisheries.
Local-Scale Ecosystem-Based Fisheries in a Gulf of Maine Estuary: Managing for Complexity, Adapting to Uncertainty
Authors: Moore Slade , Sowles John
Published: April 2010

A comprehensive resource management plan for the Taunton Bay estuary, Maine, was developed to support the estuary's capacity to accommodate human uses without degrading ecosystem integrity or resilience. The initial phases of this plan, which has little precedent in the Gulf of Maine, target issues of immediate concern regarding environmental alteration and stock depletion associated with fisheries for four benthic species. Having no dedicated funding, our overall approach to developing ecosystem-based fisheries for this estuary relies heavily on thrift and efficiency, two attributes not usually associated with managing for ecosystem complexity. Despite our gaining a better understanding of this estuary through site-specific research and management activities, the complexity of the ecosystem's components and the unpredictability of its responses to management actions leave much uncertainty. Advancing a nascent, ecosystem-based management effort under such conditions requires the adoption of coping strategies that allow positive shifts in management. Our overall approach emphasizes using alternative knowledge systems to their best advantage, encouraging the participation of and provision of guidance by local resource users, prioritizing key information needs, conducting local research and monitoring, creating opportunities for prompt management corrections, striving for fairness to and stewardship from resource users, and encouraging a long-term commitment to this process.
Essential Fishery Information for Trap-Based Fisheries: Development of a Framework for Collaborative Data Collection
Authors: Culver Carolynn S. , Schroeter Stephen C. , Page Henry M. , Dugan Jenifer E.
Published: April 2010

The availability of up-to-date information for managing marine resources is limited worldwide. In California, lack of data is hindering the execution and evaluation of two recent state laws, the Marine Life Management Act and the Marine Life Protection Act. The inability to meet the objectives of these laws is particularly acute for large cryptic benthic species (e.g., crabs, lobster, and prawns) that support valuable trap fisheries. Such species are not readily quantified by conventional methods and thus are not usually included in existing monitoring efforts. We explored the integration of data collection with ongoing commercial crab fishing activities to address this information gap and developed sampling regimes that provided accurate estimates of at-sea catches that could show the status of crab populations. Crab catches sampled in port represented only a subset of the catch at sea owing to selective harvesting of the catch (i.e., sorting) and thus would be a poor estimator of wild stocks. We developed a framework for addressing data accuracy and validity, data management and sharing, incentives, compensation, and long-term funding. Our findings suggest that data collection programs in which fishermen, managers, and scientists collaboratively design, collect, and analyze data are well suited for trap fisheries, particularly those that include multiple species or practice high rates of selectivity. The resulting recommendations for ensuring that the process is transparent and that the data are accurate and integrated into management include having (1) well-defined goals and appropriate, scientifically sound data collection methods, (2) hands-on training for participants, (3) validation of the collected data, (4) well-defined procedures for handling confidential data, (5) an adequate funding source, and (6) timely and consistent reviews of the data with subsequent actions as needed. This program offers a sound solution for obtaining comprehensive fishery information in a more cost-effective manner than is currently available.
Assemblage Structure of Fish at Offshore Petroleum Platforms on the San Pedro Shelf of Southern California
Authors: Martin Christopher J. B. , Lowe Christopher G.
Published: April 2010

Offshore petroleum platforms in California's Santa Barbara Channel have been shown to be of ecological importance for local fish populations; however, before our investigation, no data existed on the fish assemblages associated with the platforms on the San Pedro Shelf further south. Our surveys of these platforms in 2006 and 2007 indicate that there is a core group of warm—temperate nearshore reef species in the midwater depth (<30 m), including California sheephead Semicossyphus pulcher, blacksmith Chromis punctipinnis, garibaldi Hypsypops rubicundus, opaleye Girella nigricans, and kelp bass Paralabrax clathratus. Platforms located further from shore (i.e., offshore platforms [>14 km]) had a strong seasonal presence of pelagic fishes (primarily jack mackerel Trachurus symmetricus) and recruit blacksmiths. At platforms closer to shore (i.e., inshore platforms [<4.8 km]), sea basses (Serranidae) and surfperches (Embiotocidae) were predominant; only slight seasonal variations were observed, which were attributed to prespawning aggregations of barred sand bass Paralabrax nebulifer. At the offshore platforms total fish density had a negative relationship with depth but a positive relationship with water temperature; conversely, total fish biomass exhibited a positive relationship with depth but a negative relationship with temperature. In contrast, at the inshore platforms both total fish density and biomass increased with increasing water temperature. With the exception of blacksmiths, nearshore reef fishes showed significantly greater densities of adults than juveniles. Furthermore, some species were observed spawning at these structures. Therefore, the San Pedro Shelf platforms may provide suitable habitat for several species of nearshore reef fish. Removing the upper levels and superstructure of the offshore platforms to a depth of 25 m (the partial removal decommissioning option) would eliminate critical habitat for several fish species and result in a potential loss of 95% of the total fish density and 77% of the total fish biomass, thus reducing the productivity advantages of some of these structures.
Examination of Inequalities in HIV/AIDS Mortality in the United States From a Fundamental Cause Perspective
Authors: Rubin Marcie S. , Colen Cynthia G. , Link Bruce G.
Published: April 2010

Objectives. We examined changes in socioeconomic status (SES) and Black to White inequalities in HIV/AIDS mortality in the United States before and after the introduction of highly active antiretroviral therapy (HAART).

Methods. Taking a fundamental cause perspective, we used negative binomial regression to analyze trends in county-level gender-, race-, and age-specific HIV/AIDS mortality rates among those aged 15 to 64 years during the period 1987–2005.

Results. Although HIV/AIDS mortality rates decreased once HAART became available, the declines were not uniformly distributed among population groups. The associations between SES and HIV/AIDS mortality and between race and HIV/AIDS mortality, although present in the pre-HAART period, were significantly greater in the peri- and post-HAART periods, with higher SES and White race associated with the greatest declines in mortality during the post-HAART period.

Conclusions. Our findings support the fundamental cause hypothesis, as the introduction of a life-extending treatment exacerbated inequalities in HIV/AIDS mortality by SES and by race. In addition to a strong focus on factors that improve overall population health, more effective public health interventions and policies would facilitate an equitable distribution of health-enhancing innovations.
African American Homicide Bereavement: Aspects of Social Support That Predict Complicated Grief, PTSD, and Depression
Authors: Burke Laurie A. , Neimeyer Robert A. , McDevitt-Murphy Meghan E.
Published: April 2010

Psychological adaptation following homicide loss is challenged not only by the violent nature of the death itself but also by the bereaved's relationships with would-be supporters. Recruiting a sample of 54 African-American homicidally bereaved individuals, we examined perceived and actual support, the size of the support network, family- versus non-family support, and number of negative relationships to gauge the role of social support in bereavement outcomes such as complicated grief, PTSD, and depression. Results of quantitative assessments revealed that size of available network, quantity of negative relationships, and levels of grief-specific support were correlated with bereavement outcome. Clinical implications and suggestions for future research on the role of social support in adaptation of African Americans to traumatic loss are discussed.
Existential Crisis and the Awareness of Dying: The Role of Meaning and Spirituality
Authors: Yang William , Staps Ton , Hijmans Ellen
Published: April 2010

An existential crisis may occur in cancer patients when they realize that their death may be imminent. We explore the ways in which patients deal with this crisis, in which the meaning of life itself is at stake. In dealing with an existential crisis, it is important to have the courage to confront the loss of meaning and security. Then, a new sense of meaning may emerge which is essentially a receptive experience of connectedness with an ego-transcending reality, such as mankind, nature, or God. This reduces existential fear and despair and leads to acceptance of “life-as-it-is,” including its finitude. The article concludes with implications for healthcare workers.
EU and U.S. Non-Reciprocal Preferences: Maintaining the Acquis
Authors: Kelly Ruth
Published: April 2010

In the light of the disparity of bargaining leverage in FTA negotiations between the EU or the U.S. and developing countries, this article presents a legal mechanism to maintain the status quo, that is, the acquis of current trade arrangements. On the basis of the test established in the EC-Tariff Preferences case, it is argued that the Enabling Clause allows for differentiation between developing countries on the basis of their levels of intra-regional trade. A scheme is then constructed which allows the EU and the U.S. to differentiate in favor of current beneficiaries of non-reciprocal trade preference schemes in this way. This allows the EU and the U.S. to maintain the acquis without making radical changes to their trade and development policy. Where the status quo is an option, developing countries involved in FTA negotiations would have a feasible best alternative to a negotiated agreement (BATNA) to replace the current alternative of a significant reduction of market access to the EU or the U.S. While the maintenance of the status quo is up to the industrialized country in question, given that the trade preferences are unilateral in nature, the scheme constructed debunks the myth that there is a legal requirement to replace the current arrangements by reciprocal trade agreements in the absence of a waiver.
The spatial relationship between the musculature and the 5-HT and FMRFamide immunoreactivities in cercaria, metacercaria and adult Opisthorchis felineus (Digenea)
Authors: Tolstenkov Oleg , Terenina Nadezhda , Serbina Elena , Gustafsson Margaretha
Published: April 2010

The organisation of the neuromuscular system in cercariae, metacercariae and adult Opisthorchis felineus was studied. The patterns of nerves immunoreactive (IR) to antibodies towards serotonin (5-HT) and FMRFamide are described in relation to the musculature, stained with TRITC-conjugated phalloidin. The general organisation of the musculature in the body wall, suckers, pharynx, intestine and sphincter of the excretory pore remains the same from the larval stages to the adult worms. However, the diameter of the individual muscle fibres increases distinctly in the adult worms. The general pattern of 5-HT IR fibres in cercariae, metacercariae and adult O. felineus remains the same. Despite the large increase in body size, the number of 5-HT IR neurones remains almost the same in the cercariae and metacercariae and only a modest increase in number of neurones was observed in the adult worms. Thus the proportion of 5-HT IR neurones/body mass is greatest in the actively moving cercariae. Anti-FMRFamide stains the nervous system strongly.
Bat flies from the deciduous Atlantic Forest in southern Brazil: Host-parasite relationships and parasitism rates
Authors: Camilotti Vagner , Graciolli Gustavo , Weber Marcelo , Arruda Jeferson , Cáceres Nilton
Published: April 2010

This study describes the assemblage of ectoparasitic bat flies, their hosts, and parasitism rates in an Atlantic Forest area in southern Brazil. Bats were captured monthly for one year at two sites. We captured 95 bats belonging to nine species, but only Artibeus lituratus, Artibeus fimbriatus, Sturnira lilium (Phyllostomidae) and Myotis nigricans (Vespertilionidae) were found to be parasitized. The bat flies collected were: Streblidae — Paratrichobius longicrus (on A. lituratus) and Megistopoda aranea (on A. lituratus and A. fimbriatus), Megistopoda proxima (on S. lilium); Nycteribiidae — Basilia andersoni (on M. nigricans). Artibeus fimbriatus and S. lilium showed the highest values of parasite prevalence (60 and 35.7%, respectively) and mean intensities (1.9 and 2.1, respectively). Only two parasitized individuals of A. lituratus were found, resulting in the lowest local rate of parasite prevalence (2.6%) and mean intensity (1.0). This low rate may result from the use of ephemeral roosts in the area. The high values of frequency and number of flies per host on A. fimbriatus and S. lilium in relation to other studies could be explained by the low richness of bat flies here, and in turn, by low competition among fly species per host.
Different Tests, Different Answers
Authors: Papay John P.
Published: April 2010

Recently, educational researchers and practitioners have turned to value-added models to evaluate teacher performance. Although value-added estimates depend on the assessment used to measure student achievement, the importance of outcome selection has received scant attention in the literature. Using data from a large, urban school district, I examine whether value-added estimates from three separate reading achievement tests provide similar answers about teacher performance. I find moderate-sized rank correlations, ranging from 0.15 to 0.58, between the estimates derived from different tests. Although the tests vary to some degree in content, scaling, and sample of students, these factors do not explain the differences in teacher effects. Instead, test timing and measurement error contribute substantially to the instability of value-added estimates across tests.
Enhancing Parent Leadership Through Building Social and Intellectual Capital
Authors: Bolívar José M. , Chrispeels Janet H.
Published: April 2010

Inequality of access to educational resources by different social classes has been widely documented, and schools have instituted parent programs to ameliorate this situation. However, lacking are theoretically based studies that explain how and why a program may be effective in bringing about change. The authors studied a 12-week parent leadership program for Hispanics that provided opportunities for interaction, knowledge exchange, leadership development, trust building, and collective action—important components of social and intellectual capital. Their research shows that when parents participate in leadership development, they are empowered to effect changes that benefit their children through individual and collective actions. Some parent graduates founded organizations that continue to affect the educational system. The authors argue that the concepts of social and intellectual capital can inform parent involvement research and practice because they explain a community’s capability to engage in new forms of action.
College Graduation Rates for Minority Students in a Selective Technical University: Will Participation in a Summer Bridge Program Contribute to Success?
Authors: Murphy Terrence E. , Gaughan Monica , Hume Robert , Moore S. Gordon
Published: April 2010

There are many approaches to solving the problem of underrepresentation of some racial and ethnic groups and women in scientific and technical disciplines. Here, the authors evaluate the association of a summer bridge program with the graduation rate of underrepresented minority (URM) students at a selective technical university. They demonstrate that this 5-week program prior to the fall of the 1st year contains elements reported as vital for successful student retention. Using multivariable survival analysis, they show that for URM students entering as fall-semester freshmen, relative to their nonparticipating peers, participation in this accelerated summer bridge program is associated with higher likelihood of graduation. The longitudinal panel data include more than 2,200 URM students.
Above-ground carbon stock assessment in different forest types of Nepal
Authors: Baral SK , Malla R , Ranabhat S
Published: April 2010

This study assessed the above-ground carbon stock in the five major forest types, representing two physiographic regions and four districts of Nepal. Altogether, 116 circular sample plots were laid out systematically in different forests types to inventory the forest. Total above-ground biomass was derived with allometric equations. Results indicated variation in age of the stand (18-75 years), above-ground carbon stock per hectare (34.30- 97.86 dry wt. ton ha-1) and rate of carbon sequestration (1.30-3.21 t ha-1yr-1), according to different forest types. The rate of carbon sequestration by different forest types depended on the growing nature of the forest stands. Tropical riverine and Alnus nepalensis forest types demonstrated the highest carbon sequestration rates in Nepal. Key Words: Above-ground biomass; carbon; forest types; Nepal DOI: 10.3126/banko.v19i2.2979 Banko Janakari, Vol. 19, No.2 2009 pp.10-14
Galectins as Cancer Biomarkers
Authors: Balan Vitaly , Nangia-Makker Pratima , Raz Avraham
Published: April 2010

Galectins are a group of proteins that bind β-galactosides through evolutionarily conserved sequence elements of the carbohydrate recognition domain (CRD). Proteins similar to galectins can be found in very primitive animals such as sponges. Each galectin has an individual carbohydrate binding preference and can be found in cytoplasm as well as in the nucleus. They also can be secreted through non-classical pathways and function extra-cellularly. Experimental and clinical data demonstrate a correlation between galectin expression and tumor progression and metastasis, and therefore, galectins have the potential to serve as reliable tumor markers. In this review, we describe the expression and role of galectins in different cancers and their clinical applications for diagnostic use.
Acral Lentiginous Melanoma in Situ: A Diagnostic and Management Challenge
Authors: Park Hyun Sun , Cho Kwang Hyun
Published: April 2010

Early stage recognition of acral lentiginous melanoma (ALM) is important for a better prognosis, but in-depth understanding and proper management of ALM in situ is complicated, because there are only a few reports, probably due to its rarity and diagnostic difficulty. We have reviewed our experience with seven patients who were diagnosed as having ALM in situ and discuss how to accurately diagnose and properly manage these rare lesions. Clinically the lesions showed black to brown discoloration of the nail with Hutchinson’s sign and hyperpigmented macules on the heel with color variegation. All the lesions showed a diffuse lentiginous pattern of melanocytic proliferation with variable level of atypism along the dermoepidermal junction. Dermoscopic findings were available in three and revealed parallel ridge patterns. Confrontation of clinical and histopathologic findings was observed in three, and the lesions were not recognized or diagnosed as ALM in situ in the first place. Excision of the primary lesion with variable operative margin was done as an initial treatment. Recurrence was observed in three patients and one developed invasive ALM and lymph node metastasis. Integration of all available information concerning the clinical presentation, histopathology, and dermoscopic findings is very important and can lead to the best classification for correct diagnosis. Lack of knowledge upon clinical course and optimal margin to control ALM in situ provokes the need for further studies with longer follow up and larger number of cases.
Health Economic Assessment: Cost-Effectiveness Thresholds and Other Decision Criteria
Authors: Simoens Steven
Published: April 2010

An article published in this Journal argued that New Zealand does not apply a cost-effectiveness threshold because medicines are funded within a fixed budget and because cost-effectiveness is only one of nine criteria that inform decisions. This Comment has explained that, from a theoretical perspective, the cost-effectiveness threshold model is not inconsistent with these two arguments. The observed annual variation in incremental cost-effectiveness ratios in New Zealand may originate from yearly differences in new medicines that request reimbursement and in the budget size, and from the fact that decision makers take into account other decision criteria in addition to cost-effectiveness.
Cell Proliferation of HaCaT Keratinocytes on Collagen Films Modified by Argon Plasma Treatment
Authors: García Jorge López , Asadinezhad Ahmad , Pacherník Jiří , Lehocký Marián , Junkar Ita , Humpolíček Petr , Sáha Petr , Valášek Pavel
Published: April 2010

Argon plasma treatment was used to modify the surface of atelocollagen films using a plasmochemical reactor. To evaluate the effects of the treatment, the untreated and treated samples were characterized by Attenuated Total Reflectance Fourier Transform Infrared Spectroscopy (ATR-FTIR), Scanning Electron Microscopy (SEM) imaging, and X-ray Photoelectron Spectroscopy (XPS) techniques. Cell growth was carried out by culturing human immortalized keratinocyte (HaCaT) cells and proliferation was measured via MTT assay. It was observed that argon plasma treatment significantly enhanced the extent of cell proliferation, which was ascribed to the favourable role of plasma treatment in inducing surface oxygen-containing entities together with increasing surface roughness. This can be considered as a potentially promising approach for tissue regeneration purposes.
New Trends in Cancer Therapy: Targeting Ion Channels and Transporters
Authors: Arcangeli Annarosa , Becchetti Andrea
Published: April 2010

The expression and activity of different channel types mark and regulate specific stages of cancer establishment and progression. Blocking channel activity impairs the growth of some tumors, both in vitro and in vivo, which opens a new field for pharmaceutical research. However, ion channel blockers may produce serious side effects, such as cardiac arrhythmias. For instance, Kv11.1 (hERG1) channels are aberrantly expressed in several human cancers, in which they control different aspects of the neoplastic cell behaviour. hERG1 blockers tend to inhibit cancer growth. However they also retard the cardiac repolarization, thus lengthening the electrocardiographic QT interval, which can lead to life-threatening ventricular arrhythmias. Several possibilities exist to produce less harmful compounds, such as developing specific drugs that bind hERG1 channels in the open state or disassemble the ion channel/integrin complex which appears to be crucial in certain stages of neoplastic progression. The potential approaches to improve the efficacy and safety of ion channel targeting in oncology include: (1) targeting specific conformational channel states; (2) finding ever more specific inhibitors, including peptide toxins, for channel subtypes mainly expressed in well-identified tumors; (3) using specific ligands to convey traceable or cytotoxic compounds; (4) developing channel blocking antibodies; (5) designing new molecular tools to decrease channel expression in selected cancer types. Similar concepts apply to ion transporters such as the Na+/K+ pump and the Na+/H+ exchanger. Pharmacological targeting of these transporters is also currently being considered in anti-neoplastic therapy.
Ecological Citizens: Identifying Values and Beliefs that Support Individual Environmental Responsibility among Swedes
Authors: Jagers Sverker C. , Matti Simon
Published: April 2010

As it has been suggested that involvement of individuals in environmental work is necessary for halting environmental degradation, one focus for contemporary environmental policy and political theory is the need for comprehensive individual lifestyle changes. Ecological Citizenship (EC) has been suggested within the field of political theory as an approach to realize personal responsibility for the environment. However, empirical research on whether EC can serve this purpose is still lacking. Based on a survey sent to 4,000 Swedish households, this paper makes the theory of EC empirically operational and explores whether, and to what extent, people in general hold values and beliefs in line with what is expected of EC, in order to shed light on the feasibility of cultivating ecological citizens in Sweden. The study concludes that a significant proportion of the respondents do demonstrate a value base consistent with EC, i.e., non-territorial altruism and the primacy of social justice. While additional tests and studies are needed, the results support the use of EC as a theoretical model for behavioral change.
Ochratoxins—Food Contaminants: Impact on Human Health
Authors: Reddy Lalini , Bhoola Kanti
Published: April 2010

Ochratoxins are secondary metabolites of Aspergillus and Penicillium, that are hazardous to health through contamination of dietary foods. Ochratoxin A (OTA) remains the single most potent member of this group of mycotoxins. OTA has a long half-life in humans and is thus easily detected in serum. Dietary intake studies have confirmed link between endemic nephrotoxicity in humans to their daily household intake of OTA. OTA has been reported to contribute to endemic nephrotoxicity and carcinogenicity in humans and animals. OTA produces renal tumours, DNA adducts and chromosomal aberrations in kidneys. OTA may be embryotoxic, teratogenic, and immunotoxic only at doses higher than those causing nephrotoxicity. The incidence of endemic nephrotoxicity has been mostly reported in northeast Europe since the early fifties. Recent studies however have warned that OTA and other toxins, such as aristolochic acid, show very similar renal pathology. There is thus the need for thorough co-occurrence studies on toxin incidence.
Ochratoxin A and β2-Microglobulin in BEN Patients and Controls
Authors: Yordanova Pavlina , Wilfried Karmaus , Tsolova Svetla , Dimitrov Plamen
Published: April 2010

Ochratoxin A (OTA) is a mycotoxin naturally occurring in different foods. OTA is arguably a risk factor for Balkan endemic nephropathy (BEN). The aims of this study are to (1) test the OTA-BEN association in BEN-groups and controls and (2) determine whether urine β2-microglobulin, a marker of impaired ability of the kidneys to re-absorb, is related to OTA. BEN patients had significantly higher OTA serum levels. Within the offspring, OTA was significantly related to higher β2-microglobulin excretion. OTA (2005/2006) was related to a higher incidence of BEN after 2008, providing further evidence that OTA is a risk factor for BEN.
On IMIA‘s International Activities in Health and Biomedical Informatics Education
Authors: Haux R. , Murray P. J.
Published: April 2010

Background: Education has long been, and continues to be, one of the major thematic areas of the activities of IMIA, the International Medical Informatics Association.

Objective: To report on IMIA’s past activities and to discuss possible future perspectives on IMIA’s role on biomedical and health informatics education.

Methods: Summarizing past activities by searching in reports and publications. Making suggestions for wider discussion on possible future activities.

Results: Since its inception, IMIA has been active in the field of education, mainly through its working group on education. Among other activities, nine working conferences have been held, many of which have resulted in publications as outcomes, which have helped to exchange knowledge on the development of high-quality health and biomedical informatics education. Recommendations on education in health and medical informatics were endorsed by IMIA in 1999, and a revised version is currently in preparation.

Conclusions: IMIA should continue to stimulate the exchange of knowledge on a range of aspects of health and biomedical informatics education in the countries and regions of the world, with IMIA’s academic institutional members playing an increasing role. Establishing procedures for the international accreditation of high-level programs in health and biomedical informatics through IMIA is one of several areas that need to be discussed as IMIA plans and develops its future activities.
Semantic Validation of Standard-based Electronic Health Record Documents with W3C XML Schema
Authors: Janzek-Hawlat S. , Sibinovic S. , Duftschmid G. , Rinner C.
Published: April 2010

Objectives: The goal of this article is to examine whether W3C XML Schema provides a practicable solution for the semantic validation of standard-based electronic health record (EHR) documents. With semantic validation we mean that the EHR documents are checked for conformance with the underlying archetypes and reference model.

Methods: We describe an approach that allows XML Schemas to be derived from archetypes based on a specific naming convention. The archetype constraints are augmented with additional components of the reference model within the XML Schema representation. A copy of the EHR document that is transformed according to the before-mentioned naming convention is used for the actual validation against the XML Schema.

Results: We tested our approach by semantically validating EHR documents conformant to three different ISO/EN 13606 archetypes respective to three sections of the CDA implementation guide “Continuity of Care Document (CCD)” and an implementation guide for diabetes therapy data. We further developed a tool to automate the different steps of our semantic validation approach.

Conclusions: For two particular kinds of archetype prescriptions, individual transformations are required for the corresponding EHR documents. Otherwise, a fully generic validation is possible. In general, we consider W3C XML Schema as a practicable solution for the semantic validation of standard-based EHR documents.