bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional impairment severity is associated with health status among older persons with intellectual disability and cerebral palsy*
Authors: Henderson C. M. , Rosasco M. , Robinson L. M. , Meccarello J. , Janicki M. P. , Turk M. A. , Davidson P. W.
Published: September 2009

Background  Studies have noted high rates of specific health disorders in adults with cerebral palsy (CP). However, it remains unclear how growing older with a lifelong neuromotor physical disability confers risk for health outcomes in adults who have both intellectual disability (ID) and CP.

Aim  To assess the relationship between health status in older adults with ID either with or without coincident diagnoses of CP.

Method  Health status data were drawn from 1373 adults aged 33 to 79 years with ID living in small group homes in New York State. Their health status was defined by the presence of common health disorders. Of these, 177 subjects had coincident CP. Prevalence data for nine diseases representing different organ systems were obtained and compared in individuals with and without CP. A Severity of Functional Impairment Index (SFII) was developed based on subjects' capabilities in activities of daily living (ADLs) and mobility. Two logistic regression analyses were conducted to determine if CP diagnosis was an independent predictor of health disorder prevalence, or rather exerted effects similar to those without CP via severity of functional impairment as determined by SFII scores. In addition, older age, gender, and severity of intellectual disability were examined as predictors of health disorder prevalence in all study subjects.

Results  Individuals with CP had higher frequencies in four out of the nine health disorders (overweight/obesity, gastroesophageal reflux, urinary tract infections and dysphagia). Analysis revealed a statistically significant association between SFII score and CP diagnosis. CP diagnosis alone was a statistically significant predictor for all of the above four common disorders; however, after adjustment for SFII score was included in health disorder models, only dysphagia showed an independent correlation with a CP diagnosis.

Conclusion  With the exception of dysphagia, impairment in ADLs and walking capabilities, and not CP diagnosis alone, accounted for disparities in specific diseases. Although the diagnosis of CP may be correlated with functional impairment, it alone may play a minor role in determining health trajectories in older persons with conjoint ID and CP.
Goal achievement as a patient‐generated outcome measure for stress urinary incontinence
Authors: Milne Jill L. , Robert Magali , Tang Selphee , Drummond Neil , Ross Sue
Published: September 2009

Objectives  To explore women’s goals and goal attainment for the conservative and surgical treatment of stress urinary incontinence (SUI), and to examine the feasibility of Goal Attainment Scaling (GAS) as an outcome measure in this population.

Background  Despite the range of treatments for SUI, little is known about the outcomes patients consider important. Current instruments measure the impact of SUI on the ability to live a ‘normal’ life without addressing what normal looks like for the patient. Patient‐generated measures that address what a patient aims to achieve may fill this gap.

Design  A mixed‐methods exploratory design combined semi‐structured interviews with validated questionnaires and individualized rating of goal achievement.

Setting and participants  Participants with SUI (n = 18) were interviewed in their homes prior to initiation of treatment and 3–6 months afterwards.

Main variables  Participants reported individualized goals pre‐treatment and rated goal attainment after surgical and conservative therapy. Quality of life impact and change were measured using short forms of the Incontinence Impact Questionnaire and Urinary Distress Inventory.

Results  Women expressed a median of four highly individualized treatment‐related goals but goal achievement following conservative treatment was poor. GAS was not feasible as an outcome measure; women readily identified personal goals but could not independently identify graded levels of attainment for each goal.

Conclusions  Although further work is needed to examine the most feasible, valid, and reliable method of measuring goal achievement in research, asking patients with UI to identify pre‐treatment goals may provide useful information to guide treatment‐related decision making.
Full length sequence of a novel HLA‐B*132202 allele
Authors: Zou H.‐Y. , Cheng L.‐H. , Li Z. , Jin S.‐Z.
Published: September 2009

Full length sequences of this novel HLA‐B*132202 allele are identical to those of HLA‐B*132201 allele, except for a synonymous amino acid substitution from ACG to ACC at codon 138 in exon 3.
Cooperation as a volunteer’s dilemma and the strategy of conflict in public goods games
Authors: ARCHETTI M.
Published: September 2009

Conflict and cooperation for the exploitation of public goods are usually modelled as an N‐person prisoner’s dilemma. Many social dilemmas, however, would be described more properly as a volunteer’s dilemma, in which a certain number of individuals are necessary to produce a public good. If volunteering is costly, but so is failure to produce the public good, cheaters can invade and form a stable mixed equilibrium with cooperators. The dilemma is that the benefit for the group decreases with group size because the larger the group is, the less likely it is that someone volunteers. This problem persists even in the presence of a high degree of relatedness between group members. This model provides precise, testable predictions for the stability of cooperation. It also suggests a counterintuitive but practical solution for this kind of social dilemmas: increasing the damage resulting from the failure to produce the public good increases the probability that the public good is actually produced. Adopting a strategy that entails a deliberate risk (brinkmanship), therefore, can lead to a benefit for the society without being detrimental for the individual.
Self‐esteem in patients treated for anorexia nervosa
Authors: Karpowicz Ewa , Skärsäter Ingela , Nevonen Lauri
Published: September 2009

ABSTRACT:  Anorexia nervosa (AN) mainly affects girls or women between 13 and 45 years of age. According to previous studies, one of the reasons for the desire to be thin is low self‐esteem. The purpose of the study was to examine the self‐esteem of 38 female patients with AN between 16 and 25 years of age, before and after 3 months of treatment at a specialist ward for eating disorders in Göteborg, Sweden. A quantitative pre‐ and post‐assessment based on two self‐rating questionnaires, the Rosenberg Self‐Esteem Scale (RSE‐S) and three subscales (weight phobia, body dissatisfaction, and ineffectiveness) of Eating Disorder Inventory‐2 (EDI‐2), together with body mass index (BMI), were used in the study, which was conducted between June 2005 and March 2008. The results reveal that self‐esteem, BMI, weight phobia, and body dissatisfaction improved significantly between pre‐ and post‐treatment. The RSE‐S and EDI‐2 ineffectiveness correlate highly with one another, which lends support to convergent validity, and the internal consistency was high for both the RSE‐S and EDI‐2 ineffectiveness. The results indicate that the treatment was effective, as both patients' self‐esteem and BMI increased after completed treatment, which was the primary goal of the treatment at this ward. Future studies should focus on follow up and the way self‐esteem manifests itself at different points in time within an individual.
Preparing mental health nurses for the future workforce: An exploration of postgraduate education in Victoria, Australia
Authors: Happell Brenda , Gough Karla
Published: September 2009

ABSTRACT:  Problems with recruitment and retention in the mental health nursing workforce have been consistently acknowledged in the Australian literature. An Australian workforce scoping study conducted in 1999 revealed a significant shortfall between the number of nurses completing postgraduate mental health nursing programmes and both current and future workforce demands. Despite this, there has been no systematic analysis of these programmes to explain why they are not meeting workforce expectations. The primary aim of the current study was to elicit information about the number of applicants, enrolments, and completions during the 5‐year period, 2000–2004. This information was obtained through structured interviews with representatives from Victorian universities (n = 6) who offered postgraduate mental health nursing programmes. Supplementary information, such as approaches to course advertising and student demographics, was also collected. The findings showed an overall increase in the number of students applying to and completing these degrees, although changes in the level of programmes students undertook were evident during this period. Despite revealing important insights regarding postgraduate mental health nursing courses within Victorian universities, the lack of systematic and comprehensive data collection was identified as a problem that limits the extent to which university data can inform recruitment strategies.
Evaluation of exenatide vs. insulin glargine in type 2 diabetes: cost‐effectiveness analysis in the German setting
Authors: Mittendorf T. , Smith‐Palmer J. , Timlin L. , Happich M. , Goodall G.
Published: September 2009

Objectives: The objective of this analysis was to determine the cost‐effectiveness of exenatide vs. insulin glargine in patients with type 2 diabetes failing to achieve glycaemic control with oral antidiabetic agents, in the German setting, from a third‐party payer perspective.

Methods: Data from a published randomized controlled trial were used in combination with a published, validated computer simulation model of type 2 diabetes to project clinical and cost outcomes over a time horizon of 10 years. Cost data were obtained from published literature and expert opinion. Clinical and cost outcomes were discounted at 5% per annum. Sensitivity analyses were performed to establish key drivers and parameters.

Results: Treatment with exenatide compared with insulin glargine was projected to be associated with improvements in life expectancy of 0.016 years and quality‐adjusted life expectancy of 0.280 quality‐adjusted life years (QALYs), increased lifetime direct medical costs of € 3854 (€ 22 095 vs. € 18 242) and an incremental cost‐effectiveness ratio (ICER) of € 13 746 per QALY. If quality of life was not taken into account, exenatide was associated with an ICER of € 238 201 per life year gained vs. insulin glargine. Sensitivity analyses revealed that outcomes were most sensitive to changes in assumptions for (dis)utility values relating to weight change and the rate of self‐monitored blood glucose testing.

Conclusions: Exenatide was projected to be associated with similar clinical outcomes and increased costs compared with insulin glargine. Analysis of cost‐effectiveness from a third‐party perspective suggests that exenatide is likely to represent good value for money in the German setting.
TheDominant whitemutation in thePMEL17gene does not cause visual impairment in chickens
Authors: Karlsson Anna‐Carin , Kerje Susanne , Hallböök Finn , Jensen Per
Published: September 2009

Objective To examine whether theDominant whitemutation (causing a hypopigmented phenotype in chicken) affects the visual ability and gives rise to ocular abnormalities in chickens (Gallus gallus).

Procedure Chickens homozygous for either theDominant whitemutation or the wild‐type alleles were tested in a visual contrast behavioral test and subjected to histological and ophthalmologic examination.

Results There were no differences between the genotypes in the visual contrast behavioral test, and there were no abnormal structures among theDominant whitechickens in the ophthalmic examination. The histological sections from theDominant whitechickens did not differ from the wild‐type chicken in structure, photoreceptor density, or RPE pigmentation.

Conclusions The results indicate that theDominant whitemutation inPMEL17does not seem to affect the visual ability or eye structures in chickens.
In vitrosusceptibility patterns ofAspergillusandFusariumspecies isolated from equine ulcerative keratomycosis cases in the midwestern and southern United States with inclusion of the new antifungal agent voriconazole
Authors: Pearce Jacqueline W. , Giuliano Elizabeth A. , Moore Cecil P.
Published: September 2009

Objective To evaluate and compare thein vitrosusceptibility ofAspergillusandFusariumspp. isolated from horses with ulcerative keratomycosis, address regional differences in equine keratomycosis isolates, and provide susceptibility data to update prior studies.

Animal studied Fourteen horses with ulcerative keratomycosis.

Procedures Banked fungal isolates from equine corneal ulcers (eightAspergillusspp. and sixFusariumspp.) were identified at The University of Texas Health Science Center at San Antonio.In vitrominimum inhibitory concentration and susceptibility to natamycin, fluconazole, itraconazole, voriconazole, ketoconazole, and miconazole were determined for each isolate.

Results Fungi were significantly more susceptible to voriconazole than to natamycin, itraconazole, fluconazole, and ketoconazole, but miconazole susceptibility did not differ significantly from voriconazole.Aspergillusspp. were most susceptible to voriconazole, miconazole, and itraconazole, which were significantly better to fluconazole and ketoconazole.Fusariumspp. susceptibility was greatest to natamycin and voriconazole and lowest to itraconazole and ketoconazole.Fusariumspp. were significantly less susceptible to itraconazole and ketoconazole compared to natamycin. No significant differences in susceptibility were found when isolates from Florida were compared with isolates from other states.

Conclusions and clinical relevance Based onin vitroevidence, voriconazole appears to be the most effective antifungal for initial treatment of equine keratomycosis in the midwestern and southern United States. Results are comparable with previous studies in that isolated fungi from equine keratomycosis cases showed consistently poor susceptibility to fluconazole. Organisms isolated in different geographic locations of the midwestern and southern United States appeared to have similar patterns of antifungal susceptibility.
Contrasting response of native and alien plant species richness to environmental energy and human impact along alpine elevation gradients
Authors: Marini Lorenzo , Gaston Kevin J. , Prosser Filippo , Hulme Philip E.
Published: September 2009

Aim  We tested whether the species–energy and species–human relationships vary between native and both naturalized and casual alien species richness when other environmental variables had been taken into account.

Location  Trento Province, a region (c. 6200 km2) on the southern border of the European Alps (Italy), subdivided into 156 contiguous (c. 37.5 km2) cells and ranging in elevation from 66 to 3769 m.

Methods  Data were separated into three subsets, representing richness of natives, naturalized aliens and casual aliens and separately related to temperature, human population and various environmental correlates of plant species diversity. We applied ordinary least squares and simultaneous autoregressive regressions to identify potential contrasting responses of the three plant status subsets and hierarchical partitioning to evaluate the relative importance of the predictor variables.

Results  Variation in alien plant species richness along the region was almost entirely explained by temperature and human population density. The relationships were positive but strongly curvilinear. Native species richness was less strongly related to either factor but was positively related to the presence of calcareous bedrock. Native species richness had a decelerating positive relationship with temperature (R2= 55%), whereas naturalized and casual aliens had a positive accelerating relationship explaining 86% and 62% of the variation in richness, respectively. Native species richness had a positive decelerating relationship with population density (R2= 42%), whilst both alien subsets had a positive accelerating relationship.

Main conclusions  Alien species richness was higher in areas with the most rich and diverse assemblages of native species. Areas at high altitudes are not especially prone to alien invasion due to energy constraints, low propagule pressure and disturbance, even considering a potential increased in temperature. Thus, if we consider future environmental change, we should expect a stronger response of aliens than natives in the currently warm, urbanized, low‐altitude areas than in cold, high‐altitude areas where human population density is low.
Government Subsidies for Professional Team Sports in Australia
Authors: Wilson John K. , Pomfret Richard
Published: September 2009

Professional team sports represent an important aspect of Australian life. Interest is great, and a significant portion of household expenditure is directed toward sports‐related goods and services. Based on international comparisons and on the size of attendance and television revenues, the sector should be highly profitable. Yet, significant amounts of public funding and regulatory exemptions are afforded to team sports in Australia. This article analyses the magnitude and reasons for government spending that subsidises professional team sports.
Obituary: Professor Samuel H. Beer (1911–2009)
Authors: Benewick Robert
Published: September 2009

Samuel H. Beer, the distinguished authority on the theory and practice of British politics, died at the age of 97 on 7 April 2009. His achievement as a scholar, a highly revered teacher and a political activist are well known and widely acknowledged. He was the first foreigner to be honoured as a vice-president of the Political Studies Association and the first recipient of the Isaiah Berlin prize for Lifetime Achievement in Politics. In 2007 the Political Studies Association made a special presentation at the annual meeting of the American Political Science Association in recognition of his long and distinguished contribution to the study of British politics. He was president of the British Politics Group whose annual award for the best dissertation was named after him. Honorary degrees were bestowed upon him by Harvard, Depauw and Drake Universities in the US and Sussex and Ulster in the UK. He was honoured at a seminar and dinner in the House of Lords on the occasion of his 90th birthday attended by politicians and journalists as well as academics. He did not let on until some time later that it was only his 89th birthday. A similar occasion organised by former colleagues and students in the US got the timing right.
A Smoothing Algorithm for Estimating Stochastic, Continuous Time Model Parameters and its Application to a Simple Climate Model
Authors: Tomassini Lorenzo , Reichert Peter , Künsch Hans R. , Buser Christoph , Knutti Reto , Borsuk Mark E.
Published: September 2009

Even after careful calibration, the output of deterministic models of environmental systems usually still show systematic deviations from measured data. To analyse possible causes of these discrepancies, we make selected model parameters time variable by treating them as continuous time stochastic processes. This extends an approach that was proposed earlier using discrete time stochastic processes. We present a Markov chain Monte Carlo algorithm for Bayesian estimation of such parameters jointly with the other, constant, parameters of the model. The algorithm consists of Gibbs sampling between constant and time varying parameters by using a Metropolis–Hastings algorithm for each parameter type. For the time varying parameter, we split the overall time period into consecutive intervals of random length, over each of which we use a conditional Ornstein–Uhlenbeck process with fixed end points as the proposal distribution in a Metropolis–Hastings algorithm. The hyperparameters of the stochastic process are selected by using a cross-validation criterion which maximizes a pseudolikelihood value, for which we have derived a computationally efficient estimator. We tested our algorithm by using a simple climate model. The results show that the algorithm behaves well, is computationally tractable and improves the fit of the model to the data when applied to an additional time-dependent forcing component. However, this additional forcing term is too large to be a reasonable correction of estimated forcing and it alters the posterior distribution of the other, time constant parameters to unrealistic values. This difficulty, and the impossibility of achieving a good simulation when making other parameters time dependent, indicates a more fundamental, structural deficit of the climate model. This is probably related to the poor resolution of the ocean in the model. Our study demonstrates the technical feasibility of the smoothing technique but also the need for a careful interpretation of the results.
Inference for Two-Stage Adaptive Treatment Strategies Using Mixture Distributions
Authors: Wahed Abdus S.
Published: September 2009

Treatment of complex diseases such as cancer, leukaemia, acquired immune deficiency syndrome and depression usually follows complex treatment regimes consisting of time varying multiple courses of the same or different treatments. The goal is to achieve the largest overall benefit defined by a common end point such as survival. Adaptive treatment strategy refers to a sequence of treatments that are applied at different stages of therapy based on the individual’s history of covariates and intermediate responses to the earlier treatments. However, in many cases treatment assignment depends only on intermediate response and prior treatments. Clinical trials are often designed to compare two or more adaptive treatment strategies. A common approach that is used in these trials is sequential randomization. Patients are randomized on entry into available first-stage treatments and then on the basis of the response to the initial treatments are randomized to second-stage treatments, and so on. The analysis often ignores this feature of randomization and frequently conducts separate analysis for each stage. Recent literature suggested several semiparametric and Bayesian methods for inference related to adaptive treatment strategies from sequentially randomized trials. We develop a parametric approach using mixture distributions to model the survival times under different adaptive treatment strategies. We show that the estimators proposed are asymptotically unbiased and can be easily implemented by using existing routines in statistical software packages.
Preliminary evaluation of electroencephalographic entrainment using thalamocortical modelling
Authors: Cvetkovic Dean , Powers Robert , Cosic Irena
Published: September 2009

Abstract: The concept of linked oscillators in biological control systems has long been established. Frequency entrainment is a predominant explanation behind many biological rhythms. In this paper a preliminary examination of electroencephalographic entrainment is made to survey the possibility and methods of achieving signal entrainment at the highest level of neurological organization and function. A model of the thalamocortical system is employed to generate simulated electroencephalographic signals and is tested in various configurations in the search for entrainment under very simple conditions. Additionally, an analysis of the coupled Van der Pol model of the circadian rhythm controller is performed to identify the possibility of affecting that system with a drastically different coupling input signal. We were able to conclude that overall signal shape can have a significant impact on the entrainment characteristics of the system. Due to the nature of the underlying mathematical structure of the model, by examining the circadian rhythm controller, we found that it is unsuitable for entrainment to an incident entraining signal of much higher frequency.
Adaptive local hyperplane algorithm for learning small medical data sets
Authors: Yang Tao , Kecman Vojislav
Published: September 2009

Abstract: It is not unique that only a few samples from medical studies are available for knowledge discovery. Hence, a suitable classifier for the small data set learning problem is very interesting in medical work. In this paper, we experiment with the adaptive local hyperplane algorithm on small medical data sets. The experimental results on two cancer data sets demonstrate that the proposed classifier outperforms, on average, all the other four benchmarking classifiers for learning small data sets.
Fuzzy based fast dynamic programming solution of unit commitment with ramp constraints
Authors: Patra S. , Goswami S.K. , Goswami B.
Published: September 2009

Abstract: A fast dynamic programming technique based on a fuzzy based unit selection procedure is proposed in this paper for the solution of the unit commitment problem with ramp constraints. The curse of dimensionality of the dynamic programming technique is eliminated by minimizing the number of prospective solution paths to be stored at each stage of the search procedure. Heuristics like priority ordering of the units, unit grouping, fast economic dispatch based on priority ordering, and avoidance of repeated economic dispatch through memory action have been employed to make the algorithm fast. The proposed method produced comparable results with the best performing methods found in the literature.
Migraines with and without aura and their response to preventive therapy with topiramate
Authors: Reuter U , Del Rio MS , Diener H-C , Allais G , Davies B , Gendolla A , Pfeil J , Schwalen S , Schäuble B , van Oene J
Published: September 2009

Data from the Prolonged Migraine Prevention (PROMPT) with Topiramate trial were evaluated post hoc to determine whether topiramate could prevent migraine auras, and whether its efficacy in preventing migraine headaches was similar in patients with (MA; n = 269) and without (MoA; n = 542) aura. Migraines and auras were recorded during prospective baseline, 6-month open-label (OL) topiramate and 6-month double-blind (DB), placebo-controlled phases. In the last 28 OL days, migraines without aura and migraine auras decreased by 43.1% and 54.1%, respectively, in MA patients. MoA patients experienced a 44.3% reduction in migraines. In the DB phase, increases in migraines with placebo vs. topiramate were similar to the full study, but were generally not statistically significant, probably due to lack of power in the subgroup analysis. Similarly, there were no statistically significant changes in number of auras between groups. Thus, topiramate appears to reduce migraine auras in parallel with headache reductions, which are similar in patients with and without aura.
Triptans: Low utilization and high turnover in the general population
Authors: Panconesi A , Pavone E , Franchini M , Mennuti N , Bartolozzi ML , Guidi L , Banfi R
Published: September 2009

Studies performed in selected populations have shown a poor utilization of triptans for migraine. Our study was aimed at establishing patterns of triptans utilization in a large community using the pharmaceutical prescriptions database of two consecutive years in a regional Health Authority in Italy. About 0.5% of the population observed received triptans prescriptions in a year, but > 50% of the cases received only one prescription. On the other hand, 46% of triptan users did not receive a triptan prescription in the following year (past users): in 80% of cases, patients received only 1–2 triptan packages. The evaluation of the discontinued triptan type has shown percentages varying between 30 and 70%. The percentage of triptan users who received a triptan prescription for the first time in the successive year of study (new users) was 52%. These findings together highlight a high turnover in triptans utilization. Less than 15% of subjects received more than one triptan product in the 2 years. In conclusion, we observed a low percentage of triptan users and a low rate of utilization, associated with a high percentage of discontinuation and new utilization (high turnover), without any substantial increase in triptans utilization during the years. All these data probably do not support optimal satisfaction with triptan therapy.
Right-to-left shunt is common in chronic migraine
Authors: Nahas SJ , Young WB , Terry R , Kim A , Van Dell T , Guarino AJ , Silberstein SD
Published: September 2009

Our aim was to determine the prevalence of right-to-left shunt (RtLS) in patients with chronic migraine (CM), and to correlate the presence and grade of RtLS with aura and neurological symptoms, and duration and severity of disease. The prevalence of RtLS in migraine without aura is similar to that of the general population (between 20 and 35%). In migraine with aura, the prevalence is much higher (approximately 50%). The prevalence in CM, with or without aura, is unknown. Consecutive patients between the ages of 18 and 60 years with CM attending a tertiary care specialty headache clinic over an 8-week period were eligible. There were 131 patients in the study. A structured diagnostic interview was performed. Bubble transcranial Doppler with Valsalva manoeuvre determined RtLS presence and grade. Sixty-six percent (86/131) of patients had RtLS, a statistically significantly greater rate than those reported in the general population and in migraine with or without aura ( P < 0.001). There was no difference in RtLS rate or grade between those with and those without aura. Specific headache features and the presence of neurological symptoms were similar between those with and those without RtLS. Compared with both the general population and the episodic migraine population (with and without aura), patients with CM, with or without aura, are more likely to have RtLS. The clinical implications of our findings need to be determined.
A molecular diagnostic for identifying central African forest artiodactyls from faecal pellets
Authors: Ntie S. , Johnston A. R. , Mickala P. , Bowkett A. E. , Jansen van Vuuren B. , Colyn M. , Telfer P. , Maisels F. , Hymas O. , Rouyer R. L. , Wallace R. A. , LeBlanc K. , Van Vliet N. , Sonet G. , Verheyen E. , Pires D. , Wickings E. J. , Lahm S. A. , Anthony N. M.
Published: September 2009

Small to medium‐sized central African forest artiodactyls constitute a diverse yet heavily hunted group composed primarily of species within the genera Cephalophus, Neotragus, Tragelaphus and Hyemoschus. Of these genera, Cephalophus is the richest with as many as seven sympatric species known to occur in central African forests. However, differentiating species from their faeces or from tissue where the whole carcass is unavailable is very difficult. In order to develop a robust molecular diagnostic for species identification, a database of mitochondrial cytochrome b (553 bp) and control region (∼675 bp) sequences was compiled from all forest Cephalophus species and other similarly sized, sympatric Tragelaphus, Neotragus and Hyemoschus species. Reference phylogenies from each marker were then used to recover the identity of sequences obtained from unknown faecal samples collected in the field. Results were then compared to determine which region best recovered species identity with the highest statistical support. Restriction fragment length polymorphisms (RFLPs) were also assessed as an alternative method for rapid species identification. Of the methods examined, tree‐based analyses built on a geographically comprehensive database of control region sequences was the best means of reliably recovering species identity from central African duikers. However, three sister taxa appear indistinguishable (Cephalophus callipygus, Cephalophus ogilbyi and Cephalophus weynsi) and not all species were monophyletic. This lack of monophyly may be due to incomplete lineage sorting commonly observed in recently derived taxa, hybridization or the presence of nuclear translocated copies of mitochondrial DNA. The high level of intra‐specific variation and lack of robust species‐specific diagnostic sites made an RFLP‐based approach to duiker species identification difficult to implement. The tree‐based control region diagnostic presented here has many important applications including fine‐scale mapping of species distributions, identification of confiscated tissue and environmental impact assessments.
Transition to adult services for young people with disabilities: current evidence to guide future research
Authors: STEWART DEBRA
Published: September 2009

This article outlines the evidence upon which best practice guidelines for transition to adulthood for young people with physical and developmental disabilities were developed in Ontario, Canada, through consensus activities. Evidence was gathered from published and unpublished literature and focus groups with young people, parents, community members, service providers and policy makers across the province. The evidence was then synthesized and analyzed by an expert panel. Guidelines were developed in the areas of collaboration, capacity‐building, information, education, and research. This article focuses on the findings of this project as they relate to transition services and care. These best practice guidelines for the transition to adulthood for young people with disabilities offer a starting point to encourage service providers to work collaboratively with young people, parents, communities, governments, and researchers. The evidence from this project supports a move away from purely service‐driven models of transition to holistic, lifecourse/lifespan approaches. Recommendations for future study and collaborative knowledge dissemination are provided.
Health, mortality, and wellness issues in adults with cerebral palsy
Authors: TURK MARGARET A
Published: September 2009

For many years, children with cerebral palsy (CP) and their parents have been told that health and functional status stabilize by early adulthood. However, adults with CP report ongoing health conditions and aging and secondary conditions that are not always recognized or managed by their healthcare providers. There is a growing body of literature to better define the health, mortality, and wellness of those aging with CP. In general, adults with CP report good health, although health outcomes appear to be linked to the severity of CP and to increasing age. Studies reporting on lifespan warrant caution in interpretation because of biases in the survey and surveillance systems. It appears that lifespan of persons with CP is at or close to that of the typical population. The most commonly reported age‐related changes and secondary conditions involve pain/fatigue, physical performance, and the musculoskeletal system. Not all adults have serious health problems, and many now recognize the aging process as a natural course of events. Few adults with CP engage in typical screening and health promotion activities due to a variety of barriers. There continues to be much to be learned and disseminated, in order to improve the care of adults with CP.
Scoliosis in cerebral palsy
Authors: KOOP STEVEN E
Published: September 2009

Spinal deformity is a common musculoskeletal problem for individuals with cerebral palsy. Severe scoliosis may impair physical function and may be a source of pain. Spine braces and carefully constructed seating arrangements may moderate the behavior of these deformities but do not seem capable of stopping progression, which often continues in adulthood. Spine fusion surgery can produce a stable, durable trunk shape that improves sitting and positioning but the process of surgery is arduous and outcomes can be compromised by numerous serious complications. Despite complications, many families and caregivers express satisfaction with the results of surgery. Careful patient evaluation, studious attention to surgical planning and performance, and a good relationship with patients, family members, and other providers is essential.
Adults with cerebral palsy: a workshop to define the challenges of treating and preventing secondary musculoskeletal and neuromuscular complications in this rapidly growing population
Authors: TOSI LAURA L , MAHER NANCY , MOORE D WINSLOW , GOLDSTEIN MURRAY , AISEN MINDY L
Published: September 2009

Although the neurological injury associated with cerebral palsy (CP) is non‐progressive, adults with the disorder often develop musculoskeletal and neurological symptoms, such as severe pain, chronic fatigue, and a premature decline in mobility and function, as they age. Little is known about how to manage, much less prevent, these symptoms. This paper summarizes the findings of a multi‐disciplinary workshop, sponsored by the Cerebral Palsy International Research Foundation, the American Academy for Cerebral Palsy and Developmental Medicine, and Reaching for the Stars, convened to review current knowledge and begin to develop a blueprint for future research. The goals of the workshop were to (1) define the current incidence and prevalence of CP, (2) review the known complications for persons aging with CP, (3) review current understanding of physiological processes that may contribute to loss of function and premature aging in CP, (4) evaluate current treatment interventions in terms of long‐term outcomes, (5) identify cutting‐edge technologies in neurorehabilitation that may help prevent or treat the effects of accelerated aging for persons diagnosed with CP, and (6) identify strategies to ensure that individuals with CP receive evidence‐based care as they transition from pediatric to adult‐care services.
Is elevated noradrenaline an aetiological factor in a number of diseases?
Authors: Fitzgerald P. J.
Published: September 2009

1 Here I put forth the hypothesis that noradrenaline (NA), which is a signalling molecule in the brain and sympathetic nervous system (SNS), is an aetiological factor in a number of diseases.

2 In a previous paper (Fitzgerald,Int. J. Cancer,124, 2009, 257), I examined evidence that elevated NA is a factor in various types of cancer. Here I extend the argument to several other diseases, including diabetes mellitus, open‐angle glaucoma, osteoarthritis and rheumatoid arthritis and asthma.

3 The principal hypothesis is that, largely as a result of genetics, elevated noradrenergic tone in the SNS predisposes a large number of individuals to a broad range of diseases.

4 For each of the above five diseases, I briefly examine the following four lines of evidence to assess the hypothesis: i) whether pharmacological studies in rodents that manipulate NA levels or receptors affect these diseases; ii) whether pharmacological manipulation of NA in humans affects these diseases; iii) whether bipolar disorder, excessive body weight, and hypertension, which may all three involve elevated NA, tend to be comorbid with these diseases and iv) whether psychological stressors tend to cause or exacerbate these conditions, since psychological stress is associated with increased release of NA.

5 The four lines of evidence tend to support the hypothesis.
Calorie restriction reduces rDNA recombination independently of rDNA silencing
Authors: Riesen Michèle , Morgan Alan
Published: September 2009

Calorie restriction (CR) extends lifespan in yeast, worms, flies and mammals, suggesting that it acts via a conserved mechanism. In yeast, activation of the NAD‐dependent histone deacetylase, Sir2, by CR is thought to increase silencing at the ribosomal DNA, thereby reducing the recombination‐induced generation of extrachromosomal rDNA circles, hence increasing replicative lifespan. Although accumulation of extrachromosomal rDNA circles is specific to yeast aging, it is thought that Sirtuin activation represents a conserved longevity mechanism through which the beneficial effects of CR are mediated in various species. We show here that growing yeast on 0.05 or 0.5% glucose (severe and moderate CR, respectively) does not increase silencing at either sub‐telomeric or rDNA loci compared with standard (2% glucose) media. Furthermore, rDNA silencing was unaffected in the hxk2Δ, sch9Δ and tor1Δ genetic mimics of CR, but inhibited by FOB1 deletion. All these interventions extend lifespan in multiple yeast backgrounds, revealing a poor correlation between rDNA silencing and longevity. In contrast, CR and deletion of the FOB1, HXK2, SCH9 and TOR1 genes, all significantly reduced rDNA recombination. This silencing‐independent mechanism for suppressing rDNA recombination may therefore contribute to CR‐mediated lifespan extension.
The effect of spironolactone on sweat and urinary sodium excretion during exercise in humans
Authors: Lee Nanette V. L. , Miller Paul W. , Buono Michael J.
Published: September 2009

This study examined the effect of spironolactone on urinary ([Na+]urine) and sweat sodium concentration ([Na+]sweat) when controlling for sweat rate. Fifteen healthy subjects were required to complete two 90‐min exercise bouts (three 30‐min ordered exercise bouts at 60%, 70%, and 80% of the subjects’ age‐predicted maximum heart rate) in a 35°C and 40% relative humidity environmental chamber, once after administration of 300 mg spironolactone, and once after administration of 300 mg placebo. Both the drug and placebo were taken over an 18 h period, with the second 100 mg dose taken 6 h prior to exercise, and the first 200 mg dose taken 12 h prior to the second dose. Sweat rate was measured during each of the three exercise bouts using a Macroduct® sweat collector affixed to the flexor surface of the forearm. Urine sodium excretion rate was calculated for the three hour period immediately prior to each exercise bout. Urinary and sweat sodium concentrations were analyzed via flame photometry. Spironolactone had no effect on [Na+]sweat at the different sweat rates. However, the urinary sodium excretion rate was significantly higher with spironolactone use (P<0·05). These results demonstrate that spironolactone caused the expected natriuresis, but greater sodium excretion was not observed in the sweat gland. Since the mineralocorticoid receptors (MR) in the sweat gland were not antagonized by spironolactone in the same manner as those in the kidney, this suggests that different isoforms of the MR exist in the kidney and the sweat gland of humans.
Englishness and the Union in Contemporary Conservative Thought
Authors: English Richard , Hayton Richard , Kenny Michael
Published: September 2009

This article analyses the importance of arguments developed since 1997 by influential right-wing commentators concerning Englishness and the United Kingdom. Drawing on historical, cultural and political themes, public intellectuals and commentators of the right have variously addressed the constitutional structure of the UK, the politics of devolved government in Wales and Scotland, and the emergence of a more salient contemporary English sensibility. This article offers case studies of the arguments of Simon Heffer, Peter Hitchens and Roger Scruton, all of whom have made controversial high-profile interventions on questions of national identity, culture and history. Drawing on original interviews with these as well as other key figures, the article addresses three central questions. First, what are the detailed arguments offered by Heffer, Hitchens and Scruton in relation to Englishness and the UK? Second, what does detailed consideration of these arguments reveal about the evolution of the politics of contemporary conservatism in relation to the Union? And, third, what kinds of opportunity currently exist for intellectuals and commentators on the fringes of mainstream politics to influence the terms of debate on these issues?
Opposition in Consensual Switzerland: A Short but Significant Experiment
Authors: Church Clive H. , Vatter Adrian
Published: September 2009

Although conventional wisdom sees Switzerland as oppositionless, in December 2007 its biggest party, the Swiss People's Party (SVP), declared itself in ‘opposition’. It implied this was something dramatic but implementation was hesitant, degenerating into personalized attacks on the minister elected over its party leader. This led to splits in the party and the strategy petered out, with the SVP returning to collegial government, consensus having proved too strong. Although political science has recently neglected opposition, the SVP's understanding of the concept was distant from most ideas of ‘opposition politics’, notably Anglo-Saxon practices. The experiment is therefore best understood as a rhetorical flourish, arising out of the SVP's powerful, but unusual, populism. Though unsuccessful, it shows Swiss politics are changing and the populist challenge remains.
DNA Sequence Conservation and Diversity in Transposable Element IS605 of Helicobacter pylori
Authors: Höök‐Nikanne Johanna , Berg Douglas E. , Peek Richard M. , Kersulyte Dange , Tummuru Murali K. R. , Blaser Martin J.
Published: September 2009

Background. IS605, a transposable element‐like sequence identified in the virulence‐associated cag region of Helicobacter pylori reference strain NCTC11638, is unusual in containing two oppositely‐oriented open reading frames whose products are homologues of the single transposases of the unrelated elements, IS200 and IS1341.

Methods. One hundred independent H. pylori isolates from different parts of the world were screened by PCR and dot blot hybridization to determine the presence of IS605. For some positive isolates, southern hybridizations and sequence analyses were done.

Results. Of the 100 isolates, 31 were found to contain sequences related to each ORF with orientation and spacing matching those in canonical IS605‐hybridizing sequences. No isolate containing just one ORF and not the other was found. The frequencies of IS605 carriage were independent of geographical origin (U.S. vs. non‐U.S.), and of the probable virulence of the isolate (cag status, toxin production or vacA alleles, patient symptoms). Southern blot hybridization of six IS605‐containing strains revealed one to nine IS605 copies per genome. Two types of DNA sequence diversity were found: first, a specific 100 bp deletion in two isolates; second, base substitution divergence of 0.4% to 7.5% in pairwise comparisons among the eight isolates characterized, a level of divergence similar to that seen in other H. pylori chromosomal genes.

Conclusions. Based on these findings, we speculate that IS605 is a relatively ancient component of the H. pylori gene pool that has proliferated in this species by horizontal gene transfer, homologous recombination, and transposition.