bluuebunny/crossref_metadata_2025 huggingface dataset:
Measuring health system resource use for economic evaluation: a comparison of data sources
Authors: Pollicino Christine , Viney Rosalie , Haas Marion
Published: February 2010

A key challenge for evaluators and health system planners is the identification, measurement and valuation of resource use for economic evaluation. Accurately capturing all significant resource use is particularly difficult in the Australian context where there is no comprehensive database from which researchers can draw. Evaluators and health system planners need to consider different approaches to data collection for estimating resource use for economic evaluation, and the relative merits of the different data sources available. This paper illustrates the issues that arise in using different data sources using a sub-sample of the data being collected for an economic evaluation. Specifically, it compares the use of Australia's largest administrative database on resource use, the Health Insurance Commission database, with the use of patient-supplied data. The extent of agreement and discrepancies between the two data sources is investigated. Findings from this study and recommendations as to how to deal with different data sources are presented.
The battle against SARS: a Chinese story
Authors: Liu Chaojie
Published: February 2010

SARS is the first major new infectious disease in the 21st century (Rodier, 2003) and is described as a "serious disaster"in mainland China where it caused unprecedented panic and social and economic consequences. A total of 5,327SARS cases were reported, with 348 deaths (Ministry of Health, 2003a). Although the Chinese government wascriticised by the international community for underreporting at the early stages of the SARS epidemic (Editor CMAJ,2003a), China eventually achieved remarkable success in combating SARS.This paper documents some aspects of the Chinese experience in fighting against SARS, based on interviews with myChinese colleagues, analysed with reference to government policy documents and published articles. My intervieweesincluded health officials at the central, provincial and municipal levels and hospital managers who had been workingin the frontline of the battle against SARS.
Emergency Presentations to Northern Territory Public Hospitals: Demand and Access Analysis
Authors: Lee Andy H , Meuleners Lynn B , Zhao Yuejen , Intrapanya Methinee , Palmer Didier , Mowatt Elizabeth
Published: February 2010

This study aims to quantify trends in emergency presentations to Northern Territory (NT) public hospitals over thepast five years with respect to demand and access. Retrospective analysis was undertaken on data extracted from theNT Module of Caresys and the Hospital Morbidity Data System. There has been a 4.6% decrease in presentations tothe five public hospitals between 1996 and 2001 compared to a 9.4% growth in the population. Despite the apparentdecline in total presentations, the acuity of patients has increased dramatically over the same period. Access analysis ofpresentations seen within the recommended triage time revealed considerable variability, especially for triage categories2, 3 and 4. The access block problem, discrepancies in recorded waiting time and irregularities among the regionalhospitals within the triage system have also been identified. Recommendations including improved access to inpatientbeds and admission to wards were developed in response to the changing role of the emergency department.
Hospital health care worker (HCW) vaccination coverage after implementation of an HCW vaccination policy
Authors: Smithers Penny , Murray Sally B , Stewart Sophie , Skull Sue
Published: February 2010

The purpose of this study was to assess knowledge, attitudes, practices, and self-reported vaccination status of HCWs at a tertiary Australian hospital, one year after implementation of a HCW vaccination policy.Two cross-sectional telephone surveys were conducted with HCWs at the hospital prior to and one year after HCW vaccination policy implementation. There was a 95% (272/287) response rate from eligible HCWs in the follow-up survey.Despite 96% (260/272) of HCWs indicating a willingness to update their vaccination status, only 24% (65/272) reported being fully vaccinated. Successful policy implementation requires adequate resource allocation and organisational commitment. Ongoing evaluation can inform the success of this process.
Delayed discharges from an adult intensive care unit
Authors: Williams Teresa , Leslie Gavin
Published: February 2010

Objective: Intensive Care Unit (ICU) services are
expensive, and therefore appropriate utilisation is
imperative. Delayed discharges impact on the
efficiency and effectiveness of ICU services. This
study examines the prevalence and reasons for
delayed discharge.
Method: Cross sectional study. We enrolled a
prospective sample of all patients admitted to a
22-bed ICU over a 6-month period. Medical staff
in ICU informed nursing shift coordinators when
patients could be discharged. Nursing shift coordinators
maintained a record of discharge times,
delays and reasons for delay. Discharge was
considered delayed if the patient was not relocated
from the ICU within 8 hours of being considered
eligible by ICU medical staff.
Results: Of 652 recorded discharges, 176 were
delayed (27%). Unavailable ward beds (81%)
were cited as the main reason for delay in discharge.
Median delay time was 21.3 hours (range,
10 minutes to 26 days). These delays were predicted
by greater patient acuity on ICU admission,
patient deterioration while waiting for transfer to
the ward, principal admitting diagnosis, discharge
destination and weekend discharge.
Conclusion: Improvement in bed management
and discharge processes (the only factors directly
controllable by the hospital) is essential to reduce
delays in discharge from ICU. Reducing discharge
delays would free up beds for other admissions;
may result in a cost saving for the hospital through
more efficient resource utilisation; and, ultimately,
would benefit patients.
Improving mental health services in a local area — an exploratory study
Authors: Buchan Terry , Boldy Duncan P
Published: February 2010

The change in the focus of care for people with
mental illness from hospital to community has
been far from uniformly successful for a variety of
reasons. A review of the development of mental
health services suggests that the views of doctors
and the responses of administrative systems are
significant forces in shaping the development of
services. This study explored the attitudes of
general practitioners, psychiatrists and administrators,
with a view to establishing areas of congruence
in order to move towards an improved
model of service delivery. Recommendations are
made in the areas of primary care psychiatry,
access, communication and education.
The only constant is change
Authors: Leggat Sandra G , Dwyer Judith
Published: February 2010

A COLLECTION OF FIVE contributions on health
policy and system infrastructure from three countries
opens this issue. Toni Ashton continues her
thinking about the changes that make a real
difference in New Zealand with an analysis of
what she sees as significant opportunities for
primary health care (page 380). Jonathan Shapiro
discusses the problems that may arise in the
implementation of the ?contestability and choice?
open market agendas in the United Kingdom
(page 383). Raisa Deber challenges current orthodoxies
in Australian health policy (particularly
the use of competition principles) from her Canadian
perspective (page 386).
As the term of the inaugural Australian Council
on Safety and Quality in Health Care draws to a
close, its chair, Bruce Barraclough, reviews the
Council?s achievements and the work that is not yet
done (page 392). Linda Mundy and colleagues
report on a new initiative in this country?s continuing
effort to manage the introduction of emerging
health technology (page 395).
Better access to psychology services in primary mental health care: an evaluation
Authors: Vagholkar Sanjyot , Hare Lesley , Hasan Iqbal , Zwar Nicholas , Perkins David
Published: February 2010

Introduction: The Access to Allied Psychological
Services program was introduced as part of the
Better Outcomes in Mental Health Care initiative
in 2001?2002. Divisions of General Practice are
funded to establish programs that allow GPs to
refer patients for psychological treatments. The
University of New South Wales evaluated programs
run by the Southern Highlands and Illawarra
Divisions of General Practice. This paper
presents the findings of these evaluations.
Method: Both evaluations analysed process and
patient outcomes. This was obtained from a combination
of program data and qualitative satisfaction
data.
Results: The two program models differed in the
mechanism of retention of the psychologists and
the method of referral of patients. Anxiety and
depression were the main reasons for referral, and
clinical data showed there was improvement in
patient outcomes. Patients, GPs and psychologists
expressed satisfaction with the programs.
Discussion: The Access to Allied Psychological
Services programs in both Divisions have proven
popular. Flexibility in the program structure allows
Divisions to develop a model which suits their
local circumstances. There is support for ongoing
Commonwealth funding and the challenge is to
find the most effective and financially sustainable
model of delivery for psychological services in
primary care.
Ethico-legal issues in relation to end-of-life care and institutional mental health
Authors: McGrath Pam D , Forrester Kim
Published: February 2010

Objectives: In view of the fact that there is a higher
mortality rate for individuals with serious mental
illness and that people with mental illness suffer
excess mortality due to physical illness, the lack of
attention to end-of-life care for patients with a serious
mental illness needs addressing. This article seeks
to put these issues on the agenda by beginning to
explore important ethico-legal issues at the interface
of palliative care and institutional mental health.
Methods: Data were collected from eight qualitative
interviews conducted with mental health professionals
at The Park, Centre for Mental Health,
Queensland. The interviews were recorded verbatim,
coded and thematically analysed.
Results: The findings highlight the inherent tension
at the interface of compassionate, patientcentred
end-of-life care and the participants? perception
of the legal restraints imposed by virtue of
being in a mental health institution. This article
examines the participants? perceptions of the legal
restraints curtailing the provision of palliative care in
a mental health institution and considers these
findings within an understanding of the limitations
imposed by law. Our hope and expectation in undertaking
this exploration is to clarify the legal limitations
that operate to restrict the type of end-of-life
care that can be offered to mental health patients, in
order to provide an informed basis for practice.
"Models of Care" — a new section in Australian Health Review
Authors: Yarmo-Roberts Deborah
Published: February 2010

HEALTH CARE SYSTEMS in Australia and abroad
encompass multiple ?models of care?. While
diversity is inevitable, the models of care can be
contradictory and controversial.
International influences are acknowledged.
From a policy perspective, the Department of
Health in the United Kingdom has issued a
number of documents outlining models of care
that are being trialled or mainstreamed. These
include an NHS (National Health Service) and
social care model and a chronic disease management
model.1,2 These models are based on a
version of a health insurer model of care from the
United States that originated with Kaiser Permanente.
Health professional education: perpetuating obsolescence?
Authors: Leggat Sandra G
Published: February 2010

THE CURRENT SUITE of health professions was
established to respond to health care needs of the
distant past. Organisation of health professional
skills that is based on health care practices of
previous centuries is unlikely to serve the public
health care system in the future. Judging by the
number of papers on health professional education
we received, it appears that health care
practitioners, policy makers and educators may
be slowly realising that, just like many of the
health care technologies of the 18th century, the
organisation of our health professional workforce
has become obsolete. But, as identified in a
survey of Australian health workforce policy
experts, there is a fundamental lack of coordination
between the national and state levels of
government and insufficient long-range planning
to effectively address health professional workforce
issues (see page 385).
A brief primer on Good Samaritan law for health care professionals
Authors: Gulam Hyder , Devereux John
Published: February 2010

The Good Samaritan law is not found on the
statute books, but has been a concept that courts
have applied as public policy. However, this has
recently changed in all the states and territories in
Australia with the codification of Good Samaritan
law. This paper is a timely reminder for health
practitioners of the doctrine of the Good Samaritan,
as well as the relative legal uncertainty of
rescue at common law.
Public health systems research: the state of the field
Authors: Bagley Prue , Lin Vivian
Published: February 2010

Public health infrastructure provides the building
blocks required for the system to achieve public
health goals. A systems approach to public health
has been suggested as a means to tackle persistent
and emerging problems. Systems and infrastructure
are attracting increased research
attention. A review of the Australian and international
literature suggests an absence of empirical
evidence about how the system and its component
parts does, or should, work and highlights
some of the difficulties associated with generating
such evidence. It also indicates there is significant
scope for further research.
Genome-wide analysis of DNA turnover and gene expression in stationary-phase Saccharomyces cerevisiae
Authors: de Morgan A. , Brodsky L. , Ronin Y. , Nevo E. , Korol A. , Kashi Y.
Published: February 2010

Exponential-phase yeast cells readily enter stationary phase when transferred to fresh, carbon-deficient medium, and can remain fully viable for up to several months. It is known that stationary-phase prokaryotic cells may still synthesize substantial amounts of DNA. Although the basis of this phenomenon remains unclear, this DNA synthesis may be the result of DNA maintenance and repair, recombination, and stress-induced transposition of mobile elements, which may occur in the absence of DNA replication. To the best of our knowledge, the existence of DNA turnover in stationary-phase unicellular eukaryotes remains largely unstudied. By performing cDNA-spotted (i.e. ORF) microarray analysis of stationary cultures of a haploidSaccharomyces cerevisiaestrain, we demonstrated on a genomic scale the localization of a DNA-turnover marker [5-bromo-2′-deoxyuridine (BrdU); an analogue of thymidine], indicative of DNA synthesis in discrete, multiple sites across the genome. Exponential-phase cells on the other hand, exhibited a uniform, total genomic DNA synthesis pattern, possibly the result of DNA replication. Interestingly, BrdU-labelled sites exhibited a significant overlap with highly expressed features. We also found that the distribution among chromosomes of BrdU-labelled and expressed features deviates from random distribution; this was also observed for the overlapping set. Ty1retrotransposon genes were also found to be labelled with BrdU, evidence for transposition during stationary phase; however, they were not significantly expressed. We discuss the relevance and possible connection of these results to DNA repair, mutation and related phenomena in higher eukaryotes.
Chickpea‐mediated effects of Bacillus thuringiensis on Helicoverpa armigera and its larval parasitoid, Campoletis chlorideae
Authors: Dhillon M. K. , Sharma H. C.
Published: February 2010

Efforts are underway to express toxin genes from Bacillus thuringiensis (Bt) in chickpea for controlling the pod borer, Helicoverpa armigera. The interaction between Bt toxins, Helicoverpa‐resistant chickpeas, and the parasitoid, Campoletis chlorideae are not fully understood. Therefore, we studied tritrophic interactions between Bt (administered as spray), chickpea genotypes, and the parasitoid, C. chlorideae. Chickpea genotypes resistant to H. armigera exercised a significant reduction in leaf feeding, survival and development of H. armigera, but did not influence the development and survival of the parasitoid, C. chlorideae. Bt sprays on different chickpea genotypes prolonged the larval period, and reduced pupation and adult emergence of C. chlorideae. Weights of H. armigera larvae showed a strong and positive association with C. chlorideae larval period on Bt treated, and a negative association on untreated chickpeas. The Bt‐intoxicated H. armigera larvae also resulted in reduced weight of the cocoons and adults of C. chlorideae, suggesting significant influence of host size on development and survival of the parasitoid. Bt toxins were detected in H. armigera larvae fed on Bt‐sprayed chickpeas, but not in C. chlorideae reared on H. armigera larvae fed on Bt‐treated chickpeas, and in the parasitoid adults fed on honey intoxicated with 0.05%Bt. The adverse effects of Bt on the parasitoid were largely through early mortality of H. armigera larvae or poor quality of the host. This information would be useful for planning appropriate strategies for testing and deployment of Bt‐transgenic chickpea with resistance to H. armigera for sustainable crop production.
REGIONAL AND FIRM COMPETITIVENESS IN THE SERVICE‐BASED ECONOMY: COMBINING ECONOMIC GEOGRAPHY AND INTERNATIONAL BUSINESS THEORY
Authors: STRÖM PATRIK , WAHLQVIST EVELINA
Published: February 2010

This paper argues the case for combining international business theory and economic geography theory in order to understand the new rules of competition for both multinational corporations (MNCs) and regions in the globalising knowledge‐based economy. Sweden serves as a case study to illustrate the shifts of sectors and people skills that have paved the way for the transformation of the Swedish economy that has occurred over the last 15 years. Combining international business theory with that of economic geography produces the possibility of developing a conceptual framework for explaining the new dynamics and interaction that are occurring between people‐place‐firm. The enhanced importance of people and place, shifting pace, complex networks of production, and new balances of power together lead to changing practices and strategic implications for both MNCs and regions competing in the globalising knowledge‐based economy.
The Relationist and Substantivalist Theories of Time: Foes or Friends?
Authors: Benovsky Jiri
Published: February 2010

Abstract: There are two traditionally rival views about the nature of time: substantivalism that takes time to be a substance that exists independently of events located in it, and relationism that takes time to be constructed out of events. In this paper, first, I want to make some progress with respect to the debate between these two views, and I do this mainly by examining the strategies they use to face the possibilities of ‘empty time’ and ‘time without change’. As we shall see, the two allegedly very different rival views are much less different than has been thought: their structure is extremely similar, their strategies are extremely similar, and they can both face the possibilities of ‘empty time’ and ‘time without change’ in the same way. Thus, I argue in favour of a certain kind of equivalence between the two views; I discuss a Strong and a Weak version of this claim; and I provide reasons for endorsing the former. I also discuss the parallel between this pair of views about the nature of time and another analogous pair of views: the bundle theory and the substratum theory about the nature of material objects, with respect to the problem with Identity of Indiscernibles.
AirborneMycobacterium aviuminfection in a group of red‐shanked douc langurs (Pygathrix nemaeus nemaeus)
Authors: Plesker Roland , Teschner Katja , Behlert Olaf , Prenger‐Berninghoff Ellen , Hillemann Doris
Published: February 2010

Background This report describes an airborneMycobacterium avium(MA)‐infection in two red‐shanked douc langurs (Pygathrix nemaeus nemaeus) from Cologne zoo.

Methods The two individuals and their tissues were investigated clinically (including x‐rays), in pathology, in pathohistology, in classical bacteriology and by polymerase chain reaction (PCR).

Results Clinically, one individual displayed emaciation and a positive reaction in an intrapalpebral testing forM. bovis/MA. The other individual was without any symptoms and did not show any reaction in the intrapalpebral test. In x‐ray photos of the lungs, calcified nodules were detected. In pathology, calcified and necrotic nodules were observed within the lungs and the bronchial lymph nodes. In pathohistology, both classical tuberculous granulomas, and few acid fast rods were seen in Ziehl‐Neelsen‐stain. However, classical bacteriology could not demonstrate mycobacteria. In PCR, MA‐infection could be confirmed in one individual using the bronchial lymph nodes.

Conclusions It was an airborne infection; however, the definite source of infection in these cases remained unclear. Animals in contact to the langurs (house sparrows and mice) as well as water used in the building are the most promising candidates. The risk for a zoonotic transmission in these cases has been calculated to be low.
Reply to “The Effects of ‘Early Offers’ in Medical Malpractice Cases: Evidence from Texas”
Authors: Hersch Joni , O'Connell Jeffrey , Viscusi W. Kip
Published: February 2010

This article is a reply to the critique by Black, Hyman, and Silver (BHS) of our 2007 Journal of Legal Studies article, “An Empirical Assessment of Early Offer Reform for Medical Malpractice.” The early offer reform gives insurers the option of making an early offer that will expedite payment of claimants' economic losses and reasonable attorney fees. Using data on closed medical malpractice claims from the Texas Department of Insurance (TDI), our 2007 article estimates the financial impact of this proposal by comparing the expected payments to claimants under the early offer reform to the payments tinder current tort rules. A central component of our calculation of expected payments is unique information on insurers' reserves associated with the claim; actual payments are reported in the TDI data for all litigated and settled cases involving payments of at least $10,000. The BHS article misrepresents fundamental aspects of our empirical analysis, including the following. BHS set out to correct our purported “false assumption” that all claims have a 1.0 probability of success, which is a problem that arises because BHS omit the probability of claimant success from the formula that is presented in our paper. BHS's error is compounded as their discussion of our paper fails to recognize that our use of reserve amounts in the analysis incorporates the insurers’ estimates of the likelihood of claimant success, Indeed, they neither acknowledge our use of the insurer reserve data, nor do they use the insurer reserve information in their paper. BHS claim incorrectly that our analysis does not discount deferred payments whereas in fact it does. Our early offer analysis uses data for both litigated and settled claims, avoiding the selection bias and measurement error problems associated with BHS's extrapolation from the 2 percent of paid claims that are litigated to the universe of all settled and litigated claims. The BHS article also reflects a misunderstanding of the operation of the early offer reform.
BACKING UP 2-DE DEPLETION WITH SOURCE SEPARATION AND WAVELET DECOMPOSITION METHODS
Authors: SOGGIU A. , MARULLO O. , CAPOBIANCO E.
Published: February 2010

The analysis of complex protein samples can be time-consuming and expensive, due to the problems in identifying low abundance proteins in complex biological samples. We show that morphological source separation and multiscale filtering by wavelet transforms yield 2-DE gel images whose partial suppression of noise improves the spot detection phase from reconstructed serum maps.
Hypoxic cutaneous vasodilation is sustained during brief cold stress and is not affected by changes in CO2
Authors: Simmons Grant H. , Fieger Sarah M. , Minson Christopher T. , Halliwill John R.
Published: February 2010

Hypoxia decreases core body temperature in animals and humans during cold exposure. In addition, hypoxia increases skin blood flow in thermoneutral conditions, but the impact of hypoxic vasodilation on vasoconstriction during cold exposure is unknown. In this study, skin blood flow was assessed using laser-Doppler flowmetry, and cutaneous vascular conductance (CVC) was calculated as red blood cell flux/mean arterial pressure and normalized to baseline ( n = 7). Subjects were exposed to four different conditions in the steady state (normoxia and poikilocapnic, isocapnic, and hypercapnic hypoxia) and were cooled for 10 min using a water-perfused suit in each condition. CVC increased during all three hypoxic exposures (all P < 0.05 vs. baseline), and the magnitude of these steady-state responses was not affected by changes in end-tidal CO2 levels. During poikilocapnic and hypercapnic hypoxia, cold exposure reduced CVC to the same levels observed during normoxic cooling ( P > 0.05 vs. normoxia), whereas CVC remained elevated throughout cold exposure during isocapnic hypoxia ( P < 0.05 vs. normoxia). The magnitude of vasoconstriction during cold stress was similar in all conditions ( P > 0.05). Thus the magnitude of cutaneous vasodilation during steady-state hypoxia is not affected by CO2 responses. In addition, the magnitude of reflex vasoconstriction is not altered by hypoxia, such that the upward shift in skin blood flow (hypoxic vasodilation) is maintained during whole body cooling.
Why Probability Has Not Succeeded in Sociology
Authors: Erola Jani
Published: February 2010

Arguably, sociologists often apply deterministic explanations, unlike in many other sciences where probabilistic explanations have turned out to be more efficient. The advantages of applying probabilistic explanations more frequently could be: improved possibilities for cross-disciplinary work; the simplification of successful explanations; an easier way to implement uncertainty to models; new ways to utilize the classical theories of sociology; and increased freedom to choose research methods. According to the previously published literature, one of the reasons for not applying probabilistic explanations has been the strong positivist heritage in sociology. The following additional factors are considered: important classics of sociology were written before probability theories matured; and qualitative methods have provided the possibility to respond to the need for empirical research. In this way, sociologists have avoided the extensive work of re-evaluating the existing theories from a probabilistic point of view.
Discovering Structure in Auditory Input: Evidence From Williams Syndrome
Authors: Elsabbagh Mayada , Cohen Henri , Karmiloff-Smith Annette
Published: February 2010

We examined auditory perception in Williams syndrome by investigating strategies used in organizing sound patterns into coherent units. In Experiment 1, we investigated the streaming of sound sequences into perceptual units, on the basis of pitch cues, in a group of children and adults with Williams syndrome compared to typical controls. We showed that individuals with Williams syndrome were sensitive to the same pitch cues as typical children and adults when streaming these patterns. In Experiment 2, we evaluated differences in reliance on pitch and contour cues in unfamiliar melody perception in a group of adults with Williams syndrome relative to typical control children and adults. Unlike controls who demonstrated greater proficiency when contour cues were available, adults with Williams syndrome showed no such advantage.
Performance in Temporal Discounting Tasks by People With Intellectual Disabilities Reveals Difficulties in Decision-Making and Impulse Control
Authors: Willner Paul , Bailey Rebecca , Parry Rhonwen , Dymond Simon
Published: February 2010

The subjective value of rewards declines as a function of the delay to receive them (temporal discounting). Three temporal discounting tasks that assessed preferences between small amounts of money (10 pence) over short delays (60 s), moderate amounts of money (£10) over moderate delays (2 weeks), and large amounts of money (£1000) over long delays (12 months) were presented to people with intellectual disabilities (Full-Scale IQ < 70) and to a comparison group (ns  =  20 for each group). Measures of IQ, financial knowledge, memory, and executive functioning were also obtained. Only a third of the service users were able to perform the temporal discounting tasks consistently, and they tended to respond impulsively. The proportion of participants responding consistently increased following training. Both the initial performance and the effect of training were related to executive functioning but not IQ.
Effectiveness of an HIV/STD Risk-Reduction Intervention for Adolescents When Implemented by Community-Based Organizations: A Cluster-Randomized Controlled Trial
Authors: Jemmott John B. , Jemmott Loretta S. , Fong Geoffrey T. , Morales Knashawn H.
Published: February 2010

Objectives. We evaluated the effectiveness of an HIV/STD risk-reduction intervention when implemented by community-based organizations (CBOs).

Methods. In a cluster-randomized controlled trial, 86 CBOs that served African American adolescents aged 13 to 18 years were randomized to implement either an HIV/STD risk-reduction intervention whose efficacy has been demonstrated or a health-promotion control intervention. CBOs agreed to implement 6 intervention groups, a random half of which completed 3-, 6-, and 12-month follow-up assessments. The primary outcome was consistent condom use in the 3 months prior to each follow-up assessment, averaged over the follow-up assessments.

Results. Participants were 1707 adolescents, 863 in HIV/STD-intervention CBOs and 844 in control-intervention CBOs. HIV/STD-intervention participants were more likely to report consistent condom use (odds ratio [OR] = 1.39; 95% confidence interval [CI] = 1.06, 1.84) than were control-intervention participants. HIV/STD-intervention participants also reported a greater proportion of condom-protected intercourse (β = 0.06; 95% CI = 0.00, 0.12) than did the control group.

Conclusions. This is the first large, randomized intervention trial to demonstrate that CBOs can successfully implement an HIV/STD risk-reduction intervention whose efficacy has been established.
Using STD Electronic Medical Record Data to Drive Public Health Program Decisions in New York City
Authors: Paneth-Pollak Rachel , Schillinger Julia A. , Borrelli Jessica M. , Handel Shoshanna , Pathela Preeti , Blank and Susan
Published: February 2010

Electronic medical records can house patient information gathered over time and at multiple sites, thus they have the potential to increase continuity of care and improve service delivery in a multiclinic system.

The New York City Department of Health and Mental Hygiene implemented an electronic medical record system in its 10 sexually transmitted disease clinics during 2004 and 2005. We examine the use of real-time electronic medical record data analyses to evaluate clinical services or program activities and present 3 examples of such analyses that have led to program improvements.

Analyses of electronic medical record data have produced changes in clinical practice that in turn have resulted in more effective staff use, increased disease detection, and increased clinic capacity.
Successful bilateral deep brain stimulation of the globus pallidus internus for persistent status dystonicus and generalized chorea
Authors: Apetauerova Diana , Schirmer Clemens M. , Shils Jay L. , Zani Janet , Arle Jeffrey E.
Published: February 2010

The authors report the cases of 2 young male patients (aged 16 and 26 years) with dystonic cerebral palsy of unknown origin, who developed status dystonicus, an acute and persistent combination of generalized dystonia and chorea. Both patients developed status dystonicus after undergoing general anesthesia, and in 1 case, after administration of metoclopramide. In attempting to control this acute hyperkinetic movement disorder, multiple medication trials failed in both cases and patients required prolonged intubation and sedation with propofol. Bilateral deep brain stimulation of the globus pallidus internus (4 and 2 months after the onset of symptoms in the first and second case, respectively) produced immediate resolution of the hyperkinetic movement disorder in each case. Deep brain stimulation provided persistent suppression of the dystonic movement potential after a follow-up of 30 and 34 months, respectively, as demonstrated by the reemergence of severe dystonia during the end of battery life of the implantable pulse generators that was readily controlled by exchange of the generators in each case.
One Step Synthesis of Chiral Olefins via Asymmetric Diamination and their Applications as Ligands for Rhodium(I)‐Catalyzed 1,4‐Additions
Authors: Hu Xichao , Cao Ziping , Liu Zhaoqun , Wang Yazhou , Du Haifeng
Published: February 2010

A variety of acyclic chiral dienes were synthesized in a single step via palladium(0)‐catalyzed asymmetric allylic and homoallylic CH diamination of terminal olefins. The applications of such simple dienes as steering ligands for rhodium(I)‐catalyzed asymmetric 1,4‐additions afforded the corresponding adducts in excellent yields and up to 85% ee.
Extents of reaction and flow for homogeneous reaction systems with inlet and outlet streams
Authors: Amrhein Michael , Bhatt Nirav , Srinivasan Balasubrahmanyan , Bonvin Dominique
Published: February 2010

For homogeneous reaction systems with inlet and outlet streams, this article proposes a linear transformation of the number of moles vector into three distinct parts, namely, the reaction variants, the inlet‐flow variants, and the reaction and inlet‐flow invariants. The transformed states can be interpreted physically as (i) the amount of material contributed by each reaction and still present in the reactor (extents of reaction), (ii) the amount of material contributed by each inlet stream and still present in the reactor (extents of inlet flow), and (iii) the fraction of the initial conditions that has left the reactor (extent of outlet flow). Furthermore, several implications of being able to compute the extents of reaction and inlet flow are discussed. The methodology is illustrated in simulation via the ethanolysis of phthalyl chloride. © 2010 American Institute of Chemical Engineers AIChE J, 2010
Robust stabilization for uncertain discrete singular time‐delay systems
Authors: Ji Xiaofu , Yang Zebin , Su Hongye
Published: February 2010

The problem of robust stabilization for uncertain discrete singular time‐delay systems is investigated. The considered systems are subject to norm‐bounded parameter uncertainties and constant time delay. A linear matrix inequality (LMI) condition is proposed for a discrete singular time‐delay system to be regular, causal and stable. With this condition, the problems of robust stability and stabilization are solved. The obtained results are formulated in terms of strict LMIs. An explicit expression of the desired state‐feedback control law is also given, which involves no matrix decomposition. The proposed synthesis method is illustrated by a numerical example. Copyright © 2010 John Wiley and Sons Asia Pte Ltd and Chinese Automatic Control Society
Synthesis of Benzo‐ and Naphthoquinonyl Boronic Acids: Exploring the Diels–Alder Reactivity
Authors: Veguillas Marcos , Redondo Maria C. , García Isabel , Ribagorda María , Carmen Carreño M.
Published: February 2010

Substituted 2‐quinonyl boronic acids have been synthesised from 1,4‐dimethoxy aromatic derivatives in two steps: regiocontrolled boronation and oxidative demethylation. The study of their dienophilic behaviour evidenced that the boron substituent significantly increases the reactivity and triggers an efficient domino process in which the Diels–Alder reaction was followed by a protodeboronation or dehydroboronation, depending on the substitution on both the quinone and diene partners. The boronic acid acts as a temporary controller, opening a direct access to trans‐fused meta‐regiosomeric adducts when 3‐methyl‐substituted 2‐quinonyl boronic acids react with dienes with a substituent at C‐1. A particularly valuable synthetic result was obtained in the reaction between 3,6‐dimethyl‐2‐quinonyl boronic acid and piperylene under an oxygen atmosphere; trans‐fused 8a‐hydroxy‐2,4a,8‐trimethyl tetrahydronaphthoquinone was formed directly, in excellent yield and in a highly diastereoselective manner.
Asymmetric Substitutions of 2‐Lithiated N‐Boc‐piperidine and N‐Boc‐azepine by Dynamic Resolution
Authors: Coldham Iain , Raimbault Sophie , Whittaker David T. E. , Chovatia Praful T. , Leonori Daniele , Patel Jignesh J. , Sheikh Nadeem S.
Published: February 2010

Proton abstraction of N‐tert‐butoxycarbonyl‐piperidine (N‐Boc‐piperidine) with sBuLi and TMEDA provides a racemic organolithium that can be resolved using a chiral ligand. The enantiomeric organolithiums can interconvert so that a dynamic resolution occurs. Two mechanisms for promoting enantioselectivity in the products are possible. Slow addition of an electrophile such as trimethylsilyl chloride allows dynamic resolution under kinetic control (DKR). This process occurs with high enantioselectivity and is successful by catalysis with substoichiometric chiral ligand (catalytic dynamic kinetic resolution). Alternatively, the two enantiomers of this organolithium can be resolved under thermodynamic control with good enantioselectivity (dynamic thermodynamic resolution, DTR). The best ligands found are based on chiral diamino‐alkoxides. Using DTR, a variety of electrophiles can be used to provide an asymmetric synthesis of enantiomerically enriched 2‐substituted piperidines, including (after Boc deprotection) the alkaloid (+)‐β‐conhydrine. The chemistry was extended, albeit with lower yields, to the corresponding 2‐substituted seven‐membered azepine ring derivatives.
ChemInform Abstract: Synthesis of Biologically Active Benzothiazole Substituted Thiazolidinone Derivatives via Cyclization of Unsymmetrical Imines.
Authors: Nagarajan Arasampattu S. , Kamalraj S. , Muthumary J. , Reddy Boreddy S. R.
Published: February 2010

ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 100 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
Prospective effects of post‐bereavement negative events on cortisol activity in parentally bereaved youth
Authors: Hagan Melissa J. , Luecken Linda J. , Sandler Irwin N. , Tein Jenn‐Yun
Published: February 2010

Dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis has been implicated in the association between adverse childhood experiences, such as parental death, and mental and physical health problems. Recent research indicates that children who experience the death of a parent exhibit HPA axis dysfunction; however, the mechanisms underlying this association have not been explored. It is theorized that physiological dysregulation may result from exposure to stressful life events subsequent to parental death. The current study examined the prospective relations between negative events following parental death and cortisol activity in parentally bereaved youth. A greater number of post‐bereavement negative events predicted significantly lower levels of cortisol activity 6 years later; this association remained significant after controlling for current externalizing symptoms and recent negative events. Results suggest that higher exposure to stressful events following childhood parental loss may result in long‐term attenuated cortisol activity. © 2010 Wiley Periodicals, Inc. Dev Psychobiol 52: 394–400, 2010.
Adolescence: A central event in shaping stress reactivity
Authors: Romeo Russell D.
Published: February 2010

The magnitude and duration of the hormonal stress response change dramatically throughout an organism's lifespan. Although much is known about the factors that modulate stress reactivity during adulthood and how neonatal development and aging influence stress responsiveness, we know relatively little about how stress reactivity changes during the juvenile to adult transition. Recent studies in adolescent boys and girls have suggested that stress is an important factor contributing to an individual's vulnerability to various neuropsychological dysfunctions, including anxiety, depression, and drug abuse. Thus, understanding how exposure to stressors during this crucial period of development lead to negative consequences is of paramount importance. A growing body of literature indicates that pubertal organisms react differentially, both physiologically and behaviorally, to a stressor compared to adults. The purpose of this review, therefore, is to discuss the recent findings regarding the pubertal maturation of stress reactivity, while also highlighting future research directions that will aid in our understanding of stress and adolescent mental health and development. © 2010 Wiley Periodicals, Inc. Dev Psychobiol 52: 244–253, 2010
Differential expression and regulation by activin of the neurotrophins BDNF and NT4 during human and mouse ovarian development
Authors: Childs Andrew J. , Bayne Rosemary A.L. , Murray Alison A. , Martins Da Silva Sarah J. , Collins Craig S. , Spears Norah , Anderson Richard A.
Published: February 2010

The tropomyosin‐related kinase (Trk) B neurotrophin receptor is essential for ovarian germ cell survival and primordial follicle formation, but the contributions of its ligands, brain‐derived neurotrophic factor (BDNF) and neurotrophin‐4 (NT4), are unknown. We have investigated their expression and regulation in developing human and mouse ovaries. BDNF expression increased with increasing gestation, expression of human NTF4 and of both Ntf5 and Bdnf in the mouse was unchanged. Bdnf expression was dramatically lower than Ntf5 in the mouse, but levels were comparable in the human. Human fetal ovarian somatic cells expressed BDNF. Activin A selectively regulated BDNF and Ntf5 expression in human and mouse, respectively, identifying an oocyte/somatic signaling pathway which might mediate the pro‐survival effects of activin. These data reveal that expression and regulation of the TrkB ligands are differentially controlled in the developing ovaries of humans and mice, and identify BDNF as a potential regulator of germ cell fate in the human fetal ovary. Developmental Dynamics 239:1211–1219, 2010. © 2010 Wiley‐Liss, Inc.
Long‐Term Testing in Dynamic Mode of HT‐PEMFC H3PO4/PBI Celtec‐P Based Membrane Electrode Assemblies for Micro‐CHP Applications
Authors: Moçotéguy P. , Ludwig B. , Scholta J. , Nedellec Y. , Jones D. J. , Rozière J.
Published: February 2010

High temperature proton exchange membrane fuel cells (HT‐PEMFC) have a promising market in micro‐combined heat and power (μ‐CHP) applications. Operating above 150 °C, they would better cope with return temperatures of typical heating systems than conventional PEMFCs and would allow simplification of system regulations dedicated to failure prevention.

Single cell and 500 We HT‐PEMFC stack integrating Celtec P 1000 MEAs were fed with synthetic reformate and air and successfully operated at 160 °C under accelerated typical annual μ‐CHP profile. The single cell was unaffected by 500 h of current cycling while stop/start cycles induced some voltage loss. After 658 h of cumulated operation, stack performance loss was limited at 7.6%: its electrical efficiency (LHV) decreased from 30.6 to 28.3%. Moreover, four initial stop/start cycles weakly impacted its performance, indicating that selected shutdown/restart protocol is convenient for field application. Conversely, after additional start/stop cycles, degradation rate was increased by stop/start cycling and some specific cells (mostly associated with lower initial OCV) exhibited significantly higher degradation rates. Finally, voltage transient evolution during current step exhibits undershoot which magnitude is strongly depends on cell location in the stack: it increased at stack dead‐end and for cells exhibiting highest degradation rates.
Case‐control study on prognostic factors in oral squamous cell carcinoma in young patients
Authors: Kaminagakura Estela , Vartanian José Guilherme , da Silva Sabrina Daniela , dos Santos Carlos Roberto , Kowalski Luiz Paulo
Published: February 2010

Background.

Oral squamous cell carcinoma affects mainly patients between the fifth and sixth decades of life, being rare in the young (≤40 years old).

Methods.

Demographic, clinical, and pathologic features, and the long‐term survival of 125 patients younger than 41 years of age were compared with 250 control patients older than 50 years old. Data were submitted to Kaplan–Meier and log‐rank tests.

Results.

The percentage of nonsmokers was higher in the younger patients (p = .04). In the younger patients, tumors at advanced clinical stage (p < .01) and poorly differentiated tumors (p = .01) were associated with a higher risk of recurrence. The relapse rate was higher in the younger patients (p = .02); however, there was no significant difference on overall survival (p = .86). The younger patients diagnosed after the 1990s had less advanced clinical stage tumors, had an increase in the use of combination of surgery, radiotherapy, and chemotherapy, and their overall survival was improved.

Conclusion.

This study emphasizes the importance of early diagnosis and aggressive treatment of oral squamous cell carcinoma. © 2010 Wiley Periodicals, Inc. Head Neck, 2010
Intrahepatic Peripheral Cholangiocarcinoma in Cirrhosis Patients May Display A Vascular Pattern Similar to Hepatocellular Carcinoma on Contrast-Enhanced Ultrasound
Authors: Vilana Ramón , Forner Alejandro , Bianchi Luis , García-Criado Ángeles , Rimola Jordi , de Lope Carlos Rodríguez , Reig María , Ayuso Carmen , Brú Concepció , Bruix Jordi
Published: February 2010

The aim of this study was to describe the imaging features by contrast-enhanced ultrasound (CEUS) of intrahepatic cholangiocarcinoma (ICC) in cirrhosis patients. We registered the CEUS images of cirrhosis patients with histologically confirmed ICC. In all cases magnetic resonance imaging (MRI) was done to confirm the diagnosis and/or staging purposes. A total of 21 patients met all the criteria to be included in the study. The median nodule size was 32 mm. All nodules showed contrast enhancement at arterial phase; in 10 cases it was homogeneous and in 11 cases peripheral (rim-like). All nodules displayed washout during the venous phases; it appeared during the first 60 seconds in 10 nodules, between 60-120 seconds in five cases, and in six cases after 2 minutes. Ten nodules (five larger than 2 cm) displayed homogeneous contrast uptake followed by washout and they correspond to the specific pattern of hepatocellular carcinoma according to the American Association for the Study of Liver Diseases criteria. However, none of these lesions displayed washout on MRI.

Conclusion

: CEUS should not be used as the sole imaging technique for conclusive hepatocellular carcinoma diagnosis and if the MRI does not display the diagnostic vascular pattern, a confirmatory biopsy is mandatory. Hepatology 2010;51:2020–2029