bluuebunny/crossref_metadata_2025 huggingface dataset:
A Deficit in Psychotherapeutic Care for Older People with Depression and Anxiety
Authors: Laidlaw Ken
Published: July 2013

In this article, the current state of evidence for psychological therapy for depression and anxiety in later life is briefly reviewed and a number of deficits in psychotherapeutic care are outlined and discussed. Deficits are identified as important in preventing older people from accessing the range and types of psychological interventions that would potentially enhance quality of life. In the main, researchers have overlooked anxiety and, relatively speaking, focused more on late life depression even though this occurs less frequently than anxiety disorders and anxiety symptoms. Similarly, psychotherapists have not given due consideration to the global demographic change in lifespan, with the implications of this unprecedented and profound event for psychotherapists rarely discussed. With the current cohort of older people living beyond the expected lifespans of previous generations, most research in psychotherapy with older people recruits from the younger-old age group (60-74 years). As such it is not known how well existing models of psychotherapy will fit this new cohort of older people. This paper briefly reviews these issues.
Karyotype Reorganization with Conserved Genomic Compartmentalization in Dot-Shaped Microchromosomes in the Japanese Mountain Hawk-Eagle (Nisaetus nipalensis orientalis, Accipitridae)
Authors: Nishida C. , Ishijima J. , Ishishita S. , Yamada K. , Griffin D.K. , Yamazaki T. , Matsuda Y.
Published: July 2013

The karyotype of the Japanese mountain hawk-eagle (Nisaetus nipalensis orientalis) (2n = 66) consists of a large number of medium-sized and small chromosomes but only 4 pairs of dot-shaped microchromosomes, in contrast to the typical avian karyotype with a small number of macrochromosomes and many indistinguishable microchromosomes. To investigate the drastic karyotype reorganization in this species, we performed a molecular cytogenetic characterization employing chromosome in situ hybridization and molecular cloning of centromeric heterochromatin. Cross-species chromosome painting with chicken chromosome-specific probes 1-9 and Z and a paint pool of 20 microchromosome pairs revealed that the N. n. orientalis karyotype differs from chicken by at least 13 fissions of macrochromosomes and 15 fusions between microchromosomes and between micro- and macrochromosomes. A novel family of satellite DNA sequences (NNO-ApaI) was isolated, consisting of a GC-rich 173-bp repeated sequence element. The NNO-ApaI sequence was localized to the C-positive centromeric heterochromatin of 4 pairs of microchromosomes, which evolved concertedly by homogenization between the microchromosomes. These results suggest that the 4 pairs of dot-shaped microchromosomes have retained their genomic compartmentalization from other middle-sized and small chromosomes.
Prepubertal Children with Growth Hormone Deficiency Treated for Four Years with Growth Hormone Experience Dose-Dependent Increase in Height, but Not in the Rate of Puberty Initiation
Authors: Rogol Alan D. , Cohen Pinchas , Weng Wayne , Kappelgaard Anne-Marie , Germak John A.
Published: July 2013

Background/Aims: Limited data exist on long-term dose response to recombinant human growth hormone (rhGH) in prepubertal GH-deficient (GHD) children. The effect of low, intermediate, and high-dose rhGH (25, 50, and 100 μg/kg/day, respectively) on growth and puberty in children with GHD was investigated for 48 months. Methods: A prospective, dose-response study in 111 patients (aged 3-16 years) evaluated growth velocity (cm/year), height standard deviation score (HSDS), corrected HSDS, bone age/chronologic age ratio, body mass index SDS, and the percentage starting puberty. Results: Dose-related increases were observed in growth velocity (p < 0.001), HSDS (p < 0.001), and corrected HSDS (p < 0.001) from baseline to 48 months. Increases in the bone age/chronologic age ratio (p = 0.043) and body mass index SDS (p = 0.018) occurred up to 36 months at intermediate and high doses versus low-dose rhGH; increases at 48 months were not significant. No significant differences in growth were found between intermediate and high doses of rhGH. Percentages of rhGH-treated patients starting puberty at each dose were equivalent (p = 0.607). Conclusions: rhGH, 50 and 100 μg/kg/day, induced greater growth than 25 μg/kg/day without altering the proportion of children starting puberty. The maximum approved dose for pubertal patients (100 μg/kg/day) is not required or recommended for prepubertal children with GHD.
Predictability of Explosive Cyclogenesis over the Northwestern Pacific Region Using Ensemble Reanalysis
Authors: Kuwano-Yoshida Akira , Enomoto Takeshi
Published: July 2013

The predictability of explosive cyclones over the northwestern Pacific region is investigated using an ensemble reanalysis dataset. Explosive cyclones are categorized into two types according to whether the region of the most rapid development is in the Sea of Okhotsk or Sea of Japan (OJ) or in the northwestern Pacific Ocean (PO). Cyclone-relative composite analyses are performed for analysis increments (the differences between the analysis and the 6-h forecast) and ensemble spreads (the standard deviations of ensemble members of the analysis or first guess) at the time of the maximum deepening rate. The increment composite shows that the OJ explosive cyclone center is forecast too far north compared to the analyzed center, whereas the PO explosive cyclone is forecast shallower than the analyzed center. To understand the cause of these biases, a diagnosis of the increment using the Zwack–Okossi (Z-O) development equation is conducted. The results suggest that the increment characteristics of both the OJ and PO explosive cyclones are associated with the most important cyclone development mechanisms. The OJ explosive cyclone forecast error is related to a deeper upper trough, whereas the PO explosive cyclone error is related to weaker latent heat release in the model. A diagnosis of the spread utilizing the Z-O development equation clarifies the mechanism underlying the uncertainty in the modeled sea level pressure. For OJ explosive cyclones, the spread of adiabatic warming causes substantial sea level pressure spreading southwest of the center of the cyclones. For PO explosive cyclones, the latent heat release causes substantial sea level pressure spreading around the cyclone center.
Universal Health Coverage: The New Face of Neoliberalism
Authors: Mukhopadhyay Indranil
Published: July 2013

Health care services in India have undergone rapid transitions in the last two decades. While government health services have been shrinking and investments got squeezed, the private sector has been promoted as an efficient alternative. This has led to an increasing dependence of people on the private sector for seeking care and a regressive form of financing based on out-of-pocket spending has emerged. The 12th Plan tries to address some of these concerns through Universal Health Coverage. The author argues that while universal access to health is a noble goal, it may not be achieved if an insurance-based model of financing and a managed care approach based on private sector delivery is adopted. Such an approach may facilitate further consolidation of capital at the expense of people’s money. The author draws from international experience to argue that egalitarian and universal access to health care can be provided only if government health services are strengthened.
Locating ‘Quality’ in Health Care and Universal Health Care Mosaic
Authors: Prachinkumar Ghodajkar
Published: July 2013

Different concepts of quality in health care have implications for nature, structure and composition of health service systems. Issues of access, cost and quality of care are intricately linked; for recipients, providers as well as for policy-makers. Quality in health care is a complex construct because it is linked not just with the quality of services provided at the institution and systemic level but has several tangible and intangible dimensions including individual patient’s interests and larger societal concerns about improvement in health status. Quality is an important consideration for choosing the services for recipients, accreditation of hospitals for care providers, and for policy-makers while making decisions regarding health service system models. This article traces the way the issue has been dealt with at the policy and planning level so far, including the National Rural Health Mission (NRHM) as well as in the proposed models for Universal Health Care by the High Level Expert Group (HLEG) and 12th Plan Steering committee reports.
Vaccines and Vaccine Policy for Universal Health Care
Authors: Madhavi Y.
Published: July 2013

The existing national policy framework vis-à-vis vaccines reflects an aggressive push towards introduction of new vaccines in the Universal Immunisation Programme (UIP) without providing an uncompromising scientific basis or committing itself to proven epidemiological needs of the population. The idea of selective immunisation is being undermined by slogans like ‘prevention is better than cure’ that are being trumped up to impart credibility to the effort, given shape by the projected panacea for all ills, that is, Public–Private Partnership (PPP), to push the line that all immunisation is universal. This article examines the aims and motives behind deliberate destruction of the public sector in favour of PPPs and establishes the need for a vaccine policy that is designed to enhance national public capacity for public immunisation programmes as opposed to the present policy that justifies spending public money on privately produced vaccines in the name of protection from diseases whose incidence figures and public health statistics are dubious and industry-manufactured.
People Reclaiming the Public Health System: Community-based Monitoring and Planning in Maharashtra
Authors: Shukla Abhay
Published: July 2013

Community-based monitoring and planning (CBMP) of health services is being implemented in selected areas of Maharashtra with support from National Rural Health Mission since 2007. CBMP processes are organised at village, Primary Health Centre, block, district and state levels by a network of nodal civil society organisations working with the State health department. Key components include multistakeholder monitoring committees at various levels; community-based data collection and filling of health report cards; organising public hearings and periodic state level dialogues, with community-based planning focused on appropriate utilisation of untied funds. Various indicators show positive impact of these processes in CBMP areas such as significant rise in positive ratings of public health services over time, increase in utilisation of PHC services in Thane district and numerous positive ‘stories of change’. However, key policy decisions are now required to ensure optimal effectiveness, generalisation and sustainability of such community action processes.
Book Review: Women’s Movement in Manipur
Authors: Subramanian K.S.
Published: July 2013

Thokchom Binarani Devi, Women’s Movement in Manipur, New Delhi, Concept Publishers, 2011.
A policy-blending formalism for shared control
Authors: Dragan Anca D , Srinivasa Siddhartha S
Published: July 2013

In shared control teleoperation, the robot assists the user in accomplishing the desired task, making teleoperation easier and more seamless. Rather than simply executing the user’s input, which is hindered by the inadequacies of the interface, the robot attempts to predict the user’s intent, and assists in accomplishing it. In this work, we are interested in the scientific underpinnings of assistance: we propose an intuitive formalism that captures assistance as policy blending, illustrate how some of the existing techniques for shared control instantiate it, and provide a principled analysis of its main components: prediction of user intent and its arbitration with the user input. We define the prediction problem, with foundations in inverse reinforcement learning, discuss simplifying assumptions that make it tractable, and test these on data from users teleoperating a robotic manipulator. We define the arbitration problem from a control-theoretic perspective, and turn our attention to what users consider good arbitration. We conduct a user study that analyzes the effect of different factors on the performance of assistance, indicating that arbitration should be contextual: it should depend on the robot’s confidence in itself and in the user, and even the particulars of the user. Based on the study, we discuss challenges and opportunities that a robot sharing the control with the user might face: adaptation to the context and the user, legibility of behavior, and the closed loop between prediction and user behavior.
Is Nursing Its Own Worst Enemy?
Authors: Karnick Paula M.
Published: July 2013

In a thought-provoking interview, one nurse theorist poses a question related to nurses. She asks nurses to defend their profession as a profession rather than as a trade. This question should give rise to a resounding response that nursing is a professional discipline. Over the years many nurses have fought to be recognized as a profession by doing the real work of building a foundation to ensure nursing’s future. Unfortunately, over the last few decades, the building of nursing science has taken a back seat to other concerns such as creating more layers of practice, continuing to confuse the public and our patients about who nurses really are and what nursing really does.
Suffering
Authors: Milton Constance L.
Published: July 2013

Human suffering is a significant yet elusive phenomenon that is frequently a topic of discussion in nursing and contemporary healthcare literature. Definitions and notions elaborating the potential meaning of human suffering are commonly linked with the concept of pain. The author here illuminates possible ethical meanings of human suffering. The ethical enduring truths embedded in the humanbecoming nursing theoretical perspective undergirds the ethical discussion and significance for advancing disciplinary knowledge, practice, and education.
Migration, transnationalism, and modernity: Thinking of Kerala’s many cosmopolitanisms
Authors: Devika J
Published: July 2013

This article claims that the history of modernity in twentieth-century Kerala is inextricably bound up with the histories of migration and transnationalisms in the region. It argues that a distinction can be made between the earlier and later phases of the migratory and transnational experience. The former allowed for the ‘cosmopolitanism of ideas’ that imagined hitherto-non-existent communities across cultural boundaries and ‘competing cosmopolitanisms’ in the region. Post-independence, however, altered political conditions that impacted migration and transnationalism and produced the ‘cosmopolitanism of duty’, which works with fairly fixed ideas about the national and community/family values and aims for flexibility in negotiating these worlds. These have had distinct effects on modernity in Kerala.
‘Beyond the limits of nation and geography’: Rabindranath Tagore and the cosmopolitan moment, 1916–1920
Authors: Frost Mark R
Published: July 2013

This article examines the emergence of a distinctive brand of political cosmopolitanism across Britain’s Asian Empire during World War I. Rather than presenting this phenomenon merely as a response to Western developments (in particular, Woodrow Wilson’s Fourteen Points), it argues for the Asian origins and political logic of such discourse. The activities of the poet Rabindranath Tagore in these crucial years, his voyage from Bengal to Japan and his scheme for an international university, are used as a lens through which to view the wider currency of cosmopolitan thinking and practice in the region. For, it is argued, while Tagore never committed himself to an explicitly ‘political’ cosmopolitan project, the success and failure of his international endeavours are best understood within this broader intellectual milieu.
Tamils and Greater India: Some issues of connected histories
Authors: Subramanian Lakshmi
Published: July 2013

The idea of connected histories has been in vogue for some time especially in the context of maritime history and linkages in the early modern period. A central and distinguishing feature of connected histories is to understand and contextualize movements and intersections of people, objects and ideas. In the nineteenth century, especially within the framework of empire, new modalities of migration and self-representation emerged to complicate the ideas of region and identity. One such mode of representation was the idea of Greater India that had multiple public manifestations. This article is an attempt to ask fresh questions mostly about the afterlife of the idea, of its deployment in journalistic practice and to investigate how and whether the Tamil experience in South East Asia was written into it in a meaningful and sustained way.
Crossing the Indian Ocean and wading through the littoral: Cosmopolitan visions in Amitav Ghosh’s ‘antique land’ and ‘tide country’
Authors: Samuelson Meg
Published: July 2013

This article traces the cosmopolitan structures Amitav Ghosh retrieves from the medieval Indian Ocean world and those he forges along the South Asian littoral in an era of climate change in the narrative works In an Antique Land and The Hungry Tide. Both turn to the Indian Ocean and its coastal delta in search of the permeability that characterises the littoral and the syncretic and/or dialogic cultural and life forms emerging along it, which stand in contrast to geopolitical boundaries and species borders. In this social, political and ecological space they locate a cosmopolitanism that interweaves, elaborates and exceeds the three principle threads in cosmopolitan thought. Reconceiving cosmopolitanism from the South in the ‘Anthropocene Age’, Ghosh – it is argued – pushes beyond the political limits of the ‘citizen of the world’ while immersing this concept in the mud of a local – sticky yet fluid – ecosystem.
Cervical cancer in pregnant women: treat, wait or interrupt? Assessment of current clinical guidelines, innovations and controversies
Authors: Han Sileny N. , Mhallem Gziri Mina , Van Calsteren Kristel , Amant Frédéric
Published: July 2013

Cervical cancer during pregnancy is relatively uncommon. However, the incidence is expected to increase as more women delay childbearing. When preservation of the pregnancy is desired, optimal treatment is a major challenge to all. Whereas delay of treatment is an option for pre-invasive disease, and also small invasive carcinomas without lymph node involvement, management of tumours >2 cm remains experimental. Type of treatment needs to be individualized and depends mainly on gestational age, disease stage, and histology. Extensive counselling regarding the maternal and foetal risks is required. In this current review, we aim to summarize available data and treatment guidelines concerning cervical cancer in pregnancy. Controversies and research priorities are also identified.
Probing the stability of the “naked” mucin-like domain of human α-dystroglycan
Authors: Bozzi Manuela , Di Stasio Enrico , Scaglione Giovanni Luca , Desiderio Claudia , Martelli Claudia , Giardina Bruno , Sciandra Francesca , Brancaccio Andrea
Published: July 2013

Background

α-Dystroglycan (α-DG) is heavily glycosylated within its central mucin-like domain. The glycosylation shell of α-dystroglycan is known to largely influence its functional properties toward extracellular ligands. The structural features of this α-dystroglycan domain have been poorly studied so far. For the first time, we have attempted a recombinant expression approach in E. coli cells, in order to analyze by biochemical and biophysical techniques this important domain of the α-dystroglycan core protein.

Results

We expressed the recombinant mucin-like domain of human α-dystroglycan in E. coli cells, and purified it as a soluble peptide of 174 aa. A cleavage event, that progressively emerges under repeated cycles of freeze/thaw, occurs at the carboxy side of Arg461, liberating a 151 aa fragment as revealed by mass spectrometry analysis. The mucin-like peptide lacks any particular fold, as confirmed by its hydrodynamic properties and its fluorescence behavior under guanidine hydrochloride denaturation. Dynamic light scattering has been used to demonstrate that this mucin-like peptide is arranged in a conformation that is prone to aggregation at room temperature, with a melting temperature of ~40°C, which indicates a pronounced instability. Such a conclusion has been corroborated by trypsin limited proteolysis, upon which the protein has been fully degraded in less than 60 min.

Conclusions

Our analysis indirectly confirms the idea that the mucin-like domain of α-dystroglycan needs to be extensively glycosylated in order to reach a stable conformation. The absence/reduction of glycosylation by itself may greatly reduce the stability of the dystroglycan complex. Although an altered pattern of α-dystroglycan O-mannosylation, that is not significantly changing its overall glycosylation fraction, represents the primary molecular clue behind currently known dystroglycanopathies, it cannot be ruled out that still unidentified forms of αDG-related dystrophy might originate by a more substantial reduction of α-dystroglycan glycosylation and by its consequent destabilization.
Genomic distribution of SINEs in Entamoeba histolytica strains: implication for genotyping
Authors: Kumari Vandana , Iyer Lakshmi Rani , Roy Riti , Bhargava Varsha , Panda Suchita , Paul Jaishree , Verweij Jaco J , Clark C Graham , Bhattacharya Alok , Bhattacharya Sudha
Published: July 2013

Background

The major clinical manifestations of Entamoeba histolytica infection include amebic colitis and liver abscess. However the majority of infections remain asymptomatic. Earlier reports have shown that some E. histolytica isolates are more virulent than others, suggesting that virulence may be linked to genotype. Here we have looked at the genomic distribution of the retrotransposable short interspersed nuclear elements EhSINE1 and EhSINE2. Due to their mobile nature, some EhSINE copies may occupy different genomic locations among isolates of E. histolytica possibly affecting adjacent gene expression; this variability in location can be exploited to differentiate strains.

Results

We have looked for EhSINE1- and EhSINE2-occupied loci in the genome sequence of Entamoeba histolytica HM-1:IMSS and searched for homologous loci in other strains to determine the insertion status of these elements. A total of 393 EhSINE1 and 119 EhSINE2 loci were analyzed in the available sequenced strains (Rahman, DS4-868, HM1:CA, KU48, KU50, KU27 and MS96-3382. Seventeen loci (13 EhSINE1 and 4 EhSINE2) were identified where a EhSINE1/EhSINE2 sequence was missing from the corresponding locus of other strains. Most of these loci were unoccupied in more than one strain. Some of the loci were analyzed experimentally for SINE occupancy using DNA from strain Rahman. These data helped to correctly assemble the nucleotide sequence at three loci in Rahman. SINE occupancy was also checked at these three loci in 7 other axenically cultivated E. histolytica strains and 16 clinical isolates. Each locus gave a single, specific amplicon with the primer sets used, making this a suitable method for strain typing. Based on presence/absence of SINE and amplification with locus-specific primers, the 23 strains could be divided into eleven genotypes. The results obtained by our method correlated with the data from other typing methods. We also report a bioinformatic analysis of EhSINE2 copies.

Conclusions

Our results reveal several loci with extensive polymorphism of SINE occupancy among different strains of E. histolytica and prove the principle that the genomic distribution of SINEs is a valid method for typing of E. histolytica strains.
The protective effect of geniposide on human neuroblastoma cells in the presence of formaldehyde
Authors: Sun Ping , Chen Jin-yan , Li Jiao , Sun Meng-ru , Mo Wei-chuan , Liu Kai-li , Meng Yan-yan , Liu Ying , Wang Feng , He Rong-qiao , Hua Qian
Published: July 2013

Background

Formaldehyde can induce misfolding and aggregation of Tau protein and β amyloid protein, which are characteristic pathological features of Alzheimer’s disease (AD). An increase in endogenous formaldehyde concentration in the brain is closely related to dementia in aging people. Therefore, the discovery of effective drugs to counteract the adverse impact of formaldehyde on neuronal cells is beneficial for the development of appropriate treatments for age-associated cognitive decline.

Methods

In this study, we assessed the neuroprotective properties of TongLuoJiuNao (TLJN), a traditional Chinese medicine preparation, against formaldehyde stress in human neuroblastoma cells (SH-SY5Y cell line). The effect of TLJN and its main ingredients (geniposide and ginsenoside Rg1) on cell viability, apoptosis, intracellular antioxidant activity and the expression of apoptotic-related genes in the presence of formaldehyde were monitored.

Results

Cell counting studies showed that in the presence of TLJN, the viability of formaldehyde-treated SH-SY5Y cells significantly recovered. Laser scanning confocal microscopy revealed that the morphology of formaldehyde-injured cells was rescued by TLJN and geniposide, an effective ingredient of TLJN. Moreover, the inhibitory effect of geniposide on formaldehyde-induced apoptosis was dose-dependent. The activity of intracellular antioxidants (superoxide dismutase and glutathione peroxidase) increased, as did mRNA and protein levels of the antiapoptotic geneBcl-2after the addition of geniposide. In contrast, the expression of the apoptotic-related gene -P53, apoptotic executer -caspase 3and apoptotic initiator -caspase 9were downregulated after geniposide treatment.

Conclusions

Our results indicate that geniposide can protect SH-SY5Y cells against formaldehyde stress through modulating the expression ofBcl-2,P53,caspase 3andcaspase 9,and by increasing the activity of intracellular superoxide dismutase and glutathione peroxidase.
The evidence for the effectiveness of safety alerts in electronic patient medication record systems at the point of pharmacy order entry: a systematic review
Authors: Ojeleye Oluwagbemileke , Avery Anthony , Gupta Vaibhav , Boyd Matthew
Published: July 2013

Background

Electronic Patient Medication Record (ePMR) systems have important safety features embedded to alert users about potential clinical hazards and errors. To date, there is no synthesis of evidence about the effectiveness of these safety features and alerts at the point of pharmacy order entry. This review aims to systematically explore the literature and synthesise published evidence about the effectiveness of safety features and alerts in ePMR systems at the point of pharmacy order entry, in primary and secondary care.

Methods

We searched MEDLINE, EMBASE, Inspec, International Pharmaceutical Abstracts, PsycINFO, CINHAL (earliest entry to March 2012) and reference lists of articles. Two reviewers examined the titles and abstracts, and used a hierarchical template to identify comparative design studies evaluating the effectiveness of safety features and alerts at the point of pharmacy order entry. The two reviewers independently assessed the quality of the included studies using Cochrane Collaboration’s risk of bias tool.

Results

Three randomised trials and two before-after studies met our criteria. Four studies involved integrated care facilities and one was hospital-based. The studies were all from the United States (US). The five studies demonstrated statistically significant reduction in medication errors in patients with renal insufficiency, pregnant women dispensed US Food Drug and Administration (FDA) risk category D (evidence of fetal risk but therapeutic benefits can outweigh the risk) or X (evidence suggests that risk to the fetus outweighs therapeutic benefits) medication, first dispensing of inappropriate medications in patients aged 65 and above, co-dispensing of interacting drugs, and adverse drug events related to hyperkalaemia.

Conclusions

This systematic review shows that the safety features of ePMR systems are effective in alerting users about potential clinical hazards and errors during pharmacy order entry. There are however, problems such as false alerts and inconsistencies in alert management. More studies are needed from other countries and pharmacy practice settings to assess the effectiveness of electronic safety features and alerts in preventing error and reducing harm to patients.
Accelerators/decelerators of achieving universal access to sexual and reproductive health services: a case study of Iranian health system
Authors: Akbari Nahid , Ramezankhani Ali , Pazargadi Mehrnoosh
Published: July 2013

Background

At the 1994 International Conference on Population and Development (ICPD), held in Cairo, the global community agreed to the goal of achieving universal access to sexual and reproductive health (SRH) and rights by 2015. This research explores the accelerators and decelerators of achieving universal access to the sexual and reproductive health targets and accordingly makes some suggestions.

Method

We have critically reviewed the latest national reports and extracted the background data on each SRH indicator. The key stakeholders, both national and international, were visited and interviewed at two sites. A total of 55 in-depth interviews were conducted with religious leaders, policy-makers, senior managers, senior academics, and health care managers. Six focus-group discussions were also held among health care providers. The study was qualitative in nature.

Results

Obstacles on the road to achieving universal access to SRH can be viewed from two perspectives. One gap exists between current achievements and the targets. The other gap arises due to age, marital status, and residency status. The most recently observed trends in the indicators of the universal access to SRH shows that the achievements in the “unmet need for family planning” have been poor. Unmet need for family planning could directly be translated to unwanted pregnancies and unwanted childbirths; the former calls for sexual education to underserved people, including adolescents; and the latter calls for access to safe abortion. Local religious leaders have not actively attended international goal-setting programs. Therefore, they usually do not presume a positive attitude towards these goals. Such negative attitudes seem to be the most important factors hindering the progress towards universal access to SRH. Lack of international donors to fund for SRH programs is also another barrier. In national levels both state and the society are interactively playing their roles. We have used a cascade model for presenting the barriers at the state levels from the strategic planning to implementation. Social factors are to be considered as a background for other factors at all stages.

Conclusion

Accelerating universal access to SRH requires adequate funding, firm political commitment, creative programming, and the involvement of diverse actors, including faith-based, civil society, and private sector partners.
Dispelling urban myths about default uncertainty factors in chemical risk assessment – sufficient protection against mixture effects?
Authors: Martin Olwenn V , Martin Scholze , Kortenkamp Andreas
Published: July 2013

Assessing the detrimental health effects of chemicals requires the extrapolation of experimental data in animals to human populations. This is achieved by applying a default uncertainty factor of 100 to doses not found to be associated with observable effects in laboratory animals. It is commonly assumed that the toxicokinetic and toxicodynamic sub-components of this default uncertainty factor represent worst-case scenarios and that the multiplication of those components yields conservative estimates of safe levels for humans. It is sometimes claimed that this conservatism also offers adequate protection from mixture effects. By analysing the evolution of uncertainty factors from a historical perspective, we expose that the default factor and its sub-components are intended to represent adequate rather than worst-case scenarios. The intention of using assessment factors for mixture effects was abandoned thirty years ago. It is also often ignored that the conservatism (or otherwise) of uncertainty factors can only be considered in relation to a defined level of protection. A protection equivalent to an effect magnitude of 0.001-0.0001% over background incidence is generally considered acceptable. However, it is impossible to say whether this level of protection is in fact realised with the tolerable doses that are derived by employing uncertainty factors. Accordingly, it is difficult to assess whether uncertainty factors overestimate or underestimate the sensitivity differences in human populations. It is also often not appreciated that the outcome of probabilistic approaches to the multiplication of sub-factors is dependent on the choice of probability distributions. Therefore, the idea that default uncertainty factors are overly conservative worst-case scenarios which can account both for the lack of statistical power in animal experiments and protect against potential mixture effects is ill-founded. We contend that precautionary regulation should provide an incentive to generate better data and recommend adopting a pragmatic, but scientifically better founded approach to mixture risk assessment.
Identifying state-level policy and provision domains for physical education and physical activity in high school
Authors: Hales Derek , Stevens June , Murray David M , Taber Dan R , Roberts Amy
Published: July 2013

Background

It is important to quickly and efficiently identify policies that are effective at changing behavior; therefore, we must be able to quantify and evaluate the effect of those policies and of changes to those policies. The purpose of this study was to develop state-level physical education (PE) and physical activity (PA) policy domain scores at the high-school level. Policy domain scores were developed with a focus on measuring policy change.

Methods

Exploratory factor analysis was used to group items from the state-level School Health Policies and Programs Study (SHPPS) into policy domains. Items that related to PA or PE at the High School level were identified from the 7 SHPPS health program surveys. Data from 2000 and 2006 were used in the factor analysis. RESULTS: From the 98 items identified, 17 policy domains were extracted. Average policy domain change scores were positive for 12 policy domains, with the largest increases for “Discouraging PA as Punishment”, “Collaboration”, and “Staff Development Opportunities”. On average, states increased scores in 4.94 ± 2.76 policy domains, decreased in 3.53 ± 2.03, and had no change in 7.69 ± 2.09 policy domains. Significant correlations were found between several policy domain scores.

Conclusions

Quantifying policy change and its impact is integral to the policy making and revision process. Our results build on previous research offering a way to examine changes in state-level policies related to PE and PA of high-school students and the faculty and staff who serve them. This work provides methods for combining state-level policies relevant to PE or PA in youth for studies of their impact.
The prevalence of human papillomavirus and its impact on cervical dysplasia in Northern Canada
Authors: Jiang Ying , Brassard Paul , Severini Alberto , Mao Yang , Li Y Anita , Laroche Julie , Chatwood Susan , Corriveau Andre , Kandola Kami , Hanley Brendan , Sobol Isaac , Ar-Rushdi Muna , Johnson Gordon , Lo Jane , Ratnam Sam , Wong Tom , Demers Alain , Jayaraman Gayatri , Totten Stephanie , Morrison Howard
Published: July 2013

Introduction

Certain types of the Human Papillomavirus (HPV) are sexually transmitted and highly associated with development of cervical dysplasia and cervical cancer but the distribution of HPV infection in the North, particularly amongst First Nations, Metis, and Inuit peoples, is little known. The purposes of the study are to identify the prevalence of type-specific HPV infections and the association of different HPV types with cervical dysplasia among women in Northern Canada.

Methods

This was a cross-sectional study with attendants of the routine or scheduled Pap testing program in the Northwest Territories (NWT), Nunavut, Labrador and Yukon, Canada. Approximately half of each sample was used for Pap test and the remaining was used for HPV genotyping using a Luminex-based method. Pap test results, HPV types, and demographic information were linked for analyses.

Results

Results from 14,598 specimens showed that HPV infection was approximately 50% higher among the Aboriginal than the non-Aboriginal population (27.6% vs. 18.5%). Although the most common HPV type detected was HPV 16 across region, the prevalence of other high risk HPV types was different. The age-specific HPV prevalence among Aboriginal showed a ‘U’ shape which contrasted to non-Aboriginal. The association of HPV infection with cervical dysplasia was similar in both Aboriginal and non-Aboriginal populations.

Conclusions

The HPV prevalence was higher in Northern Canada than in other Areas in Canada. The prevalence showed a higher rate of other high risk HPV infections but no difference of HPV 16/18 infections among Aboriginal in comparison with non-Aboriginal women. This study provides baseline information on HPV prevalence that may assist in surveillance and evaluation systems to track and assess HPV vaccine programs.
Spatial and temporal variations relevant to tsetse control in the Bipindi focus of southern Cameroon
Authors: Tchouomene-Labou Judith , Nana-Djeunga Hugues , Simo Gustave , Njitchouang Guy Roger , Cuny Gerard , Asonganyi Tazoacha , Njiokou Flobert
Published: July 2013

Background

Human African Trypanosomiasis (HAT) remains a public health problem in many poor countries. Due to lack of financial resources in these countries, cost-effective strategies are needed for efficient control of this scourge, especially the tsetse vector. It was shown that perennial water sources maintain a favourable biotope for tsetse flies and thus the transmission dynamics of sleeping sickness. The present paper aimed at assessing the transmission dynamics of HAT in a forest environment where the hydrographic network is important.

Methods

Two entomological surveys were carried out in July 2009 and March 2010 in the Bipindi sleeping sickness focus of the South Region of Cameroon. Entomological and parasitological data were collected during both trapping periods (including the climate variations throughout a year) and compared to each other. The level of risk for transmission of the disease during each trapping period was also evaluated at the trap level and materialised on the map of the Bipindi focus.

Results

Glossina palpalis palpalis was the most prevalent tsetse fly species captured in this focus. The overall densities of tsetse flies as well as the risk for transmission of HAT in the Bipindi focus were significantly higher in July than in March. At the trap level, we observed that these parameters were almost constant, whatever the trapping period, when the biotope included perennial water sources.

Conclusions

This study shows that the spatial distribution of traps, as well as the temporal climatic variations might influence entomological and parasitological parameters of HAT and that the presence of perennial water sources in biotopes would favour the development of tsetse flies and thus the transmission of sleeping sickness. These factors should, therefore, be taken into account in order to provide more efficient vector control.
Exploring the response of rice (Oryza sativa) leaf to gibberellins: a proteomic strategy
Authors: Wang Xiaoqin , Han Feng , Yang Mingfeng , Yang Pingfang , Shen Shihua
Published: July 2013

Background

Gibberellins (GAs) are plant-specific hormones that play a central role in the regulation of growth and development with respect to environmental variability. Plants respond to GAs signal through various biochemical and physiological processes. To better understand the response for GA signal, we carried out a proteomic study in rice (Oryza sativa L. spp. japonica) leaf.

Results

Through two-dimensional gel electrophoresis (2-DE) and mass spectroscopy analysis, we identified 61 proteins as GA-responsive. These proteins were annotated in various biological functions, such as signal transduction and cell growth/division, photosynthesis and energy metabolism, protein stability and defense. Among these, photosynthetic proteins decreased while many catabolic proteins increased. In addition, GA up-regulated a variety of cell growth/division, protein stability and defense proteins such as cell division cycle protein 48, molecular chaperones, and catalases.

Conclusion

This is the first report that cell division cycle protein 48 may be responsible for leaf expansion after leaf sensing GA signal. The results presented here provide new insight into the mechanism of rice leaf in response to GA signal.
Induction of autophagy by cystatin C: a potential mechanism for prevention of cerebral vasospasm after experimental subarachnoid hemorrhage
Authors: Liu Yizhi , Cai Hongfa , Wang Zhong , Li Jianke , Wang Kaiyong , Yu Zhengquan , Chen Gang
Published: July 2013

Background

Studies have demonstrated that autophagy pathways are activated in the brain after experimental subarachnoid hemorrhage (SAH) and this may play a protective role in early brain injury. However, the contribution of autophagy in the pathogenesis of cerebral vasospasm (CVS) following SAH, and whether up-regulated autophagy may contribute to aggravate or release CVS, remain unknown. Cystatin C (CysC) is a cysteine protease inhibitor that induces autophagy under conditions of neuronal challenge. This study investigated the expression of autophagy proteins in the walls of basilar arteries (BA), and the effects of CysC on CVS and autophagy pathways following experimental SAH in rats.

Methods

All SAH animals were subjected to injection of 0.3 mL fresh arterial, non-heparinized blood into the cisterna magna. Fifty rats were assigned randomly to five groups: control group (n = 10), SAH group (n = 10), SAH + vehicle group (n = 10), SAH + low dose of CysC group (n = 10), and SAH + high dose of CysC group (n = 10). We measured proteins by western blot analysis, CVS by H&E staining method, morphological changes by electron microscopy, and recorded neuro-behavior scores.

Results

Microtubule-associated protein light chain-3, an autophagosome biomarker, and beclin-1, a Bcl-2-interacting protein required for autophagy, were significantly increased in the BA wall 48 h after SAH. In the CysC-handled group, the degree of CVS, measured as the inner BA perimeter and BA wall thickness, was significantly ameliorated in comparison with vehicle-treated SAH rats. This effect paralleled the intensity of autophagy in the BA wall induced by CysC.

Conclusions

These results suggest that the autophagy pathway is activated in the BA wall after SAH and CysC-induced autophagy may play a beneficial role in preventing SAH-induced CVS.
Comparative utility of LC3, p62 and TDP-43 immunohistochemistry in differentiation of inclusion body myositis from polymyositis and related inflammatory myopathies
Authors: Hiniker Annie , Daniels Brianne H , Lee Han S , Margeta Marta
Published: July 2013

Background

Inclusion body myositis (IBM) is a slowly progressive inflammatory myopathy of the elderly that does not show significant clinical improvement in response to steroid therapy. Distinguishing IBM from polymyositis (PM) is clinically important since PM is steroid-responsive; however, the two conditions can show substantial histologic overlap.

Results

We performed quantitative immunohistochemistry for (1) autophagic markers LC3 and p62 and (2) protein aggregation marker TDP-43 in 53 subjects with pathologically diagnosed PM, IBM, and two intermediate T cell-mediated inflammatory myopathies (polymyositis with COX-negative fibers and possible IBM). The percentage of stained fibers was significantly higher in IBM than PM for all three immunostains, but the markers varied in sensitivity and specificity. In particular, both LC3 and p62 were sensitive markers of IBM, but the tradeoff between sensitivity and specificity was smaller (and diagnostic utility thus greater) for LC3 than for p62. In contrast, TDP-43 immunopositivity was highly specific for IBM, but the sensitivity of this test was low, with definitive staining present in just 67% of IBM cases.

Conclusions

To differentiate IBM from PM, we thus recommend using a panel of LC3 and TDP-43 antibodies: the finding of <14% LC3-positive fibers helps exclude IBM, while >7% of TDP-43-positive fibers strongly supports a diagnosis of IBM. These data provide support for the hypothesis that disruption of autophagy and protein aggregation contribute to IBM pathogenesis.
Lost in translation: transferring knowledge from research to clinical practice
Authors: Wallace John
Published: July 2013

Using a new treatment is not an instantaneous act. There is a gap between research and practice and carefully evaluated evidence often fails to achieve widespread use. Various factors intercede along the pathway from knowledge generation to knowledge utilisation. These can hinder, or indeed facilitate, the use of research evidence in psychiatry. Knowledge translation is a discipline that attempts to identify and understand these barriers and facilitators to knowledge transfer. In this article, the terminology and key concepts of knowledge translation will be outlined, the evidence transfer pipeline described and obstacles and facilitators to uptake of evidence explored. The article also identifies sources of information on knowledge transfer. Innovative approaches designed to enhance the uptake of evidence from research, such as summaries, systematic reviews and targeted messaging, are also described.
Lack of interventions for anxiety in older people
Authors: Voshaar Richard C. Oude
Published: July 2013

Although anxiety disorders are common in later life, only a minority of patients receive appropriate treatment. The scarcity of clinical trials and decreasing effectiveness of current treatment modalities with advancing age, as shown by Wetherell and colleagues in this issue, argue for more clinical trials and development of age-specific psychotherapeutic techniques.
Crises and Recoveries in an Empirical Model of Consumption Disasters
Authors: Nakamura Emi , Steinsson Jón , Barro Robert , Ursúa José
Published: July 2013

We estimate an empirical model of consumption disasters using new data on consumption for 24 countries over more than 100 years, and study its implications for asset prices. The model allows for partial recoveries after disasters that unfold over multiple years. We find that roughly half of the drop in consumption due to disasters is subsequently reversed. Our model generates a sizable equity premium from disaster risk, but one that is substantially smaller than in simpler models. It implies that a large value of the intertemporal elasticity of substitution is necessary to explain stock-market crashes at the onset of disasters. (JEL E21, E32, E44, G12, G14)
The Financial Crisis: Lessons for International Macroeconomics
Authors: Bussière Matthieu , Imbs Jean , Kollmann Robert , Rancière Romain
Published: July 2013

This article introduces a special section of the American Economic Journal: Macroeconomics, containing five papers presented during a conference in Paris in October 2011. The aim of the conference was to derive lessons from the financial crisis, for research on international macroeconomics and for policy. The article opens with a summary of the key mechanisms at play during the crisis. The question of the crisis transmission across borders is addressed, with a focus on international trade and financial institutions. Recent advances in the analysis of sovereign default risk are also discussed. The article concludes with a discussion of policy responses to the crisis. (JEL E32, E44, F14, G01, G21, G28)