bluuebunny/crossref_metadata_2025 huggingface dataset:
Re‐examining a measure of diabetes‐related burden in parents of young people with Type 1 diabetes: the Problem Areas in Diabetes Survey – Parent Revised version (PAID‐PR)
Authors: Markowitz J. T. , Volkening L. K. , Butler D. A. , Antisdel‐Lomaglio J. , Anderson B. J. , Laffel L. M. B.
Published: September 2011

Diabet. Med. 29, 526–530 (2012)

Aims  In a pediatric patients, the burden of diabetes lies within the family. In the current era of intensive insulin therapy, perceived parental burden may affect the family’s efforts at effective diabetes management. The aims of this study were to re‐examine and revise a measure of perceived parental burden associated with caring for a child with diabetes in the current era.

Methods  A geographically diverse population of young people (N = 376) with Type 1 diabetes and their parents included participants in the Juvenile Diabetes Research Foundation continuous glucose monitoring study and patients from the Joslin Diabetes Center. Participants provided data on demographics, diabetes management, diabetes‐specific family conflict, and quality of life at baseline and after 6 months of follow‐up.

Results  Young people were 12.9 ± 2.7 years old with diabetes duration of 6.3 ± 3.5 years. Mean HbA1C was 8.0 ± 1.2%(64 mmol/mol), 58% received insulin pump therapy, and young people monitored blood glucose 5.2 ± 2.3 times/day. Factor analysis yielded two factors, ‘Immediate Burden’ and ‘Theoretical Burden’. The Problem Areas in Diabetes Survey – Parent Revised version (PAID‐PR) demonstrated excellent internal consistency (Cronbach’s α = 0.87; factor 1 α = 0.78; factor 2 α = 0.83). Greater parental burden was associated with more frequent blood glucose monitoring, higher HbA1C levels, greater diabetes‐specific family conflict, and lower quality of life. Test–retest analysis was acceptable (r = 0.62).

Conclusions  The PAID‐PR demonstrated excellent internal consistency, good test‐retest reliability, and associations with diabetes‐specific family conflict and quality of life. This brief measure may have both clinical and research utility in the management of young people with Type 1 diabetes.
History and Time
Authors: Christian David
Published: September 2011

Time is the medium in which history and politics evolve, yet historians and political scientists have devoted limited efforts to understanding it. The familiar notion that time flows regularly, objectively and in a clear direction has severe limitations. Above all, it makes it difficult to understand the huge differences in perceptions of time in different cultural contexts. Norbert Elias argued that time, like money, can be understood as a social convention; it arises from the activity of “timing” or “scheduling”. All living organisms have to align their actions to the rhythms of a real world, so natural selection has built into them the ability to detect and react to significant rhythms. Humans are unique because they relate to the world's rhythms in diverse ways, so different communities may experience time differently. Elias argued that as societies became larger and more complex, schedules became more inter‐twined, creating the illusion of a single, unified temporal dimension. Meanwhile, the increasing pace of social change generated a growing awareness of time as history. These changes are the foundations for our distinctively modern sense of time.
Commandeering Time: The Ideological Status of Time in the Social Darwinism of Herbert Spencer
Authors: Stewart Iain
Published: September 2011

The once world‐famed philosophy of Herbert Spencer is the most thoroughly developed version of what is commonly but misleadingly termed “Social Darwinism”. It will be argued that Spencer confers upon time a super‐objectivity within which his own political preferences appear to lie beyond historical time, hence as not subject to politics but as a frame within which only a restricted range of political choices appear to be available. Using the example of Spencer, it is then asked how an ideology may be identified not only as effect and as process but also as to its “mechanism”. In everyday life, how is ideology done? It is suggested that the mechanism lies not on the plane of the signified but on that of the signifier, in what will be termed a “dark performative” use of language.
Developmental Continuity in Theory of Mind: Speed and Accuracy of Belief–Desire Reasoning in Children and Adults
Authors: Apperly Ian A. , Warren Frances , Andrews Benjamin J. , Grant Jay , Todd Sophie
Published: September 2011

On belief–desire reasoning tasks, children first pass tasks involving true belief before those involving false belief, and tasks involving positive desire before those involving negative desire. The current study examined belief–desire reasoning in participants old enough to pass all such tasks. Eighty‐three 6‐ to 11‐year‐olds and 20 adult participants completed simple, computer‐based tests of belief–desire reasoning, which recorded response times as well as error rates. Both measures suggested that, like young children, older children and adults find it more difficult to reason about false belief and negative desires than true beliefs and positive desires. It is argued that this developmental continuity is most consistent with either executive competence or executive performance accounts of the development of belief–desire reasoning.
Social Groups and Children’s Intergroup Attitudes: Can School Norms Moderate the Effects of Social Group Norms?
Authors: Nesdale Drew , Lawson Michael J.
Published: September 2011

The effects of social group norms (inclusion vs. exclusion vs. exclusion‐plus‐relational aggression) and school norms (inclusion vs. no norm) on 7‐ and 10‐year‐old children’s intergroup attitudes were examined. Children (n = 383) were randomly assigned to a group with an inclusion or exclusion norm, and to 1 of the school norm conditions. Findings indicated that children’s out‐group attitudes reflected their group’s norm but, with increasing age, they liked their in‐group less, and the out‐group more, if the group had an exclusion norm. The school inclusion norm instigated more positive attitudes toward out‐group members, but it did not moderate or extinguish contrary group norms. The use of school norms to counteract the effects of children’s social group norms is discussed.
Performances on Rey Auditory Verbal Learning Test and Rey Complex Figure Test in a healthy, elderly Danish sample – reference data and validity issues
Authors: VOGEL ASMUS , STOKHOLM JETTE , JØRGENSEN KASPER
Published: September 2011

Vogel, A., Stokholm, J. & Jørgensen, K. (2012). Performances on Rey Auditory Verbal Learning Test and Rey Complex Figure Test in a healthy, elderly Danish sample – reference data and validity issues. Scandinavian Journal of Psychology 53, 26–31.

This study presents Danish data for Rey Auditory Verbal Learning Test (RAVLT) and Rey Complex Figure Test (RCFT) from 100 subjects aged 60–87 years. Education and estimated verbal intelligence (DART score) had a significant impact on the RAVLT trial 1–5 score but not on other RAVLT measures. The RCFT copy score was significantly related to age and the DART score. On RCFT recall a highly significant difference was found between persons who could make a faultless copy and persons with incomplete copy performance. Thus, this study presents separate data for RCFT recall scores according to the subjects’ copying performance (in separate tables for age and education groups). For all measures on both RAVLT and RCFT wide distributions of scores were found and the impact of this broad score range on the tests’ discriminative validity is discussed. RAVLT performances for elderly were similar to previous published meta‐norms, but the included sample of elderly Danes performed better on RCFT (copy and recall) than elderly from the United States.
The Importance of Place: Re‐territorialising Embeddedness
Authors: Bowen Sarah
Published: September 2011

Sociologists have used the concept of embeddedness to examine the relationships between social networks, social capital, cultural and cognitive elements and the construction of markets. Yet important questions remain regarding how local and extra‐local actors actively construct embedded markets and how networks exhibit both embedding and disembedding tendencies. I use qualitative data on a case study of Comté cheese, an origin‐labelled cheese produced in eastern France, to develop a more critical and precise analysis of what embeddedness means in the context of (localised) food systems. I demonstrate the importance of horizontal and vertical forms of embeddedness. The expansion of the market and the entry of extra‐local actors into the chain put a strain on the proximity and close ties that have historically constituted the basis of the social embeddedness of the Comté supply chain. The institutions that the Inter‐professional Committee for Gruyère from Comté has developed, the support offered by the French state and the actors' shared belief in terroir are forms of vertical embeddedness that all act to re‐embed the Comté supply chain in its particular territory, even in the context of these destabilising forces.
Numerical simulations of amethyst geode cavity formation by ballooning of altered Paraná volcanic rocks, South America
Authors: HARTMANN L. A. , MEDEIROS J. T. N. , PETRUZZELLIS L. T.
Published: September 2011

Numerical modelling by finite element methods provides two significant insights into the formation of the giant amethyst geodes of the Paraná volcanic province: the conditions needed to open the cavities and the conditions that control their size and shape. Giant amethyst geodes were formed in the Cretaceous (135 Ma) in altered volcanic rocks by water vapour pressure (Δp) at about 0.5 MPa under an altered basalt cover of 5–20 m. Only rocks with Young’s modulus values (E) in the range 1–2 GPa can sustain ballooning, which is the growth of a cavity in a ductile medium by the pressure of water and its vapour. The size of the proto‐geode is dependent on the water vapour pressure, which is directly related to thickness of the overlying basalt. Varying the yield points causes the formation of either prolate or oblate cavities. A low transition point (smaller than 0.18 MPa) generates a prolate‐shaped cavity, whereas a high transition point (larger than 0.18 MPa) generates oblate proto‐geodes. Proto‐geodes are smaller when Young’s modulus is higher (rock is less altered) or when water vapour pressure is lower (because of thinner overburden of basalt). The calculations are an indication that the processes operative in the altered basalts led to the opening of giant cavities by ballooning.
A randomized controlled trial of preschool‐based joint attention intervention for children with autism
Authors: Kaale Anett , Smith Lars , Sponheim Eili
Published: September 2011

Background:  Deficits in joint attention (JA) and joint engagement (JE) represent a core problem in young children with autism as these affect language and social development. Studies of parent‐mediated and specialist‐mediated JA‐intervention suggest that such intervention may be effective. However, there is little knowledge about the success of the intervention when done in preschools.

Aim:  Assess the effects of a preschool‐based JA‐intervention.

Methods:  61 children (48 males) with autistic disorder (29–60 months) were randomized to either 8 weeks of JA‐intervention, in addition to their preschool programs (n = 34), or to preschool programs only (n = 27). The intervention was done by preschool teachers with weekly supervision by trained counselors from Child and Adolescent Mental Health Clinics (CAMHC). Changes in JA and JE were measured by blinded independent testers using Early Social Communication Scale (ESCS) and video taped preschool teacher–child and mother–child play at baseline and post‐intervention.

Clinical trials registration:  Clinicaltrials.gov: NCT00378157.

Results:  Intention‐to‐treat analysis showed significant difference between the intervention and the control group, with the intervention group yielding more JA initiation during interaction with the preschool teachers. The effect generalized to significantly longer duration of JE with the mothers.

Conclusions:  This is the first randomized study to show positive and generalized effects of preschool‐based JA‐intervention.
Socially induced infertility in Ansell's mole‐rat: are there depressed hormone levels in non‐reproductive males and females?
Authors: de Bruin P. R. , Viljoen H. , Sichilima A. M. , Bennett N. C.
Published: September 2011

Ansell's mole‐rat, Fukomys anselli, is a social subterranean mammal and exhibits an extreme reproductive division of labour. Reproduction in the colony is restricted usually to a single female. Complete colonies captured throughout an entire calendar year were euthanased and the histology of the gonads and plasma hormone concentrations were measured in reproductive and non‐reproductive members of both sexes. In males, the circulating levels of testosterone were significantly higher in the reproductive male than the non‐reproductive males. The mean testes mass for the reproductive males corrected for body mass was not significantly greater than that of the non‐reproductive male. Similarly, the mean testes volume of reproductive males was not greater than that for the non‐reproductive males but the seminiferous tubule diameter was significantly greater in the reproductive males than the non‐reproductive males. Reproductive females characteristically possessed corpora lutea of ovulation and pregnancy in their ovaries and this was met with much higher progesterone concentrations in the reproductive females 34 nmol/L compared with 4 nmols/L in the non‐reproductive females. In contrast, non‐reproductive females showed a complete range of follicular genesis, but they did not possess corpora lutea of ovulation or pregnancy, in turn they show depressed progesterone concentrations. The current evidence suggests that in Ansell's mole‐rats, the non‐reproductive males and females refrain from sexual activity by being subordinate and moreover, related to the breeding pair.
A herbivore's food landscape: seasonal dynamics and nutritional implications of diet selection by a red deer population in contrasting Alpine habitats
Authors: Zweifel‐Schielly B. , Leuenberger Y. , Kreuzer M. , Suter W.
Published: September 2011

Dietary constraints for large herbivores tend to be most strongly linked to quality of the forage available. In highly seasonal environments, such as mountain areas, both plant quality and available biomass may act as constraints. However, studies addressing the nutritional basis of diet selection of wild large herbivores under harsh conditions in sufficiently large spatial and temporal frameworks are scarce. We studied the functional importance of relative variability in plant quality and biomass for diet selection by a migratory population of Alpine red deer (Cervus elaphus) at the landscape scale and across an annual cycle. Botanical diet composition at plant group level did not show a particular ‘Alpine pattern’ but was similar to known patterns from lowland areas. Sources of variability were season, habitat (either open land or forest) and sex. Red deer foraged selectively in all seasons, and preferences for plant groups were negatively linked to plant abundances. Use and selection of plant groups were associated with high nutritional value (high crude protein and organic matter, low fibre), but partly also with high levels of active tannins. In the cold season, deer made strong nocturnal use of fertilized valley floor meadows offering high‐quality grass, but still showed some selection for tannin‐ and fibre‐rich coniferous browse, indicating a need for supplementing grass intake. Altogether, the nutritional value of the diet exceeded that of the forage available in the forested habitat, which was at or below the lower threshold for fulfilling metabolic needs of red deer. High‐quality grass on farmed meadows may thus be a critical source of food in mountainous areas during winter.
Activity, movement and secretive behavior of a threatened arboreal folivore, the thin‐spined porcupine, in the Atlantic forest of southern Bahia, Brazil
Authors: Giné Gastón Andrés Fernandez , Duarte José Maurício Barbanti , Motta Tatiana Cristina Senra , Faria Deborah
Published: September 2011

Activity and behavior patterns are important components of a given species’ ecological strategy, as they have profound implications for its survival and reproduction. Here, we studied the activities, movements and secretive behavior of the thin‐spined porcupine Chaetomys subspinosus (Rodentia: Erethizontidae), a threatened arboreal folivore in the Brazilian Atlantic rainforest. We aimed to ascertain the behavioral strategies used by this species as well as its responses to seasonal and daily climatic changes. Four radio‐collared individuals were followed continuously for 72‐h in the summer and winter, as well as during 146 half‐night sessions conducted from April 2005 to September 2006 in forest remnants in southern Bahia. The thin‐spined porcupines were nocturnally active (17:30–05:40 h), with peaks in activity and movement from 19:00 to 20:00 h and 03:00 to 04:00 h. Animals followed a circadian rhythm of activity during both the summer and winter. During the diel cycle, porcupines spent 74% of their time resting, 14% feeding, 11% traveling and 2% performing other activities. Distance traveled during the diel cycle averaged 277.5 ± 117.9 m sd. The mean movement rate during the night was 21.6 ± 30.1 m/h sd. No significant changes in activity budget or daily distance traveled were observed between seasons, most likely in response to the low fluctuations in climatic conditions and food availability throughout the year in the study region. However, rainfall reduced the time that the animals spent on feeding activities and explained day‐to‐day differences in activity budgets. We also provide details about intraspecific interactions and defecation behavior. Our observations confirmed that thin‐spined porcupines, similar to other folivorous species, present low activity levels and short daily movements, and have adopted various cryptic habits, such as nocturnality, a solitary lifestyle, the tendency to leave offspring alone most of the time and defecation in concealed latrines.
Spatial and temporal variation in natal dispersal byEurasian lynx inScandinavia
Authors: Samelius G. , Andrén H. , Liberg O. , Linnell J. D. C. , Odden J. , Ahlqvist P. , Segerström P. , Sköld K.
Published: September 2011

Dispersal patterns are male biased in most mammals whereas the patterns are less clear within the genusLynx (four species), with findings ranging from male biased dispersal to males and females dispersing equally far and with equal frequency. In this study, we examined various aspects of natal dispersal byEurasian lynx inScandinavia by comparing dispersal patterns of 120 radio‐marked lynx in two study areas inSweden (Sarek andBergslagen) and two study areas inNorway (Hedmark andAkershus). We found that male lynx dispersed farther than female lynx with mean dispersal distances of 148 and 47 km for male and female lynx that were followed to the age of 18 months or older (range = 32–428 and 3–215 km for each sex, respectively). In fact, female lynx often established home ranges that overlapped or partly overlapped that of their mothers. Similarly, the dispersal rate was greater among male lynx than among female lynx, with 100% of the males dispersing compared with 65% of the females dispersing. This study showed that dispersal patterns by lynx in Scandinavia were male biased, with (1) male lynx dispersing farther and more frequently than female lynx and (2) female lynx often settling near their natal areas. These patterns, in turn, will have large impact on gene flow and the ability by lynx to colonize new and formerly occupied areas.
α‐Synuclein promotes clathrin‐mediated NMDA receptor endocytosis and attenuates NMDA‐induced dopaminergic cell death
Authors: Cheng Furong , Li Xin , Li Yaohua , Wang Chaodong , Wang Tao , Liu Guangwei , Baskys Andrius , Uéda Kenji , Chan Piu , Yu Shun
Published: September 2011

J. Neurochem. (2011) 119, 815–825.

Abnormalities of α‐synuclein (α‐syn) and NMDA receptors (NMDARs) are implicated in the pathogenesis of Parkinson’s disease. However, how these proteins interact with each other has not been elucidated. Here, the effect of α‐syn on NMDARs was investigated by examining the alterations of surface NMDAR NR1 subunits in MES23.5 dopaminergic cells transfected with the human α‐syn gene as well as in cells treated with extracellularly added human α‐syn. As demonstrated previously that α‐syn can enter cells in a non‐endocytic manner without being degraded by the cellular proteolytic systems, the extracellularly added α‐syn entered the cytoplasm of MES23.5 cells in a concentration‐dependent manner. Both the α‐syn‐transfected cells and α‐syn‐treated cells exhibited increased intracellular α‐syn levels and reduced surface NR1 without altering the total NR1. The α‐syn‐induced surface NR1 reduction was accompanied by suppression of NMDA‐elicited intracellular Ca2+ elevation and reductions of NMDA‐induced caspase 3 activation and cell death, which was abolished by hypotonic shock and K+ depletion, a procedure that blocks clathrin‐mediated endocytosis, and by suppression of RAB5B expression with anti‐RAB5B oligonucleotides. The data obtained provide evidence for the first time that α‐syn may promote clathrin‐mediated NMDAR endocytosis.
Can't get no satisfaction with the Westminster model? Winners, losers and the effects of consensual and direct democratic institutions on satisfaction with democracy
Authors: BERNAUER JULIAN , VATTER ADRIAN
Published: September 2011

Are citizens in consensus democracies with developed direct democratic institutions more satisfied with their political system than those in majoritarian democracies? In this article, individual‐level data from the second wave of the Comparative Study of Electoral Systems and an updated version of Lijphart's multivariate measure of consensus and majoritarian democracy covering 24 countries are used to investigate this question. The findings from logistic multilevel models indicate that consensual cabinet types and direct democratic institutions are associated with higher levels of citizens' satisfaction with democracy. Furthermore, consensus democracy in these institutions closes the gap in satisfaction with democracy between losers and winners of elections by both comforting losers and reducing the satisfaction of winners. Simultaneously, consensus democracy in terms of electoral rules, the executive–legislative power balance, interest groups and the party system reduces the satisfaction of election winners, but does not enhance that of losers.
Inhibiting fatty acid amide hydrolase normalizes endotoxin‐induced enhanced gastrointestinal motility in mice
Authors: Bashashati M , Storr MA , Nikas SP , Wood JT , Godlewski G , Liu J , Ho W , Keenan CM , Zhang H , Alapafuja SO , Cravatt BF , Lutz B , Mackie K , Kunos G , Patel KD , Makriyannis A , Davison JS , Sharkey KA
Published: September 2011

BACKGROUND AND PURPOSE Gastrointestinal (GI) motility is regulated in part by fatty acid ethanolamides (FAEs), including the endocannabinoid (EC) anandamide (AEA). The actions of FAEs are terminated by fatty acid amide hydrolase (FAAH). We investigated the actions of the novel FAAH inhibitor AM3506 on normal and enhanced GI motility.

EXPERIMENTAL APPROACH We examined the effect of AM3506 on electrically‐evoked contractility in vitro and GI transit and colonic faecal output in vivo, in normal and FAAH‐deficient mice treated with saline or LPS (100 µg·kg−1, i.p.), in the presence and absence of cannabinoid (CB) receptor antagonists. mRNA expression was measured by quantitative real time‐PCR, EC levels by liquid chromatography‐MS and FAAH activity by the conversion of [3H]‐AEA to [3H]‐ethanolamine in intestinal extracts. FAAH expression was examined by immunohistochemistry.

KEY RESULTS FAAH was dominantly expressed in the enteric nervous system; its mRNA levels were higher in the ileum than the colon. LPS enhanced ileal contractility in the absence of overt inflammation. AM3506 reversed the enhanced electrically‐evoked contractions of the ileum through CB1 and CB2 receptors. LPS increased the rate of upper GI transit and faecal output. AM3506 normalized the enhanced GI transit through CB1 and CB2 receptors and faecal output through CB1 receptors. LPS did not increase GI transit in FAAH‐deficient mice.

CONCLUSIONS AND IMPLICATIONS Inhibiting FAAH normalizes various parameters of GI dysmotility in intestinal pathophysiology. Inhibition of FAAH represents a new approach to the treatment of disordered intestinal motility.
Opportunities and Challenges for Ecological Restoration within REDD+
Authors: Alexander Sasha , Nelson Cara R. , Aronson James , Lamb David , Cliquet An , Erwin Kevin L. , Finlayson C. Max , de Groot Rudolf S. , Harris Jim A. , Higgs Eric S. , Hobbs Richard J. , Robin Lewis Roy R. , Martinez Dennis , Murcia Carolina
Published: September 2011

The Reducing Emissions from Deforestation and Forest Degradation (REDD+) mechanism has the potential to provide the developing nations with significant funding for forest restoration activities that contribute to climate change mitigation, sustainable management, and carbon‐stock enhancement. In order to stimulate and inform discussion on the role of ecological restoration within REDD+, we outline opportunities for and challenges to using science‐based restoration projects and programs to meet REDD+ goals of reducing greenhouse gas emissions and storing carbon in forest ecosystems. Now that the REDD+ mechanism, which is not yet operational, has expanded beyond a sole focus on activities that affect carbon budgets to also include those that enhance ecosystem services and deliver other co‐benefits to biodiversity and communities, forest restoration could play an increasingly important role. However, in many nations, there is a lack of practical tools and guidance for implementing effective restoration projects and programs that will sequester carbon and at the same time improve the integrity and resilience of forest ecosystems. Restoration scientists and practitioners should continue to engage with potential REDD+ donors and recipients to ensure that funding is targeted at projects and programs with ecologically sound designs.
THE TOXIC DINOFLAGELLATEGYMNODINIUM CATENATUM(DINOPHYCEAE) REQUIRES MARINE BACTERIA FOR GROWTH1
Authors: Bolch Christopher J. S. , Subramanian Thaila A. , Green David H.
Published: September 2011

Interactions with the bacterial community are increasingly considered to have a significant influence on marine phytoplankton populations. Here we used a simplified dinoflagellate‐bacterium experimental culture model to conclusively demonstrate that the toxic dinoflagellateGymnodinium catenatumH. W. Graham requires growth‐stimulatory marine bacteria for postgermination survival and growth, from the point of resting cyst germination through to vegetative growth at bloom concentrations (103 cells · mL−1). Cysts ofG. catenatumwere germinated and grown in unibacterial coculture with antibiotic‐resistant or antibiotic‐sensitiveMarinobactersp. DG879 orBrachybacteriumsp., and with mixtures of these two bacteria. Addition of antibiotics to cultures grown with antibiotic‐sensitive strains of bacteria resulted in death of the dinoflagellate culture, whereas cultures grown with antibiotic‐resistant bacteria survived antibiotic addition and continued to grow beyond the 21 d experiment. Removal of either bacterial type from mixed‐bacterial dinoflagellate cultures (using an antibiotic) resulted in cessation of dinoflagellate growth until bacterial concentration recovered to preaddition concentrations, suggesting that the bacterial growth factors are used for dinoflagellate growth or are labile. Examination of published reports of axenic dinoflagellate culture indicate that a requirement for bacteria is not universal among dinoflagellates, but rather that species may vary in their relative reliance on, and relationship with, the bacterial community. The experimental model approach described here solves a number of inherent and logical problems plaguing studies of algal‐bacterium interactions and provides a flexible and tractable tool that can be extended to examine bacterial interactions with other phytoplankton species.
Proton Pump Inhibitor Discontinuation in Long‐Term Care
Authors: Linsky Amy , Hermos John A. , Lawler Elizabeth V. , Rudolph James L.
Published: September 2011

OBJECTIVES: To determine factors associated with proton pump inhibitor (PPI) discontinuation in long‐term care.

DESIGN: Retrospective cohort analysis.

SETTING: Veterans Affairs (VA) long‐term care facilities.

PARTICIPANTS: Veterans admitted for nonhospice care in 2005 with a length of stay of 7 days or more who were prescribed a PPI within 7 days of admission (N=10,371).

MEASUREMENTS: Prescribed medications and comorbidities were determined from VA pharmacy and administrative databases and functional status from Minimum Data Set records. Associations between participant characteristics and PPI discontinuation were determined using Cox proportional hazard ratios (HRs), censoring at death, discharge, or 180 days after admission.

RESULTS: Participants were predominantly male (97%) and had a median age of 73 (interquartile range 60–81). There were 2,749 (27%) PPI discontinuations; 43% of these occurred within 28 days of admission. Hospitalizations (HR=1.22, 95% confidence interval (CI)=1.01–1.46), preadmission PPI use (HR=1.35, 95% CI=1.16–1.56), and lowest functional status (HR=1.22, 95% CI=1.03–1.45) were associated with early PPI discontinuation in adjusted models. Participants with gastric acid–related disease (HR=0.53, 95% CI 0.46–0.61), diabetes mellitus (HR=0.82, 95% CI 0.72–0.94), and those who were prescribed six or more medications (6–7 medications, HR=0.78, 95% CI=0.66–0.92; 8–10 medications, HR=0.64, 95% CI=0.54–0.76; ≥11 medications 0.51, 95% CI=0.42–0.62) were less likely to have early discontinuation. No PPI discontinuer had PPIs resumed during the study, and few (9%) had histamine‐2 receptor antagonist substitutions.

CONCLUSION: Although there may be clinical uncertainty regarding PPI discontinuation, more than one‐quarter of participants prescribed a PPI upon admission to long‐term care had it discontinued within 180 days. Targeting individuals prescribed PPIs for medication appropriateness review may reduce prescribing of potentially nonindicated medications.
Psychoactive Medications and Crash Involvement Requiring Hospitalization for Older Drivers: A Population‐Based Study
Authors: Meuleners Lynn B. , Duke Janine , Lee Andy H. , Palamara Peter , Hildebrand Janina , Ng Jonathon Q.
Published: September 2011

OBJECTIVES: To determine the association between psychoactive medications and crash risk in drivers aged 60 and older.

DESIGN: Retrospective population‐based case‐crossover study.

SETTING: A database study that linked the Western Australian Hospital Morbidity Data System and the Pharmaceutical Benefits Scheme.

PARTICIPANTS: Six hundred sixteen individuals aged 60 and older who were hospitalized as the result of a motor vehicle crash between 2002 and 2008 in Western Australia.

MEASUREMENTS: Hospitalization after a motor vehicle crash.

RESULTS: Greater risk for a hospitalization crash was found for older drivers prescribed benzodiazepines (odds ratio (OR)=5.3, 95% confidence interval (CI)=3.6–7.8, P<.001), antidepressants (OR=1.8, 95% CI=1.0–3.3, P=.04), and opioid analgesics (OR=1.5, 95% CI=1.0–2.3, P=.05). Crash risk was significantly greater in men prescribed a benzodiazepine (OR=6.2, 95% CI=3.2–12.2, P<.001) or an antidepressant (OR=2.7, 95% CI=1.1–6.9, P=.03). Women prescribed benzodiazepines (OR=4.9, 95% CI=3.1–7.8, P<.001) or opioid analgesics (OR=1.8, 95% CI=1.1–3.0, P=.03) also had a significantly greater crash risk. Subgroup analyses further suggested that drivers with (OR=4.0, 95% CI=2.9–8.1, P<.001) and without (OR=6.0, 95% CI=3.8–9.5, P<.001) a chronic condition who were prescribed benzodiazepines were at greater crash risk. Drivers with a chronic condition taking antidepressants (OR=3.4, 95% CI=1.3–8.5, P=.01) also had a greater crash risk.

CONCLUSION: Psychoactive medication usage was associated with greater risk of a motor vehicle crash requiring hospitalization in older drivers.
Contribution of Multiple Chronic Conditions to Universal Health Outcomes
Authors: Tinetti Mary E. , McAvay Gail J. , Chang Sandy S. , Newman Anne B. , Fitzpatrick Annette L. , Fried Terri R. , Peduzzi Peter N.
Published: September 2011

OBJECTIVES: To determine the relative effect of five chronic conditions on four representative universal health outcomes.

DESIGN: Cross‐sectional.

SETTING: Cardiovascular Health Study.

PARTICIPANTS: Five thousand two hundred and ninety‐eight community‐living participants aged 65 and older.

MEASUREMENTS: Multiple regression and Cox models were used to determine the effect of heart failure (HF), chronic obstructive pulmonary disease (COPD), osteoarthritis, depression, and cognitive impairment on self‐rated health, 12 basic and instrumental activities of daily living (ADLs and IADLs), six‐item symptom burden scale, and death.

RESULTS: Each condition adversely affected self‐rated health (P<.001) and ADLs and IADLs (P<.001). For example, persons with HF performed 0.70±0.08 fewer ADLs and IADLs than those without; persons with depression and persons with cognitive impairment performed 0.59±0.04 and 0.58±0.06 fewer activities, respectively, than those without these conditions. Depression, HF, COPD, and osteoarthritis were associated with 1.18±0.04, 0.40±0.08, 0.40±0.05, and 0.57±0.03 more symptoms, respectively, in individuals with these conditions than in those without. HF (hazard ratio (HR)=2.84, 95% confidence interval (CI)=1.97–4.10), COPD (2.62, 95% CI=1.94–3.53), cognitive impairment (2.05, 95% CI=1.47–2.85), and depression (1.47, 95% CI=1.08–2.01) were each associated with death within 2 years. Several paired combinations of conditions had synergistic effects on ADLs and IADLs. For example, individuals with HF plus depression performed 2.0 fewer activities than persons with neither condition, versus the 1.3 fewer activities expected from adding the effects of the two conditions together.

CONCLUSION: Universal health outcomes may provide a common metric for measuring the effects of multiple conditions and their treatments. The varying effects of the conditions across universal outcomes could inform care priorities.
A Critical Test of Temporal and Spatial Accuracy of the Tobii T60XL Eye Tracker
Authors: Morgante James D. , Zolfaghari Rahman , Johnson Scott P.
Published: September 2011

Infant eye tracking is becoming increasingly popular for its presumed precision relative to traditional looking time paradigms and potential to yield new insights into developmental processes. However, there is strong reason to suspect that the temporal and spatial resolution of popular eye tracking systems is not entirely accurate, potentially compromising any data from an infant eye tracking experiment. Moreover, “best practices” for infant eye tracking, such as knowing which software tool enhances experimental flexibility, remain to be determined. The present investigation was designed to evaluate the temporal and spatial accuracy of data from the Tobii T60XL eye tracker through the use of visual latency and spatial accuracy tasks involving adults and infants. Systematic delays and drifts were revealed in oculomotor response times, and the system’s spatial accuracy was observed to deviate somewhat in excess of the manufacturer’s estimates; the experimental flexibility of the system appears dependent on the chosen software.
Effects of granulocyte–colony‐stimulating factor on Monosomy 7 aneuploidy in healthy hematopoietic stem cell and granulocyte donors
Authors: Olnes Matthew J. , Poon Andrea , Miranda Susan J. , Pfannes Loretta , Tucker Zachary , Loeliger Kelsey , Padilla‐Nash Hesed , Yau Yu Ying , Ried Thomas , Leitman Susan F. , Young Neal S. , Sloand Elaine M.
Published: September 2011

BACKGROUND: Reports of Monosomy 7 in patients receiving granulocyte–colony‐stimulating factor (G‐CSF) have raised concerns that this cytokine may promote genomic instability. However, there are no studies addressing whether repeated administration of G‐CSF produces Monosomy 7 aneuploidy in healthy donors.

STUDY DESIGN AND METHODS: We examined Chromosomes 7 and 8 by fluorescent in situ hybridization (FISH) in CD34+ cells from 35 healthy hematopoietic stem cell transplant (HSCT) donors after G‐CSF administration for 5 days and by spectral karyotyping analysis (SKY) in four individuals to assess chromosomal integrity. We also studied 38 granulocyte donors who received up to 42 doses of G‐CSF and dexamethasone (Dex) using FISH for Chromosomes 7 and 8.

RESULTS: We found no abnormalities in Chromosomes 7 and 8 in G‐CSF–mobilized CD34+ cells when assessed by FISH or SKY, nor did we detect aneuploidy in G‐CSF– and Dex‐treated donors.

CONCLUSION: G‐CSF does not promote clinically detectable Monosomy 7 or Trisomy 8 aneuploidy in HSCT or granulocyte donors. These findings should be reassuring to healthy HSCT and granulocyte donors.
Evaluation of the automated collection and extended storage of apheresis platelets in additive solution
Authors: Johnson Lacey , Winter Kelly M. , Hartkopf‐Theis Tanja , Reid Samantha , Kwok Matthew , Marks Denese C.
Published: September 2011

BACKGROUND: Collecting apheresis platelets (PLTs) into additive solution has many potential benefits. The new Trima software (Version 6.0, CaridianBCT) allows automated addition of PLT additive solution (PAS) after collection, compared to Trima Version 5.1, which only collects PLTs into plasma. The aim of this study was to compare PLT quality during extended storage, after collection with the different Trima systems.

STUDY DESIGN AND METHODS: Apheresis PLTs were collected using both Trima Accel apheresis systems. The test PLT units (n = 12) were collected using the new Trima Version 6.0 into PLT AS (PAS‐IIIM), while the control units (n = 8) were collected into autologous plasma using Trima Version 5.1. All units were stored for 9 days, and in vitro cell quality variables were evaluated during this time.

RESULTS: PLTs collected in PAS‐IIIM maintained a stable pH between 7.2 and 7.4, whereas plasma‐stored apheresis units exhibited significantly increased acidity during storage, due to lactate accumulation and bicarbonate exhaustion. Plasma‐stored PLTs also demonstrated a more rapid consumption of glucose. However, there was little difference in PLT activation or cytokine secretion between PAS‐IIIM and control PLTs.

CONCLUSION: These data indicate that apheresis PLT concentrates collected in PAS‐IIIM, using Trima Version 6.0 software, maintained acceptable PLT metabolic and cellular characteristics until Day 9 of storage.
Experience with Urban Air Pollution in Paterson, New Jersey and Implications for Air Pollution Communication
Authors: Johnson Branden B.
Published: September 2011

Communication about air pollution can help reduce health risks, but a scattered, largely qualitative literature on air pollution beliefs, attitudes, and behaviors raises questions about its effectiveness. A telephone survey of Paterson, New Jersey (USA) residents tested four hypotheses aimed toward integrating these findings. Self‐reported sheltering indoors during high pollution, the recommended strategy, was predicted by perceived air quality and self‐reported “sensitivity” to air pollution. Nearly a quarter of the sample reported mandatory outdoor activity (e.g., work) that might increase their exposures, but this factor did not significantly affect self‐reported sheltering. Perceptions of air quality did not correlate strongly with official monitoring data (U.S. Air Quality Index (AQI)); even people who regularly sought AQI data relied upon sensory cues to high pollution, and secondarily upon health cues. Use of sensory and health cues, definitions of what makes someone sensitive to air pollution, and (less strongly) definitions of vulnerability to air pollution varied widely. The minority aware of the AQI were more likely to seek it if they had illnesses or saw themselves in the targeted AQI audience, yet less likely if they believed themselves sensitive to pollution. However, their sense of the AQI's match to their own experience was driven by whether they used sensory (yes) or health (no) cues, not by illness status. Some urban residents might not have access to AQI data, but this barrier seems outweighed by need to bridge interpretive gaps over definitions of air pollution, sensory perception, vulnerability, and health consequences.
Risk Management in a Developing Country Context: Improving Decisions About Point‐of‐Use Water Treatment Among the Rural Poor in Africa
Authors: Arvai Joseph , Post Kristianna
Published: September 2011

More than 1 billion people, the vast majority of which live in the developing world, lack basic access to clean water for domestic use. For this reason, finding and promoting effective and sustainable solutions for the provision of reliable clean water in developing nations has become a focus of several public health and international development efforts. Even though several means of providing centrally located sources of clean water in developing communities exist, the severity and widespread nature of the water problem has led most development agencies and sanitation experts to strongly advocate the use of point‐of‐use treatment systems alongside whatever source of water people regularly use. In doing so, however, development practitioners have been careful to point out that any interventions or infrastructure regarding water safety and human health must also adhere to one of the central principles of international development: to facilitate more democratic and participatory models of decision making and governance. To this end, the research reported here focused on the development of a deliberative risk management framework for involving affected stakeholders in decisions about POU water treatment systems. This research, which was grounded in previous studies of structured decision making, took place in two rural villages in the East African nation of Tanzania.
Microvascular Dysfunction: A Potential Mechanism in the Pathogenesis of Obesity‐associated Insulin Resistance and Hypertension
Authors: DE BOER MICHIEL P. , MEIJER RICK I. , WIJNSTOK NIENKE J. , JONK AMY M. , HOUBEN ALPHONS J. , STEHOUWER COEN D. , SMULDERS YVO M. , ERINGA ETTO C. , SERNÉ ERIK H.
Published: September 2011

Please cite this paper as: de Boer, Meijer, Wijnstok, Jonk, Houben, Stehouwer, Smulders, Eringa and Serné (2012). Microvascular Dysfunction: A Potential Mechanism in the Pathogenesis of Obesity‐associated Insulin Resistance and Hypertension. Microcirculation 19(1), 5–18.

The intertwined epidemics of obesity and related disorders such as hypertension, insulin resistance, type 2 diabetes, and subsequent cardiovascular disease pose a major public health challenge. To meet this challenge, we must understand the interplay between adipose tissue and the vasculature. Microvascular dysfunction is important not only in the development of obesity‐related target‐organ damage but also in the development of cardiovascular risk factors such as hypertension and insulin resistance. The present review examines the role of microvascular dysfunction as an explanation for the associations among obesity, hypertension, and impaired insulin‐mediated glucose disposal. We also discuss communicative pathways from adipose tissue to the microcirculation.
High‐Resolution Electron Microscopical Study of Cyst Walls of Entamoeba spp.
Authors: CHÁVEZ‐MUNGUÍA BIBIANA , MARTÍNEZ‐PALOMO ADOLFO
Published: September 2011

ABSTRACT. Knowledge of the fine structural organization, molecular composition and permeability properties of the cell surface of intestinal protozoan cysts is important to understand the biologic basis of their resistance. Recent studies on the biology of the cyst walls of Entamoeba histolytica and Entamoeba invadens have considerably advanced knowledge on the cellular processes involved in the transport and surface deposition of the main cyst wall components. Using transmission electron microscopy, cytochemistry, scanning electron microscopy and freeze‐fracture techniques, we have obtained new information. In mature cysts the permeability of Entamoeba cysts is limited to small molecules not by the cyst wall, but by the plasma membrane, as demonstrated with the use of ruthenium red as an electron‐dense tracer. Cell walls of E. histolytica cysts are made up of five to seven layers of unordered fibrils 7–8 nm thick. Alcian blue stains a regular mesh of fibrils approximately 4 nm thick, running perpendicularly to the cyst wall. In addition, abundant ionogenic groups are seen in cyst walls treated with cationized ferritin. In the mature cysts of E. histolytica and E. invadens small cytoplasmic vesicles with granular material were in close contact with the plasma membrane, suggesting a process of fusion and deposition of granular material to the cell wall. The plasma membrane of mature cysts is devoid of intramembrane particles when analyzed with the freeze‐fracture technique. When viewed with scanning electron microscopy the surface of E. histolytica cysts clearly differs from that of Entamoeba coli and E. invadens.
Intra‐Arterial Tenecteplase for Treatment of Acute Ischemic Stroke: Feasibility and Comparative Outcomes
Authors: Georgiadis Alexandros L. , Memon Muhammad Zeeshan , Shah Qaisar A. , Vazquez Gabriela , Tariq Nauman A. , Suri M. Fareed K. , Taylor Robert A. , Qureshi Adnan I.
Published: September 2011

OBJECTIVE

Tenecteplase (TNK) is a third‐generation thrombolytic agent. We evaluated the safety and feasibility of intra‐arterial (IA) administration of TNK in patients with acute ischemic stroke.

METHODS

Patients who received endovascular treatment for acute ischemic stroke were identified from prospectively collected databases at three university hospitals. We compared clinical and radiological outcomes of patients treated with TNK to those treated with other IA thrombolytics or mechanical thrombectomy alone. Primary outcome measures were favorable functional outcome at 30 days (modified Rankin Scale score of 0‐2), and rate of intracranial hemorrhage (ICH). Early neurological improvement, angiographic recanalization, time to recanalization, and mortality at 30 days were additional outcome measures.

RESULTS

We identified 114 patients (mean age 67 ± 15 years, 54 were women). Thirty‐three patients received IA TNK, 48 received alteplase (n = 11) or reteplase (n = 37), and 33 patients had mechanical thrombectomy alone. Stroke severity was similar among the three groups. No difference between the groups was found in the secondary outcome measures and ICH. Borderline statistical significance was seen toward favorable functional outcome at 1 month in the TNK‐treated patients [odds ratio (OR) = 2.8; 95% confidence interval (CI) .96‐8.1, P = .063 vs. other thrombolytics, and OR = 3.0, 95% CI .97‐9.5, P = .06 vs. mechanical thrombectomy alone].

CONCLUSION

Our study demonstrates that administration of IA TNK in acute stroke is safe and results in rates of favorable outcomes that are comparable to those observed with currently used drugs. Additional studies are needed to further determine the safety and efficacy of IA TNK in acute stroke treatment.