bluuebunny/crossref_metadata_2025 huggingface dataset:
Stress and coping in Singaporean nurses: A literature review
Authors: Lim Joanne , Bogossian Fiona , Ahern Kathy
Published: January 2010

Stress is ubiquitous in the nursing profession and is also prevalent in Asian countries, particularly the “four tigers of Asia”: Singapore, Hong Kong, Taiwan, and South Korea. Based on the theoretical framework of Lazarus and Folkman (1984), the present review of the nursing literature aims to identify sources and effects of stress in Singaporean nurses and the coping strategies they use. Nurses reported major stressors including shortage of staff, high work demands and conflict at work. Common coping strategies included problem orientation, social support and relaxation techniques. Several studies reported nurses' intent to leave the profession. Recommendations to minimize the impact of stress include in‐service programs to facilitate a problem‐solving approach to resolving work‐related issues such as conflict. Relaxation therapy and debriefing sessions may also help in reducing negative effects of work stressors. Finally, nurses' emotional coping can be enhanced by strengthening sources of social support, particularly from family.
The Value of Organizational Ambivalence for Small and Medium Size Enterprises in an Uncertain World
Authors: Tang Zhi , Dickson Pat , Marino Louis , Tang Jintong , Powell Benjamin C.
Published: January 2010

Prior literature suggests two competing mechanisms for how organizations respond to environmental forces – absorption and reduction – but there is no consensus on which mechanism is more effective. We solve this puzzle by analysing one underlying dimension of these two mechanisms – organizational ambivalence – in a small and medium size enterprise context. Specifically, we believe that because of the difference in consuming resources, organizational ambivalence can be divided into latent and active, which exhibit different uses in dealing with environmental forces and improving firm performance. We conducted two studies in four countries to test our hypotheses. These two studies yield unanimous support for our hypotheses regarding the impact of organizational ambivalence on organizational performance and mixed support for our hypotheses concerning environmental impacts on organizational ambivalence.
Clinical feature and DYT1 mutation screening in primary dystonia patients from South‐West China
Authors: Zhang S.‐S. , Fang D.‐F. , Hu X.‐H. , Burgunder J.‐M. , Chen X.‐P. , Zhang Y.‐W. , Shang H.‐F.
Published: January 2010

Background:  Clinical presentation and DYT1 status amongst Chinese patients with primary dystonia have not been well studied.

Methods:  One hundred and twenty patients with primary dystonia from South‐West China were studied in a prospective survey for 3.5 years. Severity and the resulting disability were assessed using the Burke–Fahn–Marsden dystonia rating scale (BFMDRS). Health related quality of life (HRQL) was measured through the 36‐item short‐form (SF‐36). The Hospital Anxiety and Depression Scale (HADS) was utilized to identify and quantify depression and anxiety. Mutations in the DYT1 exon 5 were screened by direct sequencing.

Results:  Cervical dystonia was found to be the most frequent form of focal dystonia and was discovered to occur at an early age. Pain and tremor were the common associated symptoms. Family history was positive in 19.5% of the cases, with a trend of earlier onset. Depression (14.5%) and anxiety (6.6%) were the main HRQL impairments. Multiple linear regression analysis suggested that gender, depression, anxiety and functional disability were amongst the principal determinants of lower HRQL. Only one instance of DYT1 GAG deletion (1.4%) was detected in 71 patients.

Conclusion:  Our data on a cohort of Chinese patients show some difference from descriptions in other ethnic groups. This includes an earlier age of onset, a lower incidence of depression and female serving as a predictor factor of a HRQL. Similar to other cohorts, DYT1 gene mutations are rare.
Gun Violence in Toronto: Perspectives from the Police
Authors: EZEONU IFEANYI
Published: January 2010

Abstract: This article discusses the ways in which the Toronto Police Service has constructed the problem of gun violence in the city. This violence is commonly associated in the media with young black males. The data for the study derived from semi‐structured interviews with police officers and secondary sources, including police public statements, press releases, and official documents. The most prominent police frame attributed the problem of gun violence in Toronto to the proliferation of gangs, illegal gun smuggling and illicit drug trafficking. Other frames, to a lesser degree, blamed structural factors such as poverty and unemployment, disintegrated neighbourhoods and families, and a faulty legal system.
On the Ordinary Concept of Death
Authors: HOLLAND STEPHEN
Published: January 2010

abstract

What is death? The question is of wide‐ranging practical importance because we need to be able to distinguish the living from the dead in order to treat both appropriately; specifically, the permissibility of retrieving vital organs for transplantation depends upon the potential donor's ontological status. There is a well‐established and influential biological definition of death as irreversible breakdown in the functioning of the organism as a whole, but it continues to elicit disquiet and rejoinders. The central claims of this paper are that the best way to address the question as to what death is, is to attend closely to our ordinary concept of death; doing so reveals that, whilst our ordinary understanding accommodates the biological definition, it also includes the thought that, for someone who has died, there will never again be anything it is like to be that person. Support for these claims is provided, and their academic and practical implications traced. The important practical implication is that we are left in quandary as to whether certain potential organ donors — for example, anencephalic babies and the permanently vegetative — are dead, a quandary that has serious implications for the relevance of the dead donor rule in transplant ethics.
Plasma orexin‐A levels in postmenopausal women: possible interaction with estrogen and correlation with cardiovascular risk status
Authors: El‐Sedeek MShEA , Korish AA , Deef MM
Published: January 2010

Please cite this paper as: El‐Sedeek M, Korish A, Deef M. Plasma orexin‐A levels in postmenopausal women: possible interaction with estrogen and correlation with cardiovascular risk status. BJOG 2010;117:488–492.

Objective  To assess plasma orexin‐A levels in a group of postmenopausal women not receiving estrogen‐replacement therapy (ERT), and to compare the values with a group on ERT and a group of reproductive‐age women, and to correlate the findings with some cardiovascular risk factors.

Design  Observational cohort study.

Setting  Alexandria University Hospital.

Population  Ninety women, in three groups: a control group of 30 healthy, reproductive‐age women, 30 healthy postmenopausal women not receiving ERT, and 30 healthy postmenopausal women on ERT for 6 months.

Methods  Quantitative clinical assessment as well as laboratory investigations.

Main outcome measures  Orexin‐A levels, serum estradiol, cholesterol, triglycerides, and fasting glucose are the main laboratory outcome measures, whereas blood pressure and weight are the main clinical outcome measures.

Results  Postmenopausal women not receiving ERT had the highest levels of plasma orexin A (705.61 ± 165.62 μg/dl). Postmenopausal women on ERT had orexin‐A levels that were comparable with the control group (233.90 ± 54.26 versus 243.81 ± 68.88 μg/dl). Plasma orexin‐A levels were directly correlated with blood glucose lipid profile, arterial blood pressure, and body mass index.

Conclusions  Higher orexin‐A levels are associated with hypoestrogenism, and are partially reversed by ERT. A possible inhibitory effect of estrogen on orexin might partially account for its cardioprotective effect.
A clinical review of borderline glandular cells reported on liquid‐based cervical cytology
Authors: Patel A , Thampy N , Hemming D , Naik R
Published: January 2010

Please cite this paper as: Patel A, Thampy N, Hemming D, Naik R. A clinical review of borderline glandular cells reported on liquid‐based cervical cytology. BJOG 2010;117:1051–1059.

Objective  To review the clinical outcome of women presenting with borderline glandular cells on liquid‐based cervical cytology (LBC).

Design  Retrospective review.

Population and setting  Women seen at a colposcopy clinic over a 26‐month period referred with borderline glandular cells on LBC.

Methods  Review of the case notes and cytology, pathology and colposcopy databases of all women referred with borderline glandular cells on LBC between June 2006 and August 2008.

Main outcome measures  Final histological diagnosis.

Results  Sixty‐nine women were identified (0.19% of all smears). Twenty‐seven women (39.1%) had premalignant or malignant lesions, five (7.2%) had cancers and 22 (31.9%) had intraepithelial neoplasia, 19 (27.5%) of which were cervical squamous intraepithelial neoplasia (CIN) and three (4.3%) of which were cervical glandular intraepithelial neoplasia (CGIN). No women under 35 years of age with normal and satisfactory colposcopy had premalignant or malignant lesions. Despite normal and satisfactory colposcopy, three women over 35 years had significant lesions: one high‐grade CIN, one CGIN and one squamous cell carcinoma.

Conclusions  On the basis of our results, it would be considered acceptable to manage women under 35 years of age with normal and satisfactory colposcopy conservatively. In women above 35 years of age, we would recommend a diagnostic ‘large loop excision of the transformation zone’ procedure, irrespective of the colposcopic findings.
Influence of fluorophore and linker composition on the pharmacology of fluorescent adenosine A1 receptor ligands
Authors: Baker Jillian G , Middleton Richard , Adams Luke , May Lauren T , Briddon Stephen J , Kellam Barrie , Hill Stephen J
Published: January 2010

Background and purpose:  The introduction of fluorescence‐based techniques, and in particular the development of fluorescent ligands, has allowed the study of G protein‐coupled receptor pharmacology at the single cell and single molecule level. This study evaluated how the physicochemical nature of the linker and the fluorophore affected the pharmacological properties of fluorescent agonists and antagonists.

Experimental approach:  Chinese hamster ovary cells stably expressing the human adenosine A1 receptor and a cyclic 3′,5′ adenosine monophosphate response element‐secreted placental alkaline phosphatase (CRE‐SPAP) reporter gene, together with whole cell [3H]‐8‐cyclopentyl‐1,3‐dipropylxanthine (DPCPX) radioligand binding, were used to evaluate the pharmacological properties of a range of fluorescent ligands based on the antagonist xanthine amine congener (XAC) and the agonist 5′ (N‐ethylcarboxamido) adenosine (NECA).

Key results:  Derivatives of NECA and XAC with different fluorophores, but equivalent linker length, showed significant differences in their binding properties to the adenosine A1 receptor. The BODIPY 630/650 derivatives had the highest affinity. Linker length also affected the pharmacological properties, depending on the fluorophore used. Particularly in fluorescent agonists, higher agonist potency could be achieved with large or small linkers for dansyl and BODIPY 630/650 derivatives, respectively.

Conclusions and implications:  The pharmacology of a fluorescent ligand was critically influenced by both the fluorophore and the associated linker. Furthermore, our data strongly suggest that the physicochemical properties of the fluorophore/linker pairing determine where in the environment of the target receptor the fluorophore is placed, and this, together with the environmental sensitivity of the resulting fluorescence, may finally decide its utility as a fluorescent probe.

This article is part of a themed section on Imaging in Pharmacology. To view the editorial for this themed section visit http://dx.doi.org/10.1111/j.1476‐5381.2010.00685.x
Integrative analysis of polychaete ontogeny: cell proliferation patterns and myogenesis in trochophore larvae of Sabellaria alveolata
Authors: Brinkmann Nora , Wanninger Andreas
Published: January 2010

SUMMARY
Aspects of muscle development are still widely neglected in studies on invertebrate ontogeny, which is probably at least partly due to the inherent complexity of animal myoanatomical bodyplans. This has resulted in significant gaps in our understanding of the evolutionary and ontogenetic origin of this crucial mesoderm‐derived organ system, particularly in indirect developing representatives of the Lophotrochozoa. Here, we document the temporal and spatial patterns of muscle formation and cell proliferation in the polychaete Sabellaria alveolata during planktotrophic larval development in order to assess the presumed generation of muscle units and segments from a posterior growth zone. In addition, we address the question whether the three primary segments differ in their mode of myogenesis from the subsequently forming segments. We found that in the first three segments the ventral transverse muscles differentiate from anterior to posterior, whereas the ventral oblique muscles develop simultaneously. Hence, subsequent and simultaneous developmental processes of specific muscle groups are possibly regulated in different ways, thus emphasizing the plasticity of the formation of metamerically arranged organ systems in polychaetes. The occurrence of three clusters of proliferating cells in the trunk region of the metatrochophore indicates synchronous subdivision of the larval mesoderm in the first three segments. Assuming a polychaete‐like ancestor at the base of the annelid tree, comparative analysis suggests that the bodywall of the last common annelid ancestor might have been devoid of circular muscles and consisted of four separate longitudinal muscle strands that develop from anterior to posterior.
Squid vascular endothelial growth factor receptor: a shared molecular signature in the convergent evolution of closed circulatory systems
Authors: Yoshida Masa‐aki , Shigeno Shuichi , Tsuneki Kazuhiko , Furuya Hidetaka
Published: January 2010

SUMMARY
The highly specialized cephalopod cardiovascular system has long been considered a valuable model for understanding the evolution of circulatory systems. Despite the number of studies devoted to this topic, the developmental regulatory mechanisms remain largely unexplored. Here, we focus on the vascular endothelial growth factor receptor (VEGFR). This factor is known to mediate levels of endothelial growth factor that is involved in hematopoiesis and vasculogenesis including multichambered heart development in vertebrates. We found a squid VEGFR ortholog that is expressed in the developing blood vessels, notably in the sheet‐like endothelial cells of the systemic and branchial hearts. The highly restricted localization of VEGFR in the vascular endothelial cells and its shared expression pattern in the developing hearts of cephalopods and vertebrates suggest a shared molecular signature of closed circulatory systems that has been independently elaborated during evolution.
Mechanisms of heart development in the Japanese lamprey, Lethenteron japonicum
Authors: Kokubo Nobuhiro , Matsuura Manami , Onimaru Koh , Tiecke Eva , Kuraku Shigehiro , Kuratani Shigeru , Tanaka Mikiko
Published: January 2010

SUMMARY
Vertebrate hearts have evolved from undivided tubular hearts of chordate ancestors. One of the most intriguing issues in heart evolution is the abrupt appearance of multichambered hearts in the agnathan vertebrates. To explore the developmental mechanisms behind the drastic morphological changes that led to complex vertebrate hearts, we examined the developmental patterning of the agnathan lamprey Lethenteron japonicum. We isolated lamprey orthologs of genes thought to be essential for heart development in chicken and mouse embryos, including genes responsible for differentiation and proliferation of the myocardium (LjTbx20, LjTbx4/5, and LjIsl1/2A), establishment of left–right heart asymmetry (LjPitxA), and partitioning of the heart tube (LjTbx2/3A), and studied their expression patterns during lamprey cardiogenesis. We confirmed the presence of the cardiac progenitors expressing LjIsl1/2A in the pharyngeal and splanchnic mesoderm and the heart tube of the lamprey. The presence of LjIsl1/2A‐positive cardiac progenitor cells in cardiogenesis may have permitted an increase of myocardial size in vertebrates. We also observed LjPitxA expression in the left side of lamprey cardiac mesoderm, suggesting that asymmetric expression of Pitx in the heart has been acquired in the vertebrate lineage. Additionally, we observed LjTbx2/3A expression in the nonchambered myocardium, supporting the view that acquisition of Tbx2/3 expression may have allowed primitive tubular hearts to partition, giving rise to multichambered hearts.
Role of Hox PG2 genes in Nile tilapia pharyngeal arch specification: implications for gnathostome pharyngeal arch evolution
Authors: Le Pabic Pierre , Scemama Jean‐Luc , Stellwag Edmund J.
Published: January 2010

SUMMARY
Phylogenetic reconstructions suggest that the ancestral osteichthyan Hox paralog group 2 gene complement was composed of two genes, Hoxa2 and b2, both of which have been retained in tetrapods, but only one of which functions as a selector gene of second pharyngeal arch identity (PA2). Genome duplication at the inception of the teleosts likely generated four Hox PG2 genes, only two of which, hoxa2b and b2a, have been preserved in zebrafish, where they serve as functionally redundant PA2 selector genes. Evidence from our laboratory has shown that other telelosts, specifically striped bass and Nile tilapia, harbor three transcribed Hox PG2 genes, hoxa2a, a2b, and b2a, with unspecified function(s). We have focused on characterizing the function of the three Nile tilapia Hox PG2 genes as a model to examine the effects of postgenome duplication gene loss on the evolution of developmental gene function. We studied Hox PG2 gene function in tilapia by examining the effects of independent morpholino oligonucleotide (MO)‐induced knockdowns on pharyngeal arch morphology and Hox gene expression patterns. Morphological defects resulting from independent MO‐induced knockdowns of tilapia hoxa2a, a2b, and b2a included the expected PA2 to PA1 homeotic transformations previously observed in tetrapods and zebrafish, as well as concordant and unexpected morphological changes in posterior arch‐derived cartilages. Of particular interest, was the observation of a MO‐induced supernumerary arch between PA6 and PA7, which occurred concomitantly with other MO‐induced pharyngeal arch defects. Beyond these previously unreported morphant‐induced transformations, a comparison of Hox PG2 gene expression patterns in tilapia Hox PG2 morphants were indicative of arch‐specific auto‐ and cross‐regulatory activities as well as a Hox paralog group 2 interdependent regulatory network for control of pharyngeal arch specification.
GRAMINIFOLIA homolog expression in Streptocarpus rexii is associated with the basal meristems in phyllomorphs, a morphological novelty in Gesneriaceae
Authors: Tononi Paola , Möller Michael , Bencivenga Stefano , Spada Alberto
Published: January 2010

SUMMARY
Streptocarpus is a genus showing great variation in vegetative plant architecture and hence provides an attractive system to study the evolution of morphological diversity. Besides species showing an orthodox caulescent plant organization, producing leaves from a conventional shoot apical meristem (SAM), there are species whose body plan is composed of units (phyllomorphs) consisting of a petiole‐like structure and a lamina that has the ability of continued growth. The first of these units is the macrocotyledon, derived from the continued growth of one of the two cotyledons by the activity of a basal meristem (BM), whereas further phyllomorphs develop from a SAM‐like meristem. We carried out anatomical and morphological studies on the macrocotyledon of Streptocarpus rexii showing that the lamina has a bifacial structure, whereas the petiolode is partially unifacial. YABBY transcription factors are known to be involved in organ polarity and also promote lamina growth. We characterized the expression of SrGRAM, an ortholog of the YABBY genes GRAMINIFOLIA (GRAM) and FILAMENTOUS FLOWER (FIL), in S. rexii by in situ hybridization and RT‐PCR. Gene expression pattern during embryogenesis was found to be conserved between SrGRAM and FIL from Arabidopsis. During subsequent seedling development SrGRAM expression in S. rexii was closely associated with the activity of the BM of the macrocotyledon and consecutively produced phyllomorphs, whereas it was excluded from the SAM‐like meristem. Our results suggest that SrGRAM acts in intercalary growth and that an altered regulation of SrGRAM may underlay the evolution of the BM in S. rexii.
The enigma of reversed asymmetry in lithodid crabs: absence of evidence for heritability or induction of morphological handedness in Lopholithodes foraminatus
Authors: Duguid William D. P.
Published: January 2010

SUMMARY
Mutations or environmental factors that result in reversal of conspicuous left–right asymmetries provide an opportunity to study developmental mechanisms. They may also provide insight into evolutionary changes in asymmetry states within and between species. King crabs (family Lithodidae) have a larger right claw and females typically exhibit a dextrally offset abdomen. Nevertheless, I observed a high incidence of left handedness in laboratory reared box crabs (Lopholithodes foraminatus) and captured the first known egg‐bearing female lithodid to exhibit reversed asymmetry. This provided a unique opportunity to characterize the reversed phenotype and to compare the incidence of reversed asymmetry in the offspring of normal and reversed females. Asymmetry of the chelae became apparent in the first postzoeal stage (glaucothoe) and handedness was maintained through subsequent instars. Females with larger left claws developed reversed abdominal asymmetry by the fourth crab stage. No reversed asymmetry was observed in the mandibles of zoea larvae or juveniles of either handedness. The incidence of reversed asymmetry in glaucothoe reared from one reversed and three normal females was high (between 20% and 30%), and independent of maternity (P=0.67). Removal of the right cheliped of fourth stage zoeae, and the major cheliped of glaucothoe, did not reverse the direction of asymmetry. Elevated larval rearing temperature also did not affect the frequency of reversed individuals. This lack of evidence for either heritability or induction of handedness is enigmatic. Further investigation of reversed asymmetry in lithodid crabs may provide valuable insights into the development and evolution of bilateral asymmetries.
Phylogenetic analysis of developmental and postnatal mouse cell lineages
Authors: Salipante Stephen J. , Kas Arnold , McMonagle Eva , Horwitz Marshall S.
Published: January 2010

SUMMARY
Fate maps depict how cells relate together through past lineage relationships, and are useful tools for studying developmental and somatic processes. However, with existing technologies, it has not been possible to generate detailed fate maps of complex organisms such as the mouse. We and others have therefore proposed a novel approach, “phylogenetic fate mapping,” where patterns of somatic mutation carried by the individual cells of an animal are used to retrospectively deduce lineage relationships through phylogenetic inference. Here, we have cataloged genomic polymorphisms at 324 mutation‐prone polyguanine tracts for nearly 300 cells isolated from a single mouse, and have explored the cells' lineage relationships both phylogenetically and through a network‐based approach. We present a model of mouse embryogenesis, where an early period of substantial cell mixing is followed by more coherent growth of clones later. We find that cells from certain tissues have greater numbers of close relatives in other specific tissues than expected from chance, suggesting that those populations arise from a similar pool of ancestral lineages. Finally, we have investigated the dynamics of cell turnover (the frequency of cell loss and replacement) in postnatal tissues. This work offers a longitudinal study of developmental lineages, from conception to adulthood, and provides insight into basic questions of mouse embryology as well as the somatic processes that occur after birth.
Ethanol Acutely Inhibits Ionotropic Glutamate Receptor‐Mediated Responses and Long‐Term Potentiation in the Developing CA1 Hippocampus
Authors: Puglia Michael P. , Valenzuela C. Fernando
Published: January 2010

Background: Developmental ethanol (EtOH) exposure damages the hippocampus, causing long‐lasting alterations in learning and memory. Alterations in glutamatergic synaptic transmission and plasticity may play a role in the mechanism of action of EtOH. This signaling is fundamental for synaptogenesis, which occurs during the third trimester of human pregnancy (first 12 days of life in rats).

Methods: Acute coronal brain slices were prepared from 7‐ to 9‐day‐old rats. Extracellular and patch‐clamp electrophysiological recording techniques were used to characterize the acute effects of EtOH on α‐amino‐3‐hydroxyl‐5‐methyl‐4‐isoxazole‐propionate receptor (AMPAR)‐ andN‐methyl‐d‐aspartate receptor (NMDAR)‐mediated responses and long‐term potentiation (LTP) in the CA1 hippocampal region.

Results: Ethanol (40 and 80 mM) inhibited AMPAR‐ and NMDAR‐mediated field excitatory postsynaptic potentials (fEPSPs). EtOH (80 mM) also reduced AMPAR‐mediated fEPSPs in the presence of an inhibitor of Ca2+permeable AMPARs. The effect of 80 mM EtOH on NMDAR‐mediated fEPSPs was significantly greater in the presence of Mg2+. EtOH (80 mM) neither affected the paired‐pulse ratio of AMPAR‐mediated fEPSPs nor the presynaptic volley. The paired‐pulse ratio of AMPAR‐mediated excitatory postsynaptic currents was not affected either, and the amplitude of these currents was inhibited to a lesser extent than that of fEPSPs. EtOH (80 mM) inhibited LTP of AMPAR‐mediated fEPSPs.

Conclusions: Acute EtOH exposure during the third‐trimester equivalent of human pregnancy inhibits hippocampal glutamatergic transmission and LTP induction, which could alter synapse refinement and ultimately contribute to the pathophysiology of fetal alcohol spectrum disorder.
Prenatal Alcohol Exposure and Chronic Mild Stress Differentially Alter Depressive‐ and Anxiety‐Like Behaviors in Male and Female Offspring
Authors: Hellemans Kim G. C. , Verma Pamela , Yoon Esther , Yu Wayne K. , Young Allan H. , Weinberg Joanne
Published: January 2010

Background:  Fetal Alcohol Spectrum Disorder (FASD) is associated with numerous neurobehavioral alterations, as well as disabilities in a number of domains, including a high incidence of depression and anxiety disorders. Prenatal alcohol exposure (PAE) also alters hypothalamic‐pituitary‐adrenal (HPA) function, resulting in increased responsiveness to stressors and HPA dysregulation in adulthood. Interestingly, data suggest that pre‐existing HPA abnormalities may be a major contributory factor to some forms of depression, particularly when an individual is exposed to stressors later in life. We tested the hypothesis that exposure to stressors in adulthood may unmask an increased vulnerability to depressive‐ and anxiety‐like behaviors in PAE animals.

Methods:  Male and female offspring from prenatal alcohol (PAE), pair‐fed (PF), and ad libitum‐fed control (C) treatment groups were tested in adulthood. Animals were exposed to 10 consecutive days of chronic mild stress (CMS), and assessed in a battery of well‐validated tasks sensitive to differences in depressive‐ and/or anxiety‐like behaviors.

Results:  We report here that the combination of PAE and CMS in adulthood increases depressive‐ and anxiety‐like behaviors in a sexually dimorphic manner. PAE males showed impaired hedonic responsivity (sucrose contrast test), locomotor hyperactivity (open field), and alterations in affiliative and nonaffiliative social behaviors (social interaction test) compared to control males. By contrast, PAE and, to a lesser extent, PF, females showed greater levels of “behavioral despair” in the forced swim test, and PAE females showed altered behavior in the final 5 minutes of the social interaction test compared to control females.

Conclusions:  These data support the possibility that stress may be a mediating or contributing factor in the psychopathologies reported in FASD populations.
Social and Financial Resources and High‐Risk Alcohol Consumption Among Older Adults
Authors: Moos Rudolf H. , Brennan Penny L. , Schutte Kathleen K. , Moos Bernice S.
Published: January 2010

Background:  This study examined long‐term mutual predictive associations between social and financial resources and high‐risk alcohol consumption in later life.

Method:  A sample of 55‐ to 65‐year‐old older adults (n = 719) was surveyed at baseline and 10 years and 20 years later. At each contact point, participants completed an inventory that assessed social and financial resources and alcohol consumption.

Results:  Over the 20‐year interval, there was evidence of both social causation and social selection processes in relation to high‐risk alcohol consumption. In support of a social causation perspective, higher levels of some social resources, such as participation in social activities, friends’ approval of drinking, quality of relationship with spouse, and financial resources, were associated with a subsequent increased likelihood of high‐risk alcohol consumption. Conversely, indicating the presence of social selection, high‐risk alcohol consumption was associated with subsequent higher levels of friends’ approval of drinking and quality of the spousal relationship, but lower quality of relationships with extended family members.

Conclusions:  These findings reflect mutual influence processes in which older adults’ social resources and high‐risk alcohol consumption can alter each other. Older adults may benefit from information about how social factors can affect their drinking habits; accordingly, information about social causation effects could be used to guide effective prevention and intervention efforts aimed at reducing the risk that late‐life social factors may amplify their excessive alcohol consumption.
Improving Anticoagulation Control in Hospitalized Elderly Patients on Warfarin
Authors: Gouin‐Thibault Isabelle , Levy Camille , Pautas Eric , Cambus Jean‐Pierre , Drouet Ludovic , Mahé Isabelle , Bal dit Sollier Claire , Horellou Marie‐Hélène , Golmard Jean‐Louis , Siguret Virginie
Published: January 2010

OBJECTIVES: To determine the effect of patient characteristics and of specific guidelines that were developed for managing warfarin therapy in older adults and included in an in‐house computer program on anticoagulation quality.

DESIGN: Thirteen‐month observational study.

SETTING: Acute care, extended care, and rehabilitation geriatric wards of a teaching hospital in Paris, France.

PARTICIPANTS: Hospitalized patients (N=307, mean age 86.1 ± 6.1) treated with warfarin with a therapeutic international normalized ratio range of 2.0 to 3.0.

INTERVENTION: Patients were assigned according to care unit to the computer‐generated dosing group (CGD) or the standard management group (SM; usual physician‐based care).

MEASUREMENTS: Relationships between anticoagulation quality criteria and covariates (age, sex, warfarin indication, treatment phase, follow‐up duration, model of care).

RESULTS: According to multivariate analysis, only model of care and follow‐up duration independently influenced anticoagulation control; the proportion of time within therapeutic INR range 2.0 to 3.0 was significantly greater in the CGD group than in the SM group (59% vs 48%, P=.004). When a wider INR range was analyzed (1.8–3.2), the proportion of time within range was 73% versus 64% (P=.006). Use of the computer was associated with fewer days with INRs greater than 3, a smaller percentage of INRs of 4 or greater, a longer time to the first INR of 4.0 or greater, and a smaller mean number of INRs per month than SM (all P<.01).

CONCLUSION: Initiation regimen and long‐term rules that have specifically been developed and included in a computerized dosage program improve quality of anticoagulation in elderly inpatients, allowing them to benefit from a quality of care as high as that of younger ambulatory patients.
Magnetic Resonance Imaging Volume of the Angular Gyri Predicts Financial Skill Deficits in People with Amnestic Mild Cognitive Impairment
Authors: Griffith H. Randall , Stewart Christopher C. , Stoeckel Luke E. , Okonkwo Ozioma C. , den Hollander Jan A. , Martin Roy C. , Belue Katherine , Copeland Jacquelynn N. , Harrell Lindy E. , Brockington John C. , Clark David G. , Marson Daniel C.
Published: January 2010

OBJECTIVES: To better understand how brain atrophy in amnestic mild cognitive impairment (MCI) as measured using magnetic resonance imaging (MRI) volumetrics could affect instrumental activities of daily living (IADLs) such as financial abilities.

DESIGN: Controlled, matched‐sample, cross‐sectional analysis regressing MRI volumetrics with financial performance measures.

SETTING: University medical and research center.

PARTICIPANTS: Thirty‐eight people with MCI and 28 older adult controls.

MEASUREMENTS: MRI volumetric measurement of the hippocampi, angular gyri, precunei, and medial frontal lobes. Participants also completed neuropsychological tests and the Financial Capacity Instrument (FCI).

RESULTS: Correlations were performed between FCI scores and MRI volumes in the group with MCI. People with MCI performed significantly below controls on the FCI and had significantly smaller hippocampi. Among people with MCI, performance on the FCI was moderately correlated with angular gyri and precunei volumes. Regression models demonstrated that angular gyrus volumes were predictive of FCI scores. Tests of mediation showed that measures of arithmetic and possibly attention partially mediated the relationship between angular gyrus volume and FCI score.

CONCLUSION: Impaired financial abilities in amnestic MCI correspond with volume of the angular gyri as mediated by arithmetic knowledge. The findings suggest that early neuropathology within the lateral parietal region in MCI leads to a breakdown of cognitive abilities that affect everyday financial skills. The findings have implications for diagnosis and clinical care of people with MCI and AD.
Prevalence of Neuropsychiatric Symptoms and Their Association with Functional Limitations in Older Adults in the United States: The Aging, Demographics, and Memory Study
Authors: Okura Toru , Plassman Brenda L. , Steffens David C. , Llewellyn David J. , Potter Guy G. , Langa Kenneth M.
Published: January 2010

OBJECTIVES: To estimate the prevalence of neuropsychiatric symptoms and examine their association with functional limitations.

DESIGN: Cross‐sectional analysis.

SETTING: The Aging, Demographics, and Memory Study (ADAMS).

PARTICIPANTS: A sample of adults aged 71 and older (N=856) drawn from Health and Retirement Study (HRS), a nationally representative cohort of U.S. adults aged 51 and older.

MEASUREMENTS: The presence of neuropsychiatric symptoms (delusions, hallucinations, agitation, depression, apathy, elation, anxiety, disinhibition, irritation, and aberrant motor behaviors) was identified using the Neuropsychiatric Inventory. A consensus panel in the ADAMS assigned a cognitive category (normal cognition; cognitive impairment, no dementia (CIND); mild, moderate, or severe dementia). Functional limitations, chronic medical conditions, and sociodemographic information were obtained from the HRS and ADAMS.

RESULTS: Forty‐three percent of individuals with CIND and 58% of those with dementia exhibited at least one neuropsychiatric symptom. Depression was the most common individual symptom in those with normal cognition (12%), CIND (30%), and mild dementia (25%), whereas apathy (42%) and agitation (41%) were most common in those with severe dementia. Individuals with three or more symptoms and one or more clinically significant symptoms had significantly higher odds of having functional limitations. Those with clinically significant depression had higher odds of activity of daily living limitations, and those with clinically significant depression, anxiety, or aberrant motor behaviors had significantly higher odds of instrumental activity of daily living limitations.

CONCLUSION: Neuropsychiatric symptoms are highly prevalent in older adults with CIND and dementia. Of those with cognitive impairment, a greater number of total neuropsychiatric symptoms and some specific individual symptoms are strongly associated with functional limitations.
Combining the Creative Arts and the House Call to Teach Medical Students About Chronic Illness Care
Authors: LoFaso Veronica M. , Breckman Risa , Capello Carol F. , Demopoulos Byron , Adelman Ronald D.
Published: January 2010

As the number of people living with chronic illness in the United States rises, it is imperative that medical school prepare physicians who are capable of caring for these patients. This article outlines a creative educational intervention to teach third‐ and fourth‐year medical students about caring for chronically ill people. All students at Weill Medical College, Cornell University, make home visits to homebound older adults with an interdisciplinary team as part of a mandatory Primary Care Clerkship. Under their guidance, students observe the myriad challenges facing homebound older adults. Afterward, students create a project, using original or found art, to express their reactions and thoughts. Students present projects to peers in a small group, with multidisciplinary faculty mentors framing the discussion. To evaluate the intervention, students responded to a nine‐item questionnaire and a series of open‐ended questions. Quantitative and qualitative analyses show consistently strong positive responses to the experience. Most students (95.0%) felt that they learned about the complexities of chronic illness care from their home visits. The opportunity to express reactions through a creative project received positive responses with 97.0% of students responding favorably. Ninety‐seven percent felt that the discussions with colleagues and faculty increased knowledge of chronic illness care. Nearly all (97.0%) felt they had a better understanding of team and that attitudes toward the chronically ill were positively affected. The coupling of the creative arts with home visits is an effective tool for teaching about chronic illness and may be a useful model for medical schools interested in expanding their chronic illness curriculum.
Geostatistical Analysis of County‐Level Lung Cancer Mortality Rates in the Southeastern United States. 美国东南部县级肺癌死亡率的地统计学分析
Authors: Goovaerts Pierre
Published: January 2010

The analysis of health data and putative covariates, such as environmental, socioeconomic, demographic, behavioral, or occupational factors, is a promising application for geostatistics. Transferring methods originally developed for the analysis of earth properties to health science, however, presents several methodological and technical challenges. These arise because health data are typically aggregated over irregular spatial supports (e.g., counties) and consist of a numerator and a denominator (i.e., rates). This article provides an overview of geostatistical methods tailored specifically to the characteristics of areal health data, with an application to lung cancer mortality rates in 688 U.S. counties of the southeast (1970–1994). Factorial Poisson kriging can filter short‐scale variation and noise, which can be large in sparsely populated counties, to reveal similar regional patterns for male and female cancer mortality that correlate well with proximity to shipyards. Rate uncertainty was transferred through local cluster analysis using stochastic simulation, allowing the computation of the likelihood of clusters of low or high cancer mortality. Accounting for population size and rate uncertainty led to the detection of new clusters of high mortality around Oak Ridge National Laboratory for both sexes, in counties with high concentrations of pig farms and paper mill industries for males (occupational exposure) and in the vicinity of Atlanta for females.
Practitioner Perceptions of the A3 Method for Process Improvement in Health Care
Authors: Visich John K. , Wicks Angela M. , Zalila Faiza
Published: January 2010

The focus of this article is to present students' perceptions of the recently developed A3 method, a structured problem‐solving approach based on lean concepts and tools that have been adapted to the health care environment. The students were all employees of a large health care provider and were enrolled in a customized health care executive MBA Program. Each student was required to complete an individual A3 Project in order to improve a process at the department for which they worked. At the end of the semester the students presented their A3 projects to their peers who voted on the best projects. A survey measuring perceptions of the A3 method for problem solving in health care was administered and from it we present propositions for A3 implementation. These propositions are applicable both to health care practitioners and to academic researchers.
Consumer Democracy vs. Good Governance
Authors: GARDELS NATHAN
Published: January 2010

“Democracy is the worst form of government except for all those other forms that have been tried from time to time”, Churchill famously said in the House of Commons in 1947. The prestige of the great British statesman who held forth when the empire was already on its last legs was such that democratic institutions have scarcely evolved as the world moved on, even after the end of the Cold War.
Recalling the Fall of the Berlin Wall
Authors: BUSH GEORGE H.W. , THATCHER MARGARET , GORBACHEV MIKHAIL , MITTERRAND FRANÇOIS
Published: January 2010

Twenty years after the fall of the Berlin Wall and the triumphant celebrations of the West, a new chapter of history has opened featuring the rising powers of Asia, led by China. Though embracing free markets, China has looked to its Confucian traditions instead of liberal democracy as the best route to good governance.

Will China manage to achieve high growth and a harmonious society through a strong state and long‐range planning that puts messy Western democracy and its short‐term mindset to shame? Or, in the end, will the weak rule of law and absence of political accountability in a one‐party state undermine its promise?

Francis Fukuyama and Kishore Mahbubani, the Singaporean thinker who has become the apostle of non‐Western modernity, debate these issues.

In this section we also republish a collective memoir by George H.W. Bush, Mikhail Gorbachev, Margaret Thatcher and François Mitterrand, recalling their fears and hopes two decades ago as they brought the Cold War to an end.
Japan: Shifting Away from American‐led Globalization
Authors: HATOYAMA YUKIO
Published: January 2010

Thanks to the draining effects of the Iraq war and the financial meltdown emanating from Wall Street, a powershift away from American dominance is taking place. Caught between a rising China and an America in relative decline, the new leadership in Japan is recalibrating its post‐World War II relationships. The G‐20 has usurped the role once played by the G‐8 as the governing committee of globalization. And the symbiotic coupling of “Chimerica”, born out of the credit bubble built up over the past two decades, is being put to the test.

In this section, the new prime minister of Japan, the president of the European Union, the president of Brazil and a leading economic historian assess these shifts.
I Support Ayatollah Khomeini's Republicanism
Authors: KARROUBI MEHDI
Published: January 2010

As the confrontation between the West and Iran over uranium enrichment comes to a head, the internal confrontation in Iran between the partisans of divine sovereignty, allied with the Revolutionary Guard, and popular sovereignty continues to simmer.

In this section, the first president of the Islamic Republic, a leading cleric of the opposition, the Iranian human rights activist and Nobel Laureate Shirin Ebadi and a former British intelligence agent ponder what lies ahead.
The Real Issue Is Iran's Emergence as a Regional Power
Authors: CROOKE ALASTAIR
Published: January 2010

As the confrontation between the West and Iran over uranium enrichment comes to a head, the internal confrontation in Iran between the partisans of divine sovereignty, allied with the Revolutionary Guard, and popular sovereignty continues to simmer.

In this section, the first president of the Islamic Republic, a leading cleric of the opposition, the Iranian human rights activist and Nobel Laureate Shirin Ebadi and a former British intelligence agent ponder what lies ahead.
Measurement of Microvascular Transport Parameters of Macromolecules in Tissues and Organs of Intact Animals
Authors: RENKIN EUGENE M. , TUCKER VICKY L.
Published: January 2010

A critical analysis is presented of two widely used approaches to measurement of microvascular transport of large molecules in intact animals: (1) measurement of lymph flow and macromolecular solute concentration relative to plasma, and (2) tissue accumulation of tracer macromolecules. To demonstrate the advantages and limitations of each method, experimental results which permit direct comparison of the two methodologies are reviewed and analyzed, and sources or error in each pointed out. It is concluded that both approaches are valid under the appropriate conditions: steady state for lymph, initial transient state for tissue uptake. These conditions are mutually exclusive, but complementary. When the requirements for neither lymph collection or tissue accumulation alone can be satisfied experimentally, a combination of the two approaches can yield valid results.
Increased Apoptosis Coincides with Onset of Involution in Infantile Hemangioma
Authors: RAZON MARIA J. , KRÄLING BIRGIT M. , MULLIKEN JOHN B. , BISCHOFF JOYCE
Published: January 2010

Objective: Hemangioma is an endothelial cell tumor that grows rapidly during infancy and regresses slowly during childhood. However, little is known about the natural history of this common tumor. To gain insight into the cellular mechanisms that underlie the switch from uncontrolled growth to involution of endothelium, we investigated the extent of cellular apoptosis versus proliferation in hemangioma specimens that spanned the natural life cycle of the tumor.

Methods: We analyzed apoptosis and cellular proliferation in frozen sections from 16 hemangioma specimens using the TUNEL assay to detect apoptotic cells and the Ki67 antigen to detect dividing cells.

Results: Apoptosis was low in proliferative phase hemangiomas but increased fivefold in involutive phase specimens obtained from children one to four years of age. Immunofluorescence double‐labeling experiments showed that at least one third of the apoptotic cells were endothelial. As expected, cellular proliferation was high in specimens up to 2 years of age but decreased significantly thereafter. Apoptosis was consistently low in nine normal skin tissues (newborn to 4 years of age) obtained from discarded pathology specimens.

Conclusions: These results suggest that increased apoptosis during the second year of life can offset cellular proliferation and may be involved in initiating regression of hemangioma.