bluuebunny/crossref_metadata_2025 huggingface dataset:
Exact Simulation of Integrate-and-Fire Models with Synaptic Conductances
Authors: Brette Romain
Published: June 2006

Computational neuroscience relies heavily on the simulation of large networks of neuron models. There are essentially two simulation strategies: (1) using an approximation method (e.g., Runge-Kutta) with spike times binned to the time step and (2) calculating spike times exactly in an event-driven fashion. In large networks, the computation time of the best algorithm for either strategy scales linearly with the number of synapses, but each strategy has its own assets and constraints: approximation methods can be applied to any model but are inexact; exact simulation avoids numerical artifacts but is limited to simple models. Previous work has focused on improving the accuracy of approximation methods. In this article, we extend the range of models that can be simulated exactly to a more realistic model: an integrate-and-fire model with exponential synaptic conductances.
Insecurity and Violence as a New Power Relation in Latin America
Authors: R Magaly Sanchez
Published: June 2006

This article shows the growing activities related to the existence of three types of urban violence: the structural violence inherent in the existing social inequalities in Latino American countries, radical violence, and criminal violence. Neoliberal policies generate more inequality, exclusion, poverty, and alienation, which yield a rising tide of criminal and radical violence, which triggers more state violence and coercion, which, in turn, encourages more resistance from below. Violence and security have become a key link in the economic arena characterizing the Latin American metropolis.
Public and Private Responses to Social Exclusion among Youth in São Paulo
Authors: Jacobi Pedro
Published: June 2006

In cities such as São Paulo, the periphery is the locus of social exclusion, segregation, disarray, and vulnerability. Programs of inclusion seek to empower local actors to work in coordinated fashion toward improvements in the quality of life. Successful experiments show that programs to foster cooperation between local actors, NGOs, community organizations, and municipal governments have very positive effects. The challenge of these programs is to increase social capital available to poor urban dwellers by creating and reinforcing dense networks of intermediate organizations—civil associations, churches, community groups, schools, professional associations—to cushion against social decomposition. The dynamic practices reviewed here—digital inclusion, social entrepreneurship, income generation, educational subsidies, and job training—offer different ways of reducing social exclusion. All depend significantly on local organizational capacities and potential individual mobilization. Important changes occur when practices are implemented cooperatively by local actors, government officials, and professionals within organized civil society.
Lula’s Political Economy: Changes and Challenges
Authors: Paiva Paulo
Published: June 2006

Promoting sustainable economic growth with social inclusion represents a challenge for Luiz Inácio Lula da Silva, the former metalworker and leader of the socialist Workers’ Party, who won the Brazilian presidency his fourth try. The election of Lula has raised expectations at home and abroad. Although the government scored impressive fiscal victories by following ultra-orthodox macroeconomic policies, its performance in achieving economic growth and social improvement has been less than brilliant. Written in February 2004 to assess his first year in office, this article examines the challenges that Lula initially had to overcome and outlines the main points of his political economy. By the end of the first year, few great changes had taken place, except perhaps in his political party’s manner of governing. Early in Lula’s presidency, his policies were quite similar to those of earlier governments.
Understanding Diabetes Medications From the Perspective of Patients With Type 2 Diabetes
Authors: Hayes Risa P. , Bowman Lee , Monahan Patrick O. , Marrero David G. , McHorney Colleen A.
Published: June 2006

Purpose

The purpose of this qualitative study was to explore diabetes medication experiences of patients with type 2 diabetes.

Methods

Study participants were recruited through newspaper advertisements and letters from primary and specialty clinics in Indianapolis, Indiana. The same professional facilitator conducted 18 focus groups (7 male, 11 female) at a Veteran Affairs facility in Indianapolis, Indiana. Participants were 138 socioeconomically diverse individuals with type 2 diabetes (68% female, 74% [.greaterequal] 50 years old, 61% non-Hispanic Caucasian). Participants were on a variety of diabetes medication regimens (61% injectable insulin monotherapy or in combination with orals). Content analysis of focus group transcripts was used to establish themes.

Results

Three major themes emerged across the focus groups: (1) the inconvenience and inflexibility of the timing and frequency of administration of many diabetes treatments on participants' lives, (2) the desire to avoid injections and/or insulin therapy, and (3) the physical and emotional side effects of diabetes medications. Assuming equivalent effectiveness of 2 medications, participants would weigh the convenience and flexibility, route of administration, side effects, and cost of the medications to arrive at a treatment preference. Participants believed they currently had no opportunity to express their treatment preference to their health care provider.

Conclusions

The best therapeutic option for a patient with type 2 diabetes will be one that is clinically effective and consistent with the patient's needs and preferences. The challenge for diabetes educators is to support patients in articulating and incorporating their needs and preferences into the treatment decision-making process.
Use of an Assessment Tool to Enhance Diabetes Educators' Ability to Identify Erectile Dysfunction
Authors: Rice Donna , Jack Leonard
Published: June 2006

An assessment tool to identify erectile dysfunction is useful to diabetes educators in recognizing patients with sexual dysfunction requiring further counseling, education, and treatment. Use of an assessment tool serves as a first step in creating dialogue between diabetes educators and patients living with undiagnosed erectile dysfunction. The assessment tool helps identify underlying causes of erectile dysfunction, its impact on psychological wellbeing, and identification of treatment and referral needs. The purpose of this article is to discuss the value of assessing erectile dysfunction as a component of comprehensive diabetes care. An example of an erectile dysfunction assessment tool developed in 1991 is presented.
Knowledge About Breast Cancer and Participation in a Faith-Based Breast Cancer Program and Other Predictors of Mammography Screening Among African American Women and Latinas
Authors: Darnell Julie S. , Chang Chih-Hung , Calhoun Elizabeth A.
Published: June 2006

This article assessed the impact of knowledge of breast cancer and type and intensity of participation in a church-based breast cancer education program and other factors on mammography screening among African Americans and Latinas. Logistic regression was used to assess the impact of these factors on self-reported mammography utilization. Passive participation in church-sponsored activities, measured by breast cancer information that was heard, seen, or read, was found to be significantly associated with the likelihood of mammography use among African Americans. Moreover, African Americans who reported hearing, seeing, or reading about mammograms at their churches four or more times were 15 times more likely to report mammography use within the past year than were those who encountered information only once. Messages from pastors and church bulletin announcements were the most significant predictors. An increase in knowledge was not associated with higher mammography use. For Latinas, none of the hypothesized knowledge or participation variables was found to be significant. The results suggest that faith-based breast cancer programs can be effective by adopting tailored strategies to raise awareness about the importance of early detection.
A Community-Based Participatory Health Information Needs Assessment to Help Eliminate Diabetes Information Disparities
Authors: Carlson Barbara A. , Neal Diane , Magwood Gayenell , Jenkins Carolyn , King Marilyn Givens , Hossler Charles L.
Published: June 2006

This article describes the participatory research process, results, action plan, and implications of the community health information needs assessment conducted within the African American community in two South Carolina counties. The REACH 2010: Charleston and Georgetown Diabetes Coalition library program is a partnership among community organizations, public and health sciences libraries, and lay community health advisors. A planning committee studied digital divide issues related to health information, designed and implemented a survey, held focus groups, analyzed data, identified needs and assets, and formulated an action plan to increase the dissemination of diabetes information. Key survey findings show that older (older than 60) and less educated (fewer than 12 years of education) African Americans in Charleston and Georgetown counties lack skills to access Internet and library services and suffer disparities in health information. Based on assessment evidence, the community plans to increase Internet access points and provide a train-the-trainer program to teach people skills for using Internet and library resources to get high-quality information about diabetes and its complications. This process taps community resources, builds local capacities and technical skills, educates about health, and empowers participants as active partners in their own health and their community’s health.
Processes and Capacity-Building Benefits of Lay Health Worker Outreach Focused on Preventing Cervical Cancer Among Vietnamese
Authors: Mock Jeremiah , Nguyen Thoa , Nguyen Kim Hanh , Bui-Tong Ngoc , McPhee Stephen J.
Published: June 2006

The authors organized a lay health worker (LHW) outreach program with Vietnamese women that produced significant increases in Pap testing. The program was conducted by five partner agencies and 50 LHWs and involved 1,005 women. This article reports on the roles of the agencies and coordinators, the selection of LHWs, the processes LHWs used in identifying and recruiting participants, the ways they conducted their outreach work, and their strategies for maintaining participation. The article also reports on the LHWs’ perspectives about how they benefited and what they found to be most rewarding and challenging about being a LHW. Based on the analysis of this information, the authors present a conceptual framework for understanding how different contextual factors shape the processes and capacity-building benefits of LHW outreach, describing four contextual domains that shape LHW outreach: the sociocultural domain and organizational domain, which overlap in the programmatic domain, all of which are framed by the structural domain. This analysis provides an approach for understanding how lay health work is shaped by a broader context.
Putting Promotion Into Practice: The African Americans Building a Legacy of Health Organizational Wellness Program
Authors: Yancey Antronette K. , Lewis Lavonna Blair , Guinyard Joyce Jones , Sloane David C. , Nascimento Lori Miller , Galloway-Gilliam Lark , Diamant Allison L. , McCarthy William J.
Published: June 2006

A Los Angeles REACH demonstration project led by Community Health Councils, Inc. adapted and implemented an organizational wellness intervention originally developed by the local health department, providing training in incorporating physical activity and healthy food choices into the routine “conduct of business” in 35 predominantly public and private, nonprofit-sector agencies. A total of 700 staff, members, or clients completed the 12-week or subsequently retooled 6-week curriculum. Attendance and retention rates between baseline and postintervention assessments were improved substantially in the shortened offering. Feelings of sadness or depression decreased significantly (p = .00), fruit and vegetable intake increased significantly (+0.5 servings/day, p = .00), and body mass index decreased marginally (-0.5 kg/m2, p = .08) among 12-week participants. The numbers of days in which individuals participated in vigorous physical activity increased significantly among 6-week participants (+0.3, p = .00). This model holds promise for extending the reach of environmentally focused work-site wellness programming to organizations and at-risk populations not traditionally engaged by such efforts.
Thematic Analysis of Documents From the SOPHE Health Disparity Elimination Research Agenda Summit: Illuminating Competencies for Future Researchers and Practitioners
Authors: Woodhouse Lynn D.
Published: June 2006

Public health education researchers are adopting a view that disparities are a product of social systems exposures. As a result, the researchers are facilitating a review of the research questions asked and highlighting underlying assumptions informing the interpretation of results. It is within this view that the Society for Public Health Education (SOPHE) Health Disparities Elimination Research Agenda Summit was implemented. Aspects of planning for the Summit are described elsewhere in this journal. This article describes an effort to facilitate additional learning from the Summit through qualitative analysis of documents from the Summit. This analysis processes records and verifies the consistently highlighted ideas or the content that offers guidance on how to move toward engaging in research that supports change. In addition, the analysis illuminates insights about the context in which research strategies can develop and suggests skill development that can foster this important research in the emerging public health education workforce.
State Health Policy Makers: What’s the Message and Who’s Listening?
Authors: Jones Ellen , Kreuter Marshall , Pritchett Sharon , Matulionis Rose Marie , Hann Neil
Published: June 2006

This article is based on a white paper commissioned by the Directors of Health Promotion and Education, a national organization representing state health agency directors and practitioners in health promotion and education initiatives. The work reflects an assessment of current understanding of how state-level policy makers receive and use information related to health promotion and chronic disease prevention. Although health education practitioners are routinely encouraged to use policy and environmental change strategies, a systematic approach to communication with policy leaders is not readily available. This work describes the current knowledge of the relationship and offers recommendations for research and practice.
Interferon-γ therapy in two patients with progressive chronic pulmonary aspergillosis
Authors: Kelleher P. , Goodsall A. , Mulgirigama A. , Kunst H. , Henderson D. C. , Wilson R. , Newman-Taylor A. , Levin M.
Published: June 2006

Infection by Aspergillus species causes a wide spectrum of pulmonary disease in humans.

In two patients with semi-invasive Aspergillus-induced lung disease, significantly reduced levels of interferon-γ secretion by peripheral blood mononuclear cells were found afterin vitrostimulation with the T-cell mitogen phytohaemagglutinin. Despite anti-fungal therapy, both patients exhibited progressive disease, and adjunctive interferon-γ therapy was associated with significant clinical improvement.

The data suggest that impaired production of interferon-γ can be seen in patients with chronic pulmonary aspergillosis. Adjunctive cytokine therapy with interferon-γ may be useful in patients with progressive disease despite adequate anti-fungal therapy.
Beyond the dogma: novel β2-adrenoceptor signalling in the airways
Authors: Giembycz M. A. , Newton R.
Published: June 2006

β2-Adrenoceptor agonists evoke rapid bronchodilatation and are the mainstay of the treatment of asthma symptoms worldwide. The mechanism of action of this class of compounds is believed to involve the stimulation of adenylyl cyclase and subsequent activation of the cyclic adenosine monosphosphate (cAMP)/cAMP-dependent protein kinase cascade.

This classical model of β2-adrenoceptor-mediated signal transduction is deeply entrenched, but there is compelling evidence that agonism of β2-adrenoceptors can lead to the activation of multiple effector pathways, which now compels researchers in academia and the pharmaceutical industry alike to think beyond the traditional dogma. Therefore, the regulation by β2-adrenoceptor agonists of responses, including airways smooth muscle tone and the secretory capacity of the epithelium and pro-inflammatory/immune cells, may be highly complex, involving both cAMP-dependent and -independent mechanisms that, in many cases, may act in concert.

In this article, the current status of β2-adrenoceptor-mediated signalling in the airways is reviewed in the context of understanding mechanisms that may underlie both the beneficial and detrimental effects of these drugs in asthma symptom management.
Marked stem cell factor expression in the airways of lung transplant recipients
Authors: Da Silva Carla A , Adda Mélanie , Stern Marc , de Blay Frédéric , Frossard Nelly , Israel-Biet Dominique
Published: June 2006

Background

Airways repair is critical to lung function following transplantation. We hypothesised that the stem cell factor (SCF) could play a role in this setting.

Methods

We studied 9 lung transplant recipients (LTx recipients) during their first year postgraft, and evaluated SCF mRNA expression in bronchial biopsy specimens using on-line fluorescent PCR and SCF protein levels in bronchoalveolar lavage (BAL) and serum using ELISA. The expression of SCF receptor Kit was assessed using immunostaining of paraffin-embedded bronchial sections.

Results

SCF mRNA was highly expressed during the early postgraft period [Month (M)1-M3] (300% increase vs controls: 356 vs 1.2 pg SCF/μg GAPDH cDNA, p < 0.001) and decreased thereafter (M4-M12: 187 pg/μg), although remaining at all times 10–100 times higher than in controls. While SCF protein levels in BAL were similar in LTx recipients and in controls, the SCF serum levels were at all times higher in LTx recipients than in controls (p < 0.05), with no relationship between these levels and the acute complications of the graft. Finally, Kit was strongly expressed by the mast cells as well as by the bronchial epithelium of LTx recipients.

Conclusion

SCF and Kit are expressed in bronchial biopsies from lung transplant recipients irrespective of the clinical status of the graft. A role for these factors in tissue repair following lung transplantation is hypothesised.
ROKU: a novel method for identification of tissue-specific genes
Authors: Kadota Koji , Ye Jiazhen , Nakai Yuji , Terada Tohru , Shimizu Kentaro
Published: June 2006

Background

One of the important goals of microarray research is the identification of genes whose expression is considerably higher or lower in some tissues than in others. We would like to have ways of identifying such tissue-specific genes.

Results

We describe a method, ROKU, which selects tissue-specific patterns from gene expression data for many tissues and thousands of genes. ROKU ranks genes according to their overall tissue specificity using Shannon entropy and detects tissues specific to each gene if any exist using an outlier detection method. We evaluated the capacity for the detection of various specific expression patterns using synthetic and real data. We observed that ROKU was superior to a conventional entropy-based method in its ability to rank genes according to overall tissue specificity and to detect genes whose expression pattern are specific only to objective tissues.

Conclusion

ROKU is useful for the detection of various tissue-specific expression patterns. The framework is also directly applicable to the selection of diagnostic markers for molecular classification of multiple classes.
Analysis of circular genome rearrangement by fusions, fissions and block-interchanges
Authors: Lu Chin Lung , Huang Yen Lin , Wang Tsui Ching , Chiu Hsien-Tai
Published: June 2006

Background

Analysis of genomes evolving via block-interchange events leads to a combinatorial problem of sorting by block-interchanges, which has been studied recently to evaluate the evolutionary relationship in distance between two biological species since block-interchange can be considered as a generalization of transposition. However, for genomes consisting of multiple chromosomes, their evolutionary history should also include events of chromosome fusions and fissions, where fusion merges two chromosomes into one and fission splits a chromosome into two.

Results

In this paper, we study the problem of genome rearrangement between two genomes of circular and multiple chromosomes by considering fusion, fission and block-interchange events altogether. By use of permutation groups in algebra, we propose an

O
MathType@MTEF@5@5@+=feaafiart1ev1aaatCvAUfKttLearuWrP9MDH5MBPbIqV92AaeXatLxBI9gBamrtHrhAL1wy0L2yHvtyaeHbnfgDOvwBHrxAJfwnaebbnrfifHhDYfgasaacH8akY=wiFfYdH8Gipec8Eeeu0xXdbba9frFj0=OqFfea0dXdd9vqai=hGuQ8kuc9pgc9s8qqaq=dirpe0xb9q8qiLsFr0=vr0=vr0dc8meaabaqaciaacaGaaeqabaWaaeGaeaaakeaaimaacqWFoe=taaa@383D@

(n
2) time algorithm to efficiently compute and obtain a minimum series of fusions, fissions and block-interchanges required to transform one circular multi-chromosomal genome into another, where n is the number of genes shared by the two studied genomes. In addition, we have implemented this algorithm as a web server, called FFBI, and have also applied it to analyzing by gene orders the whole genomes of three human Vibrio pathogens, each with multiple and circular chromosomes, to infer their evolutionary relationships. Consequently, our experimental results coincide well with our previous results obtained using the chromosome-by-chromosome comparisons by landmark orders between any two Vibrio chromosomal sequences as well as using the traditional comparative analysis of 16S rRNA sequences.

Conclusion

FFBI is a useful tool for the bioinformatics analysis of circular and multiple genome rearrangement by fusions, fissions and block-interchanges.
Array2BIO: from microarray expression data to functional annotation of co-regulated genes
Authors: Loots Gabriela G , Chain Patrick SG , Mabery Shalini , Rasley Amy , Garcia Emilio , Ovcharenko Ivan
Published: June 2006

Background

There are several isolated tools for partial analysis of microarray expression data. To provide an integrative, easy-to-use and automated toolkit for the analysis of Affymetrix microarray expression data we have developed Array2BIO, an application that couples several analytical methods into a single web based utility.

Results

Array2BIO converts raw intensities into probe expression values, automatically maps those to genes, and subsequently identifies groups of co-expressed genes using two complementary approaches: (1) comparative analysis of signal versus control and (2) clustering analysis of gene expression across different conditions. The identified genes are assigned to functional categories based on Gene Ontology classification and KEGG protein interaction pathways. Array2BIO reliably handles low-expressor genes and provides a set of statistical methods for quantifying expression levels, including Benjamini-Hochberg and Bonferroni multiple testing corrections. An automated interface with the ECR Browser provides evolutionary conservation analysis for the identified gene loci while the interconnection with Crème allows prediction of gene regulatory elements that underlie observed expression patterns.

Conclusion

We have developed Array2BIO – a web based tool for rapid comprehensive analysis of Affymetrix microarray expression data, which also allows users to link expression data to Dcode.org comparative genomics tools and integrates a system for translating co-expression data into mechanisms of gene co-regulation. Array2BIO is publicly available athttp://array2bio.dcode.org.
Identification and characterisation of human apoptosis inducing proteins using cell-based transfection microarrays and expression analysis
Authors: Palmer Ella L , Miller Andrew D , Freeman Tom C
Published: June 2006

Background

Cell-based microarrays were first described by Ziauddin and Sabatini in 2001 as a powerful new approach for performing high throughput screens of gene function. An important application of cell-based microarrays is in screening for proteins that modulate gene networks. To this end, cells are grown over the surface of arrays of RNAi or expression reagents. Cells growing in the immediate vicinity of the arrayed reagents are transfected and the arrays can then be scanned for cells showing localised changes in function. Here we describe the construction of a large-scale microarray using expression plasmids containing human genes, its use in screening for genes that induce apoptosis when over-expressed and the characterisation of a number of these genes by following the transcriptional response of cell cultures during their induction of apoptosis.

Results

High-density cell-based arrays were successfully fabricated using 1,959 un-tagged open reading frames (ORFs) taken from the Mammalian Gene Collection (MGC) in mammalian expression vectors. The arrays were then used to screen for genes inducing apoptosis in Human Embryonic Kidney (HEK293T) cells. Using this approach, 10 genes were clearly identified and confirmed to induce apoptosis. Some of these genes have previously been linked to apoptosis, others not. The mechanism of action of three of the 10 genes were then characterised further by following the transcriptional events associated with apoptosis induction using expression profiling microarrays. This data demonstrates a clear pro-apoptotic transcriptional response in cells undergoing apoptosis and also suggests the use of common apoptotic pathways regardless of the nature of the over-expressed protein triggering cell death.

Conclusion

This study reports the design and use of the first truly large-scale cell-based microarrays for over-expression studies. Ten genes were confirmed to induce apoptosis, some of which were not previously known to possess this activity. Transcriptome analysis on three of the 10 genes demonstrated their use of similar pathways to invoke apoptosis.
Verification of predicted alternatively spliced Wnt genes reveals two new splice variants (CTNNB1 and LRP5) and altered Axin-1 expression during tumour progression
Authors: Pospisil Heike , Herrmann Alexander , Butherus Kristine , Pirson Stefan , Reich Jens G , Kemmner Wolfgang
Published: June 2006

Background

Splicing processes might play a major role in carcinogenesis and tumour progression. The Wnt pathway is of crucial relevance for cancer progression. Therefore we focussed on the Wnt/β-catenin signalling pathway in order to validate the expression of sequences predicted as alternatively spliced by bioinformatic methods. Splice variants of its key molecules were selected, which may be critical components for the understanding of colorectal tumour progression and may have the potential to act as biological markers. For some of the Wnt pathway genes the existence of splice variants was either proposed (e.g. β-Catenin and CTNNB1) or described only in non-colon tissues (e.g. GSK3β) or hitherto not published (e.g. LRP5).

Results

Both splice variants – normal and alternative form – of all selected Wnt pathway components were found to be expressed in cell lines as well as in samples derived from tumour, normal and healthy tissues. All splice positions corresponded totally with the bioinformatical prediction as shown by sequencing. Two hitherto not described alternative splice forms (CTNNB1 and LRP5) were detected. Although the underlying EST data used for the bioinformatic analysis suggested a tumour-specific expression neither a qualitative nor a significant quantitative difference between the expression in tumour and healthy tissues was detected. Axin-1 expression was reduced in later stages and in samples from carcinomas forming distant metastases.

Conclusion

We were first to describe that splice forms of crucial genes of the Wnt-pathway are expressed in human colorectal tissue. Newly described splicefoms were found for β-Catenin, LRP5, GSK3β, Axin-1 and CtBP1. However, the predicted cancer specificity suggested by the origin of the underlying ESTs was neither qualitatively nor significant quantitatively confirmed. That let us to conclude that EST sequence data can give adequate hints for the existence of alternative splicing in tumour tissues. That no difference in the expression of these splice forms between cancerous tissues and normal mucosa was found, may indicate that the existence of different splice forms is of less significance for cancer formation as suggested by the available EST data. The currently available EST source is still insufficient to clearly deduce colon cancer specificity. More EST data from colon (tumour and healthy) is required to make reliable predictions.
Persisters: a distinct physiological state of E. coli
Authors: Shah Devang , Zhang Zhigang , Khodursky Arkady B , Kaldalu Niilo , Kurg Kristi , Lewis Kim
Published: June 2006

Background

Bacterial populations contain persisters, phenotypic variants that constitute approximately 1% of cells in stationary phase and biofilm cultures. Multidrug tolerance of persisters is largely responsible for the inability of antibiotics to completely eradicate infections. Recent progress in understanding persisters is encouraging, but the main obstacle in understanding their nature was our inability to isolate these elusive cells from a wild-type population since their discovery in 1944.

Results

We hypothesized that persisters are dormant cells with a low level of translation, and used this to physically sort dim E. coli cells which do not contain sufficient amounts of unstable GFP expressed from a promoter whose activity depends on the growth rate. The dim cells were tolerant to antibiotics and exhibited a gene expression profile distinctly different from those observed for cells in exponential or stationary phases. Genes coding for toxin-antitoxin module proteins were expressed in persisters and are likely contributors to this condition.

Conclusion

We report a method for persister isolation and conclude that these cells represent a distinct state of bacterial physiology.
Does updating improve the methodological and reporting quality of systematic reviews?
Authors: Shea Beverley , Boers Maarten , Grimshaw Jeremy M , Hamel Candyce , Bouter Lex M
Published: June 2006

Background

Systematic reviews (SRs) must be of high quality. The purpose of our research was to compare the methodological and reporting quality of original versus updated Cochrane SRs to determine whether updating had improved these two quality dimensions.

Methods

We identifed updated Cochrane SRs published in issue 4, 2002 of the Cochrane Library. We assessed the updated and original versions of the SRs using two instruments: the 10 item enhanced Overview Quality Assessment Questionnaire (OQAQ), and an 18-item reporting quality checklist and flow chart based upon the Quality of Reporting of Meta-analyses (QUOROM) statement. At least two reviewers extracted data and assessed quality. We calculated the percentage (with a 95% confidence interval) of 'yes' answers to each question. We calculated mean differences in percentage, 95% confidence intervals and p-values for each of the individual items and the overall methodological quality score of the updated and pre-updated versions using OQAQ.

Results

We assessed 53 SRs. There was no significant improvement in the global quality score of the OQAQ (mean difference 0.11 (-0.28; 0.70 p = 0.52)). Updated reviews showed a significant improvement of 18.9 (7.2; 30.6 p < .01) on the OQAQ item assessing whether the conclusions drawn by the author(s) were supported by the data and/or analysis presented in the SR. The QUOROM statement showed that the quality of reporting of Cochrane reviews improved in some areas with updating. Improvements were seen on the items relating to data sources reported in the abstract, with a significant difference of 17.0 (9.8; 28.7 p = 0.01), review methods, reported in the abstract 35 (24.1; 49.1 p = 0.00), searching methods 18.9 (9.7; 31.6 p = 0.01), and data abstraction 18.9 (11.7; 30.9 p = 0.00).

Conclusion

The overall quality of Cochrane SRs is fair-to-good. Although reporting quality improved on certain individual items there was no overall improvement seen with updating and methodological quality remained unchanged. Further improvement of quality of reporting is possible. There is room for improvement of methodological quality as well. Authors updating reviews should address identified methodological or reporting weaknesses. We recommend to give full attention to both quality domains when updating SRs.
A qualitative study of an integrated maternity, drugs and social care service for drug-using women
Authors: Hall Jennifer L , van Teijlingen Edwin R
Published: June 2006

Background

The care of drug-using pregnant women is a growing health and social care concern in many countries. A specialist clinic was established offering multidisciplinary care and advice to pregnant drug users in and around Aberdeen (UK) in 1997. The majority of women stabilise and reduce their drug use. By determining the needs and views of the women more appropriate services and prevention strategies may be developed. There has been little research conducted in this area and none in Scotland.

Methods

This is a qualitative study that aimed to gain an understanding of the experiences of women drug users, seeking and receiving prenatal care and drug services from a specialist clinic. Twelve women participated in semi-structured one-to-one interviews.

Results

The women preferred the multidisciplinary clinic (one-stop shop) to traditional prenatal care centred within General Practice. The relationships of the clients to the range of Clinic professionals and in hospital were explored as well as attitudes to Clinic care. The study participants attributed success in reducing their drug use to the combination of different aspects of care of the multi-agency clinic, especially the high level prenatal support. It is this arrangement of all aspects of care together that seem to produce better outcomes for mother and child than single care elements delivered separately. Some women reported that their pregnancy encouraged them to rapidly detoxify due to the guilt experienced. The most important aspects of the Clinic care were found to be non-judgemental attitude of staff, consistent staff, high level of support, reliable information and multi-agency integrated care.

Conclusion

There is an impetus for women drug users to change lifestyle during pregnancy. The study highlighted a need for women to have access to reliable information on the effects of drugs on the baby.

Further research is required to determine whether positive outcomes related to clinic attendance in the prenatal period are sustained in the postnatal period. Early referral to a specialist clinic is of benefit to the women, as they reported to receive more appropriate care, especially in relation to their drug use. A greater awareness of needs of the pregnant drug user could help the design of more effective prevention strategies.
Health Research Profile to assess the capacity of low and middle income countries for equity-oriented research
Authors: Tugwell P , Sitthi-Amorn C , Hatcher-Roberts J , Neufeld V , Makara P , Munoz F , Czerny P , Robinson V , Nuyens Y , Okello D
Published: June 2006

Background

The Commission on Health Research for Development concluded that "for the most vulnerable people, the benefits of research offer a potential for change that has gone largely untapped." This project was designed to assess low and middle income country capacity and commitment for equity-oriented research.

Methods

A multi-disciplinary team with coordinators from each of four regions (Asia, Latin America, Africa and Central and Eastern Europe) developed a questionnaire through consensus meetings using a mini-Delphi technique. Indicators were selected based on their quality, validity, comprehensiveness, feasibility and relevance to equity. Indicators represented five categories that form the Health Research Profile (HRP): 1) Research priorities; 2) Resources (amount spent on research); 3) Production of knowledge (capacity); 4) Packaging of knowledge and 5) Evidence of research impact on policy and equity. We surveyed three countries from each region.

Results

Most countries reported explicit national health research priorities. Of these, half included specific research priorities to address inequities in health. Data on financing were lacking for most countries due to inadequate centralized collection of this information. The five main components of HRP showed a gradient where countries scoring lower on the Human Development Index (HDI) had a lower capacity to conduct research to meet local health research needs. Packaging such as peer-reviewed journals and policy forums were reported by two thirds of the countries. Seven out of 12 countries demonstrated impact of health research on policies and reported engagement of stakeholders in this process.

Conclusion

Only one out of 12 countries indicated there was research on all fronts of the equity debate. Knowledge sharing and management is needed to strengthen within-country capacity for research and implementation to reduce inequities in health. We recommend that all countries (and external agencies) should invest more in building a certain minimum level of national capacity for equity-oriented research.
No difference in stroke knowledge between Korean adherents to traditional and western medicine – the AGE study: an epidemiological study
Authors: Park Moon Ho , Jo Sangmee Ahn , Jo Inho , Kim Eunkyung , Eun Su-Yong , Han Changsu , Park Min Kyu
Published: June 2006

Background

Effective stroke intervention and risk reduction depend on the general public's awareness and knowledge of stroke. In Korea, where both traditional Oriental medicine and Western medicine are practiced, estimates of the general public's awareness and knowledge of stroke are poor. The present study sought to describe the inception cohort of the Ansan Geriatric Study (AGE study) and to determine baseline stroke awareness and preferred medical treatment for stroke in this Korean sample.

Methods

A total of 2,767 subjects selected randomly from the Ansan Geriatric Study in South Korea were questioned about stroke. Their answers were compared with their sociodemographic data and other variables.

Results

Only 44.8% of participants correctly identified stroke as a vascular disease in the human brain. Sudden numbness or weakness was the most frequently identified stroke warning sign (60.2%). Hypertension (66.7%) and mental stress (62.2%) were most frequently identified as stroke risk factors. The contributions of diabetes mellitus and cardiovascular disease to stroke were underestimated; they were identified as risk factors by 28.3% and 18.6% of participants, respectively. The predictors for poor knowledge of stroke warning signs and risk factors were similar irrespective of preference for Western or Oriental medical treatment, and included those with lower levels of education and inaccurate definition of stroke. Television and radio (40.3%) were the most frequent sources of stroke information for both groups.

Conclusion

This study shows that knowledge of stroke is similar among Koreans with preferences for either Western or Oriental medical treatment and that misunderstandings about stroke are common among the Korean elderly. In order to prevent and manage stroke effectively, public health education regarding basic concepts of stroke is necessary. This should target those with a lower level of education and a misunderstanding of the definition of stroke.
Two years of psychogeriatric consultations in a nursing home: reasons for referral compared to psychiatrists' assessment
Authors: Callegari Camilla MT , Menchetti Marco , Croci Giovanni , Beraldo Scilla , Costantini Chiara , Baranzini Federico
Published: June 2006

Background

In spite of the high prevalence of psychiatric disorders among elderly residents in nursing homes, only a small number of patients in need of specialist care are referred to a psychiatric consultant. The aim of this research was to evaluate the consultation activity and the appropriateness of referral to psychiatric assessment.

Methods

Data were collected and analysed on consultation carried out over a two-year period in a RSA (Residenza Socio-Assistenziale) in Northern-Italy. Data were catalogued with reference to: patients, consultation, diagnosis and recommended medications. Statistical correlation analysis by means of Spearman test and signification test was carried out.

Results

Residents referred to psychiatric consultation at least once were 112 (14.5% of all residents). Reason for referral were: depression (17.2%), delusions and hallucinations (14%), agitation (34.8%), aggressive behaviour (23.5%) and disturbances of sleep (6.8%). Most frequent diagnoses were organic, including symptomatic, mental disorders (33.9%), mood disorders (22.3%) and schizophrenia, schizotypal and delusional syndromes (18.8%). No psychiatric diagnosis was found only in 1.8% of cases, thus confirming high sensibility of referring physicians.

A statistically significant correlation was found when comparing referrals for depression or delusions and allucinations or sleep disturbances and diagnostic confirmation of such symptoms by specialistic assessment (respectively 49.8%, 52.7% and 19.6%).

Correlation between psychotic symptoms and the consequent prescription of antipsychotic drugs had a significant if somewhat modest value (24%) while correlation between depression symptoms and prescription of antidepressant drugs was more noticeable (66.5%).

Conclusion

Main reason for referral to psychiatric consultation resulted to be the presence of agitation, a non-specific symptom often difficult to attribute. Data concerning depression confirm tendency to underestimating this diagnosis in the elderly. Furthermore, symptomatic reasons for referral did not always correspond to subsequent diagnostic definitions by psychiatric consultants, therefore demonstrating modest predictive power.
Aortic distensibility measured by pulse-wave velocity is not modified in patients with Chagas' disease
Authors: Villacorta Humberto , Bortolotto Luiz Aparecido , Arteaga Edmundo , Mady Charles
Published: June 2006

Background

Experimental studies demonstrate that infection with trypanosoma cruzi causes vasculitis. The inflammatory lesion process could hypothetically lead to decreased distensibility of large and small arteries in advanced Chagas' disease. We tested this hypothesis.

Methods and results

We evaluated carotid-femoral pulse-wave velocity (PWV) in 53 Chagas' disease patients compared with 31 healthy volunteers (control group). The 53 patients were classified into 3 groups: 1) 16 with indeterminate form of Chagas' disease; 2) 18 with Chagas' disease, electrocardiographic abnormalities, and normal systolic function; 3) 19 with Chagas' disease, systolic dysfunction, and mild-to-moderate congestive heart failure. No difference was noted between the 4 groups regarding carotid-femoral PWV (8.4 ± 1.1 vs 8.2 ± 1.5 vs 8.2 ± 1.4 vs 8.7 ± 1.6 m/s, P = 0.6) or pulse pressure (39.5 ± 7.6 vs 39.3 ± 8.1 vs 39.5 ± 7.4 vs 39.7 ± 6.9 mm Hg, P = 0.9). A positive, significant, similar correlation occurred between PWV and age in patients with Chagas' disease (r = 0.42, P = 0.002), in controls (r = 0.48, P = 0.006), and also between PWV and systolic blood pressure in both groups (patients with Chagas' disease, r = 0.38, P = 0.005; healthy subjects, r = 0.36, P = 0.043).

Conclusion

Carotid femoral pulse-wave velocity is not modified in patients with Chagas' disease, suggesting that elastic properties of large arteries are not affected in this disorder.
Neuromuscular organization and aminergic modulation of contractions in the Drosophila ovary
Authors: Middleton C Adam , Nongthomba Upendra , Parry Katherine , Sweeney Sean T , Sparrow John C , Elliott Christopher JH
Published: June 2006

Background

The processes by which eggs develop in the insect ovary are well characterized. Despite a large number of Drosophila mutants that cannot lay eggs, the way that the egg is moved along the reproductive tract from ovary to uterus is less well understood. We remedy this with an integrative study on the reproductive tract muscles (anatomy, innervation, contractions, aminergic modulation) in female flies.

Results

Each ovary, consisting of 15–20 ovarioles, is surrounded by a contractile meshwork, the peritoneal sheath. Individual ovarioles are contained within a contractile epithelial sheath. Both sheaths contain striated muscle fibres. The oviduct and uterine walls contain a circular striated muscle layer. No longitudinal muscle fibres are seen.

Neurons that innervate the peritoneal sheath and lateral oviduct have many varicosities and terminate in swellings just outside the muscles of the peritoneal sheath. They all express tyrosine decarboxylase (required for tyramine and octopamine synthesis) and Drosophila vesicular monoamine transporter (DVMAT). No fibres innervate the ovarioles. The common oviduct and uterus are innervated by two classes of neurons, one with similar morphology to those of the peritoneal sheath and another with repeated branches and axon endings similar to type I neuromuscular junctions.

In isolated genital tracts from 3- and 7-day old flies, each ovariole contracts irregularly (12.5 ± 6.4 contractions/minute; mean ± 95% confidence interval). Peritoneal sheath contractions (5.7 ± 1.6 contractions/minute) move over the ovary, from tip to base or vice versa, propagating down the oviduct. Rhythmical spermathecal rotations (1.5 ± 0.29 contractions/minute) also occur. Each genital tract organ exhibits its own endogenous myogenic rhythm.

The amplitude of contractions of the peritoneal sheath increase in octopamine (100 nM, 81% P < 0.02) but 1 μM tyramine has no effect. Neither affects the frequency of peritoneal sheath contractions.

Conclusion

The muscle fibres of the reproductive tract are circular and have complex bursting myogenic rhythms under octopaminergic neuromodulation. We propose a new model of tissue-specific actions of octopamine, in which strengthening of peritoneal sheath contractions, coupled with relaxation of the oviduct, eases ovulation. This model accounts for reduced ovulation in flies with mutations in the octopaminergic system.