bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular characterisation of the gut microflora of healthy and inflammatory bowel disease cats using fluorescence in situ hybridisation with special reference to Desulfovibrio spp.
Authors: Inness V. L. , McCartney A. L. , Khoo C. , Gross K. L. , Gibson G. R.
Published: September 2006

Inflammatory bowel disease (IBD) is a common cause of chronic large bowel diarrhoea in cats. Although the aetiology of IBD is unknown, an immune‐mediated response to a luminal antigen is thought to be involved. As knowledge concerning the colonic microflora of cats is limited and requires further investigation, the purpose of this study was to determine the presence of specific bacterial groups in normal and IBD cats, and the potential role they play in the health of the host. Total bacterial populations, Bacteroides spp., Bifidobacterium spp., Clostridium histolyticum subgp., Lactobacillus–Enterococcus subgp. and Desulfovibrio spp. were enumerated in 34 healthy cats and 11 IBD cats using fluorescence in situ hybridisation. The study is one of the first to show the presence of Desulfovibrio in cats. Total bacteria, Bifidobacterium spp. and Bacteroides spp. counts were all significantly higher in healthy cats when compared with IBD cats, whereas Desulfovibrio spp. (producers of toxic sulphides) numbers were found to be significantly higher in colitic cats. The information obtained from this study suggests that modulation of bacterial flora by increasing bifidobacteria and decreasing Desulfovibrio spp. may be beneficial to cats with IBD. Dietary intervention may be an important aspect of their treatment.
Effects of dexamethasone on mRNA abundance of nuclear receptors and hepatic nuclear receptor target genes in neonatal calves
Authors: Greger D. L. , Blum J. W.
Published: September 2006

Hepatic nuclear receptors (NR), particularly constitutive androstane receptor (CAR) and pregnane X receptor (PXR), are involved in the coordinated transcriptional control of genes that encode proteins involved in the metabolism and detoxification of xeno‐ and endobiotics. A broad spectrum of metabolic processes are mediated by NR acting in concert with ligands such as glucocorticoids. This study examined the role of dexamethasone on hepatic mRNA expression of CAR, PXR and several NR target genes. Twenty‐eight male calves were allotted to one of four treatment groups in a 2 × 2 arrangement of treatments: feed source (colostrum or milk‐based formula) and glucocorticoid administration (twice daily intramuscular dexamethasone). Liver biopsies were obtained at 5 days of age. Real‐time reverse transcription polymerase chain reaction was used to quantify mRNA abundances. No effects of feed source on mRNA abundances were observed. For the NR examined, mRNA abundance of both CAR and PXR in dexamethasone‐treated calves was lower (p < 0.05) by 39% and 40%, respectively, than in control calves. Abundance of NR target genes exhibited a mixed response. SULT1A1 mRNA abundance was 39% higher (p < 0.05) in dexamethasone‐treated calves compared with control calves. mRNA abundance of CYP2C8 tended also to be higher (+44%; p = 0.053) after dexamethasone treatment. No significant treatment effects (p > 0.10) were observed for mRNA abundances of CYP3A4, CYP2E1, SULT2A1, UGT1A1 or cytochrome P450 reductase (CPR). In conclusion, an enhanced glucocorticoid status, induced by pharmacological amounts of dexamethasone, had differential and in part unexpected effects on NR and NR target systems in 5‐day‐old calves. Part of the unexpected responses may be due the immaturity of NR and NR receptor target systems.
Plasma growth hormone concentrations in female mithun (Bos frontalis) of different ages: relations with age and body weight
Authors: Mondal M. , Rajkhowa C. , Prakash B. S.
Published: September 2006

The role of growth hormone (GH) in postnatal somatic growth is well established. Its basal level and relation to growth performance in different age group mithun (Bos frontalis), a semiwild ruminant has not been characterized until now. To estimate the normal blood GH level and also to assess the influence of age and body weight (BW) on blood GH level in captive mithuns, a total of 65 female mithuns was divided into six age groups (group I, 0–6 months; group II, >6–12 months; group III, >1–2 years; group IV, >2–2.5 years; group V, >2.5–3.0 years and group VI, >3.0 years). Blood samples collected weekly for six consecutive weeks were assayed for GH. GH was also estimated in the samples collected from six growing mithuns at −60, −45, −30, −15, −10, −5 and 0 min prior to GH‐releasing hormone (GHRH) administration for calculation of basal GH level and at 5, 10, 15, 30 min and thereafter at 15‐min interval up to 8 h post‐GHRH to assess blood GH response following GHRH administration in growing mithuns. For calculation of basal plasma GH in adult mithuns, GH was measured in blood samples collected at 30‐min interval for 24 h from four animals. BW of all animals was recorded on two consecutive days per week and average of weekly BW was considered for growth rate calculation. It was found that both mean GH and GH per 100 kg BW between the age groups differ (p < 0.01). With increasing age and BW, GH and GH per 100 kg BW both decreased (p < 0.01). The age group with higher plasma GH and GH per 100 kg BW showed higher growth rates (r = 0.83 and 0.97 respectively). Interestingly, mean plasma GH for six consecutive weeks in all the groups showed much greater GH concentration (group I, 86.6 ± 9.7 ng/ml to group VI 33.2 ± 5 ng/ml) than reported in other species. Mean basal plasma GH calculated in growing and adult mithuns was 29.6 ± 4.01 ng/ml and around 25 ± 3.6 ng/ml respectively. The GH peak (444 ± 21.3 ng/ml) was registered at 15 min post‐GHRH administration in growing mithuns. In conclusion, age and BW influence plasma GH and GH per 100 kg BW but the latter is a better indicator of growth. The basal plasma GH and GH response to GHRH administration is six to eight and four to five times higher in mithun than in other species reported so far. An accurate assessment of the relationship between GH profiles and protein metabolism, proper receptor level study for GH action at the cellular level and the interaction of GH with other growth factors awaits better understanding of higher GH in this unique species.
CLINICAL MALIGNANCY RISK OF GIST ASSESSED BY ENDOSCOPIC ULTRASONOGRAPHY
Authors: Ohashi Shinji , Okamura Shozo , Urano Fumihiro , Maeda Matsuyoshi , Goto Hidemi , Niwa Yasumasa
Published: September 2006

Background:  The aim of the present study was to analyze clinicopathological findings in primary gastrointestinal stromal cell tumors (GIST) and to determine the clinical factors that indicate higher risk potential.

Methods:  Forty‐seven patients with primary GIST were enrolled, and their clinical, endosonographic ultrasonography (EUS), microscopic and immunohistochemical findings were evaluated. Risk categorization of GIST was made on histological tumor size and the mitotic rate.

Results:  EUS features (a larger diameter, an irregular border, and cystic areas) were significantly correlated with higher risk and unfavorable prognosis. Pathological features (tumor size > 50 mm, > 10 mitoses per 50 high‐power fields (HPF), necrosis, and high‐risk category) were significant unfavorable prognostic factors. However, some high‐risk GIST less than 50 mm in diameter did not have any cystic areas, an irregular border on EUS images. Among GIST that measured 50 mm or less on EUS, tumors with rapid growth and a change of internal echo (more inhomogeneity) were higher risk, while tumors that did not grow and showed no change of a homogeneous internal echo were lower risk.

Conclusions:  EUS parameters (a larger diameter, an irregular border, and cystic areas) indicate high‐risk potential. Tumor growth rate and change of internal echo pattern will be a helpful prognosticator, especially for asymptomatic and incidentally detected small GIST, where the classical EUS high‐risk parameters come up against limiting factors.
IDIOPATHIC BENIGN STRICTURES OF THE EXTRAHEPATIC BILE DUCT: RESULTS OF ENDOSCOPIC THERAPY
Authors: Sharma Barjesh Chander , Agarwal Naresh , Agarwal Anil , Sakhuja Puja , Sarin Shiv Kumar
Published: September 2006

Background:  Idiopathic, benign, non‐traumatic, non‐inflammatory strictures of bile ducts are rare. We report cases with benign non‐traumatic, non‐inflammatory strictures of bile ducts diagnosed on histopathology of endoscopic tissue specimens and managed with endoscopic therapy.

Methods:  Eight patients with benign non‐traumatic, non‐inflammatory strictures of bile ducts were studied. Diagnosis of benign stricture was based on imaging studies (ultrasound and CT scanning), normal CA 19–9 levels, negative brush cytology and histopathology, endoscopic retrograde cholangiopancreatography (ERCP) and no evidence of malignancy on follow up. Endoscopic balloon dilatation of stricture was performed and biliary stent was placed.

Results:  Median age was 42 years and five patients were males. Clinical presentation included jaundice (5), abdominal pain (7), fever (2) and pruritus (6). Liver function tests and imaging studies revealed features of obstructive jaundice. ERCP revealed smooth concentric and tapering stricture in all patients. Brush cytology and histopathological specimen revealed cubocolumnar epithelium surrounded by fibrous tissue without inflammation and negative for malignant cells. All patients got relief of fever, jaundice, pain and pruritus after balloon dilatation and stenting. Symptoms completely resolved in a median of 24 days. Liver function tests normalized in a median of 36 days. Follow up ERCP after 6 months did not show evidence of stricture and stent could be removed successfully in all patients. Thereafter, for a median follow up of 19 months, patients remained asymptomatic and their liver function tests and ultrasound were normal.

Conclusions:  Benign strictures of extrahepatic bile ducts can be non‐traumatic and non‐inflammatory without any cause and can be managed successfully with endoscopic balloon dilatation and biliary stenting.
CARDIOVASCULAR TOLERANCE IN UNSEDATED UPPER GASTROINTESTINAL ENDOSCOPY: PROSPECTIVE RANDOMIZED COMPARISON BETWEEN TRANSNASAL AND CONVENTIONAL ORAL PROCEDURES
Authors: Mori Akihiro , Fushimi Nobutoshi , Asano Takayuki , Maruyama Takako , Ohashi Noritsugu , Okumura Shoji , Inoue Hiroshi , Takekoshi Shodo , Friedman Scott L. , Okuno Masataka
Published: September 2006

Background:  The utility of transnasal esophagogastroduodenoscopy (EGD) using ultrathin endoscopy has previously been described by analyzing subjective information and comparing it to conventional oral EGD. Limited information is available regarding the advantageous use of nasal EGD when assessed by reliable objective data.

Methods:  A total of 927 patients undergoing unsedated EGD between June 2004 and May 2005 were enrolled. We used a partially randomized patient‐centered study design in order to exclude a bias of the patient’s preference. Patients were divided into four groups. Patients who preferred oral or nasal EGD underwent endoscopy according to their preference (preferred group). Patients without preference were randomly assigned to oral and nasal EGD (randomized group). Pulse, blood pressure (BP) and peripheral blood oxygen saturation (SpO2) were monitored during the procedure. Acceptability of EGD was also assessed by an acceptance score and the rate of willingness to repeat the same procedure.

Results:  Oral and nasal EGD were performed in 325 and 387 patients, respectively, in the preferred group, and 81 and 77 cases, respectively, in the randomized group. Nasal EGD was incomplete in 57 patients. Increases in BP were significantly lower in nasal EGD than in oral endoscopy in both the randomized and preferred groups, whereas no significant difference was found in the increment of pulse between the groups. Changes in SpO2 were minimal in either procedure. Analyses of patient acceptability showed favorable evaluation of nasal EGD in both randomized and preferred groups.

Conclusions:  Nasal EGD appears to be less stressful to the cardiovascular system. Patient’s acceptability also supports its usefulness unless difficulties in transnasal insertion are encountered.
INSULIN‐LIKE GROWTH FACTOR‐I RECEPTOR AS A CANDIDATE FOR A NOVEL MOLECULAR TARGET IN GASTROINTESTINAL CANCERS
Authors: Adachi Yasushi , Yamamoto Hiroyuki , Imsumran Arisa , Oka Toshikuni , Oki Mariko , Nosho Katsuhiko , Min Yongfen , Shinomura Yasuhisa , Lee Choon‐Taek , Carbone David P. , Imai Kohzoh
Published: September 2006

Abnormal activation of growth factor receptors and their signal pathways are required for neoplastic transformation and tumor progression. The concept of targeting specific tumorigenic receptors has been validated by successful clinical application of multiple new drugs, such as those acting against HER2/neu, epidermal growth factor receptor 1, and c‐Kit. In this review, we focus on the next promising therapeutic molecular target of insulin‐like growth factor (IGF)‐I receptor (IGF‐Ir). The IGF/IGF‐Ir system is an important modifier of cancer cell proliferation, survival, growth, and treatment sensitivity in a number of neoplastic diseases, including human gastrointestinal carcinomas. Preclinical studies demonstrated that downregulation of IGF‐Ir signals reversed the neoplastic phenotype and sensitized cells to antitumor treatments. We summarize a variety of ways to disrupt IGF‐Ir function. Then, we introduce our strategy of adenoviruses expressing dominant negative of IGF‐Ir (IGF‐Ir/dn) against gastrointestinal cancers, including stomach, colon, and pancreas. IGF‐Ir/dn suppresses tumorigenicity both in vitro and in vivo and increases stressor‐induced apoptosis. IGF‐Ir/dn expression upregulates chemotherapy‐induced apoptosis and these combination therapies with chemotherapy are very effective against tumors in mice. Some drugs blocking IGF‐Ir function are now entering clinical trial, thus IGF‐Ir might be a candidate for a therapeutic target in several gastrointestinal malignancies.
EFFECTIVENESS OF CYTODIAGNOSIS WITH PANCREATIC DUCT LAVAGE FLUID FOR PANCREATIC DUCTAL CARCINOMA: NEW SAMPLING TECHNIQUE
Authors: Imamura Tsunao , Takeshita Rie , Koyama Rikako , Okuda Chikao , Takeuchi Kazuo , Matsuda Masamichi , Hashimoto Masashi , Watanabe Goro , Yoshida Hitoshi , Imawari Michio
Published: September 2006

Background:  Pancreatic carcinoma is one of the most lethal cancers. Because pancreatic carcinoma is still very difficult to diagnose in its early stage, many of these patients will be considered unsuitable for surgery. If a cytological diagnosis is obtained at initial endoscopic retrograde cholangiopancreatography (ERCP), suitable treatment will be initiated without delay.

Methods:  To increase the number of exfoliated cells from the pancreatic duct, we devised a new technique, pancreatic duct lavage fluid (PDLF), following bronchoalveolar lavage fluid. The present paper reports the effectiveness of cytological examination using PDLF in the diagnosis of pancreatic carcinoma. We examined 18 pancreatic carcinoma cases. After the endoscopic retrograde pancreatography (ERP), PDLF was collected from a double‐lumen catheter inserted into the main pancreatic duct. Saline injected from the lumen for the injection, and PDLF was aspirated from the other lumen for the guidewire at the same time. The cytological examination was performed using PDLF.

Results:  Exfoliated cells were more frequently found in PDLF from all patients. In 15 cases (83%), cytological examination of PDLF revealed positive cytological results as the diagnosis of pancreatic carcinoma.

Conclusion:  Cytological examination using PDLF has a high sensitivity for detection of pancreatic carcinoma. The new examination, PDLF, is simple, safe and effective, so we expect PDLF to become widely popular.
SUCCESSFUL PLACEMENT OF SELF‐EXPANDABLE METALLIC STENTS FOR DOUBLE COLORECTAL CANCERS
Authors: Abe Tsuyoshi , Maetani Iruru , Kakemura Tadayoshi , Fujinuma Sumio , Sakai Yoshihiro
Published: September 2006

Stent placement for the palliation of unresectable colon cancer is an alternative to surgical treatment that has recently become popular. A dedicated stent for colorectal cancer is not available in Japan. We report a patient with two colonic obstructions who underwent a successful palliative treatment using two stents. He was admitted to Toho University Ohashi Medical Center because of ileus. A colonoscopy revealed two advanced lesions with stenosis in the sigmoid and transverse colon. Because he had multiple liver metastases and severe Alzheimer dementia, we selected palliative stent placement for the treatment of both strictures. We placed a covered stent in the sigmoid colon stricture and subsequently attempted to place a second stent in the transverse colon stricture. However, the second stent could not be placed in the transverse colon because the modified delivery system could not pass through the first stent in the sigmoid colon. This probably led to a twisting of the stent in the sigmoid colon. We next used the 24 F introducer sheath that is included in Keller‐Timmermans Introducer Sets. This strategy allowed the modified delivery system to be easily passed through the initial stent in the sigmoid colon and then advanced into the transverse colon stricture, enabling both stents to be positioned properly.
PEUTZ‐JEGHERS SYNDROME ASSOCIATED WITH RENAL AND GASTRIC CANCER THAT DEMONSTRATED AN STK11 MISSENSE MUTATION
Authors: Kataoka Hiromi , Joh Takashi , Inoue Yusuke , Ogasawara Naotaka , Oshima Tadayuki , Tanida Satoshi , Sasaki Makoto , Nakao Haruhisa , Nakazawa Takahiro , Ohara Hirotaka
Published: September 2006

A 75‐year‐old male was admitted to the gastroenterology unit of Nagoya City University Hospital due to epigastralgia after surgical treatment for right renal cancer. Endoscopy revealed advanced type 1 gastric cancer in the corpus of the stomach and multiple polypoid lesions in the stomach and duodenum. X‐ray examination of the small intestine using barium showed multiple polyps in the upper jejunum. Faint pigmentation on the palm was also detected. Peutz‐Jeghers syndrome (PJS) was diagnosed, despite a lack of family history. Total gastrectomy, resection of part of the upper jejunum and intraoperative endoscopic polypectomy of duodenal polyps was performed. This is the second reported case of PJS associated with renal cancer. We also detected a missense mutation in the tumor suppressor gene STK11 that, when mutated, is causative for PJS.
Effects of care pathways on stroke care practices at regional hospitals
Authors: Read S. J. , Levy J.
Published: September 2006

Background: Our previous work identified deficiencies in stroke care practices at regional hospitals in comparison to standards suggested by published stroke care guidelines. These deficiencies might be improved by the implementation of clinical pathways. The aim of this study was to assess changes in acute stroke care practices following the implementation of stroke care pathways at four regional Queensland hospitals.

Methods: The medical records of two cohorts of 120 patients with a discharge diagnosis of stroke or transient ischaemic attack were retrospectively audited before and after implementation of stroke care pathways to identify differences in the use of acute interventions, investigations and secondary prevention strategies.

Results: Following pathway implementation there were clinically important, but not statistically significant, increases in the rates of swallow assessment, allied health assessment (significant for occupational therapy, P = 0.04) and use of deep vein thrombosis prevention strategies (also significant, P = 0.006). Fewer patients were discharged on no anti‐thrombotic therapy (statistically significant in the subgroup of patients with atrial fibrillation, P = 0.02). Only 37% of the patients audited were actually enrolled on the pathway. Among this subgroup there were significant increases in the rates of swallow assessment (first 24 h, P = 0.01; any time during admission, P = 0.0001), allied health assessments (all P < 0.05), estimation of blood glucose level (P = 0.0015) and the use of deep vein thrombosis prevention strategies (P = 0.0003).

Conclusion: Stroke care pathways appear to improve the process of care. Whether this influences outcomes such as mortality, functional and neurological recovery, the incidence of complications, length of stay or the cost of care was beyond the scope of this study and will require further examination.
Patients with acute myocardial infarction have an inaccurate understanding of their risk of a future cardiac event
Authors: Broadbent E. , Petrie K. J. , Ellis C. J. , Anderson J. , Gamble G. , Anderson D. , Benjamin W.
Published: September 2006

Background: Accurate perceptions of future cardiac risk are important to ensure informed treatment choices and lifestyle adaptation in patients following myocardial infarction (MI). The aim of this study was to investigate whether risk perceptions of patients with MI were accurate compared with an established clinical risk model.

Methods: Seventy‐nine consecutive patients with acute MI admitted to the Coronary Care Unit, Auckland Hospital, completed a questionnaire assessing risk perceptions. Clinical data were used to calculate patients’ Thrombolysis In Myocardial Infarction (TIMI) risk scores, a validated predictive model of prognosis. The main outcome measures were the associations between perceived risk, TIMI risk scores and troponin T.

Results: Patients’ risk perceptions showed no correlation with thrombolysis in myocardial infarction risk scores (r = −0.06; P = 0.61) or with troponin T (r = −0.07; P = 0.53). Patients’ risk perceptions were not significantly associated with age or sex, and were not significantly higher in those who had experienced a previous MI, a family history of coronary heart disease, diabetes or smokers. Higher perceived risk was significantly associated with a number of illness perceptions, including worse consequences of the MI and lower beliefs in the benefit of treatment. Patients who overestimated their risk were more anxious than other patients (F(2, 73) = 22.97; P = 0.0001).

Conclusion: Patients with MI ideas about their personal risk of future MI are not congruent with their clinical risk assessments. Inpatient hospital care appears to be unsuccessful in communicating prognosis effectively to patients. Improving the accuracy of risk perceptions may help decrease unnecessary cardiac anxiety and invalidism in some patients and prompt risk‐reducing behaviours in others.
Tauopathies: classification and clinical update on neurodegenerative diseases associated with microtubule‐associated protein tau
Authors: Williams D. R.
Published: September 2006

The majority of neurodegenerative diseases are characterized by the deposition of insoluble protein in cells of the neuromuscular system. Advances in molecular neuropathology have allowed a classification system of neurodegenerative diseases based on this protein accumulation. Microtubule‐associated tau is one protein that has important functions in healthy neurons, but forms insoluble deposits in diseases now known collectively as tauopathies. Tauopathies encompass more than 20 clinicopathological entities, including Alzheimer’s disease, the most common tauopathy, progressive supranuclear palsy, Pick’s disease, corticobasal degeneration and post‐encephalitic parkinsonism. There are important clinical, pathological, biochemical and genetic similarities in the range of these diseases and they have helped to advance our understanding of the aetiological factors that initiate neurodegeneration and tau accumulation. This review examines the important clinical features of the most prevalent tauopathies and the molecular and pathological features that underpin the classification system.
Safety of iron polymaltose given as a total dose iron infusion
Authors: Newnham E. , Ahmad I. , Thornton A. , Gibson P. R.
Published: September 2006

An audit of the in‐hospital safety and tolerability of 401 infusions of iron polymaltose in 386 patients has shown no cases of anaphylaxis or other cardiorespiratory compromise. The infusion was terminated prematurely because of adverse events in six patients (1.6%). No adverse events occurred within the first 15 min of the infusion. Premedication (in 24%) was not associated with fewer adverse events. Fear of anaphylaxis should not inhibit the use of total dose iron infusion and the practices of premedication and of medical supervision during the first 15 min of the infusion should be abandoned.
Etanercept in severe active rheumatoid arthritis: first Australian experience
Authors: Perera L. C. , Tymms K. E. , Wilson B. J. , Shadbolt B. , Brook A. S. , Dorai Raj A. K. , Khoo K. B. K.
Published: September 2006

Background: Etanercept reduces disease activity in adults with chronic rheumatoid arthritis (RA) who are resistant to other therapies. Medicare Australia Pharmaceutical Benefit Scheme subsidized treatment (since August 2003) restricts etanercept availability to a most drug‐resistant RA population. The aim of the study was to assess the efficacy of etanercept in this unique group after 12 months of therapy.

Methods: A prospective study of the first 50 consecutive private practice, adult RA patients whom were commenced on etanercept. The primary efficacy measures included short form 36 scores, Disease Activity Score 28, American College of Rheumatology (ACR) response improvement in per cent and the ACR individual core set components at baseline, 3 and 12 months. Analysis was by intention to treat.

Results: There was significant improvement in all mean short form 36 component scores (P < 0.05) and all ACR core set component scores (P < 0.05) comparing 12 months to baseline. The disease activity score 28 also significantly fell from baseline at both 3 and 12 months (P < 0.05). The ACR 20% response significantly improved (P < 0.05) both at baseline to 3 months 92% (81.2, 96.9) and to 12 months 80% (67.0, 88.8). Serious adverse events occurred in 16%. At 12 months 88% completed treatment.

Conclusion: Etanercept therapy will, by 3 and 12 months, significantly improve the short form 36, disease activity score 28, ACR 20% response and core set components. Our results are similar to international studies using etanercept in efficacy and tolerance despite our cohort being more resistant to preceding drug therapy. Etanercept offers this unique active severe refractory late RA Australian population a new therapeutic option to control their disease.
Strongyloides stercoralis: risks posed to immigrant patients in an Australian tertiary referral centre
Authors: Einsiedel L. , Spelman D.
Published: September 2006

Background: Strongyloides stercoralis is a nematode human parasite with a global prevalence that is able to maintain a prolonged infestation by means of its autoinfective life cycle. Immunosuppression may result in a life‐threatening hyperinfection syndrome. Recent changes in migration have resulted in the arrival of many immigrants from endemic areas. As to whether physicians are alert to the risks of strongyloidiasis in these patient groups is unclear. The aim of the study was to assess the risks posed by chronic strongyloidiasis in patients presenting to a tertiary referral centre and the need for screening of immigrant patients before immunosuppression.

Methods: The study comprised a retrospective review of cases of strongyloidiasis presenting to the Alfred Hospital, Melbourne. Thirty‐three cases were diagnosed by either positive serology or faecal microscopy between January 1998 and January 2005. The medical records for 29 cases were examined with regard to demographics, clinical features and complications.

Results: Two major groups were identified: immigrants (17) and returned travellers (11). Six immigrants, but no returned traveller, developed a hyperinfective syndrome. Five immigrants received immunosuppressive therapies before developing symptoms of hyperinfection and this was complicated by life‐threatening sepsis in two patients. Diagnosis was frequently delayed in the immigrant group who were significantly more likely to present with respiratory symptoms. Four immigrants and two returned travellers were treated with corticosteroids for symptoms that were probably related to larval migration.

Conclusion: Before giving immunosuppressive therapies, patients with a history of potential exposure must be investigated for strongyloidiasis and consideration given to empirical treatment.
Continuing professional development for rural physicians: an oxymoron or just non‐existent?
Authors: McLean R.
Published: September 2006

There is geographic maldistribution of physicians across Australia and their professional isolation, particularly in relation to continuing professional development, is a definite problem. It tends to be worse in smaller centres where there is no critical mass that allows for peer support. Although some academic research has been carried out concerning the needs of rural GP, none has targetted rural specialists. Several activities, including the Commonwealth‐funded Support Scheme for Rural Specialists, have been well received and other initiatives, including the rural clinical schools and university departments of rural health, are beginning to provide an infrastructure that will help overcome the professional isolation through the use of innovative technologies such as interactive videoconferencing. This is being used to deliver RACP initiatives such as the basic physician trainee lecture series and the potential for vertical integration of training in rural settings which offer some promise to address the rural workforce shortage in the years to come.
‘Right’ way to ‘do’ illness? Thinking critically about positive thinking
Authors: McGrath C. , Jordens C. F. C. , Montgomery K. , Kerridge I. H.
Published: September 2006

Exhortations to ‘be positive’ accompany many situations in life, either as a general injunction or in difficult situations where people are facing pressure or adversity. It is particularly evident in health care, where positive thinking has become an aspect of the way people are expected to ‘do’ illness in developed society. Positive thinking is framed both as a moral injunction and as a central belief system. It is thought to help patients cope emotionally with illness and to provide a biological benefit. Yet, the meanings, expectations and outcomes of positive thinking are infrequently questioned and the risks of positive thinking are rarely examined. We outline some of the latter and suggest that health professionals should exercise caution in both ‘prescribing’ positive thinking and in responding to patients and carers whose belief systems and feelings of obligation rest on it.
Self‐Regulated Learning in Technology‐Enhanced Learning Environments: lessons of a European peer review
Authors: STEFFENS KARL
Published: September 2006

This article first describes the state‐of‐the‐art of model building and empirical research in the field of self‐regulated learning (SRL) and then focuses on self‐regulated learning in Technology‐Enhanced Learning Environments (TELEs). We present recent research results obtained in a European project (TELEPEERS) in the context of which we evaluated TELEs in a peer review manner with respect to their potential for supporting self‐regulated learning. In addition, data were obtained on a sample of TELEPEERS students working in these environments and comparative analyses were made across the European project partners.
Self‐Regulated Learning in a TELE at the Université de Technologie de Compiègne: an analysis from multiple perspectives
Authors: TRIGANO PHILIPPE
Published: September 2006

Self‐regulation has become a very important topic in the field of learning and instruction. At the same time, the introduction of new technologies in the field of Information and Communication Technologies (ICT) has made it possible to create rich Technology‐Enhanced Learning Environments (TELEs) with multiple affordances for supporting self‐regulated learning (SRL). This study was conducted within the framework of the TELEPEERS project where we wanted to identify TELEs that seemed to have a potential for supporting SRL. For the last ten years, our University has been deeply involved in research, innovation, and exploration of digital technologies for training (initial and continuous). Local, regional, national, European and international projects were conceived and developed, so that a very significant knowledge base exists today. Our study focuses on a course called ‘Introduction to Algorithms and Programming’ (NF01) which our University is offering and on the perception of different stakeholders (experts and students) of its affordances for supporting SRL.
SRL in Online Cooperative Learning: implications for pre‐service teacher training
Authors: DETTORI GIULIANA , GIANNETTI TANIA , PERSICO DONATELLA
Published: September 2006

The aim of this article is to investigate the relation between self‐regulated learning and online collaborative environments. Based on the study of a blended course for trainee teachers, it explores the potential of the online collaborative component of the course for the practice and development of Self‐Regulated Learning. The study made use of two questionnaires, developed within the TELEPEERS European project, to evaluate the potential support to SRL provided by technology‐enhanced learning environments. The results provide information about the aspects of SRL practised in our environment. These include social competences, such as communication and negotiation with tutors and peers, emotional and motivational aspects, such as keeping up motivation and maintaining and restoring a positive working attitude, and cognitive and metacognitive skills such as management of time and learning environment and reflection on learning outcomes. The study also suggests the need to consider not only the SRL of the individuals involved in the learning process, but also the SRL of the whole community, that is, the result of the mediation between individual autonomy and group collaboration.
Motivating School Teachers to Learn: can ICT add value?
Authors: CARNEIRO ROBERTO
Published: September 2006

The article summarises the main findings from a study on school teachers who enrolled on a technology‐rich graduate training programme. It features the impact of a distance education environment, strongly supported with Information and Communication Technologies (ICT), on the motivation profiles of student teachers and the acquisition of self‐regulation skills to conduct one’s own learning path. The conceptual framework and the results may be useful in mapping future research on graduate students’ motivation and learning strategies in the context of Technology‐Enhanced Learning Environments.
Self‐Regulated Learning and New Literacies: an experience at the University of Barcelona
Authors: WILLEM CILIA , AIELLO MARTÍN , BARTOLOMÉ ANTONIO
Published: September 2006

This article summarises the findings from an evaluation of a Media Literacy course at the University of Barcelona. It focuses on some aspects of Self‐Regulation and on the learning environment used by students. The students’ learning processes were embedded in an eLearning project, in which students analysed the representation of immigrants and ethnic minorities in the media.

Key findings are the usefulness of this particular Technology‐Enhanced Learning Environment (TELE), and its specific settings regarding Self‐Regulated Learning (SRL). Students self‐regulated their learning processes, in that they were working in a blended learning environment. However, their acquired media literacy skills seem to be fostered by the TELE rather than by the self‐regulation mechanisms.

Throughout the article, special attention is paid to the conceptual framework of digital and media literacy, and the specific competences related to them.
Self‐Regulated Learning and Open Writing
Authors: BAGGETUN RUNE , WASSON BARBARA
Published: September 2006

In our study, we describe a situation where students take ownership of their learning and, on their own initiative, use digital tools actively in their learning activities. In our research we were interested in students who used weblogs and in the dynamic relationship between students and the weblogs they create. In particular, we were interested in how self‐regulated learning was facilitated both by the technology that enables the creation of the weblogs, and in the content, or open writings, that are posted on the weblog.

The article begins with an introduction to weblogs. We then present the results of the analysis of the affordances of weblogs to facilitate self‐regulated learning. We used a category system developed by experts from the universities of Aalborg, Amsterdam and Bergen to structure our study of the weblogs which we received from Bergen students. One of our most interesting findings was that students’ reflection on both their own learning and access to other’s reflections on their learning was a powerful tool to collectively develop a conceptual understanding of a topic. We could call this collective self‐regulation.
The Introduction of Portfolios in Higher Education: a comparative study in the UK and the Netherlands
Authors: BEISHUIZEN JOS , VAN BOXEL PATRIS , BANYARD PHILIP , TWINER ALISON , VERMEIJ HELLE , UNDERWOOD JEAN
Published: September 2006

This article describes a comparative study of the introduction of student portfolios in two departments of the Vrije Universiteit Amsterdam in the Netherlands and Nottingham Trent University in the UK. Portfolios are designed to facilitate effective management of lifelong learning, to provide a record of achievements and to encourage self‐reflection by students.

The justifications for the portfolio initiative are different in the two countries. At the Vrije Universiteit, the initiative arose within the University but is being implemented by individual faculties. There is no standard model of implementation. At Nottingham Trent University, portfolios are being introduced as a response to a government directive, as part of a lifelong learning portfolio that each individual will carry forward into their working life. The University’s response to this imperative is top‐down and a University‐wide model is being sought. The department model is one of several models that are being evaluated for this purpose.

This research project investigates whether these alternative starting points lead to differential responses from student users or not. Data are drawn from quantitative (questionnaires) and qualitative (interviews with managers, consultants and teachers) sources. Similarities and differences in students’ responses to the portfolio exercise are identified and discussed in terms of factors such as the way the portfolios are introduced, the incentives offered to complete them, the role of the lecturer and peers in the monitoring of study progress, the quality of self‐regulative skills, and students’ learning expectations.
Understanding the Adoption of TELEs — The Importance of Management
Authors: CHRISTIANSEN ELLEN , NYVANG TOM
Published: September 2006

For a TELE to become adopted by the vast majority of individual learners as a tool for learning, adoption at the institutional level must be considered, because the vast majority of a population of technology users depends on external stimuli to adopt the technology. This article analyses a case where a social simulation game, a prize‐winning e‐learning product, which is based on theory of, and dedicated to, self‐regulated learning – in other words, a product predestined to succeed in supporting self‐regulated learning – was implemented for training in academic information literacy. Applying a systemic, Bateson‐inspired, understanding of learning and based on data from observation, qualitative interviews, and surveys, a number of barriers to adoption at the organisational level are identified, all requiring management initiatives if the application is to fully unfold its potential.
Flatbrain spreadsheets: Mindtool outside the box?
Authors: Lamontagne Claude , Desjardins Francois , Bénard Michèle
Published: September 2006

Managing the pedagogical aspects of the ‘computational turn’ that is occurring within the Humanities in general and the disciplines associated with cognitive science and neuroscience in particular, first implies facing the challenge of introducing students to computation. This paper presents what has proven to be an efficient approach to bringing undergraduate Humanities students to reach insight into the nature of computation and its bearing on reflecting upon the mind in general, and the brain in particular. It is set within the context of a course on the topic of sensory perception featuring a laboratory component aimed at guiding students to develop neuronal networking skills. In this course, students are asked to design, test and discuss the neurophysiological, psychological and philosophical implications of the neuronal blueprints of a virtual creature’s brain which they are challenged to ‘wire’ themselves in such a way as to allow it to ‘see the world’ within which they choose to place it. The insight on which we are reporting here is simply that a basic competence in using a spreadsheet application is all that is required to allow implementing and testing of virtual brains made of basic formal neurones, bringing the miracle of computer simulation within the reach of even the most computer‐shy undergraduates. Once introduced to basic neuronal networks (two 90‐minute laboratory sessions), two laboratory sessions are sufficient to bring groups of up to some 50 undergraduates to manipulate the basic spreadsheet operations successfully and understand how virtual brains consisting of basic formal neurones can be implemented in terms of these basic spreadsheet operations. It is the ‘flattening’ to which the virtual (formal neuronal) brains are thus subjected, as they are turned into spreadsheets that led to coining the concept of a ‘flatbrain spreadsheet’. The students are then challenged to develop and implement their very own virtual creature’s flatbrain spreadsheets, and gently tutored into noticing the key problems out of which arise the great debates in cognitive science about such issues as consciousness, qualia, categorisation, induction, computational explanation and the like. Empirical evidence gathered over the course of the last 6 years strongly suggests that the construction of flatbrain spreadsheets by students does make a difference in the classroom.
Private Regulation of Food Safety by Supermarkets
Authors: HAVINGA TETTY
Published: September 2006

Food safety is a highly debated issue. Food industry organizations, retailers and national and transnational governments have been trying to find new ways to regulate food safety. Can private regulation of food safety meet the high expectations? A review of existing literature shows some conditions to be important for effectively protecting public interests by private regulation. In particular, retailers worldwide are actively engaged in setting food safety standards for their suppliers. A case study of food safety regulation by Dutch retailers shows that they can force food industry organizations and producers to accept food safety standards because of their economic (market) power.
The impact of structured activities among Palestinian children in a time of conflict
Authors: Loughry Maryanne , Ager Alastair , Flouri Eirini , Khamis Vivian , Afana Abdel Hamid , Qouta Samir
Published: September 2006

Background:  There is growing evidence of the impact on children's well‐being of exposure to political conflict in such settings as the Palestinian territories. This study examined the impact of child‐focused interventions involving structured activities, supported by provision of equipment and training of facilitators. The focus of interventions was participation in recreational, cultural and other non‐formal activities supporting the development of resilience. Impacts were hypothesised on children's social and emotional well‐being, relationships with parents and degree of future orientation.

Methods:  Two hundred and fifty children from the West Bank and 150 children from Gaza took part in the study. Of these 400 children, 300 comprised the intervention group. Fifty children from Gaza and 50 children from the West Bank comprised the comparison group. There were equal numbers of girls and boys in all groups, with similar proportions of children aged between 6 and 11 years, and between 12 and 17 years. Measures used were the Child Behavior Checklist (CBCL), the Parental Support Scale and the Hopefulness Scale: Youth Version. Assessment was made as children enrolled on the structured activity programmes (T1) and again twelve months later (T2).

Results:  There was no difference in the CBCL Total, Internalising or Externalising problem scores at baseline (Time 1) between the children who subsequently took the intervention and those who did not. Compared to children in the comparison group, children in the intervention group had lower CBCL total problem scores, externalising problem scores, and internalising problem scores at Time 2 compared to Time 1. Exposure to the intervention was not associated with changes in children's hopefulness, but those receiving the intervention in the West Bank did report improved parental support at Time 2.

Conclusions:  The intervention appeared successful in improving children's emotional and behavioural well‐being but not hopefulness. It was also linked with increased parental support in some areas (those located in the West Bank).
Species‐specific chemosignals evoke delayed excitation of the vomeronasal amygdala in freely‐moving female rats
Authors: Mucignat‐Caretta Carla , Colivicchi Maria A. , Fattori Manuela , Ballini Chiara , Bianchi Loria , Gabai Gianfranco , Cavaggioni Andrea , Della Corte Laura
Published: September 2006

Male rat chemosignals attract females and influence their reproductive status. Through the accessory olfactory bulb and its projection target, the posteromedial cortical nucleus of the amygdala (PMCo), species‐specific chemosignals detected by the vomeronasal organ (VNO) may reach the hypothalamus. To test this hypothesis in vivo, behavioural activation and neurotransmitter release in the PMCo were simultaneously monitored in freely moving female oestrus rats exposed to either rat or mouse urinary stimuli, or to odorants. Plasma levels of the luteinizing hormone were subsequently monitored. All stimuli induced an immediate behavioural activation, but only species‐specific chemosignals led to a delayed behavioural activation. This biphasic behavioural activation was accompanied by a VNO‐mediated release of the excitatory amino acids, aspartate and glutamate, in the PMCo. The late behavioural and neurochemical activation was followed by an increase in the levels of circulating luteinizing hormone. In conclusion, these data show that only species‐specific chemosignals induce a delayed behavioural activation and excitatory activation of the PMCo, which is dependent on an intact VNO.