bluuebunny/crossref_metadata_2025 huggingface dataset:
Cloning of swine desmoglein 1 and its direct proteolysis by Staphylococcus hyicus exfoliative toxins isolated from pigs with exudative epidermitis
Authors: NISHIFUJI KOJI , FUDABA YASUYUKI , YAMAGUCHI TAKAYUKI , IWASAKI TOSHIROH , SUGAI MOTOYUKI , AMAGAI MASAYUKI
Published: October 2005

Abstract  Exudative epidermitis (EE) is an acute, often fatal skin disease of piglets caused by Staphylococcus hyicus. Clinical and histopathological manifestations of EE are similar to those of staphylococcal scalded skin syndrome (SSSS), a human blistering skin disease, in which exfoliative toxins produced by Staphylococcus aureus digest the extracellular domains of desmoglein (Dsg) 1 and cause loss of epidermal cell–cell adhesion. The aims of this study were to isolate and characterize cDNA for full length of swine Dsg1, and to determine whether the extracellular domains of swine Dsg1 produced by baculovirus (sDsg1‐His) could be digested by four isoforms of exfoliative toxin produced by S. hyicus (ExhA, ExhB, ExhC and ExhD). Nucleotide sequencing revealed that swine Dsg1 cDNA consisted of an open reading frame of 3138 bp, encoding a precursor protein of 1045 amino acids. Deduced amino acid sequence of the swine Dsg1 precursor were highly homologous to corresponding bovine, canine, human and murine sequences. Immunoadsorption assay with a secreted form of sDsg1‐His revealed that sDsg1‐His specifically absorbs the immunoreactivity of 10 human pemphigus foliaceus sera against swine keratinocyte cell surfaces, suggesting its proper conformation. When sDsg1‐His was incubated in vitro with Exhs, all four isoforms of Exh directly digested sDsg1‐His into smaller peptides, whereas removal of calcium from sDsg1‐His completely inhibited its proteolysis by these four Exhs. Recognition and digestion of calcium‐stabilized structure on the extracellular domains of swine Dsg1 by Exhs indicated that EE shares similar molecular pathophysiological mechanisms of intra‐epidermal splitting with SSSS in humans.
Acute appendicitis occurring immediately post‐renal transplant
Authors: Hegde Shivaram , Moghal Nadeem E. , Coulthard Malcolm G.
Published: October 2005

Abstract:  A 10‐yr‐old boy who presented with vomiting and abdominal pain 12 days after an uneventful renal transplant had no identifiable transplant‐related cause for these symptoms. Four days later a perforated appendix was diagnosed. His case illustrates that common abdominal pathologies may present differently in immunosuppressed, transplanted patients, causing diagnostic delay.
Specific autologous cytotoxic T lymphocytes for chronic varicella in a liver transplanted child
Authors: Melzi Maria Luisa , Sonzogni Aurelio , Comoli Patrizia , Stroppa Paola , Riva Silvia , Altobelli Monica , Casati Annalia , Torre Giuliano , Alberti Daniele , Guizzetti Michela , Furione Milena , Spada Marco , Colledan Michele , Gridelli Bruno
Published: October 2005

Abstract:  Infections by herpesviruses may have severe complications in liver transplant patients. Although prophylactic varicella zoster virus vaccination is strongly recommended and widely applied, severe infection may still occur. We report the case of systemic chronic varicella, which developed in a liver allograft recipient, unresponsive to antiviral drug treatment, successfully treated by varicella zooster‐specific CTL. Graft failure ensued, likely, because of massive cytolysis of infected hepatocytes. The patient, who was re‐transplanted in the absence of signs of varicella zooster reactivation, is now well and disease free 3 yr after second liver transplant.
Microscopic Anatomy of the Ringed Seal (Phoca hispida) Lower Respiratory Tract
Authors: Smodlaka H. , Reed R. B. , Henry R. W.
Published: October 2005

The microscopic anatomy of the ringed seal lung exhibits unique features and many features similar to those described in other seal species. Unique features include: Trachealis muscle predominately oriented longitudinally; Large veins within the tracheal wall supported by elastic fibers; Goblet cells and pseudostratified epithelium lining the duct system of bronchial glands of the segmental bronchi; Lamina propria of the segmental bronchus heavily invested with elastic fibers clustered into dense longitudinal bundles; and Capillaries and venules covered with squamous epithelium protruding into bronchiolar lumina. Common features include: Cartilage support of the bronchial tree extending distally into respiratory bronchioles; Smooth muscle enhancements in the distal airways producing sphincter like formations; and Lungs extensively supported with interstitial tissue, which divide lungs into lobules.
Ultrastructural Characterization of Gills in Juveniles of the Argentinian Silverside, Odontesthes bonariensis (Valenciennes, 1835) (Teleostei: Atheriniformes)
Authors: Vigliano F. A. , Alemañ N. , Quiroga M. I. , Nieto J. M.
Published: October 2005

An ultrastructural study was performed on the gills of juvenile Argentinian silverside, Odontesthes bonariensis. The gills are composed of two sets of four holobranchs and, in turn, each holobranch consists of a gill arch and two rows of caudolaterally projecting branchial filaments. From the dorsal and ventral surfaces of each filament, branchial lamellae radiate out as foldings of the epithelial layer. Gill rakers are present on each of the gill arches, on the anteromedial side of the arch opposite to the filaments. Gill rakers, gill arches and branchial filaments are covered by a stratified epithelium, whereas branchial lamellae essentially consist of a thin epithelial envelope containing capillaries. In the stratified epithelium, mucous cells, rodlet cells, granular cells, pavement epithelial cells and mitochondria‐rich cells are identified. The thin epithelium that lines the lamellae comprises two cell types, outer and inner epithelial cells, and the capillary walls on the inside of the epithelial envelope are defined by pillar cells. The ultrastructure of all these cell types is described and our findings are discussed in light of the existing data on fish gill morphology. In the gills of juvenile Argentinian silverside is of particular interest the characteristics showed by mitochondria‐rich cells, such as their arrangement in clusters of 2–3 cells and their small and depressed surface in contact with the aquatic milieu, features which strongly resemble those of euryhaline species.
Investigation of Direct Toxic and Teratogenic Effects of Anticoagulants on Rat Embryonic Development Using In Vitro Culture Method and Genotoxicity Assay
Authors: Uysal I. I. , Karabulut A. K. , Ozdemir K. , Aksoy M. , Altunkeser B. B. , Acar H.
Published: October 2005

Heparin and low molecular weight heparins (LMWHs) are used to reduce the incidence of venous thromboembolism in pregnancy. Although, these agents have been shown to be safe when used during pregnancy, the studies about direct toxic and teratogenic effects of these drugs on embryonic development are limited. In this study, the effects of heparin and LMWHs on rat embryonic development were investigated by using in vitro embryo culture and micronucleus (MN) assay methods. Rat embryos were cultured in vitro in the presence of different concentrations of heparin (5–40 IU/ml), dalteparin (2.5–20 IU/ml), enoxaparin (25–100 μg/ml) and nadroparin (1–4 IU/ml). Effects of anticoagulants on embryonic developmental parameters were compared and embryos were evaluated for the presence of any malformations. After culturing the embryos, classic MN assay was performed. Anticoagulants significantly decreased all growth and developmental parameters dose‐dependently. Dalteparin and enoxaparin were found to cause more developmental toxicity than heparin and nadroparin. Along with haematoma in general, heparin and nadroparin caused maxillary deformity, situs inversus and oedema most frequently, while neural tube defects were observed with dalteparin and enoxaparin. All agents also significantly induced MN formation in rat embryonic blood cells. These results indicate the possible genotoxic effects of anticoagulant agents on the developing rat embryo when applied directly.
Immunohistochemical Localization of Glutamate in the Gerbil Main Olfactory Bulb Using an Antiserum Directed against Glutamate
Authors: Yoo K.‐Y. , Hwang I. K. , Lee J. C. , Cho J. H. , Kim S.M. , Jung J.‐Y. , Kang T.‐C. , Won M. H.
Published: October 2005

Information on the localization and the roles of glutamate in the nervous system is becoming valuable because the axon terminals of the olfactory sensory neurons and the synapses of the mitral and tufted output cells appear to be glutamatergic. In this study, we have analysed the distribution of glutamate immunoreactivity in the main olfactory bulb (MOB) of the Mongolian gerbil using an antiserum directed against glutamate. Glutamate immunoreactivity in the MOB was present in the olfactory nerve layer (Onl), glomerular layer (GL), external plexiform layer (EPL) and mitral cell layer (ML), but not in the granule cell layer (GCL). Glutamate immunoreactivity detected in the Onl was thought to be terminal ramifications of glomeruli. Some neurons in the periglomerular region showed glutamate immunoreactivity. In the EPL, glutamate immunoreactivity was found in some neuronal somata (tufted cells) and processes. In addition, mitral cells in the ML were labelled by the glutamate antibody. The pattern of glutamate immunoreactivity in the mitral cells was similar to that in the tufted cells. In brief, glutamate in the gerbil MOB is the neurotransmitter used by primary afferents and output neurons.
Ultrastructural Analysis of the Integument of a Desert‐Adapted Mammal, the One‐Humped Camel (Camelus dromedarius)
Authors: Pfeiffer C. J. , Osman A. H. K. , Pfeiffer D. C.
Published: October 2005

In this study, we conducted a light microscopic and ultrastructural analysis of the integument of the one‐humped camel (Camelus dromedarius). In general, the epidermal strata of the camel integument appeared typical of those found in non‐desert mammals. Two cell populations were noted in the stratum basale: one with a flat, non‐serrated base and the other with a highly serrated base. Typical fine structure was observed in keratinocytes of the stratum spinosum and stratum granulosum. The stratum corneum was six to 10 cells thick. Within the different strata, overall cell morphologies and the general distribution and relative abundance of cellular organelles appeared typical. Dermal features included the presence of myoepithelial cells surrounding apocrine tubular glands. Inter‐ or intracellular canaliculi within the secretory cells of the apocrine glands, reported to be present in certain other non‐desert mammals, were not evident in the camel. Together, these data indicate that while the camel is clearly adapted for a desert lifestyle, these adaptations do not include significant specializations at the cellular or subcellular level in the integument.
The Regional Distribution and Relative Frequency of Gastrointestinal Endocrine cells in the Nude Mice, Balb/c‐nu/nu: An Immunohistochemical Study
Authors: Ku S. K. , Lee H. S. , Lee J. H.
Published: October 2005

The distributions and frequencies of some endocrine cells in the eight portions of the gastrointestinal (GI) tract – fundus, pylorus, duodenum, jejunum, ileum, cecum, colon and rectum of the nude mouse, Balb/c‐nu/nu were studied with immunohistochemical method using six types of anti‐sera against serotonin, gastrin, cholecystokinin (CCK)‐8, somatostatin, glucagon and human pancreatic polypeptide (hPP). All of six types of immunoreactive (IR) cells were identified. Most of IR cells in the intestinal portion were generally spherical or spindle in shape (open type cell) while cells showing round in shape (close type cell) were found in the intestinal gland and stomach regions occasionally. Their relative frequencies were varied according to each portion of GI tract. Serotonin‐IR cells were detected throughout the whole GI tract and they showed the highest frequency in the pylorus. Gastrin‐IR cells were restricted to the pylorus and duodenum with numerous and a few frequencies, respectively. CCK‐8‐IR cells were also restricted to the pylorus, duodenum and jejunum with numerous, a few and rare frequencies, respectively. Somatostatin‐IR cells were demonstrated throughout the whole GI tract except for the colon and rectum, and they showed the highest frequency in the fundus. In addition, glucagon‐ and hPP‐IR cells were restricted to the fundus and rectum, respectively with a few frequencies. In conclusion, the general distribution patterns and relative frequency of GI endocrine cells of the nude mouse, Balb/c‐nu/nu was similar to that of other strains of mice. However, some strain and/or species‐dependent unique distributions and frequencies of endocrine cells were also observed especially for somatostatin‐ and hPP‐IR cells.
Serum IgG and IgA antibodies to Chlamydia pneumoniae and severity of emphysema
Authors: KURASHIMA Kazuyoshi , KANAUCHI Tetsu , TAKAYANAGI Noboru , SATO Nagato , TOKUNAGA Daido , UBUKATA Mikio , YANAGISAWA Tsutomu , SUGITA Yutaka , KANAZAWA Minoru
Published: October 2005

Objective:  Chronic Chlamydia pneumoniae infection has been identified serologically in patients with COPD. The aim of this study was to examine whether the severity of emphysema is related to elevated antibody titres against C. pneumoniae.

Methodology:  We measured antibody titres against C. pneumoniae using ELISA, and assessed the severity of emphysema by the percentage of low attenuation area (%LAA) using high resolution (HR) CT in patients with COPD and in non‐smoking control subjects.

Results:  The mean %LAA was 2.2% in non‐smoking controls (n = 28) and 13.3% in COPD patients (n = 94). COPD patients with a high IgG antibody index to C. pneumoniae (≥2.0, n = 42) had a significantly higher %LAA (16.8%) than those with a low IgG index (<2.0, n = 52) (10.6%, P = 0.01). In addition, COPD patients with a high IgA antibody index (≥2.0, n = 46) had a significantly higher %LAA (15.9%) than those with a low IgA index (<2.0, n = 48) (10.9%, P = 0.048). COPD patients with a high IgA antibody index also had a significantly lower %DLco than that associated with a low IgA index (68.1% and 80.3%, respectively, P = 0.007). There were no significant differences in age, smoking index or FEV1/FVC between these groups.

Conclusion:  These results suggest that high antibody titres against C. pneumoniae are linked with the severity of emphysema on high resolution CT and decreased diffusing capacity to carbon monoxide.
Protective effects of N‐acetylcysteine on the peroxidative changes of rat lungs exposed to inhalation of thinners
Authors: DILLIOGLUGIL Meltem Ozlen , ILGAZLI Ahmet , MARAL Hale , SENGUL Canan , OZDEMIR Gulsen , ERCIN Cengiz
Published: October 2005

Objective:  Long‐term inhalation of thinners may cause damage, both to the lungs and to other organ systems. It causes cellular damage via formation of reactive oxygen species. The lung is protected from oxidative stress by the glutathione (GSH) antioxidant system which can be augmented by the thiol drug, N‐acetylcysteine (NAC). This study investigated the protective effect of NAC on peroxidative changes in rat lungs exposed to inhalation of thinners for 8 weeks.

Methodology:  Seventy‐two male Wistar albino rats were used and divided into two groups: one group inhaled only thinners (TI), while the other inhaled TI plus NAC. Rats in the TI and TI + NAC groups were divided into four subgroups (each consisting of eight rats) according to the duration of exposure to TI: 2, 4, 6 and 8 weeks. A control group (n = 7) of rats inhaled neither TI nor NAC. Malondialdehyde (MDA) and GSH levels, and superoxide dismutase (SOD) activities were determined in the lung tissues. Histopathological findings were evaluated as acute and chronic changes in the alveoli and interstitium in the TI and TI + NAC groups and compared with those in the control group.

Results:  While tissue MDA levels in the groups inhaling TI for 4, 6 and 8 weeks were significantly higher than those in the control groups (P < 0.01, P < 0.01, P < 0.0001, respectively), GSH levels were significantly lower (P < 0.05, P < 0.01, P < 0.01, respectively). Tissue SOD activities in the groups inhaling TI for 6 and 8 weeks were significantly lower than those in the control group (P < 0.05, P < 0.01, respectively). In the TI group, MDA levels were significantly increased (P < 0.01) with increasing duration of inhalation (from the second week through to the eighth week), while GSH levels and SOD activities were significantly decreased (P < 0.01, P < 0.01). Tissue MDA levels were significantly lower in the TI + NAC groups across all inhalation periods, when compared with the TI groups (P < 0.01, P < 0.0001, P < 0.0001, P < 0.0001, respectively). Tissue GSH levels in the TI + NAC groups were significantly higher than those of the TI groups (respective values: P < 0.05, P < 0.01, P < 0.01, P < 0.0001). Tissue SOD activities in the TI + NAC groups were significantly higher than those of the TI groups (respective values: P < 0.05, P < 0.0001, P < 0.05, P < 0.0001). Pathological examinations with light microscopy did not show any beneficial effect of NAC application in terms of deferring or alleviating the negative effects of TI

Conclusions:  Thinners are agents that cause imbalance between oxidants and antioxidants produced by aerobic cellular systems. This imbalance between oxidant and antioxidant systems is decreased by the effect of NAC. However, ultrastructural studies may be needed to substantiate this evidence morphologically, as light microscopy was inconclusive.
Thymic carcinoma originating from the mid‐posterior mediastinum
Authors: KADOWAKI Toru , HAMADA Hironobu , YOKOYAMA Akihito , KATAYAMA Hitoshi , ARAMOTO Takayoshi , UEDA Norifumi , TOMIOKA Hiromi , HIGAKI Jitsuo
Published: October 2005

Abstract:  An unusual thymic carcinoma in a 74‐year‐old woman is described. Initial chest CT revealed a mass at the mid‐posterior mediastinum. Transbronchial fine needle biopsy of the mass failed to provide a definite diagnosis. The mass was treated as a malignant mediastinal tumour, and chemoradiotherapy was performed as initial treatment. The patient died 5 years after receiving primary treatment. The results of postmortem microscopic examination, including immunohistochemical study with CD5 antibody, were consistent with thymic carcinoma. This case is interesting in that the mid‐posterior mediastinum is the site where thymic carcinoma is least likely to originate.
Remodelling of spinal nociceptive mechanisms in an animal model of monoarthritis
Authors: Naeini Reza Sharif , Cahill Catherine M. , Ribeiro‐da‐Silva Alfredo , Ménard Henri A. , Henry James L.
Published: October 2005

Intra‐articularly injected complete Freund's adjuvant creates in rats a chronic monoarthritis suitable for studying neuronal plasticity and chronic pain. Using such a model, we report electrophysiological and morphological evidence of alterations in somatosensory synaptic function. In arthritic rats, the baseline activity of dorsal spinal cord wide dynamic range or nociceptive‐specific neurons was greater than in control animals. Moreover, neuronal responses elicited by an innocuous stimulation with von Frey filaments applied to the arthritic joint were greater in amplitude and produced the afterdischarge that normally characterizes a nociceptive response. In contrast to the response in control animals, passive movement of the arthritic joint produced an increase in the amplitude of the response of these neurons to iontophoretic application of glutamate receptor agonists over a time frame of 10–30 min. This potentiation was blocked by pretreatment with a neurokinin‐1 (NK‐1) receptor antagonist, suggesting the involvement of substance P. Ultrastructural analysis of the dorsal horn revealed that movement of the arthritic joint also induced NK‐1 receptor internalization, indicative of nociception. Morphological examination revealed significantly increased expression of substance P and its receptor within the superficial dorsal horn of monoarthritic animals. These unique functional and chemical changes reflect alterations in both presynaptic and postsynaptic mechanisms in nociceptive transmission at the spinal level. Thus, although treatment of arthritis should obviously target its peripheral aetiology, targeting its central components is a logical therapeutic complementary objective.
Prognostic significance of glycaemic control in patients with HBV and HCV‐related cirrhosis and diabetes mellitus
Authors: Kwon S. Y. , Kim S. S. , Kwon O. S. , Kwon K. A. , Chung M. G. , Park D. K. , Kim Y. S. , Koo Y. S. , Kim Y. K. , Choi D. J. , Kim J. H.
Published: October 2005

Aims  Diabetes mellitus (DM) is frequently observed in patients with cirrhosis, particularly that due to hepatitis C virus (HCV) infection. However, no studies have focused on the clinical significance of glycaemic control in cirrhotic patients because of their short life expectancy and poor hepatic function. The aim of this study was to evaluate the prognostic impact of glycaemic control in patients with hepatitis B virus (HBV) and HCV‐related cirrhosis and DM.

Methods  A total of 434 patients with HCV‐related (HCV group, n = 88) or HBV‐related (HBV group, n = 346) cirrhosis were studied retrospectively. We determined the prevalence of DM and treatment methods for hyperglycaemia and status of glycaemic control, and the patients’ outcome.

Results  The prevalence of DM was 43.2% (38/88) in the HCV group and 19.7% (68/346) in the HBV group. Patients in the HCV group were older with a female preponderance. DM was detected before the diagnosis of cirrhosis or simultaneously in 92% and 79% in the HCV and HBV groups, respectively. Most patients were treated with insulin or oral hypoglycaemic agents. However, blood glucose levels were maintained within the normal range in 34.2% of the HCV group and in 23.5% of the HBV group. Forty‐six patients died during the observation period in both groups. Hepatic failure was the most common cause of death, and sepsis and variceal bleeding were more frequent in the HCV group than in the HBV group. Multivariate analysis showed that Child–Pugh class was the most important factor for survival in both groups. In the HCV group, the status of glycaemic control was a significant independent factor of survival (P = 0.018). In the HBV group, age and the development of spontaneous bacterial peritonitis were significant.

Conclusion  DM is more frequent in patients with HCV‐related cirrhosis than in patients with HBV. Strict control of blood glucose levels could improve survival in HCV patients. A precise assessment of the risks and benefits of glycaemic control is required to reduce the mortality and morbidity of patients with cirrhosis and DM.
Urinary albumin levels in the normal range determine arterial wall thickness in adults with Type 2 diabetes: a FIELD substudy
Authors: Keech A. C. , Grieve S. M. , Patel A. , Griffiths K. , Skilton M. , Watts G. F. , Marwick T. H. , Groshens M. , Celermajer D. S. ,   for the FIELD Vascular Study Investigators
Published: October 2005

Aim  Cardiovascular disease (CVD) rates are substantially higher among patients with Type 2 diabetes than in the general population. The objective of this study was to identify the determinants of carotid intima media thickness (IMT) in patients with Type 2 diabetes.

Methods  We measured the thickness of the intima media layer of the carotid artery, a strong predictor of the risk of future vascular events, in 397 Type 2 diabetic patients drawn from the Fenofibrate Intervention and Event Lowering in Diabetes study, prior to treatment allocation.

Results  The mean IMT was 0.78 mm [interquartile range (IQR) 0.23 mm], and the maximum IMT was 1.17 mm (IQR 0.36 mm). By multivariate analysis, age, sex, duration of diabetes, triglycerides, and total cholesterol were independently correlated with IMT, as was urine albumin–creatinine ratio (ACR) (P < 0.001). The effect of ACR on IMT was further examined by tertile. Clinically significant differences in IMT were associated with ACR > 0.65 mg/mmol, approximately one‐fifth the standard clinical threshold for microalbuminuria (P < 0.01). Long‐term diabetes, independent of other parameters, was associated with a 50% increase in age‐related thickening.

Conclusions  IMT in people with Type 2 diabetes is independently and continuously related to urine albumin levels and to the duration of diabetes. These results support previous data linking urine albumin measurements within the normal range with increased ischaemic cardiac mortality in the setting of Type 2 diabetes, and strongly suggest that urine albumin levels within this range should trigger a formal evaluation for CVD.
Evaluating the therapeutic approach in pregnancies complicated by borderline glucose intolerance: a randomized clinical trial
Authors: Bonomo M. , Corica D. , Mion E. , Gonçalves D. , Motta G. , Merati R. , Ragusa A. , Morabito A.
Published: October 2005

Aims  Most studies relating minor gestational metabolic alterations to macrosomia refer to glucose intolerance classified on the basis of the National Diabetes Data Group or previous World Health Organization diagnostic thresholds. Our aim was to evaluate the consequences of very mild forms of gestational glucose intolerance, defined by an elevated 50‐g glucose challenge test followed by a normal oral glucose tolerance test, using the more restrictive Carpenter and Coustan's criteria (Borderline Gestational Glucose Intolerance, BGGI).

Methods  Three hundred BGGI women were randomly assigned to: Group A (standard management), Group B (dietary treatment and regular monitoring). A control group (C) was also considered. Newborns were classified as macrosomic, large (LGA), or small for gestational age (SGA).

Results  The three groups were similar in age, body mass index and parity. Therapy in Group B significantly improved fasting (from 4.68 ± 0.45 to 4.28 ± 0.45 mmol/l) and 2‐h postprandial glycaemia (from 6.01 ± 0.57 to 5.13 ± 0.68 mmol/l). Fasting glycaemia at delivery was significantly lower in B (4.20 ± 0.38 mmol/l) than in A (4.84 ± 0.45 mmol/l), and was also lower than in C (4.31 ± 0.39 mmol/l). Significantly fewer LGA babies were born to Group B (6.0%) than Group A (14.0%) and Group C (9.1%). No difference was found in the SGA rate. The neonatal Ponderal Index was higher (P = 0.030) in group A (2.73 ± 0.35) than in C (2.64 ± 0.30) and B (2.64 ± 0.24).

Conclusions  Even very mild alterations in glucose tolerance can result in excessive or disharmonious fetal growth, which may be prevented by simple, non‐invasive therapeutic measures.
Short‐term effects of cognitive behavioural group training (CBGT) in adult Type 1 diabetes patients in prolonged poor glycaemic control. A randomized controlled trial
Authors: van Der Ven N. C. W. , Hogenelst M. H. E. , Tromp‐Wever A. M. E. , Twisk J. W. R. , van Der Ploeg H. M. , Heine R. J. , Snoek F. J.
Published: October 2005

Aims  To assess the effects of cognitive behavioural group training (CBGT) on glycaemic control, diabetes self‐efficacy and well‐being in Type 1 diabetes patients in persistent poor glycaemic control.

Methods  In a randomized controlled trial, a total of 107 patients with Type 1 diabetes in poor glycaemic control (HbA1c≥ 8%) were assigned to a 6‐week CBGT or blood glucose awareness training (BGAT) as control condition. The intervention was preceded by a 3‐month run‐in period. Glycaemic control (HbA1c), diabetes‐specific self‐efficacy (CIDS), diabetes‐related distress (PAID) and depressive symptoms (CES‐D), were assessed at baseline (T1), directly before (T2) and 3 months after (T3) the intervention.

Results  No significant changes in HbA1c were found after CBGT, whilst diabetes self‐efficacy increased (mean CIDS score 71.6 ± 14.0 to 74.3 ± 12.2) and diabetes‐related distress (mean PAID score 47.0 ± 21.6 to 42.6 ± 20.8) and depressive symptoms decreased (mean CES‐D score 16.9 ± 12.8 to 13.5 ± 12.6). Changes in psychological outcomes were similar for both treatment groups. Diabetes self‐care behaviours improved equally. Drop‐out rate, which was higher among CBGT participants, was relatively low overall (total n = 15, 17.05%), and both interventions were well‐appreciated by the participants.

Conclusions  CBGT was successful in improving self‐efficacy, diabetes‐related distress and mood at 3 months’ follow‐up, but not in improving glycaemic control.
Factors associated with glycaemic outcome of childhood diabetes care in Denmark
Authors: Nordly S. , Mortensen H. B. , Andreasen A. H. , Hermann N. , Jørgensen T. ,   on behalf of the Danish Study Group on Childhood Diabetes
Published: October 2005

Aims  To study how structure and process of care is associated with outcome assessed by HbA1c.

Methods  Data for this cross‐sectional study originated from the nationwide Danish Registry for Childhood Diabetes and two questionnaires. One questionnaire was sent to all children under 16 years of age with Type 1 diabetes in the year 2000 (N = 1087, response rate 80%). Another questionnaire was sent to the 19 centres in Denmark treating these children (response rate 100%). Simultaneously the children were asked to take a blood sample for central HbA1c analysis. Linear mixed models were used for analysis of associations between structure and process indicators and HbA1c. Age, diabetes duration, sex, ethnicity, family structure and parents’ occupational status were included as patient factors possibly affecting HbA1c.

Results  More visits to the outpatient clinic and higher insulin dosage were significantly associated with higher HbA1c (P = 0.002 and P = 0.0001, respectively). Increased frequency of blood glucose monitoring (BGM/week) and completed nephropathy screening were significantly associated with lower HbA1c value (estimates −0.008 and −0.49, P = 0.02, respectively). The structure indicators were not associated with HbA1c, but telephone hot‐line was positively associated with the process indicator BGM (estimate 4.02, P = 0.04). Children without Danish parents performed BGM significantly less frequently (−7.11, P = 0.0005) and had higher HbA1c (0.41, P = 0.06).

Conclusions  Most process indicators were significantly associated with HbA1c, indicating relevant action of staff on glucose regulation. The structure indicators were not associated with outcome, necessitating more detailed studies on the influence of staffing resources, treatment strategies and targets in childhood diabetes management.
Increased risk of diabetes among relatives of female insulin‐treated patients diagnosed at 15–34 years of age
Authors: Åkesson K. , Nyström L. , Färnkvist L. , Östman J. , Lernmark Å. , Kockum I. ,   the DISS study group
Published: October 2005

Aims  This study aimed to determine the risk of developing diabetes among relatives of patients diagnosed between 15 and 34 years of age who were treated with insulin. Our second aim was to determine whether there was a difference in risk of diabetes between relatives of male and female patients.

Methods  A questionnaire was sent to patients in the Diabetes Incidence Study in Sweden registry diagnosed between 1983 and 1993 to determine the presence of first‐degree relatives with diabetes.

Results  In 3087 index patients treated with insulin, 17.8% (95% confidence interval 16.5, 19.2) had a first‐degree relative (excluding offspring) treated with insulin, the frequency being higher in female (19.8%) than in male (16.5%, P = 0.018) patients. A total of 10.7% had a parent treated with insulin. The prevalence of insulin‐treated diabetes was higher among parents of female (12.5%) than of male (9.5%), insulin‐treated index patients (P = 0.0068). A similar difference was observed using life table analysis (P = 0.0025), which also showed that the risk by 63 years of age was 7.6% for parents of female and 4.9% for parents of male insulin‐treated index patients. In insulin‐treated index patients, 8.4% had a sibling with insulin‐treated diabetes.

Conclusions  We conclude that the risk for relatives of women with insulin‐treated diabetes was higher than for relatives of insulin‐treated male patients. We suggest that greater genetic susceptibility is required for females compared with males in the 15–34 age group in order to develop diabetes and hence females might carry more diabetes genes since more of their relatives also develop diabetes.
Diabetes mellitus: clinical presentation and outcome in men and women with acute coronary syndromes. Data from the Euro Heart Survey ACS
Authors: Dotevall A. , Hasdai D. , Wallentin L. , Battler A. , Rosengren A.
Published: October 2005

Aims  To study clinical presentation, in‐hospital course and short‐term prognosis in men and women with diabetes mellitus and acute coronary syndromes (ACS).

Methods  Men (n = 6488, 21.2% with diabetes) and 2809 women (28.7% with diabetes) ≤ 80 years old, with a discharge diagnosis of ACS were prospectively enrolled in the Euro Heart Survey of ACS.

Results  Women with diabetes were more likely to present with ST elevation than non‐diabetic women, a difference that became more marked after adjustment for differences in smoking, hypertension, obesity, medication and prior disease [adjusted odds ratio (OR) 1.46 (1.20, 1.78)], whereas there was little difference between diabetic and non‐diabetic men [adjusted OR 0.99 (0.86, 1.14)]. In addition, women with diabetes were more likely to develop Q‐wave myocardial infarction (MI) than non‐diabetic women [adjusted OR 1.61 (1.30, 1.99)], while there was no difference between men with and without diabetes [adjusted OR 0.99 (0.85, 1.15)]. There were significant interactions between sex, diabetes and presenting with ST‐elevation ACS (P < 0.001), and Q‐wave MI (P < 0.001), respectively. Of the women with diabetes, 7.4% died in hospital, compared with 3.6% of non‐diabetic women [adjusted OR 2.13 (1.39, 3.26)], whereas corresponding mortality rates in men with and without diabetes were 4.1% and 3.3%, respectively [OR 1.13 (0.76, 1.67)] (P for diabetes–sex interaction 0.021).

Conclusion  In women with ACS, diabetes is associated with higher risk of presenting with ST‐elevation ACS, developing Q‐wave MI, and of in‐hospital mortality, whereas in men with ACS diabetes is not significantly associated with increased risk of either. These findings suggest a differential effect of diabetes on the pathophysiology of ACS based on the patient's sex.
Contributing to the ICNP®: validating the term ‘informal settlement’
Authors: Geyer N. , Mmuwe‐Hlahane S. , Shongwe‐Magongo R. G. , Uys E.
Published: October 2005

Aim:  The specific aims of this study were to propose a definition of the term informal settlement, validate the term informal settlement, and submit a term and definition for international utilization to the International Council of Nurses (ICN) for consideration for inclusion in the International Classification of Nursing Practice (ICNP®).

Background:  South Africa was one of four African countries (Botswana, South Africa, Swaziland and Zimbabwe) funded by the WK Kellogg Foundation to participate in the ICNP® project. South Africa had two research groups. One of the research groups identified the term informal settlement to define.

Methods:  This was a qualitative study where a philosophical perspective was used to explore, explain and describe nursing practice. The combined method proposed by the ICN was utilized to define and validate the term informal settlement.

Findings:  Validation and literature review provided sufficient support for the defined characteristics and the term was finally defined and submitted to ICN on 12 April 2001 as informal settlement is a type of residential development with the specific characteristics – temporary residential structures, erected with limited or no formal infrastructure, densely populated, no secure tenure for occupants, no property demarcations, often associated with overcrowding/limited or no privacy, and low standard of living, being situated in high risk areas with an increased risk for disease and disasters.

Conclusion:  The ICNP® Evaluation Committee recommended inclusion in the ICNP® with minor changes in February 2003.
Nursing shortages and international nurse migration
Authors: Ross S. J. , Polsky D. , Sochalski J.
Published: October 2005

Background: The United Kingdom and the United States are among several developed countries currently experiencing nursing shortages. While the USA has not yet implemented policies to encourage nurse immigration, nursing shortages will likely result in the growth of foreign nurse immigration to the USA. Understanding the factors that drive the migration of nurses is critical as the USA exerts more pull on the foreign nurse workforce.

Aim: To predict the international migration of nurses to the UK using widely available data on country characteristics.

Method: The Nursing and Midwifery Council serves as the source of data on foreign nurse registrations in the UK between 1998 and 2002. We develop and test a regression model that predicts the number of foreign nurse registrants in the UK based on source country characteristics. We collect country‐level data from sources such as the World Bank and the World Health Organization.

Results: The shortage of nurses in the UK has been accompanied by massive and disproportionate growth in the number of foreign nurses from poor countries. Low‐income, English‐speaking countries that engage in high levels of bilateral trade experience greater losses of nurses to the UK.

Conclusion: Poor countries seeking economic growth through international trade expose themselves to the emigration of skilled labour. This tendency is currently exacerbated by nursing shortages in developed countries. Countries at risk for nurse emigration should adjust health sector planning to account for expected losses in personnel. Moreover, policy makers in host countries should address the impact of recruitment on source country health service delivery.
The WTO Doha Agenda—Progress and Issues for Asia Pacific Developing Economies
Authors: Bsosworth Malcolm , Holmes Leanne
Published: October 2005

Progress in the Doha Round of WTO negotiations has been slow. Frameworks for establishing modalities for agriculture, non‐agricultural market access and trade facilitation were agreed upon in July 2004 but key details are still to be negotiated and many commitments remain vague. For developing economies in the Asia Pacific region, the July package contains many potentially positive elements, including a commitment to remove all forms of agricultural export subsidies and a framework for reducing domestic supports and market access restrictions. However, most of the difficult issues are still to be addressed. Already it is apparent the agreements and commitments will be complex, full of exceptions (especially for developing countries due to their insistence on economically damaging forms of special and differential treatment) and difficult to interpret. This will serve to enable all governments to fudge commitments and to undermine the transparency of the multilateral trading system. Latest developments are not encouraging. Critical target dates set in the July package in preparation for the December Hong Kong Ministerial Conference were missed due to negotiations lagging in all key areas. Without a successful outcome in Hong Kong, it is unlikely the Doha Round will be completed by the current deadline of 2007.
How can academics stay in control?
Authors: Nijhuis Gerard Gervedink , Collis Betty
Published: October 2005

As universities transform into enterprises, academics are facing new challenges, especially in their teaching. This is because of the demands for student‐centred programmes that offer more flexibility, the use of Course Management Systems such as Blackboard, and the expectation that instructors will perform (more) efficiently and effectively. In this research, the focus is on teaching‐related activities to support instructors to stay in control, given these increasing pressures. A Personal Performance Model that shows key aspects of academics’ performance relating to teaching tasks was developed. A series of studies relating to gaps between expected and actual performance was carried out using the Human Performance Technology methodology. As an intervention based on these gaps, a Personal Performance Support Tool was developed to support instructors with their time and task management in relation to teaching, as well as to develop an elaborated insight on how to support instructors as they respond to changing expectations for their teaching performance. Key steps to guide universities in implementing such a support tool have been identified as a result of the research.
From Border Control to Migration Management: The Case for a Paradigm Change in the Western Response to Transborder Population Movement
Authors: Taylor Savitri
Published: October 2005

Today most international migratory movement is from the rest of the world to the West. Much of this movement is irregular because the opportunities available for authorized migration to Western countries are extremely limited. The main argument made in this article is that Western countries need not, should not and cannot control transborder movement in the manner attempted until now, but that they can and should cooperate with countries of origin, countries of transit and other receiving countries to manage migration in a manner which benefits all stakeholders, including would‐be migrants.
European Union Policy on Asylum and Immigration. Addressing the Root Causes of Forced Migration: A Justice and Home Affairs Policy of Freedom, Security and Justice?
Authors: Lindstrøm Channe
Published: October 2005

This paper contributes to the debate on the development of the future common European Union Policy on Asylum and Immigration. It seeks to explain the rationale behind the evolution of the Union's policy outlook on asylum and immigration. It then analyses the most recent Union‐wide policy tools available to address asylum and migration issues, arguing that common European asylum policies thus far have focused on containment of migration flows seen as a threat to the European internal security regime and in response to perceived populist pressures. The return and readmission clauses now being implemented, in agreements with countries outside of the Union, serve to illustrate this point, as does the political willingness to extra‐territorialize asylum processing. However, the focus on eliminating the root causes of migration flows is a relatively new paradigm, developed since the 1999 Tampere European Council. Although off to a slow start, the European Union Neighbourhood and Partnership Instrument may become an institutional outlet to create a more normative framework for asylum and migration. The success of such a framework is contingent upon breaking with earlier conceptualizations of “asylum” as a security threat. Implicit in such a framework is the need to retain a clear distinction between asylum‐ and labour‐related migration. Partnerships must also be granted a budget sufficient for their establishment in real terms with countries of origin and transit. Lastly, there must be changes in modes of governance, as well as institutional reform, if efforts to elaborate a strategy on asylum and migration are to be executed successfully. Curiously, while the proposed Treaty establishing a Constitution for Europe sought to abolish the pillar structure put in place by the 1992 Treaty of Maastricht, it would have retained the institutional inhibitions imposed by long‐existing tensions between national and community administrations and the “inter‐pillar” battles between the foreign policy, humanitarian and development dimensions of the EU apparatus. The current political debate about moving Europe “closer to its people”, following the rejection of the proposed Constitution at national referenda in France and the Netherlands, appears unlikely to solve any of these tensions.
The Experiences of Frontline Staff Working with Children Seeking Asylum
Authors: Dunkerley D. , Scourfield J. , Maegusuku‐Hewett T. , Smalley N.
Published: October 2005

The focus of this paper is welfare professionals’ accounts of their work with children who are seeking asylum. The empirical basis is a commissioned study of children seeking asylum in Wales. As well as qualitative research with children (which is not discussed in this paper), 62 professionals took part in interviews and focus groups. This sample included staff from social services, health, housing, education, police and the voluntary sector. Research findings are presented in relation to the experience of these frontline staff. We attempt to identify some of the sites of tension and the nature of the professional dilemmas, as well as discussing the potential for the exercise of discretion to be exercised. We conclude that there is very little room for manoeuvre within the asylum system for welfare professionals, but that there is evidence of questioning and even minor challenge of current policy from frontline staff. We discuss the extent to which the professional dilemmas raised by the asylum system are of a different order from those experienced throughout social welfare work.
Why It Is Bad to Be Kind. Educating Refugees to Life in the Welfare State: A Case Study from Norway
Authors: Hagelund Anniken
Published: October 2005

In Norway, as elsewhere in Europe, the aim of policy‐making is to ensure the integration of immigrants into mainstream society. This paper focuses on one of the most concrete and practical measures Norwegian authorities have ever taken in this field, namely the recent establishment of a compulsory two‐year introduction programme for newly arrived refugees. This is an activation‐style programme involving both a financial and an educational component, where out‐payments depend on participation in a full‐time training programme aimed at enabling participants to become self‐sufficient members of Norwegian society. In the first part of the paper the establishment of this policy is located within a broader context of integration crisis, before it moves on to look more specifically at the background for the programme and the problems it is set up to address. The latter part of the paper addresses the implementation of the introduction programmes in one medium‐sized Norwegian city. The local discourse here is one of before and after, where the failings of previous policies have been overcome and new and productive practices have been established. Connections can be made between public and political discourses on integration crisis and the local discourses of implementation through the notion of kindness and the idea that kindness has hampered the integration efforts of the state. Herein lies a story not only about views on immigrants and diversity, but also about how immigration has challenged the Norwegian welfare state model.
How Studies of the Educational Progression of Minority Children Are Affecting Education Policy in Denmark
Authors: Colding Bjørg , Hummelgaard Hans , Husted Leif
Published: October 2005

Over the past decade, the number of ethnic minorities in Denmark has increased rapidly, now accounting for over 8 per cent of the total population. This paper presents results from a number of recent studies regarding the educational choices of minority children from less developed countries. An important social concern is that the educational attainment of these children is much lower than among native Danes. The studies show that that a main reason for the education gap is very high dropout rates from vocational schools among minority children and that inadequate Danish language proficiency of immigrants, parents and their children, is an important reason for the high dropout rates, as are inadequate educational preparedness from grade school and insufficient apprenticeship positions available for minority youth. Socio‐economic background, however, has relatively little effect. Recent policy changes to reduce dropout rates from vocational schools are reviewed and additional policy interventions are proposed.