bluuebunny/crossref_metadata_2025 huggingface dataset:
Optional student use of online lecture resources: resource preferences, performance and lecture attendance
Authors: Grabe M. , Christopherson K.
Published: February 2007

Abstract  One of the most common uses of a course management system in the on‐campus environment is to offer lecture resources to students. Few researchers have investigated how students use such resources. This study considers student use of lecture resources that offer a representation of the lecture presented (i.e. lecture outline, lecture summary, audio recording) and the relationship of the use of such resources to examination performance and attendance. The present research is argued to be an extension of research that investigated the benefits of providing students instructor notes conducted some 30 years ago. The Internet provides a practical way to apply some of these ideas and to collect data on the reaction of students to the opportunity to view lecture resources. Students made very little use of the audio recordings. We suggest audio recordings may be regarded by students as less efficient and less useful than text‐based lecture summaries. The use of online lecture resources, lecture attendance, and examination performance were positively related. For one of three examinations, there was a significant negative interaction of note use and attendance in predicting examination performance providing some support for the hypothesis that students may be able to successfully compensate by viewing online lecture resources when unable to attend class. Because students in this study were not asked to explain their use of these resources, the present findings are regarded as speculative. However, given the interests of many practitioners in providing students lecture resources, the descriptive data and the relationships observed here encourage additional investigation.
Parental work: an account of the day‐to‐day activities of parents of adults with learning disabilities
Authors: Shearn J. , Todd S.
Published: February 2007

The parental role can be an enduring one for many people with sons or daughters with learning disabilities. Despite this, there has been little research on parents’ experiences during their offspring's adult years. The present paper examines the different dimensions of work undertaken by parents in the care of their adult offspring and how they felt these had changed over the years. The paper also explores how parents seek to combine parental work with other aspects of their lives. Data for this study were derived from a qualitative, in‐depth study of the experiences of parents of 33 coresident adult offspring with learning disabilities. The data suggest that the long‐term nature of parenting involves both stability and change. For example, some parents had experienced a depletion of physical resources and enthusiasm that made it difficult for them to carry out some aspects of parental work. Parents had also met new difficulties, such as the handling of the disclosure of learning disability to their offspring, as well as to members of the public. For all parents, parenting had remained an extensive involvement, so that they still found it difficult to meet the demands of parenting, and their own non‐parental tasks and interests. The data also indicate that service intervention needs to be based on an appreciation of the temporal and personal difficulties in parents’ lives, and that service intervention can add to the perceived burden of carers without such an appreciation.
Voice, speech and language characteristics of children with Prader‐Willi syndrome
Authors: Akefeldt A. , Åkefeldt B. , Gillberg C.
Published: February 2007

Eleven individuals with Prader‐Willi syndrome (PWS), aged between 4 and 25 years, were compared with 1 1 non–PWS children of the same sex, age, body mass index and IQ level. Voice, speech and language skills were generally impaired in subjects with PWS. Oral motor function, pitch level and resonance were specifically disordered and clearly differentiated the two groups from each other. Certain biological perinatal factors separated subjects with PWS from other obese children and adolescents, but did not differentiate within the group with PWS and could not account for the speech/language problems. Underlying cerebral dysfunction, combined with a characteristic anatomy of the mouth and larynx in PWS, contributes to altered voice, speech and language function.
Cancer and learning disability
Authors: Cooke L. B.
Published: February 2007

This study was performed in order to complete a 60‐year survey of the rate of deaths from cancer in a group of people with a learning disability. It was carried out on an in‐patient population, and information was obtained from hospital records of deaths and patient medical notes. During the 10–year period studied, 13.6% of all deaths were from cancer, compared to a rate of 26% in the general population. The ratios of different types of cancer were also markedly different to those in the general population, with a very high proportion (55%) being cancers of the gastro‐intestinal tract Other types of cancer, such as those affecting the bronchus, breast and prostate gland, which cause death most often in the general population, hardly appeared at all in the in‐patient population studied. The present paper explores some of the possible reasons for these findings and the implications for the current research in the wider field of cancer in the general population.
Executive function and psychosocial adjustment in children with early treated phenylketonuria: correlation with historical and concurrent phenylalanine levels
Authors: Griffiths P. , Tarrini M. , Robinson P.
Published: February 2007

The issue of what level of phenylalanine (phe) constitutes a safe upper limit for the therapeutic range in dietary treatment of phenylketonuria (PKU) remains unsettled. It has been proposed that the previous guideline figure of 600 μmol 1− may result in specific impairment of executive functions such as attention, planning and set maintenance. The executive dysfunction theory was investigated by correlating historical and concurrent phe with executive, nonexecutive and personality tests in a group of early and continuously treated children, aged 10–13 years, with classical PKU, whose average phe levels of 355 μmol 1− (SD =± 144) for the pre‐school period and 480 μmol 1− (SD ± 193) for the primary school period corresponded to the upper limits presently recommended in the UK of 360 and 480 μmoll− for these age ranges. No clear associations were found between historical or concurrent phe levels and any of the neuropsychological or personality measures, thereby weakening the case for the emergence of executive deficits, at least when average phe levels remain close to the upper limits now considered safe. Furthermore, no significant differences were found on psychological variables where comparison with population norms was possible.
Deficient health and social services for elderly people with learning disabilities
Authors: Cooper S.‐A.
Published: February 2007

Elderly people with learning disabilities have greater psychiatric morbidity than younger individuals, but a previous report has suggested that themajorityoftheformerdonot receive treatment All people with leaming disabilities aged 65 years and over living in Leicestershire, England (n= 134), and a random sample of adults with learning disabilities aged between 20 and 64 years (n= 73) were assessed for psychiatric disorders and service use. Elderly people received less day care, less respite care, and were less likely to have a social worker and receive input from most health services than the younger group. Chiropody was an exception. Those receiving psychiatric services did so through the leaming disabilities specialist services only. Those with an additional psychiatric disorder were more likely to receive services, but results still favoured the younger group. Services were better accessed by those living in residential care. Failure to access services may relate to carers attitudes and beliefs: in leaming disability settings, morbidity was attributed to ‘it's just old age’ in the elderly settings, morbidity was attributed to ‘it's because s/he has leaming disabilities’. The specialist health and social services need to take the lead in health promotion and education.
Learning disabilities: moving forward ‐ a focus on epilepsy, Birrningham, England, 29 June 1996
Authors: Ahmed Z. , O'Brien G. , Betts T. , Kerr M. P. , Fraser W. I.
Published: February 2007

On 29 June 1996 a conference was held in Birmingham to highlight the status of epilepsy in people with learning disabilities. The conference consisted both of seminars and workshops. Dr Tim Betts, Birmingham; Dr Greg O'Brien, Northumberland; and Dr Mike Kerr addressed issues of assessment, diagnosis and drug treatment of epilepsy in this population. This meeting report summarizes the proceedings of the conference.
Primary health care and people with an intellectual disability: the evidence base
Authors: Lennox N. G. , Kerr M. P.
Published: February 2007

There is growing awareness of the importance of evidence‐based medicine in guiding health care delivery. This paper reviews the evidence pertinent to the delivery of primary health care to people with an intellectual disability. Research concerning issues of health status, specialist knowledge of health care, and barriers and solutions to health care delivery for people with an intellectual disability is presented and discussed. Recommendations for future evidence‐based research are made, including suggested areas of importance.
People with intellectual disability in general practice: case definition and case finding
Authors: van Schrojenstein Lantman‐de Valk H. M. J. , Metsemakers J. F. M. , Soomers‐Turlings M. J. M. S. J. G. , Haveman M. J. , Crebolder H. F. j. M.
Published: February 2007

In a general practice database containing data on 62000 patients, those with intellectual disability (ID) were traced. Health problems in this database were recorded according to the International Classification of Health Problems in Primary Care (ICPC) code. By using selected codes, 318 people with ID (0.65% of the study population) were found; the sample contained nearly as many false positives. Adding up the percentage of people with ID living in residential facilities, the total prevalence of people with ID was estimated as 0.82%. Documentation on the cause and level of ID was available in about half of the cases. The demographic characteristics of the people with ID were significantly different from the general population: there was a higher percentage of males and a lower percentage of people over 50 years of age among those with ID. Information about the use of home care was virtually non‐existent in the general practice data. The results are compared with those of other studies. The discussion de ls with reasons for complete documentation of cases with ID in general practice and the role of the general practitioner in health care supply to people with ID.
The general practice care of people with intellectual disability: barriers and solutions
Authors: Lennox N. G. , Diggens J. N. , Ugoni A. M.
Published: February 2007

A questionnaire exploring general practitioners′(GPs′) perceptions of the barriers and solutions to providing health care to people with intellectual disability was sent to 912 randomly selected GPs throughout Australia. A response rate of 58% was obtained. Results indicated that numerous barriers compromise the quality of health care able to be provided to people with intellectual disability. Communication difficulties with patients and other health professionals, and problems in obtaining patient histories stood out as the two most significant barriers. A range of other barriers were identified, including GPs′lack of training and experience, patients′poor compliance with management plans, consultation time constraints, difficulties in problem determination, examination difficulties, poor continuity of care, and GPs′inadequate knowledge of the services and resources available. General practitioners also suggested numerous solutions to these barriers, and emphasized the need for increased opportunitis for education and training in intellectual disability. The GPs showed an overwhelming willingness to be involved in further education. Other major solutions included increasing consultation duration or frequency, proactively involving families and carers in patients′ongoing health care, and increasing remuneration.
Attitudes of general practitioners towards health care for people with intellectual disability and the factors underlying these attitudes
Authors: Bond L. , Kerr M. , Dunstan F. , Thapar A.
Published: February 2007

An intellectual disability attitude questionnaire was used to explore the attitudes of general practitioners (GPs) towards primary health care, organizing health promotion and the role of specialist services for people with intellectual disability. The results of this questionnaire from GPs in Gwent (Wales) and GPs in west Gloucestershire (England) were compared. The GPs in both areas responded similarly and tended to agree that they were responsible for the medical care of people with intellectual disability in the community. They also tended to feel that the move from hospitals to the community of people with intellectual disability would greatly increase their workload. The GPs in both areas were generally against a responsibility on their part for health promotion and health screening initiatives for people with intellectual disability. However, GPs in west Gloucestershire felt more strongly against these issues. Further analysis of the data revealed factors which influenced the response of GPs to the questionnaire, including their position regarding health promotion and screening, and their view of the role of specialist health services. The GPs generally felt that community learning disability teams provided useful support, and there is clearly scope for team members to liaise more closely with GP practices and to provide helpful information to GPs about intellectual disability and the specialist health services available. Professionals seeking to work collaboratively with GPs should be sensitive to their workload pressures and to their attitudes towards health promotion initiatives and health screening.
Health gain through health checks: improving access to primary health care for people with intellectual disability
Authors: Martin D. M. , Roy A. , Wells M. B.
Published: February 2007

People with intellectual disability were identified through the local register and through liaison with general practitioners (GPs). A consultation exercise was conducted with users and carers to ascertain their experiences and perspectives of primary health care (GP services). A comprehensive health check was devised and administered to about 120 people to detect physical disorders, especially cardiovascular risk factors. A standardized checklist was used to determine the population of people with psychological and psychiatric problems. Case notes were reviewed after nearly one year to determine physical and psychological health gain. Significant gains were noted with regard to physical disorders. In contrast, mental health problems were underreported and participants had achieved few gains on follow‐up. The reasons and implications for future service planning are discussed.
Nutritional support for patients with intellectual disability and nutrition/dysphagia disorders in community care
Authors: Kennedy M. , McCombie L. , Dawes P. , McConnell K. N. , Dunnigan M. G.
Published: February 2007

Patients with intellectual disability and neurological handicaps associated with swallowing difficulties are vulnerable to dehydration and undernutrition. Some patients are severely undernourished, a condition which is usually associated with recurrent food aspiration and respiratory infections. Underweight patients are usually provided with adequate dietary protein by carers: their low energy intakes reflect inadequate intakes of fat and carbohydrate. Many patients gain weight following the provision of easily assimilated energy‐dense fat‐ and sugar‐containing foods. Where these measures fail, the provision of a percutaneous endoscopic gastrostomy (PEG) tube may be life‐saving. Optimal supervision of patients with severe nutrition/dysphagia problems requires a support network linking carers at home or in community care facilities with the primary health care team and the local district general hospital.
Mental disorders and problematic behaviours in people with intellectual disability: future directions for research
Authors: Moss S. , Emerson E. , Bouras N. , Holland A.
Published: February 2007

In recent years there has been a nriajor growth of interest in the field of mental health and intellectual disability. This article outlines some of the issues that will be important to address in the coming years. The issues discussed include: the interaction of biological and environmental factors in the aetiology of behavioural and psychiatric disorders; diagnosis and classification; epidemiology; dementia; recognition of mental illness in the community; treatment; service provision; and training.
The international consensus process on psychopharmacology and intellectual disability
Authors: Reiss S. , Aman M. G.
Published: February 2007

The present authors invited 115 scientists, practitioners and consumers from 11 nations to form an international consensus panel on best practices and clinical effects regarding psychoactive medicines and intellectual disability. Co‐sponsors included the American Association on Mental Retardation, the American Psychiatric Association, the American Psychological Association, the National Institute of Mental Health, the National Association on Dual Diagnosis and The Arc of the United States. The panel developed 21 reports that were revised to reflect comments from 351 participants at a 1995 Ohio State University conference in Columbus, OH, USA. The reports will be published as chapters In a forthcoming book entitled Psychotropic Medication and Developmental Disabilities: The International Consensus Handbook. The need for research and training programmes is discussed.
Self‐injurious behaviour and body site preference
Authors: Symons F. J. , Thompson T.
Published: February 2007

Self‐injury by people with intellectual disabilities is a highly problematic and damaging behaviour with profound implications for quality of life. To date, very little detailed descriptive information has been available on the distribution and location of body sites that are injured. This study presents preliminary information on the locations of the self‐injury body sites of 29 school‐age individuals with developmental and intellectual disabilities who self‐injured daily. Teaching staff in school‐based special education programmes independently recorded the body locations of where their student's self‐injured. Approximately 80% of the reported self‐injury was directed disproportionately toward the head and hands. Three‐quarters of head‐directed self‐injury was located on the front of the head, and 83% of hand‐directed self‐injury was located on the back of the hands. Furthermore. 32% of the body sites toward which self‐injury was directed were located on stimulation‐produced analgesia body sites. The implications of these findings are discussed in relation to the opioid hypothesis of self‐injurious behaviour, and with regard to future research investigating functional diagnostic strategies considering both social and biological variables.
Emotion recognition as a function of social connpetence and depressed mood in Individuals with intellectual disability
Authors: Rojahn J. , Warren V. J.
Published: February 2007

The present study was designed to test whether social competence and mood were predictive of the performance by adults with mild or moderate intellectual disability on a matching‐to‐sample task using facially expressed emotions as stimuli. Thirty‐eight subjects were assigned to either a depressed mood group or a non‐depressed mood group based on their scores on the two depression sub‐scales of the Reiss Screen for Maladaptive Behavior. The groups were matched on sex, age and level of intellectual disability. Each group consisted of 10 women and nine men; 12 participants in each group had mild and seven had moderate intellectual disability, respectively. Social competence was assessed with the Social Performance Survey Schedule (SPSS). Performance on the matching‐to‐sample task correlated positively with the subjects′ level of intellectual disability, their mood scores and the scores on the Appropriate Skills sub‐scale of the SPSS. The implications of these findings for social skills training programmes and limitations of this study are discussed.
Manifestations of depression in people with intellectual disability
Authors: Marston G. M. , Perry D. W. , Roy A.
Published: February 2007

The symptoms of 36 people with varying degrees of intellectual disability (ID) who had had an ICD‐I0 depressive syndrome in the preceding year were compared with 46 non‐depressed people with comparable degrees of ID. Throughout the spectrum of ID, symptoms of depressed affect and sleep disturbance were significantly different between the groups. While symptoms in people with mild ID were reflected in the standard diagnostic criteria, this was not the case in people with moderate and severe ID. With increasing disability there was a move towards ‘behavioural depressive equivalents’ such as aggression, screaming and self‐injurious behaviour. Diagnostic criteria for depression among people with severe ID, should place more emphasis on behavioural ‘depressive equivalents’.
Prevalence of psychotropic and anticonvulsant drug use among North Dakota group home residents
Authors: Burd L. , Williams M. , Klug M. G. , Fjelstad K. , Schimke A. , Kerbeshian J.
Published: February 2007

In a previous study, the present authors reported on the prevalence of psychoactive (psychotropic and anticonvulsant) medication use among people vs'ith intellectual disability residing in community settings in the state of North Dakota, USA. The present study replicates the earlier survey. A questionnaire was sent to all group homes serving people with developmental disabilities. Questionnaires were obtained for 100% of North Dakota group home residents. Psychoactive medications (anticonvulsants included) were used by 38% of the 1384 residents represented. The results are discussed in relation to the previous study from North Dakota.
Persons with intellectual disability receiving psychiatric treatment
Authors: Driessen G. , DuMoulin M. , Haveman M. J. , van Os J.
Published: February 2007

Determinants of (1) referral to psychiatric services and (2) the amount of mental health care consumed were analysed in a population of individuals with intellectual disability, using data from a cumulative mental health case register in a defined geographical area. Associations between level of disability, gender, age and social environment on the one hand, and psychiatric referral and service consumption on the other were expressed as odds ratios (ORs). Being older (OR = 1.9; 95% Cl = 1.5–2.5), having milder intellectual disability (OR= 1.4; 95% Cl = 0.9–2.3) and living alone (OR = 5.8; 95% Cl = 2.8–1 1.9) predicted a higher probability of receiving psychiatric treatment. Living alone (OR = 15.3; 95% Cl = 1.7–136.1) was also associated with higher level of mental health service consumption.
The prevalence of people with intellectual disability admitted to general hospital psychiatric units: level of handicap, psychiatric diagnoses and care utilization
Authors: Gustafsson C.
Published: February 2007

Previous studies have stated that people with intellectual disability (ID) are more often afflicted by psychiatric disorders than the general population. In spite of the high prevalence of psychiatric disorders among people with ID, it is not known how many actually receive psychiatric in‐patient care and treatment by the mental health services. In the present study, the number of people with mild and severe ID admitted to in‐patient psychiatric care were compared with corresponding figures in the general population in Sweden. The results show a low frequency of psychiatric care utilization among people with ID and coexisting psychiatric disorders in comparison to the proportion of psychiatric care utilization among people with psychiatric disorders in the general population. The results are discussed in terms of how the level of ID might influence referral or diagnoses, the length of admissions, and the support provided within the special services to people with ID and psychiatric disorders.
Gender differences in repetitive language in fragile X syndrome
Authors: Murphy M. M. , Abbeduto L.
Published: February 2007

Background  Verbal perseveration (i.e. excessive self‐repetition) is a characteristic of male individuals with fragile X syndrome; however, little is known about its occurrence among females or its underlying causes. This project examined the relationship between perseveration and (1) gender, (2) cognitive and linguistic ability, and (3) language sampling context, among youth with fragile X syndrome.

Method  Language transcripts were obtained from adolescent male (n = 16) and female participants (n = 8) with fragile X syndrome in two language contexts (i.e. narration and conversation) designed to elicit spontaneous language samples. Transcripts were coded for utterance‐level repetition (i.e. repetition of words, phrases, dependent clauses or whole utterances), topic repetition and conversational device repetition (i.e. repetition of rote phrases or expressions).

Results  Male participants produced more conversational device repetition than did female participants. Gender differences in conversational device repetition were not explained by differences in non‐verbal cognitive or expressive language ability. Context influenced the type of repetition observed; for example, more topic repetition occurred in conversation than in narration regardless of gender.

Conclusions  The observed gender differences in conversational device repetition among adolescents with fragile X syndrome suggest that, relative to females, male participants may rely more heavily on rote phrases or expressions in their expressive language. Further, results suggest that this gender difference is not simply the result of the correlation between gender and cognitive or linguistic ability in fragile X syndrome; rather, gender may make an independent contribution to conversational device repetition. Repetition type also varied as a function of expressive language context, suggesting the importance of assessing language characteristics in multiple contexts.
A 13‐year longitudinal study of the impact of double mutations in the core promoter region of hepatitis B virus on HBeAg seroconversion and disease progression in patients with genotype C chronic active hepatitis
Authors: Jang J. W. , Lee Y. C. , Kim M. S. , Lee S. Y. , Bae S. H. , Choi J. Y. , Yoon S. K.
Published: February 2007

Summary.  The pathogenic role of core promoter (CP) mutations (T1762/A1764) of hepatitis B virus (HBV) in hepatitis B e antigen (HBeAg) seroconversion or disease progression remains unclear. We investigated the clinical relevance of these mutants over a long‐term follow‐up period of up to 15 years. In this longitudinal cohort study, 29 HBeAg‐positive patients with biopsy‐proved chronic active hepatitis without cirrhosis were regularly monitored for >10 years. The viral isolates were characterized, using the frozen liver tissue obtained on the day of biopsy. Long‐term outcomes were compared between patients with and without CP mutations of HBV at baseline. HBV genotyping showed that 100% of study subjects were infected with genotype C HBV. During a median follow‐up period of 12.5 years, patients without double CP mutations of HBV at baseline showed a tendency towards achieving an earlier HBeAg seroconversion than those with (6.9 vs 9.4 years, P = 0.062) double CP mutations. Double CP mutations at baseline were also significantly associated with the eventual development of cirrhosis or hepatocellular carcinoma (P = 0.013), whereas the absence of double CP mutations predicted inactive carrier status at the last follow‐up (P = 0.027). At 10 years, liver‐related tests were also significantly better in patients without double CP mutations of HBV than in those with these mutations, as reflected by higher platelet counts and albumin levels (P = 0.036 and P = 0.044, respectively). Double T1762/A1764 mutations are significantly related to liver deterioration in HBeAg‐positive genotype C active hepatitis patients. A longer period of immune clearance coupled with delayed HBeAg seroconversion appears to contribute to disease progression in patients harbouring these mutations in the CP region of HBV.
Liver‐related mortality in human‐immunodeficiency‐virus‐infected patients between 1995 and 2003 in the French GERMIVIC Joint Study Group Network (MORTAVIC 2003 Study)*
Authors: Rosenthal E. , Pialoux G. , Bernard N. , Pradier C. , Rey D. , Bentata M. , Michelet C. , Pol S. , Perronne C. , Cacoub P. ,   the GERMIVIC Joint Study Group
Published: February 2007

Summary.  The objective of the present study was to determine mortality because of end‐stage liver disease (ESLD) in a nationwide population of HIV‐infected patients, 7 years following the introduction of highly active antiretroviral therapy (HAART). All departments of internal medicine and infectious diseases from the GERMIVIC Study Group prospectively recorded all deaths in HIV‐infected patients during 2003. Fifty‐nine departments, following a total of 20 940 HIV‐infected patients, participated in the study. Results were compared with those of previous surveys conducted using similar methodology in 1995, 1997 and 2001. Among 215 deaths observed during 2003, 101 (46.9%) were related to AIDS, 27 (12.6%) to ESLD and 87 (40.5%) to other causes. Mortality because of ESLD represented 23.7% of non‐AIDS‐related deaths. Patients dying from ESLD had chronic hepatitis because of hepatitis C virus (HCV) in 92.6% of cases and moderate (30–60 g) or high (>60 g) alcohol consumption (43.5% and 26.0%, respectively). In this population, deaths because of ESLD were 1.5% in 1995, 6.6% in 1997, 14.3% in 2001 and 12.6% in 2003. The prevalence of hepatocellular carcinoma as a cause of death remained high in 2003 but stable when compared with 2001 (25%vs 14.8%). Treatment of hepatitis C in patients who died from ESLD was more frequent in 2003 (44.4%) than in 2001 (26.3%). Seven years after the introduction of HAART, ESLD associated with HCV infections is a leading cause of mortality in HIV‐infected patients, which did not increase between the years 2001 and 2003.
Treatment of hepatitis B with lamivudine and tenofovir in HIV/HBV‐coinfected patients: factors associated with response
Authors: Jain M. K. , Comanor L. , White C. , Kipnis P. , Elkin C. , Leung K. , Ocampo A. , Attar N. , Keiser P. , Lee W. M.
Published: February 2007

Summary.  As therapy for human immunodeficiency virus (HIV) infection evolves, optimizing hepatitis B virus (HBV) treatment and identifying factors that impact its response in the HIV/HBV‐coinfected population is critical. We identified retrospectively 45 HBV/HIV‐coinfected patients with detectable HBV DNA by the Bayer VERSANT® HBV 3.0 bDNA assay (limit of quantification 2000 copies/mL) at baseline and/or year 1 of therapy. Patients were divided into three groups based on the active HBV agent in their antiretroviral regimen: group 1 (n = 15) received lamivudine; group 2 (n = 10), lamivudine plus tenofovir and group 3 (n = 20), lamivudine followed by lamivudine plus tenofovir. HBV genotypes and resistance profiles were determined by the Bayer Trugene® HBV 1.0 assay. More patients in group 2 achieved HBV DNA suppression below 2000 copies/mL (80%), loss of HBe antigen (HBeAg) (40%) and loss of HBeAg and gain of anti‐HBe (20%) than did patients in group 1 or 3. More patients with HBV genotype A, achieved HBV DNA suppression <2000 copies/mL than did patients with non‐A genotypes [74% (26/35) vs 20% (2/10)], respectively (P = 0.003). Risk for virological nonresponse was significant in those with non‐A genotypes [odds ratio (OR) 11.1; 95% CI: 2.0–50], previous HIV therapy (OR 6.5; 95% CI: 1.2–35) and <90% compliance (OR 3.7; 95% CI: 0.99–14.3). Simultaneous therapy with lamivudine/tenofovir suppresses HBV DNA more effectively than lamivudine or tenofovir added to lamivudine. More patients infected with HBV genotype A responded than the non‐A patients, regardless of therapeutic regimen, compliance or prior HIV therapy.
Twenty years of selective hepatitis B vaccination: is hepatitis B declining among injecting drug users in England and Wales?
Authors: Judd A. , Hickman M. , Hope V. D. , Sutton A. J. , Stimson G. V. , Ramsay M. E. , Gill O. N. , Parry J. V.
Published: February 2007

Summary. Injection drug use is a common route of infection for the hepatitis B virus (HBV) in the UK. The aim of this study was to establish the prevalence and force of infection for HBV among injecting drug users (IDUs) recruited from multiple community and drug agency settings in England and Wales between 1990 and 2004. Cross‐sectional studies of IDUs in and out of contact with drug agencies were conducted throughout the 15‐year period. Oral fluid samples were tested for antibodies to the hepatitis B core antigen (anti‐HBc). Logistic regression was used to investigate associations between risk factors and anti‐HBc positivity and force of infection models were explored. In total, 2527 injectors were recruited from community settings, and 29 386 from drug agencies. Anti‐HBc prevalence was 31% (95% CI 30.7–31.8%). It declined in the early 1990s from around 50% in 1992 to 25% in 1999, after which it increased slightly. It was also higher in those who had injected for longer, older IDUs, those recruited in London and North West England, and those reporting having a previous voluntary confidential HIV test. The force of infection models suggested that the incidence of infection increased in 1999–2004 compared with 1993–1998, and was higher in new injectors compared with those injecting for ≥1 year. In conclusion, findings suggest ongoing HBV transmission in recent years despite an overall decline in prevalence in the early and mid‐1990s, and highlight the importance of targeting vaccination programmes at new IDUs who have high incidence rates of infection.
HCV infection is a risk factor for gallstone disease in liver cirrhosis: an Italian epidemiological survey
Authors: Stroffolini T. , Sagnelli E. , Mele A. , Cottone C. , Almasio P. L. ,   the Italian Hospitals’ Collaborating Group
Published: February 2007

Summary.  We assessed the prevalence of gallbladder disease (i.e. gallstones plus cholecystectomy) among patients with liver disease and its association with the severity and aetiology of hepatic injury. Subjects, referred to 79 Italian hospitals, were enrolled in a 6‐month period. The independent effect of the severity and aetiology of liver disease on gallstone disease prevalence was assessed by multiple logistic regression analysis. Overall, 4867 subjects tested anti‐hepatitis C virus (HCV) positive alone, 839 were hepatitis B virus surface antigen (HBsAg) alone, and 652 had an excessive alcohol intake. The prevalence of gallstone disease was 23.3% in anti‐HCV‐positive patients, 12.4% in HBsAg positive and 24.2% in subjects reporting excessive alcohol intake, respectively. Gallstone disease prevalence increased by age in each aetiological category. The proportion of patients with gallstone disease who had a cholecystectomy was the highest in HCV+ subjects. After adjusting for the confounding effect of age and body mass index, compared with patients with less severe liver disease, subjects with HCV‐related cirrhosis, but not those with alcohol‐related cirrhosis, were more likely to have gallstone disease. Subjects with HCV‐related cirrhosis (OR 2.13, 95% CI: 1.38–3.26) were more likely to have gallstone disease when compared with those with HBV‐related cirrhosis. HCV infection is a risk factor for gallstone disease. In Italy, the high prevalence of HCV infection among cirrhotic patients has important implications, as cholecystectomy in these subjects is associated with high risk of morbidity and mortality.
Risk factors for anaemia in human immunodeficiency virus/hepatitis C virus‐coinfected patients treated with interferon plus ribavirin
Authors: Bani‐Sadr F. , Goderel I. , Penalba C. , Billaud E. , Doll J. , Welker Y. , Cacoub P. , Pol S. , Perronne C. , Carrat F. ,   the ANRS HC02 – Ribavic Study team
Published: February 2007

Summary.  The most frequent and the most troublesome adverse effect of interferon plus ribavirin‐based therapy is anaemia. The aim of this analysis was to determine the incidence and risk factors of anaemia (Hb < 10 g/dL) in human immunodeficiency virus/hepatitis C virus (HCV)‐coinfected patients receiving anti‐HCV therapy. We reviewed all cases of anaemia occurring among 416 patients participating in a randomized, controlled 48‐week trial comparing peginterferon (peg‐IFN) alpha 2b plus ribavirin with interferon alpha‐2b plus ribavirin. Univariate and multivariate analyses were used to identify links with antiretroviral treatments, HCV therapy and clinical and laboratory findings. Sixty‐one (15.9%) of the 383 patients who received at least one dose of anti‐HCV treatment developed anaemia. In multivariate analysis the risk of anaemia was significantly associated with zidovudine (OR, 3.27 95% CI, 1.64–6.54, P = 0.0008) and peg‐IFN (OR, 2.35; 95% CI, 1.16–4.57, P = 0.0179). The risk of anaemia was lower in patients with higher baseline haemoglobin levels (OR, 0.35 95% CI, 0.26–0.49, P < 0.0001) and in patients receiving protease inhibitor‐based antiretroviral therapy (OR, 0.51 95% CI, 0.30–0.86, P = 0.0114). Zidovudine discontinuation could help to avoid anaemia associated with anti‐HCV therapy.
Revising how the computer program cervus accommodates genotyping error increases success in paternity assignment
Authors: KALINOWSKI STEVEN T. , TAPER MARK L. , MARSHALL TRISTAN C.
Published: February 2007

Genotypes are frequently used to identify parentage. Such analysis is notoriously vulnerable to genotyping error, and there is ongoing debate regarding how to solve this problem. Many scientists have used the computer program cervus to estimate parentage, and have taken advantage of its option to allow for genotyping error. In this study, we show that the likelihood equations used by versions 1.0 and 2.0 of cervus to accommodate genotyping error miscalculate the probability of observing an erroneous genotype. Computer simulation and reanalysis of paternity in Rum red deer show that correcting this error increases success in paternity assignment, and that there is a clear benefit to accommodating genotyping errors when errors are present. A new version of cervus (3.0) implementing the corrected likelihood equations is available at http://www.fieldgenetics.com.
The PKC, HOG and Ca2+ signalling pathways co‐ordinately regulate chitin synthesis in Candida albicans
Authors: Munro Carol A. , Selvaggini Serena , De Bruijn Irene , Walker Louise , Lenardon Megan D. , Gerssen Bertus , Milne Sarah , Brown Alistair J. P. , Gow Neil A. R.
Published: February 2007

Chitin is an essential component of the fungal cell wall and its synthesis is under tight spatial and temporal regulation. The fungal human pathogen Candida albicans has a four member chitin synthase gene family comprising of CHS1 (class II), CHS2 (class I), CHS3 (class IV) and CHS8 (class I). LacZ reporters were fused to each CHS promoter to examine the transcriptional regulation of chitin synthesis. Each CHS promoter had a unique regulatory profile and responded to the addition of cell wall damaging agents, to mutations in specific CHS genes and exogenous Ca2+. The regulation of both CHS gene expression and chitin synthesis was co‐ordinated by the PKC, HOG MAP kinase and Ca2+/calcineurin signalling pathways. Activation of these pathways also resulted in increased chitin synthase activity in vitro and elevated cell wall chitin content. Combinations of treatments that activated multiple pathways resulted in synergistic increases in CHS expression and in cell wall chitin content. Therefore, at least three pathways co‐ordinately regulate chitin synthesis and activation of chitin synthesis operates at both transcriptional and post‐transcriptional levels.
Genetic crosses in the apicomplexan parasite Cryptosporidium parvum define recombination parameters
Authors: Tanriverdi Sultan , Blain J Craig , Deng Bingbing , Ferdig Michael T. , Widmer Giovanni
Published: February 2007

Recombinant progeny lines of Cryptosporidium parvum were generated by coinfecting immunosuppressed mice with two genetically distinct isolates of C. parvum. Progeny lines were obtained from a cross of parental lines MD × TU114 through targeted propagation in mice of progeny oocysts originating from populations lacking one parental allele at one or more loci. For each infection lineage this process was repeated until only a single allele remained for each marker, indicating that the progeny line was clonal. To study genetic recombination, 16 progeny clones were genotyped at 40 loci located on each of the eight chromosomes. The inheritance of parental alleles was significantly skewed towards the more virulent parent isolate MD. A contiguous 476 kb segment of chromosome V displayed MD allele in all progeny recovered, while MD and TU114 alleles were detected at other loci throughout the genome. The absence of alleles from one parental isolate in this chromosomal region may indicate phenotypic selection for the MD allele during the generation of these lines. A range for the meiotic crossover frequency was determined on the basis of 40 markers and the number of meioses estimated to have taken place during the crossing experiment. C. parvum exhibits a high rate of recombination commensurate with other Apicomplexa.
Regulation of pyrG expression in Bacillus subtilis: CTP‐regulated antitermination and reiterative transcription with pyrG templates in vitro
Authors: Jensen‐MacAllister Irene E. , Meng Qi , Switzer Robert L.
Published: February 2007

The regulation of pyrG expression in a group of low GC Gram‐positive bacteria was previously shown to be mediated by a novel form of transcription attenuation in which low levels of intracellular CTP induce reiterative addition of G residues at position +4 in the 5′ end of the pyrG mRNA, which is encoded as pppGGGC.  . . . The poly(G) sequences formed under these conditions act to prevent attenuation by base pairing with the C‐ and U‐rich 5′ strand of a downstream terminator stem‐loop located in the pyrG leader. In this work we document the reconstitution of this regulatory system in vitro using only the native pyrG DNA template, RNA polymerase and appropriate concentrations of ribonucleotides. CTP‐regulated reiterative transcription producing 5′‐poly(G) tracts and regulation of transcription termination at the pyrG attenuator by CTP were demonstrated. Mutations in the native pyrG template that altered reiterative transcription and attenuation in vivo resulted in alternations in expression in the in vitro transcription system that were predicted by the mechanism described above. These findings provide strong experimental support for the proposed reiterative transcription/antitermination mechanism and confirm that no trans‐acting regulatory protein is required for pyrG regulation.
Characterization of relA and codY mutants of Listeria monocytogenes: identification of the CodY regulon and its role in virulence
Authors: Bennett Hayley J. , Pearce David M. , Glenn Sarah , Taylor Clare M. , Kuhn Michael , Sonenshein Abraham L. , Andrew Peter W. , Roberts Ian S.
Published: February 2007

Listeria monocytogenes is a Gram‐positive intracellular parasite and the causative organism of human listeriosis. In this article we demonstrate that L. monocytogenes encodes a functional member of the CodY family of global regulatory proteins that is responsive to both GTP and branched chain amino acids. By transcript analyses we identified the CodY regulon in L. monocytogenes and demonstrated that it comprises genes involved in amino acid metabolism, nitrogen assimilation as well as genes involved in sugar uptake and incorporation, indicating a role for CodY in L. monocytogenes in both carbon and nitrogen assimilation. A ΔrelA mutation reduced expression of the CodY regulon in early stationary phase and introduction of a ΔcodY mutation into a ΔrelA strain restored virulence. These data indicate that the avirulence of the ΔrelA mutant can in part be explained by the continued repression of the CodY regulon. The phenotypes of ΔrelA and ΔcodY mutants were studied in J774.A1 and Caco‐2 cells and the ΔrelA mutation shown to effect intracellular growth. These results provide the first direct evidence that the activity of a CodY‐type protein influences pathogenesis and provides new information on the physiological adaptation of L. monocytogenes to post‐exponential phase growth and virulence.
Clp ATPases and ClpP proteolytic complexes regulate vital biological processes in low GC, Gram‐positive bacteria
Authors: Frees Dorte , Savijoki Kirsi , Varmanen Pekka , Ingmer Hanne
Published: February 2007

Clp proteolytic complexes consisting of a proteolytic core flanked by Clp ATPases are widely conserved in bacteria, and their biological roles have received considerable interest. In particular, mutants in the clp genes in the low‐GC‐content Gram‐positive phyla Bacillales and Lactobacillales display a diverse range of phenotypic changes including general stress sensitivity, aberrant cell morphology, failure to initiate developmental programs, and for pathogens, severely attenuated virulence. Extensive research dedicated to unravelling the molecular mechanisms underlying these complex phenotypes has led to fascinating new insights that will be covered by this review. First, Clp ATPases and ClpP‐containing proteolytic complexes play indispensable roles in cellular protein quality control systems by refolding or degrading damaged proteins in both stressed and non‐stressed cells. Secondly, ClpP proteases and the chaperone activity of Clp ATPases are important for controlling stability and activity of central transcriptional regulators, thereby exerting tremendous impact on cell physiology. Targets include major stress regulators like Spx (oxidative stress), the antisigma factor RsiW (alkaline stress) and HdiR (DNA damage) in addition to regulators of developmental programs like ComK (competence development), σH and Sda (sporulation). Thus, Clp proteins are central in co‐ordinating developmental decisions and stress response in low GC Gram‐positive bacteria.
The role of ferritins in the physiology of Salmonella enterica sv. Typhimurium: a unique role for ferritin B in iron‐sulphur cluster repair and virulence
Authors: Velayudhan Jyoti , Castor Margaret , Richardson Anthony , Main‐Hester Kara L. , Fang Ferric C.
Published: February 2007

Ferritins are ubiquitous iron (Fe) storage proteins that play a fundamental role in cellular Fe homeostasis. The enteric pathogen Salmonella enterica serovar Typhimurium possesses four ferritins: bacterioferritin, ferritin A, ferritin B and Dps. The haem‐containing bacterioferritin (Bfr) accounts for the majority of stored Fe, followed by ferritin A (FtnA). Inactivation of bfr elevates the intracellular free Fe concentration and enhances susceptibility to H2O2 stress. The DNA‐binding Dps protein provides protection from oxidative damage without affecting the steady‐state intracellular free Fe concentration. FtnB appears to be particularly important for the repair of oxidatively damaged Fe‐sulphur clusters of aconitase and, in contrast to Bfr and FtnA, is required for Salmonella virulence in mice. Moreover, ftnB and dps are repressed by the Fe‐responsive regulator Fur and induced under conditions of Fe limitation, whereas bfr and ftnA are maximally expressed when Fe is abundant. The absence of a conserved ferroxidase domain and the potentiation of oxidative stress by FtnB in some strains lacking Dps suggest that FtnB serves as a facile cellular reservoir of Fe2+.