bluuebunny/crossref_metadata_2025 huggingface dataset:
Coming to Terms
Authors: Furness Penny , Garrud Paul , Faulder Annabella , Swift Judy
Published: May 2006

Facial surgery is associated with both functional difficulties and disfigurement, and there is evidence to show that psychosocial outcomes vary widely between individuals. This article reports the findings of a grounded theory study of the predictors and process of adaptation to facial surgery in adulthood. Interviews and focus groups were conducted with 29 facial surgery survivors. Four super-ordinate data categories were generated, namely ‘Demands’,‘Resources’, ‘Responding and managing’ and ‘Consequences’. A model of adaptation was developed which reflected the inter-relationships apparent between these categories. Data extracts are presented to illustrate the grounding of the model in participants’ accounts, and the model is discussed with reference to previous theory and research.
Stigmatization, Physical Illness and Mental Health in Primary Ciliary Dyskinesia
Authors: McManus I. C. , Stubbings G. F. , Martin N.
Published: May 2006

Primary ciliary dyskinesia (PCD) causes chronic cough, sinusitis and bronchiectasis, and half of patients also show situs inversus. The genetic basis and visible and concealed chronic symptoms provide potential for stigmatization. We describe a structural equation model linking a questionnaire measure of stigmatization to sex, age, personality (Big Five), symptoms (St George’s Respiratory Questionnaire), health status (SF-36) and stress (GHQ-12). Stigma did not relate to physical symptoms or health, or to situs, but correlated with mental health and the social impact of symptoms. Neuroticism, extroversion, openness to experience, age, age at diagnosis and being female indirectly affected stigmatization via mental health.
Social Support and Social-ecological Resources as Mediators of Lifestyle Intervention Effects for Type 2 Diabetes
Authors: Barrera Manuel , Toobert Deborah J. , Angell Karyn L. , Glasgow Russell E. , MacKinnon David P.
Published: May 2006

A study was conducted to determine if an intervention could change social support and social-ecological resources of post-menopausal women diagnosed with type 2 diabetes, and if those changes mediated the intervention’s effects on health behaviors and outcomes. Women ( N = 279) were randomly assigned to receive a comprehensive 6-month Mediterranean Lifestyle Program (MLP) or usual care from their physicians (UC). MLP was successful in changing social embeddedness and social-ecological resources, but not a measure of perceived support. Changes in social-ecological resources mediated intervention effects on fat consumption, exercise and glycemic control. The experimental manipulation of mediators and the demonstrated mediation effects support the conclusion that social-ecological resources can contribute to improvements in healthful lifestyles for women with type 2 diabetes.
Personal and Social Comparison Information about Health Risk
Authors: French David P. , Hevey David , Sutton Stephen , Kinmonth Ann Louise , Marteau Theresa M.
Published: May 2006

This study extended previous research on the impact of personal and social comparison information about health risk by asking respondents what other information they require. A total of 197 students responded to 1 of 12 vignettes describing hypothetical risks of developing pancreatic disease. These vignettes varied in terms of personal risk, comparison group risk and disease severity. Higher threat manipulations elicited higher ratings of negative affect, although perceived ambiguity moderated this effect. When information was more threatening, respondents requested more information, especially about controlling the disease threat. These results indicate the importance of providing unambiguous information, information about how to control a threat and information people want.
Predictors of Tanning Salon Use
Authors: Danoff-Burg Sharon , Mosher Catherine E.
Published: May 2006

This study investigated cognitive predictors of tanning salon use, based on Jaccard’s Theory of Alternative Behavior. A total of 164 undergraduates completed questionnaires that assessed tanning salon use, attitudes toward tanning salon use and attitudes toward behavioral alternatives for enhancing appearance, relaxing and socializing. Results indicated that attitudes toward alternatives for enhancing appearance were not significantly related to tanning salon use. However, favorable attitudes toward engaging in a hobby to relax and going to the gym to socialize were inversely related to frequency of tanning salon use. Findings suggest that interventions for reducing skin cancer risk should focus not only on decreasing favorable attitudes toward tanning, but also on increasing favorable attitudes toward healthier alternatives to tanning salon use.
English Identity and Ethnic Diversity in the Context of UK Constitutional Change
Authors: Condor Susan , Gibson Stephen , Abell Jackie
Published: May 2006

At the time of the devolution settlement in the UK, there was widespread concern that the establishment of the Scottish Parliament and National Assembly for Wales would prompt a rise in English identity at the expense of British identity and, in turn, threaten polyethnic constructions of citizenship. Such presumptions typically rested on reified understandings of the category labels British and English, and conflated the construct of national identity with the constructs of territorial belonging, social inclusion and citizenship. Post-devolution survey data do not currently reveal a decline in British identity in England. Measures of attachment to Englishness vary as a function of ethnic origin of respondent, but also as a function of question wording. A qualitative interview study of young adult Pakistani-origin Muslims in Greater Manchester, north-west England, illustrates how Englishness may be understood to pertain variously to an exclusive cultural or racial category, or to an inclusive territorial entity or community of political interest. Ethnic constructions of English identity need not imply exclusive understandings of citizenship, but their meaning depends crucially on the ways in which nationality and identity are in turn understood in relation to matters of polity and civil society. Conversely, inclusive understandings of national identity do not guarantee the existence of effective ethnic integration or substantive ethnic equality.
‘Race’, Space and Place
Authors: Garland Jon , Chakraborti Neil
Published: May 2006

Rural village communities in England are commonly portrayed as being neighbourly and close-knit, with villagers perceived as having a deep-seated sense of local identity complemented by strong feelings of belonging. This narrow view obscures, and marginalizes, the experiences of minority ethnic residents who can often feel excluded from village life. This article assesses whether the process of ‘othering’ that works to ostracize minority ethnic households is similar to that experienced by all ‘outsiders’ who are newcomers to rural living. It is argued that the conflation of rurality with notions of Englishness and ‘whiteness’ serves to reinforce this marginalization. Indeed, the scattered distribution of minority ethnic populations in the rural means that any understanding of these ‘communities’ needs to recognize that they are not ‘communities of place’ but instead are ‘communities of shared risk’, as it is the risk of racist harassment that provides commonality, kinship and shared experience amongst these diverse populations.
Ethnicity, Social Capital and the Internet
Authors: Parker David , Song Miri
Published: May 2006

This article explores websites developed to express the interests and experiences of young Chinese people in Britain. Drawing on content analysis of site discussions and dialogues with site users, we argue these new communicative practices are best understood through a reworking of the social capital problematic. First, by recognizing the irreducibility of Internet-mediated connections to the calculative instrumentalism underlying many applications of social capital theory. Second, by providing a more differentiated account of social capital. The interactions we explore comprise a specifically ‘second generation’ form of social capital, cutting across the binary of bonding and bridging social capital. Third, judgement on the social capital consequences of Internet interactions must await a longer-term assessment of whether British Chinese institutions emerge to engage with the wider polity.
‘Core’Culture Hegemony and Multiculturalism
Authors: Forrest James , Dunn Kevin
Published: May 2006

Tensions between acceptance of policies aimed at creating a multicultural society and British (Anglo or Anglo-Celtic) Australians concerned about loss of their privileged position as members of the dominant society have been an important feature of political debate in Australia in recent years. There is, however, a paucity of empirical evidence available to assess the extent of recognition of Anglo privilege in this debate. This study draws on questions about attitudes to multicultural values and Anglo privilege from a recent survey of New South Wales and Queensland respondents to address this issue. Principal components analysis of the attitudinal data shows that multiculturalism and privilege are separate, independent dimensions in respondents’ thinking. Cross-tabulations show both polarization of views and ambivalence in attitudes to Anglo privilege, which are in substantial part resolved by consideration of the geography of privilege and linked multicultural values.
Republican freedom and the rule of law
Authors: List Christian
Published: May 2006

At the core of republican thought, on Philip Pettit’s account, lies the conception of freedom as non-domination, as opposed to freedom as noninterference in the liberal sense. I revisit the distinction between liberal and republican freedom and argue that republican freedom incorporates a particular rule-of-law requirement, whereas liberal freedom does not. Liberals may also endorse such a requirement, but not as part of their conception of freedom itself. I offer a formal analysis of this rule-of-law requirement and compare liberal and republican freedom on its basis. While I agree with Pettit that republican freedom has broader implications than liberal freedom, I conclude that we face a trade-off between two dimensions of freedom (scope and robustness) and that it is harder for republicans to solve that trade-off than it is for liberals.
On the Research Value of Large Games
Authors: Castronova Edward
Published: May 2006

Coordination game theory is quite important to a number of literatures but has had very few direct empirical tests because that would require experimental participation by large numbers of people. Large games however can produce natural experiments: situations that through no intent of the designer offer controlled variations on a phenomenon of theoretical interest. Unlike any other social science research technology, such games provide for both sufficient participation numbers and careful control of experimental conditions, making them like Petri dishes for social science. This article examines two examples of games as Petri dishes for macro-level coordination effects: (a) the location of markets inside EverQuest and (b) the selection of battlefields inside Dark Age of Camelot.
What Are We Really Looking at?
Authors: Atkins Barry
Published: May 2006

This article looks at the specificity of the image within contemporary video games and examines what might be thought of as the distinct qualities of a game gaze that is different from the cinema gaze. This necessitates a consideration of the specific temporality of video game play where the aesthetic is generated in a maelstrom of anticipation, speculation, and action. Video games prioritize the participation of the player as he or she plays, and that player always apprehends the game as a matrix of future possibility. The focus, always, is not on what is before the player or the “what happens next” of traditionally unfolding narrative but on the “what happens next if I” that places the player at the center of experience as its principle creator, necessarily engaged in an imaginative act, and always orientated toward the future.
Parlaying Value
Authors: Malaby Thomas
Published: May 2006

Recent scholarship has made it clear that people within synthetic worlds (otherwise known as virtual worlds or MMORPGs) produce commodities and currencies with market value, whereas other work has established the increasing importance of social networks within and between worlds and across the boundary that appears to separate them from the rest of users' lives. To tie these two threads together and account for the use of these environments for the development of expertise and credentials, the author proposes adding a third form, cultural capital, to the mix and outlines a model for understanding capital in all its manifestations: material, social, and cultural. This model will make it possible to explore how actors within synthetic worlds transform, or parlay, these forms from one into the other and how these forms are used across all the domains wherein users act, blurring any qualitative distinction between virtual and real worlds.
The First Days of the Principalship
Authors: Holloman Hal L.
Published: May 2006

The intense experiences that fill a principal's school day often create blind spots in which one cannot see the greater opportunities for discovery. In fact, these daily challenges of the principalship can lead to very reactive measures and sometimes tunnel vision. The purpose of this case is to help future educational administrators recognize the importance of knowing that the challenges will come and knowing that the school culture itself can provide tremendous insight into leading positive change efforts. In this case, students are provided empirical data from various sources (i.e., test data, specific faculty information, school climate survey results) and additional observational data (i.e., conversations with stakeholders). These data will be used to address and evaluate issues pertaining to the school district's culture and the need for organizational change at Eastside School. Students are asked to analyze all of the information in light of needed reforms and determine appropriate responses. In addition, students will be challenged to recognize clear opportunities when the principal's vision and beliefs should be communicated to the various players within the case—all in an effort to influence positive change efforts at Eastside.
School Board and Superintendent Relations
Authors: Fusarelli Bonnie C.
Published: May 2006

Superintendents and school boards mustwork together to improve schools and student academic performance. In an attempt to improve often dismal school system performance, several states passed laws over the past decade changing certification requirements for superintendents, effectively permitting anyone, however trained, to become superintendent of a school system. What happens when people outside the traditional educational establishment become leaders of schools? This case describes the actions of a nontraditional superintendent (a noneducator) hired by a district with a history of conflict between the superintendent and the school board. This case demonstrates the challenges surrounding the hiring of nontraditional superintendents, the politics of local school boards, and issues with changes in school governance structures.
Phosphatidylserine exposure in B lymphocytes: a role for lipid packing
Authors: Elliott James I. , Sardini Alessandro , Cooper Joanne C. , Alexander Denis R. , Davanture Suzel , Chimini Giovanna , Higgins Christopher F.
Published: May 2006

Plasma membrane lipids are usually distributed asymmetrically, with phosphatidylserine (PS) confined to the inner leaflet. PS exposure at the outer leaflet occurs early in apoptosis, but it is also constitutive on some nonapoptotic cell populations where it plays a role in cell signaling. How PS is transported (“flopped”) to the cell surface is unknown. Contrary to previous reports that normal murine B lymphocytes lack lipid asymmetry, we show that PS is normally restricted to the inner leaflet of these cells. PS exposure on normal B cells did, however, occur spontaneously ex vivo. Consistent with the hypothesis that loss of PS asymmetry is regulated by CD45, PS is constitutively exposed on viable, CD45-deficient B cells. We show that calcium-stimulated PS exposure in B cells is strain variable, ABCA1 independent, and both preceded by and dependent on a decrease in lipid packing. This decrease in lipid packing is concomitant with cell shrinkage and consequent membrane distortion, both of which are potently inhibited by blockers of volume-regulatory K+ and Cl- ion channels. Thus, changes in plasma membrane organization precede PS translocation. The data suggest a model in which PS redistribution may occur by a translocase-independent mechanism at energetically favorable sites of membrane perturbation where lipid packing is decreased.
Do patients receive recommended treatment of osteoporosis following hip fracture in primary care?
Authors: Petrella Robert J , Jones Tim J
Published: May 2006

Background

Osteoporosis results in fractures and treatment of osteoporosis has been shown to reduce risk of fracture particularly in those who have had a history of fracture.

Methods

A prospective study was conducted using patients admitted to a hip fracture rehabilitation program at a large referral center to evaluate the use of treatments recommended for secondary prevention of osteoporotic fracture between September 1, 2001 and September 30, 2003. The frequency of medication use for the treatment of osteoporosis including estrogen replacement therapy, bisphosponates, calcitonin, calcium and vitamin D therapy was determined on admission, at 6 weeks post discharge and one year following discharge. All patients were discharged to the care of their family physician. All family physicians in the referral region received a copy of the Canadian Consensus recommendations for osteoporosis management 1–3 months prior to the study.

Results

During the study period, 174 patients were enrolled and 121 completed all assessments. Fifty-seven family physicians were identified as caring for 1 or more of the study patients. Only 7 patients had previous BMD, only 5 patients had previously been prescribed a bisphosponate and 14 patients were taking calcium and/or vitamin D. All patients were prescribed 2500 mg calcium, 400 IU vitamin D and 5 mg residronate daily during rehabilitation and at discharge.

Following discharge, a significant improvement was seen in all clinical indices of functional mobility, including the functional independence measure (FIM), walking distance, fear of falling score (FFS), and the Berg balance score (BBS). At six weeks a significant (p < 0.01) decrease in calcium and vitamin D use was observed. All patients remained compliant with residronate therapy. At twelve months 71 patients remained on residronate (p < 0.01), 10 were now taking alternate bisphosphonate therapy and few were taking calcium and/or vitamin D (p < 0.001). FIM, FFS and Berg scores were significantly decreased from discharge (p < 0.001) while walking distance was unchanged.

Conclusion

Few patients admitted for hip fracture had previously taken recommended osteoporosis therapy including bisphosphonates. While compliance with Canadian Consensus recommendations was observed at six weeks, this was not the case at twelve months post hip fracture rehabilitation. Interventions to improve not only the detection and treatment of osteoporosis but also the ongoing treatment and management post-fracture need to be developed and implemented.
Genetic dissection of apoptosis and cell cycle control in response of colorectal cancer treated with preoperative radiochemotherapy
Authors: Sturm Isrid , Rau Beate , Schlag Peter M , Wust Peter , Hildebrandt Bert , Riess Hanno , Hauptmann Steffen , Dörken Bernd , Daniel Peter T
Published: May 2006

Background

In previous analyses we identified therapy-induced upregulation of the CDK inhibitor p21CIP/WAF-1 and consequently decreased tumor cell proliferation or loss of Bax as adverse factors for survival in rectal cancer treated with radiochemotherapy. Here, we address the individual role of p53 and its transcriptional targets, p21CIP/WAF-1 and Bax, on apoptosis induced by individual components of multimodal anticancer therapy, i.e. 5-fluorouracil (5-FU), ionising γ-radiation (IR) and heat shock/hyperthermia.

Methods

We analysed tumor samples 66 patients with rectal carcinoma treated by a neoadjuvant approach with radiochemotherapy ± heat shock/hyperthermia for the expression and mutation of p53 and the expression of p21CIP/WAF-1 and Bax. These data were correlated with the tumor response. The functional relevance of p53, p21CIP/WAF-1 and Bax was investigated in isogeneic HCT116 cell mutants treated with 5-FU, IR and heat shock.

Results

Rectal carcinoma patients who received an optimal heat shock treatment showed a response that correlated well with Bax expression (p = 0.018). Local tumor response in the whole cohort was linked to expression of p21CIP/WAF-1 (p < 0.05), but not p53 expression or mutation. This dichotomy of p53 pathway components regulating response to therapy was confirmed in vitro. In isogeneic HCT116 cell mutants, loss of Bax but not p53 or p21CIP/WAF-1 resulted in resistance against heat shock. In contrast, loss of p21CIP/WAF-1 or, to a lesser extent, p53 sensitized predominantly for 5-FU and IR.

Conclusion

These data establish a different impact of p53 pathway components on treatment responses. While chemotherapy and IR depend primarily on cell cycle control and p21, heat shock depends primarily on Bax. In contrast, p53 status poorly correlates with response. These analyses therefore provide a rational approach for dissecting the mode of action of single treatment modalities that may be employed to circumvent clinically relevant resistance mechanisms in rectal cancer.
Arteriogenesis depends on circulating monocytes and macrophage accumulation and is severely depressed in op/op mice
Authors: Bergmann Caroline E , Hoefer Imo E , Meder Benjamin , Roth Holger , van Royen Niels , Breit Sabine M , Jost Marco M , Aharinejad Seyedhossein , Hartmann Susanne , Buschmann Ivo R
Published: May 2006

It has been suggested that monocytes/macrophages represent the pivotal cell type during early adaptive growth of pre-existent arterial anastomoses toward functional collateral arteries (arteriogenesis) upon arterial occlusion. This hypothesis was supported by previous studies providing evidence that elevation of the peripheral monocyte count, increased monocyte survival (e.g., granulocyte macrophage-colony stimulating factor), as well as enhanced attraction or adhesion (e.g., monocyte chemoattractant protein 1; intercellular adhesion molecule 1) of the latter cells correlates directly with the arteriogenic response to restore tissue perfusion. However, the experimental proof of the essential role of monocytes/macrophages remains to be given. We therefore hypothesized that arteriogenesis is reduced in a genuine, nonpharmocologically induced monocyte/macrophage-deficient model of femoral artery occlusion in osteopetrotic (op/op) mice. Total leukocyte count did not differ between op/op mice and control (B6C3Fe a/a-Csf1+/+) mice. op/op mice show a significant monocytopenia (0.67%±0.38% vs. 1.53%±0.32%), granulocytosis (33.66%±6.67% vs. 22.83±7.47%), and a concomitant, relative lymphopenia (65.67%±6.58% vs. 75.65%±7.31%). Microsphere-based perfusion measurement 7 days after femoral artery occlusion demonstrated a significantly reduced perfusion restoration upon femoral artery occlusion in op/op mice as compared with controls (28.19%±0.91% vs. 47.88%±2.49%). The application of a novel method of high resolution (microfocus X-ray system) angiography revealed a reduction of proliferation and diameter of collateral arteries. Quantitative immunohistology showed significantly lower numbers of macrophages in the surrounding tissue of proliferating arteries. This study provides additional evidence for the preeminent role of monocytes/macrophages during arteriogenesis in a genuine model of monocyte deficiency, i.e., without pharmacological intervention.
Analysis of DAX1 (NR0B1) and Steroidogenic Factor-1 (NR5A1) in Children and Adults with Primary Adrenal Failure: Ten Years’ Experience
Authors: Lin Lin , Gu Wen-Xia , Ozisik Gokhan , To Wing S. , Owen Catherine J. , Jameson J. Larry , Achermann John C.
Published: May 2006

Context: Primary adrenal failure is a life-threatening condition that can be caused by a range of etiologies, including autoimmune, metabolic, and developmental disorders. The nuclear receptors DAX1 (NR0B1) and steroidogenic factor-1 (SF1/Ad4BP, NR5A1) play an important role in adrenal development and function, and mutations in these transcription factors have been found in patients with adrenal hypoplasia.

Objective: Our objective was to investigate the prevalence of DAX1 and SF1 mutations in children and adults with primary adrenal failure of unknown etiology (i.e. not caused by congenital adrenal hyperplasia, adrenoleukodystrophy, or autoimmune disease).

Patients: One hundred seventeen patients were included. Eighty-eight individuals presented in infancy or childhood with adrenal hypoplasia or primary adrenal failure of unknown etiology (n = 64 46,XY phenotypic males; n = 17 46,XY gonadal dysgenesis/impaired androgenization; n = 7 46,XX females). Twenty-nine individuals presented in adulthood with Addison’s disease of unknown etiology.

Methods: Mutational analysis of DAX1 (NR0B1) (including exon 2α/1A) and SF1 (NR5A1) was done by direct sequencing.

Results: DAX1 mutations were found in 58% (37 of 64) of 46,XY phenotypic boys referred with adrenal hypoplasia and in all boys (eight of eight) with hypogonadotropic hypogonadism and a family history suggestive of adrenal failure in males. SF1 mutations causing adrenal failure were found in only two patients with 46,XY gonadal dysgenesis. No DAX1 or SF1 mutations were identified in the adult-onset group.

Conclusions: DAX1 mutations are a relatively frequent cause of adrenal failure in this group of boys. SF1 mutations causing adrenal failure in humans are rare and are more likely to be associated with significant underandrogenization and gonadal dysfunction in 46,XY individuals.
Implementing cognitive services in community pharmacy: a review of models and frameworks for change
Authors: Roberts Alison S , Benrimoj S I , Chen Timothy F , Williams Kylie A , Aslani Parisa
Published: May 2006

Objective

To investigate models and frameworks for the implementation of cognitive pharmaceutical services (CPS) in community pharmacy.

Method

Relevant literature published in English was identified through searches of online databases (no date limits), texts, conference proceedings, and bibliographies of identified literature. Literature that involved a discussion of models or frameworks for community pharmacy practice change in relation to the implementation of CPS was selected for review. Many of the identified studies were conceptual in nature, and although they were selected in the same way as the empirical research papers, were not able to be critically reviewed in an equivalent manner. A narrative, rather than systematic review, was considered more appropriate.

Key findings

Many of the identified models focused on specific services, seeming to overlook the complexity of the implementation process. Many relied on behavioural theories, with an assumption that changing pharmacists' knowledge, skills or attitude will automatically result in successful change, often ignoring organisational aspects of change. Models that included business aspects remain largely untested, and where testing occurred sample sizes were generally small and populations conveniently or purposively sampled, limiting the generalisability of the findings.

Conclusion

The factors affecting change are more than just those confined to the individual pharmacist who is providing a service, and the implementation process is more complex, involving a range of organisational factors. Research is needed to identify the key elements of a framework for how new CPS should be implemented and delivered.
Knock-in of α3 connexin prevents severe cataracts caused by an α8 point mutation
Authors: Xia Chun-hong , Cheung Debra , DeRosa Adam M. , Chang Bo , Lo Woo-Kuen , White Thomas W. , Gong Xiaohua
Published: May 2006

A G22R point mutation in α8 connexin (Cx50) has been previously shown to cause a severe cataract by interacting with endogenous wild-type α3 connexin (Cx46) in mouse lenses. Here, we tested whether a knocked-in α3 connexin expressed on the locus of the endogenous α8 connexin could modulate the severe cataract caused by the α8-G22R mutation. We found that the α3(-/-) α8(G22R/-) mice developed severe cataracts with disrupted inner fibers and posterior rupture while the α3(-/-) α8(G22R/KIα3) lens contained relatively normal inner fibers without lens posterior rupture. The α8-G22R mutant proteins produced typical punctate staining of gap junctions between fiber cells of α3(-/-) α8(G22R/KIα3) lenses, but not in those of α3(-/-) α8(G22R/-) lenses. Thus, we hypothesize that the knocked-in α3 connexin subunits interact with the α8-G22R connexin subunits to form functional gap junction channels and rescue the lens phenotype. Using an electrical coupling assay consisting of paired Xenopus oocytes, we demonstrated that only co-expression of mutant α8-G22R and wild-type α3 connexin subunits forms functional gap junction channels with reduced conductance and altered voltage sensitivity compared with the channels formed by α3 connexin subunits alone. Thus, knocked-in α3 connexin and mutant α8-G22R connexin probably form heteromeric gap junction channels that influence lens homeostasis and lens transparency.
A complex interaction pattern of CIS and SOCS2 with the leptin receptor
Authors: Lavens Delphine , Montoye Tony , Piessevaux Julie , Zabeau Lennart , Vandekerckhove Joël , Gevaert Kris , Becker Walter , Eyckerman Sven , Tavernier Jan
Published: May 2006

Hypothalamic leptin receptor signalling plays a central role in weight regulation by controlling fat storage and energy expenditure. In addition, leptin also has direct effects on peripheral cell types involved in regulation of diverse body functions including immune response, bone formation and reproduction. Previous studies have demonstrated the important role of SOCS3 (suppressor of cytokine signalling 3) in leptin physiology. Here, we show that CIS (cytokine-inducible SH2 protein) and SOCS2 can also interact with the leptin receptor. Using MAPPIT (mammalian protein-protein interaction trap), a cytokine receptor-based two-hybrid method operating in intact cells, we show specific binding of CIS with the conserved Y985 and Y1077 motifs in the cytosolic domain of the leptin receptor. SOCS2 only interacts with the Y1077 motif, but with higher binding affinity and can interfere with CIS and STAT5a prey recruitment at this site. Furthermore, although SOCS2 does not associate with Y985 of the leptin receptor, we find that SOCS2 can block interaction of CIS with this position. This unexpected interference can be explained by the direct binding of SOCS2 on the CIS SOCS box, whereby elongin B/C recruitment is crucial to suppress CIS activity.
A MORN-repeat protein is a dynamic component of theToxoplasma gondiicell division apparatus
Authors: Gubbels Marc-Jan , Vaishnava Shipra , Boot Nico , Dubremetz Jean-François , Striepen Boris
Published: May 2006

Apicomplexan parasites divide and replicate through a complex process of internal budding. Daughter cells are preformed within the mother on a cytoskeletal scaffold, endowed with a set of organelles whereby in the final stages the mother disintegrates and is recycled in the emerging daughters. How the cytoskeleton and the various endomembrane systems interact in this dynamic process remains poorly understood at the molecular level. Through a random YFP fusion screen we have identified two Toxoplasma gondii proteins carrying multiple membrane occupation and recognition nexus (MORN) motifs. MORN1 is highly conserved among apicomplexans. MORN1 specifically localizes to ring structures at the apical and posterior end of the inner membrane complex and to the centrocone, a specialized nuclear structure that organizes the mitotic spindle. Time-lapse imaging of tagged MORN1 revealed that these structures are highly dynamic and appear to play a role in nuclear division and daughter cell budding. Overexpression of MORN1 resulted in severe but specific defects in nuclear segregation and daughter cell formation. We hypothesize that MORN1 functions as a linker protein between certain membrane regions and the parasite's cytoskeleton. Our initial biochemical analysis is consistent with this model. Whereas recombinant MORN1 produced in bacteria is soluble, in the parasite MORN1 was associated with the cytoskeleton after detergent extraction.
Litophynin D and E, Two New Diterpenoids from a Soft Coral Litophyton sp.
Authors: Ochi Masamitsu , Yamada Koji , Futatsugi Kensuke , Kotsuki Hiyoshizo , Shibata Kozo
Published: May 2006

The structures of litophynin D and E, two new diterpenoids isolated from a soft coral Litophyton sp., have been established on the basis of spectral and chemical evidence.
The Structure of a Germacrane-Type Sesquiterpene Alcohol, a Possible Precursor of Guaiane-Type Sesquiterpenes from the Brown Alga Dictyopteris divaricata
Authors: Suzuki Minoru , Kowata Nobuhiko , Kobayashi Hirokazu , Tanaka Isao
Published: May 2006

A new sesquiterpene alcohol was isolated from the title alga, and its structure established as (E,5S,7S)-germacra-1(10),4(15),11-trien-5-ol by an X-ray crystallographic analysis of the p-bromobenzoate derivative.
Reaction of Dimethylzirconocene with Alkylmagnesium Halides as a Potentially General Method for Preparing Zirconocene-Alkene Complexes
Authors: Takahashi Tamotsu , Nitto Yu , Seki Takashi , Saburi Masahiko , Negishi Ei-ichi
Published: May 2006

Addition of one equivalent of RCH2CH2MgX to Cp2ZrMe2 (Cp = C5H5) in the presence of PMe3 led to a transmetalation reaction to afford zirconocene-alkene complexes Cp2Zr(RCH=CH2)(PMe3) in good yields along with the formation of MeMgX.
Regio- and Stereo-controlled Cyclopropanation of Unsaturated Enol Ether
Authors: Sugimura Takashi , Futagawa Tohru , Tai Akira
Published: May 2006

Stereochemically pure tricyclic system consisting of seven and two three membered rings was prepared by highly regio- and diastereo-controlled successive cyclopropanations of cyclic unsaturated enol ether prepared from 2-cycloalkenone and optically pure 2,6-dimethyl-3,5-heptanediol.
Direct Optical Resolution of 2,2′-Dihydroxy-1,1′-binaphthy
Authors: Kawashima Masatoshi , Hirayama Akihisa
Published: May 2006

2,2′- Dihydroxy-1,1′-binaphthy1 (1) was directly resolved with (1R,2R)-1,2-diaminocyclohexane to afford (R)-(+)-1 in a high yield with a high optical purity.
An international constant: the crucial role of policy competence in the effective strategic management of health services organizations
Authors: Longest B. B.
Published: May 2006

In view of the pervasive impact of government policies on health services organizations worldwide, policy competence is an increasingly important element in the successful strategic management of these organizations. This article discusses a conceptual perspective of policy competence, including three intertwined components of this competence. Firstly, policy competence is built upon understanding the government policies that affect health services organizations, as well as understanding the process by which such policies are made and the forces that can affect the process and its outcomes. Secondly, policy competence helps strategic managers anticipate and lead responses of health services organizations to the opportunities and threats emanating from their policy environments. Finally, policy competence assists strategic managers to participate effectively in shaping the policy environments of health services organizations to the benefit of these organizations.
Why do we keep on meeting like this? The board as ritual in health and social care
Authors: Peck Edward ,   Perri 6, Gulliver Pauline , Towell David
Published: May 2006

Despite their prevalence and longevity in many forms of social organization, most research on formal meetings suggests that they do not fulfil the instrumental purposes (e.g. setting strategy) that their constitutions propose. A three-year study of the Joint Commissioning Board for mental health in Somerset, UK, revealed that it was no exception. However, many of the participants on the Board suggested that it fulfilled important purposes that drew attention to its role as ritual. This paper examines the role of the Board in the light of the literature on ritual - in particular the work of the neo-Durkheimian tradition flowing from the work of Douglas - and locates the importance of the meeting in the formation of social solidarity. This theoretical perspective illuminates issues around classification and language which explain the disempowerment felt by some members of the Board. Finally, this paper identifies the challenges in engaging a broader range of stakeholders (including users and carers) in these rituals.
Manual handling risk controls in hospitals (MARCH): a cross-sectional survey of UK hospitals
Authors: Smedley J. , Poole J. , Waclawski E. , Harrison J. , Stevens A. , Buckle P. , Coggon D.
Published: May 2006

Injury and ill health among healthcare staff associated with handling patients is an important area of risk for UK National Health Service (NHS) employers. Since the introduction of a specific legal duty to control this risk in 1992, many Trusts have developed manual handling risk management strategies. Anecdotally, however, practice varies between Trusts and there is no published description of common practice among NHS employers. The latter would be useful as a benchmark for risk managers. Therefore, we undertook a cross-sectional survey of 158 UK trusts (81% of those invited) using a structured interviewer-administered questionnaire to collect information about manual handling risk controls. Most Trusts had basic systems for risk management, including defined management accountability, written policies, provision of handling equipment, training, expert advice about manual handling and access to occupational health services and physiotherapy for injured employees. However, there was wide variation in important aspects, including the extent of expert manpower and criteria for referral to occupational health. Arrangements for monitoring risk controls were generally poor, and the variation in practice was a cause for concern. These data will help NHS employers by providing a benchmark against which to measure and develop risk management systems for manual handling. Future research should aim to develop standards through consensus opinion and ultimately evidence of effectiveness of risk controls.
Long-term planning to meet UK Government coronary heart disease revascularization targets
Authors: Bowie Cameron , Duff Celia , Harper Paul , Shahani Arjan , Wilderspin Hilary , Yates Jan
Published: May 2006

The National Service Framework (NSF) for Coronary Heart Disease, published in the UK in 2000, gave target intervention rates of 750 procedures per million population (pmp) for both percutaneous transluminal angioplasty (PTCA) and coronary artery bypass graft (CABG). This paper describes how one Regional Office of the Department of Health, with CABG and PTCA rates of around half the NSF target levels, designed a strategy to plan rationally to meet the derived population need for these procedures. A bottom-up needs assessment model was used to predict the population need for these procedures for the Eastern Region of the UK. The Excel-based model took account of the effects of demographic change, anticipated reduction in incidence of heart disease due to primary prevention programmes and the expected improvement in cardiology and cardiac surgery technologies. The model predicted that excess procedures would be required across the region over the next 20 years. Further access study modelling was used to determine the best location for additional tertiary cardiac centres. Further, a commissioning tool was produced that could compare the predicted need, including additional procedures needed to meet waiting list targets, with capacity available from a range of providers. These tools have been used successfully in the Eastern Region to increase the regional revascularization rates from 371 pmp CABG and 322 pmp PTCA in 2000 to planned rates of 453 pmp CABG and 447 pmp PTCA in 2002 / 2003, to recommend the building of a new tertiary cardiac centre in Essex in the next decade and to inform the commissioning of revascularization rates in three coronary heart disease networks.
Antiviral treatment of genital herpes
Authors: Apoola A , Radcliffe K
Published: May 2006

A review of the randomized, controlled trials in the literature on the treatment of genital herpes infection with aciclovir, famciclovir and valaciclovir. Common clinical questions encountered by physicians, such as the effect of antivirals on symptoms, healing, aborting attacks and subsequent recurrences, are addressed. There is very little comparative data between the three licensed drugs but the little data that there is shows no difference in efficacy, tolerability and toxicity between aciclovir, valaciclovir or famciclovir when taken orally. Choice of therapy would then depend on convenience of dosing and cost.
An audit on the management of female victims of sexual assault attending a genitourinary medicine clinic
Authors: Das Satyajit , Huengsberg Mia
Published: May 2006

The victims of sexual assault may attend GUM clinic without any referral from any other agency. The management of these cases need special care. We audited the management of females who were known to us as victims of sexual assault. In 15 months, 68 females attended our clinic. All were screened for sexually transmitted infections (STI). Emergency contraception was offered to only 38.4% at risk cases, and formal counselling support was offered to only 25% cases. Further care is necessary to improve counselling support and offering emergency contraception to the victims of sexual assault.
Correlates of condom breakage and slippage among university undergraduates
Authors: Yarber William L , Graham Cynthia A , Sanders Stephanie A , Crosby Richard A
Published: May 2006

An anonymous questionnaire was used to explore relationships between condom breakage, slippage and possible correlates in a sample of 428 single, nevermarried college men and women. Specific condom use errors and problems that could lead to breakage and slippage were also examined. A three-month recall period was used. Breakage/slippage was found to be associated with never receiving instruction on correct condom use ( P = 0.001), more than one sex partner ( P = 0.001) , more frequent use of condoms ( P = 0.001), and partner(s) being less than highly motivated to use condoms ( P = 0.02). Those reporting that condoms had contacted a sharp object were three times as likely to report breakage ( P = 0.001). Those using condoms without proper lubrication ( P = 0.006) and those experiencing loss of erection during sex ( P = 0.001) were more likely to report slippage. Further research should investigate the efficacy of instruction addressing specific factors that may reduce the incidence of breakage/slippage, thereby enhancing condom effectiveness.
Running on empty: sexual co-factors are insufficient to fuel Africa's turbocharged HIV epidemic
Authors: Gisselquist David , Potterat John J , Brody Stuart
Published: May 2006

The hypothesis that heterosexual transmission drives sub-Saharan Africa's HIV epidemics requires much faster transmission dynamics in Africa than in the US and Europe, where heterosexual transmission is arguably insufficient to maintain existing levels of HIV prevalence. Initially, experts surmised that Africans had more sexual partners; however, studies of sexual behaviour circa 1990 undermined this assumption. Next, it was supposed that the high burden of bacterial sexually transmitted disease (STD) in Africa explained greater HIV transmission efficiency; however, during the 1990s, community studies in Africa showed that STD had much less than expected impact on HIV transmission. Current attempts to explain HIV as a primarily sexual epidemic in Africa propose multiple factors, including herpes simplex virus type 2, lack of male circumcision, concurrency, and others. These factors also fail for various reasons to account for Africa's HIV epidemics: they are present also in the US and/or Europe; they do not correlate with differences in HIV prevalence across Africa; etc. While behavioural and biological variables influence personal risk for HIV acquisition, the available evidence suggests that they do not differentiate African from US and European epidemics, nor do they determine the differential HIV epidemic trajectories noted across Africa.
Level 2 genitourinary medicine training and ongoing supervision — how we can all benefit
Authors: Pattman Richard S , Richards Jane E
Published: May 2006

An innovative six-month, two sessions a week, funded clinical attachment programme was devised and introduced for practical training and experience to meet the demands and requirements of those wishing practical experience and training in genitourinary medicine. This has been generated by interest from previous theoretical teaching and as a desire to provide Level 2 services in the community. To date four doctors have completed this training with excellent mutual evaluation and a recognition by all involved, including commissioners, of the importance of maintaining a regular formal session while providing Level 2 community sexual health services. To be formally recognized improved evaluation, standardization and certification are required. However, if pursued, this package with continuing specialist links should prove beneficial to all involved and with the current epidemic of sexually transmitted infections will improve and enhance available services.
Chronic penile oedema secondary to chronic masturbation
Authors: Noble H , Goh BT
Published: May 2006

We report the case of a man with proven chlamydial conjunctivitis and urethritis who was found to have asymptomatic chronic penile oedema secondary to masturbation.
Oral Kaposi's sarcoma in a non-HIV homosexual White male
Authors: Kua H W , Merchant W , Waugh M A
Published: May 2006

This paper reports the exceeedingly rare occurrence of oral Kaposi's sarcoma in a non-HIV Caucasian White male. The lesion presented as a 8 mm vascular nodule on the buccal mucosa on the left. He was homosexual. The lesion was removed and histological examination confirmed Kaposi's sarcoma. The patient has been tested on 10 occasions for HIV from December 1998 to March 2004 and has been negative. The patient remains alive and well with no evidence of recurrence.
Completeness and timeliness of treatment for chlamydia within a sexual health service
Authors: Chen Marcus Y , Ryder Nathan , Donovan Basil
Published: May 2006

Prompt treatment of genital Chlamydia trachomatis infection will reduce the duration of infectiousness and further transmission of infection. In 2002, an audit was conducted to assess the completeness and timeliness of treatment for uncomplicated chlamydial infection at the Sydney Sexual Health Centre, Australia. Over a nine-month period, chlamydia was diagnosed in 250 patients, 97% of whom received appropriate treatment. The median duration between initial attendance and treatment was two days. Prompt delivery of treatment was facilitated by: initial treatment of patients likely to be chlamydia-infected; rapid availability of test results; urgent communication of positive test results; and effective procedures for recalling untreated patients.