bluuebunny/crossref_metadata_2025_split huggingface dataset:
Citizens’ participation in the Italian health‐care system: the experience of the Mixed Advisory Committees
Authors: Serapioni Mauro , Duxbury Nancy 
Published: April 2012

AbstractBackground  In 1994, the region of Emilia‐Romagna recognized the importance of citizens’ participation in the regional health‐care system and recommended the institution of Mixed Advisory Committees in the health districts and hospitals with the objective of monitoring and assessing health‐care quality from the users’ perspective.Design  This paper reports findings from a qualitatively based evaluation involving direct observations of the committees and 39 semi‐structured interviews: 20 with representatives of patients and users’ associations and 19 with health professionals and managers involved in the activities of the committees.Results  The Mixed Advisory Committees introduced for the first time in the Italian health system an ongoing deliberative approach that gave patients and users’ representatives the opportunity to be involved in health service governance. The committees enabled the creation of a method of collective participation that overcame the reductive individualistic ‘approach’ to health‐care participation. MAC participants evaluated the committees positively for their mixed composition, which integrated different cultures, experiences and professional profiles with the potential to contribute to solving health‐care problems, in a consultative role. Although patients and users’ representatives were able to exert some form of influence, their expectations were greater than the results obtained. The study illuminated some weak points of public consultation, such as a decline in participation by citizen representatives and a weak influence on decision making.Discussion and conclusions  MACs developed a mechanism of participation that provides health‐care users’ representatives with the opportunity to contribute to the identification and analysis of critical points of the health‐care system. A strength of the MACs is their level of institutionalization within the health system in the region of Emilia‐Romagna. However, they contain a problem of representativeness, lacking a formal system of determining a representative composition from among patients and users’ associations. The case study also illustrates that participation without the cooperation of the health service, and financial and organizational support, will result in a decline in citizen participation, given the resources required of these volunteer citizens in return for limited results.
Contributing to research via biobanks: what it means to cancer patients
Authors: Pellegrini Isabelle , Chabannon Christian , Mancini Julien , Viret Frederic , Vey Norbert , Julian‐Reynier Claire 
Published: April 2012

AbstractContext and objective  Biobanks have become strategic resources for biomedical and genetic research. The aim of the present empirical qualitative study was to investigate how patients with cancer perceive and experience the process of donation to biobanks, focussing on the subjective meanings associated with their decisions when they are asked in a routine context to agree to their own biological specimens being used for research projects.Design  A qualitative study, using semi‐structured interviews to explore in depth the reasons why patients with cancer agree to participating in biobanking.Participants  Nineteen patients (aged 28–82 years) being treated for colorectal cancer or leukaemia at a French cancer centre participated in this study.Results  Contributing to biobanks was experienced here as a rewarding and empowering individual experience because of the psychological issues involved, such as feelings of hope associated with research, because it makes the relationship with researchers and clinicians less asymmetrical, revalorization of otherwise ‘wasted’ tissue, and also as an act of solidarity and reciprocity, which makes patients part of a community.Discussion and conclusion  Patients seem to regard contributing to biobanks as an act of benevolence, which they are motivated to perform because of societal welfare considerations as well as the hope of subjective benefits. Knowledge about the patients’ perspective and of the psychological rewards associated with tumour donation should be taken into account by physicians and caregivers discussing this topic with their patients.
Aquaculture and stress management: a review of probiotic intervention
Authors: Mohapatra S. , Chakraborty T. , Kumar V. , DeBoeck G. , Mohanta K. N. 
Published: April 2012

SummaryTo meet the ever‐increasing demand for animal protein, aquaculture continuously requires new techniques to increase the production yield. However, with every step towards intensification of aquaculture practices, there is an increase in stress level on the animal as well as on the environment. Feeding practices in aqua farming usually plays an important role, and the addition of various additives to a balanced feed formula to achieve better growth is a common practice among the fish and shrimp culturists. Probiotics, also known as ‘bio‐friendly agents’, such as LAB (Lactobacillus), yeasts and Bacillus sp., can be introduced into the culture environment to control and compete with pathogenic bacteria as well as to promote the growth of the cultured organisms. In addition, probiotics are non‐pathogenic and non‐toxic micro‐organisms, having no undesirable side effects when administered to aquatic organisms. Probiotics are also known to play an important role in developing innate immunity among the fishes, and hence help them to fight against any pathogenic bacterias as well as against environmental stressors. The present review is a brief but informative compilation of the different essential and desirable traits of probiotics, their mode of action and their useful effects on fishes. The review also highlights the role of probiotics in helping the fishes to combat against the different physical, chemical and biological stress.
Growth allocation between height and stem diameter in nonsuppressed reproducing Abies mariesii trees
Authors: SEKI TAKESHI , OHTA SADAAKI , FUJIWARA TAKESHI , NAKASHIZUKA TOHRU 
Published: April 2012

AbstractTo understand the growth patterns with respect to competition and leaf‐mass increase in reproducing trees, growth allocation between height and stem diameter was examined for nonsuppressed reproducing Abies mariesii trees in a subalpine forest in northern Honshu, Japan. The growth allocation was analyzed by dividing the relative growth rate of the stem volume into the relative contributions of height and stem‐diameter growth. During a 9‐yr period, height growth and seed‐cone production showed obvious annual variation, while stem‐diameter growth recorded moderate variation. For two of three years of seed‐cone production during the 9‐yr period, trees with larger seed‐cone production were associated with less height growth in the following year of seed‐cone production; however, there was no trend of height growth in the year of seed‐cone production. In the following year of mast seeding, trees with larger stem‐volume growth were associated with less height growth. This trend was also shown for the relationship between the cumulative stem‐volume growth during the 9‐yr period and growth allocation to height, suggesting that trees with a larger biomass increase depress the allocation of photosynthate to competition with a large expenditure for reproduction. In contrast to this, trees with a smaller biomass increase might allocate photosynthate to competition with surrounding trees. The results of this study suggest that an increase in reproductive organs during life history and annual variation in reproduction are closely associated with the growth patterns of the stem in A. mariesii trees.
Role of vasoactive intestinal peptide in seasonal encoding by the suprachiasmatic nucleus clock
Authors: Lucassen Eliane A. , van Diepen Hester C. , Houben Thijs , Michel Stephan , Colwell Christopher S. , Meijer Johanna H. 
Published: April 2012

AbstractThe neuropeptide vasoactive intestinal peptide (VIP) is critical for the proper functioning of the neural circuit that generates circadian rhythms. Mice lacking VIP show profound deficits in the ability to generate many behavioral and physiological rhythms. To explore how the loss of VIP impacts on the intact circadian system, we carried out in vivo multiunit neural activity (MUA) recordings from the suprachiasmatic nucleus of freely moving VIP knockout (KO) mice. The MUA rhythms were largely unaltered in the VIP KO mice, with no significant differences being seen in the amplitude or phase of the rhythms in light–dark conditions. Robust differences between the genotypes were revealed when the mice were transferred from light–dark to constant darkness conditions. In addition, the ability of the VIP KO mice to encode changes in photoperiod was examined. Strikingly, the behavioral and physiological rhythms of VIP KO mice showed no adaptation to short or long photoperiods. The data indicate that the intact circadian system can compensate for some of the consequences of the loss of VIP, whereas this peptide is indispensable for endogenous encoding of seasonal information.
Altered profile of basket cell afferent synapses in hyper‐excitable dentate gyrus revealed by optogenetic and two‐pathway stimulations
Authors: Ledri Marco , Nikitidou Litsa , Erdelyi Ferenc , Szabo Gabor , Kirik Deniz , Deisseroth Karl , Kokaia Merab 
Published: April 2012

AbstractCholecystokinin (CCK‐) positive basket cells form a distinct class of inhibitory GABAergic interneurons, proposed to act as fine‐tuning devices of hippocampal gamma‐frequency (30–90 Hz) oscillations, which can convert into higher frequency seizure activity. Therefore, CCK‐basket cells may play an important role in regulation of hyper‐excitability and seizures in the hippocampus. In normal conditions, the endogenous excitability regulator neuropeptide Y (NPY) has been shown to modulate afferent inputs onto dentate gyrus CCK‐basket cells, providing a possible novel mechanism for excitability control in the hippocampus. Using GAD65‐GFP mice for CCK‐basket cell identification, and whole‐cell patch‐clamp recordings, we explored whether the effect of NPY on afferent synapses to CCK‐basket cells is modified in the hyper‐excitable dentate gyrus. To induce a hyper‐excitable state, recurrent seizures were evoked by electrical stimulation of the hippocampus using the well‐characterized rapid kindling protocol. The frequency of spontaneous and miniature excitatory and inhibitory post‐synaptic currents recorded in CCK‐basket cells was decreased by NPY. The excitatory post‐synaptic currents evoked in CCK‐basket cells by optogenetic activation of principal neurons were also decreased in amplitude. Interestingly, we observed an increased proportion of spontaneous inhibitory post‐synaptic currents with slower rise times, indicating that NPY may inhibit gamma aminobutyric acid release preferentially in peri‐somatic synapses. These findings indicate that increased levels and release of NPY observed after seizures can modulate afferent inputs to CCK‐basket cells, and therefore alter their impact on the oscillatory network activity and excitability in the hippocampus.
Mechanistic theory and modelling of complex food‐web dynamics in Lake Constance
Authors: Boit Alice , Martinez Neo D. , Williams Richard J. , Gaedke Ursula 
Published: April 2012

AbstractMechanistic understanding of consumer‐resource dynamics is critical to predicting the effects of global change on ecosystem structure, function and services. Such understanding is severely limited by mechanistic models’ inability to reproduce the dynamics of multiple populations interacting in the field. We surpass this limitation here by extending general consumer‐resource network theory to the complex dynamics of a specific ecosystem comprised by the seasonal biomass and production patterns in a pelagic food web of a large, well‐studied lake. We parameterised our allometric trophic network model of 24 guilds and 107 feeding relationships using the lake’s food web structure, initial spring biomasses and body‐masses. Adding activity respiration, the detrital loop, minimal abiotic forcing, prey resistance and several empirically observed rates substantially increased the model's fit to the observed seasonal dynamics and the size‐abundance distribution. This process illuminates a promising approach towards improving food‐web theory and dynamic models of specific habitats.
Surgical management of primary appendiceal malignancy
Authors: Whitfield C. G. , Amin S. N. , Garner J. P. 
Published: April 2012

AbstractAim  Primary appendiceal neoplasms are rare, with carcinoid being more common than carcinoma. Preoperative diagnosis is infrequent. We report a series of 24 primary appendiceal neoplasms treated over a 5‐year period.Method  All primary appendiceal neoplasms diagnosed in a university teaching hospital between April 2003 and June 2008 were identified from the prospective histopathology database. Patient records were reviewed for clinical, operative and pathological data.Results  Fourteen carcinomas and 10 carcinoids were identified in the 5‐year period. The former presented at median age 55.8 years with median symptom duration of 35 days, compared with 48 years and 3 days, respectively, for carcinoids. An abdominal mass was commoner in carcinomas (8/14 vs 1/10). Six patients with carcinoma underwent appendicectomy followed by completion right‐hemicolectomy, two of whom had residual disease; seven underwent primary right‐hemicolectomy and one had abscess drainage. Five patients with appendiceal carcinoma died of the disease during a median follow‐up of 633 (256–1158) days. Six patients underwent appendicectomy for acute appendicitis, one had a primary right‐hemicolectomy for a caecal mass. Three had a subsequent right‐hemicolectomy for a high‐risk carcinoid. An appendiceal carcinoid was an incidental finding in three right‐hemicolectomy specimens removed for other indications. No metastases or deaths were recorded at median follow‐up 451 (51–975) days.Conclusion  Appendiceal carcinomas follow a more protracted clinical course than carcinoids, which usually present as acute appendicitis. Caution is needed when diagnosing simple appendicitis in older patients with longer symptom duration, particularly if a mass is present. Patients with appendiceal carcinoma should be offered completion right‐hemicolectomy. Carcinoma has a poor prognosis.
Monkey lipsmacking develops like the human speech rhythm
Authors: Morrill Ryan J. , Paukner Annika , Ferrari Pier F. , Ghazanfar Asif A. 
Published: April 2012

AbstractAcross all languages studied to date, audiovisual speech exhibits a consistent rhythmic structure. This rhythm is critical to speech perception. Some have suggested that the speech rhythm evolved de novo in humans. An alternative account – the one we explored here – is that the rhythm of speech evolved through the modification of rhythmic facial expressions. We tested this idea by investigating the structure and development of macaque monkey lipsmacks and found that their developmental trajectory is strikingly similar to the one that leads from human infant babbling to adult speech. Specifically, we show that: (1) younger monkeys produce slower, more variable mouth movements and as they get older, these movements become faster and less variable; and (2) this developmental pattern does not occur for another cyclical mouth movement – chewing. These patterns parallel human developmental patterns for speech and chewing. They suggest that, in both species, the two types of rhythmic mouth movements use different underlying neural circuits that develop in different ways. Ultimately, both lipsmacking and speech converge on a ∼5 Hz rhythm that represents the frequency that characterizes the speech rhythm of human adults. We conclude that monkey lipsmacking and human speech share a homologous developmental mechanism, lending strong empirical support to the idea that the human speech rhythm evolved from the rhythmic facial expressions of our primate ancestors.
The politics of counter‐reform in the Argentine pension system: Actors, political discourse, and policy performance
Authors: Arza Camila 
Published: April 2012

Arza C. The politics of counter‐reform in the Argentine pension system: Actors, political discourse, and policy performanceIn November 2008, the Argentine National Congress passed a bill drafted by the executive branch to reform the country's pension system. The law eliminated the fully funded pension accounts created in 1993/94 and transferred all participants in that system to a pre‐existing pay‐as‐you‐go pension system. On the basis of debates in the National Congress and statements in the media, this article analyzes the political process of pension reform. It studies the positions of major actors and the arguments presented in favor of and against the bill. In sum, the article analyzes a recent policy experience that may be of interest to other countries in the region that have similar pension systems, offering empirical insights for conceptual analysis of institutional change and continuity.
Big city life: carnivores in urban environments
Authors: Bateman P. W. , Fleming P. A. 
Published: April 2012

AbstractCities may represent one of the most challenging environments for carnivorous mammals. For example, cities have a dearth of vegetation and other natural resources, coupled with increased habitat fragmentation and an abundance of roads as well as altered climate (e.g. temperature, light, rainfall and water runoff). It is therefore intriguing that several carnivore species have become established in cities across the globe. Medium‐sized carnivores such as the red fox, coyote, Eurasian badger and raccoon not only survive in cities but also have managed to exploit anthropogenic food sources and shelter to their significant advantage, achieving higher population densities than are found under natural conditions. In addition, although they may not live permanently within cities, even large carnivores such as bears, wolves and hyaenas derive significant benefit from living adjacent to urbanized areas. In this review, we examine the history of urban adaptation by mammalian carnivores, explore where they are living, what they eat, what kills them and the behavioural consequences of living in urban areas. We review the biology of urban carnivores, exploring traits such as body size and dietary flexibility. Finally, we consider the consequences of having populations of carnivores in urbanized areas, both for humans and for these charismatic mammals. In conclusion, in a time of massive environmental change across the globe, the continuing encroachment of urbanization upon wilderness areas is substantially reducing the availability of natural habitats for many species; therefore, understanding the biology of any taxon that is able to adapt to and exploit anthropogenically disturbed systems must aid us in both controlling and developing suitable conservation measures for the future of such species.
Take‐Up of Public Insurance and Crowd‐Out of Private Insurance under Recent CHIP Expansions to Higher Income Children
Authors: Gresenz Carole Roan , Edgington Sarah E. , Laugesen Miriam , Escarce José J. 
Published: April 2012

ObjectiveTo analyze the effects of states' expansions of Children's Health Insurance Program (CHIP) eligibility to children in higher income families on health insurance coverage outcomes.Data Sources2002–2009 Current Population Survey linked to multiple secondary data sources.Study DesignInstrumental variables estimation of linear probability models. Outcomes are whether the child had any public insurance, any private insurance, or no insurance coverage during the year.Principal FindingsAmong children in families with incomes between two and four times the federal poverty line (FPL), four enrolled in CHIP for every 100 who became eligible. Roughly half of the newly eligible children who took up public insurance were previously uninsured. The upper bound “crowd‐out” rate was estimated to be 46 percent.ConclusionsThe CHIP expansions to children in higher income families were associated with limited uptake of public coverage. Our results additionally suggest that there was crowd‐out of private insurance coverage.
COBRA ARRA Subsidies: Was the Carrot Enticing Enough?
Authors: Graetz Ilana , Reed Mary , Fung Vicki , Dow William H. , Newhouse Joseph P. , Hsu John 
Published: April 2012

ObjectiveTo help preserve continuity of health insurance coverage during the recent recession, the American Recovery and Reinvestment Act provided a 65 percent Consolidated Omnibus Budget Reconciliation Act (COBRA) premium subsidy for workers laid off in 2008–2010. We examined COBRA enrollment levels with the subsidy and the health, access, and financial consequences of enrollment decisions.Study Design/Data CollectionTelephone interviews linked with health system databases for 561 respondents who were laid off in 2009 and eligible for the COBRA subsidy (80 percent response rate).Principal FindingsOverall, 38 percent reported enrolling in COBRA and 54 percent reported having some gaps in insurance coverage since being laid off. After adjustments, we found that those who had higher cost‐sharing, who had higher incomes, were older, or were sicker were more likely to enroll in COBRA. COBRA enrollees less frequently reported access problems or that their health suffered because of poor access, but they reported greater financial stress due to health care spending.ConclusionDespite the substantial subsidy, a majority of eligible individuals did not enroll in COBRA, and many reported insurance coverage gaps. Nonenrollees reported more access problems and that their health worsened. Without a mandate, subsidies may need to be widely publicized and larger to encourage health insurance enrollment among individuals who suffer a negative income shock.
Elucidating the Role of Place in Health Care Disparities: The Example of Racial/Ethnic Residential Segregation
Authors: White Kellee , Haas Jennifer S. , Williams David R. 
Published: April 2012

ObjectiveTo develop a conceptual framework for investigating the role of racial/ethnic residential segregation on health care disparities.Data Sources and SettingsReview of the MEDLINE and the Web of Science databases for articles published from 1998 to 2011.Study DesignThe extant research was evaluated to describe mechanisms that shape health care access, utilization, and quality of preventive, diagnostic, therapeutic, and end‐of‐life services across the life course.Principal FindingsThe framework describes the influence of racial/ethnic segregation operating through neighborhood‐, health care system‐, provider‐, and individual‐level factors. Conceptual and methodological issues arising from limitations of the research and complex relationships between various levels were identified.ConclusionsIncreasing evidence indicates that racial/ethnic residential segregation is a key factor driving place‐based health care inequalities. Closer attention to address research gaps has implications for advancing and strengthening the literature to better inform effective interventions and policy‐based solutions.