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Selected AbstractsGlobalisation, rural restructuring and health service delivery in Australia: policy failure and the role of social work?HEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 3 2007BSocStud, MLitt, Margaret Alston PhD Abstract The impacts of globalisation and rural restructuring on health service delivery in rural Australia have been significant. In the present paper, it is argued that declining health service access represents a failure of policy. Rural communities across the world are in a state of flux, and Australia is no different: rural communities are ageing at faster rates than urban communities and young people are out-migrating in large numbers. During the past 5 years, rural Australia has also experienced a severe and widespread drought that has exacerbated rural poverty, and impacted on the health and well-being of rural Australians. Australian governments have responded to globalising forces by introducing neoliberal policy initiatives favouring market solutions and championing the need for self-reliance among citizens. The result for rural Australia has been a withdrawal of services at a time of increased need. This paper addresses the social work response to these changes. [source] Lipid Peroxidation and Antioxidant Activities Involved in Resistance Response against Downy Mildew in Opium PoppyJOURNAL OF PHYTOPATHOLOGY, Issue 2 2010Mukesh K. Dubey Abstract The aim of this study was to observe the lipid peroxidation (LP) of cell membranes and antioxidant systems in response to inoculation of Peronospora arborescens causing downy mildew (DM) in opium poppy. Contents of the LP product, malondialdehyde (MDA) and antioxidant glutathione (GSH) were determined in leaves of two opium poppy genotypes, Pps-1 (highly resistant to DM) and Jawahar-16 (highly susceptible to DM) at different time intervals after inoculation (12 h, 24 h, 48 h and 72 h). The provided GSH content corresponded to that of total non-protein sulfhydryl groups. In leaves of Jawahar-16, a significant decrease in concentration of GSH and a persistent increase in concentration of MDA were recorded after inoculation in comparison to leaves of control plants. The continuous decrease in GSH content contributed to damage of cell membranes leading to disease development in Jawahar-16. On the other hand in a resistant genotype (Pps-1), initially at 12 h after inoculation (hai) the level of GSH was found to be high, but a transient and highly significant decrease in content of GSH and increase in content of MDA was observed at 24 hai in comparison to control plants of same genotype and also in comparison to inoculated plants of susceptible genotype (Jawahar-16). These results indicate that generation of GSH and MDA is negatively correlated during the infection process as found in the case of DM-resistant genotype Pps-1 at 24hai, which also suggests an increased need by the host plant for oxidative stress, required for hypersensitive response mediated defense mechanism. [source] IscR acts as an activator in response to oxidative stress for the suf operon encoding Fe-S assembly proteinsMOLECULAR MICROBIOLOGY, Issue 1 2006Won-Sik Yeo Summary In Escherichia coli, Fe-S clusters are assembled by gene products encoded from the isc and suf operons. Both the iscRSUA and sufABCDSE operons are induced highly by oxidants, reflecting an increased need for providing and maintaining Fe-S clusters under oxidative stress conditions. Three cis -acting oxidant-responsive elements (ORE-I, II, III) in the upstream of the sufA promoter serve as the binding sites for OxyR, IHF and an uncharacterized factor respectively. Using DNA affinity fractionation, we isolated an ORE-III-binding factor that positively regulates the suf operon in response to various oxidants. MALDI-TOF mass analysis identified it with IscR, known to serve as a repressor of the iscRSUA gene expression under anaerobic condition as a [2Fe-2S]-bound form. The iscR null mutation abolished ORE-III-binding activity in cell extracts, and caused a significant decrease in the oxidant induction of sufA in vivo. OxyR and IscR contributed almost equally to activate the sufA operon in response to oxidants. Purified IscR that lacked Fe-S cluster bound to the ORE-III site and activated transcription from the sufA promoter in vitro. Mutations in Fe-S-binding sites of IscR enabled sufA activation in vivo and in vitro. These results support a model that IscR in its demetallated form directly activates sufA transcription, while it de-represses isc operon, under oxidative stress condition. [source] Follow-Up Recommendations for Benign Breast BiopsiesTHE BREAST JOURNAL, Issue 5 2006Susanna Shin MD Abstract: Histologically proven benign breast disease increases a woman's relative risk for subsequent cancer development. Yet follow-up guidelines for mammogram and clinical breast examination after a benign breast biopsy are lacking. Our objective was to determine if increased surveillance is indicated following a benign breast biopsy. Following institutional review board approval, a retrospective database review was conducted of prospectively gathered patients who had a benign breast biopsy (core or excisional) for an abnormality detected on mammogram, ultrasound, or clinical breast examination. Follow-up, for all subjects, was a clinical breast examination and mammogram or ultrasound at 6 months, 1 year, and 2 years after benign breast biopsy by a breast surgeon. End points were the need for additional biopsies or cancer detection. Statistical analysis was performed using chi-squared analysis. From January 2000 to July 2003, 156 patients age 18,86 years had a benign breast biopsy. During the 2 year follow-up, 20 patients (13%) required a subsequent biopsy. No significant difference was observed in mean age, race, menarche, menopause, parity, age at first live birth, use of oral contraceptives, history of prior biopsy, or the pathology of the initial lesion between those who needed a subsequent biopsy and those who did not. Seven excisional biopsies were performed (one at 6 months, four at 1 year, and two at 2 years follow-up) for growth of the benign breast biopsy lesion, and pathology remained concordant with the original diagnosis. Thirteen biopsies were done for new findings on mammogram or ultrasound. Three of these (1.9%) yielded a cancer diagnosis (one at 6 months, one at 1 year, and one at 2 years follow-up). No new lesions were identified on follow-up by clinical breast examination alone. Increased surveillance following a benign breast biopsy is necessary because of the increased need for subsequent biopsy or risk of cancer development. This should include imaging (mammography or ultrasound) and a clinical breast examination 6 months, 1 year, and 2 years after a benign breast biopsy. [source] Clinal variation of maxillary sinus volume in Japanese macaques (Macaca fuscata)AMERICAN JOURNAL OF PRIMATOLOGY, Issue 4 2003Todd C. Rae Abstract Macaques (genus Macaca) are unique among cercopithecids in that they possess a maxillary sinus, and among anthropoids in that they demonstrate a relatively weak relationship between the size of this sinus and the cranium. To test the hypothesis that extrinsic factors may contribute to maxillary sinus size variation, a sample of 46 Japanese macaque (M. fuscata) crania from known localities were subjected to computed tomography (CT) imaging, and sinus volume and nasal cavity area were analyzed relative to latitude and temperature variables. The results suggest that the environmental factors are significant determinants of nasal cavity size in Japanese macaques, but that the relationships between the environment and maxillary sinus volume (MSV) are probably a passive consequence of changes in the size of the nasal cavity. The sinus shrinks as the nasal cavity expands, due to an increased need to condition inspired air in colder climates. This in turn suggests that the sinus itself does not contribute significantly to upper respiratory function. Am. J. Primatol. 59:153,158, 2003. © 2003 Wiley-Liss, Inc. [source] Relationship between elevated preoperative troponin T and adverse outcomes following cardiac surgeryANZ JOURNAL OF SURGERY, Issue 1-2 2003William J. Lyon Background: The prognostic value of troponin T (TnT) has been demonstrated in patients following a myocardial infarction. There are limited data regarding the prognostic utility of preoperative TnT in patients undergoing cardiac surgery. The aim of the present study was to determine if elevated preoperative TnT is a predictor of more complex recovery outcomes in the cardiac surgical setting. Methods: A single preoperative TnT measurement was assessed in 696 patients undergoing isolated coronary artery bypass graft surgery. Elevated preoperative TnT levels were classified as ,0.2 ng/mL. Preoperative, intraoperative, intensive care and postoperative events were prospectively recorded for all patients, and retrospectively reviewed for the present study. Results: Elevated preoperative TnT levels were detected in 10% (71/696) of patients. Compared to patients with normal TnT levels, elevated preoperative TnT increased the risk of mortality at 30 days (7%vs 1%, P = 0.004, odds ratio (OR) = 6.7) and 2 years (14%vs 3%, P < 0.001, OR = 5.0), and resulted in prolonged intensive care unit (ICU) stays (P < 0.001) and longer postoperative hospitalization (P < 0.001). Elevated preoperative TnT was also associated with an increased need for perioperative and postoperative cardiovascular support, early ischaemic change and postoperative congestive cardiac failure. In multivariate analyses preoperative TnT was a significant independent predictor of 30-day and 2-year mortality, and duration of ICU stay. Conclusions: Elevated preoperative TnT highlights a subgroup of cardiac surgical patients who are more likely to have a postoperative course with increased morbidity and mortality. [source] Rapid whole monoclonal antibody analysis by mass spectrometry: An Ultra scale-down study of the effect of harvesting by centrifugation on the post-translational modification profile,BIOTECHNOLOGY & BIOENGINEERING, Issue 1 2010C.Q. Reid Abstract With the trend towards the generation and production of increasing numbers of complex biopharmaceutical (protein based) products, there is an increased need and requirement to characterize both the product and production process in terms of robustness and reproducibility. This is of particular importance for products from mammalian cell culture which have large molecular structures and more often than not complex post-translational modifications (PTMs) that can impact the efficacy, stability and ultimately the safety of the final product. It is therefore vital to understand how the operating conditions of a bioprocess affect the distribution and make up of these PTMs to ensure a consistent quality and activity in the final product. Here we have characterized a typical bioprocess and determined (a) how the time of harvest from a mammalian cell culture and, (b) through the use of an ultra scale-down mimic how the nature of the primary recovery stages, affect the distribution and make up of the PTMs observed on a recombinant IgG4 monoclonal antibody. In particular we describe the use of rapid whole antibody analysis by mass spectrometry to analyze simultaneously the changes that occur to the cleavage of heavy chain C-terminal lysine residues and the glycosylation pattern, as well as the presence of HL dimers. The time of harvest was found to have a large impact upon the range of glycosylation patterns observed, but not upon C-terminal lysine cleavage. The culture age had a profound impact on the ratio of different glycan moieties found on antibody molecules. The proportion of short glycans increased (e.g., (G0F)2 20,35%), with an associated decrease in the proportion of long glycans with culture age (e.g., (G2F)2 7,4%, and G1F/G2F from 15.2% to 7.8%). Ultra scale-down mimics showed that subsequent processing of these cultures did not change the post-translational modifications investigated, but did increase the proportion of half antibodies present in the process stream. The combination of ultra scale-down methodology and whole antibody analysis by mass spectrometry has demonstrated that the effects of processing on the detailed molecular structure of a monoclonal antibody can be rapidly determined early in the development process. In this study we have demonstrated this analysis to be applicable to critical process design decisions (e.g., time of harvest) in terms of achieving a desired molecular structure, but this approach could also be applied as a selection criterion as to the suitability of a platform process for the preparation of a new drug candidate. Also the methodology provides means for bioprocess engineers to predict at the discovery phase how a bioprocess will impact upon the quality of the final product. Biotechnol. Bioeng. 2010;107: 85,95. © 2010 Wiley Periodicals, Inc. [source] Convalescence after colonic surgery with fast-track vs conventional careCOLORECTAL DISEASE, Issue 8 2006D. H. Jakobsen Abstract Objective, To compare convalescence after colonic surgery with a fast-track rehabilitation programme vs conventional care. Background, Introduction of a multimodal rehabilitation programme (fast-track) with focus on epidural anaesthesia, minimal invasive surgical techniques, optimal pain control, and early nutrition and mobilization together with detailed patient information have led to a shorter hospital stay after colonic surgery. There are not much data on convalescence after discharge. Methods, A prospective, controlled, non-randomized interview-based assessment in 160 patients undergoing an elective, uncomplicated, open colonic resection or the Hartmann reversal procedure with a fast-track or a conventional care programme in two university hospitals. A structured interview-based assessment was performed preoperatively, and day 14 and 30 postoperatively. Results, Patients undergoing colonic surgery with a fast-track programme regained functional capabilities earlier with less fatigue and need for sleep compared with patients having conventional care. Despite early discharge of the fast-track patients (mean 3.4 days vs 7.5 days), no differences were found according to the need for home care, social care and visit to general practitioners, although the fast-track group had an increased number of visits at the outpatient clinic for wound care. More patients in the fast-track group were re-admitted, but the overall mean total hospital stay was 4.2 days vs 8.3 days in the conventional group. Conclusion, A fast-track rehabillitation programme led to a shorter hospital stay, less fatigue and earlier resumption of normal activities, without the increased need for support after discharge compared with conventionally treated patients after uncomplicated colonic resection. [source] Persecutory symptoms and perceptual disturbance in a community sample of older people: the Islington studyINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 5 2001G. Livingston Abstract Background While there are extensive studies of paranoid symptoms and perceptual disturbance (PPD) in younger adults, relatively little is known about older adults with similar symptoms. Method This study took place in Islington, an inner London borough. Enumeration Districts were randomised to provide a sampling frame. Residents aged 65 or over were interviewed at home. The Short-CARE was used to elicit psychiatric symptoms and diagnosis. Sociodemographic particulars were elicited using the Client Sociodemographic and Service Receipt Inventory. Questions were asked regarding sight and hearing. We used subsections of the geriatric mental scale to identify people who had PPD symptoms. Medications taken were recorded. We asked ,Do you have any health problems?' as a screening question for subjective health problems. Results We interviewed 720 people. Twenty-eight (3.9%) participants scored positively on the PPD sub-scales of the GMS. A forward logistic regression analysis for independent predictors of PPD found the significant independent predictors were dementia (p,=,0.0000; odds ratio 6.8), drinking alcohol in last 6 months (p,<,0.03; odds ratio 0.3), drinking alcohol to help sleep (p,<,0.005; odds ratio 9.6), subjective memory loss (p,<,0.007; odds ratio 3.3) and uncorrected visual impairment (p,<,0.02; odds ratio 2.8). Conclusion There is a relatively high prevalence of PPD in older people living in the community. This is not associated with higher use of services despite the increased needs. Further studies should consider interventions to meet this unmet need. Copyright © 2001 John Wiley & Sons, Ltd [source] Middle East and North Africa take growing share of EU's gas marketOIL AND ENERGY TRENDS, Issue 8 2007Article first published online: 13 AUG 200 The Middle East and North Africa are becoming an increasingly important source of supply for the European Union (EU). The 25 member-states now import some 17% of all the gas they consume from this region. A decade ago, its share was only 9%. This is perhaps not too surprising given the Middle Eastern and North African share of global gas reserves. It is likely moreover that the EU will seek even more of its gas from this source, despite the fears of some energy planners that Europe is already too dependent on what they regard as a politically unstable region. An even bigger worry, however, might be that Middle East and North Africa may not have sufficient gas to meet the increased needs of both the EU and their own home markets, as the latest study by OET's Global Energy Review suggests (see 'Middle Eastern Gas: An under-used Resource?' at http://oilandenergytrends.com). [source] Public Health Considerations in Knowledge Translation in the Emergency DepartmentACADEMIC EMERGENCY MEDICINE, Issue 11 2007Steven L. Bernstein MD Effective preventive and screening interventions have not been widely adopted in emergency departments (EDs). Barriers to knowledge translation of these initiatives include lack of knowledge of current evidence, perceived lack of efficacy, and resource availability. To address this challenge, the Academic Emergency Medicine 2007 Consensus Conference, "Knowledge Translation in Emergency Medicine: Establishing a Research Agenda and Guide Map for Evidence Uptake," convened a public health focus group. The question this group addressed was "What are the unique contextual elements that need to be addressed to bring proven preventive and other public health initiatives into the ED setting?" Public health experts communicated via the Internet beforehand and at a breakout session during the conference to reach consensus on this topic, using published evidence and expert opinion. Recommendations include 1) to integrate proven public health interventions into the emergency medicine core curriculum, 2) to configure clinical information systems to facilitate public health interventions, and 3) to use ancillary ED personnel to enhance delivery of public health interventions and to obtain successful funding for these initiatives. Because additional research in this area is needed, a research agenda for this important topic was also developed. The ED provides medical care to a unique population, many with increased needs for preventive care. Because these individuals may have limited access to screening and preventive interventions, wider adoption of these initiatives may improve the health of this vulnerable population. [source] | |||||||||||||