Environmental Accountability: Who's Kidding Whom?

International declarations and charters have been produced to encourage and support higher education institutions (HEIs) to address their environmental responsibilities. This paper discusses the results of a critical examination of a range of international HEIs that have signed the global environmental Talloires Declaration. It also assesses the Talloires Secretariat (University Leaders for a Sustainable Future, ULSF) and the extent to which this has been a primary stimulus. An international survey was undertaken and the results presented in a discursive format in order to highlight key driving forces, barriers, and opportunities for environmental responsibility in HEIs. Analysis reveals that they occur on two distinct and evolving levels: the macro national framework level and the micro institutional framework level. Survey responses revealed that none of the HEIs have an embedded institutional environmental culture and most did not have all the micro institutional mechanisms in place for an integrated university-wide environmental response. Many of the institutional barriers to environmental responsibility occurred as a result of this lack of strategy. The most significant institutional opportunity cited was enthusiastic individuals, particularly those at senior management or directorate level, and these individuals were found to be a key driving force. Results also showed that environmental reporting along the lines developed by the private sector is a flexible mechanism that can stimulate progress internally and externally and can be cost effectively disseminated via the World Wide Web. Moreover the survey results indicate that ULSF is not currently a primary stimulus for institution wide action.

Prevalence of headaches in football players

BACKGROUND

Football coaches and team physicians rely heavily on players' reports of symptoms in deciding whether a player may return to the game after sustaining head trauma. The decision is made difficult by the wide variety of associated symptoms, some of which (e.g., headache is among the most common) may or may not be associated with serious head injury. More information is needed about the clinical significance of football-related headache.

METHODS

To assess the frequency of headache associated with playing football, we analyzed responses to our questionnaire asking about incidence, frequency, and outcome of football-related headache from 443 football players (320 from college, 123 from high school).

RESULTS

Eighty-five percent of respondents reported previous headache related to hitting in football. Asked specifically about their most recent game, 21% of respondents reported having had headache during that game. Of players who had headache, only 19% informed the team physician, trainer, or coach, and only 6% were removed from the game. Twenty-seven percent of respondents reported previous diagnosis of cerebral concussion by medical personnel. Defensive backs (25%), defensive linemen (19%), and offensive linemen (18%) were most likely to have headache, related to hitting.

CONCLUSIONS

Our data confirm that posttraumatic headache is commonly associated with football participation and often goes unreported. Given that the most serious complications of head injuries (e.g., second-impact syndrome) occur infrequently, headache as an isolated symptom lacks specificity in predicting such complications in football players. Therefore, unless it persists or is accompanied by additional symptoms, headache alone may not reliably suggest the need to remove players from the game.

Structure-based design and synthesis of phosphinate isosteres of phosphotyrosine for incorporation in Grb2-SH2 domain inhibitors. Part 2

A series of novel phosphinates, derived from 4-phosphonomethylphenylalanine, are described as isosteres of phosphotyrosine. Benzyl (or alkyl) phosphinomethylphenylalanine derivatives were prepared by alkylation of an amino acid P-H phosphinate.

Dialogues in the exam room: medical interviewing by resident family physicians

BACKGROUND

Limited information exists about the application of the biopsychosocial model in medical practice. This study expanded our knowledge about the extent to which psychosocial content is included in medical interviews conducted by resident family physicians.

METHODS

Interviews of 180 patients conducted by six second-year family practice residents were audiotaped and transcribed. Physician statements were analyzed and coded as social talk, physician-centered statements, patient-centered statements, and discussion of patient affect, family, health promotion, and patient education.

RESULTS

The proportion of interviews in which specific physician interactions occurred were physician-centered statements: 100%, patient-centered statements: 66%, dealing with patient affect: 18%, information about family: 61%, initiation of health promotion: 33%, and initiation of patient education: 46%. Discussions of patient opinion/perception, patient affect, family information, and health promotion occurred most commonly during well-care visits and with female patients.

CONCLUSIONS

In this sample of residents, providers extended the interview beyond a purely biomedical focus. However, the psychosocial focus often was brief and applied inconsistently across patients.

Accuracy of cyclosporin measurements made in capillary blood samples obtained by skin puncture

International consensus guidelines suggest that cyclosporin should be measured in whole blood. In some instances it may be advantageous to collect capillary blood, by a finger or ear prick method. However, drug concentrations in skin-puncture blood may not necessarily correlate with those measured in venous blood. This study compared cyclosporin concentrations in blood collected from the fingertip or earlobe with blood collected by standard venipuncture. Patient preference for each of the blood collection methods was also assessed. Specimens were obtained from organ transplant patients receiving cyclosporin, using each of the three methods: venipuncture, finger prick, and earlobe prick. The samples were assayed using a specific radioimmunoassay and the results were compared. In the 102 sets of samples collected, the mean difference (+/- standard deviation) in cyclosporin concentration between finger prick and venipuncture and ear prick and venipuncture was 2.6% (+/- 9.5%) and 2.7% (+/- 12.1%), respectively, while the comparable median (IQR) differences were 1.9% (-3.4% to +6.6%) and -1.1% (-2.8% to +7.2%), respectively. A high degree of correlation was observed between finger prick and venipuncture or ear prick and venipuncture or ear prick and finger prick (r2 > 0.86). Of the three methods of blood collection, finger prick was the patients' preferred method (P < 0.01). These data suggest that capillary blood collected by skin puncture is suitable for use in cyclosporin blood monitoring and acceptable to patients.

Consumed with worry: 'unsafe' alcohol consumption and self-reported problem drinking in England

Using data from the 1994 Health Survey for England, logistic multivariate multilevel modelling techniques are used to investigate the simultaneous effect of individual demographic characteristics and socio-structural factors on self-reported problem drinking as revealed by CAGE scores and 'unsafe' levels of alcohol consumption. Whilst the influence of key socio-structural variables is broadly similar for both unsafe alcohol consumption and high CAGE scores, there are notable exceptions when results are examined by tenure group: those in the rented sector are more likely to be problem drinkers as revealed by CAGE, but less likely to consume 'unsafe' amounts of alcohol. Both dimensions of drinking behaviour are influenced by the consumption patterns of others in the household, with both likelihoods increasing as the average consumption of others in the household rises. After taking into account individual compositional variables, the research indicates that there is very little evidence for geographical variation remaining in these two dimensions of drinking behaviour. It is found that the proportion of the population whose drinking behaviour may be classed as (potentially) problematic via the CAGE responses is substantially less than the proportion consuming above recommended 'safe' levels. The research concludes, however, that the two measures are broadly similar in their relationship to social and structural variables. Tenure provides an exception to this conclusion and indicates a continuing need to take account of housing circumstances in developing an understanding of drinking behaviour.

Impact of synthetic pyrethroid-sheep dip on the indigenous microflora of animal slurries

The chemical constituents of sheep dip in the UK are currently changing from organophosphate-based to synthetic pyrethroid-based insecticides. As a result, changes are also being made to the methods of disposal of these chemicals in the environment, such that pyrethroid sheep dips must now be diluted in animal slurry or water. To date, there is a lack of quantitative information on the impact of the insecticide on the indigenous microflora of animal slurries. This paper investigated the impact of Bayticol (synthetic pyrethroid sheep dip) over a range of concentrations on selected populations of bacteria within animal slurry. It was found that, with increasing pesticide concentration, there was up to a four orders of magnitude increase in the numbers of faecal coliforms and pathogens, such as putative Salmonella spp. These findings have implications for the disposal of sheep dip-amended animal slurries to land from several aspects: (i) the longevity of putative pathogens in the field may require re-evaluation of the time required before the return of grazing livestock to a slurry-amended field; (ii) the potential for the transfer of pathogenic bacteria and faecal coliforms into human and animal foodchains, and (iii) the increased potential for faecal coliforms being washed into streams, rivers and coastal bathing waters.

Interaction of the U3-55k protein with U3 snoRNA is mediated by the box B/C motif of U3 and the WD repeats of U3-55k

U3 small nucleolar RNA (snoRNA) is a member of the Box C/D family of snoRNAs which functions in ribosomal RNA processing. U3-55k is a protein that has been found to interact with U3 but not other members of the Box C/D snoRNA family. We have found that interaction of the U3-55k protein with U3 RNA in vivo is mediated by the conserved Box B/C motif which is unique to U3 snoRNA. Mutation of Box B and Box C, but not of other conserved sequence elements, disrupted interaction of U3-55k with U3 RNA. Furthermore, a fragment of U3 containing only these two conserved elements was bound by U3-55k in vivo. RNA binding assays performed in vitro indicate that Box C may be the primary determinant of the interaction. We have cloned the cDNA encoding the Xenopus laevis U3-55k protein and find strong homology to the human sequence, including six WD repeats. Deletion of WD repeats or sequences near the C-terminus of U3-55k resulted in loss of association with U3 RNA and also loss of localization of U3-55k to the nucleolus, suggesting that protein-protein interactions contribute to the localization and RNA binding of U3-55k in vivo.

Two-year-olds will name artifacts by their functions

Do young children take functional information into account in naming artifacts? In three studies of lexical categorization, 112 children 2 years of age learned new names for novel artifacts with novel functions and then extended the names to new objects. The objects were designed to have functions that were causally related in simple and compelling ways to perceptible aspects of their physical structure. Despite only minimal opportunity to familiarize themselves with the objects, children generalized the names in accordance with the objects' functions. This result obtained even when children had to discover the functions of the named objects on their own (Experiment 2) and when all the test objects had some discernible function (Experiment 3). Two-year-olds name by function when they can make sense of the relation between the appearances and the functions of artifacts.

Proficiency-testing issues relating to sirolimus

BACKGROUND

A need exists to document laboratory proficiency to (1) compare results produced by different analytical techniques and (2) ensure consistency of results from multiple testing sites.

OBJECTIVES

To enable concentration-controlled studies of sirolimus to proceed with confidence, proficiency-testing schemes were put in place at laboratories selected to act as reference laboratories. The feasibility of establishing an ongoing proficiency-testing scheme was addressed with respect to sample stability. The scheme was then used to test proficiency for the measurement of sirolimus in 3 blinded samples each month.

METHODS

The method chosen for measurement of sirolimus was a prototype microparticle enzyme immunoassay. Initially, 15 laboratories were asked to analyze a series of 85 blinded samples that tested their inaccuracy, repeatability, and reproducibility for the measurement and their ability to dilute over-range samples competently. Both blood samples spiked with sirolimus and pooled blood samples from patients receiving the drug were circulated to a maximum of 50 laboratories.

RESULTS

Overall, both inaccuracy and imprecision were acceptable by predefined criteria. Inaccuracy for the immunoassay (percentage difference of the measured value against the nominal value) averaged -5% (95% CI, -9% to -1%). The mean percentage difference between the immunoassay and a high-performance liquid chromatographic assay with mass-spectrometric detection for the measurement of sirolimus in pooled samples (n = 5) from patients receiving the drug was 29% (95% CI, 24% to 34%).

CONCLUSION

The techniques documented here as part of the International Sirolimus Proficiency Testing Scheme could be applied to other clinical studies requiring protocol-driven dosing adjustments based on sirolimus measurements, irrespective of analytical technique used.

An immunoassay for the measurement of sirolimus

OBJECTIVE

This study assessed the performance characteristics of a new microparticle enzyme immunoassay (MEIA) for the determination of sirolimus in whole blood.

BACKGROUND

In clinical investigatory studies, dose adjustments of the immunosuppressive drug sirolimus have been carried out using either high-performance liquid chromatography (HPLC) or, more recently, this investigational immunoassay kit based on the MEIA technique.

METHODS

Calibration was made over the linear range 0 to 30 ng/mL. Inaccuracy and imprecision were assessed by means of 3 control samples supplied with the kit (5, 11, and 22 ng/mL) and dilution of an above-quantitation-limit sample (154 ng/mL). Specificity was determined by the addition of 2 sirolimus metabolites to sirolimus-free human whole blood or to I of the control samples supplied with the kit. In addition, whole-blood samples from patients receiving either cyclosporine or tacrolimus (N = 24) were analyzed for sirolimus. A comparison of the MEIA and a validated HPLC/MS/MS assay analyzed both pooled samples from patients receiving sirolimus and spiked samples (sirolimus 2-60 ng/mL). In a more extensive comparison of patient samples measured by the MEIA assay, a validated HPLC assay with UV detection (HPLC-UV) was used (HPLC-UV sirolimus 7-64 ng/mL).

RESULTS

Inaccuracy (between-run) was < or =16.2% at all 4 concentrations (N = 5). Within-assay imprecision (repeatability) was <6% (N = 5), and between-assay imprecision (reproducibility) for the same samples was < 11% (N = 5). Recovery, assessed by means of 3 in-house control samples prepared in both fresh and previously frozen sirolimus-free human whole blood, ranged from 93.9% to 109.5%. The limit of detection, determined by dilution of the lowest nonzero calibrator (3 ng/mL), was set at 1 ng/mL, at which repeatability was 20.5% (N = 5). Five ng/mL of hydroxysirolimus cross-reacted with the assay by a mean of between 44% and 50% (N = 4); 5 ng/mL of 41-O-demethylsirolimus cross-reacted with the assay by a mean of between 86% and 127% (N = 4). Assay specificity was further challenged by ethylenediamine-tetraacetic acid (EDTA)-whole-blood samples from transplant patients not receiving sirolimus. These samples had tacrolimus and cyclosporine concentrations of 7.8 to 15.9 ng/mL and 38 to 485 microg/L, respectively. The median result was 0 ng/mL (third quartile, 0.7 ng/mL; maximum, 1.4 ng/mL); no value was above the lowest nonzero calibrator. The results of the comparison between the MEIA and the HPLC/MS/MS assay showed mean positive biases of 21% and 8% for the MEIA in measuring sirolimus in pooled patient samples and spiked samples, respectively. The results of the comparison of the MEIA and HPLC-UV median sirolimus concentrations were 18.2 and 20.1. Whole-blood samples anticoagulated with EDTA and containing sirolimus were stable for analysis by MEIA for 3 freeze-thaw cycles when stored at -20 degrees C and for 10 days when stored at 4 degrees C or at ambient temperature. A decline in sirolimus concentration occurred when samples were stored at 37 degrees C.

CONCLUSION

The MEIA showed suitable precision across a clinically relevant concentration range. In terms of patient management, the practical significance of cross-reactivity with sirolimus metabolites remains to be assessed.

A new route to spirooxindoles

[reaction: see text]Reaction of indole amides 5 with tributylstannane gave spiroindolenines 9 which are readily converted into spiropyrrolidinyloxindoles. This tricyclic system is found in a number of interesting natural products.

Activity of antibiotics used in human medicine for Campylobacter jejuni isolated from farm animals and their environment in Lancashire, UK

A retrospective study of 96 Campylobacter jejuni isolated from farm animals and the environment showed that most were less susceptible than the NCTC type strain to nalidixic acid (MICs 4-32 mg/L), ciprofloxacin (MICs 1-2 mg/L) and erythromycin (MICs 16-64 mg/L), but had similar susceptibility to tetracycline (MICs 4-8 mg/L) and kanamycin (MICs 4-8 mg/L). None had the high MICs of ciprofloxacin (>32 mg/L) or erythromycin (1024 mg/L) typically associated with clinical resistance in this species. Some farms used antimicrobial agents, but there was no obvious association between the use of agents and the susceptibility of the isolates.

Effects of teacher feedback on the reputations and peer perceptions of children with behavior problems

We explored whether teacher feedback modified children's preferences and perceptions of a target child with behavior problems. First- and second-grade children (M age = 7.8 years) viewed a videotape of a target actor presented as having a liked, average, or disliked reputation. A second videotape depicted a teacher's verbal responses to the target's behavior as (a) positive, (b) neutral-salient, or (c) corrective. Both salience and valence of teacher feedback were assessed. Main effects of feedback and reputation indicated that feedback had at least minimal effects at each level of the target's reputation. Teacher feedback is discussed with respect to its effects on perceptions of behavior versus affective responses toward behavior-problem children. A significant interaction showed that when combined with a liked reputation, positive and neutral-salient feedback conditions increased the salience and positive evaluation of the target child, thus illustrating the importance of considering nonevaluative teacher attention in combination with children's reputational status.

Real-time transmission of full-motion echocardiography over a high-speed data network: impact of data rate and network quality of service

With high-resolution network transmission required for telemedicine, education, and guided-image acquisition, the impact of errors and transmission rates on image quality needs evaluation.

METHODS

We transmitted clinical echocardiograms from 2 National Aeronautics and Space Administration (NASA) research centers with the use of Motion Picture Expert Group-2 (MPEG-2) encoding and asynchronous transmission mode (ATM) network protocol over the NASA Research and Education Network. Data rates and network quality (cell losses [CLR], errors [CER], and delay variability [CVD]) were altered and image quality was judged.

RESULTS

At speeds of 3 to 5 megabits per second (Mbps), digital images were superior to those on videotape; at 2 Mbps, images were equivalent. Increasing CLR caused occasional, brief pauses. Extreme CER and CDV increases still yielded high-quality images.

CONCLUSIONS

Real-time echocardiographic acquisition, guidance, and transmission is feasible with the use of MPEG-2 and ATM with broadcast quality seen above 3 Mbps, even with severe network quality degradation. These techniques can be applied to telemedicine and used for planned echocardiography aboard the International Space Station.

Expression of nitric oxide synthase isoforms and arginase in normal human skin and chronic venous leg ulcers

Chronic venous ulcers, an example of abnormal wound healing, show chronic inflammation with defective matrix deposition which together with the underlying vascular pathology, result in delayed healing. L-arginine is known to be metabolized by one of two pathways: nitric oxide synthase (NOS), producing nitric oxide (NO), or arginase, producing ornithine. NO is involved in many pathological conditions including vascular and inflammatory disorders. This study therefore investigated the distribution, level and activity of NOS and arginase in chronic venous ulcers in comparison with normal skin, using immunocytochemistry, western blotting, and enzyme assays. The results demonstrated an increased distribution of both NOS and arginase in chronic venous ulcer tissue compared with normal skin, with inflammatory cells and vascular endothelial cells as the main sources. These data were confirmed by western blot analysis, which showed increased levels of both enzymes in chronic venous ulcers. Moreover, there was significantly increased activity of both total NOS (p<0.04) and inducible NOS (p<0.05) in chronic venous ulcer tissue compared with normal skin, and significantly increased activity of arginase (p<0.01) in chronic venous ulcer tissue in comparison with normal skin. NO is known to combine with hydroxyl free radicals forming peroxynitrite, a potent free radical which causes tissue destruction. NO overexpression in chronic venous ulcers may be involved directly or indirectly (through production of peroxynitrite) in the pathogenesis and delayed healing of chronic venous ulcers, through its effects on vasculature, inflammation, and collagen deposition. Arginase is known to enhance matrix deposition. Thus, increased levels of arginase in chronic venous ulcers could contribute to the pathogenesis of lipodermatosclerosis associated with chronic venous insufficiency, predisposing to the formation of chronic venous ulcers and also to matrix cuff formation around blood vessels.

Biomimetic ligands for transition metals: catechol-containing peptides

The tetrapeptide ligands 6a and 6b containing a catechol moiety have been synthesised and their metal binding with Fe(III), Mn(III) and Cu(II) has been studied using fluorescence spectroscopy.

Formation of a full complement of cranial proprioceptors requires multiple neurotrophins

Inactivation of neurotrophin-3 (NT3) completely blocks the development of limb proprioceptive neurons and their end organs, the muscle spindles. We examined whether cranial proprioceptive neurons of the trigeminal mesencephalic nucleus (TMN) require NT3, brain-derived neurotrophic factor (BDNF) or neurotrophin-4 (NT4) for their development. Complements of TMN neurons and masticatory muscle spindles were decreased by 62% in NT3 null mutants, 33% in BDNF null mutants, and 10% in NT4 null mutant mice at birth. The extent of proprioceptive deficiencies differed among different masticatory muscles, particularly in NT3 null mice. Masticatory muscles of embryonic mice heterozygous for the NT3(lacZneo) or BDNF(lacZ) reporter genes expressed both NT3 and BDNF, consistent with target-derived neurotrophin support of TMN neurons. Although more than 90% of TMN neurons expressed TrkB as well as TrkC receptor proteins by immunocytochemistry in wild-type newborns, TrkC or TrkB null mice exhibited only partial proprioceptive deficiencies similar to those present in NT3 or BDNF;NT4 null mice. Thus, in terms of the survival outcome, two main subpopulations of TMN neurons may exist during embryogenesis, one dependent on TrkC/NT3 functioning and the other utilizing TrkB/BDNF signaling. The differential dependence of TMN neurons on neurotrophins may reflect differential accessibility of the neurons to limiting amounts of NT3, BDNF, or NT4 in target tissues, especially if the tissue distribution or levels of BDNF, NT3, and NT4 were dynamically regulated both spatially and temporally.

Do psychosocial variables predict the physical growth of infants with orofacial clefts?

This study sought to determine whether psychosocial variables (parent-infant feeding interactions, infant temperament, maternal social support, family socioeconomic status) are important in predicting the physical growth of infants with orofacial clefts, after controlling for selected medical variables (infant health status, cleft diagnosis, and previous weight). Infant growth (weight-to-height zscores) was tracked for 2 years, and models were developed to predict growth at 3, 12, and 24 months. The authors also examined the growth trajectories of infants with different cleft types: cleft lip and palate (CLP) and cleft palate only (CPO). CPO infants showed some increase in their growth relative to the population mean over time, whereas the growth of CLP infants remained lower than the population mean at all time points. After controlling for medical variables, psychosocial variables collectively accounted for an additional 42% of the variance in infants' growth at 3 months of age, but they did not account for growth at 12 months and 24 months, largely due to the strong effect of previous growth. The authors tentatively conclude that psychosocial variables influence the early growth trajectory of infants with clefts, but subsequent growth becomes increasingly regulated by biological factors.