Memory and attention problems in children with brain tumors at diagnosis

Purpose: Results from previous studies indicate that children with brain tumors (BT) might present with cognitive problems at diagnosis and thus before the start of any medical treatment. The question remains whether these problems are due to the underlying tumor itself or due to the high level of emotional and physical stress which is involved at diagnosis of a malignant disorder. All children with a de novo oncological diagnosis not involving the central nervous systems (CNS) are usually exposed to a comparable level of distress. However, patients with cancer not involving the CNS are not expected to show disease-related cognitive problems. Thus they serve as a well-balanced control group (CG) to help distinguish between the probable causes of the effect. Method: In a pilot study we analyzed an array of cognitive functions in 16 children with BT and 17 control patients. In both groups, tests were administered in-patient at diagnosis before any therapeutic intervention such as surgery, chemotherapy od irradiation. Results: Performance of children with BT was comparable to that of CG patients in the areas of intelligence, perceptual reasoning, verbal comprehension, working memory, and processing speed. In contrast, however, BT patients performded significantly worse in verbal memory and attention. Conclusion: Memory and attention seem to be the most vulnerable funstions affected by BT, with other functions being preserved at the time of diagnosis. It ist to be expected that this vulnerability might exacerbate the cognitive decline after chemotherapy and radiation treatment - known to impair intellectual performance. The findings highlight the need of early cognitive assessments in children with BT in order to introduce cognitive training as early as possible to minimize or even prevent cognitive long-term sequelae. This might improve long-term academic and professional outcome of these children, but especially helps their return to school after hospitalization.

Management and outcomes of anorectal infection in the cancer patient

Background. The objective of this retrospective cohort study is to examine the presentation and outcomes for a contemporary series of cancer patients with anorectal infection. In addition, we seek to identify factors which are associated with surgical intervention. ^ Methods. The study cohort was identified from ICD-9 codes for diagnosis of infection of the anal and rectal region and patients who underwent a surgical oncology consultation between 1/2000 and 12/2006. Clinical presentation, treatment rendered, and outcomes were retrospectively recorded. ^ Results. Of the 100 patients evaluated by the surgical oncology service for anorectal infection, 42 were treated non-operatively and 58 underwent surgical intervention. Factors associated with surgical intervention based on logistic multivariable analysis included the diagnosis of an abscess (odds ratio [OR] 10.5; 95% confidence interval [CI] 2.9-38.5) and the documentation of erythema on physical examination (OR 3.1; 95% CI 1.1-8.4). Thrombocytopenia (platelets < 50,000) was associated with non-operative management (OR 0.3; 95% CI 0.1-0.7). Incision and drainage was the most common surgical procedure (79%) while a wide debridement for a necrotizing soft tissue infection was required in 2 patients. Infection-specific 90-day mortality was only 1% (N=1). However, the median overall survival for the entire cohort was only 14.4 months (95% CI 7.9-19.5). ^ Conclusions. Non-operative management is a reasonable treatment option for anorectal infection in patients with cancer. Identification of an abscess, erythema on physical exam, and thrombocytopenia were associated with management strategy. Although rare, necrotizing soft tissue infections are associated with significant mortality. ^

Perceptions of work engagement of nurses in Taiwan

Purpose. The purpose of this study was to determine the perceptions of work engagement of Taiwanese nurses with 3 specific aims: (1) understand Taiwanese nurses' perceptions of work engagement; (2) explore the factors influencing work engagement, and (3) examine how work engagement impacts nursing care for patients. ^ Design. The study used an ethnographic approach with participant observation and semi-structured interviews with RNs. ^ Setting. The study was conducted in the highest and lowest nurse turnover medical surgical units at a regional teaching hospital in southwestern Taiwan. ^ Sample. Purposive sampling resulted in 28 formal interviews with RNs who provided direct patient care, had at least 3 months experience in nursing, and were full-time employees. ^ Methods. Descriptive data were collected through participant observation in each unit. Observations were made while attending meetings, continuing education sessions, and informal conversations with RNs. Field notes and audio recorded semi-structured interviews were analyzed using qualitative thematic analytic techniques. ^ Findings. Findings revealed perceptions of work engagement spanned four domains: patients ("wholehearted care"), work (positive attitude), self (fulfillment and happiness), and others (relationships with colleagues). Providing "wholehearted care" toward patients was the foundation of work engagement for nurses in Taiwan. Engaged nurses felt fulfilled, happy, and found "meaning" through the process of patient care. The study revealed five factors that influenced work engagement: personal, organizational, social, patient, and professional. The impact of work engagement on nurse and patient outcomes are confirmed. ^ Conclusions. Taiwanese nurses connect work engagement with patients, the job, oneself, and colleagues. "Wholehearted patient care" is the core manifestation of work engagement among these nurses. In contrast, studies in western business only focused on work attitudes. Losing interest and "heart" lead to work routines which can lead to individual unhappiness. Findings from this study validate the multiple factors contributing to work engagement of nurses. Job demands and resources can only partially explain what hinders work engagement. Work disengagement and burnout share some commonality but should be measured differently. An understanding of RNs' perceptions of work engagement may provide direction for strategies that improve work engagement leading to decreased RN turnover. ^

Transcriptional changes and oxidative stress associated with the synergistic interaction between potato virus X and potato virus Y and their relationship with symptom expression.

Many virus diseases of economic importance to agriculture result from mixtures of different pathogens invading the host at a given time. This contrasts with the relatively scarce studies available on the molecular events associated with virus---host interactions in mixed infections. Compared with single infections, co-infection of Nicotiana benthamiana with Potato virus X (PVX) and Potato virus Y (PVY) resulted in increased systemic symptoms (synergism) that led to necrosis of the newly emerging leaves and death of the plant. A comparative transcriptional analysis was undertaken to identify quantitative and qualitative differences in gene expression during this synergistic infection and correlate these changes with the severe symptoms it caused. Global transcription profiles of doubly infected leaves were compared with those from singly infected leaves using gene ontology enrichment analysis and metabolic pathway annotator software. Functional gene categories altered by the double infection comprise suites of genes regulated coordinately, which are associated with chloroplast functions (downregulated), protein synthesis and degradation (upregulated), carbohydrate metabolism (upregulated), and response to biotic stimulus and stress (upregulated). The expressions of reactive oxygen species?generating enzymes as well as several mitogen-activated protein kinases were also significantly induced. Accordingly, synergistic infection induced a severe oxidative stress in N. benthamiana leaves, as judged by increases in lipid peroxidation and by the generation of superoxide radicals in chloroplasts, which correlated with the misregulation of antioxidative genes in microarray data. Interestingly, expression of genes encoding oxylipin biosynthesis was uniquely upregulated by the synergistic infection. Virus-induced gene silencing of ?-dioxygenase1 delayed cell death during PVX?PVY infection.

La Ordenaci��n del Territorio en las Ciudades Globales Europeas: El caso de Madrid

En la Comunidad de Madrid el modelo de ocupaci��n del territorio en las dos ��ltimas d��cadas ha obedecido a factores de oferta del mercado y no a las necesidades de la poblaci��n, ello provoca un consumo de suelo y de recursos que conducen a una sobrexplotaci��n insostenible. Las metr��polis globales est��n experimentando r��pidas e intensas transformaciones, basadas en los paradigmas emergentes de la globalizaci��n, la gobernanza, la metropolizacion y la dispersi��n de las actividades en el territorio y a trav��s de ellos se abordan los planes de Londres, Par��s y las tentativas de Madrid. La globalizaci��n provoca la p��rdida de soberan��a de las administraciones publicas y la competitividad entre las ciudades globales en Europa, Londres, Paris y Madrid, son centros de poder, de concentraci��n y crecimiento donde se produce la dualizaci��n del espacio y donde la desigualdad participa de la restructuraci��n urbana, concentraci��n de pobreza frente a espacios de la nueva clase emergente en donde dominan los sectores de servicios y las tecnolog��as de la informaci��n. Frente al desarrollo urbano neoliberal de regulaci��n a trav��s del mercado y basada en criterios de eficiencia de la Nueva Gesti��n P��blica, se vislumbra la posibilidad de que la sociedad se administre a si misma por medio de acciones voluntarias y responsables que promuevan los intereses colectivos mediante el reconocimiento de su propia identidad, introduciendo el concepto de gobernanza. Frente, a la explotaci��n del territorio por parte de la sociedad extractiva que genera corrupcion, se propone un modelo de cooperaci��n p��blico-privada basado en la confianza mutua, un marco regulador estable, la transparencia y la informaci��n a cuyo flujo m��s homog��neo contribuir��n sin duda las TICs. En todo este proceso, las regiones metropolitanas en Europa se erigen como motores del crecimiento, donde los l��mites administrativos son superados, en un territorio cada vez m��s extendido y donde los gobiernos locales tienen que organizarse mediante un proceso de cooperaci��n en la provisi��n de servicios que ayuden a evitar los desequilibrios territoriales. El fen��meno de la dispersi��n urbana en desarrollos de baja densidad, los centros comerciales perif��ricos, la expulsi��n hacia la periferia de las actividades de menor valor a��adido y la concentraci��n de funciones directivas en el centro, conducen a una fragmentaci��n del territorio en islas dependientes del autom��vil y a procesos de exclusi��n social por la huida de las rentas altas y la expulsi��n de las rentas bajas de los centros urbanos. Se crean fragmentos monofuncionales y discontinuos, apoyados en las autov��as, lugares carentes de identidad y generadores de despilfarro de recursos y una falta de sostenibilidad ambiental, econ��mica y social. El estudio de la cultura de la planificaci��n en Europa ayuda a comprender los diferentes enfoques en la ordenaci��n del territorio y el proceso de convergencia entre las diferentes regiones. Los documentos de la UE se basan en la necesidad de la competitividad para el crecimiento europeo y la cohesi��n social y en relaci��n al territorio en los desarrollos polic��ntricos, la resoluci��n del dualismo campo-ciudad, el acceso equilibrado a las infraestructuras, la gesti��n prudente de la naturaleza, el patrimonio y el fomento de la identidad. Se proponen dos niveles de estudio uno actual, los ��ltimos planes de Londres y Paris y el otro la evoluci��n de las tentativas de planes en la Regi��n madrile��a siempre en relaci��n a los paradigmas emergentes se��alados y su reflejo en los documentos. El Plan de Londres es estrat��gico, con una visi��n a largo plazo, donde se confiere un gran inter��s al proceso, al papel del alcalde como l��der y su adaptaci��n a las circunstancias cambiantes, sujeto a las incertidumbres de una ciudad global. El desarrollo del mismo se concibe a trav��s de la colaboraci��n y cooperaci��n entre las administraciones y actores. La estructura del documento es flexible, establece orientaciones y gu��as indicativas, para la redacci��n de los planes locales, no siendo las mismas vinculantes y con escasa representaci��n grafica. El Plan de Par��s es m��s un plan f��sico, similar al de otros centros europeos, trabaja sobre los sectores y sobre los territorios, con informaci��n extensa, con caracter��sticas de ���Plan Latino��� por la fuerza de la expresi��n gr��fica, pero al mismo tiempo contiene una visi��n estrat��gica. Es vinculante en sus determinaciones y normativas, se plantea fomentar, pero tambi��n prohibir. Ambos planes tratan la competitividad internacional de sus centros urbanos, la igualdad social, la inclusi��n de todos los grupos sociales y la vivienda como una cuesti��n de dignidad humana. Londres plantea la gobernanza como cooperaci��n entre sector p��blico-privado y la necesaria cooperaci��n con las regiones lim��trofes, en Par��s las relaciones est��n m��s institucionalizadas resaltando la colaboraci��n vertical entre administraciones. Ambos plantean la densificaci��n de nodos servidos por transporte p��blico, modos blandos y el uso los TODs y la preservaci��n de la infraestructura verde jerarquizada, la potenciaci��n de la red azul y la mejora del paisaje de las periferias. En las ���tentativas��� de planes territoriales de Madrid se constata que estuvieron sujetas a los ciclos econ��micos. El primer Documento las DOT del a��o 1984, no planteaba crecimiento, ni econ��mico ni demogr��fico, a medio plazo y por ello no propon��a una modificaci��n del modelo radio conc��ntrico. Se trataba de un Plan r��gido volcado en la recuperaci��n del medio rural, de la ciudad, el dimensionamiento de los crecimientos en funci��n de las dotaciones e infraestructuras existentes. Aboga por la intervenci��n de la administraci��n p��blica y la promoci��n del peque��o comercio. Destaca el desequilibrio social en funci��n de la renta, la marginaci��n de determinados grupos sociales, el desequilibrio residencia/empleo y la excesiva densidad. Incide en la necesidad de viviendas para los m��s desfavorecidos mediante el alquiler, la promoci��n suelo p��blico y la promoci��n del ferrocarril para dar accesibilidad al espacio central. Aboga por el equipamiento de proximidad y de peque��o tama��o, el tratamiento paisaj��stico de los l��mites urbanos de los n��cleos y el control de las actividades ilegales se��alando orientaciones para el planeamiento urbano. Las Estrategias (1989) contienen una visi��n: la modificaci��n del modelo territorial, mediante la intervenci��n p��blica a trav��s de proyectos. Plantea la reestructuraci��n econ��mica del territorio, la reconversi��n del aparato productivo, la deslocalizaci��n de actividades de escaso valor a��adido y una mayor ubicuidad de la actividad econ��mica. Incide en la difusi��n de la centralidad hacia el territorio del sur, equilibr��ndolo con el norte, tratando de recomponer empleo y residencia, integrando al desarrollo econ��mico las periferias entre s�� y con el centro. Las actuaciones de transporte consolidar��an las actuaciones, modificando el modelo radio conc��ntrico facilitando la movilidad mediante la red de cercan��as y la intermodalidad. El plan se basaba en el liderazgo del Consejero, no integrando sectores como el medio ambiente, ni estableciendo un documento de seguimiento de las actuaciones que evaluara los efectos de las pol��ticas y su aportaci��n al equilibrio territorial, a trav��s de los proyectos realizados. El Documento Preparatorio de las Bases (1995), es m��s de un compendio o plan de planes, recoge an��lisis y propuestas de los documentos anteriores y de planes sectoriales de otros departamentos. Presenta una doble estructura: un plan f��sico integrador cl��sico, que abarca los sectores y territorios, y recoge las Estrategias previas a��adiendo puntos fuertes, como el malestar urbano y la rehabilitaci��n el centro. Plantea la consecuci��n del equilibrio ambiental mediante el crecimiento de las ciudades existentes, la vertebraci��n territorial basada en la movilidad y en la potenciaci��n de nuevas centralidades, la mejora de la habitabilidad y rehabilitaci��n integral del Centro Urbano de Madrid, y la modernizaci��n del tejido productivo existente. No existe una idea-fuerza que aglutine todo el documento, parte del reconocimiento de un modelo existente concentrado y congestivo, un centro urbano dual y dos periferias al este y sur con un declive urbano y obsolescencia productiva y al oeste y norte con una dispersi��n que amenaza al equilibrio medioambiental. Se��ala como aspectos relevantes, la creciente polarizaci��n y segregaci��n social, la deslocalizaci��n industrial, la aparici��n de las actividades de servicios a las empresas instaladas en las ��reas metropolitanas, y la dispersi��n de las actividades econ��micas en el territorio por la banalizaci��n del uso del autom��vil. Se plantea el reto de hacer ciudad de la extensi��n suburbana y su conexi��n con el sistema metropolitano, mediante una red de ciudades integrada y complementaria, en b��squeda de un mayor equilibrio y solidaridad territorial. Las Bases del PRET (1997) ten��an como prop��sito iniciar el proceso de concertaci��n en que debe basarse la elaboraci��n del Plan. Parte de la ciudad mediterr��nea compacta, y diversa, y de la necesidad de que las actividades econ��micas, los servicios y la residencia est��n en proximidad, resolvi��ndolo mediante una potente red de transporte p��blico que permitiese una accesibilidad integrada al territorio. El flujo de residencia hacia la periferia, con un modelo ajeno de vivienda unifamiliar y la concentraci��n del empleo en el centro producen desequilibrio territorial. Madrid manifiesta siempre apost�� por la densificaci��n del espacio central urbanizado, produciendo su congesti��n, frente al desarrollo de nuevos suelos que permitieran su expansi��n territorial. Precisa que es necesario preservar los valores de centralidad de Madrid, como generador de riqueza, canalizando toda aquella demanda de centralidad, hacia espacios m��s perif��ricos. El problema de la vivienda no lo ve solo como social, sino como econ��mico, debido a la p��rdida de empleos que supone su paralizaci��n. Observa ya los crecimientos residenciales en el borde de la region por el menor valor del suelo. Plantea como la pol��tica de oferta ha dado lugar a un modelo de crecimiento fragmentado, desequilibrado, desestructurado, con fuertes d��ficits dotacionales y de equipamiento, que inciden en la segregaci��n espacial de las rentas, agravando el proceso de falta de identidad morfol��gica y de desarraigo de los valores urbanos. El plan se��alaba que la presi��n sobre el territorio creaba su densificaci��n por las limitaciones de espacio, Incid��a en limitar el peso de la intervenci��n p��blica, no planteando propuestas de cooperaci��n p��blico-privado. La mayor incoherencia estriba en que los objetivos eran innovadores y coinciden en su mayor��a con las propuestas estudiadas de Londres o Paris, pero se intentan implementar a trav��s de un cambio hacia un modelo reticulado homog��neo, expansivo sobre el territorio, que supone un consumo de suelo y de infraestructuras para solucionar un problema inexistente, la gesti��n de la densidad. Durante las dos ��ltimas d��cadas en ausencia de un plan regional, la postura neoliberal fue la de un exclusivo control de legalidad del planeamiento, los municipios entraron en un proceso de competencia para aprovechar las iniciales ventajas econ��micas de los crecimientos detectados, que proporcionaban una base econ��mica ���s��lida��� a unos municipios con escasos recursos en sus presupuestos municipales. La legislaci��n se modifica a requerimiento de grupos interesados, no existiendo un marco estable. Se pierde la figura del plan no solo a nivel regional, si no en los sectores y el planeamiento municipal donde los municipios tiende a basarse en modificaciones puntuales con la subsiguiente p��rdida del modelo urban��stico. La protecci��n ambiental se estructura mediante un extenso nivel de figuras, con diversidad de competencias que impide su efectiva protecci��n y control. Este proceso produce un despilfarro en la ocupaci��n del suelo, apoyada en las infraestructuras viarias, y un crecimiento disperso y de baja densidad, cada vez m��s perif��rico, produci��ndose una segmentaci��n social por dualizaci��n del espacio en funci��n de niveles de renta. Al amparo del boom inmobiliario, se produce una falta de pol��tica social de vivienda p��blica, m��s basada en la dinamizaci��n del mercado con producci��n de viviendas para rentas medias que en pol��ticas de alquiler para determinados grupos concentr��ndose estas en los barrios desfavorecidos y en la periferia sur. Se produce un incremento de la vivienda unifamiliar, muchas veces amparada en pol��ticas p��blicas, la misma se localiza en el oeste principalmente, en espacios de valor como el entorno del Guadarrama o con viviendas m��s baratas por la popularizaci��n de la tipolog��a en la frontera de la Regi��n. El territorio se especializa a modo de islas monofuncionales, las actividades financieras y de servicios avanzados a las empresas se localizan en el norte y oeste pr��ximo, se pierde actividad industrial que se dispersa m��s al sur, muchas veces fuera de la regi��n. Se incrementan los grandes centros comerciales colgados de las autov��as y sin poblaci��n en su entorno. Todo este proceso ha provocado una p��rdida de utilizaci��n del transporte p��blico y un aumento significativo del uso del veh��culo privado. En la dos ��ltimas d��cadas se ha producido en la regi��n de Madrid desequilibrio territorial y segmentaci��n social, falta de implicaci��n de la sociedad en el territorio, dispersi��n del crecimiento y un incremento de los costes ambientales, sociales y econ��micos, situaci��n, que solo, a trav��s del uso racional del territorio se puede reconducir, apoyado en una planificaci��n integrada sensible y participativa. ABSTRACT In Madrid the model of land occupation in the past two decades has been driven by market supply factors rather than the needs of the population. This results in a consumption of land and resources that leads to unsustainable overexploitation. Addressing this issue must be done through sensitive and participatory integrated planning. Global cities are experiencing rapid and intense change based on the emerging paradigms of globalization, governance, metropolization and the dispersion of activities in the territory. Through this context, a closer look will be taken at the London and Paris plans as well as the tentative plans of Madrid. Globalization causes the loss of state sovereignty and the competitiveness among global cities in Europe; London, Paris and Madrid. These are centres of power, concentration and growth where the duality of space is produced, and where inequality plays a part in urban restructuration. There are concentrated areas of poverty versus areas with a new emerging class where the services sector and information technologies are dominant. The introduction of ICTs contributes to a more homogeneous flow of information leading, us to the concept of governance. Against neoliberal urban development based on free market regulations and efficiency criteria as established by the ���New Public Management���, emerge new ways where society administers itself through voluntary and responsible actions to promote collective interests by recognizing their own identity. A new model of public-private partnerships surfaces that is based on mutual trust, transparency, information and a stable regulatory framework in light of territorial exploitation by the ���extractive society��� that generates corruption. Throughout this process, European metropolitan regions become motors of growth where administrative boundaries are overcome in an ever expanding territory where government is organized through cooperative processes to provide services that protect against regional imbalances. Urban sprawl or low-density development as seen in peripheral shopping centres, the off-shoring of low added-value activities to the periphery, and the concentration of business and top management functions in the centre, leads to a fragmentation of the territory in automobile dependent islands and a process of social exclusion brought on by the disappearance of high incomes. Another effect is the elimination of low income populations from urban centres. In consequence, discontinuous expansions and mono-functional places that lack identity materialize supported by a highway network and high resource consumption. Studying the culture of urban planning in Europe provides better insight into different approaches to spatial planning and the process of convergence between different regions. EU documents are based on the need of competitiveness for European growth and social cohesion. In relation to polycentric development territory they are based on a necessity to solve the dualism between field and city, balanced access to infrastructures, prudent management of nature and solidifying heritage and identity Two levels of study unfold, the first being the current plans of London and ��le-de-France and the second being the evolution of tentative plans for the Madrid region as related to emerging paradigms and how this is reflected in documents. The London Plan is strategic with a long-term vision that focuses on operation, the role of the mayor as a pivotal leader, and the adaptability to changing circumstances brought on by the uncertainties of a global city. Its development is conceived through collaboration and cooperation between governments and stakeholders. The document structure is flexible, providing guidance and indicative guidelines on how to draft local plans so they are not binding, and it contains scarce graphic representation. The Plan of Paris takes on a more physical form and is similar to plans of other European centres. It emphasizes sectors and territories, using extensive information, and is more characteristic of a ���Latin Plan��� as seen in its detailed graphic expression. However, it also contains a strategic vision. Binding in its determinations and policy, it proposes advancement but also prohibition. Both plans address the international competitiveness of urban centres, social equality, inclusion of all social groups and housing as issues of human dignity. London raises governance and cooperation between public and private sector and the need for cooperation with neighbouring regions. In Paris, the relations are more institutionalized highlighting vertical collaboration between administrations. Both propose nodes of densification served by public transportation, soft modes and the use of TOD, the preservation of a hierarchical green infrastructure, and enhancing the landscape in urban peripheries. The tentative territorial plans for the Madrid region provide evidence that they were subject to economic cycles. The first document of master guidelines (1984) does not address either economic or demographic growth in the mid term and therefore does not propose the modification of the radio-concentric model. It is a rigid plan focused on rural and urban recovery and the dimensioning of growth that depends on endowments and infrastructures. It advocates government intervention and promotes small business. The plan emphasizes social imbalance in terms of income, marginalization of certain social groups, the imbalance of residence/employment and excessive density. It stresses the need for social rent housing for the underprivileged, promotes public land, and the supports rail accessibility to the central area. It backs facilities of proximity and small size, enhancing the landscaping of city borders, controlling illegal activities and draws out guidelines for urban planning. The strategies (1989) contain a vision: Changing the territorial model through public intervention by means of projects. They bring to light economic restructuring of territory, the reconversion of the productive apparatus, relocation of low value-added activities, and greater ubiquity of economic activity. They also propose the diffusion of centrality towards southern territories, balancing it with the north in an attempt to reset employment and residence that integrates peripheral economic development both in the periphery and the centre. Transport would consolidate the project, changing the radius-concentric model and facilitating mobility through a commuter and inter-modality network. The plan derives itself from the leadership of the minister and does not integrate sectors such as environment. It also does not incorporate the existence of a written document that monitors performance to evaluate the effects of policies and their contribution to the territorial balance. The Preparatory Document of the Bases, (1995) is more a compendium, or plan of plans, that compiles analysis and proposals from previous documents and sectorial plans from other departments. It has a dual structure: An integrating physical plan covering the sectors and territories that includes the previous strategies while adding some strengths. One such point is the urban discomfort and the rehabilitation of the centre. It also poses the achievement of environmental balance through the growth of existing cities, the territorial linking based on mobility, strengthening new centres, improving the liveability and comprehensive rehabilitation of downtown Madrid, and the modernization of the existing production network. There is no one powerful idea that binds this document. This is due to the recognition of an existing concentrate and congestive model, a dual urban centre, two eastern and southern suburbs suffering from urban decay, and an obsolescent productive north and west whose dispersion threatens the environmental balance. Relevant aspects the document highlights are increasing polarization and social segregation, industrial relocation, the emergence of service activities to centralized companies in metropolitan areas and the dispersion of economic activities in the territory by the trivialization of car use. It proposes making the city from the suburban sprawl and its connection to the metropolitan system through a network of integrated and complementary cities in search of a better balance and territorial solidarity. The Bases of PRET (1997) aims to start the consultation process that must underpin the development of the plan. It stems from a compact and diverse Mediterranean city along with the need for economic activities, services and residences that are close. To resolve the issue, it presents a powerful network of public transport that allows integrated accessibility to the territory. The flow of residence to the periphery based on a foreign model of detached housing and an employment concentration in the centre produces territorial imbalance. Madrid always opted for the densification of the central space, producing its congestion, against the development of new land that would allow its territorial expansion. The document states that the necessity to preserve the values of the housing problem is not only viewed as social, but also economic due to the loss of jobs resulting from their paralysis. It notes the residential growth in the regional border due to the low price of land and argues that the policy of supply has led to a fragmented model of growth that is unbalanced, unstructured, with strong infrastructure and facility deficits that affect the spatial segregation of income and aggravate the lack of morphological identity, uprooting urban values. The pressure on the territory caused its densification due to space limitation; the proposed grid model causes land consumption and infrastructure to solve a non-problem, density. Focusing on limiting the weight of public intervention, it does not raise proposals for public-private cooperation. The biggest discrepancy is that the targets were innovative and mostly align with the proposals in London and Paris. However, it proposes to be implemented through a shift towards a uniform gridded model that is expansive over territory. During the last two decades, due to the absence of a regional plan, a neoliberal stance held exclusive control of the legality of urban planning. The municipalities entered a competition process to take advantage of initial economic benefits of such growth. This provided a ���solid��� economic base for some municipalities with limited resources in their municipal budgets. The law was amended without a legal stable framework at the request of stakeholders. The character of the plan is lost not only regionally, but also in the sectors and municipal planning. This tends to be based on specific changes with the loss of an urban model. Environmental protection is organized through an extensive number of protection figures with diverse competencies that prevent its effective protection. This process squanders the use of the land, backed by increasing road infrastructure, dispersed occupations with low-density growth causing a social segmentation due to space duality based on income levels. During the housing boom, there is a reduction in social public housing policy mostly due to a boost in the market of housing production for average incomes than in rental policies for needy social groups that focus on disadvantaged neighbourhoods and southern suburbs. As a result, there is an increase in single-family housing, often protected by public policy. This is located primarily in the west in areas of high environmental value such as Guadarrama. There is also cheaper housing due to the popularization of typology in the border region. There, territory works as a mono-functional islands. Financial activities and advanced services for companies are located to the north and west where industrial activity is lost as it migrates south, often outside the region. The number of large shopping centres hanging off the highway infrastructure with little to no surrounding population increases. This process leads to the loss of dependency on public transport and a significant increase in the use of private vehicles. The absence of regional planning has produced more imbalance, more social segmentation, more dispersed growth and a lot of environmental, social and economic costs that can only be redirected through rational territorial.

A secreted Salmonella protein with homology to an avirulence determinant of plant pathogenic���bacteria

Bacterial pathogens have evolved sophisticated mechanisms to interact with their hosts. A specialized type III protein secretion system capable of translocating bacterial proteins into host cells has emerged as a central factor in the interaction between a variety of mammalian and plant pathogenic bacteria with their hosts. Here we describe AvrA, a novel target of the centisome 63 type III protein secretion system of Salmonella enterica. AvrA shares sequence similarity with YopJ of the animal pathogen Yersinia pseudotuberculosis and AvrRxv of the plant pathogen Xanthomonas campestris pv. vesicatoria. These proteins are the first examples of putative targets of type III secretion systems in animal and plant pathogenic bacteria that share sequence similarity. They may therefore constitute a novel family of effector proteins with related functions in the cross-talk of these pathogens with their hosts.

Spontaneous Abortions and Shift Work in a Cohort of Nurses in Norway

Background: An association between spontaneous abortions and shift work has been suggested, but present research results are conflicting. The aim of the study is to evaluate the relationship between spontaneous abortions among nurses, shift schedules, and nights worked. Methods: This is a longitudinal study where we identified 914 females from a cohort of nurses in Norway who had worked the same type of shift schedule 2008-2010; either permanent day shift, three-shift rotation or permanent night shift. Information on age, work and life-style factors, as well as spontaneous abortions during lifetime and the past three years (2008-2010) was obtained by annual questionnaires. Results: A higher prevalence of experienced spontaneous abortions before study start (2008) was found among nurses working permanent night shift compared to other nurses. In a linear regression analysis, a risk of 1.3 was found for experienced spontaneous abortions before study start among permanent night shift nurses, with day shift as reference, when adjusting for age, smoking, caffeine and job strain, but the finding was not statistical significant (95 per cent confidence interval 0.8-2.1). Permanent night shift workers had a risk of 1.5 experiencing spontaneous abortions in 2008-2010 compared to day shift nurses, although not statistical significant (95 per cent confidence interval 0.7-3.5). The number of night shifts the past three years was not associated with experiencing spontaneous abortions 2008-2010, but associated with a reduced risk of experiencing spontaneous abortions during lifetime. The results must be interpreted in the light of a possible selection bias; both selections into the occupation of nursing and into the different shift types of the more healthy persons may have occurred in this population. Conclusion: No significant increased risk of spontaneous abortion among permanent night shift nurses compared to day-time nurses was found in this study, and no association was found between spontaneous abortions and the number of worked night shifts.

[Consolidation and reorganization activities, status and results of facilities management pursuant to Executive Order 2003-10] /

Illinois Executive Order 2003-10 authorized the consoldiation of facilities management for agencies, offices, divisions, departments, bureaus, boards and commissions directly responsible to the Governor into the Dept. of Central Management Services (CMS). Facilities management functions include the operation and maintenance of state-owned or state-leased facilties.

Standard Army Financial Inventory Accounting and Reporting System (STARFIARS).

"April 1989"--Pt. 2.

Systemic gene expression in arabidopsis during an incompatible interaction with Alternaria brassicicola

Pathogen challenge can trigger an integrated set of signal transduction pathways, which ultimately leads to a state of high alert, otherwise known as systemic or induced resistance in tissue remote to the initial infection. Although large-scale gene expression during systemic acquired resistance, which is induced by salicylic acid or necrotizing pathogens has been previously reported using a bacterial pathogen, the nature of systemic defense responses triggered by an incompatible necrotrophic fungal pathogen is not known. We examined transcriptional changes that occur during systemic defense responses in Arabidopsis plants inoculated with the incompatible fungal pathogen Alternaria brassicicola. Substantial changes (2.00-fold and statistically significant) were demonstrated in distal tissue of inoculated plants for 35 genes (25 up-regulated and 10 down-regulated), and expression of a selected subset of systemically expressed genes was confirmed using real-time quantitative polymerase chain reaction. Genes with altered expression in distal tissue included those with putative functions in cellular housekeeping, indicating that plants modify these vital processes to facilitate a coordinated response to pathogen attack. Transcriptional up-regulation of genes encoding enzymes functioning in the beta-oxidation pathway of fatty acids was particularly interesting. Transcriptional up-regulation was also observed for genes involved in cell wall synthesis and modification and genes putatively involved in signal transduction. The results of this study, therefore, confirm the notion that distal tissue of a pathogen-challenged plant has a heightened preparedness for subsequent pathogen attacks.

Differences in ethical attitudes between registered nurses and medical students

In this study we compared the ethical attitudes of a group of experienced, predominantly female, registered nurses (n = 67) with those of a group of final year, mixed sex, medical students (n = 125). The purpose was to determine the basis of differences in attitudes that could lead to ethical disagreements between these two groups when they came to work together. A questionnaire developed to explore ethical attitudes was administered and the responses of the two groups were compared using t-tests. Because of the preponderance of females among the nurses an analysis of variance of the gender-adjusted scores for each group was also carried out. On comparing the responses, the nurses differed significantly from the medical students in a number of ethical domains. A potential source of conflict between these two groups is that the nurses were inclined to adopt the perspective of patients but the medical students identified with their profession. When corrected for the effects of gender, the differences persisted, indicating that it was discipline that determined the differences. We recommend that students of nursing and medicine receive ethics education together, and that more open dialogue between doctors and nurses with respect to their different ethical viewpoints is needed in the work setting. This article will be of interest to educators of students of medicine and nursing, as well as to doctors and nurses who are eager to improve their professional relations and thereby improve patient care.

Objectives for multiple-species conservation planning

The first step in conservation planning is to identify objectives. Most stated objectives for conservation, such as to maximize biodiversity outcomes, are too vague to be useful within a decision-making framework. One way to clarify the issue is to define objectives in terms of the risk of extinction for multiple species. Although the assessment of extinction risk for single species is common, few researchers have formulated an objective function that combines the extinction risks of multiple species. We sought to translate the broad goal of maximizing the viability of species into explicit objectives for use in a decision-theoretic approach to conservation planning. We formulated several objective functions based on extinction risk across many species and illustrated the differences between these objectives with simple examples. Each objective function was the mathematical representation of an approach to conservation and emphasized different levels of threat Our objectives included minimizing the joint probability of one or more extinctions, minimizing the expected number of extinctions, and minimizing the increase in risk of extinction from the best-case scenario. With objective functions based on joint probabilities of extinction across species, any correlations in extinction probabilities bad to be known or the resultant decisions were potentially misleading. Additive objectives, such as the expected number of extinctions, did not produce the same anomalies. We demonstrated that the choice of objective function is central to the decision-making process because alternative objective functions can lead to a different ranking of management options. Therefore, decision makers need to think carefully in selecting and defining their conservation goals.

Protein kinases associated with the yeast phosphoproteome

Background: Protein phosphorylation is an extremely important mechanism of cellular regulation. A large-scale study of phosphoproteins in a whole-cell lysate of Saccharomyces cerevisiae has previously identified 383 phosphorylation sites in 216 peptide sequences. However, the protein kinases responsible for the phosphorylation of the identified proteins have not previously been assigned. Results: We used Predikin in combination with other bioinformatic tools, to predict which of 116 unique protein kinases in yeast phosphorylates each experimentally determined site in the phosphoproteome. The prediction was based on the match between the phosphorylated 7-residue sequence and the predicted substrate specificity of each kinase, with the highest weight applied to the residues or positions that contribute most to the substrate specificity. We estimated the reliability of the predictions by performing a parallel prediction on phosphopeptides for which the kinase has been experimentally determined. Conclusion: The results reveal that the functions of the protein kinases and their predicted phosphoprotein substrates are often correlated, for example in endocytosis, cytokinesis, transcription, replication, carbohydrate metabolism and stress response. The predictions link phosphoproteins of unknown function with protein kinases with known functions and vice versa, suggesting functions for the uncharacterized proteins. The study indicates that the phosphoproteins and the associated protein kinases represented in our dataset have housekeeping cellular roles; certain kinases are not represented because they may only be activated during specific cellular responses. Our results demonstrate the utility of our previously reported protein kinase substrate prediction approach (Predikin) as a tool for establishing links between kinases and phosphoproteins that can subsequently be tested experimentally.

Extending a model of shift-work tolerance

The present study contributes to theory and practice through the development of a model of shift-work tolerance with the potential to indicate interventions that reduce nurses' intention toward turnover and increase job satisfaction in hospital-based settings. Survey data from 1257 nurses were used to conduct structural equation modeling that examine the direct and indirect effects of supervisor and colleague support, team identity, team climate, and control over working environment on time-based work/life conflict, psychological well-being, physical symptoms, job satisfaction, and turnover intention. The analysis of the proposed model revealed a good fit The chi-square difference test was non-significant (��2(26)=338.56), the fit indices were high (CFI=.923, NFI=.918, and NNFI=.868), the distribution of residuals was symmetric and approached zero, the average standardized residual was low (AASR=.04), and the standardized RMR was .072. In terms of the predictor variable, the final model explained 48% of the variance in turnover intention. The data revealed considerable evidence of both direct effects on adjustment and complex indirect links between levels of adjustment and work-related social support, team identity, team climate, and control. Nurses with high supervisor and coworker support experienced more positive team climates, identified more strongly with their team, and increased their perceptions of control over their work environment. This in turn lowered their appraisals of their time-based work/life conflict, which consequently increased their psychological well-being and job satisfaction and reduced their physical health symptoms and turnover intention. The type of shift schedule worked by the nurses influenced levels of turnover intention, control over work environment, time-based work/life conflict, and physical symptoms.

Brilliant mistake! Essays on incidents of management mistakes and mea culpa

Purpose ��� The purpose of this paper is to examine students��� perceptions of managerial mistakes and why (and why not) managers admit mistakes. Design/methodology/approach ��� This paper provides a reflective account of how students��� perceive management mistakes and deal with admitting ���mea culpa��� ��� ���I am to blame���. Findings ��� The findings show a range of attitudes: they highlight the intermingling pressures associated with the cultural environment and mistakes; they identify media characteristics and its influences on mistakes and mea culpa; they highlight ceremonial processes and tasks that shape and influence the declaration of mea culpa; and they identify how the psychology and sociology of mistakes confronts and affects students. Taken together, the study highlights the varying degrees of wariness that is carried forward by the students from vicariously learning about management mistakes. Originality/value ��� This paper links up with recent discussions on retail failure and retail pedagogy. It is hoped that this paper will encourage more academics to address, and engage with, management mistakes creatively in their teaching.