Expanded Knowledge Research Articles

Immunomodulatory interplay of the microbiome and therapy of rheumatic diseases

ABSTRACTModulation of the immune system by microbes, especially from the gastrointestinal tract, is increasingly considered a key factor in the onset, course and outcome of rheumatic diseases. The interplay of the microbiome, along with genetic predisposition and environmental exposure, is thought to be an important trigger for rheumatic diseases. Improved identification of the relationship of disease-specific genetic alterations and rheumatic diseases has potential diagnostic and therapeutic applications. Treatment of rheumatic disorders is influenced by microbial actions but this interplay can be challenging due to variable and unpredictable responses to therapies. Expanded knowledge of the microbiome now allows clinicians to more precisely select ideal medication regimens and to predict response to and toxicity from drugs. Rheumatic diseases and associated therapies were among the earliest microbiome interactions investigated, yet it is notable that current research is focused on clinical and immunological associations but, in comparison, a limited number of studies regarding the microbiome’s impact on treatment for rheumatic diseases have been published. In the coming years, further knowledge of immunomodulating interactions between the microbiome and the immune system will aid our understanding of autoimmunity and will be increasingly important in selection of therapeutic agents for patients with autoimmune and rheumatic diseases. In this review, recent literature regarding the bidirectional immunomodulatory effects of the microbiome with rheumatic diseases and current understanding and gaps regarding the drug–microbiome interface in the management of these disorders is presented.

Project Activities and Encouraging Critical Thinking: Exploring Teachers’ Attitudes

The contemporary education process frequently emphasises the importance of teaching and learning by focusing teaching activities towards research and collaborative work, the encouragement of critical thinking, the creative and productive application of knowledge, an active approach to the teaching content, and solving specific problems in project activities. A survey was conducted on a sample of 220 elementary school teachers from three counties in Croatia (Primorje-Gorski Kotar, Lika-Senj, and Istria) regarding the frequency of implementing project activities that encourage critical thinking in pupils. The objectives of the research were to determine the regularity of implementing project activities at the class level and at the level of the entire school, and to examine possible differences between teachers who estimated regular implementation of project activities in their schools and those who estimated the levels of irregular implementation of project activities, in the application of contemporary work strategies, as well as in the attitudes on the contemporary paradigm of childhood and the education process. The research results showed that the majority of teachers estimated that project activities were carried out regularly at their school (66.5% on a class level and65% on a school level). Teachers who reported the regular implementation of project activities at the class level and at the school level more frequently applied contemporary work strategies and techniques of critical thinking than their colleagues did. The research results also indicated that those teachers more frequently use established approaches to the educational process (teacher should explain, exhibit facts, and point out important conclusions) than their colleagues do. There were no statistically significant differences in contemporary attitudes between the two groups of teachers. Since the objective behind the implementation of project activities was to create the knowledge that, in the creative act, boundaries of the known or tried are transcended in the direction of new and expanded knowledge, importance should be given to the role of teachers in promoting the development of critical thinking and guiding pupils to explore and discover new knowledge.

Quality of life in anxious adolescents

PurposeTo examine associations between health-related quality of life (HRQoL) and anxiety symptoms across anxiety domains (obsessions/compulsions, social anxiety, panic disorder, agoraphobia, separation anxiety, physical injury fears, generalised anxiety, and posttraumatic stress) in a general adolescent population. Expanded knowledge about these associations can provide valuable information for improving interventions and prevention strategies for adolescent anxiety.MethodsCross-sectional data about anxiety were collected via a school survey from a community sample of Norwegian adolescents aged 12–17 (N = 1719). Based on scores from the Spence Children’s Anxiety Scale (SCAS), each adolescent was categorized as reporting a low, medium, or high level of anxiety. Each adolescent’s HRQoL was then measured using the Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents Revised Version (KINDL-R). Hierarchical regression analyses were performed to determine any relationship between anxiety symptoms and HRQoL.ResultsAcross domains of anxiety, anxiety symptoms were inversely associated with overall HRQoL. All HRQoL-dimensions were inversely associated with overall level of anxiety symptoms. In adolescents with medium and high anxiety symptoms, poor HRQoL was documented in all HRQoL dimensions with the exception of the family dimension.ConclusionsThe strong association between elevated levels of anxiety symptoms and poor HRQoL demonstrate the importance of improved mental health interventions and prevention initiatives targeting anxious adolescents.

Community Education of Personalized Breast Cancer Therapy Utilizing Students of HealthCare Professions

<i>Introduction:</i> Health literacy is a growing problem that can further lead to altered decision making, an amplified variety of health conditions, and decreased survival rates. This study demonstrates that by providing brief, educational seminars to medically underserved members of local communities, we could improve patients’ basic knowledge of breast cancer and explain specific treatment options that are available. Through this expanded knowledge, it is expected that patients will take a more active role in their own healthcare. <i>Methods:</i> The study began by developing a PowerPoint; based on a fifth grade reading level so all levels of education could be involved and understand how to respond. Topics such as breast cancer statistics, incidence rates, screening, risk factors, signs and symptoms, genetic testing and markers, and treatment were combined in order to give a diversity of subjects patients would benefit from in regards to breast cancer. Once created, pharmacy students reached out to local underserved communities to raise awareness about breast cancer and the many options patients have. Patients were given a pre-presentation survey in order to assess their basic knowledge of breast cancer. The survey consisted of a one (strongly disagree) to five (strongly agree) key to measure the patients understanding of various topics related to breast cancer. After the pre-presentation survey was completed, an educational breast cancer PowerPoint was presented. Questions were then asked and a post-survey (with the same questions as the pre-survey) was given in order to determine whether the presentation met its primary goal of elevating patient’s awareness of breast cancer. <i>Results:</i> Whether breast cancer naïve or a survivor, the majority of the patients present reported expanded knowledge of breast cancer and felt that they were more confident in taking initiative in their healthcare. With an alpha level set at 0.05, all of the questions showed statistical significance. Three key elements that showed the greatest improvement of gained knowledge involved the causes of breast cancer (pre-score 2.9- post-score 4.6 (standard deviation 1.69)), signs and symptoms of breast cancer (pre-score 3.5-post-score 4.5 (standard deviation 0.96)), and treatment options available to the public (pre-score 3.3-post-score 4.6 (standard deviation 1.31)). This suggests that at baseline, the patients were comparatively less aware and educated on breast cancer then after the presentation, when the post-survey was given. By presenting the material with a pre- and post-presentation survey, this enables the amount of knowledge gained by participants to be measured, and helps shape future presentations to guarantee maximum awareness to the patients attending. <i>Conclusion:</i> By this study, it can be concluded that pharmacists play a vital role in increasing health literacy and perhaps a subsequent improvement in survival rates by promoting breast cancer education and community outreach. By utilizing pharmacy students as presenters, this enables patients to have their medication questions answered, but also provides a platform for furthering pharmacy student’s education and skills as they develop into healthcare providers. The students also serve as a reminder that pharmacists are the most accessible healthcare provider, and a valuable resource for medical information and referrals.

Development of Knowledge-Expandable Ontology-Based Expert System for Process Planning in Cold Forging of Flange Nuts

Abstract This paper proposed a new method of constructing an ontology-based expert system with an expandable knowledge base for process planning in cold forging of flange nuts. There are two essential parts of this method. In the first part, the software Protege is used for expressing the experiential knowledge as a Web Ontology Language (OWL) ontology and Semantic Web Rule Language (SWRL) rules. The inference is executed in Java by means of the API provided by Jess, the rule engine for the Java platform. In the second part, new knowledge is acquired from parameter optimisation experiments, combing process simulation and Taguchi methods. Deform-3D was adopted as the process simulation engine. Then the tool wear of front punch at the 4th stage was predicted for the tool life evaluation. A modified Archard wear model is used for tool wear prediction during the simulation. On the other hand, Taguchi methods is used for designing an optimal tool which makes the tool life longer than that of the existing design. The novelty of the proposed system is that the new knowledge is represented as an OWL ontology and SWRL rules, which makes the knowledge base of the system expandable. The knowledge base can thus be expanded if there are modifications or new knowledge. The system is capable of inferring a workable forging process for flange nuts. It could recommend dimensions of tools after the necessary information, such as the nominal size and specifications of the product, has been input. Users are able to reduce tool design time by taking the results from the system as a process planning decision support. In this way, when the manufacturer gets a new quotation from the client, engineers can search from the company tooling database for feasible forging tools and make the cost estimation based on the forging process plan generated by this system.

Exploring partners' perspectives on participation in heart failure home care: a mixed-method design.

To describe the partners' perspectives on participation in the care for patients with heart failure receiving home care. Partners are often involved in care of patients with heart failure and have an important role in improving patients' well-being and self-care. Partners have described both negative and positive experiences of involvement, but knowledge of how partners of patients with heart failure view participation in care when the patient receives home care is lacking. A convergent parallel mixed-method design was used, including data from interviews and questionnaires. A purposeful sample of 15 partners was used. Data collection lasted between February 2010 - December 2011. Interviews were analysed with content analysis and data from questionnaires (participation, caregiving, health-related quality of life, depressive symptoms) were analysed statistically. Finally, results were merged, interpreted and labelled as comparable and convergent or as being inconsistent. Partners were satisfied with most aspects of participation, information and contact. Qualitative findings revealed four different aspects of participation: adapting to the caring needs and illness trajectory, coping with caregiving demands, interacting with healthcare providers and need for knowledge to comprehend the health situation. Results showed confirmatory results that were convergent and expanded knowledge that gave a broader understanding of partner participation in this context. The results revealed different levels of partner participation. Heart failure home care included good opportunities for both participation and contact during home visits, necessary to meet partners' ongoing need for information to comprehend the situation.

ΔNp63α and microRNAs: leveraging the epithelial-mesenchymal transition.

The epithelial-mesenchymal transition (EMT) is a cellular reprogramming mechanism that is an underlying cause of cancer metastasis. Recent investigations have uncovered an intricate network of regulation involving the TGFβ Wnt, and Notch signaling pathways and small regulatory RNA species called microRNAs (miRNAs). The activity of a transcription factor vital to the maintenance of epithelial stemness, ?Np63a, has been shown to modulate the activity of these EMT pathways to either repress or promote EMT. Furthermore, ?Np63a is a known regulator of miRNA, including those directly involved in EMT. This review discusses the evidence of ?Np63a as a master regulator of EMT components and miRNA, highlighting the need for a deeper understanding of its role in EMT. This expanded knowledge may provide a basis for new developments in the diagnosis and treatment of metastatic cancer.

Developing a concept for external audits of psychosocial risks in certified occupational health and safety management systems

Psychosocial risks are closely related to work organization, management and organizational context. Therefore, the nature of psychosocial risks is complex and differs from more traditional OHS risks. The OHSAS 18001 standard explicitly claims to deal with all OHS risks, including psychosocial risks, and the audit is a key element in OHS management systems. However, the literature indicates that audits of psychosocial risk management are difficult and multifaceted, and the available practice excludes psychosocial risks from audits. Based on an analysis of the literature and available methodological approaches, we propose a new conceptual model for audits of psychosocial risk management. The model is grounded in the British “Guidance on the management of psychosocial risks in the workplace” (BSI, 2011), which has recently been developed to remedy the shortcomings of the OHSAS standard. The model builds on an interpretation of audit evidence that includes an integration of general scientific knowledge regarding psychosocial risks with local contextual knowledge. A key tool for the application of the integration is realistic evaluation, which provides the opportunity to assess the link between psychosocial risk management measures and expected outcomes. Another important tool is the qualitative interview, which is the primary method for data collection. The concept has important implications for the dominant audit practice and auditor competencies. It leads to an expanded knowledge base and a broader concept of audit evidence that further presupposes considerable auditor resources, and changes the required knowledge base and skills of auditors.

Characterization of biofuel refinery byproduct via selective electrospray ionization tandem mass spectrometry

To achieve economic viability, biorefineries need to increase efficiency through characterization of byproducts for the purpose of valorization. One such byproduct is the liquid stream produced after autohydrolysis pretreatment, autohydrolyzate liquor, which contains valuable organic derivatives of hemicellulose and lignin from biomass. To characterize the autohydrolysis liquor, we employed a novel method for such liquor analysis that uses electrospray ionization and ion dopants in combination with tandem mass spectrometry using a quadrupole–time-of-flight mass spectrometer. Electrospray expands current analysis of such liquors through softer ionization. Ion dopants provide for differentiation of the complex mixture components without requiring derivatization or preliminary separation. The dopants—ammonium chloride and sodium hydroxide—primarily target and enhance ionization of hemicellulosic or lignin derivative species, respectively, based on the species’ differing functionalities. Valuable structural information can be gleaned from these enhanced species by ion isolation and collision-activated dissociation (CAD), which reveals the presence of hemicellulosic or lignin derivative functionalities. These ionization techniques coupled with CAD enabled us to not only confirm the presence of low molecular weight ions, such as vanillin, as previously seen with gas chromatography-mass spectrometry but also expand the characterization to high molecular weight species. This expanded knowledge of the composition of autohydrolyzate liquor opens up the potential to develop lucrative co-products from this stream in a commercial biorefinery.

Body Language

Name: Charlotte Houberg Main Subject: Classical Singing Research Supervisor: Gerda van Zelm Title of Research: Body language of a singer on stage Research Question: How can a singer on stage use his body language to support his expression? Summary of Results: By the use of different research methods, there have been created ideas and strategies to become aware of your body language and how to use it in a confident way on stage. Body language is, next to singing, an equally important communication tool for singers on stage. It shows knowledge of the movements of the body and understanding of the role or character. The libretto can be translated into body language, so the audience can understand it without knowing exactly what text is sung. It can be concluded that all body parts can be chosen to show a certain mood which fits within the role or character. Gestures do not have to be over- exaggerated, because the audience is able to see and interpret small signs, even from a distance. Consciously chosen body language is easier to decode than spontaneous body language and can be more convincing, even though the singer is not in that certain mood. Body language is part of the luggage of a singer and a tool for showing his expression and intentions. I chose for the form of a research paper, because I would like to share new or expanded knowledge with my colleagues by doing an in-depth research. Biography: Charlotte (1991) takes part in Studio 32, an opera studio of her teacher Henny Diemer. She sang the roles Amor (Cadmus et Hermione), Zerlina (Don Giovanni) and Bess (Porgy and Bess). She had a tour with Sinfonia Rotterdam and sang solo with several Dutch orchestras. In Jordan she performed Miroir de Peine of Andriessen with the Amman Orchestra. She has been invited for chamber concerts and has given song recitals on several stages of the Netherlands. From the oratorio repertoire she sings regularly the Matthew Passion (Bach) and the requiem (Fauré and Mozart). She will sing the role First Witch in the new opera of Andriessen (The Theatre of the World) in LA and Amsterdam.

Cancer Vaccines: Past, Present, and Future.

Cancer is a common and potentially deadly disease. Some of the cancers may be difficult to treat by conventional means such as surgery, radiation, and chemotherapy, but may be controlled by the stimulation of the immune response of the body with the help of cancer vaccines. The use of vaccines for preventing infections by oncogenic viruses such as hepatitis B virus and human papilloma virus has been extremely successful in reducing the incidence of cancers resulting from these infections. The use of vaccines for treating cancers that are not due to viral infections and that are already established is currently the object of numerous clinical trials. Several types of cancer vaccines are being tried. These include antigen vaccines, tumor cell vaccines, dendritic vaccines, deoxyribonucleic acid vaccines, and viral vector vaccines. The development of these therapeutic vaccines is proving difficult with only 1 recent success. However, there is significant enthusiasm and optimism regarding the development of effective therapeutic vaccines stemming from the fact that our understanding regarding the cancer immunology is considerably enhanced in recent years. This expanded knowledge regarding the mechanisms that cancers use to escape the immune system is likely to open new avenues in modulating the immune response to cancer, thus enhancing the effectiveness of therapeutic cancer vaccines.

IL-17A negatively regulates lymphatic vessel formation

Abstract Lymphatic vessels (LVs), well-known conduits of immune cells, enable antigen presenting cells (APCs) to enter draining lymph node resulting in the induction of adaptive immune responses against various antigens. During inflammation, LVs are increased and enlarged by the effect of pro-lymphangiogenic factors including vascular endothelial growth factor -A, C, and D secreted by APCs and stromal cells, and facilitate the migration of activated immune cells. However, after antigen clearance, these expanded LVs should be shrunk similar to apoptotic cell death of activated immune cells to maintain homeostasis. It is known that, failure of inflammation resolution causes chronic inflammation in many diseases. Chronic inflammation often accompanies increased LVs which enable continuous antigen delivery and immune cell trafficking from infection sites to draining lymph node. Previously, it was discovered that several cytokines secreted by type 1 and 2 helper T (Th) cells inhibit lymphangiogenesis during resolution phase but less is known about the effect of Th17 cytokines. Here, we show that interleukin-17A (IL-17A) secreted from Th17 cells is a putative negative regulator of lymphangiogenesis in Th17-mediated immune responses, especially during resolution phase. IL-17A suppressed gene expression of lymphatic specific markers in lymphatic endothelial cells. Also, we utilized cholera toxin mixed with chicken egg ovalbumin peptide (CTO) challenge model which induces Th17 dominant inflammation to examine the in vivo effect of IL-17A. Blockade of IL-17A increased LVs and enhanced their function. Thus, this study will provide expanded knowledge on unidentified role of IL-17A as a negative regulator of lymphangiogenesis.

The association between preoperative mental distress and patient-reported outcome measures in patients treated surgically for cervical radiculopathy

Background ContextPrevious research indicates that there might exist a link between the experience of pain and mental distress. Pain can possibly trigger anxiety and chronic pain, as well as also depression. On the other hand, anxiety and depression might also be risk factors for painful conditions and more pronounced subsequent disability and thus, the pathways may be bidirectional. Expanded knowledge of how different factors affect pain and function may help surgeons in preoperative decision-making. PurposeThe aim of this study was to evaluate the impact of potential preoperative risk factors with special reference to mental distress. Study Design/SettingThis is a prospective outcome study in a cohort from a multicenter randomized controlled trial comparing anterior cervical decompression and fusion with disc replacement. Patient SampleThe sample included 151 patients with cervical radiculopathy planned for surgery. Outcome MeasuresSurgical outcome was evaluated with Neck Disability Index (NDI), health related quality-of-life with European Quality of Life-5 Dimensions, and pain with visual analogue scale for arm and neck. Mental distress was preoperatively measured with the Hospital Anxiety and Depression (HAD) scale. MethodsPreoperative data regarding possible risk factors for poor outcome were analyzed in multiple linear regression models with postoperative NDI and change of NDI as dependent factors. Patients with high preoperative levels of anxiety or depression (H-HAD), indicating mental distress, were compared with patients scoring low/moderate levels (L-HAD) regarding patient-reported outcome measures (PROMs) preoperatively and at 1- and 2-year follow-up. ResultsOutcome data were available for 136 patients at the 2-year follow-up. No statistically significant difference in any outcome data could be demonstrated between the two surgical treatment groups. Mental distress was the variable most strongly associated with NDI at 2 years in the regression analysis. There were 42 patients classified as H-HAD and 94 as L-HAD. The average improvement in NDI was 16.9 in the H-HAD group and 26.3 in the L-HAD group, p=.02. The H-HAD patients showed a tendency for poorer baseline data and worse outcome overall in all PROMs at follow-up at both 1 and 2 years. ConclusionsPreoperative mental distress measured with HAD was associated with worse outcome overall. More research is needed to investigate whether patients with mental distress may achieve better results if other treatments are offered, either as non-surgical treatment alone or as an adjunct to surgery.

Are the Current Changes Good or Bad for Chemistry?

"… The key discoveries on which many commercial products are ultimately based are often the result of fundamental research performed with no (commercial) end-use even contemplated. It is remarkable that the idea of supporting truly fundamental research is under assault to varying degrees worldwide. Humankind will benefit from an environment where the emergence of completely new ideas is encouraged …" Read more in the Editorial by Ian Manners.

Rejection of organic micro-pollutants from water by a tubular, hydrophilic pervaporative membrane designed for irrigation applications

ABSTRACTThe links between chemical properties, including those relating to molecular size, solubility, hydrophobicity and vapour pressure, and rejection of model aromatic micro-pollutants by a tubular, hydrophilic polymer pervaporation membrane designed for irrigation applications were investigated. Open air experiments were conducted at room temperature for individual solutions of fluorene, naphthalene, phenol, 1,2-dichlorobenzene, 1,2-diethylbenzene and 2-phenoxyethanol. Percentage rejection generally increased with increased molecular size for the model micro-pollutants (47–86%). Molecular weight and log Kow had the strongest positive relationships with rejection, as demonstrated by respective correlation coefficients of r = 0.898 and 0.824. Rejection was also strongly negatively correlated with aqueous solubility and H-bond δ. However, properties which relate to vapour phase concentrations of the micro-pollutants were not well correlated with rejection. Thus, physicochemical separation processes, rather than vapour pressure, drive removal of aromatic contaminants by the investigated pervaporation tube. This expanded knowledge could be utilized in considering practical applications of pervaporative irrigation systems for treating organic-contaminated waters such as oilfield-produced waters.

The old age health security in rural China: where to go?

IntroductionThe huge number of rural elders and the deepening health problems (e.g. growing threats of infectious diseases and chronic diseases etc.) place enormous pressure on old age health security in rural China. This study aims to provide information for policy-makers to develop effective measures for promoting rural elders’ health care service access by examining the current developments and challenges confronted by the old age health security in rural China.MethodsSearch resources are electronic databases, web pages of the National Bureau of Statistics of China and the National Health and Family Planning Commission of China on the internet, China Population and Employment Statistics Yearbook, China Civil Affairs’ Statistical Yearbook and China Health Statistics Yearbooks etc. Articles were identified from Elsevier, Wiley, EBSCO, EMBASE, PubMed, SCI Expanded, ProQuest, and National Knowledge Infrastructure of China (CNKI) which is the most informative database in Chinese. Search terms were “rural”, “China”, “health security”, “cooperative medical scheme”, “social medical assistance”, “medical insurance” or “community based medical insurance”, “old”, or “elder”, “elderly”, or “aged”, “aging”. Google scholar was searched with the same combination of keywords.ResultsThe results showed that old age health security in rural China had expanded to all rural elders and substantially improved health care service utilization among rural elders. Increasing chronic disease prevalence rates, pressing public health issues, inefficient rural health care service provision system and lack of sufficient financing challenged the old age health security in rural China.ConclusionsIncreasing funds from the central and regional governments for old age health security in rural China will contribute to reducing urban–rural disparities in provision of old age health security and increasing health equity among rural elders between different regions. Meanwhile, initiating provider payment reform may contribute to improving the efficiency of rural health care service provision system and promoting health care service access among rural elders.

Expanded Knowledge Production in an Amorphous Field: The “Case” of the Comparative Education Review’s Yearly Bibliography

Previous articleNext article No AccessEditorialExpanded Knowledge Production in an Amorphous Field: The “Case” of the Comparative Education Review’s Yearly BibliographyBjorn H. NordtveitBjorn H. Nordtveit Search for more articles by this author PDFPDF PLUSFull Text Add to favoritesDownload CitationTrack CitationsPermissionsReprints Share onFacebookTwitterLinkedInRedditEmail SectionsMoreDetailsFiguresReferencesCited by Comparative Education Review Volume 59, Number 4November 2015 Sponsored by the Comparative and International Education Society Article DOIhttps://doi.org/10.1086/683109 Views: 71Total views on this site Citations: 1Citations are reported from Crossref © 2015 by the Comparative and International Education Society. All rights reserved.PDF download Crossref reports the following articles citing this article:Peter B. Easton Closing the Shop: A Retrospective on Comparative Education Review Bibliographies, 1959–2015, Comparative Education Review 61, no.22 (Mar 2017): 413–424.https://doi.org/10.1086/691156

Participatory approach to the development of a knowledge base for problem-solving in diabetes self-management

ObjectiveTo develop an expandable knowledge base of reusable knowledge related to self-management of diabetes that can be used as a foundation for patient-centric decision support tools. Materials and methodsThe structure and components of the knowledge base were created in participatory design with academic diabetes educators using knowledge acquisition methods. The knowledge base was validated using scenario-based approach with practicing diabetes educators and individuals with diabetes recruited from Community Health Centers (CHCs) serving economically disadvantaged communities and ethnic minorities in New York. ResultsThe knowledge base includes eight glycemic control problems, over 150 behaviors known to contribute to these problems coupled with contextual explanations, and over 200 specific action-oriented self-management goals for correcting problematic behaviors, with corresponding motivational messages. The validation of the knowledge base suggested high level of completeness and accuracy, and identified improvements in cultural appropriateness. These were addressed in new iterations of the knowledge base. DiscussionThe resulting knowledge base is theoretically grounded, incorporates practical and evidence-based knowledge used by diabetes educators in practice settings, and allows for personally meaningful choices by individuals with diabetes. Participatory design approach helped researchers to capture implicit knowledge of practicing diabetes educators and make it explicit and reusable. ConclusionThe knowledge base proposed here is an important step towards development of new generation patient-centric decision support tools for facilitating chronic disease self-management. While this knowledge base specifically targets diabetes, its overall structure and composition can be generalized to other chronic conditions.

Systematic review and meta-analysis of the efficacy and safety of therapy with linezolid containing regimens in the treatment of multidrug-resistant and extensively drug-resistant tuberculosis.

Linezolid containing regimens have been proposed as potentially valuable alternatives for the treatment of patients with multidrug-resistant tuberculosis (MDR-TB) or extensively drug-resistant TB (XDR-TB). A systematic review and meta-analysis was conducted to assess the efficacy, safety and tolerability of linezolid for drug-resistant TB (DR-TB) treatment. We searched the Cochrane Controlled Trial Registry, PubMed, Embase, Science Citation Index Expanded (SCI) and China National Knowledge Infrastructure (CNKI), database up to May 2014 to identify studies providing data of the use of linezolid for the treatment of DR-TB. The search yielded 15 studies (367 patients) including one randomized controlled trial (RCT), covering 239 patients who could be evaluated for effectiveness; 83% [95% confidence interval (CI), 75-90%; I(2)=62.8%] had a favorable outcome, defined as either cure or treatment completion. The pooled rate of culture conversion was 89% (95% CI, 83-95%; I(2)=49.6%). Between the group receiving daily linezolid doses of ≤600 or >600 mg, the mortality was considerably lower in patients treated with less than 600 mg/day (P value <0.001). Of 367 patients for whom data on safety was available, peripheral neuropathy (31%, 95% CI, 19-42%; I(2)=81.7%) and anemia (25%, 95% CI, 15-34%; I(2)=76.6%) were the main adverse effects. Patients receiving less than 600 mg/day were more likely to experience nervous system adverse events (P value <0.01). The available evidence suggests that linezolid could be considered as a promising option as treatment of MDR/XDR TB. Randomized trials are warranted to define the dose and frequency of administration.

Information behaviors in value adding of farmers’ production and marketing in Thailand

Purpose – The purpose of this paper was to study the information behavior of farmers regarding value adding in production and marketing. This paper is a component of a larger and more comprehensive research study of farmers and their behavior regarding the acquisition and use of information. Design/methodology/approach – This research was qualitative and based on the Grounded Theory. In-depth interviews, observations and field survey recordings were conducted to collect data. Pan Tae Sub-district, Khuan Khanun District, Phatthalung Province, Thailand was selected as the research field site. The sample consisted of 14 key informants selected by the theoretical sampling technique. These informants were successful in value adding to their production and marketing process. Findings – Farmers require information because of problems associated with low product prices and being taken advantage of by middlemen. Farmers’ information-seeking behavior includes: transfer of information from governmental academic officers and community leaders, exchanges of information among community farmers and training/study trips. Farmers use information in brand building, product differentiation and development of product quality, all with the main objective of increasing income. Originality/value – Information behaviors of farmers were theoretically summarized from farmers’ development in their social and farming context. The new and expanded knowledge obtained from a Thai context will be useful for the science and profession of library and information science. This information will also improve methods of communicating valuable information to farmers, thereby improving productivity and quality of life.