C-Jun N-terminal kinase (JNK) isoforms play differing roles in otitis media

BACKGROUND: Innate immunity and tissue proliferation play important roles in otitis media (OM), the most common disease of childhood. CJUN terminal kinase (JNK) is potentially involved in both processes. RESULTS: Genes involved in both innate immune and growth factor activation of JNK are upregulated during OM, while expression of both positive and negative JNK regulatory genes is altered. When compared to wildtypes (WTs), C57BL/6 mice deficient in JNK1 exhibit enhanced mucosal thickening, with delayed recovery, enhanced neutrophil recruitment early in OM, and delayed bacterial clearance. In contrast, JNK2(−/−) mice exhibit delayed mucosal hyperplasia that eventually exceeds that of WTs and is slow to recover, delayed recruitment of neutrophils, and failure of bacterial clearance. CONCLUSIONS: The results suggest that JNK1 and JNK2 play primarily opposing roles in mucosal hyperplasia and neutrophil recruitment early in OM. However, both isoforms are required for the normal resolution of middle ear infection. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12865-014-0046-z) contains supplementary material, which is available to authorized users

Psychosocial stress at work and perceived quality of care among clinicians in surgery

Abstract Background Little is known about the association between job stress and job performance among surgeons, although physicians' well-being could be regarded as an important quality indicator. This paper examines associations between psychosocial job stress and perceived health care quality among German clinicians in surgery. Methods Survey data of 1,311 surgeons from 489 hospitals were analysed. Psychosocial stress at work was measured by the effort-reward imbalance model (ERI) and the demand-control model (job strain). The quality of health care was evaluated by physicians' self-assessed performance, service quality and error frequency. Data were collected in a nationwide standardised mail survey. 53% of the contacted hospitals sent back the questionnaire; the response rate of the clinicians in the participating hospitals was about 65%. To estimate the association between job stress and quality of care multiple logistic regression analyses were conducted. Results Clinicians exposed to job stress have an increased risk of reporting suboptimal quality of care. Magnitude of the association varies depending on the respective job stress model and the indicator of health care quality used. Odds ratios, adjusted for gender, occupational position and job experience vary between 1.04 (CI 0.70-1.57) and 3.21 (CI 2.23-4.61). Conclusion Findings indicate that theoretical models of psychosocial stress at work can enrich the analysis of effects of working conditions on health care quality. Moreover, results suggest interventions for job related health promotion measures to improve the clinicians' working conditions, their quality of care and their patients' health.</p

The pre-history of health psychology in the UK: From natural science and psychoanalysis to social science, social cognition and beyond

Health psychology formally came of age in the United Kingdom in the 1980s, but it was prefigured by much discussion about challenges to the dominance of biomedicine in healthcare and debates. This articles focuses on what could be termed the pre-history of health psychology in the UK. This was the period in the earlier 20th century when psychological approaches were dominated by psychoanalysis which was followed by behaviourism and then cognitivism. Review of this pre-history provides the backdrop for the rise of health psychology in the UK and also reveals the tensions between the different theoretical perspectives

The role of health literacy in explaining the association between educational attainment and the use of out-of-hours primary care services in chronically ill people: a survey study

Abstract Background Low socioeconomic status (SES) is persistently associated with poor health and suboptimal use of healthcare services, and more unplanned healthcare use. Suboptimal use of emergency and acute healthcare services may increase health inequalities, due to late diagnosis or lack of continuity of care. Given that health literacy has been associated with healthcare utilisation and with education attainment, we sought to explore whether health literacy is related to the use of out-of-hours (OOH) Primary Care Services (PCSs). Additionally, we aimed to study whether and to what extent health literacy accounts for some of the association between education and OOH PSC use. Methods A survey including measures of education attainment, health literacy (assessed by means of the Dutch version of the nine-dimension Health Literacy Questionnaire) and use of PCS was conducted among a sample of adults diagnosed with (any) somatic chronic condition in the Netherlands (response 76.3%, n = 1811). We conducted linear and logistic regression analyses to examine associations between education level and PCS use in the past year. We performed mediation analyses to assess whether the association between education and PCS use was (partly) explained by different aspects of health literacy. We adjusted the models for patient characteristics such as age and morbidity. Results Higher education attainment was associated with higher scores on the health literacy aspects Appraisal of health information, and Navigating the healthcare system. Additionally, appraisal and navigating the healthcare system partially accounted for educational differences in PCS use. Finally, higher appraisal of health information scores were associated with higher PCS utilisation. Conclusion Several aspects of health literacy were demonstrated to relate to PCS use, and partly accounted for educational differences herein. Accordingly, developing health literacy within individuals or communities may help to reduce inappropriate PCS use among people with low education

Finding space for flowing water in Japan's densely populated landscapes

With its rapidly flowing rivers and plentiful summer rainfall, 20th-century Japan has a history of frequent flooding. The effects on its densely populated flood plains have often been devastating. Japan also has one of the world's landscapes most heavily covered in concrete. In recent decades, however, the Japanese state has turned hesitantly to new techniques of releasing of water into the sea buttressed by a concern for ecological well-being. Its 'nature-oriented' river landscaping programme is an attempt to find a more sustainable balance between flowing water and the built terrain, allowing water to make space for itself. Our paper sets this programme in its historical context, relating it back to the premodern period and juxtaposing it to prevalent modernist 20th-century practice. Throughout this paper, we focus on the interweaving of discourse and practice, drawing attention to the 'idiom' of river landscaping as well as to the role of the state in defining this idiom. We argue that a sort of reconciliation is occurring between the contrasting discourses and practices of 'hard' and 'green' engineers

A Neo-Meadian approach to human agency: relating the social and the psychological in the ontogenesis of perspective-coordinating persons

How can human agency be reconciled with bio-physical determinism? Starting with a discussion of the long standing debate between determinism and agency, we argue that the seeds of a reconciliation can be found in George Herbert Mead’s ideas concerning social acts, perspectives, differentiation, self-other interactivity, and conscious understanding. Drawing on more recent reformulations of Mead’s ideas, we present an integrated account of the ontogenesis of human agency. Human agency, we argue, should be conceptualized in terms of distanciation from immediate experience, and we show how social interactions, institutions and symbolic resources foster the development of agency in increasingly complex ways. We conclude by situating our work in relation to other developmental accounts and the larger project of theorizing and empirically supporting a compatibilist rendering of human agency as the “determined” self-determination of persons