Ruminants are recognised to suffer from Cu-responsive disorders. Present understanding of Cu transport and metabolism is limited and inconsistent across vets and veterinary professionals. There has been much progress from the studies of the 1980s and early 1990s in cellular Cu transport and liver metabolism which has not been translated into agricultural practice. Cu metabolism operates in regulated pathways of Cu trafficking rather than in pools of Cu lability. Cu in the cell is chaperoned to enzyme production, retention within metallothionein or excretion via the Golgi into the blood. The hepatocyte differs in that Cu-containing caeruloplasmin can be synthesised to provide systemic Cu supply and excess Cu is excreted via bile. The aim of the present review is to improve understanding and highlight the relevant progress in relation to ruminants through the translation of newer findings from medicine and non-ruminant animal models into ruminants.

The objectives of this paper are to: (1) identify contextual factors such as policy that impacted the implementation of community-based primary health care (CBPHC) innovations among 12 Canadian research teams and (2) describe strategies used by the teams to address contextual factors influencing implementation of CBPHC innovations. In primary care settings, consideration of contextual factors when implementing change has been recognized as critically important to success. However, contextual factors are rarely recorded, analyzed or considered when implementing change. The lack of consideration of contextual factors has negative implications not only for successfully implementing primary health care (PHC) innovations, but also for their sustainability and scalability. For this evaluation, data collection was conducted using self-administered questionnaires and follow-up telephone interviews with team representatives. We used a combination of directed and conventional content analysis approaches to analyze the questionnaire and interview data. Representatives from all 12 teams completed the questionnaire and 11 teams participated in the interviews; 40 individuals participated in this evaluation. Four themes representing contextual factors that impacted the implementation of CBPHC innovations were identified: (I) diversity of jurisdictions (II) complexity of interactions and collaborations (III) policy, and (IV) the multifaceted nature of PHC. The teams used six strategies to address these contextual factors including: (1) conduct an environmental scan at the beginning (2) maintaining engagement among partners and stakeholders by encouraging open and inclusive communication; (3) contextualizing the innovation for different settings; (4) anticipating and addressing changes, delays, and the need for additional resources; (5) fostering a culture of research and innovation among partners and stakeholders; and (6) ensuring information about the innovation is widely available. Implementing CBPHC innovations across jurisdictions is complex and involves navigating through multiple contextual factors. Awareness of the dynamic nature of context should be considered when implementing innovations.

We examine the game theoretic properties of a model of crime first introduced by Short et al. (2010 Phys. Rev. E82, 066114) as the SBD Adversarial Game. We identify the rationalizable strategies and one-shot equilibria under multiple equilibrium refinements. We further show that SBD's main result about the effectiveness of defecting-punishers (“Informants”) in driving the system to evolve to the cooperative equilibrium under an imitation dynamic generalizes to a best response dynamic, though only under certain parameter regimes. The nature of this strategy's role, however, differs significantly between the two dynamics: in the SBD imitation dynamic, Informants are sufficient but not necessary to achieve the cooperative equilibrium, while under the best response dynamic, Informants are necessary but not sufficient for convergence to cooperation. Since a policy of simply converting citizens to Informants will not guarantee success under best response dynamics, we identify alternative strategies that may help the system reach cooperation in this case, e.g., the use of moderate but not too severe punishments on criminals.

Social phobia (SP) is characterized by a fear of one or more social or performance situations. Studies of comorbidity in SP youth find anxiety and affective disorders co-occurring. The present study examined children with primary SP and compared them to children with primary Separation Anxiety Disorder (SAD) or Generalized Anxiety Disorder (GAD) prior to treatment and in response to treatment. The groups differed significantly on self-, parent- and teacher-rated pretreatment measures. Additionally, the two groups showed differential treatment outcomes. When the SP youth with comorbid Affective Disorder were excluded in treatment outcome analyses, there were non significant differences, indicating that comorbid affective disorders likely contributed to differential treatment outcome. Results are discussed in terms of treatment recommendations for socially phobic youth.

Direct payments have moved to the heart of the government's drive for increased user choice. At the same time, implementation has remained disappointing. This article explores the demand, supply and related factors associated with patterns of local variability in uptake and intensity of care package provision. Statistical analyses are conducted for key client groups – people with physical disabilities, older people, people with learning disabilities and people who use mental health services – using data for England from 2000–01 to 2002–03. The results suggest that direct payments variability reflects a complex array of factors, both within and beyond the control of local public actors. In particular, while local policy preferences appear to shape the extent of direct payments growth, the results also demonstrate that understanding levels of activity requires attention to local circumstances.

I see direct payments, personal cash budgets, and other ways of extending choice and control as key to developing social care for the twenty-first century (Parliamentary Under Secretary of State for Community Care, Department of Health, 2004).

The financial and social climate in which the residential-care sector operates in the United Kingdom has changed substantially over recent years. This paper examines the underlying motivations for providing residential-care services for older people. We focus on the motivations of a sample of managers and owners of care homes drawn from eight English local authorities, and explore the intrinsic aspects of their motivations, particularly professional achievement, recognition and job satisfaction. The majority of the respondents' primary motivations were to meet the needs of older people and to accomplish professional achievements. Their caring motivations had four principal components, which were labelled professional, financial, client-specific and client-generic, and as for their professional motivations, the interviewees reported high levels of job satisfaction. The respondents were satisfied with their career choice and felt that, through their work, they were contributing to society. The study identified several personal and external factors that influenced the providers' intrinsic motivations and professional aspirations. The presented evidence suggests that if future policies are to improve the quality of care-home services, it is essential that they also incorporate the professional needs of care-home providers.

The independent sector domiciliary care market has always been an integral part of the social care system in England, but has become especially important in recent years. Its smooth running is crucial for the delivery of an effective community care policy. This paper argues that the motivations of these providers is an important aspect of this system's functioning, and derives a typology which captures the most important ingredients which theory and practice suggest should be taken into account in this regard. Four provider types are identified; they can be labelled satisfied team players; demoralised isolates; ambivalence-experiencing go-getters; and ambivalence-experiencing quiet lifers. The categories reflect both the balance of intrinsic and extrinsic motivations, and these providers' situational contexts, including the nature of the relationships developed with local authority purchasers. The latter exert exceptional power and influence in social care markets in England.

One of the key objectives of the community care reforms of 1990 in the United Kingdom was the development of a flourishing independent sector alongside good quality public services. The aims of the reforms were to increase the available range of options, widen consumer choice and promote independence. The purpose of the study reported here was to examine – from the perspective of older service users, their carers and care managers – experiences at the operational level of arranging, delivering and receiving care services. The findings are based on data gathered in seven local authorities including reviews of case files, policy documents and face-to-face, in-depth interviews with 55 users, 37 carers and 28 care managers. There is evidence of a pronounced emphasis on procedure-based systems of care management. Potentially this has two significant consequences. First, the fostering of personal relationships may be subordinated to the organisation of short-term tasks and thereby may threaten patterns of trust and accountability. Second, the associated fragmentation of the assessment and care management process which in turn can lead to discontinuities of care for users and their carers. The paper concludes that there is still some way to go before care managers as micro-commissioners have sufficient and reliable information or available service capacity to match providers' capabilities with users' and carers' needs.

The mechanism underlying acute changes in secretory immunoglobulin A (sIgA) remains to be determined. In this experiment, sIgA and cardiovascular activity were monitored at rest and while participants performed a mental arithmetic task, cold pressor, and submaximal cycle exercise following placebo or 1 mg of the alpha-adrenergic blocker, doxazosin. Under placebo, the tasks produced patterns of cardiovascular activity indicative of combined alpha- and beta-adrenergic, alpha-adrenergic, and beta-adrenergic activation, respectively. Doxazosin was associated with reduced blood pressure during cold pressor, but not during arithmetic or exercise. Mental arithmetic elicited increases in sIgA concentration and exercise produced increases in both sIgA concentration and secretion rate; these changes were unaffected by alpha blockade. In contrast, the cold pressor was associated with decreases in both sIgA concentration and secretion rate, which were blocked by doxazosin. These data suggest that acute decreases, but not increases, in sIgA are mediated by alpha-adrenergic mechanisms.

We investigated the influence of sympathetic nervous system processes on mucosal immunity by comparing the effects of beta-adrenoceptor blockade with 40 mg propranolol and placebo on secretory immunoglobulin A (sIgA) at rest and during paced serial arithmetic, cold pressor, and submaximal cycling. These tasks produced patterns of cardiovascular activity indicative of combined alpha- and beta-adrenergic, alpha-adrenergic, and beta-adrenergic activation, respectively. The effectiveness of the beta blockade was confirmed by the attenuation under propranolol of the shortening of the cardiac preejection period and the tachycardia elicited by mental arithmetic and exercise. The cold pressor test did not affect sIgA under either the placebo or the propranolol. Mental arithmetic increased sIgA concentration, and this increase was not blocked by propranolol. Exercise elicited increases in both sIgA concentration and sIgA secretion rate, which were not diminished by beta blockade. These data suggest that sIgA is not regulated by beta-adrenergic mechanisms.

The implementation of the NHS and Community Care Act, the greatly increased use of voluntary sector providers and the switch from grants to contracts form the background to this study. The article brings together two main themes in current social policy debate in the personal social services: regulation and quality assurance. Contracts are seen as increasingly significant forms of input, process and output regulation, although their impact depends upon their type and specificity and upon the capacity of purchasers to monitor contract compliance, and the sanctions available to them. Clarification of the conceptual framework is followed by the report of an empirical study of the position in a single large county. The results from this study are then discussed in the context of evidence from other parts of Britain and the United States. The main issues identified in this discussion are competition, consumer choice, user involvement, the dangers of excessive and inappropriate regulation, the importance of trust and risk, and the relationship of resources to quality.