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Regina Sala,1 Lorene Amet,2 Natasa Blagojevic-Stokic,3 Paul Shattock,4 Paul Whiteley5 1Centre for Psychiatry, Wolfson Institute, Barts & The London School of Medicine & Dentistry Queen Mary University of London, London, UK; 2Autism Treatment Plus, Edinburgh, UK; 3Thinking Autism, London, UK; 4Education & Services for People with Autism, Sunderland, UK; 5Education & Services for People with Autism Research, Sunderland, UKCorrespondence: Dr Regina SalaCentre for Psychiatry, Wolfson Institute, Barts & The London School of Medicine & Dentistry Queen Mary University of London, London, UKEmail regina.sala@nhs.netAbstract: Autism spectrum disorder (ASD) is a highly complex and heterogeneous developmental disorder that affects how individuals communicate with other people and relate to the world around them. Research and clinical focus on the behavioural and cognitive manifestations of ASD, whilst important, have obscured the recognition that ASD is also commonly associated with a range of physical and mental health conditions. Many physical conditions appear with greater frequency in individuals with ASD compared to non-ASD populations. These can contribute to a worsening of social communication and behaviour, lower quality of life, higher morbidity and premature mortality. We highlight some of the key physical comorbidities affecting the immune and the gastrointestinal systems, metabolism and brain function in ASD. We discuss how healthcare professionals working with individuals with ASD and parents/carers have a duty to recognise their needs in order to improve their overall health and wellbeing, deliver equality in their healthcare experiences and reduce the likelihood of morbidity and early mortality associated with the condition.Keywords: autism spectrum disorder, ASD, physical health, comorbidity, inequality

Paul Whiteley, Kevin Carr, Paul Shattock ESPA Research, Sunderland, UKCorrespondence: Paul WhiteleyThe Robert Luff Laboratory, Unit 133i Business Innovation Centre (BIC), ESPA Research, Wearfield, Sunderland SR5 2TA, UKTel +44 191 516 6366Email paul.whiteley@espa-research.org.ukAbstract: Autism or autism spectrum disorder (ASD) is described as a lifelong condition with core behavioural symptoms appearing during infancy or early childhood. Genetic and other effects occurring during the earliest times of life are thought to play a significant contributory role to the presentation of autism, denoting that autism is typically seen as an innate or inborn condition. Such descriptions have, and continue to, define autism research and clinical practice. Inspection of the existing research literature, however, suggests that within the vast heterogeneity of autism, not everyone experiences autism in such a prescribed way. Various reports have observed the presentation of “acquired autism” following a period of typical development. Other findings have documented an abatement of clinically relevant autistic features and related comorbid pathology for some. Such reports offer important insights into the heterogeneity and complexity of autism.Keywords: autism, regression, innate, lifelong, acquired, heterogeneity

The article addresses the issues surrounding the importance and impact of 'hinterlands' in the construction of European higher education systems and in the formation of sectoral policy. It draws on studies of Germany, Hungary, Ireland, Norway, Portugal and the United Kingdom to illustrate different policy approaches and shows how in some countries 'hinterland' issues have been the major factor in the reconstruction of national higher education systems. It draws a distinction between the past, where policies were essentially based on the growth of student numbers, and the present, where the drivers are much more related to regional social and economic factors and, in some countries, to public good policies on equalising opportunities between deprived and affluent areas. It suggests that 'hinterland' issues are now central to how higher education systems are constructed. As a result, systems will become more complex to manage but that regional and institutional 'bottom up' determination may offer better prospects for innovation and flexibility in the face of societal change.

Reviewing institutional governance arrangements through a European lens has the benefit of broadening the argument away from differences between pre-1992 and post-1992 constitutions or between research-intensive and teaching-led university perspectives. In the last two decades in Europe is a massive increase in student numbers and institutional size, significant changes in funding models and very considerable pressures on modes of university governance. The title of this article encloses 'modernisation' in inverted commas and reflects the stated ambition of the European Commission in one of its many Communications issued to governments and higher education over the period (Delivering on the modernisation agenda for universities, education, research and innovation 2006). The question this article asks if Europe is in fact modernising university governance or simply responding "ad hoc" to government intervention, growth in the size of institutions and demands for greater public accountability?

This article explores the impact of devolution from a centralised UK governance model on universities in Scotland, Wales, Northern Ireland and England, and shows how a unified system of higher education has been transformed into four systems with contrasting aims and objectives. The structure that has been arrived at makes the UK Government directly responsible for English higher education, the largest of the four systems, but the devolved nations often find themselves making policies which are reactive to or opposed to those adopted by the English system. It argues that devolution may not have been good for the English system where the freedom to adopt a fully marketised policy with its consequential reinforcement of differentiation between institutions and its encouragement of the establishment of a 'business model' of institutional governance would have been resisted by political representation from Scotland and Wales, both unsympathetic to the approach adopted in England. It concludes that the creation of devolved systems in Scotland and Wales has been successful in that it has increased the diversity of UK higher education and moved universities closer to their regions. However, devolution has not served Northern Ireland well because of the stalemate in the political life there.

To evaluate antibody specificities induced by simian immunodeficiency virus (SIV) versus human immunodeficiency virus type 1 (HIV-1) envelope antigens in nonhuman primate (NHP), we profiled binding antibody responses to linear epitopes in NHP studies with HIV-1 or SIV immunogens. We found that, overall, HIV-1 Env IgG responses were dominated by V3, with the notable exception of the responses to the vaccine strain A244 Env that were dominated by V2, whereas the anti-SIVmac239 Env responses were dominated by V2 regardless of the vaccine regimen.

This paper is the third in a series of reviews published in this issue resulting from the University of California Davis Cardiovascular Symposium 2014: Systems approach to understanding cardiac excitation-contraction coupling and arrhythmias: Na(+) channel and Na(+) transport. The goal of the symposium was to bring together experts in the field to discuss points of consensus and controversy on the topic of sodium in the heart. The present review focuses on cardiac Na(+)/Ca(2+) exchange (NCX) and Na(+)/K(+)-ATPase (NKA). While the relevance of Ca(2+) homeostasis in cardiac function has been extensively investigated, the role of Na(+) regulation in shaping heart function is often overlooked. Small changes in the cytoplasmic Na(+) content have multiple effects on the heart by influencing intracellular Ca(2+) and pH levels thereby modulating heart contractility. Therefore it is essential for heart cells to maintain Na(+) homeostasis. Among the proteins that accomplish this task are the Na(+)/Ca(2+) exchanger (NCX) and the Na(+)/K(+) pump (NKA). By transporting three Na(+) ions into the cytoplasm in exchange for one Ca(2+) moved out, NCX is one of the main Na(+) influx mechanisms in cardiomyocytes. Acting in the opposite direction, NKA moves Na(+) ions from the cytoplasm to the extracellular space against their gradient by utilizing the energy released from ATP hydrolysis. A fine balance between these two processes controls the net amount of intracellular Na(+) and aberrations in either of these two systems can have a large impact on cardiac contractility. Due to the relevant role of these two proteins in Na(+) homeostasis, the emphasis of this review is on recent developments regarding the cardiac Na(+)/Ca(2+) exchanger (NCX1) and Na(+)/K(+) pump and the controversies that still persist in the field.

This article reviews changes in British university governance over a period of nearly a century. During this time there have been considerable changes in the way universities have distributed authority in governance although the legal frameworks, statutory and legislative, have remained largely unchanged. The article shows that there were distinct phases in the internal balances within governance structures and relates these to external pressures, mostly state driven. Critics of current trends in university governance tend to look back to a utopian traditional model but the evidence suggests that the internal balances were always to a considerable extent contingent on external conditions and fluctuated accordingly. There is no evidence that while the state applied pressure for change in various aspects of governance it substantially intervened to impose constitutional changes except in respect to the Higher Education corporation (HEC) structure for the former polytechnics in 1988 and that, in its most managerial details, was in response to demands from the polytechnic directors themselves. The changes in how authority is distributed were therefore decided by the institutions themselves albeit in response to external pressures. But the article suggests that institutions' responses were variable and that where a strong research culture existed the accumulation of social capital was such that radical changes in the distribution of authority were resisted. One consequence is that there is now much greater diversity in institutional governance structures with some pre-1992 universities leaning much more towards HEC models, some HECs edging towards more traditional models and some institutions preserving significant elements of authority which others would regard as utopian. In Britain, reputation, research success and brand image are closely associated with the latter.

In the heart, Na/K-ATPase regulates intracellular Na(+) and Ca(2+) (via NCX), thereby preventing Na(+) and Ca(2+) overload and arrhythmias. Here, we test the hypothesis that nitric oxide (NO) regulates cardiac intracellular Na(+) and Ca(2+) and investigate mechanisms and physiological consequences involved. Effects of both exogenous NO (via NO-donors) and endogenously synthesized NO (via field-stimulation of ventricular myocytes) were assessed in this study. Field stimulation of rat ventricular myocytes significantly increased endogenous NO (18 ± 2 μM), PKCε activation (82 ± 12%), phospholemman phosphorylation (at Ser-63 and Ser-68) and Na/K-ATPase activity (measured by DAF-FM dye, western-blotting and biochemical assay, respectively; p

The aim of this article is to explore the relationship between the concept of the 'world class' university and the evidence provided by published global institutional ranking systems and to assess the policy implications of seeking 'world class' standing whether driven by governments or by institutions themselves. There would be little disagreement that higher education is subject to a league table culture or that ranking systems have a habit of driving policy [Hazelkorn, E. 2011. "Rankings and the Reshaping of Higher Education". London: Palgrave Macmillan]. What is less clear is whether policy-makers fully recognise the limitations of the messages which ranking systems seem to convey. In an increasingly market-conscious higher education environment the claim to be 'world class' is ubiquitous and is rarely subjected to critical scrutiny in public discourse so that the concept has become overused and devalued, albeit it remains a powerful element in policy formation. The paper argues that the concept can distort policy and lead to a concentration on unrealistic and unachievable goals.

This article seeks to compare the characteristics of the academic profession as described historically by Perkin in 1969 against the definitions of a profession derived from the published views of sociologists and others. It then measures the position of the academic community today against these definitions: a common range of professional tasks and competences, representation by a membership-led organisation, participation in institutional governance, a role in determining professional development and conditions of service, powers of self-regulation, and exclusive control of the knowledge and expertise it professes. The article goes on to analyse how the characteristics of twenty-first century academic life measure up to these provisions and concludes that in many ways they now fall substantially short to the extent that in a strict sense it is no longer possible to claim that academics belong to an academic profession.

The last decade has seen an acceleration of change in the way British universities have been governed, led and managed. This has substantially been driven by the instability of the external environment, which has encouraged a greater centralisation of decision-making leading to less governance and more management, but it is also a consequence of the growing convergence of the governance and management models of the pre- and post-1992 universities. The article identifies a rise in "the executive" at the expense of the traditional components of university governance, governing bodies, senates, academic boards and faculty boards, and a growing tendency to push academic participation to the periphery. It describes the dangers implicit in such developments and suggests that they may lead to a loss in academic vitality and distinctiveness.

In a conversation between Francis Fukuyama, the Stanford-based political scientist, to publicise his new book "The Origins of Political Order," and Martin Wolf, the distinguished financial journalist, Fukuyama compares political systems in countries like China and Singapore with the liberal West. Without taking the analogy too far the same might be said of university governance which, like the international political scene, is facing potential unprecedented turmoil with polarised views as to how to react to it. In this article, the author discusses the changing face of university governance and describes alternative approaches to modern university governance. (Contains 2 figures.)

This article explores the context, contents and impact of Burton Clark's two books devoted to the concept of "the entrepreneurial university". It describes the widespread influence of the entrepreneurial idea particularly in Europe and discusses its relevance a decade or so after its first formulation. It argues that "Creating Entrepreneurial Universities" had a major impact on the way European universities thought about the appropriate balance between institutional autonomy and state control and it released energies in many countries and a concern for self-management which had hitherto lain dormant. It also raised the important question of the relationship between the organisational framework necessary to assist institutional self-reliance and the conduct of academic work.

The higher education systems in Ireland and the UK have seen several decades of remarkable change, particularly with the development of mass higher education. Yet the economic recession is creating a turbulent environment for higher education systems which will pose new challenges for universities. In this article, Michael Shattock argues that Irish universities are potentially vulnerable during this age of austerity, and new policy issues will need to be tackled. He argues for universities to maintain a clarity of vision as to their long term objectives.

This article argues that in moving from being self governed to being state governed the policy drivers for higher education are no longer those of the system itself but are derived from a set of policies designed for the reform and modernisation of the public sector of the economy. The formation of higher education policy therefore needs to be reinterpreted as an adjunct of public policy, rather than as something intrinsic to higher education. The impact of "new public management" approaches and of political interventions are explored in illustrating the consequences of the centralisation of the management of the public services and of higher education becoming an issue in national politics.

Where have been the main policy drivers for the development of British higher education over the last 50 years? This article argues that while higher education policy was once driven from the inside outwards, from the late 1970s it has been driven exclusively from the outside inwards. Policy decisions under either regime were rarely driven by research findings especially from within the higher education community. The current imbalance between "inside-out" and "outside-in" policy formation is paradoxically most apparent when the higher education system has a more widely diversified funding base than at any time since the 1930s. The key policy challenge is now not what new policies are needed but what new framework should be developed for policy making.