Miracle-dz/UniFAR-FTUs huggingface dataset:
Multi-faceted palliative care intervention: aged care nurses' and care assistants' perceptions and experiences.

AIM This paper is a report of a study to describe residential aged care nurses' and care assistants' perceptions of a multi-faceted palliative care intervention to identify potential areas to be addressed during subsequent action research phases. BACKGROUND Action research was used to enhance the delivery of a palliative approach in residential aged care. The chronic care model guided the development of a multi-faceted intervention. This involved the: (1) establishment of a 'link nurse' role; (2) learning and development strategies for nurses, care assistants and general practitioners; (3) use of multi-disciplinary team meetings; and (4) access to specialist consultation. METHOD A purposive sample (n = 28) of aged care nurses and care assistants participated in a series of four focus groups conducted in July 2005. Thematic content analysis of the transcripts was performed. FINDINGS Four themes emerged: (1) targeted education can make a difference; (2) a team approach is valued; (3) clinical assessment tools are helpful; and (4) using the right language is essential. Participants described increased understanding of palliative care concepts, enhanced competencies, greater confidence to deliver palliative care and a desire to adopt a multi-disciplinary approach to care planning. CONCLUSION Sustaining a culture that is committed to ongoing learning and development interventions and creating multi-disciplinary teams in the aged care setting is critical to embedding a palliative approach. The chronic care model is a useful framework to guide the development of interventions leading to better palliative care outcomes for residents and their families.
Identification of Residues in Chromodomain Helicase DNA-Binding Protein 1 (Chd1) Required for Coupling ATP Hydrolysis to Nucleosome Sliding*

Background: Chromatin remodelers slide nucleosomes in an ATP-dependent manner. Results: Residues between the ATPase motor and DNA-binding domain of chromodomain helicase DNA-binding protein 1 (Chd1) are required for sliding but not nucleosome-stimulated ATP hydrolysis. Conclusion: Residues outside the conserved ATPase core are required for efficiently utilizing the energy of ATP hydrolysis for sliding. Significance: Understanding the role of ATPase-coupling residues will be critical for revealing nucleosome sliding mechanisms. Chromatin remodelers are ATP-dependent machines responsible for directionally shifting nucleosomes along DNA. We are interested in defining which elements of the chromodomain helicase DNA-binding protein 1 (Chd1) remodeler are necessary and sufficient for sliding nucleosomes. This work focuses on the polypeptide segment that joins the ATPase motor to the C-terminal DNA-binding domain. We identify amino acid positions outside the ATPase motor that, when altered, dramatically reduce nucleosome sliding ability and yet have only ∼3-fold reduction in ATPase stimulation by nucleosomes. These residues therefore appear to play a role in functionally coupling ATP hydrolysis to nucleosome sliding, and suggest that the ATPase motor requires cooperation with external elements to slide DNA past the histone core.
The mental health of young people in Ireland:a report of the Psychiatric Epidemiology Research across the Lifespan (PERL) Group Dublin.

There has been a dearth of epidemiological research on rates of mental disorder among Irish people and little is known about the numbers of young people in Ireland who are experiencing diagnosable mental disorders. In the context of such limited epidemiological research in the field of mental health, the PERL Group in the Royal College of Surgeons in Ireland has conducted two studies on mental disorders and psychopathology among young Irish people. This report is the first research report from these two studies by the PERL Group. It provides data on the prevalence rates of mental disorder, substance use, deliberate self-harm and suicidality among young Irish people aged 11-24 years.
Celluloid angels: a research study of nurses in feature films 1900-2007.

AIM This paper is a report of a study examining the influence on how nursing and nurses are portrayed in feature films made between 1900 and 2007, with a nurse as their main or a principle character and a story-line related specifically to nursing. BACKGROUND Nurses and the nursing profession are frequently portrayed negatively or stereotypically in the media, with nurses often being portrayed as feminine and caring but not as leaders or professionals capable of autonomous practice. METHODS A mixed method approach was used to examine feature films made in the Western world. Over 36,000 feature film synopses were reviewed (via CINAHL, ProQuest and relevant movie-specific literature) for the keywords 'nurse'/'nursing'. Identified films were analysed quantitatively to determine their country of production, genre, plot(s) and other relevant data, and qualitatively to identify the emergence of themes related to the image of nurses/nursing in films. FINDINGS For the period from 1900 to 2007, 280 relevant feature films were identified. Most films were made in the United States of America or United Kingdom, although in recent years films have been increasingly produced in other countries. Early films portrayed nurses as self-sacrificial heroines, sex objects and romantics. More recent films increasingly portray them as strong and self-confident, professionals. CONCLUSION Nurse-related films offer a unique insight into the image of nurses and how they have been portrayed. Nurses need to be aware of the impact the film industry has on how nurses and nursing are perceived and represented in feature films.
Somatic/gonadal mosaicism in a syndromic form of ectrodactyly, including eye abnormalities, documented through array‐based comparative genomic hybridization

Split hand/foot malformation (SHFM) is characterized by underdeveloped or absent central digital rays, clefts of hands and feet, and variable syndactyly of the remaining digits. SHFM is a heterogeneous condition caused by abnormalities at one of multiple loci, including SHFM1 (SHFM1 at 7q21–q22), SHFM2 (Xq26), SHFM3 (FBXW4/DACTYLIN at 10q24), SHFM4 (TP63 at 3q27), and SHFM5 (DLX1 and DLX 2 at 2q31). SHFM3 is unique in that it is caused by submicroscopic tandem chromosome duplications of FBXW4/DACTYLIN. In order to show that array‐based comparative genomic hybridization should be considered an essential aspect of the genetic analysis of patients with SHFM, we report on a family with two brothers who have ectrodactyly. Interestingly, both also have ocular abnormalities. Their sister and both parents are healthy. DNA of all five family members was analyzed using oligonucleotide‐based DNA microarray and quantitative PCR. The two affected brothers were found to have a small duplication of approximately 539 kb at 10q24.32. The patients' sister and father do not have the microduplication, but qPCR showed that mother's DNA carries the duplication in 20% of blood lymphocytes. In this family, two children were affected with ectrodactyly having a duplication over the SHFM3 locus. The mother, who shows no clinical features of ectrodacytyly, is a mosaic for the same duplication. Therefore, we demonstrate that somatic/gonadal mosaicism is a mechanism that gives rise to SHFM. We also suggest that ocular abnormalities may be part of the clinical description of SHFM3. © 2011 Wiley‐Liss, Inc.
Exercise and Cognitive Function: Can Working Out Train the Brain, Too?

Studies exploring the relationship between physical activity, fitness, and cognitive function vary across the lifespan in terms of both their number and the apparent strength of the associations. Studies of children are relatively few in number but generally show a positive association between physical activity and cognitive function. Studies of younger adults are even more scarce; findings are equivocal and do not support the hypothesis that greater physical activity or fitness benefits cognitive function. Studies of older adults suggest that greater physical activity and fitness may improve or at least maintain cognitive function. Increasing physical activity may improve cognitive function, especially executive function in elderly persons. A veritable handful of studies suggest that long-term strength training may have cognitive benefits for elderly persons. Regular exercise and greater aerobic fitness are associated with greater brain volume, improved neurophysiological responses to stimuli as measured by electroencephalography (EEG), and higher levels of growth factors that promote growth of brain tissue, neurogenesis, and angiogenesis. However, the findings are not unequivocal (EEG), often based on animal studies (growth factors), and the physiological significance is not well understood. Therefore, while promising, much work remains to validate these findings in humans and to determine their physiological significance for brain health and function. Current evidence does not support the cardiovascular fitness hypothesis and suggests that the neural activity during exercise itself may initiate changes in the brain, independent of the nature of the exercise. More studies are needed to establish a causal relationship, not merely associations, between exercise and cognitive function. These studies need to better quantify physical activity. Likewise, more work is needed to determine the mechanisms by which exercise alters brain function.
Local Institutional Development: An Analytical Sourcebook With Cases

The importance of local institutions for sustainable rural development has until recently been afforded inadequate attention by governments and donor agencies. This analytical sourcebook draws on experience summarized in mini-case studies from throughout the Third World. Critical concepts and issues are explored in its examination of various sectors of Local Institutional Development (LID) including agriculture, infrastructure and primary health care. Intended especially fro practitioners and researchers seeking a regorous understanding of LID, the material presented is suited for both field and classroom use
Causes of depression: perceptions among people recovering from depression.

AIM This paper is a report of a study to explore perceptions of the causes of depression among Taiwanese people recovering from depression. BACKGROUND Depression is a leading worldwide cause of disability. The prevalence of depression in general, and the incidence of suicide in particular, are causing concern in Taiwan. The suicide rate here has doubled in the last decade and the use of psychotic drugs has also increased. People's perceptions of their condition determine when and how they access and utilize services. METHOD A purposive sample of 40 participants (21 women and 19 men) recovering from depression after discharge from four hospitals in Taipei was recruited. In-depth, qualitative interviews using a narrative style were carried out in 2003. The tape-recorded interviews were transcribed and analysed for themes. FINDINGS Participants perceived the causes of their depression as being mainly social and cultural in origin. The main identified causes were: stress in marital relationships; conflict in extended families; changes in life circumstances and early life experiences. Women participants viewed their depression as being caused by their 'dominant' (traditional) husbands, who still thought that women should stay at home to take care of their children and the housekeeping and who refused to share these roles. Women also felt socially isolated when joining their extended marital families. CONCLUSION These findings have implications for community nurses' education and practice in relation to depression. Uncovering and addressing conflict and stress in marital relationships and in extended families is challenging, especially for nurses who traditionally work within medical models of care delivery.
Measurement of information and communication technology experience and attitudes to e-learning of students in the healthcare professions: integrative review.

AIM This paper is a report of a review to describe and discuss the psychometric properties of instruments used in healthcare education settings measuring experience and attitudes of healthcare students regarding their information and communication technology skills and their use of computers and the Internet for education. BACKGROUND Healthcare professionals are expected to be computer and information literate at registration. A previous review of evaluative studies of computer-based learning suggests that methods of measuring learners' attitudes to computers and computer aided learning are problematic. DATA SOURCES A search of eight health and social science databases located 49 papers, the majority published between 1995 and January 2007, focusing on the experience and attitudes of students in the healthcare professions towards computers and e-learning. REVIEW METHODS An integrative approach was adopted, with narrative description of findings. Criteria for inclusion were quantitative studies using survey tools with samples of healthcare students and concerning computer and information literacy skills, access to computers, experience with computers and use of computers and the Internet for education purposes. RESULTS Since the 1980s a number of instruments have been developed, mostly in the United States of America, to measure attitudes to computers, anxiety about computer use, information and communication technology skills, satisfaction and more recently attitudes to the Internet and computers for education. The psychometric properties are poorly described. CONCLUSION Advances in computers and technology mean that many earlier tools are no longer valid. Measures of the experience and attitudes of healthcare students to the increased use of e-learning require development in line with computer and technology advances.
Modified Low Density Lipoprotein Stimulates Complement C3 Expression and Secretion via Liver X Receptor and Toll-like Receptor 4 Activation in Human Macrophages*

Background: Complement C3 is expressed and secreted by human macrophages. Results: Modified low density lipoprotein (mLDL) up-regulates C3 expression and secretion, whereas C3a stimulates mLDL uptake by macrophages. Conclusion: Interplays between mLDL and C3 may be involved in atherosclerotic lesion formation. Significance: Novel cross-talk has been shown between mLDL, complement component C3, and Toll-like receptor 4 in human macrophages. Complement C3 is a pivotal component of three cascades of complement activation. C3 is expressed in human atherosclerotic lesions and is involved in atherogenesis. However, the mechanism of C3 accumulation in atherosclerotic lesions is not well elucidated. We show that acetylated low density lipoprotein and oxidized low density lipoprotein (oxLDL) increase C3 gene expression and protein secretion by human macrophages. Modified LDL (mLDL)-mediated activation of C3 expression mainly depends on liver X receptor (LXR) and partly on Toll-like receptor 4 (TLR4), whereas C3 secretion is increased due to TLR4 activation by mLDL. LXR agonist TO901317 stimulates C3 gene expression in human monocyte-macrophage cells but not in human hepatoma (HepG2) cells. We find LXR-responsive element inside of the promoter region of the human C3 gene, which binds to LXRβ in macrophages but not in HepG2 cells. We show that C3 expression and secretion is decreased in IL-4-treated (M2) and increased in IFNγ/LPS-stimulated (M1) human macrophages as compared with resting macrophages. LXR agonist TO901317 potentiates LPS-induced C3 gene expression and protein secretion in macrophages, whereas oxLDL differently modulates LPS-mediated regulation of C3 in M1 or M2 macrophages. Treatment of human macrophages with anaphylatoxin C3a results in stimulation of C3 transcription and secretion as well as increased oxLDL accumulation and augmented oxLDL-mediated up-regulation of the C3 gene. These data provide a novel mechanism of C3 gene regulation in macrophages and suggest new aspects of cross-talk between mLDL, C3, C3a, and TLR4 during development of atherosclerotic lesions.
Maternal age and prevalence of isolated congenital heart defects in an urban area of the United States

Although maternal age has been associated with a number of birth defects in several reports, the literature on the association of maternal age with isolated congenital heart defect (CHD) phenotypes has been limited. We evaluated CHD prevalence based on a cohort of 5,289 infants and fetuses with isolated CHDs born during the period 1968–2005 and ascertained by the Metropolitan Atlanta Congenital Defects Program (MACDP) among residents of five central counties in Atlanta. For our denominator, we obtained information on births to residents of the same counties from vital records (n = 1,301,143). We calculated prevalence ratios for 23 CHD phenotypes by several maternal age categories, using the group 25–29 years of age as a reference group. We used Poisson regression models to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs), controlling for maternal race, infant sex, and birth cohort. A maternal age of 35 years or older was associated with an increased prevalence for several CHD phenotypes: laterality defects (aPR = 2.06; CI 1.22–3.48), all conotruncal defects (aPR = 1.30; CI 1.03–1.65), and specifically for dextro‐transposition of the great arteries (aPR = 1.65; CI 1.10–2.48), coarctation of the aorta (aPR = 1.54; CI 1.10–2.16), ventricular septal defects (aPR = 1.20; CI 1.06–1.36), and atrial septal defects (aPR = 1.36; CI 1.05–1.77). Our findings suggest that the birth prevalence of specific isolated CHDs varies with maternal age. Further studies are warranted to corroborate these observations, taking into account potential confounding by known modifiable risk factors. Published 2011 Wiley‐Liss, Inc.
Clinical and genomic characterization of siblings with a distal duplication of chromosome 9q (9q34.1‐qter)

We report herein on two female siblings exhibiting mild intellectual disability, hypotonia in infancy, postnatal growth retardation, characteristic appearance of the face, fingers, and toes. Their healthy mother had a translocation between 9q34.1 and the 13pter. FISH and array CGH analysis demonstrated that the two children had an additional 8.5 Mb segment of the 9q34.1‐qter at 13pter. The clinical features of the present cases were similar to those of previously reported 9q34 duplication cases; however, the present cases did not exhibit other abnormal behaviors, such as autistic features or attention deficit disorders, those are reportedly associated with 9q34 duplications. A 3.0 Mb region (9q34.1‐q34.3) within 9q34 duplication in our patients are overlapped with duplication region of previously reported cases and is proposed to be critical for the presentation of several phenotypes associated with 9q34 duplications. © 2011 Wiley‐Liss, Inc.
AMP Is an Adenosine A1 Receptor Agonist*

Background: There is no known receptor for the nucleotide AMP. Results: AMP directly activates the adenosine A1 receptor (A1R) but not the adenosine A2B receptor. Conclusion: A1R is a receptor for adenosine and AMP. Significance: The diverse physiological effects of AMP could be due to direct, ectonucleotidase-independent activation of A1R. Numerous receptors for ATP, ADP, and adenosine exist; however, it is currently unknown whether a receptor for the related nucleotide adenosine 5′-monophosphate (AMP) exists. Using a novel cell-based assay to visualize adenosine receptor activation in real time, we found that AMP and a non-hydrolyzable AMP analog (deoxyadenosine 5′-monophosphonate, ACP) directly activated the adenosine A1 receptor (A1R). In contrast, AMP only activated the adenosine A2B receptor (A2BR) after hydrolysis to adenosine by ecto-5′-nucleotidase (NT5E, CD73) or prostatic acid phosphatase (PAP, ACPP). Adenosine and AMP were equipotent human A1R agonists in our real-time assay and in a cAMP accumulation assay. ACP also depressed cAMP levels in mouse cortical neurons through activation of endogenous A1R. Non-selective purinergic receptor antagonists (pyridoxalphosphate-6-azophenyl-2′,4′-disulfonic acid and suramin) did not block adenosine- or AMP-evoked activation. Moreover, mutation of His-251 in the human A1R ligand binding pocket reduced AMP potency without affecting adenosine potency. In contrast, mutation of a different binding pocket residue (His-278) eliminated responses to AMP and to adenosine. Taken together, our study indicates that the physiologically relevant nucleotide AMP is a full agonist of A1R. In addition, our study suggests that some of the physiological effects of AMP may be direct, and not indirect through ectonucleotidases that hydrolyze this nucleotide to adenosine.
Raising issues about children's overweight--maternal and child health nurses' experiences.

AIM This paper is a report of a study carried out to describe maternal and child health nurses' experiences of communicating and raising issues with parents about children's overweight. BACKGROUND Children's overweight and obesity are rapidly increasing in many countries around the world. Maternal and child health nurses are in a unique position to influence parents, but studies of their experiences in communicating with parents about overweight are lacking. METHOD Ten maternal and child health nurses in culturally diverse rural and urban areas in Melbourne, Australia, were interviewed in 2007. Data were analysed using qualitative content analysis to identify key categories. FINDINGS During the analysis, eight categories were identified. In summary, nurses described it as difficult to raise weight issues, especially if parents were overweight themselves. The growth chart was felt to be an essential tool in discussions about weight and nurses often described themselves as holding 'expert' roles in conversations. Denial, defensiveness and excuses about children being overweight were common reactions among parents and were described as difficult to deal with. However, a strong nurse-parent relationship was experienced as facilitating conversations about weight. CONCLUSION Raising issues about weight can be difficult, especially if parents are overweight themselves. Further research in communications is needed to understand and approach parents better--especially overweight parents--about their children's weight. Interventions involving patient-centred approaches in this context have potential, but the area is still relatively unexplored. Maternal and child health centres could be important contributors in such future interventions.