bluuebunny/crossref_metadata_2025 huggingface dataset:
Staff perception of their roles during the transition of psychiatric care into the community
Authors: BSC S. REDA
Published: February 2008

RED A S. (1995) Journal of Psychiatric and Mental Health Nursing2, 13–22: Staff perception of their roles during the transition of psychiatric care into the community.: The objective of this study was to investigate the staff's experiences involved in the processes of the transition of 20 non‐demented long‐stay psychiatric patients. Staff members expressed satisfaction from working outside the hospital. They believed that the patients' condition and their quality of life had improved and that they were likely to achieve successful resettlement after a lengthy process of rehabilitation. However, staff members considered that their roles were demanding and involved a lot of domestic activities. They recommended gradual and slow preparation for the patients, and an educational programme for the public as well as appropriate preparation and continuing professional support for staff.
Revisiting the nursing management of the psychopath
Authors: MORAN T. , MASON T.
Published: February 2008

Revisiting the nursing management of the psychopath

There has been a growing concern regarding the treatability of those patients labelled as psychopathically disordered. Notwithstanding this important debate, and the ultimate outcome of it, the nursing management of this categorized legal group continues on a daily basis. This paper contributes a theoretical foundation to the practicalities of nursing this particularly difficult patient group, based upon clinical experience, and offers a nursing perspective to the complexities of the debate.
The Tao, social constructionism and psychiatric nursing practice and research
Authors: STEVENSON C.
Published: February 2008

A foreword to the abstract/introduction

For the reader who is more accustomed to the standard form of academic papers, it seemed necessary to prepare the ground for a more discursive presentation that does not follow the conventions of, for example, using the third person or summarizing the paper initially. If conventions are simply customs agreed amongst people then the academic ‘form’ can be put in parentheses for this paper, for this journal, for…?–‘… Scholarly Dissertations contain no more of the character of Taoist wisdom than does the typical wax museum’ (Hoff 1982, p. 26).1
An exploration of nurses' attitudes to the nursing care of the suicidal patient in an acute psychiatric ward
Authors: LONG A. , REID W.
Published: February 2008

Suicidal patients admitted to hospital following a suicidal attempt or expressing suicidal ideation present a real challenge to health professionals with regard to their therapeutic Co. Antrim care. This study was undertaken to explore the attitudes of psychiatric nurses caring for such patients. Results reveal that psychiatric nurses do hold positive views on caring for potentially suicidal patients, contradicting previous studies where more negative feelings were expressed by nurses, especially those with initial contact. Findings also show that some nurses experience an element of distress, and the length of experience within such a working environment does not affect the nurses' level of satisfaction gained on caring for the suicidal patient. This study also identifies an expression of need for further education and practice in interpersonal skills and therapeutic modalities to enhance and develop a more effective delivery of care for this group of patients.
Nitrate signalling mediated by the NRT1.1 nitrate transporter antagonises l‐glutamate‐induced changes in root architecture
Authors: Walch‐Liu Pia , Forde Brian G.
Published: February 2008

Arabidopsis root architecture is highly responsive to changes in the nitrogen supply. External NO3− stimulates lateral root growth via a signalling pathway involving the ANR1 MADS box transcription factor, while the presence of exogenous l‐glutamate (Glu) at the primary root tip slows primary root growth and stimulates root branching. We have found that NO3−, in conjunction with Glu, has a hitherto unrecognized role in regulating the growth of primary roots. Nitrate was able to stimulate primary root growth, both directly and by antagonising the inhibitory effect of Glu. Each response depended on direct contact between the primary root tip and the NO3−, and was not elicited by an alternative N source (NH4+). The chl1‐5 mutant, which is defective in the NRT1.1 (CHL1) NO3− transporter, was insensitive to NO3− antagonism of Glu signalling, while an anr1 mutant retained its sensitivity. Sensitivity to NO3− was restored in a chl1‐5 mutant constitutively expressing NRT1.1. However, expression in chl1‐5 of a transport‐competent but non‐phosphorylatable form of NRT1.1 not only failed to restore NO3− sensitivity but also had a dominant‐negative effect on Glu sensitivity. Our results indicate the existence of a NO3− signalling pathway at the primary root tip that can antagonise the root’s response to Glu, and they further suggest that NRT1.1 has a direct NO3− sensing role in this pathway. We discuss how the observed signalling interactions between NO3− and Glu could provide a mechanism for modulating root architecture in response to changes in the relative abundance of organic and inorganic N.
Erwinia amylovora modifies phenolic profiles of susceptible and resistant apple through its type III secretion system
Authors: Pontais Isabelle , Treutter Dieter , Paulin Jean‐Pierre , Brisset Marie‐Noëlle
Published: February 2008

Fire blight is a disease affecting Maloideae caused by the necrogenic bacterium Erwinia amylovora, which requires the type III protein secretion system (TTSS) for pathogenicity. Profiles of methanol‐extractable leaf phenolics of two apple (Malus × domestica) genotypes with contrasting susceptibility to this disease were analyzed by HPLC after infection. Some qualitative differences were recorded between the constitutive compositions of the two genotypes but in both of them dihydrochalcones accounted for more than 90% of total phenolics. Principal component analysis separated leaves inoculated with a virulent wild‐type strain from those inoculated with a non‐pathogenic TTSS‐defective mutant or with water. The changes in levels of the various groups of phenolics in response to the virulent bacterium were similar between the two genotypes, with a significant decrease of dihydrochalcones and a significant increase of hydroxycinnamate derivatives. Differences between genotypes were, however, recorded in amplitude and kinetic of variation in these groups. Occurrence of oxidation and polymerization reactions is proposed, based on the browning process of infected tissues, but whether some by‐products act in defense as toxic compounds remain to be tested. Among direct antibacterial constitutive compounds present in apple leaves, the dihydrochalcone phloretin only was found at levels close to lethal concentrations in both genotypes. However, E. amylovora exhibited the ability to stabilize this compound at sublethal levels even in the resistant apple, rejecting the hypothesis of its involvement in the resistance of this genotype.
The cooperative relation between non‐hydraulic root signals and osmotic adjustment under water stress improves grain formation for spring wheat varieties
Authors: Fan Xian‐Wei , Li Feng‐Min , Xiong You‐Cai , An Li‐Zhe , Long Rui‐Jun
Published: February 2008

Non‐hydraulic root signals (nHRS) and osmotic adjustment (OA) are two important adaptive responses of plants to water stress. There is little understanding of their relationships during water stress. The threshold range of soil water potential to occurrence of nHRS, the capacity for OA, grain yield and water use efficiency (WUE) were examined in three spring wheat (Triticum aestivum L.) varieties (two bred after 1975 and one bred before 1900) under water stress conditions. The threshold range of nHRS was significantly correlated with the maintenance rate of grain yield (MRGY) (r = 0.99, P < 0.05) under moderate drought (−0.49 to −0.55 MPa) but not under severe drought (−0.70 to −0.76 MPa). There were similar correlations between OA and the MRGY. However, regulation of nHRS precedes OA during gradual water stress. The threshold range of nHRS and OA was positively correlated (r = 0.93, P < 0.05), suggesting a mechanism for adapting to drought. WUE was higher for modern than for old varieties and was correlated with the root efficiency (full biomass weight including root per root weight, r = 0.78, P < 0.05) and the root water uptake efficiency (water consumption per root weight, r = 0.72, P < 0.05). However, there was a significant negative correlation between WUE and root weight (r = –0.84, P < 0.01). The cooperative relationship between the threshold range of nHRS and OA under water stress was beneficial for improving grain formation for spring wheat varieties.
Nitrogen nutrition and antioxidant metabolism in ammonium‐tolerant and ‐sensitive plants
Authors: Domínguez‐Valdivia María Dolores , Aparicio‐Tejo Pedro María , Lamsfus Carmen , Cruz Cristina , Martins‐Loução Maria Amelia , Moran Jose Fernando
Published: February 2008

Ammonium nutrition is of interest as an alternative to that of using nitrate. However, the former has been reported as stressful to many plant species especially to some important crops, as most abiotic stresses may trigger oxidative imbalances in plants. In this work, we investigate the response of oxidative metabolism of two plant species, spinach (Spinacia oleracea L. cv. Gigante de invierno) and pea (Pisum sativum L. cv. Rondo), which have distinct tolerance to ammonium. Plants were grown in the presence of 1.5 and 3.0 mM N as ammonium and compared with equivalent nitrate nutrition. The antioxidant enzymes and metabolites as well as oxidative damage to proteins were determined. Protein and amino acid contents in both types of plants were also analysed. Ammonium nutrition in sensitive spinach or in the tolerant pea plants does not alter the redox status of ascorbate and glutathione or the phenolic contents, while no clear effect is seen in the antioxidant enzymes. The results showed that the stress originated from applying ammonium as the only N source is not an oxidative stress, independent of the ammonium tolerance of the plant species studied. Moreover, ammonium stress diminishes oxidative damage to proteins in the spinach plants. The data of the protein oxidation together with those from N metabolism highlight the relation between the stress induced by ammonium and an increased protein turnover.
Heparan sulphate proteoglycans in glia and in the normal and injured CNS: expression of sulphotransferases and changes in sulphation
Authors: Properzi Francesca , Lin Rachel , Kwok Jessica , Naidu Murali , Van Kuppevelt Toin H. , Ten Dam Gerdy B. , Camargo Luiz M. , Raha‐Chowdhury Ruma , Furukawa Yoko , Mikami Tadahisa , Sugahara Kazuyuki , Fawcett James W.
Published: February 2008

Heparan sulphate proteoglycans (HSPGs) have multiple functions relevant to the control of the CNS injury response, particularly in modulating the effects of growth factors and localizing molecules that affect axon growth. We examined the pattern of expression and glycanation of HSPGs in the normal and damaged CNS, and in astrocytes and oligodendrocyte precursors because of their participation in the injury reaction. The composition of HS glycosaminoglycan (GAG) chains was analysed by biochemical analysis and by the binding of antibodies that recognize sulphated epitopes. We also measured levels of HS sulphotransferases and syndecans. Compared with oligodendrocytes, oligodendrocyte precursors have more 2‐O‐sulphation in their HS GAG. This is accompanied by higher expression of the enzyme responsible for 2‐O‐sulphation, HS 2‐O‐sulphotransferase (HS2ST) and a fall in syndecan‐1. Astrocytes treated with tumour growth factor (TGF)α or TGFβ to mimic the injury response showed upregulation of syndecan‐1 and HS2ST correlating with an increase in 2‐O‐sulphate residues in their HS GAGs. This also correlated with increased staining with AO4B08 anti‐GAG antibody that recognizes high sulphation, and reduced staining with RB4EA12 recognizing low sulphation. After injury to the adult rat brain there was an overall increase in the quantity of HSPG around the injury site, mRNA for HS2ST was increased, and the changes in staining with sulphation‐specific antibodies were consistent with an increase in 2‐O‐sulphated HS. Syndecan‐1 was upregulated in astrocytes. The major injury‐related change, seen in injured brain and cultured glia, was an increase in 2‐O‐sulphated HS and increased syndecan‐1, suggesting novel approaches to modulating scar formation.
Costs Associated With Going‐Concern‐Modified Audit Opinions: An Analysis of the Australian Audit Market
Authors: CAREY PETER J. , GEIGER MARSHALL A. , O’CONNELL BRENDAN T.
Published: February 2008

This article examines the potential costs to Australian auditors and their clients from the issuance of first‐time going‐concern‐modified audit opinions. We examine the population of Australian companies receiving a first‐time going‐concern‐modified audit opinion during the period 1994–97 and a matched sample of financially distressed firms receiving a clean audit opinion. Results indicate that auditor switching is positively associated with receipt of a going‐concern‐modified opinion. However, we find no empirical evidence that there is a self‐fulfilling prophecy of increased probability of company failure following the issuance of a going‐concern‐modified opinion for the Australian companies in our study. Our analyses of lost audit fees indicate that auditors issuing first‐time going‐concern‐modified audit opinions lost proportionately more fees by losing clients (through switching or company failure) than firms not issuing a going‐concern‐modified opinion to financially stressed clients.
The Impact of Universal Stock Futures on Feedback Trading and Volatility Dynamics
Authors: Chau Frankie , Holmes Phil , Paudyal Krishna
Published: February 2008

Abstract:  This paper investigates the impact of the introduction of Universal Stock Futures (USFs) on underlying market dynamics (volatility and the level of feedback trading). Analysis of USFs provides a number of advantages compared to investigation of index futures, leading to reliable and wider ranging insights into the impact of derivatives. Specifically: (i) any impact of derivatives is more likely to be evident in the behaviour of individual stocks; (ii) with USFs it is possible to directly trade the underlying; (iii) USFs have multiple introduction dates within a given market; (iv) differential country/industry effects can be identified; and (v) the endogeneity issue can be addressed using control stocks. Findings suggest limited feedback trading in USF stocks, but listing has reduced this further. While news has less impact and persistence and asymmetry effects are more evident post‐futures, control stock results suggest these changes are not futures induced. Differences are evident across industries. The need for analysis of an appropriate (industry based) control sample is highlighted if reliable policy conclusions are to be reached.
New Yorkers Respond to the World Trade Center Attack: An Anatomy of an Emergent Volunteer Organization
Authors: Voorhees William R.
Published: February 2008

In the aftermath of the New York World Trade Center attack, an emergent group of citizen volunteers organized to provide needed supplies to the workers at Ground Zero. The emergent‐group phenomenon has been documented after many disasters. This paper examines the organization of this emergent group through the organizational characteristics of structure, legitimacy, communications, leadership and organizational change. Finally, it argues that through a better understanding of the organizational characteristics, emergency‐management personnel will be better prepared to manage and coordinate the activities of disaster‐related emergent groups.
Disaster and Preparedness: Lessons from Hurricane Rita
Authors: Mayer Bradley W. , Moss Jimmy , Dale Kathleen
Published: February 2008

This paper investigates the lessons learned and preparedness behaviours of businesses in the southeast Texas region affected by Hurricane Rita. The data were collected through an e‐mail survey sent to businesses in the southeast Texas region affected by Hurricane Rita. Findings from the study indicate that the majority of businesses took only ‘few’ or ‘some’ preparedness measures before the hurricane. However, those businesses that experienced impacts and losses due to Hurricane Rita report that they are now taking greater preparedness measures. This study identifies specific areas that should be addressed in a disaster preparedness plan based on information gathered from organizations that went through a major disaster first‐hand.
A Review of Literature: Individual Blame vs. Organizational Function Logics in Accident Analysis
Authors: Catino Maurizio
Published: February 2008

When an accident happens in an organization, two different approaches are possible to explain its origin and dynamics. The first approach, calledindividual blame logicaims at finding the guilty individuals. The second approach, calledorganizational function logicaims to identify the organizational factors that favoured the occurrence of the event. This article compares the two different logics of inquiry, the consequences that they produce, in particular in the case of accidents caused by unintentional actions. Though favoured by the scientists, the organizational function logic approach is in real life usually beaten by the individual blame logic. Reviewing the literature, this article brings together the arguments for using the organizational function logic from the perspective that learning from accidents is necessary to prevent them from happening again.
Characterisation of the zebrafish serotonin transporter functionally links TM10 to the ligand binding site
Authors: Severinsen Kasper , Sinning Steffen , Müller Heidi Kaastrup , Wiborg Ove
Published: February 2008

The selective serotonin reuptake inhibitors and tricyclic antidepressants act by inhibiting pre‐synaptic reuptake of serotonin (5‐HT) leading to elevated synaptic 5‐HT concentrations. However, despite extensive efforts little is known about the protein‐ligand interactions of serotonin transporter (SERT) and inhibitors. To identify domains and individual amino acids important for ligand binding, we cloned the serotonin transporter from zebrafish, Danio rerio, (drSERT) and compared its pharmacological profile to that of the human serotonin transporter (hSERT) with respect to inhibition of [3H]5‐HT uptake and [3H]‐escitalopram binding in transiently transfected human embryonic kidney cells; HEK293‐MSR. Residues responsible for altered affinities inhibitors were pinpointed by generating cross‐species chimeras and subsequent point mutations by site directed mutagenesis. drSERT has a higher affinity towards compounds of the imipramine class, desipramine in particular, exhibiting a 35‐fold increased affinity compared to hSERT. drSERT has a 15–30‐fold lower affinity towards cocaine and cocaine analogues. The differences in ligand recognition are shown to be primarily caused by interspecies differences in TM10 and were tracked down to three residues (Ala505, Leu506 and Ile507).
Group III metabotropic glutamate receptor activation suppresses self‐replication of undifferentiated neocortical progenitor cells
Authors: Nakamichi Noritaka , Yoshida Kohei , Ishioka Yukichi , Makanga Juliet O. , Fukui Masaki , Yoneyama Masanori , Kitayama Tomoya , Nakamura Nobuhiro , Taniura Hideo , Yoneda Yukio
Published: February 2008

We evaluated the possible functional expression of metabotropic glutamate receptors (mGluRs) by neural progenitors from embryonic mouse neocortex. Constitutive expression was seen with group I, II, and III mGluRs in undifferentiated cells and neurospheres formed by clustered cells during culture with epidermal growth factor. The group III mGluR agonist,l‐2‐amino‐4‐phosphonobutyrate, drastically reduced proliferation activity at 1–100 μM without inducing cell death, with group I and group II mGluR agonists being ineffective, in these neurospheres. Both forskolin and a group III mGluR antagonist significantly increased the proliferation alone, but significantly prevented the suppression byl‐2‐amino‐4‐phosphonobutyrate. Activation of group III mGluR significantly decreased mRNA expression of the cell cycle regulator cyclinD1, in addition to inhibiting the transactivation mediated by cAMP of cyclinD1 gene in the pluripotent P19 progenitor cells. Prior activation of group III mGluR led to a significant decrease in the number of cells immunoreactive for a neuronal marker, with an increase in that for an astroglial marker irrespective of differentiation inducers. These results suggest that group III mGluR may be functionally expressed to suppress self‐renewal capacity through a mechanism related to cAMP formation with promotion of subsequent differentiation into astroglial lineage in neural progenitors.
TRAIL‐related neurotoxicity implies interaction with the Wnt pathway in human neuronal cells in vitro
Authors: Cantarella Giuseppina , Di Benedetto Giulia , Pezzino Salvatore , Risuglia Nunziata , Bernardini Renato
Published: February 2008

Tumor necrosis factor related apoptosis inducing ligand (TRAIL) is involved in amyloid beta dependent neurotoxicity via the extrinsic pathway. Recently, several genes modulating TRAIL cytotoxicity have been characterized, providing evidence for a role of wingless‐type mouse mammary tumor virus integration site family (Wnt), Jun‐N‐terminal kinase and other pathways in increased cell susceptibility to the cytokine. We investigated whether neurotoxic effects of TRAIL could be due to modulation of the Wnt signaling pathway. Western blot analysis of Wnt in SH‐SY5Y human neuroblastoma cells showed significantly decreased Wnt expression in cultures treated with TRAIL. Correspondingly, both phosphorylation of glycogen synthase kinase 3 beta and degradation of cytoplasmic β‐catenin were increased, as well as phosphorylation of the τ protein, bringing about the picture of neuronal damage. As a counterproof of the interaction of TRAIL with the Wnt pathway, the addition of the specific glycogen synthase kinase 3 beta inhibitor SB216763 resulted in rescue of a significant percent of cells from TRAIL‐induced apoptosis. The rescue was total when the caspase 8 inhibitor z‐IETD‐FMK was added in combination with SB216763. Results show that, probably, in addition to triggering caspase signaling, TRAIL also interferes with the Wnt pathway, additionally concurring to neuronal damage. These data suggest that the Wnt pathway substantially contributes to the TRAIL‐related neurotoxicity and indicate the TRAIL system as a candidate target for pharmacological treatment of Alzheimer’s disease and related disorders.
An Endangered Longhorn Beetle Associated with Old Oaks and Its Possible Role as an Ecosystem Engineer
Authors: BUSE J. , RANIUS T. , ASSMANN T.
Published: February 2008

Abstract:  For more than 10 years, ecologists have been discussing the concept of ecosystem engineering (i.e., nontrophic interactions of an organism that alters the physical state of its environment and affects other species). In conservation biology, the functional role of species is of interest because persistence of some species may be necessary for maintaining an entire assemblage with many threatened species. The great capricorn (Cerambyx cerdo), an endangered beetle listed in the European Union's Habitats Directive, has suffered a dramatic decline in the number of populations and in population sizes in Central Europe over the last century. The damage caused by C. cerdo larvae on sound oak trees has considerable effects on the physiological characteristics of these trees. We investigated the impacts of these effects on the species richness and heterogeneity of the saproxylic beetle assemblage on oaks. We compared the catches made with flight interception traps on 10 oaks colonized and 10 oaks uncolonized by C. cerdo in a study area in Lower Saxony (Germany). Our results revealed a significantly more species‐rich assemblage on the trees colonized by C. cerdo. Colonized trees also harbored more red‐listed beetle species. Our results suggest that an endangered beetle species can alter its own habitat to create favorable habitat conditions for other threatened beetle species. Efforts to preserve C. cerdo therefore have a positive effect on an entire assemblage of insects, including other highly endangered species. On the basis of the impact C. cerdo seems to have on the saproxylic beetle assemblage, reintroductions might be considered in regions where the species has become extinct.
Pain, Dyspnea, and the Quality of Dying in Long‐Term Care
Authors: Caprio Anthony J. , Hanson Laura C. , Munn Jean C. , Williams Christianna S. , Dobbs Debra , Sloane Philip D. , Zimmerman Sheryl
Published: February 2008

OBJECTIVES: To evaluate the relationship between pain, dyspnea, and family perceptions of the quality of dying in long‐term care.

DESIGN: After‐death interviews.

SETTING: Stratified random sample of 111 nursing homes and residential care and assisted living facilities in four states.

PARTICIPANTS: Paired interviews from facility staff and family caregivers for 325 deceased residents.

MEASUREMENTS: The outcome variable was the Quality of Dying in Long‐Term Care (QOD‐LTC), a psychometrically sound, retrospective scale representing psychosocial aspects of the quality of dying, obtained from interviews with family caregivers. Facility staff reported the presence, frequency, and severity of pain and dyspnea.

RESULTS: During the last month of life, nearly half of residents experienced pain or dyspnea. QOD‐LTC scores did not differ for residents with and without pain (4.15 vs 4.02, P=.16). Overall, residents with dyspnea had better QOD‐LTC scores than those without dyspnea (4.20 vs 3.99, P=.006). The association between dyspnea and a better QOD‐LTC score was strongest in cognitively impaired residents and for those dying in residential care and assisted living facilities.

CONCLUSION: For residents dying in long‐term care, pain and dyspnea were not associated with a poorer quality of dying as perceived by families of deceased residents. Instead, dyspnea may alert staff to the need for care. Initiatives to improve the quality of dying in long‐term care should focus not only on physical symptoms, but also on the alleviation of nonphysical sources of suffering at the end of life.
Effectiveness of Falls Clinics: An Evaluation of Outcomes and Client Adherence to Recommended Interventions
Authors: Hill Keith D. , Moore Kirsten J. , Dorevitch Michael I. , Day Lesley M.
Published: February 2008

OBJECTIVES: To evaluate outcomes associated with falls clinic programs.

DESIGN: Longitudinal.

SETTING: Thirteen outpatient falls clinics in Victoria, Australia.

PARTICIPANTS: Four hundred fifty‐four people referred for clinic assessment (mean age±standard deviation 77.9±8.8; 73% female).

INTERVENTION: After assessment, multifactorial interventions were organized to address identified risk factors.

MEASUREMENTS: A Minimum Data Set was developed and used across all clinics to derive common data on falls, falls injuries, and secondary measures associated with falls risk, including balance, falls efficacy, gait, leg strength, function, and activity. All measures were repeated 6 months later.

RESULTS: Clients had a high risk of falls, with 78% having had falls in the preceding 6 months (63% multiple fallers, 10% experiencing fractures from the falls). An average of 7.6±2.8 falls risk factors were identified per client. The clinic team organized an average of 5.7±2.3 new or additional interventions per client. Sixty‐one percent of eligible clients returned for the 6‐month assessment. At this time, there was more than a 50% reduction in falls, multiple falls, and fall injuries (P≤.004) and small but significant improvements evident on secondary measures of balance, leg strength, gait speed, and confidence outcomes (P<.006). Average adherence to recommendations was 74.3%. Factors associated with higher adherence included being male, younger than 65, living with others, and having a caregiver (P<.05).

CONCLUSION: This large multicenter study identified high falls risk of older people referred to falls clinics, the multifactorial nature of their presenting problems and provides preliminary evidence of positive outcomes after falls clinic management.
Description of Perkinsus beihaiensis n. sp., a new Perkinsus sp. Parasite in Oysters of Southern China
Authors: MOSS JESSICA A. , XIAO JIE , DUNGAN CHRISTOPHER F. , REECE KIMBERLY S.
Published: February 2008

ABSTRACT. Oysters were collected from coastal locations in China from 1999–2006 for parasite analyses by molecular, culture, and histological techniques. Polymerase chain reaction‐based assays targeting the internal transcribed spacer (ITS) region of the ribosomal RNA gene complex were performed to detect the presence of Perkinsus species. Sequencing and phylogenetic analysis of amplified Perkinsus sp. DNAs indicated that a novel Perkinsus sp. infects Crassostrea hongkongensis, Crassostrea ariakensis, and other bivalve hosts from Fujian to Guangxi provinces in southern China. Prevalence of this Perkinsus sp. reaches as high as 60% in affected oyster populations. Analyses of nucleotide sequences of the rRNA ITS region and of large subunit rRNA and actin genes, consistently confirmed the genus affiliation of this Perkinsus sp., but distinguished it from currently accepted Perkinsus species. Parasite cell types, such as signet ring trophozoites of 2–8 μm diameter, were observed by histology, and application of both genus Perkinsus and Perkinsus species‐specific in situ hybridization probes consistently labelled the same Perkinsus sp. cells in histological sections from infected oyster tissues. Combined phylogenetic and histological results support the identity of a new parasite species, Perkinsus beihaiensis n. sp.
Correlation of Optic Nerve Sheath Diameter with Direct Measurement of Intracranial Pressure
Authors: Kimberly Heidi Harbison , Shah Sachita , Marill Keith , Noble Vicki
Published: February 2008

Background:  Measurements of the optic nerve sheath diameter (ONSD) using bedside ultrasound (US) have been shown to correlate with clinical and radiologic signs and symptoms of increased intracranial pressure (ICP).

Objectives:  Previous literature has identified 5 mm as the ONSD measurement above which patients exhibit either clinical or radiologic signs of elevated ICP. The goals of this study were to evaluate the association between ONSD and ICP and to validate the commonly used ONSD threshold of 5 mm using direct measurements of ICP as measured by ventriculostomy.

Methods:  A prospective blinded observational study was performed using a convenience sample of adult patients in both the emergency department (ED) and the neurologic intensive care unit (ICU) who had invasive intracranial monitors placed as part of their clinical care. Ocular USs were performed with a 10–5 MHz linear probe. Emergency physicians (EPs) with previous ocular US experience performed ONSD measurements while blinded to the contemporaneous ICP reading obtained directly from invasive monitoring. The association between ONSD and ICP was assessed with the Spearman rank correlation coefficient, and a receiver operator characteristic (ROC) curve was created to determine the optimal ONSD cutoff to detect ICP > 20 cm H2O.

Results:  Thirty‐eight ocular USs were performed on 15 individual patients. Spearman rank correlation coefficient of ONSD and ICP was 0.59 (p < 0.0005) demonstrating a significant positive correlation. An ROC curve was created to assess the ability of ONSD to distinguish an abnormal ICP greater than 20 cm H2O. The area under the ROC curve was 0.93 (95% confidence interval [CI] = 0.84 to 0.99). Based on inspection of the ROC curve, ONSD > 5 mm performed well to detect ICP > 20 cm H2O with a sensitivity of 88% (95% CI = 47% to 99%) and specificity of 93% (95% CI = 78% to 99%).

Conclusions:  Using an ROC curve the authors systematically confirmed the commonly used threshold of ONSD > 5 mm to detect ICP > 20 cm H2O. This study directly correlates ventriculostomy measurements of ICP with US ONSD measurements and provides further support for the use of ONSD measurements as a noninvasive test for elevated ICP.
International Survey of Emergency Physicians’ Priorities for Clinical Decision Rules
Authors: Eagles Debra , Stiell Ian G , Clement Catherine M , Brehaut Jamie , Kelly Anne‐Maree , Mason Suzanne , Kellermann Arthur , Perry Jeffrey J
Published: February 2008

Objectives:  One of the first stages in the development of new clinical decision rules (CDRs) is determination of need. This study examined the clinical priorities of emergency physicians (EPs) working in Australasia, Canada, the United Kingdom, and the United States for the development of future CDRs.

Methods:  The authors administered an e‐mail and postal survey to members of the national emergency medicine (EM) associations in Australasia, Canada, the United Kingdom, and the United States. Results were analyzed via frequency distributions.

Results:  The total response rate was 54.8% (1,150/2,100). The respondents were primarily male (74%), with a mean age of 42.5 years (SD ± 8), and a mean of 12 years of experience (SD ± 7). The top 10 clinical priorities (% selected) were: 1) investigation of febrile child < 36 months (62%); 2) identification of central or serious vertigo (42%); 3) lumbar puncture or admission of febrile child < 3 months (41%); 4) imaging for suspected transient ischemic attack (39%); 5) admission for anterior chest pain (37%); 6) computed tomography (CT) angiography for pulmonary embolus (30%); 7) admission for suicide risk (29%); 8) ultrasound for pain or bleeding in the first trimester of pregnancy (28%); 9) nonspecific weakness in elders (26%); and 10) CT for abdominal pain (25%). Between study countries, there was consistency in identification of clinical problems, but variation in prioritization.

Conclusions:  This international survey identified the sampled EPs’ priorities for the future development of CDRs. The top priority overall was investigation of the febrile child < 36 months. These results will be valuable to researchers for future development of CDRs in EM that are relevant internationally.
The microanatomy of T‐cell responses
Authors: Lämmermann Tim , Sixt Michael
Published: February 2008

Summary: The priming of a T cell results from its physical interaction with a dendritic cell (DC) that presents the cognate antigenic peptide. The success rate of such interactions is extremely low, because the precursor frequency of a naive T cell recognizing a specific antigen is in the range of 1:105–106. To make this principle practicable, encounter frequencies between DCs and T cells are maximized within lymph nodes (LNs) that are compact immunological projections of the peripheral tissue they drain. But LNs are more than passive meeting places for DCs that immigrated from the tissue and lymphocytes that recirculated via the blood. The microanatomy of the LN stroma actively organizes the cellular encounters by providing preformed migration tracks that create dynamic but highly ordered movement patterns. LN architecture further acts as a sophisticated filtration system that sieves the incoming interstitial fluid at different levels and guarantees that immunologically relevant antigens are loaded on DCs or B cells while inert substances are channeled back into the blood circulation. This review focuses on the non‐hematopoietic infrastructure of the lymph node. We describe the association between fibroblastic reticular cell, conduit, DC, and T cell as the essential functional unit of the T‐cell cortex.
Triggering of merger-induced starbursts by the tidal field of galaxy groups and clusters
Authors: Martig M. , Bournaud F.
Published: February 2008

Star formation in galaxies is for a part driven by galaxy mergers. At low redshift, star formation activity is low in high-density environments like groups and clusters, and the star formation activity of galaxies increases with their isolation. This star formation–density relation is observed to be reversed at z∼ 1, which is not explained by theoretical models so far. We study the influence of the tidal field of a galaxy group or cluster on the star formation activity of merging galaxies, using N-body simulations including gas dynamics and star formation. We find that the merger-driven star formation is significantly more active in the vicinity of such cosmological structures compared to mergers in the field. The large-scale tidal field can thus enhance the activity of galaxies in dense cosmic structures, and should be particularly efficient at high redshift before quenching processes take effect in the densest regions.
Scoping the family history: Assessment of Lynch syndrome (hereditary nonpolyposis colorectal cancer) in primary care settings—A primer for nurse practitioners
Authors: Maradiegue Ann , Jasperson Kory , Edwards Quannetta T. , Lowstuter Katrina , Weitzel Jeffrey
Published: February 2008

Purpose: To describe and discuss the characteristic features and red flags of Lynch syndrome, also known as hereditary nonpolyposis colorectal cancer, that warrants referral for genetic cancer risk assessment (GCRA). A focus on the nurse practitioner’s (NP) role in familial risk assessment, physical examination, initiation of genetic referrals, and issues related to the genetic counseling process are also discussed.

Data sources: A review and synopsis of professional guidelines, clinical articles, and research studies on Lynch syndrome and the genetics of inherited cancer syndromes associated with colorectal cancer. Online resources from the American Gastroenterological Association, American Medical Association, the American Nurses Association, the National Comprehensive Cancer Network, the National Cancer Institute, the National Cancer Institute—Physician Data Query, the National Coalition of Health Professional Education in Genetics, the National Human Genome Research Institute, the National Society of Genetic Counselors, International Society of Nurses in Genetics, and the Oncology Nursing Society.

Conclusions: Approximately 5% of all colon cancers are because of a germ line mutation predisposing individuals and their family members to colorectal and other cancers. Although the efficacy of screening modalities is established, healthcare providers often fail to identify those at greatest risk for disease. The extended family history is the first step in recognition of individuals “suspect” for hereditary colon cancers such as Lynch syndrome. Early‐age onset of Lynch syndrome–associated cancers, an autosomal‐dominant pattern, multiple primary tumors in an individual or multiple family members with Lynch syndrome–associated cancers, characteristic pathological features of colon cancer, or a known germ line Lynch syndrome mutation in a family member are “red flags” that will aid NPs in identifying individuals who may benefit from GCRA.

Implications for nurse practitioner practice: The importance of enhanced surveillance for early diagnosis and prevention of disease is a critical part of primary care. Thus, it is imperative that NPs obtain a minimum of a three‐generation pedigree, recognize hereditary cancer patterns, and provide referral counseling for consideration of genetic testing of individuals suspect for Lynch syndrome.
Systematic pelvic floor training for lower urinary tract symptoms post‐prostatectomy: a randomized clinical trial
Authors: Robinson Joanne P. , Bradway Christine W. , Nuamah Isaac , Pickett Mary , McCorkle Ruth
Published: February 2008

Because the majority of prostate cancers are diagnosed in the local or regional stages, radical prostatectomy is a treatment of choice for many patients, particularly men younger than 65 years of age. However, radical prostatectomy carries a significant risk of lower urinary tract symptoms (LUTS) and may also impair quality of life. The aim of the study was to examine the effects of systematic postoperative pelvic floor training (PFT) on LUTS intensity, LUTS distress and health‐related quality of life (HRQL) at 3, 6 and 12 months following radical prostatectomy. This randomized clinical trial was guided by the Theory of Unpleasant Symptoms. All participants (n = 126) received brief instructions for exercising pelvic floor muscles before surgery and the offer of a biofeedback evaluation session 1 month following catheter removal. The intervention group (n = 62) received an additional 4 weeks of PFT immediately following catheter removal. Intervention and control groups both reported steady declines in the intensity and distress associated with LUTS, but no between‐group differences were found. Similarly, no between‐group differences were found in impact on HRQL; however, the pattern of HRQL impact differed by group (p < 0·01) in the direction of greater impairment over time for the control group. LUTS intensity, LUTS distress and negative effects on HRQL decline for many radical prostatectomy patients over the first postoperative year; however, improvement does not occur in all patients. Further research is needed to improve our understanding of factors that influence development, resolution and management of LUTS following radical prostatectomy.
Preventing IUC infections in Tanzanian patients; nurses’ knowledge, clinical practice and patients’ views
Authors: Ndomba Asteria LM , Smide Bibbe , Aarts Clara
Published: February 2008

Nosocomial infections related to indwelling urinary catheters (IUC) are a worldwide problem. While this is true in areas of the globe where care facilities are optimal, it is even more the case that in countries where care conditions are compromised or when practice is lacking a substantial knowledge base. The primary aim of this study was to investigate nurses’ knowledge and clinical practise regarding care of patients with IUC in preventing nosocomial infections in four hospitals in Tanzania. Additionally, the study investigated patients’ views about received care relating to the presence of an IUC. Registered and enrolled nurses (n = 135) working in four hospitals in Dar‐es‐Salaam municipality completed a questionnaire about IUC procedures. Four nurse students performed bedside observations of nurses (n = 127) on the care for patients with IUC. Sixty patients were interviewed about their views of the care given in relation to IUC. The nurses’ overall knowledge was good, but there was a discrepancy between knowledge and clinical practice. Hand washing prior to care for patients with IUC was poor due to lack of water and soap. Half of the patients experienced problems; haematuria, offensive smell, pus around the catheter and swelling of the scrotum in male patients. Patients expressed frustration regarding the care of IUC. There was a shortage of trained hospital staff, shortage of beds to the extent that patients had to share beds and appropriate equipment was not available. Although the nurses’ knowledge in IUC care was relatively good, the nursing care for patients with IUC in the studied hospitals ought to be improved. This can be done by developing evidence‐based, culturally congruent guidelines for assurance of quality care. Many of the problems that were considered to increase the risk of nosocomial infections were identified as being related to the logistics of the wards and lack of staff. Therefore, on the strength of these findings, it is recommended that unnecessary use of IUC should be avoided particularly where weak infrastructure has been identified.
Urban Festivals: Geographies of Hype, Helplessness and Hope
Authors: Waitt Gordon
Published: February 2008

Let's hold a festival! This article explores why hosting festivals has been widely prescribed as a panacea for the contemporary social and economic ills of cities. In this article, this is contextualised in relationship to the urban politics of neoliberalism, and the demise of many urban centres through global shifts in economic production. Boosting of city images through the hype of public–private partnerships re‐imagines urban centres as world showcases – places that are vibrant, dynamic, affluent, healthy, tolerant, cosmopolitan and sexy. Focusing on two thematic areas – geographies of helplessness and geographies of hope – this article then investigates how both strands qualify the geographies of hype by revealing how contemporary urban festival spaces, while liberating certain social groups, also constrain, disadvantage and oppress.
Mental Health First Aid: an international programme for early intervention
Authors: Kitchener Betty A. , Jorm Anthony F.
Published: February 2008

Abtract

Aim: To describe the development of the Mental Health First Aid (MHFA) programme in Australia, its roll‐out in other countries and evaluation studies which have been carried out.

Methods: A description of the programme's development and evaluation, its cultural adaptations and its dissemination in seven countries.

Results: The programme was developed in Australia in 2001. By the end of 2007, there were 600 instructors and 55 000 people trained as mental health first aiders. A number of evaluations have been carried out, including two randomized controlled trials that showed changes in knowledge, attitudes and first aid behaviours. Special adaptations of the course have been rolled out for Aboriginal and Torres Strait Islander peoples and some non‐English speaking immigrant groups. The course has spread to seven other countries with varying degrees of penetration. In all countries, the programme has been initially supported by government funding. Independent evaluations have been carried out in Scotland and Ireland.

Conclusions: The concept of first aid by the public for physical health crises is familiar in many countries. This has made it relatively easy to extend this approach to early intervention by members of the public for mental disorders and crises. Through MHFA training, the whole of a community can assist formal mental health services in early intervention for mental disorders.
Local anaesthesia
Authors: Meechan J.G.
Published: February 2008

This article describes current concepts in the mechanism of action of local anaesthetic drugs and discusses recent advances in the equipment and drugs that may be used to provide intra‐oral anaesthesia.
Normal Heptane-Diesel Combustion and Odorous Emissions in Direct Injection Diesel Engines
Authors: Roy Murari Mohon
Published: February 2008

This study investigated normal heptane (N-heptane)-diesel combustion and odorous emissions in a direct injection diesel engine during and after engine warmup at idling. The odor is a little worse with N-heptane and blends than that of diesel fuel due to overleaning of the mixture. In addition, formaldehyde (HCHO) and total hydrocarbon (THC) in the exhaust increase with increasing N-heptane content. However, 50% and 100% N-heptane showed lower eye irritation than neat diesel fuel. Due to low boiling point of N-heptane, adhering fuel on the combustion chamber wall is small and as a single-component C7 fuel, relatively high volatile components present in the exhaust are low. This may cause lower eye irritation. On the contrary, bulk in-cylinder gas temperature is lower and ignition delay significantly increases for 50% and 100% N-heptane due to the low boiling point, high latent heat of evaporation, and low bulk modulus of compressibility of N-heptane than standard diesel fuel. This longer ignition delay and lower bulk in-cylinder gas temperature of N-heptane blends deteriorate exhaust odor and emissions of HCHO and THC.