bluuebunny/crossref_metadata_2025 huggingface dataset:
The nursing programme ‘Coping with itch’: a promising intervention for patients with chronic pruritic skin diseases
Authors: Van Os‐Medendorp Harmieke , Eland‐de Kok Petra CM , Ros Wynand JG , Bruijnzeel‐Koomen Carla AFM , Grypdonck Mieke
Published: June 2007

Aims and objective.  To examine the feasibility of the nursing programme ‘Coping with Itch’ and the effect of the programme on the frequency and intensity of itching and scratching, itch‐related coping, skin‐related psychosocial morbidity and quality of life.

Background.  Itch is a major symptom of many chronic skin diseases and has a considerable impact on the quality of life. Therefore, the nursing programme ‘Coping with Itch’ has been developed and implemented at the outpatient departments of dermatology of one university and one general hospital in the Netherlands. The programme is intended to reduce itch and to help the patient cope with his or her itch.

Design and methods.  The feasibility of the programme has been determined by interviewing the nurses who carried out the programme, dermatologists and one medical social worker and by counting the number of visits and specific interventions. The effect of the nursing care programme ‘Coping with Itch’ was evaluated in 32 patients with pruritic skin diseases. Paired t‐tests were used to determine its effect after three and nine months.

Results.  The nursing programme ‘Coping with Itch’ proved to be practically feasible. It leads to a significant reduction of the frequency and intensity of itching and scratching, to a significant reduction of catastrophizing and helpless coping and to a significant reduction of skin‐related psychosocial morbidity in the short term. These results stabilized at nine months. No changes were found in the quality of life.

Conclusion.  The nursing programme ‘Coping with Itch’ is a promising intervention for patients with chronic pruritic skin diseases.
Validity of an instrument to measure the impact of valve heart disease on the patient's daily life
Authors: Padilha Kátia Melissa , Gallani Maria Cecília Bueno Jayme , Colombo Roberta Cunha Rodrigues
Published: June 2007

Aim.  This study was to verify the psychometric properties of the Heart Valve Disease Impact on daily life, an instrument for measuring the impact of illness in the daily life of the heart valve disease patient, related to its construct validity, criterion‐related validity and reliability.

Methods.  One hundred and twenty heart valve disease outpatients were enrolled. Data were submitted to descriptive analysis, factor analysis, Pearson's correlation coefficient and Cronbach's alpha coefficient.

Results.  The factor analysis generated four factors that explained 58% of the variance in response to the Heart Valve Disease Impact on daily life. Weak to moderate correlation was measured between the Heart Valve Disease Impact on daily life total score and two of its factors and the General Measure of Impact of illness, indicating criterion‐related validity. A Cronbach's alpha of 0·74 was measured.

Conclusion.  The results of the current study confirm both the construct and criterion validity and the internal consistency of the Heart Valve Disease Impact on daily life. Future studies are necessary to confirm its reliability and provide a better understanding of the meaning of the Heart Valve Disease Impact on daily life dimensions, as well as to evaluate its response to health interventions.

Relevance to clinical practice.  The Heart Valve Disease Impact on daily life could be a useful instrument to measure the impact of heart valve disease and to evaluate the response to health interventions.
Use of self‐chosen therapies by depressed people in primary care
Authors: Badger Frances , Nolan Peter
Published: June 2007

Aims.  This paper focuses on attitudes towards and use of self‐chosen treatment among people prescribed antidepressants and discusses the implications for practitioners involved in medicines management.

Background.  In the wide‐ranging debate around the extension of non‐medical prescribing in the UK the relationship between complementary and alternative therapies and prescribed medication has received little attention. Research indicates that self‐treatment, including use of complementary and alternative therapies is burgeoning, yet there is uncertainty about the degree to which practitioners should be knowledgeable about therapies or be capable of advising clients on their use. Complementary and alternative therapy use is common among people with depression and greater knowledge of their use may be appropriate if health practitioners are to be able to support and inform people with depressive symptoms.

Methods.  Qualitative methodology was adopted and 60 people from four primary care practices in the West Midlands, UK were interviewed individually and their self‐reported treatment journeys documented.

Results.  Almost two‐thirds of participants had attempted to use self‐chosen therapies during their recent illness though few had discussed their use with health service practitioners. Use of a range of self‐chosen therapies was supported by a belief that they were natural, combined with a desire to avoid consulting health practitioners. Reasons for non‐use of such therapies included confidence in health practitioners and caution about the possibility of drug interactions.

Conclusions.  Health practitioners require an awareness that people with mental health problems are using a range of self‐chosen treatments and might consider the appropriateness of initiating discussions on self‐chosen treatments with clients. This area requires greater debate and if necessary identification of an appropriate knowledge base.

Relevance to clinical practice.  Assessment of common mental health problems should include discussion of patients’ previous and current self‐treatment. Such discussions will assist in identifying attitudes and beliefs towards health service treatment and provide a basis for selecting appropriate interventions.
Independent extended nurse prescribing for patients with skin conditions: a national questionnaire survey
Authors: Courtenay Molly , Carey Nicola , Burke Joanna
Published: June 2007

Aim.  To examine the prescribing practices of independent extended nurse prescribers for patients with skin conditions.

Background.  Nurse‐led services are one means of improving healthcare provision for dermatology patients. The advent of nurse prescribing should optimize the role of the nurse in these situations. Medicines for skin conditions constitute a significant category within the Nurse Prescribers Extended Formulary. The impact and activity of independent extended nurse prescribing for patients with skin disease has yet to be evaluated.

Methods.  A convenience sample of 638 qualified independent extended nurse prescribers self completed a written questionnaire. spss and splus were used for data entry and analysis.

Results.  The majority of nurses (89·7%) were based in primary care and worked in general practice. Four hundred and seventy‐six (75%) participants held a degree level qualification or higher. Forty‐four (6·9%) held a diploma, degree or master's level module/s in dermatology, 433 (67·9%) had undertaken study day/s in dermatology. Five hundred and sixty (87·8%) had more than 10 years postregistration nursing experience. A significantly broader range of skin conditions, and more items for these conditions, were prescribed by nurses with higher academic qualifications, nurses with specialist dermatology training (i.e. a diploma, degree or master's level module in dermatology or dermatology study days), nurses over 45 years and nurses in general practice. A small number of nurses felt unconfident in their prescribing practice.

Conclusion.  The majority of nurses treating skin conditions work in general practice, are highly qualified, and have a wealth of clinical experience. Nurses’ dermatology training is inconsistent A small number of nurses feel unconfident in their prescribing practice.

Relevance to clinical practice.  Nurses prescribing for skin conditions must be provided with appropriate dermatological training in order to treat the enormous numbers of patients with skin conditions treated in primary care.
Inter‐ and intra‐observer (dis)agreement among nurses and doctors to classify colour and exudation of open surgical wounds according to the Red‐Yellow‐Black scheme
Authors: Vermeulen Hester , Ubbink Dirk T , Schreuder Sanne M , Lubbers Maarten J
Published: June 2007

Aim and objectives.  Primary: to study the level of agreement among nurses and doctors in classifying the colour and exudation of open wounds according to the Red‐Yellow‐Black scheme. Secondary: to check their agreement with an international expert panel on whether their classification was correct.

Background.  Nurses and doctors classify open wounds to assess systemic and local treatment options. Nowadays, several classification schemes are being used. The Red‐Yellow‐Black‐scheme is commonly used for classifying open wounds or is part of other, more intricate, wound classification models.

Methods.  Eighteen representative photographs of red, yellow and black wounds were presented to 63 nurses and 79 doctors from the Department of Surgery. They classified these open wounds for colour and amount of exudation. Group kappa's (κ) were calculated to assess inter‐ and intra‐observer agreement and their agreement with an expert panel.

Results.  Agreement among the 63 nurses on wound colour (κ = 0·61; 95% CI: 0·49–0·74) and exudation (κ = 0·49; 95% CI: 0·29–0·68) was moderate to good. Agreement among the 79 doctors was similar: κ = 0·61; 95% CI 0·49–0·73 for wound colour and κ = 0·48; 95% CI: 0·36–0·61 for exudation. Nurses’ and doctors’ agreement with the expert panel was also moderate to good: κ‐values ranged between 0·48 and 0·77.

Conclusion.  Based on the good to moderate inter‐observer agreement as found in this study, the Red‐Yellow‐Black ‐scheme appears to be a reliable and accurate classification scheme to assess open (surgical) wounds. Such a scheme may enable nurses and doctors to select the appropriate treatment modalities and evaluate the progress of the healing process.

Relevance to clinical practice.  The Red‐Yellow‐Black scheme is a helpful tool to classify all kinds of wounds and can be used as stand‐alone classification method or as part of wound management concepts.
Inducements for medical and health research: issues for the profession of nursing
Authors: Shields Linda , Pearn John
Published: June 2007

Aims and objectives. Inducements, incentives, reimbursements and payment to subjects for participation in research projects raise many practical, professional and philosophical issues for nurses. Nurses are enjoined, either formally as research co‐participants or informally as patients’ professional carers, in any research which involves their patients. This role inescapably brings significant ethical obligations, which include those of bioethical audit.

Background. A review of current international guidelines on reimbursement recommendations indicates that researchers select one of several paradigms which range from the ‘commercial market model’ of supply and demand to that of pure un‐reimbursed altruism. In this latter, volunteers not only give their bodies and emotional commitment, but also sacrifice their time and convenience. Inducement is defined as the provision of resources or rewards which exceed the ‘resource neutral’ compensation for legitimate expense. If potential volunteers are truly free to make an informed choice to participate in research, no ethical compromise exists if inducements are offered; but by so doing both the research team and the volunteer patients have shifted the ethos of their research fromcaritasand altruism to one of a simple commercial relationship.

Conclusions. Inducements are inappropriate when offered to those who are ‘ethically captive’ in the sense that autonomy of choice may be compromised.

Relevance to clinical practice. In contemporary nursing practice, research involvement is both frequent and desirable. A perspective of current debate about inducements for volunteering, including legal and ethical issues, empowers nurses to protect the patients or clients in their care.
Population genetic structure of two ecologically distinct multimammate rats: the commensalMastomys natalensisand the wildMastomys erythroleucusin southeastern Senegal
Authors: BROUAT C. , LOISEAU A. , KANE M. , BÂ K. , DUPLANTIER J.‐M.
Published: June 2007

Using the same set of microsatellite markers, we compared the population genetic structure of twoMastomysspecies, one being exclusively commensal in southeastern Senegal, and the other being continuously distributed outside villages in this region. Both species were sampled in the same landscape context and at the same spatial scale. According to the expectations based on the degree of habitat patchiness (which is higher for commensal populations in this rural area), genetic diversity was lower and genetic differentiation was higher in commensal populations ofMastomys natalensisthan in wild populations ofMastomys erythroleucus.Contrasting estimates of effective dispersal and current migration rates corroborates previous data on differences in social structure between the two species. Isolation‐by‐distance analyses showed that human‐mediated dispersal is not a major factor explaining the pattern of genetic differentiation forM. natalensis, and that gene flow is high and random betweenM. erythroleucuspopulations at the spatial scale considered.
Uptake or extrusion: crystal structures of full ABC transporters suggest a common mechanism
Authors: Dawson Roger J. P. , Hollenstein Kaspar , Locher Kaspar P.
Published: June 2007

ATP‐binding cassette (ABC) transporters are integral membrane proteins that move diverse substrates across cellular membranes. ABC importers catalyse the uptake of essential nutrients from the environment, whereas ABC exporters facilitate the extrusion of various compounds, including drugs and antibiotics, from the cytoplasm. How ABC transporters couple ATP hydrolysis to the transport reaction has long remained unclear. The recent crystal structures of four complete ABC transporters suggest that a key step of the molecular mechanism is conserved in importers and exporters. Whereas binding of ATP promotes an outward‐facing conformation, the release of the hydrolysis products ADP and phosphate promotes an inward‐facing conformation. This basic scheme can in principle explain ATP‐driven drug export and binding protein‐dependent nutrient uptake.
Chromosome segregation control by Escherichia coli ObgE GTPase
Authors: Foti James J. , Persky Nicole S. , Ferullo Daniel J. , Lovett Susan T.
Published: June 2007

Escherichia coli cells depleted of the conserved GTPase, ObgE, show early chromosome‐partitioning defects and accumulate replicated chromosomes in which the terminus regions are colocalized. Cells lacking ObgE continue to initiate replication, with a normal ratio of the origin to terminus. Localization of the SeqA DNA binding protein, normally seen as punctate foci, however, was disturbed. Depletion of ObgE also results in cell filamentation, with polyploid DNA content. Depletion of ObgE did not cause lethality, and cells recovered fully after expression of ObgE was restored. We propose a model in which ObgE is required to license chromosome segregation and subsequent cell cycle events.
A cline in the Drosophila melanogaster period gene in Australia: neither down nor under
Authors: KYRIACOU C. P. , PEIXOTO A. A. , COSTA R.
Published: June 2007

Weeks et al. (2006) have reported their inability to find a cline in the frequencies of the major Thr‐Gly encoding length variant alleles of the period gene in Drosophila melanogaster in Eastern Australia. This is in contrast to a study by Sawyer et al. (2006), who found a cline on this continent from samples collected in 1993. Weeks et al. then cast doubt on the validity of a robust cline found for these variants in Europe by Costa et al. (1992), criticizing their molecular techniques and sampling methods. We show how these claims are unjustified, and reveal a number of potential problems in their own methodology. Finally by reanalysing the subset of their data which they state is more reliable, we suggest that their results from Australia may be reasonably consistent with our own.
Robust clines and robust sampling: a reply to Kyriacou et al.
Authors: WEEKS A. R. , MCKECHNIE S. W. , HOFFMANN A. A.
Published: June 2007

Kyriacou et al. (2007) have questioned a number of issues with our recent paper on a lack of clinal variation in the period and clock timing genes in Drosophila melanogaster from eastern Australia. Here we show why their arguments are not valid and reiterate that clinal variation in genes and molecular markers need to be assessed on field flies collected over a brief period of time.
Effective rumen degradation of dry matter, crude protein and neutral detergent fibre in forage determined by near infrared reflectance spectroscopy
Authors: Ohlsson C. , Houmøller L. P. , Weisbjerg M. R. , Lund P. , Hvelplund T.
Published: June 2007

The objective of the present study was to examine if near infrared reflectance spectroscopy (NIRS) could be used to predict degradation parameters and effective degradation from scans of original forage samples. Degradability of dry matter (DM), crude protein (CP) and neutral detergent fibre (NDF) of 61 samples of perennial ryegrass (Lolium perenne L.) and orchardgrass (Dactylis glomerata L.) was tested by using the in situ technique. The grass samples were harvested at three different stages, early vegetative growth, early reproductive growth and late reproductive growth. Degradability was described in terms of immediately rumen soluble fraction (a fraction, for DM and CP only as NDF does not contain a soluble fraction), the degradable but not soluble faction (b fraction) and the rate of degradation of the b fraction (c value). Overall effective degradability of DM, CP and NDF was also calculated. Near infrared reflectance spectroscopy was examined for its ability to predict degradation parameters and to make a direct prediction of effective degradation from scans of the original samples of perennial ryegrass and orchardgrass. Prediction of effective degradation of the different feed fractions showed different accuracy. The coefficients of determination (R2) from regressions of predicted vs. measured effective degradation, using a cross‐validation method, were 0.92 for DM, 0.78 for CP and 0.61 for NDF. The attempt to predict the degradation parameters (a, b and c) by NIRS was less successful as the coefficients of determination for the degradation parameters were low. Concentrations of CP and NDF in the original samples were predicted by using NIRS and the validated R2 value was 0.98 for CP and 0.92 for NDF. It is concluded that using NIRS predictions from scans of original samples is a promising method to obtain values for the effective degradation of DM, CP and NDF in ruminant feeds, but that larger calibration sets are necessary for obtaining improved accuracy.
Effects of diets supplemented with organic acids and nucleotides on growth, immune responses and digestive tract development in weaned pigs
Authors: Lee D. N. , Liu S. R. , Chen Y. T. , Wang R. C. , Lin S. Y. , Weng C. F.
Published: June 2007

Sixty‐eight (Experiment 1, 46 days feeding) and sixteen (Experiment 2, 21 days feeding) 21‐days‐old weaned pigs were allotted to four dietary treatments including control, 0.6% organic acids (OA), 0.1% nucleotides (NA) and 0.6% OA plus 0.1% NA for determining the dietary effects. In Experiment 1, OA enhanced peripheral blood mononuclear cells proliferation on day 28 and 46. The plasma immunoglobulin (Ig) A level was elevated by OA (p < 0.06) and NA (p < 0.07), respectively. In Experiment 2, NA increased plasma IgM level, and had an interactive effect with OA on ileal Peyer's patches and mesenteric lymph node lymphocyte proliferation, bile and plasma IgA levels, and jejunal crypt depth. NA elevated gastric pepsin and jejunal alkaline phosphatase activities, however, decreased ileal aminopeptidase N, sucrase or maltase activity. These results suggest that OA and NA have synergistically enhanced the gut‐associated lymphocyte responses and NA modulates the digestive tract development of weaned pigs.
Fermentation characteristics and microbial growth promoted by diets including two‐phase olive cake in continuous fermenters
Authors: Moumen A. , Yáñez‐Ruiz D. R. , Martín‐García I. , Molina‐Alcaide E.
Published: June 2007

Two‐phase olive cake (2POC) is the by‐product obtained from the so called ‘two‐phase’ procedure to extract olive oil by mechanical methods. After the mechanical extraction the 2POC is dried and most of the remaining oil extracted by chemical means. The production of the crude by‐product may reach more than 4 millions t/year in Spain (MAPA, 2003), most of it in areas (Southeast) with shortage of pastures and conventional feeds for ruminants. Six continuous fermenters, inoculated with ruminal liquor from wethers or goats, were fed lucerne hay (LH); LH plus a concentrate including dried two‐phase olive cake (LHCO) and; diet LHCO added with polyethylene glycol (LHCOP). The highest pH values and ammonia N (NH3‐N) output were found in fermenters fed diet LH (6.19 and 6.35 for pH, and 53.7 and 68.9 mg NH3N/day, respectively, in fermentes inoculated with rumen liquor from sheep and goats) without differences due to the inoculum origin. The digestibility of carbohydrates (CHO) was affected (p < 0.001) by inoculum (67.0 and 58.8%, respectively, for goats and wethers) the lowest values being for diet LHCO (53.2 and 57.0% with inoculum from wethers and goats, respectively). The main volatile fatty acid (VFA) was acetic acid with higher (p < 0.01) values in fermenters with inoculum from goats than from wethers (80.2 and 63.0 mmol/day respectively). The efficiency of bacterial protein synthesis (EBS) was not different (p > 0.05) with inoculum from wethers and goats [26.4 and 28.1 and 35.2 and 33.5 g bacterial N/kg digested CHO, respectively, obtained by using diamino pimelic acid (DAPA) and purine bases (PB) as microbial markers]. The lowest (p < 0.05) values were found in fermenters fed diets LHCOP and LH, estimated, respectively, from DAPA and PB (21.9 and 29.0 g bacterial N/kg digested CHO). The substitution of a part of lucerne hay by a concentrate including dried 2POC does not seem to cause important differences in efficiency of VFA production. Results concerning bacterial protein synthesis are not so clear since values estimated from DAPA and PB did not show similar trends. Neither inoculum origin nor PEG had important effects on fermentation characteristics. The DAPA could be an adequate marker in continuous fermenters, with comparative purposes, as protozoa are not present and, estimated protein synthesis values are similar to those obtained in vivo with similar diets using urinary excretion of PD (Yáñez Ruiz et al., 2004b). Further research is needed to state the optimal proportion of 2POC in practical diets for ruminants at both maintenance and production stages.
Investigations on iron bioavailability of different sources and supply levels in piglets
Authors: Ettle T. , Schlegel P. , Roth F. X.
Published: June 2007

Two experiments were conducted to investigate the iron bioavailability of different sources and supply levels in piglets. In experiment 1, the influence of feeding an iron deficient basal diet or the basal diet supplemented with 28 ppm Fe either in form of Fe‐chelate, crystalline Fe‐glycinate, or Fe‐sulphate on apparent iron digestibility and on blood parameters was determined. In experiment 2, a dose–response approach was used to determine the effects of supplementing an iron‐deficient basal diet with 30, 60, or 90 ppm of Fe either in form of crystalline Fe‐glycinate or Fe‐sulphate on digestibility of Fe, growth and blood parameters. In experiment 1, comparison of iron sources revealed a tendency (0.05 < p < 0.1) for a higher Fe digestibility from Fe‐glycinate (40.9%) compared with Fe‐chelate (30.8%) or Fe‐sulphate (30.7%). Fe‐balance was higher (p < 0.05) for Fe‐glycinate compared with Fe‐sulphate but iron balance was similar for iron sulphate and iron chelate. Those results, however, were not reflected in data of blood parameters. In experiment 2, iron digestibility, blood parameters and performance were significantly (p < 0.05) influenced by iron supply. Effects of iron source on digestibility of iron were lower than observed in the first experiment.
Role of ultrasound in assessment of early rheumatoid arthritis
Authors: Hyzy MD , Slavotinek J , Smith MD
Published: June 2007

This report reviews imaging methods used for diagnosis and monitoring of rheumatoid arthritis, with emphasis on the role of ultrasonography. Traditionally, conventional radiography has been useful in detecting and monitoring the extent of joint destruction in rheumatic disease. However, it is particularly difficult to detect pathological joint changes in the early stages. Magnetic resonance imaging is able to detect inflammation of the synovial membrane and erosions but is limited by cost and availability. Ultrasound has recently emerged as a useful and potentially reliable method for assessing the degree of joint inflammation and erosion in patients with early rheumatoid arthritis.
Quality of life, sexual function and decisional regret at 1 year after surgical treatment for localized prostate cancer
Authors: Davison B. Joyce , So Alan I. , Goldenberg S. Larry
Published: June 2007

OBJECTIVE

To examine the effect of changes in quality of life (QoL) and levels of sexual function on decisional regret after surgical treatment of localized prostate cancer.

PATIENTS AND METHODS

Patients who decided to have a radical prostatectomy (RP) were assessed for health‐related QoL using the general European Organization for Research and Treatment of Cancer C30 instrument and disease‐specific prostate cancer module, and sexual function using the abbreviated International Index of Erectile Function‐5 before and 1 year after RP. Decision control was measured before RP, and decisional regret 1 year afterward, using measures mailed to participants 1 year after treatment.

RESULTS

Of 130 respondents (mean age 62 years), 4% expressed regret over their decision to have surgery. Physical and social functioning, and finances, were compromised, while emotional functioning and treatment‐related symptoms improved by 1 year. Higher levels of decisional regret were correlated with decreases in role and social functioning, increased pain and financial difficulty (all P < 0.01). Sexual function was decreased (P < 0.001) after treatment. Men reported feeling less masculine, having less sexual enjoyment, difficulty in getting and maintaining an erection, and discomfort when being sexually intimate after surgery. Mean scores of decisional regret were similar among patients who reported assuming either active (84%) or collaborative (11%) roles in treatment decision‐making. Men who assumed a passive role reported the most variability and highest scores on decision regret.

CONCLUSIONS

Few men regretted having RP at 1 year after treatment, even though some QoL functions and domains were significantly affected. Ongoing assessment of the effect of surgical treatment on sexual function, sexuality and masculinity certainly deserves further exploration with this group of cancer survivors.
Influence of intravesical potassium on pelvic floor activity in women with overactive bladder syndrome: comparative urodynamics might provide better detection of dysfunctional voiding
Authors: Akkad Thomas , Pelzer Alexandre , Mitterberger Michael , Rehder Peter , Leonhartsberger Nicolai , Bartsch Georg , Strasser Hannes
Published: June 2007

OBJECTIVES

To assess the influence of intravesical potassium on pelvic floor activity (PFA) during voiding in women with symptoms of overactive bladder (OAB), by using comparative urodynamics (CUD).

PATIENTS AND METHODS

The study included 175 women who met the criteria of OAB (mean age 52.7 years, range 18–87). CUD included two sessions of pressure‐flow studies (0.9% saline vs 0.2 m KCl) with simultaneous measurement of PFA using perineal electromyography (EMG) with surface electrodes. Dysfunctional voiding (DV) was diagnosed if significant PFA was measured by EMG during voiding.

RESULTS

In 44 patients (25%) there was increased EMG activity only in the presence of KCL; in 58 (33%) there was DV with increased PFA during filling with saline. In all these patients PFA was significantly greater in

the presence of KCl (P < 0.001). In patients with DV, filling with KCl prompted a statistically significant difference in maximum bladder capacity, maximum flow rate, mean flow rate and postvoid residual urine volume (P < 0.05). In summary, 102 patients (58%) had DV.

CONCLUSION

These findings suggest that DV is associated with epithelial dysfunction of the bladder mucosa, which clinically leads to OAB syndrome and can be revealed by CUD. The detection of DV might elude conventional urodynamics, but can be significantly enhanced by CUD (0.9% saline vs 0.2 m KCl).
Nursing involvement in euthanasia: a ‘nursing‐as‐healing‐praxis’ approach
Authors: McCabe Helen
Published: June 2007

Abstract  In an earlier article, it was found that the terms of preference utilitarianism are insufficiently sound for guiding nursing activity in general, including in relation to nursing involvement in euthanasia. In this article, I shall examine the terms of a more traditional philosophical approach in order to determine the moral legitimacy, or otherwise, of nursing engagement in measures intended to end the lives of patients. In attempting this task, nursing practice is considered in light of what I shall call a ‘nursing‐as‐healing‐praxis’ approach which includes an account of the moral purpose of nursing and the virtues necessary for realizing that purpose. Ultimately, it is concluded that the terms of this approach rule out the involvement of nurses in euthanasia such that if euthanasia can be justified at all, those outside the nursing profession must provide for its administration.
The potential role of soyfoods in weight and adiposity reduction: an evidence‐based review
Authors: Cope M. B. , Erdman Jr J. W. , Allison D. B.
Published: June 2007

Evidence concerning the relationship between soyfoods and weight loss was reviewed. Detailed searches of PubMed and Web of Science were performed to identify and evaluate evidence for or against four propositions related to soyfoods and weight loss (Data fromin vitro, animal, epidemiologic, and clinical studies were evaluated and summarized). (1) Certain soyfoods will improve weight and/or fat loss when fed at isolcaloric levels (similar calories given across experimental conditions, but not necessarily at a level to maintain current body weight); generally supportive evidence in animal studies, but there is no compelling support in human studies. (2) Certain soyfoods will improve weight and fat loss when included as part of a diet by affecting caloric intake; limited supportive evidence in animal and human studies. (3) Certain soyfoods will prevent/improve risk factors related to glucoregulatory function and cardiovascular health during weight loss; some evidence supporting this proposition, but additional evidence is needed before conclusions can be made. (4) Certain soyfoods will minimize the loss of bone mass during weight loss; no data available pertinent to this proposition. Limitations in existing data make it difficult to reach conclusions regarding these four propositions. Overall, the current data suggest that soyfoods are as good as other protein sources for promoting weight loss and there is a suggestive body of evidence that soyfoods may confer additional benefits, but results must be carefully interpreted and additional evidence is needed before making firm conclusions concerning soyfoods and weight loss.
Structural diversification of the gustatory organs during metamorphosis in the alpine newt Triturus alpestris
Authors: Żuwała Krystyna , Jakubowski Michał
Published: June 2007

Gustatory organs of the taste bud type occur in the epithelial lining of the oropharyngeal cavity of alpine newt larvae. They resemble the taste buds of bony fish, both in appearance (as revealed by scanning electron microscopy) and in detailed internal structure (seen on transmission electron micropscopy). During metamorphosis, at stage 55 of development, the secondary tongue (i.e. the soft tongue) is well formed and the anlages of taste discs are clearly apparent. Somewhat later, taste discs also appear in the epithelial lining outside the tongue, paralleling the disappearance of the taste buds. Well‐developed taste discs of the newt differ from taste buds mainly by their structurally diversified set of ‘associate cells’ (mucous, wing and glial cells), which have no synaptic contact with nerve fibres. These cells accompany the neurosensory cellular components of the taste disc, i.e. the taste receptor cells and basal cells. This indicates that gustatory organs in metamorphosed newts, regardless of their small dimensions, fulfil the criteria established for taste discs previously defined in other Caudata and Anura species. Therefore, in the development of the newt there are two subsequent types of gustatory organs and two generations of the tongue: primary, in the larvae, and secondary, in metamorphosed animals.
Radio‐telemetric monitoring of dispersing stag beetles: implications for conservation
Authors: Rink M. , Sinsch U.
Published: June 2007

Migratory movements of the endangered stag beetles Lucanus cervus (18 males, 38 females) were monitored radio‐telemetrically for three reproductive periods (2003–2005). The aim of the study was to estimate the migratory range of free‐ranging individuals as a measure of connectivity among neighbouring populations for future conservation measures. Miniature transmitters of c. 350 mg (battery life: 10–15 days) were attached externally to the pronotum. Transmitter/beetle mass ratio was 12.8% on average (7.1–28.0%). Male dispersal behaviour consisted of frequent flights directed to sites with reproductive females and rarely of on‐ground movement. Total displacement distance recorded was up to 2065 m, the maximum distance of a single flight being 1720 m. Flights always began at elevated structures such as trees and shrubs and took place in an air temperature range of 11–27°C. Within this range, temperature did not influence flight distance. Female dispersal behaviour consisted mostly of a single flight, followed by mating and consequent ground movements towards oviposition sites. Total displacement distance recorded was up to 762.6 m, the maximum distance of a single flight being 701 m. Climatic constraints of flights were the same as in males. Modelling the dispersal behaviour suggests that about 1% of males are capable of maintaining gene flux among nest sites within a radius of about 3 km. However, the colonization of new nest sites depends on the dispersal ability of females and amounts to less than 1 km. Thus, isolated populations (distance to the next population greater than 3 km) have an increased probability of local extinction.
The information requirements and information‐seeking behaviours of health and social care professionals providing care to children with health care needs: a pilot study
Authors: Jackson Rachel , Baird Wendy , Davis‐Reynolds Loretta , Smith Christine , Blackburn Stephen , Allsebrook Janet
Published: June 2007

Objectives:  The objectives of this work were to identify the sources of information currently received, information‐seeking behaviours, information requirements and preferences for future information provision amongst health and social care professionals providing care to children with health care needs.

Methods:  Data were collected using a cross‐sectional postal questionnaire survey.

Results:  A wide range of information resources was reported as being available to professionals. However, a large proportion of respondents found it necessary to perform additional searches for information, suggesting that current resources were not satisfying their needs. The majority of professionals reported a preference for electronic formats, whilst a smaller proportion preferred hard copy materials. Participants promoted the use of informal networks as a means of support and exchange of information.

Conclusion:  Supplementing the information that is provided in electronic and hard copy formats, by enhancing informal networks, may be the most effective way of meeting the information needs of this group of professionals.
Spinal cord injury induces endoplasmic reticulum stress with different cell‐type dependent response
Authors: Penas Clara , Guzmán Mónica‐Sofía , Verdú Enrique , Forés Joaquim , Navarro Xavier , Casas Caty
Published: June 2007

The mechanisms of injury‐induced apoptosis of neurons within the spinal cord are poorly understood. In this study, we show that spinal cord injury (SCI) induces endoplasmic reticulum stress revealed by the activation of an unbalanced unfolded protein response (UPR). Using a weight‐drop contusion model of SCI, the UPR activation was characterized by a quick transient phosphorylation of alpha subunit of eukaryotic initiation factor 2 soon restored by the up‐regulation of its regulator Gadd34; an effective cleavage/activation of the ATF6α transcription factor leading to up‐regulation of the canonical UPR target genes Chop, Xbp1 and Grp78; the presence of the processing of Xbp1 mRNA indicative of inositol requiring kinase 1 activation, and a gradual accumulation of C/EBP homologous transcription factor protein (CHOP) with concomitant caspase‐12 activation. Interestingly, the subcellular distribution of CHOP was found in the nucleus of neurons and oligodendrocytes but in the cytoplasm of astrocytes. Considering the pro‐apoptotic action attributed to this transcription factor, this phenomenon might account for the different susceptibility of cell types to dye after SCI.
Sex‐specific costs of reproduction in Eastern Bluebirds Sialia sialis
Authors: SIEFFERMAN LYNN , HILL GEOFFREY E.
Published: June 2007

In species with bi‐parental care, individuals must partition energy between parental effort and mating effort. Typically, female songbirds invest more than males in reproductive activities such as egg‐laying and incubation, but males invest more in secondary sexual traits used in attracting mates. Animals that breed more than once within a season must also allocate time and energy between first and subsequent breeding attempts and between current and future breeding seasons. To investigate strategies of reproductive investment by males and females and the consequences of such strategies, we manipulated the size of broods of Eastern Bluebirds Sialia sialis. Pairs with enlarged first broods were less likely to produce a second clutch or took longer to initiate one than pairs with reduced broods. After rearing enlarged broods, females were less likely than males to survive to the following year. Although plumage coloration is a sexually selected trait in Eastern Bluebirds that is influenced by nutritional stress, we did not detect an effect of brood‐size manipulation on female coloration. Past research, however, demonstrates that, in males, plumage colour is negatively affected by increasing brood size. We suggest that there are sex‐specific strategies of reproductive investment in Eastern Bluebirds, and that researchers should incorporate measures of residual reproductive value in studies of life‐history evolution.
Treating Patients for Cardiovascular Protection: Combination Therapy to Achieve Complete Renin‐Angiotensin System Blockade
Authors: Gradman Alan H.
Published: June 2007

Inhibition of the renin‐angiotensin system (RAS) with angiotensin‐converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) is a proven antihypertensive strategy. Understanding of the pathophysiologic effects of chronic RAS activation and clinical data indicate that RAS inhibition may exert beneficial effects in addition to blood pressure reduction. Studies indicate that monotherapy with ACE inhibitors and ARBs slows progression of diabetic and non‐diabetic renal disease. Vascular protective effects of RAS inhibition have also been demonstrated in patients at high risk for cardiovascular events in the absence of significant blood pressure elevation or left ventricular dysfunction. Combining the complementary effects of ACE inhibitors and ARBs to achieve more complete RAS blockade is a promising approach to further reducing cardiovascular risk. This review will present the rationale for dual RAS inhibition, clinical data relating to its efficacy, and ongoing studies designed to evaluate its utility in patients at high risk for cardiovascular events.
Hypertensive Pregnancy Disorders: Current Concepts
Authors: Wagner Steven J. , Barac Snezana , Garovic Vesna D.
Published: June 2007

Hypertensive pregnancy disorders complicate 10% of all pregnancies and cover a spectrum of conditions, namely preeclampsia, eclampsia, and chronic and gestational hypertension. Preeclampsia is a pregnancy‐specific disorder clinically characterized by hypertension and proteinuria that occurs after 20 weeks of gestation. It remains a leading cause of both fetal and maternal morbidity and mortality worldwide. Traditionally, hypertensive pregnancy disorders were considered not to have any long‐term impact on mothers' cardiovascular health; however, recent studies consistently have supported the role of hypertension in pregnancy as a risk factor for cardiovascular disease later in life. Therefore, improved screening, and preventive and treatment strategies may not only optimize management of hypertensive pregnancy disorders, but may have a long‐term impact on women's cardiovascular events and outcomes years after the affected pregnancies. This article will provide a brief review of hypertensive pregnancy disorders and important recent discoveries regarding their pathogeneses, while focusing on current diagnostic and treatment strategies.
The Association Between Cognition and Histamine‐2 Receptor Antagonists in African Americans
Authors: Boustani Malaz , Hall Kathleen S. , Lane Kathleen A. , Aljadhey Hisham , Gao Sujuan , Unverzagt Frederick , Murray Michael D. , Ogunniyi Adesola , Hendrie Hugh
Published: June 2007

OBJECTIVES: To evaluate the association between histamine‐2 receptor antagonist (H2A) exposure and incident cognitive impairment in a community‐based sample of African Americans.

DESIGN: Five‐year longitudinal observational study.

PARTICIPANTS: A sample of 1,558 community‐dwelling African Americans aged 65 and older with no baseline cognitive impairment living in Indianapolis, Indiana.

OUTCOME MEASURE: Incident cognitive impairment, defined as incident dementia, cognitive impairment without dementia, or poor cognitive performance, as determined using combined cognitive assessments that included the Community Screening Instrument for Dementia, a comprehensive clinical assessment including informant interview, and neuropsychological testing.

EXPOSURE: Trained interviewers assessed the use of prescription and over‐the‐counter H2As using in‐home inspection of medications and report of participants and informants.

RESULTS: Incident cognitive impairment occurred in 275 (17.7%) participants. After controlling for age, education, baseline cognitive score, the use of anticholinergics, and history of diabetes mellitus and depression, continuous use of H2As was associated with greater risk of incident cognitive impairment than for nonusers (odds ratio=2.42; 95% confidence interval=1.17–5.04).

CONCLUSION: H2As might be a risk factor for the development of cognitive impairment in African Americans. This finding requires confirmation from future studies.
China: The Aging Giant
Authors: Flaherty Joseph Henry , Liu Mei Lin , Ding Lei , Dong Birong , Ding Qunfang , Li Xia , Xiao Shifu
Published: June 2007

This article examines the changing demographics of China, with particular attention paid to the effect of the one‐child policy in relation to long‐term care of older people. It also examines the current state of health care for older people. Long‐term stays characterize hospital care. Most geriatric syndromes are less common in hospitalized older people (e.g., delirium, falls), but some (e.g., polypharmacy) are more common. A high volume of patients and brief targeted visits characterize outpatient care. Nursing homes exist in China, but relatively fewer than in the most developed countries.

Geriatric departments in university‐based hospitals primarily have developed out of a need to care for retired government officials and workers. There are no formal geriatric fellowships or national board certifications in geriatrics

Health care is primarily based on fee for service. Not all elderly have healthcare insurance. Although costs of health care and medications are less expensive than in the United States, they are relatively high for lower‐and middle‐class Chinese and have increased more quickly than has the standard of living in the past 20 years.

Family and community support for older people is strong in China. Some older people have one‐to‐one care from a baomu (literally “protection” (bao) “mother” (mu)), a type of live‐in maid who also provides care for the older person. Some of the challenges facing China in the care of its aging population are how to increase geriatric research and training, how to care for the uninsured or underinsured, and how to handle the inevitable growth of disabled and frail older people.
Comparable Preference Estimates across Time and Institutions for the Court, Congress, and Presidency
Authors: Bailey Michael A.
Published: June 2007

Empirically oriented scholars often struggle with how to measure preferences across time and institutional contexts. This article characterizes these difficulties and provides a measurement approach that incorporates information that bridges time and institutions in a Bayesian Markov Chain Monte Carlo approach to ideal point measurement. The resulting preference estimates for presidents, senators, representatives, and Supreme Court justices are comparable across time and institutions. These estimates are useful in a variety of important research projects, including research on statutory interpretation, executive influence on the Supreme Court, and Senate influence on court appointments.
Immigration and the Evolving American Welfare State: Examining Policies in the U.S. States
Authors: Hero Rodney E. , Preuhs Robert R.
Published: June 2007

The inclusion of racial/ethnic minorities is often considered an important factor leading to a relatively limited American welfare system. However, given the federal nature of welfare eligibility rules and the states' role in determining benefit levels, few studies explicitly link questions of inclusion and benefit levels when explaining the evolution of American welfare policy. This study examines the relationship between inclusion and benefit levels by analyzing state policies related to the welfare reforms of 1996 which allowed states to decide if recent immigrants would be included in welfare benefits, and subsequently the extent to which this decision affected overall benefit levels offered by states under TANF. The results suggest that states' decisions regarding inclusion subsequently affect benefit levels, with the direction of these relationships most closely reflecting the erosion model's prediction of broader eligibility associated with lower benefit levels.