bluuebunny/crossref_metadata_2025 huggingface dataset:
General anaesthesia and day‐case patient anxiety
Authors: Mitchell Mark
Published: March 2010

mitchell m. (2010) General anaesthesia and day‐case patient anxiety. Journal of Advanced Nursing 66(5), 1059–1071.

Title.  General anaesthesia and day‐case patient anxiety.

Aim.  This paper is a report of a study carried out to uncover the most anxiety‐provoking aspects of general anaesthesia and determine what interventions may help to alleviate such anxiety.

Background.  General anaesthesia has proved to be highly anxiety‐provoking. With the rise in elective day surgery, this aspect of patients’ experience has become a prominent issue. Indeed, with brief hospital stays, limited contact with healthcare professionals, restricted formal anxiety management and the acute psychological impact of day surgery, such anxiety may be increasing.

Method.  As part of a larger study, a questionnaire was given on the day of surgery to 1250 adult patients undergoing surgery with general anaesthesia over a two year period from 2005–2007. The issue examined was anxiety in relation to the environment, hospital personnel and general anaesthesia. Participants were requested to return the questionnaire by mail 24–48 hours following surgery, and 460 completed questionnaires were returned.

Findings.  A total of 85% of respondents experienced some anxiety on the day of surgery. Immediate preoperative experiences and concerns about unconsciousness were highly anxiety‐provoking. Using factor analysis Preoperative Anaesthetic Information, Anaesthetic Catastrophising, Final Support, Personal Support, Imminence of Surgery, Possible Adverse Events and Final Preoperative Experiences were identified as central features. Multiple regression demonstrated Preoperative Anaesthetic Information, Anaesthetic Catastrophising and Imminence of Surgery were statistically significantly associated with an overall increased level of anxiety.

Conclusions.  Focusing on the timely, formal delivery of information about anaesthesia management, emphasizing the notion of ‘controlled unconsciousness’ and dispelling misconceptions associated with general anaesthesia may help to limit patient anxiety.
The response of intestinal mucous cells to the presence of enteric helminths: their distribution, histochemistry and fine structure
Authors: Dezfuli B S , Pironi F , Campisi M , Shinn A P , Giari L
Published: March 2010

Histochemical and ultrastructural investigations were conducted on the mucous cells of the intestine of brown trout, Salmo trutta L., naturally infected with the cestode Cyathocephalus truncatus (Pallas, 1781) and the acanthocephalan Echinorhynchus truttae Shrank, 1788. A subpopulation of 45 S. trutta were examined of which 15 specimens harboured E. truttae, 15 of which were infected with C. truncatus and 15 fish, the control group, were uninfected. In histological sections, hyperplasia and hypertrophy of the mucous cells were evident at the site of parasite infection. Enhanced mucus secretion was also recorded in infected fish. The number of mucous cells close to the site of parasite attachment within the intestine was significantly higher than the number detected in uninfected individuals and in infected individuals at sites 1 cm or greater from the point of parasite attachment. There were no significant differences between the number of mucous cells found at the latter two sites. Alcian blue and periodic acid‐Schiff’s staining of representative histological sections revealed a significant increase in the number of mucous cells staining positively for acid glycoconjugates compared to the number of cells found in the intestines of uninfected S. trutta. In transmission electron microscopy sections, each mucous cell typically possessed an elongated, basally positioned nucleus. The cytoplasm was observed to possess numerous electron dense and lucent vesicles, in addition to well‐developed rough endoplasmic reticulum, Golgi apparatus and a few round mitochondria.
Short‐term dynamics of the carbon isotope composition of CO2 emitted from a wheat agroecosystem – physiological and environmental controls
Authors: Kodama N. , Ferrio J. P. , Brüggemann N. , Gessler A.
Published: March 2010

Understanding environmental and physiological controls of the variations in δ13C of CO2 respired (δ13CR) from different compartments of an ecosystem is important for separation of CO2 fluxes and to assess coupling between assimilation and respiration. In a wheat field, over 3 days we characterised the temporal dynamics of δ13CR from shoots and roots, from the soil and from the whole agroecosystem. To evaluate the basis of potential variations in δ13CR, we also measured δ13C in different organic matter pools, as well as meteorological and gas exchange parameters. We observed strong diel variations up to ca. 6% in shoot, root and soil δ13CR, but not in δ13C of the putative organic substrates for respiration, which varied by not more than ca. 1% within 24 h. Whole ecosystem‐respired CO2 was least depleted in 13C in the afternoon and most negative in the early morning. We assume that temporally variable respiratory carbon isotope fractionation and changes in fluxes through metabolic pathways, rather than photosynthetic carbon isotope fractionation, governs the δ13C of respired CO2 at the diel scale, and thus provides insights into the metabolic processes related to respiration under field conditions.
Group‐Size Effect on Vigilance and Foraging in a Predator‐Free Population of Feral Goats (Capra hircus) on the Isle of Rum, NW Scotland
Authors: Shi Jianbin , Beauchamp Guy , Dunbar Robin I. M.
Published: March 2010

Many previous studies have found that as group size increases, individual vigilance levels decrease and forage intake increases (group‐size effect), but few such studies have considered the impact of within‐group interactions and other confounding factors on the direction of group‐size effects. A free‐ranging population of feral goats (Capra hircus), with little predation threat, was studied on the Isle of Rum (northwest Scotland), from Jun. to Nov. 2000, to investigate the effects of group size on individual vigilance levels and foraging efficiency after taking into account the effect of confounding factors (e.g. sex, season, time of day, habitat, predation risk) and within‐group interactions (via changes in movement rates while feeding). Our results show that, while group size exerted a negative influence on individual vigilance levels and a positive effect on movement rate, foraging efficiency never increased with group size and even decreased at certain times of day. There was no sex difference in individual vigilance in feral goats, but foraging efficiency was higher in females than in males. Goats were more vigilant in fall than in summer. The results imply that the benefits for foraging obtained from the reduced vigilance level in larger groups may be constrained or offset by increased interaction (or competition) within larger groups even in a population that faces negligible predation risk.
Human cytomegalovirus infection inhibits response of chronic hepatitis‐C‐virus‐infected patients to interferon‐based therapy
Authors: Bader El Din Noha G , Abd El Meguid Mai , Tabll Ashraf A , Anany Mohamed A , Esmat Gamal , Zayed Naglaa , Helmy Amr , El Zayady Abdel Rahman , Barakat Ahmed , El Awady Mostafa K
Published: March 2010

Background and Aim:  Cytomegalovirus (CMV) is a ubiquitous pathogen that infects the majority of humans. Co‐infection of CMV and hepatitis C virus (HCV) may deteriorate the prognosis of HCV‐infected patients. This study was conducted to examine the role of CMV reactivation in determining the response rate to treatment with interferon and ribavirin therapy in chronic HCV patients.

Methods:  Viral loads and genotyping were assessed using reverse transcription polymerase chain reaction and Innolipa systems, respectively. Reactivation of CMV in HCV patients who were all positive for CMV immunoglobulin G antibodies was tested by amplification of the gB1 gene using the end‐point dilution quantitative‐nested polymerase chain reaction method.

Results:  CMV DNA was detected in 89.7% of non‐responders and in 34.6% of sustained virological responders. Patients with reactivated CMV had significantly higher fibrosis scores (72.7%) than those with undetectable CMV DNA (23.8%, P = 0.002). Patients with positive CMV had higher rates of non‐response and relapse (79.5%) than those with negative CMV DNA (19%). Chronic HCV patients with latent CMV had higher rates of response (81%) to treatment than those with reactivated CMV (20.5%, P < 0.001). Therefore, HCV patients with reactivated CMV and advanced fibrosis were least likely to achieve a sustained virological response following interferon therapy. This possibility is reduced to 50% of its original value in patients with reactivated CMV without fibrosis.

Conclusions:  Besides the staging of liver fibrosis, CMV co‐infection should be considered as an extremely important factor when designing predictive models for HCV response to interferon treatment.
Accuracy of multiparametric magnetic resonance imaging in detecting recurrent prostate cancer after radiotherapy
Authors: Arumainayagam Nimalan , Kumaar Senthil , Ahmed Hashim U. , Moore Caroline M. , Payne Heather , Freeman Alex , Allen Clare , Kirkham Alex , Emberton Mark
Published: March 2010

OBJECTIVE

To assess the role of multiparametric magnetic resonance imaging (mp‐MRI) of the prostate in evaluating local recurrence of prostate cancer, using transperineal template‐guided 5 mm‐spaced biopsies as a reference standard, in men treated with external beam radiotherapy (EBRT) for prostate cancer.

PATIENTS AND METHODS

The study included 13 patients with evidence of biochemical recurrence after EBRT who had undergone mp‐MRI and prostate mapping. Each MRI scan (consisting of T1/T2 weighting, dynamic contrast enhancement and diffusion weighting) was reported by two expert uro‐radiologists. Each prostate was divided into four regions of interest (ROI), generating 52 paired datasets for analysis.

RESULTS

The mean (range) age of the men was 65.5 (55–70) years, the mean prostate‐specific antigen (PSA) level before EBRT was 36.6 (4.5–150) ng/mL, the mean time from EBRT to biochemical recurrence was 5.7 (3–10) years and the mean PSA level at the time of recurrence was 7.1 (0.83–27.9) ng/mL. Eleven men had histological evidence of recurrence, with 23 of 52 ROIs involved with cancer. Overall accuracy, as expressed by the area under a receiver‐operator curve, was 0.77 and 0.89 for all cancer, with accuracies of 0.86 and 0.93 for those cancers with ≥3 mm biopsy core length. Inter‐observer variability was measured by calculating κ coefficients, which showed fair and moderate agreement between radiologists.

CONCLUSIONS

Interpretation of mpMRI of the prostate after previous EBRT is challenging. Our results show that the accuracy is good using an accurate reference standard. These results need verification in more patients, but have implications for determining presence or absence of local recurrence and subsequent local salvage therapy.
Experiences of follow‐up after treatment in patients with prostate cancer: a qualitative study
Authors: O’Brien Rosaleen , Rose Peter W. , Campbell Christine , Weller David , Neal Richard D. , Wilkinson Clare , Watson Eila K. ,   Prostate Cancer Follow‐up Group
Published: March 2010

OBJECTIVE

To develop an understanding of experiences of follow‐up in patients with prostate cancer, to seek explanations as to why men’s needs might not be well met, and explore views on the possible role of primary care in follow‐up. The experiences of these patients, and views on the delivery of follow‐up care, have been relatively neglected compared to those diagnosed with other cancers.

PATIENTS AND METHODS

In all, 35 patients were recruited from 20 practices across three regions in the UK. Maximum variation was sought by purposely sampling by age (59–82 years), treatment, length (0.75–14 years) and mode of follow‐up.

RESULTS

Patients’ descriptions of the content and organization of follow‐up showed the shortcomings of follow‐up, which included system failings causing patients to be lost to follow‐up, and unmet psychosexual needs. Patients were mainly positive about the prospect of follow‐up taking place outside the hospital setting. However, some expressed concerns about current follow‐up practices and suggested several improvements that need considering if primary care were to take a greater role.

CONCLUSION

This study identified some general deficiencies with the current system of follow‐up, and our data indicate that primary care could have a role in addressing some of these.
Laparoscopic radical prostatectomy is feasible and effective in ‘fit’ senior men with localized prostate cancer
Authors: Sanchez‐Salas Rafael , Prapotnich Dominique , Rozet Francois , Mombet Annick , Cathala Nathalie , Barret Eric , Galiano Marc , Cathelineau Xavier , Vallancien Guy
Published: March 2010

Study Type – Therapy (case series) Level of Evidence 4

OBJECTIVE To assess the effect of age and comorbidity on short‐term complications, long‐term continence and oncological outcome after laparoscopic radical prostatectomy (LRP) for localized prostate cancer.

PATIENTS AND METHODS In all, 2048 consecutive men underwent LRP for localized prostate cancer in one institution. Comorbidity was assessed using the Charlson index. Short‐term postoperative complications, transfusion rate, duration of hospital stay, long‐term continence and oncological outcome were analysed by age and comorbidity classes.

RESULTS Of the 2048 men, 297 were aged ≥70 years and 281 had a Charlson index of >0 (mainly diabetes 31%, chronic pulmonary disease 26%, prior other nonmetastatic cancer 16%, prior myocardial infarction 12%). Compared with younger men, senior men had significantly higher pathological stages and tumor grades. Of those 297 men aged ≥70 years, 90 (30.3%) developed biochemical relapse, none died from prostate cancer and five (1.7%) died from another cause over a median follow‐up of 5 years. The occurrence and severity of short‐term postoperative complications were more strongly related to comorbidity than chronological age. Multivariate analysis with stepwise regression confirmed that most important predictors of short‐term postoperative complications were a Charlson index of ≥2, prostate weight of >80 g, obesity and age of ≥70 years. Postoperative continence significantly declined with age (ranging from 87% in men aged <60 years to 67.5% in men aged ≥70 years). Predictors of long‐term incontinence were age of ≥70 years, obesity and need for perioperative transfusion.

CONCLUSIONS LRP is feasible and effective in fit senior men (aged ≥70 years) with localized prostate cancer, including those at high risk of dying from it.
Prognostic value of initial prostate‐specific antigen levels after salvage cryoablation for prostate cancer
Authors: Levy David A. , Pisters Louis L. , Jones J. Stephen
Published: March 2010

OBJECTIVE

To assess the prognostic value of initial prostate‐specific antigen (PSA) levels after salvage cryoablation (SCA) for the long‐term biochemical progression‐free survival (bPFS) in patients with prostate cancer.

PATIENTS AND METHODS

In all, 455 hormone‐naïve patients from the Cryo On Line Data Registry, and treated with whole‐gland SCA were assessed for PSA‐based bPFS using the Phoenix criteria. The initial PSA level measured after SCA was considered the nadir. Kaplan‐Meier plots of bPFS for initial PSA level of <0.6, ≥0.6–≤5.0 and >5.0 ng/mL were constructed and plotted to 60 months.

RESULTS

In all, 280 patients had an initial PSA level of <0.6 ng/mL after SCA. At 12, 24 and 36 months 80%, 73.6%, and 67% of patients, respectively, were progression‐free. For 118 patients with an initial PSA level after SCA of ≥0.6–≤5 ng/mL, 28% and 50% of these patients at 6 and 12 months, respectively, had PSA progression. Of 57 patients with an initial PSA level of ≥5 ng/mL, 64% progressed at 6 months. The PSA level before SCA and Gleason score correlated with bPFS by Spearman correlation (P < 0.001 and 0.002), respectively.

CONCLUSION

Curative therapy in prostate cancer not responding to radiotherapy is extremely challenging. There is no definition of success for cryosurgical treatment. The available data indicate that an initial PSA level of <0.6 ng/mL after SCA portends a favourable (67% at 36 months) bPFS. Individuals with initial PSA levels of ≥0.6 ng/mL after SCA are at risk of short‐term biochemical progression (50% at 12 months).
A Merger of Movements: Peace and Civil Rights Activism in Postwar Miami
Authors: Mohl Raymond A.
Published: March 2010

This article suggests the importance of studying local peace movements in postwar America, as civil rights historians have been doing for two decades. The article also argues that peace and civil rights often reflected the same progressive impulse for social justice—thus the importance of exploring the relationships and interconnections between the two movements. This case study of peace and civil rights in postwar Miami documents the role of politically progressive Jews, especially Jewish women, in forging a social justice movement focused on peace, civil liberties, and civil rights. Mostly newcomers from northern cities, a small group of activist Jews played a major organizational role in local branches of such civil rights and peace groups as the Civil Rights Congress, the Congress of Racial Equality, the Women’s International League for Peace and Freedom, the National Committee for a Sane Nuclear Policy, and Women Strike for Peace. For those who chose the activist path, peace and civil rights became inseparable components of a local social justice crusade challenging racial segregation and national Cold War policies.
Toward an Ecological Theory of the Norms of Practical Deliberation
Authors: Morton Jennifer M.
Published: March 2010

Abstract:Practical deliberation is deliberation concerning what to do governed by norms on intention (e.g. means‐end coherence and consistency), which are taken to be a mark of rational deliberation. According to the theory of practical deliberation I develop in this paper we should think of the norms of rational practical deliberation ecologically: that is, the norms that constitute rational practical deliberation depend on the complex interaction between the psychological capacities of the agent in question and the agent's environment. I argue that this view does a better job of justifying particular norms for practical deliberation than intrinsic or constitutivist theories. Finally, I argue against the Myth Theory of deliberation, which takes there to be no such norms on deliberation.
Serum inflammatory proteins and frontal lobe dysfunction in patients with cardiovascular risk factors
Authors: Hoshi T. , Yamagami H. , Furukado S. , Miwa K. , Tanaka M. , Sakaguchi M. , Sakoda S. , Kitagawa K.
Published: March 2010

Background:  Recent studies have shown that the levels of circulating inflammatory markers are associated with cognitive decline and cerebral small‐vessel disease. Frontal lobe dysfunction is believed to be a relatively characteristic neuropsychological symptom in vascular cognitive impairment caused by cerebral small‐vessel disease. The purpose of this study was to investigate whether the levels of serum inflammatory markers are associated with frontal lobe dysfunction, particularly executive dysfunction.

Methods:  Between January 2003 and September 2007, 388 patients who had one or more atherosclerotic risk factors and subsequently underwent brain MRI and neuropsychological testing including mini‐mental state examination (MMSE), frontal assessment battery (FAB), and modified Stroop test were enrolled in this study. We evaluated the effect of serum levels of inflammatory markers and white matter lesions on frontal lobe function.

Results:  The FAB score was negatively correlated with serum inflammatory marker levels (hsCRP; r = −0.170, IL‐6; r = −0.143, IL‐18; r = −0.175) and white matter lesions. In the modified Stroop test, interference measure was positively correlated with the levels of hsCRP (r = −0.198), and IL‐18 (r = −0.152), and white matter lesions. However, the MMSE score was not correlated with either inflammatory marker levels. The association between hsCRP and FAB score or interference measure remained significant when controlling for other confounding factors and MRI findings.

Conclusions:  The circulating level of hsCRP is associated with frontal lobe dysfunction in patients with cardiovascular risk factors independent of white matter lesions in brain MRI.
Adapting the Individualized Care Scale for cross‐cultural comparison
Authors: Suhonen Riitta , Berg Agneta , Idvall Ewa , Kalafati Maria , Katajisto Jouko , Land Lucy , Lemonidou Chryssoula , Schmidt Lee A. , Välimäki Maritta , Leino‐Kilpi Helena
Published: March 2010

Scand J Caring Sci; 2010; 24; 392–403
 
Adapting the Individualized Care Scale for cross‐cultural comparison

Rationale:  Cross‐cultural comparative studies using reliable and valid instruments can increase awareness of the differences and similarities between health worker’s ability to respond to patients’ individual needs within different health systems. This will enable a better understanding of cultural perspectives in individualized nursing care.

Aim:  To describe the translation and adaptation process of the Individualized Care Scale (ICS) and examine its reliability and validity in a cross‐cultural study.

Design:  A cross‐sectional comparative study.

Settings:  Twenty‐seven orthopaedic and trauma in‐patient units at 14 hospitals in 5 countries.

Participants:  A total of 1126 patients were included in the study: Finland (n = 425), Greece (n = 315), Sweden (n = 218), UK (n = 135) and USA (n = 33).

Methods:  A systematic forward‐ and back‐translation procedure using bilingual techniques, a committee approach, pretest techniques and pilot testing were used with a convenience sample to produce a valid ICS for each participating group. Psychometric evaluation of the adapted ICS was based on means, SD, missing data analysis, Cronbach’s alpha coefficients and average inter‐item correlations. Construct validity was examined using sub‐scale correlations to total scales and principal components analysis.

Results:  The use of the range of options and the sub‐scale mean scores ranging from 2.72 to 4.30 demonstrated the sensitivity of the scale. Cronbach’s alpha coefficients (0.77–0.97) and average inter‐item correlations (0.37–0.77) were acceptable. The sub‐scale correlations to total scales were high (0.83–0.97). The underlying theoretical construct of the ICS was demonstrated by the explained variances ranging from 58% to 79%.

Conclusions:  The ICS shows promise as a tool for evaluating individualized care in European cultures. The international expansion of an existing instrument developed for one country facilitates comparative studies across countries. There is a need to further test the construct validity and appropriateness of the ICS in different settings in European and nonwestern cultures.
The effect of designed exercise programme on quality of life in women with breast cancer receiving chemotherapy
Authors: Maryam Aghabarari , Fazlollah Ahmadi , Eesa Mohammadi , Ebrahim Hajizadeh , Abbas Varvani‐Farahani
Published: March 2010

Scand J Caring Sci; 2010; 24; 251–258
 
The effect of designed exercise programme on quality of life in women with breast cancer receiving chemotherapy

Aim and objective:  The researchers sought to investigate the effect of a designed exercise programme on the quality of life (QOL) in women with breast cancer receiving chemotherapy.

Background:  Regarding the destructive effects of breast cancer and chemotherapy on women’s lifestyle and well‐being, health‐care providers have the responsibility of searching for effective and safe programmes in order to bring an improvement to the patients’ QOL.

Methods:  In a quasi‐experimental design, 56 women with breast cancer receiving chemotherapy in an Iranian cancer institution were chosen; and then divided into two control and experiment groups consisting of 28 participants each. The patients in the experiment group followed a designed exercise programme characterized with daily physical exercises, 3–5 days per week, which lasted for 9 weeks. The Quality of Life‐Breast Cancer (QOL‐BC) questionnaire was employed to measure the participants’ QOL in physical, emotional and social dimensions before and after the intervention. Descriptive and inferential statistics were utilized for data analysis.

Results:  No significant differences were found in the QOL dimensions between two groups before the manipulation; but significant differences in physical (p = 0.004), emotional (p = 0.01), social (p = 0.02) and spiritual (p = 0.45) dimensions as well as the total QOL (p = 0.003) after the intervention, were indicative of the effectiveness of the programme.

Conclusion:  Based on the study findings, it is recommended that this programme can be employed as an effective means of improving the QOL among patients with breast cancer.
In their own words: early childhood asthma and parents’ experiences of the diagnostic process
Authors: Finnvold Jon Erik
Published: March 2010

Scand J Caring Sci; 2010; 24; 299–306
 
In their own words: early childhood asthma and parents’ experiences of the diagnostic process

This paper explores the experiences of parents of asthmatic children in the period leading up to their child receiving a formal medical diagnosis. To what extent did the parents face difficulties in obtaining this diagnosis? How did they describe their encounters with the healthcare professionals? In particular, did parents portray themselves as passive and dominated or active and participating during the prediagnosis phase? In‐depth interviews with individuals and participants in a focus group exposed the prediagnosis phase as a distinct and memorable phase of the disease, often recalled as a period of frustration and uncertainty. Results show that instead of accepting the authority of the professional, parents eventually acquire knowledge elsewhere about the diagnosis and the healthcare system, and act according to that knowledge. As a fundamental uncertainty appears involved in the diagnostic process, parents dealing with this uncertainty use a number of strategies to gain control of the process of alleviating their child’s disease. The paper discusses the status of the information that the researcher obtained from parents. Lay narratives cannot be treated as simple reports of an external reality. As the parental role is rooted in normative conceptions about what constitutes ‘responsible parenthood’, information given to the observer may therefore be influenced by the informants’ concern with their appearance as moral persons or adequate parents. Although a research strategy based on one‐sided interviews has limitations, using parents as a source of information offers a rare glimpse into the realities of patient‐physician encounters.
The Australian Tax‐Transfer System: Architecture and Outcomes*
Authors: WHITEFORD PETER
Published: March 2010

This article evaluates the Australian tax‐transfer system in an international comparative perspective, discussing the distributional profile of Australian transfers compared with those in other Organisation for Economic Cooperation and Development countries, and assessing the efficiency and effectiveness of the Australian system in terms of impacts on income inequality and providing assistance to poor households.
The metabolic enhancer piracetam ameliorates the impairment of mitochondrial function and neurite outgrowth induced by ß‐amyloid peptide
Authors: Kurz C , Ungerer I , Lipka U , Kirr S , Schütt T , Eckert A , Leuner K , Müller WE
Published: March 2010

Background and purpose:  β‐Amyloid peptide (Aβ) is implicated in the pathogenesis of Alzheimer's disease by initiating a cascade of events from mitochondrial dysfunction to neuronal death. The metabolic enhancer piracetam has been shown to improve mitochondrial dysfunction following brain aging and experimentally induced oxidative stress.

Experimental approach:  We used cell lines (PC12 and HEK cells) and murine dissociated brain cells. The protective effects of piracetam in vitro and ex vivo on Aβ‐induced impairment of mitochondrial function (as mitochondrial membrane potential and ATP production), on secretion of soluble Aβ and on neurite outgrowth in PC12 cells were investigated.

Key results:  Piracetam improves mitochondrial function of PC12 cells and acutely dissociated brain cells from young NMRI mice following exposure to extracellular Aβ1‐42. Similar protective effects against Aβ1‐42 were observed in dissociated brain cells from aged NMRI mice, or mice transgenic for mutant human amyloid precursor protein (APP) treated with piracetam for 14 days. Soluble Aβ load was markedly diminished in the brain of those animals after treatment with piracetam. Aβ production by HEK cells stably transfected with mutant human APP was elevated by oxidative stress and this was reduced by piracetam. Impairment of neuritogenesis is an important consequence of Aβ‐induced mitochondrial dysfunction and Aβ‐induced reduction of neurite growth in PC12 cells was substantially improved by piracetam.

Conclusion and implications:  Our findings strongly support the concept of improving mitochondrial function as an approach to ameliorate the detrimental effects of Aβ on brain function.

This article is commented on by Moncada, pp. 217–219 of this issue. To view this commentary visit http://dx.doi.org/10.1111/j.1476‐5381.2010.00706.x and to view related papers by Pravdic et al. and Puerta et al. visit http://dx.doi.org/10.1111/j.1476‐5381.2010.00698.x and http://dx.doi.org/10.1111/j.1476‐5381.2010.00663.x
Effect of aromatherapy on patients with Alzheimer's disease
Authors: JIMBO Daiki , KIMURA Yuki , TANIGUCHI Miyako , INOUE Masashi , URAKAMI Katsuya
Published: March 2010

Objective:  Recently, the importance of non‐pharmacological therapies for dementia has come to the fore. In the present study, we examined the curative effects of aromatherpay in dementia in 28 elderly people, 17 of whom had Alzheimer's disease (AD).

Methods:  After a control period of 28 days, aromatherapy was performed over the following 28 days, with a wash out period of another 28 days. Aromatherapy consisted of the use of rosemary and lemon essential oils in the morning, and lavender and orange in the evening. To determine the effects of aromatherpay, patients were evaluated using the Japanese version of the Gottfries, Brane, Steen scale (GBSS‐J), Functional Assessment Staging of Alzheimer's disease (FAST), a revised version of Hasegawa's Dementia Scale (HDS‐R), and the Touch Panel‐type Dementia Assessment Scale (TDAS) four times: before the control period, after the control period, after aromatherpay, and after the washout period.

Results:  All patients showed significant improvement in personal orientation related to cognitive function on both the GBSS‐J and TDAS after therapy. In particular, patients with AD showed significant improvement in total TDAS scores. Result of routine laboratory tests showed no significant changes, suggesting that there were no side‐effects associated with the use of aromatherapy. Results from Zarit's score showed no significant changes, suggesting that caregivers had no effect on the improved patient scores seen in the other tests.

Conclusions:  In conclusion, we found aromatherapy an efficacious non‐pharmacological therapy for dementia. Aromatherapy may have some potential for improving cognitive function, especially in AD patients.
Physical complications for elderly inpatients with senile dementia in the Imaise Branch of Ichinomiya City Hospital
Authors: UKAI Katsuyuki , MIZUNO Yutaka
Published: March 2010

Background:  In the present study, we investigated the physical complications of elderly patients with senile dementia in the Department of Psychogeriatrics, Imaise Branch, Ichinomiya City Hospital.

Methods:  Physical complications that occurred in our ward in the 12 months from April 2007 to March 2008 were recorded. Our ward has 50 beds and, over the 12 months, the average occupation rate was approximately 90%. We subdivided physical complications into two categories: (i) serious emergencies occurring in the ward with a possible high risk of mortality within a few days (e.g. pneumonia and upper airway obstruction); and (ii) life‐threatening complications arising in the ward that required diagnosis and treatment by specialists from other medical departments (e.g. bone fracture and cancer).

Results:  Serious emergencies with a high risk of mortality occurred 56 times. Six patients died. Life‐threatening complications requiring diagnosis and treatment by specialists from other departments occurred 44 times. Both categories of physical complications in occurred at a high rate, with various types of diseases recorded.

Conclusions:  The present study confirms the high frequency of physical complications that require treatment in facilities for patients with senile dementia. It is necessary to diagnose and treat these various physical complications and to cooperate with specialists from other medical departments.
Impact of donepezil hydrochloride on the care burden of family caregivers of patients with Alzheimer's disease
Authors: HASHIMOTO Mamoru , YATABE Yusuke , KANEDA Keiichiro , HONDA Kazuki , IKEDA Manabu
Published: March 2010

Background:  To evaluate the impact of donepezil hydrochloride on the care burden on family members of patients with Alzheimer's disease (AD). At present, donepezil is the only drug approved for the treatment of AD in Japan. Although the care burden on primary caregivers of AD patients comprises both physical and psychological burdens and donepezil is recognized to improve cognitive dysfunction and associated symptoms, there are few data on the effects of the drug on the care burden.

Methods:  Of the uninstitutionalized AD patients who visited a dementia clinic between June 2008 and May 2009 with their primary family caregivers, 416 subjects who satisfied the enrollment criteria were registered for the study. All participants provided informed consent. Assessment included changes in scores on the Japanese version of the Zarit Caregiver Burden Interview (J‐ZBI) and the Mini‐Mental State Examination (MMSE), as well as the presence of behavioral and psychological symptoms of dementia (BPSD). Caregivers answered the questionnaires at baseline and after 12 weeks treatment with donepezil (starting dose 3 mg, p.o., once daily, followed by 5 mg after 1 or 2 weeks).

Results:  There were significant changes in mean scores on the J‐ZBI (−1.9 ± 9.5; P < 0.01) and MMSE (+0.9 ± 2.9; P < 0.01) from baseline to Week 12, without significant correlation between these two scores. In patients with BPSD, there was a significant decrease in J‐ZBI scores over the 12 weeks (P = 0.013); in contrast, in patients without BPSD, the decrease in the J‐ZBI score did not reach statistical significance (P = 0.418).

Conclusions:  The results indicate that donepezil improves cognitive function and some of the BPSD. As a possible consequence of improvements in BPSD, donepezil may also reduce caregivers' burden.
Foetal and adult cardiomyocyte progenitor cells have different developmental potential
Authors: Van Vliet Patrick , Smits Anke M. , De Boer Teun P. , Korfage Tom H. , Metz Corina H.G. , Roccio Marta , Van Der Heyden Marcel A.G. , Van Veen Toon A.B. , Sluijter Joost P.G. , Doevendans Pieter A. , Goumans Marie‐José
Published: March 2010

In the past years, cardiovascular progenitor cells have been isolated from the human heart and characterized. Up to date, no studies have been reported in which the developmental potential of foetal and adult cardiovascular progenitors was tested simultaneously. However, intrinsic differences will likely affect interpretations regarding progenitor cell potential and application for regenerative medicine. Here we report a direct comparison between human foetal and adult heart‐derived cardiomyocyte progenitor cells (CMPCs). We show that foetal and adult CMPCs have distinct preferences to differentiate into mesodermal lineages. Under pro‐angiogenic conditions, foetal CMPCs form more endothelial but less smooth muscle cells than adult CMPCs. Foetal CMPCs can also develop towards adipocytes, whereas neither foetal nor adult CMPCs show significant osteogenic differentiation. Interestingly, although both cell types differentiate into heart muscle cells, adult CMPCs give rise to electrophysiologically more mature cardiomyocytes than foetal CMPCs. Taken together, foetal CMPCs are suitable for molecular cell biology and developmental studies. The potential of adult CMPCs to form mature cardiomyocytes and smooth muscle cells may be essential for cardiac repair after transplantation into the injured heart.
Effects of stocked trout on native fish communities in boreal foothills lakes
Authors: Nasmith Leslie E. , Tonn William M. , Paszkowski Cynthia A. , Scrimgeour Garry J.
Published: March 2010

Nasmith LE, Tonn WM, Paszkowski CA, Scrimgeour GJ. Effects of stocked trout on native fish communities in boreal foothills lakes. Ecology of Freshwater Fish 2010: 19: 279–289. © 2010 John Wiley & Sons A/S

Abstract –  Ecological effects of stocking nonnative trout into lakes are receiving increased attention, especially in alpine environments. We assessed effects of stocked trout on native forage fishes in the boreal foothills of Alberta (Canada) by comparing fish density, population size structure and spatial and temporal activities in stocked and unstocked lakes over 3 years (2005–2007). The numerically dominant dace (primarily Phoxinus spp.) were larger in stocked lakes, consistent with size‐limited predation. Dace were also more crepuscular and concentrated on the lake‐bottom in stocked lakes, compared to more daytime activity in the water column in unstocked lakes. There were, however, no demonstrable effects of trout on the abundance of forage fish. The lack of major population‐level impacts of stocked trout suggests that current stocking practices, characteristics of boreal foothill lakes (e.g. thermal structure, abundant invertebrates, dense macrophytes) and/or behavioural adjustments of forage fish contribute to healthy native fish populations in our stocked lakes.
Anaerobic sulfatase‐maturating enzyme – A mechanistic link with glycyl radical‐activating enzymes?
Authors: Benjdia Alhosna , Subramanian Sowmya , Leprince Jérôme , Vaudry Hubert , Johnson Michael K. , Berteau Olivier
Published: March 2010

Sulfatases form a major group of enzymes present in prokaryotes and eukaryotes. This class of hydrolases is unique in requiring essential post‐translational modification of a critical active‐site cysteinyl or seryl residue to Cα‐formylglycine (FGly). Herein, we report mechanistic investigations of a unique class of radical‐S‐adenosyl‐L‐methionine (AdoMet) enzymes, namely anaerobic sulfatase‐maturating enzymes (anSMEs), which catalyze the oxidation of Cys‐type and Ser‐type sulfatases and possess three [4Fe‐4S]2+,+ clusters. We were able to develop a reliable quantitative enzymatic assay that allowed the direct measurement of FGly production and AdoMet cleavage. The results demonstrate stoichiometric coupling of AdoMet cleavage and FGly formation using peptide substrates with cysteinyl or seryl active‐site residues. Analytical and EPR studies of the reconstituted wild‐type enzyme and cysteinyl cluster mutants indicate the presence of three almost isopotential [4Fe‐4S]2+,+ clusters, each of which is required for the generation of FGly in vitro. More surprisingly, our data indicate that the two additional [4Fe‐4S]2+,+ clusters are required to obtain efficient reductive cleavage of AdoMet, suggesting their involvement in the reduction of the radical AdoMet [4Fe‐4S]2+,+ center. These results, in addition to the recent demonstration of direct abstraction by anSMEs of the Cβ H‐atom from the sulfatase active‐site cysteinyl or seryl residue using a 5′‐deoxyadenosyl radical, provide new insights into the mechanism of this new class of radical‐AdoMet enzymes.
Data protection in the outsourced call centre: an exploratory case study
Authors: Ball Kirstie
Published: March 2010

Against a backdrop of growing concern about the protection of consumer data as it is transferred to call centres in offshore locations, this article examines data protection (DP) compliance in the multi‐client outsourced call centre. Using an in‐depth single case study of a South African outsourcer and drawing on the now extensive body of call centre research, it argues that routine DP compliance is predominantly driven by the employment relationship and the client contract. With no research of this nature ever having been undertaken previously, it is argued that compliance is affected by the manner in which employees are paid, contracted and performance managed. This study also confirms that the employment relationship is an information security measure for organisations.
Hydrogels as a Platform for Stem Cell Delivery to the Heart
Authors: Kurdi Mazen , Chidiac Rony , Hoemann Caroline , Zouein Fouad , Zgheib Carlos , Booz George W.
Published: March 2010

Stem cell therapy offers great promise to repair the injured or failing heart. The outcomes of clinical trials to date, however, have shown that the actual benefit realized falls far short of the promise. A number of factors may explain why that is the case, but poor stem cell retention and engraftment in the hostile environment of the injured heart would seem to be a major factor. Improving stem cell retention and longevity once delivered would seem a logical means to enhance their reparative function. One way to accomplish this goal may be injectable hydrogels, which would serve to fix stem cells in place while providing a sheltering environment. Hydrogels also provide a means to allow for the paracrine factors produced by encapsulated stem cells to diffuse into the injured myocardium. Alternatively, hydrogels themselves can be used for the sustained delivery of reparative factors. Here the authors discuss chitosan‐based hydrogels. Congest Heart Fail. 2010;16:132–135. © 2010 Wiley Periodicals, Inc.
Statistical analysis of binary data generated from multilocus dominant DNA markers
Authors: KHANG T. F. , YAP V. B.
Published: March 2010

The use of methodologies such as RAPD and AFLP for studying genetic variation in natural populations is widespread in the ecology community. Because data generated using these methods exhibit dominance, their statistical treatment is less straightforward. Several estimators have been proposed for estimating population genetic parameters, assuming simple random sampling and the Hardy–Weinberg (HW) law. The merits of these estimators remain unclear because no comparative studies of their theoretical properties have been carried out. Furthermore, ascertainment bias has not been explicitly modelled. Here, we present a comparison of a set of candidate estimators of null allele frequency (q), locus‐specific heterozygosity (h) and average heterozygosity () in terms of their bias, standard error, and root mean square error (RMSE). For estimating q and h, we show that none of the estimators considered has the least RMSE over the parameter space. Our proposed zero‐correction procedure, however, generally leads to estimators with improved RMSE. Assuming a beta model for the distribution of null homozygote proportions, we show how correction for ascertainment bias can be carried out using a linear transform of the sample average of h and the truncated beta‐binomial likelihood. Simulation results indicate that the maximum likelihood and empirical Bayes estimator of have negligible bias and similar RMSE. Ascertainment bias in estimators of is most pronounced when the beta distribution is J‐shaped and negligible when the latter is inverse J‐shaped. The validity of the current findings depends importantly on the HW assumption—a point that we illustrate using data from two published studies.
Design of phylum‐specific hybrid primers for DNA barcoding: addressing the need for efficient COI amplification in the Echinodermata
Authors: HOAREAU T. B. , BOISSIN E.
Published: March 2010

Recent research has shown the usefulness of the Folmer region of the cytochrome oxidase I (COI) as a genetic barcode to assist in species delimitation of echinoderms. However, amplification of COI is often challenging in echinoderms (low success or pseudogenes). We present a method that allows the design of phylum‐specific hybrid primers, and use this to develop COI primers for the Echinodermata. We aligned COI sequences from 310 echinoderm species and designed all possible primers along the consensus sequence with two methods (standard degenerate and hybrid). We found much lower degeneracy for hybrid primers (4‐fold degeneracy) than for standard degenerate primers (≥48‐fold degeneracy). We then designed the most conserved hybrid primers to amplify a >500‐bp region within COI. These primers successfully amplified this gene region in all tested taxa (123 species across all echinoderm classes). Sequencing of 30 species among these confirmed both the quality of the sequences (>500 bp, no pseudogenes) and their utility as a DNA barcode. This method should be useful for developing primers for other mitochondrial genes and other phyla. The method will also be of interest for the development of future projects involving both community‐based genetic assessments on macroorganisms and biodiversity assessment of environmental samples using high‐throughput sequencing.
Design of occupancy studies with imperfect detection
Authors: Guillera‐Arroita Gurutzeta , Ridout Martin S. , Morgan Byron J. T.
Published: March 2010

1. Occupancy is an important concept in ecology. To obtain an unbiased estimator of occupancy it is necessary to address the issue of imperfect detection, which requires conducting replicate surveys at the sites being sampled. As the allocation of total effort can be done in different ways, occupancy studies should be designed carefully to ensure an efficient use of available resources.

2. In this paper we address the design of single‐season single‐species occupancy studies with a focus on: (1) issues relating to small sample sizes and (2) the potential relevance of including the precision of the detectability estimator as a criterion for design. We explore analytically the model with constant probabilities and examine how bias and precision are affected by the numbers of sites and replicates used.

3. We show how, for small sample sizes, the estimator properties depart from those predicted by large sample approximations, emphasize the need to use simulations when designing for small sample sizes and provide a new software tool that can assist in this process.

4. We offer advice on the amount of replication needed when the probability of detection is a quantity of interest and show that, in this case, it is more efficient to reduce the number of sites and increase the amount of replication per site compared with situations where only occupancy is of concern.

5. Synthesis and applications. It is essential to have clearly stated objectives before starting a study and to design the sampling accordingly. As the allocation of effort into replication and sites can be done in different ways, occupancy studies should be designed carefully to ensure an efficient use of available resources. To avoid waste, it is crucial to anticipate the quality of the estimates that can be expected from a particular study design. The discussion and guidance provided here is of special interest for those designing occupancy studies with small sample sizes, something not uncommon in the context of ecology and conservation.