bluuebunny/crossref_metadata_2025 huggingface dataset:
Hepatitis C virus RNA and core protein in kidney glomerular and tubular structures isolated with laser capture microdissection
Authors: Sansonno D , Lauletta G , Montrone M , Grandaliano G , Schena F P , Dammacco F
Published: June 2005

The role of hepatits C virus (HCV) in the production of renal injury has been extensively investigated, though with conflicting results. Laser capture microdissection (LCM) was performed to isolate and collect glomeruli and tubules from 20 consecutive chronically HCV-infected patients, namely 6 with membranoproliferative glomerulonephritis, 4 with membranous glomerulonephritis, 7 with focal segmental glomerulosclerosis and 3 with IgA-nephropathy. RNA for amplification of specific viral sequences was provided by terminal continuation methodology and compared with the expression profile of HCV core protein. For each case two glomeruli and two tubular structures were microdissected and processed. HCV RNA sequences were demonstrated in 26 (65%) of 40 glomeruli, but in only 4 (10%) of the tubules (P < 0·05). HCV core protein was concomitant with viral sequences in the glomeruli and present in 31 of the 40 tubules. HCV RNA and/or HCV core protein was found in all four disease types. The immunohistochemical picture of HCV core protein was compared with the LCM-based immunoassays of the adjacent tissue sections. Immune deposits were detected in 7 (44%) of 16 biopsy samples shown to be positive by extraction methods. The present study indicates that LCM is a reliable method for measuring both HCV RNA genomic sequences and HCV core protein in kidney functional structures from chronically HCV-infected patients with different glomerulopathies and provides a useful baseline estimate to define the role of HCV in the production of renal injury. The different distribution of HCV RNA and HCV-related proteins may reflect a peculiar ‘affinity’ of kidney microenvironments for HCV and point to distinct pathways of HCV-related damage in glomeruli and tubules.
Respiratory syncytial virus and neutrophil activation
Authors: Bataki E L , Evans G S , Everard M L
Published: June 2005

Respiratory syncytial virus infects almost all children by 2 years of age. Neutrophils are the predominant airway leucocytes in RSV bronchiolitis and they are activated in the presence of infection. However it is not clear whether RSV can directly signal to activate neutrophil cytotoxic function. To investigate this we have used a preparation of RSV washed using a new centrifugal diafiltration method to rapidly remove inflammatory molecules produced by the epithelial cells used to propagate the RSV stock. Human neutrophils were isolated from peripheral blood and activated with either the unwashed crude RSV preparations or the purified intact RSV. Neutrophils were also challenged with purified RSV G-glycoprotein. The effect of challenging human neutrophils with these preparations of intact RSV, or the RSV G-glycoprotein, was assessed by measuring the cell surface expression of CD11b and CD18b, the phagocytic oxidative burst, and intracellular release of calcium pools. Neutrophils challenged with the washed RSV exhibited significantly lower activation of surface marker expression (P < 0·001) and oxidative burst (P < 0·001) than those challenged with unwashed virus or with virus free supernatant. There was no increase in intracellular calcium release on exposure to the washed RSV. Purified G glycoprotein did not stimulate neutrophils, whilst the use of a blocking antibody to the F protein did not prevent unwashed RSV from activating cytotoxic responses. These results suggest that neutrophils have no innate signalling system that recognizes RSV but they are activated at sites of RSV infection as a result of the cytokines and inflammatory molecules released by virally infected cells.
Growth factor deficiency in patients with ataxia telangiectasia
Authors: Schubert R , Reichenbach J , Zielen S
Published: June 2005

One prominent feature of patients with the autosomal recessive disease ataxia telangiectasia (AT) is somatic growth retardation. Due to their essential roles in development we examined levels of insulin-like growth factor-I (IGF-I) as well as its main binding protein (IGFBP-3) in a group of AT patients. Growth status of 19 patients was assessed by body mass index (BMI) and nutritional protocols. As suspected, BMI was low in AT patients despite adequate nutrition. Serum levels of IGF-I were found to be below the 3rd percentile in 9 (56%) out of 16 patients and of IGFBP-3 in 13 (81%) out of 16 patients. Our observations demonstrate that IGF-I and IGFBP-3 levels reflect the impaired growth status in patients with AT.
The immune recognition of gluten in coeliac disease
Authors: Ciccocioppo R , Di Sabatino A , Corazza G R
Published: June 2005

Coeliac disease, the most common intestinal disorder of western populations, is an autoimmune enteropathy caused by an abnormal immune response to dietary gluten peptides that occurs in genetically susceptible individuals carrying the HLA-DQ2 or -DQ8 haplotype. Despite the recent progresses in understanding the molecular mechanisms of mucosal lesions, it remains unknown how increased amounts of gluten peptides can enter the intestinal mucosa to initiate the inflammatory cascade. Current knowledge indicates that different gluten peptides are involved in the disease process in a different manner, some fragments being ‘toxic’ and others ‘immunogenic’. Those defined as ‘toxic’ are able to induce mucosal damage either when added in culture to duodenal endoscopic biopsy or when administered in vivo, while those defined as ‘immunogenic’ are able to specifically stimulate HLA-DQ2- or DQ8-restricted T cell clones isolated from jejunal mucosa or peripheral blood of coeliac patients. These peptides are able to trigger two immunological pathways: one is thought to be a rapid effect on the epithelium that involves the innate immune response and the other represents the adaptive immune response involving CD4+ T cells in the lamina propria that recognize gluten epitopes processed and presented by antigen presenting cells. These findings are the subject of the present review.
Differential pattern of cytokine expression by macrophages infectedin vitrowith differentMycobacterium tuberculosisgenotypes
Authors: Chacón-Salinas R , Serafín-López J , Ramos-Payán R , Méndez-Aragón P , Hernández-Pando R , Van Soolingen D , Flores-Romo L , Estrada-Parra S , Estrada-García I
Published: June 2005

It has been shown recently that different genotypes of Mycobacterium tuberculosis induce distinct immune responses in the host, as reflected by variations in cytokine and iNOS expression. Because these molecules are probably regulated by multiple factors in vivo this complex phenomenon was partially analysed by assessing cytokine and iNOS expression by real-time polymerase chain reaction (PCR) and enzyme-linked immunosorbent assay (ELISA) in an in vitro model of bone marrow-derived macrophages infected with three different M. tuberculosis genotypes: Canetti, H37 Rv and Beijing. Although the three genotypes induced production of iNOS and the different cytokines tested at 24 h post-infection, macrophages infected with the Beijing isolate expressed the highest levels of mRNA for iNOS, interleukin (IL)-1β, tumour necrosis factor (TNF)-α, IL-12 cytokines and lower levels of IL-10 compared with cells infected with other genotypes. This expression pattern has been associated with infection control, but during infection in vivo with the Beijing genotype it is lost upon progression to chronic phase. The failure to control infection is likely to be influenced by cytokines produced by other cell types and bacterial molecules expressed during the course of disease. Results presented in this work show that each genotype has the ability to induce different levels of cytokine expression that could be related to its pathogenesis during infection.
Mammalian Toll-like receptors: to immunity and beyond
Authors: Hopkins P A , Sriskandan S
Published: June 2005

Toll-like receptors (TLRs) constitute an archetypal pattern recognition system. Their sophisticated biology underpins the ability of innate immunity to discriminate between highly diverse microbial pathogens and self. However, the remarkable progress made in describing this biology has also revealed new immunological systems and processes previously hidden to investigators. In particular, TLRs appear to have a fundamental role in the generation of clonal adaptive immune responses, non-infectious disease pathogenesis and even in the maintenance of normal mammalian homeostasis. Although an understanding of TLRs has answered some fundamental questions at the host–pathogen interface, further issues, particularly regarding therapeutic modulation of these receptors, have yet to be resolved.
Effects of increasing fire frequency on black carbon and organic matter in Podzols of Siberian Scots pine forests
Authors: Czimczik C. I. , Schmidt M. W. I. , Schulze E.‐D.
Published: June 2005

Fires in boreal forests frequently convert organic matter in the organic layer to black carbon, but we know little of how changing fire frequency alters the amount, composition and distribution of black carbon and organic matter within soils, or affects podzolization. We compared black carbon and organic matter (organic carbon and nitrogen) in soils of three Siberian Scots pine forests with frequent, moderately frequent and infrequent fires.

Black carbon did not significantly contribute to the storage of organic matter, most likely because it is consumed by intense fires. We found 99% of black carbon in the organic layer; maximum stocks were 72 g m−2. Less intense fires consumed only parts of the organic layer and converted some organic matter to black carbon (> 5 g m−2), whereas more intense fires consumed almost the entire organic layer. In the upper 0.25 m of the mineral soil, black carbon stocks were 0.1 g m−2 in the infrequent fire regime.

After fire, organic carbon and nitrogen in the organic layer accumulated with an estimated rate of 14.4 g C m−2 year−1 or 0.241 g N m−2 year−1. Maximum stocks 140 years after fire were 2190 g organic C m−2 and 40 g N m−2, with no differences among fire regimes. With increasing fire frequency, stocks of organic carbon increased from 600 to 1100 g m−2 (0–0.25 m). Stocks of nitrogen in the mineral soil were similar among the regimes (0.04 g m−2). We found that greater intensities of fire reduce amounts of organic matter in the organic layer but that the greater frequencies may slightly increase amounts in the mineral soil.
A numerical investigation into factors affecting the anchorage of roots in tension
Authors: Dupuy L. , Fourcaud T. , Stokes A.
Published: June 2005

The arrangement of a plant's roots in the soil determines the ability of the plant to resist uprooting. We have investigated the influence of root morphology on anchorage using simple patterns of root systems and numerical simulation. The form and mechanical properties of roots were derived from results found in the literature. Major parameters determining soil characteristics, root patterns and strength were varied so that their influence could be evaluated. The design of the experimental method we used generated an optimal number of configurations of different root systems, the tensile resistances of which were calculated by two‐dimensional finite element analysis. We could quantify the influence of specific parameters, e.g. branching angle, number of lateral roots and soil cohesion, as well as global parameters such as total contact area, basal diameter and volume of the whole root system. We found that the number of roots and the diameter of roots were major components affecting the resistance to uprooting. The combination of topology and biomass explained 70% of the variation of tensile resistance.
Characterization of recently 14C pulse‐labelled carbon from roots by fractionation of soil organic matter
Authors: Bhupinderpal‐Singh  , Hedley M. J. , Saggar S.
Published: June 2005

The inability of physical and chemical techniques to separate soil organic matter into fractions that have distinct turnover rates has hampered our understanding of carbon (C) and nutrient dynamics in soil. A series of soil organic matter fractionation techniques (chemical and physical) were evaluated for their ability to distinguish a potentially labile C pool, that is ‘recent’ root and root‐derived soil C. ‘Recent’ root and root‐derived C was operationally defined as root and soil C labelled by 14CO2 pulse labelling of rye grass–clover pasture growing on undisturbed cores of soil. Most (50–94%) of total soil + root 14C activity was recovered in roots.

Sequential extraction of the soil + roots with resin, 0.1 m NaOH and 1 m NaOH allocated ‘recent’ soil + root 14C to all fractions including the alkali‐insoluble residual fraction. Approximately 50% was measured in the alkali‐insoluble residue but specific activity was greater in the resin and 1 m NaOH fractions. Hot 0.5 m H2SO4 hydrolysed 80% of the 14C in the alkali‐insoluble residue of soil + roots but this diminished specific activity by recovering much non‐14C organic matter. Pre‐alkali extraction treatment with 30% H2O2 and post‐alkali treatment extractions with hot 1 m HNO3 removed organic matter with a large 14C specific activity from the alkali‐insoluble residue.

Density separation failed to isolate a significant pool of ‘recent’ root‐derived 14C. The density separation of 14C‐labelled roots, and roots remixed with non‐radioactive soil, showed that the adhesion of soil particles to young 14C‐labelled roots was the likely cause of the greater proportion of 14C in the heavy fraction.

Simple chemical or density fractionations of C appear unsuitable for characterizing ‘recent’ root‐derived C into fractions that can be designated labile C (short turnover time).
Influence of land use on the characteristics of humic substances in some tropical soils of Nigeria
Authors: Piccolo A. , Conte P. , Spaccini R. , Mbagwu J. S. C.
Published: June 2005

In highly weathered tropical conditions, soil organic matter is important for soil quality and productivity. We evaluated the effects of deforestation and subsequent arable cropping on the qualitative and quantitative transformation of the humic pool of the soil at three locations in Nigeria. Cultivation reduced the humic pool in the order: acetone‐soluble hydrophobic fraction (HE) > humic acid (HA) > humin (HU) > fulvic acid (FA), but not to the same degree at all three sites. The C and N contents, as well as the C/N ratios of humic extracts, were large and not substantially influenced by land use. The δ13C values of the humic extracts were invariably more negative in forested soils thereby showing a dilution of δ13C signature with cultivation from C3 to C4 plants. The δ13C values of apolar HE fractions were generally more negative, indicating a reduced sensitivity compared with other humic fractions to turnover of crop residues. The contents of hydrophobic constituents (alkyl and aromatic C), as revealed by cross‐polarization magic angle spinning (CPMAS)13C‐NMR spectroscopy, in HA, FA and HU were generally < 50%, with the exception of larger hydrophobicity in HU in the forested soil at Nsukka and HA in that at Umudike. The HE fraction contained significantly more apolar constituents, and consequently had a larger intrinsic hydrophobicity than the other humic fractions. The larger reduction of apolar humic constituents than of the less hydrophobic humic fractions, when these soils were deforested for cultivation, indicates that at those sites the stability of accumulated organic matter is to be ascribed mainly to the selective preservation of hydrophobic compounds.
Exploring scale‐dependent correlation of soil properties by nested sampling
Authors: Lark R. M.
Published: June 2005

The value of nested sampling for exploring the spatial structure of univariate variation of the soil has been demonstrated in several studies and applied to practical problems. This paper shows how the method can be extended to the multivariate case. While the extension is simple in theory, in practice the direct estimation of covariance components by equating mean‐square matrices with their expectation will often lead to estimates that are not positive semidefinite. This paper discusses solutions to this problem for balanced and unbalanced sample designs. In the balanced case there is a residual maximum likelihood (REML) estimator that will find estimates of covariance components that maximize an overall likelihood on the condition that all components are positive semidefinite (p.s.d.). This is possible because the condition is met if the differences of successive mean‐square matrices are positive semidefinite, and this constraint can be incorporated into an algorithm. This does not hold for unbalanced designs. In this paper the problem was solved for unbalanced designs by scaling covariance components that were not p.s.d. to the nearest p.s.d. matrix according to a Euclidean distance.

These methods were applied to data from three surveys, two with balanced and one with unbalanced sampling. Different patterns of scale‐dependence of the correlation of soil properties were found. For example, at Ginninderra Experimental Station in Australia the soil water content and bulk density were correlated significantly, with the correlation increasing with distance to 56 m, but at longer distances the properties were not significantly correlated. By contrast, the pH of the soil and the available P content showed correlation that increased with distance. The implications of these results for planning more detailed sampling, both for prediction and for investigation of processes, are discussed.
In situ accumulation of methane bubbles in a natural wetland soil
Authors: Tokida T. , Miyazaki T. , Mizoguchi M. , Seki K.
Published: June 2005

Natural wetlands are a significant source of atmospheric methane, an important greenhouse gas. Compared with numerous papers on measurements of methane emission from natural wetland surfaces, there are few reports on methane configuration and distribution within wetland soil profiles. By using a newly designed gas sampler, we succeeded in collecting free‐phase gas from beneath the water table down to 120 cm in a peat. The volumetric percentage of methane in the gas phase increased with depth and was generally more than 50% beneath the zone within which the water table fluctuates. The volume of the gas phase in the peat beneath the water table was estimated to be from 0 to 19% with significant variation with depth, suggesting uneven distribution of gas bubbles. Using the volume ratio of the gas and liquid phases and methane concentration data in the gas phase, as well as assuming that methane was in equilibrium (based on Henry's Law between the two phases), we calculated that ∼60% of the methane accumulates in the form of bubbles. These results suggest the importance of ebullition in methane emission, which might be a major cause for the reportedly large variation of methane emission in both space and time. Most importantly, our results show the need to consider gaseous‐phase methane for understanding the production, transport and emission mechanisms of methane in wetlands, which has been overlooked to date.
Direct evidence of basic aluminium sulphate minerals in an S‐impacted Andosol
Authors: Delfosse T. , Elsass F. , Delvaux B.
Published: June 2005

The formation of basic aluminium sulphate (BAS) minerals [(K,Na)nAlx(OH)y(SO4)z] has often been invoked to explain sulphate retention in soils. These minerals have not yet, however, been directly observed in the soil. We extracted the clay fractions of Andosols intercepting large inputs of volcanogenic sulphur dioxide and acids (HCl, HF), simply by dispersing clays with Na+‐resins in deionized water without any other chemical treatment. Clay fractions concentrate 39–63% of total sulphur content of soil. Transmission electron microscopy coupled with energy‐dispersive analysis revealed the presence of BAS particles, appearing as nodules and spheres. These particles have an equivalent diameter smaller than 0.2 µm. They have an Al:S ratio close to 2.2 and 3.8 and are possibly amorphous aluminite or basaluminite, respectively. They seem to have been formed in microenvironments enriched in sulphate, but also in fluoride anions. Their formation seems to have been enhanced by the combination of large inputs of acids and SO2 and an effective Al supply from weathering of volcanic glass.
Hydrostructural characteristics of two African tropical soils
Authors: Braudeau E. , Sene M. , Mohtar R. H.
Published: June 2005

This paper describes the characteristic shrinkage curve of a soil as it dries. It also introduces a new method to measure specific soil moisture states such as permanent wilting point and field capacity using the shrinkage curve. The model considers the soil fabric as a non‐rigid, aggregated and unsaturated soil water medium. Its functional parameters (defined as pedohydral parameters) are the independent parameters of the shrinkage curve, which defines two major aspects of the structure of the fabric: (i) the volumetric functional elements of the soil fabric, and (ii) the arrangement of solid, water and air as functions of water content.

Two African tropical soils were characterized and analysed according to a structural model with parameters of their shrinkage curve. The parameters of four soil horizons for the two soil types were determined continuously along their shrinkage curves. They were then used as descriptive variables representing the soil's hydrostructural behaviour in a canonical variate analysis, the results of which showed the A horizons to be distinct from the lower horizons, which appear as continua down the profiles. Analysis of the results reveals the importance of the clay and of the iron/clay ratio in the hydrostructural properties of the two soils. Transitional points of the shrinkage curve matched well some particular moisture states of the water potential curve, such as wilting points and field capacities. A more precise method of calculating water‐holding characteristics and other structural properties such as air capacity and swelling index can be obtained from the characteristic shrinkage curve.
Kinetics of degradation of adenosine triphosphate in chill‐stored rainbow trout (Oncorhynchus mykiss)
Authors: Howgate Peter
Published: June 2005

Trout that had been held in freshwater or in sea water were stored at 0, 5, or 10 °C, and in the case of sea‐water‐held trout, also at 15 °C. Samples were taken during storage for analysis of ATP‐derived metabolites. The kinetics of degradation of ATP were investigated using two mathematical models, one depending on only endogenous enzymes acting in a sequence of consecutive first order reactions, and one assuming inosine was additionally converted to hypoxanthine by bacterial action. The former model adequately fitted the data from trout held in sea water, but the latter model was a better fit to data from the trout held in freshwater. The activation energy of loss of inosine monophosphate was estimated to be 17.4 kcal mol−1.
From the emergency department to home
Authors: Dunnion Mary E , Kelly Billy
Published: June 2005

Aim.  The purpose of this study was to explore dimensions of the management of the older person following care in an emergency department in preparation for discharge home by identifying perceptions and attitudes of staff in both emergency department and primary care sectors.

Background.  It is recognized that older people discharged home directly from the emergency department are a vulnerable group. Effective communication and liaison are seen to be keys to the provision of high quality care for older people in the emergency department and in ensuring a seamless care between sectors.

Design.  A purposeful sample was collected that comprised the total population (n = 222) of all grades of medical and nursing staff in both the emergency department and all nursing (Public Health Nurses & Practice nurses) and medical staff (General Practitioners) in the primary care area.

Methods.  Methodology used was that of a survey approach of nursing and medical staff in both the emergency department and primary care services. Standardized questionnaires were employed which comprised both open and closed questioning style. Raw statistical data were analysed using SPSS for Windows while the qualitative data arising from the open‐ended questions were content analysed for themes.

Results.  Many staff in the primary care area reported the level of communication between the emergency department and the primary care area as unsatisfactory with confusion regarding follow‐up care and a lack of support for older people on discharge. Hospital staff reported the level of communication to be much greater than that perceived by their colleagues in primary care. There was agreement of staff in both sectors in relation to the perceived usefulness of a discharge liaison nurse in the emergency department.

Conclusions.  Previous research highlights communication difficulties when patients are discharged from hospital. Findings from this study indicate that this problem can also be applied to the emergency department.

Relevance to clinical practice.  Implications for practice include a need for a multidisciplinary approach to developing referral guidelines, staff training and a comprehensive dissemination of information between sectors ultimately to improve quality and continuity of care for the older person.
Finnish nurses’ and nursing students’ pharmacological skills
Authors: Grandell‐Niemi Heidi , Hupli Maija , Leino‐Kilpi Helena , Puukka Pauli
Published: June 2005

Purposes and objectives.  The purposes of this study were to investigate the pharmacological skills of Finnish nurses and graduating nursing students, to determine how pharmacological skills are related to background factors and to identify differences between nurses and students and, finally, to examine how the instrument used, the Medication Calculation Skills Test, works.

Background.  Pharmacology is a relevant and topical subject. In several studies, however, pharmacological skills of nurses and nursing students have been found insufficient. In addition, pharmacology as a subject is found to be difficult for both nursing students and nurses.

Design and methods.  The study was evaluative in nature; the data were collected using the Medication Calculation Skills Test, developed for the purposes of this study. The instrument was used to gather information on background factors and self‐rated pharmacological and mathematical skills and to test actual skills in these areas.

Results.  Results concerning pharmacological skills are reported in this paper. The maximum Medication Calculation Skills Test score was 24 points. The mean score for nurses was 18.6 and that for students 16.3. Half of (50%) the students attained a score of 67% and 57% of nurses attained a score of 79%.

Conclusions.  Nurses and students had some deficiencies in their pharmacological skills. Nurses had better pharmacological skills than students according to both self‐ratings and actual performance on the test.

Relevance to clinical practice.  It is vitally important that nurses have adequate pharmacological skills to administer medicines correctly. This study showed that the Medication Calculation Skills Test seems to work well in measuring pharmacological skills, even though it needs further evaluation. Findings from this study can be used when planning the nursing curriculum and further education for Registered Nurses.
Asthma – quality of life for Swedish children
Authors: Rydström Ingela , Dalheim‐Englund Ann‐Charlotte , Holritz‐Rasmussen Birgit , Möller Christian , Sandman Per‐Olof
Published: June 2005

Aims and objectives.  The purpose of this study was to describe how Swedish children with asthma experience their QoL and to search for possible associations between their experience of QoL and some determinants.

Background.  Asthma is a chronic disorder that can restrict a child's life, physically, emotionally, socially and spiritually, and this has an impact on a child's quality of life (QoL).

Methods.  Two hundred and twenty‐six children with asthma (37% girls and 63% boys) and 371 parents of these children participated in the study. The Paediatric Asthma Quality Of Life Questionnaire (PAQLQ) was used to measure the children's QoL. This questionnaire reveals how the children's asthma interferes with their normal activities, their symptoms and how this interference has made them feel.

Results.  The findings show that most children with asthma estimated their QoL towards the positive end of the scale. The children reported more impairment in the domain of activities than in emotions and symptoms. The most commonly restricted activity was the children's ability to run. Significant associations were found between a higher QoL outcome and being a boy, as well as living in the south of Sweden. A higher QoL was also found in children with mothers older than 40 years of age and in children with cohabiting parents. It was also associated with their fathers’ QoL in a positive direction.

Conclusions.  It is important that children with asthma will maintain a high QoL. In this study the children were being treated with asthma medication when they evaluated their QoL. Perhaps this fact might have influenced the results in a positive direction.

Relevance to clinical practice.  The findings of our study underline the importance of accurate nursing assessment including background variables of the children. Nurses also have to be aware that some of the children in the study have a low QoL and these children must not be forgotten. In addition, as caring tends to focus on the patients’ limitations, another important issue for nurses is to try to discover those aspects in a child's daily life that contribute to a high QoL in order to improve and maintain the child's wellbeing.
Assessment of nursing management and utilization of nursing resources with the RAFAELA patient classification system – case study from the general wards of one central hospital
Authors: Rainio Anna‐Kaisa , Ohinmaa Arto E
Published: June 2005

Background.  RAFAELA is a new Finnish PCS, which is used in several University Hospitals and Central Hospitals and has aroused considerable interest in hospitals in Europe.

Aims and objectives.  The aim of the research is firstly to assess the feasibility of the RAFAELA Patient Classification System (PCS) in nursing staff management and, secondly, whether it can be seen as the transferring of nursing resources between wards according to the information received from nursing care intensity classification.

Methods.  The material was received from the Central Hospital's 12 general wards between 2000 and 2001. The RAFAELA PCS consists of three different measures: a system measuring patient care intensity, a system recording daily nursing resources, and a system measuring the optimal nursing care intensity/nurse situation. The data were analysed in proportion to the labour costs of nursing work and, from that, we calculated the employer's loss (a situation below the optimal level) and savings (a situation above the optimal level) per ward as both costs and the number of nurses.

Results.  In 2000 the wards had on average 77 days below the optimal level and 106 days above it. In 2001 the wards had on average 71 days below the optimal level and 129 above it. Converting all these days to monetary and personnel resources the employer lost €307,745 or 9.84 nurses and saved €369,080 or 11.80 nurses in total in 2000. In 2001 the employer lost in total €242,143 or 7.58 nurses and saved €457,615 or 14.32 nurses. During the time period of the research nursing resources seemed not have been transferred between wards.

Conclusions.  RAFAELA PCS is applicable to the allocation of nursing resources but its possibilities have not been entirely used in the researched hospital. The management of nursing work should actively use the information received in nursing care intensity classification and plan and implement the transferring of nursing resources in order to ensure the quality of patient care.

Relevance to clinical practice.  Information on which units resources should be allocated to is needed in the planning of staff resources of the whole hospital. More resources do not solve the managerial problem of the right allocation of resources. If resources are placed wrongly, the problems of daily staff management and cost control continue.
The impact of an ICU liaison nurse: a case study of ward nurses’ perceptions
Authors: Chaboyer Wendy , Gillespie Brigid , Foster Michelle , Kendall Melissa
Published: June 2005

Aims and objectives.  To provide a description of ward nurses perceptions of the intensive care unit liaison nurse role.

Background.  Critical care outreach services have become commonplace over recent years. In Australia, the intensive care unit liaison nurse, developed at a local level by healthcare providers, has emerged as a way of improving the continuity of care offered to this patient group. As a relatively new development in critical care services, evaluation of this role has been limited, particularly in relation to the perceptions of ward nurses who receive patients on discharge from intensive care unit.

Design.  Case study of one Australian hospital that utilizes an intensive care unit liaison nurse.

Methods.  Ten ward nurses were purposefully selected for their representativeness of the population and for their experience with the intensive care unit liaison nurse role. Each of these nurses participated in semi‐structured in‐depth interviews. Thematic analysis was used to analyse the data.

Findings.  Three major themes emerged from the interviews, highlighting role behaviours, contextual demands and outcomes associated with the intensive care unit liaison nurse role. The role behaviours of the liaison nurse included the professional characteristics of the individual and the primacy of clinical liaison as a role descriptor. Contextual demands were environmental characteristics relevant to providing patient, family and staff support. Outcomes of the role were perceived to include environmental preparation and education.

Conclusions.  This qualitative study has presented an overview of ward nurses perceptions of the intensive care unit liaison nurse role within one Australian hospital, illustrating the educative and empathic support that the liaison nurse role can provide to ward nurses.

Relevance to clinical practice.  Collaboration with ward nurses in developing specialist roles such as the intensive care unit liaison nurse is essential in ensuring improvements in patient and family care across the continuum.
Care needs of residents in community‐based long‐term care facilities in Taiwan
Authors: Li I‐chuan , Yin Teresa Jeo‐chen
Published: June 2005

Aim.  The purpose of this study is to gain an understanding both of the characteristics of residents who receive the services of nursing assistants and the service intensity (service tasks, service time and cost) of nursing assistants as a means of developing a patient classification based upon resource consumption.

Background.  Most people in Taiwan send their disabled older family members to community‐based long‐term care facilities instead of nursing homes because they are much cheaper, and because they are generally closer to their homes, making visits more convenient. Nursing assistants make up the largest group of personnel in long‐term care facilities. To determine resource use, both the service time and the actual activities performed for a resident by nursing assistants need to be assessed and this will help to develop a patient classification system to predict resource use and patient outcomes.

Methods.  A descriptive survey method was used to identify the tasks performed by nursing assistants in community‐based long‐term care facilities in Taiwan. Nursing assistants were recruited from 10 long‐term care facilities in the Shihlin and Peitou Districts of Taipei City. Thirty‐four nursing assistants and 112 residents participated in this study.

Results.  Findings showed that each nursing assistant spent 5.05 hours per day doing direct service care, which is much higher than the 2.08 hours for nursing assistants in the United States. Among service tasks provided by nursing assistants, personal care consumed 35.1% of their time. Non‐complex treatments were second (33.3%). Skilled nursing and medical services were third (31.6%). The service intensity required of nursing assistants was strongly related to the residents’ activities of daily living and their needs.

Conclusion.  Complex nursing procedures are normally provided by Registered Nurses in nursing homes and consumed almost as much of the nursing assistants’ time as did personal care activities in this study.

Relevance to clinical practice.  It is suggested that a training program for nursing assistants, especially for foreigners in community‐based long‐term care facilities, should be mandated to assure the quality of service.
Surgeon island granite SHRIMP zircon ages: a clue for the Cambrian tectonic setting and evolution of the Palaeopacific margin of Gondwana (northern Victoria Land, Antarctica)
Authors: Fioretti A.M. , Capponi G. , Black L.P. , Varne R. , Visona D.
Published: June 2005

In northern Victoria Land (NVL), Antarctica, the palaeopacific margin of Gondwana is made up of the inboard Wilson (WT) and the two outboard Bowers (BT) and Robertson Bay (RBT) terranes. The occurrence of a Cambro‐Ordovician magmatic arc in the WT argues for a southwestward subduction leading to the final configuration of this margin during the Ross–Delamerian Orogeny. A U‐Pb SHRIMP crystallization age (511.7 ± 2.9 Ma) obtained on the Surgeon Island Granite (SIG), located at the eastern end of the RBT, indicates that the SIG also belongs to the Ross cycle, and provides evidence for multiple subduction zones during the Ross Orogeny. Structural observations show that the SIG and its country rocks are basement to the RBT turbidites. SIG inherited zircon ages indicate the occurrence of Proterozoic crust east of the RBT and constrains the location of the Proterozoic–Palaeozoic boundary in Cambrian Gondwana.
δ11B as tracer of slab dehydration and mantle evolution in Western Anatolia Cenozoic Magmatism
Authors: Tonarini Sonia , Agostini Samuele , Innocenti Fabrizio , Manetti Piero
Published: June 2005

Boron isotope data are presented for Cenozoic Western Anatolia rocks, which define two main associations: (i) calc‐alkaline, shoshonitic and ultra‐potassic rocks (Early to Middle Miocene); and (ii) Late Miocene–Quaternary intraplate alkali basalts. Boron data, together with Sr–Nd isotope and other trace elements, are consistent with a progressive dehydration of the slab, producing fluid phases gradually depleted in B (and 11B). These fluids were added to the supraslab mantle, triggering a partial melting that gave rise to orogenic magmatism. The stretching and tearing of the slab caused by the faster convergence of Greece over Africa with respect to Anatolia facilitated an interaction of the upwelling subslab asthenosphere with residual slab‐fluids during the Late Miocene followed by production of typical intraplate magmas during the Pleistocene–Holocene, whose relatively high δ11B (approximately −2‰) is considered representative of the local asthenosphere not affected by subduction contamination.
Dating faulted alluvial fans with cosmogenic10Be in the Gurvan Bogd mountain range (Gobi‐Altay, Mongolia): climatic and tectonic implications
Authors: Vassallo Riccardo , Ritz Jean‐François , Braucher Régis , Carretier Sébastien
Published: June 2005

The Gurvan Bogd mountain range is a fault system characterized by strong earthquakes (M ∼ 8) separated by long periods of quiescence. Further to the previous works in the area, our study provides new data concerning the tectonic and climatic processes in the Gobi‐Altay. To quantify the slip rates along the faults, we dated offset alluvial fans analysing thein situproduced10Be along profiles at depth. The slip rates along the Bogd strike–slip fault and its associated thrust faults over the Upper Pleistocene–Holocene period are 0.95 ± 0.29 mm yr−1and comprised between 0.12 ± 0.02 and 0.13 ± 0.02 mm yr−1, respectively. The surfaces ages account for a cyclic formation of the fans over the past ∼360 ka, in correlation with the terminations of the marine isotope stages 2, 6, 8 and 10.
Plasmodium falciparum: higher incidence of molecular resistance markers for sulphadoxine than for pyrimethamine in Kasangati, Uganda
Authors: Sendagire Hakim , Kyabayinze Daniel , Swedberg Göte , Kironde Fred
Published: June 2005

In November of 2000, Uganda changed its anti‐malarial policy to replace chloroquine (CQ) with a combination of CQ and sulphadoxine–pyrimethamine (SP) as the first line agents. Information was limited on the efficacy of either drug. The present study was designed to provide baseline information on the efficacy of SP and the prevalence of molecular markers that are associated with SP resistance. Blood samples were collected on filter paper from 169 consenting patients who were diagnosed with malaria. Patients were treated with SP and followed for 14 days using the WHO clinical guidelines. The samples were analysed for molecular resistance markers and correlation of the molecular markers with clinical findings was assessed. SP monotherapy was efficacious for 140 of 163 (85.9%) treated patients. We found a high level of mutations in alleles which have previously been reported to be associated with SP resistance, but there was no correlation between clinical outcomes and molecular markers. With the exception of codon S108 in dhfr (dhfr S108N was at 94.9%), frequencies of dihydropteroate synthase (dhps) mutant and mixed alleles combined (A437G 89% and K540E 83.9%) were higher than those of dihydrofolate reductase (dhfr) (N51I 58.4%, C59R 31.3%).
Risk factors for acute pesticide poisoning in Sri Lanka
Authors: Van Der Hoek Wim , Konradsen Flemming
Published: June 2005

This report describes the characteristics of patients with acute pesticide poisoning in a rural area of Sri Lanka and, for intentional self‐poisoning cases, explores the relative importance of the different determinants. Data were collected for 239 acute pesticide‐poisoning cases, which were admitted to two rural hospitals in Sri Lanka. Sociodemographic characteristics, negative life events and agricultural practices of the intentional self‐poisoning cases were compared with a control group. Most cases occurred among young adults and the large majority (84%) was because of intentional self‐poisoning. Case fatality was 18% with extremely high case fatality for poisoning with the insecticide endosulfan and the herbicide paraquat. Cases were generally younger than controls, of lower educational status and were more often unemployed. No agricultural risk factors were found but a family history of pesticide poisoning and having ended an emotional relationship in the past year was clearly associated with intentional self‐poisoning. The presence of mental disorders could only be assessed for a subsample of the cases and controls and this showed that alcohol dependence was a risk factor. This study shows that acute pesticide poisoning in Sri Lanka is determined by a combination of sociodemographic and psychological factors. Suggestions are given for interventions that could control the morbidity and mortality due to acute pesticide poisoning in developing countries.
Seroprevalence of Q‐fever in febrile individuals in Mali
Authors: Steinmann P. , Bonfoh B. , Péter O. , Schelling E. , Traoré M. , Zinsstag J.
Published: June 2005

Objectives  We conducted a serological survey for Q‐fever among febrile patients in Bamako and Mopti (Mali) and investigated the main risk factors for seroconversion.

Methods  Blood samples from 156 febrile patients were collected in healthcare facilities of Bamako and Mopti and examined with the microimmunofluorescence test.

Results  Forty per cent (n = 63) were seropositive for Q‐fever, 28% in Bamako and 51% in Mopti. A more recent infection was suspected in 9.5% (n = 6) of all seropositive patients. This is the first time that Q‐fever seropositivity is reported in febrile individuals in Mali. The patients’ symptoms and diagnoses spanned a wide range of conditions; none had been diagnosed with Q fever by their treating physician. No risk factors for seropositivity could be identified with the exception of the city of residence and none could be identified with a logistic regression model with ‘city’ taken as random effect.

Conclusion  A high rate of seropositivity to C. burnetii was found among febrile urban patients in Mali but no risk factors for seropositivity could be identified in this study.
Modelling malaria risk in East Africa at high‐spatial resolution
Authors: Omumbo J. A. , Hay S. I. , Snow R. W. , Tatem A. J. , Rogers D. J.
Published: June 2005

Objectives  Malaria risk maps have re‐emerged as an important tool for appropriately targeting the limited resources available for malaria control. In Sub‐Saharan Africa empirically derived maps using standardized criteria are few and this paper considers the development of a model of malaria risk for East Africa.

Methods  Statistical techniques were applied to high spatial resolution remotely sensed, human settlement and land‐use data to predict the intensity of malaria transmission as defined according to the childhood parasite ratio (PR) in East Africa. Discriminant analysis was used to train environmental and human settlement predictor variables to distinguish between four classes of PR risk shown to relate to disease outcomes in the region.

Results  Independent empirical estimates of the PR were identified from Kenya, Tanzania and Uganda (n = 330). Surrogate markers of climate recorded on‐board earth orbiting satellites, population settlement, elevation and water bodies all contributed significantly to the predictive models of malaria transmission intensity in the sub‐region. The accuracy of the model was increased by stratifying East Africa into two ecological zones. In addition, the inclusion of urbanization as a predictor of malaria prevalence, whilst reducing formal accuracy statistics, nevertheless improved the consistency of the predictive map with expert opinion malaria maps. The overall accuracy achieved with ecological zone and urban stratification was 62% with surrogates of precipitation and temperature being among the most discriminating predictors of the PR.

Conclusions  It is possible to achieve a high degree of predictive accuracy for Plasmodium falciparum parasite prevalence in East Africa using high‐spatial resolution environmental data. However, discrepancies were evident from mapped outputs from the models which were largely due to poor coverage of malaria training data and the comparable spatial resolution of predictor data. These deficiencies will only be addressed by more random, intensive small areas studies of empirical estimates of PR.
Physical and psychosocial burden due to lymphatic filariasis as perceived by patients and medical experts
Authors: Krishna Kumari A. , Harichandrakumar K. T. , Das L. K. , Krishnamoorthy K.
Published: June 2005

Patients with lymphatic filariasis (LF) face considerable physical, psychological and social disabilities. Morbidity management and control are important components of the Global Programme to Eliminate Lymphatic Filariasis. But information on the various disabilities caused by LF is scanty. We measured the severity levels of seven health states of LF in the physical and psychosocial domains of health from the perspective of patients and medical experts, using a 7‐domain 5‐level (7D5L) descriptive system. Adenolymphangitis had the highest severity levels in all domains of health followed by lymphoedema grade 4 (L4), lymphoedema grade 3 (L3), hydrocele grade 2 (H2), lymphoedema grade 2 (L2), lymphoedema grade1 (L1) and hydrocele grade 1 (H1). People with higher grades of lymphoedema and hydrocele had more severe psychosocial problems than physical ones. Severity levels assessed by medical experts were lower than those reported by sufferers. These findings indicate that LF has considerable impact on the physical, mental and social domains of health. Morbidity management programmes should be broadened to include counselling, rehabilitation and health education to manage the psychosocial problems caused by LF.