bluuebunny/crossref_metadata_2025 huggingface dataset:
DIBER: protein, DNA or both?
Authors: Chojnowski Grzegorz , Bochtler Matthias
Published: May 2010

The programDIBER(an acronym for DNA and FIBER) requires only native diffraction data to predict whether a crystal contains protein, B-form DNA or both. In standalone mode, the classification is based on the cube root of the reciprocal unit-cell volume and the largest local average of diffraction intensities at 3.4 Å resolution. In combined mode, thePhaserrotation-function score (for the 3.4 Å shell and a canonical B-DNA search model) is also taken into account. In standalone (combined) mode,DIBERclassifies 87.4 ± 0.2% (90.2 ± 0.3%) of protein, 69.1 ± 0.3% (78.8 ± 0.3%) of protein–DNA and 92.7 ± 0.2% (90.0 ± 0.2%) of DNA crystals correctly. Reliable predictions with a correct classification rate above 80% are possible for 36.8 ± 1.0% (60.2 ± 0.4%) of the protein, 43.6 ± 0.5% (59.8 ± 0.3%) of the protein–DNA and 83.3 ± 0.3% (82.6 ± 0.4%) of the DNA structures. Surprisingly, selective use of the diffraction data in the 3.4 Å shell improves the overall success rate of the combined-mode classification. An open-sourceCCP4/CCP4i-compatible version ofDIBERis available from the authors' website at http://www.iimcb.gov.pl/diber and is subject to the GNU Public License.
A crystallization screen based on alternative polymeric precipitants
Authors: Grimm Clemens , Chari Ashwin , Reuter Klaus , Fischer Utz
Published: May 2010

Most commercially available crystallization screens are sparse-matrix screens with a predominance of inorganic salts and polyethylene glycols (PEGs) as precipitants. It was noted that commercially available screens are largely unsatisfactory for the purpose of the crystallization of multimeric protein and protein–nucleic acid complexes. This was reasoned to be a consequence of the redundancy in screening crystallization parameter space by the predominance of PEG as a precipitant in standard screens and it was suggested that this limitation could be overcome by introducing a variety of other organic polymers. Here, a set of 288 crystallization conditions was devised based on alternative polymeric precipitants and tested against a set of 20 different proteins/complexes; finally, a screen comprising the 96 most promising conditions designed to complement PEG- and salt-based commercial screens was proposed.
A conserved domain in type III secretion links the cytoplasmic domain of InvA to elements of the basal body
Authors: Lilic Mirjana , Quezada Cindy M. , Stebbins C. Erec
Published: May 2010

Protein type III secretion systems (T3SSs) are organic nanosyringes that achieve an energy-dependent translocation of bacterial proteins through the two membranes of Gram-negative organisms. Examples include the pathogenic systems of animals, plants and symbiotic bacteria that inject factors into eukaryotic cells, and the flagellar export system that secretes flagellin. T3SSs possess a core of several membrane-associated proteins that are conserved across all known bacterial species that use this system. TheSalmonellaprotein InvA is one of the most highly conserved proteins of this core of critical T3SS components. The crystal structure of a C-terminal domain of InvA reveals an unexpected homology to domains that have been repeatedly found as building blocks of other elements of the T3SS apparatus. This suggests the surprising hypothesis that evolution has produced a significant component of the apparatus structure through a series of gene-duplication and gene-rearrangement events.
Near-atomic resolution structures of urate oxidase complexed with its substrate and analogues: the protonation state of the ligand
Authors: Gabison Laure , Chiadmi Mohamed , El Hajji Mohamed , Castro Bertrand , Colloc'h Nathalie , Prangé Thierry
Published: May 2010

Urate oxidase (uricase; EC 1.7.3.3; UOX) fromAspergillus flavuscatalyzes the oxidation of uric acid in the presence of molecular oxygen to 5-hydroxyisourate in the degradation cascade of purines; intriguingly, catalysis proceeds using neither a metal ion (Fe, Cuetc.) nor a redox cofactor. UOX is a tetrameric enzyme with four active sites located at the interface of two subunits; its structure was refined at atomic resolution (1 Å) using new crystal data in the presence of xanthine and at near-atomic resolution (1.3–1.7 Å) in complexes with the natural substrate (urate) and two inhibitors: 8-nitroxanthine and 8-thiouric acid. Three new features of the structural and mechanistic behaviour of the enzyme were addressed. Firstly, the high resolution of the UOX–xanthine structure allowed the solution of an old structural problem at a contact zone within the tetramer; secondly, the protonation state of the substrate was determined from both a halochromic inhibitor complex (UOX–8-nitroxanthine) and from the H-atom distribution in the active site, using the structures of the UOX–xanthine and the UOX–uric acid complexes; and thirdly, it was possible to extend the general base system, characterized by the conserved catalytic triad Thr–Lys–His, to a large water network that is able to buffer and shuttle protons back and forth between the substrate and the peroxo hole along the reaction pathway.
Flexibility of the Cu,Zn superoxide dismutase structure investigated at 0.57 GPa
Authors: Ascone Isabella , Savino Carmelinda , Kahn Richard , Fourme Roger
Published: May 2010

The 2 Å resolution crystal structure of bovine erythrocyte Cu,Zn superoxide dismutase (CuZnSOD) has been determined by X-ray diffraction at high pressure (0.57 GPa) and room temperature. At 0.57 GPa the secondary, tertiary and quaternary structures are similar to other previously determined bovine erythrocyte CuZnSOD structures. Nevertheless, pressure has a localized impact on the atomic coordinates of Cαatoms and on side chains. The compression of the crystal and of the protein backbone is anisotropic. This anisotropy is discussed, taking into account intermolecular contacts and protein conformation. Pressure perturbation highlights the more flexible zones in the protein such as the electrostatic loop. At 0.57 GPa, a global shift of the dimetallic sites in both subunits and changes in the oxidation state of Cu were observed. The flexibility of the electrostatic loop may be useful for the interaction of different metal carriers in the copper-uptake process, whereas the flexibility of the metal sites involved in the activity of the protein could contribute to explaining the ubiquitous character of CuZnSODs, which are found in organisms living in very different conditions, including the deep-sea environment. This work illustrates the potential of combining X-ray crystallography with high pressure to promote and stabilize higher energy conformational substates.
De-icing: recovery of diffraction intensities in the presence of ice rings
Authors: Chapman Michael S. , Somasundaram Thayumanasamy
Published: May 2010

Macromolecular structures are routinely determined at cryotemperatures using samples flash-cooled in the presence of cryoprotectants. However, sometimes the best diffraction is obtained under conditions where ice formation is not completely ablated, with the result that characteristic ice rings are superimposed on the macromolecular diffraction. In data processing, the reflections that are most affected by the ice rings are usually excluded. Here, an alternative approach of subtracting the ice diffraction is tested. High completeness can be retained with little adverse effect upon the quality of the integrated data. This offers an alternate strategy when high levels of cryoprotectant lead to loss of crystal quality.
Structure ofArabidopsischloroplastic monothiol glutaredoxin AtGRXcp
Authors: Li Lenong , Cheng Ninghui , Hirschi Kendal D. , Wang Xiaoqiang
Published: May 2010

Monothiol glutaredoxins (Grxs) play important roles in maintaining redox homeostasis in living cells and are conserved across species.Arabidopsis thalianamonothiol glutaredoxin AtGRXcp is critical for protection from oxidative stress in chloroplasts. The crystal structure of AtGRXcp has been determined at 2.4 Å resolution. AtGRXcp has a glutaredoxin/thioredoxin-like fold with distinct structural features that differ from those of dithiol Grxs. The structure reveals that the putative active-site motif CGFS is well defined and is located on the molecular surface and that a long groove extends to both sides of the catalytic Cys97. Structural comparison and molecular modeling suggest that glutathione can bind in this groove and form extensive interactions with conserved charged residues including Lys89, Arg126 and Asp152. Further comparative studies reveal that a unique loop with five additional residues adjacent to the active-site motif may be a key structural feature of monothiol Grxs and may influence their function. This study provides the first structural information on plant CGFS-type monothiol Grxs, allowing a better understanding of the redox-regulation mechanism mediated by these plant Grxs.
Coping strategies in farmed African catfish Clarias gariepinus. Does it affect their welfare?
Authors: Van de Nieuwegiessen P. G. , Ramli N. M. , Knegtel B. P. F. J. M. , Verreth J. A. J. , Schrama J. W.
Published: May 2010

The objective of this study was to assess whether and how coping strategies affect the welfare of African catfish Clarias gariepinus housed at low and high densities. Group composition influenced feed intake; re‐active groups (comprised of 100% re‐active fish) had a lower specific growth rate (G) and feed intake and a higher feed conversion ratio (RFC) than pro‐active groups. Furthermore, re‐active groups had a lower energy retention than pro‐active groups. The latter was fully due to differences in feed intake, since energy partitioning (on % total gross energy intake basis) was similar among the group composition treatments. Fish held at high stocking density showed a higher RFC and feeding speed and a lower energy retention and agonistic behaviour. None of the measured variables was influenced by the interaction effect. In mixed groups, G and number of skin lesions seemed to be affected by different behavioural phenotypes at low stocking density, but not at high density. These results indicate that both stocking density and group composition affect physical and behavioural responses of C. gariepinus. Furthermore, physical and behavioural data of individual fish housed in mixed groups suggest that coping strategy affects the fitness of different behavioural phenotypes at low, but not at high, stocking density.
Hepatitis C virus risk behaviors within the partnerships of young injecting drug users
Authors: Hahn Judith A. , Evans Jennifer L. , Davidson Peter J. , Lum Paula J. , Page Kimberly
Published: May 2010

Aims  Young injection drug users (IDU) are at high risk for hepatitis C virus (HCV). We sought to determine whether perceiving one's injecting partner to be HCV positive was associated with decreased odds of engaging in receptive needle/syringe sharing (RNS) or ancillary equipment sharing (AES) with that partner.

Design  Cross sectional study.

Setting  2003 to 2007 in San Francisco.

Participants  212 young (under age 30) IDU who were HCV antibody negative reported on 492 injecting partnerships.

Measurements  Self‐reported RNS and AES within injecting partnerships.

Findings  RNS and AES (in the absence of RNS) occurred in 23% and 64% of injecting partnerships in the prior month. The odds of engaging in RNS were significantly lower for relationships in which the participant reported that his/her partner was HCV positive (odds ratio [OR] 0.49; 95% confidence interval [CI] 0.25–0.95). This association was attenuated when adjusted for reusing one's own needle/syringe (adjusted OR 0.57; 95% CI 0.28–1.15). The odds of engaging in AES were lower for participants who did not know the HCV status of their partner, only among non‐sexual partnerships (OR 0.47; 95% CI 0.29–0.76).

Conclusions  Because perceiving one's partner to be HCV positive was associated with decreased RNS, increased HCV testing and partner disclosure may be warranted. AES was common and was decreased only among non‐sexual partnerships in which the HCV status of the partner was not known. This suggests that interventions to reduce AES in young IDU must be widespread.
Changes in alcohol consumption and beverage preference among adolescents after the introduction of the alcopops tax in Germany
Authors: Müller Stefanie , Piontek Daniela , Pabst Alexander , Baumeister Sebastian E. , Kraus Ludwig
Published: May 2010

Aims The aim of this study is to assess the contribution of the alcopops tax to changes in alcohol consumption and beverage preference among adolescents in Germany. We hypothesize that the decrease of alcohol intake by alcopops is substituted by an increase of alcohol intake by other alcoholic beverages.

Design Data came from the German 2003 (n = 10 551) and 2007 (n = 10 598) cross‐sectional study of the European School Survey Project on Alcohol and other Drugs (ESPAD).

Participants A propensity score‐matched subsample of 9thand 10thgraders (n = 4694) was used for the analyses.

Measurement Alcohol consumption within the last 7 days was assessed by a beverage‐specific quantity–frequency index. An individual's beverage preference was assigned for the beverage that had the highest share in total alcohol consumption. Multiple regression analyses were used to assess changes in alcohol consumption; changes in beverage preference were tested using multinomial logistic regression.

Findings While alcopop consumption declined after the alcopops tax was implemented, consumption of spirits increased. Changes in beverage preference revealed a decrease in alcopop preference and an increase in the preference for beer and spirits.

Conclusions Results indicate a partial substitution of alcopops by spirits and a switch in preference to beverages associated with riskier drinking patterns. Effective alcohol policies to prevent alcohol‐related problems should focus upon the reduction of total alcohol consumption instead of regulating singular beverages.
Addiction Research Centres and the Nurturing of Creativity The Chinese National Institute on Drug Dependence, Peking University: past, present and future
Authors: Wang Xi , Zhao Dong , Shi Jie , Zhao Chengzheng , Liu Zhimin , Lu Lin
Published: May 2010

In the 25 years since drug abuse re‐emerged in China in the 1980s, the National Institute of Drug Dependence (NIDD) has made many contributions to China's antidrug campaign. This present paper offers an account of the history, current status and future of drug dependence research at NIDD. NIDD was originally a research centre at Beijing Medical University, founded by the Chinese Ministry of Health to address the rapid spread of drug abuse in China. Originally, the main task of NIDD was to complete the commissions assigned by the government and university. Further developments transformed NIDD into a national research institute in the field of drug addiction that began to conduct its own research. NIDD has now created a professional team spread across several independent departments involved in neurobiological mechanisms, epidemiological surveys and monitoring, pre‐clinical and clinical evaluation of new drugs (mainly analgesic drugs and detoxification drugs) and informatics and data analysis. As a university‐based research institute, NIDD's funding derives mainly from grants provided by the government and financial support from international organizations. Its past and present research has a gained NIDD a reputation with both practitioners and policy makers in the field of drug addiction. In the future, NIDD will continue to engage in various aspects of drug addiction research and will enter the field of brain function.
Nest architecture and traffic flow: large potential effects from small structural features
Authors: BURD MARTIN , SHIWAKOTI NIRAJAN , SARVI MAJID , ROSE GEOFFREY
Published: May 2010

1. Research on human pedestrian dynamics predicts that seemingly small architectural features of the surroundings can have large effects on the behaviour of crowds and the flow of pedestrian traffic, particularly when a crowd is panicked. This theoretical framework might usefully be applied to the study of collective movement within subterranean nests of social insects.

2. We examined the rate of egress from artificial nests by alarmed Linepithema humile ants. In accord with model predictions, but counter to intuition, we found that a partially obstructed exit enhanced the average rate of escape from the nest.

3. The study of traffic flows in subterranean nests is almost non‐existent, but it would be worth studying the effect of nest design elements on collective movements, given the great variety of nest forms among ants and termites.
Asymmetric impacts of two herbivore ecotypes on similar host plants
Authors: TIPPING PHILIP W. , MARTIN MELISSA R. , BAUER LAURIE , POKORNY EILEEN , CENTER TED D.
Published: May 2010

1. Ecotypes may arise following allopatric separation from source populations. The simultaneous transfer of an exotic plant to a novel environment, along with its stenophagous herbivore, may complicate more traditional patterns of divergence from the plant and insect source populations.

2. The present study evaluated herbivory effects by twoCyrtobagous salviniaeecotypes on two species ofSalvinia: the largerS. molestaand the smallerS. minima. Evaluations were based on relative growth rates, biomass production, coverage, and nutrient cycling in a series of complementary and comparative laboratory and outdoor tank experiments.

3. In general, the experiment results indicated that the smaller Florida ecotype ofC. salviniaeimpacted bothSalviniaspecies more than the larger Brazil ecotype. Herbivory, especially by the Florida ecotype, also improved water quality and accelerated nutrient cycling by increasing the rates of litterfall from the standing crops of salvinia.

4. The smaller size of the Florida ecotype may be adaptive by allowing maximal exploitation of host plants via internal larval feeding, which presumably reduces predation risk while increasing damage to the plant. These findings provide support for relying on the suppressive effects of the Florida ecotype in Florida, rather than introducing the Brazil ecotype to counter new infestations ofS. molesta.
Genome‐wide DNA methylation profile of tissue‐dependent and differentially methylated regions (T‐DMRs) residing in mouse pluripotent stem cells
Authors: Sato Shinya , Yagi Shintaro , Arai Yoshikazu , Hirabayashi Keiji , Hattori Naoko , Iwatani Misa , Okita Keisuke , Ohgane Jun , Tanaka Satoshi , Wakayama Teruhiko , Yamanaka Shinya , Shiota Kunio
Published: May 2010

DNA methylation profile, consisting of tissue‐dependent and differentially methylated regions (T‐DMRs), has elucidated tissue‐specific gene function in mouse tissues. Here, we identified and profiled thousands of T‐DMRs in embryonic stem cells (ESCs), embryonic germ cells (EGCs) and induced pluripotent stem cells (iPSCs). T‐DMRs of ESCs compared with somatic tissues well illustrated gene function of ESCs, by hypomethylation at genes associated with CpG islands and nuclear events including transcriptional regulation network of ESCs, and by hypermethylation at genes for tissue‐specific function. These T‐DMRs in EGCs and iPSCs showed DNA methylation similar to ESCs. iPSCs, however, showed hypomethylation at a considerable number of T‐DMRs that were hypermethylated in ESCs, suggesting existence of traceable progenitor epigenetic information. Thus, DNA methylation profile of T‐DMRs contributes to the mechanism of pluripotency, and can be a feasible solution for identification and evaluation of the pluripotent cells.
Factor XI deficiency: two novel mutations in asymptomatic Italian patients
Authors: TOMAIUOLO M. , FAVUZZI G. , CAPPUCCI F. , PISANELLI D. , TISCIA G. L. , MUSTO P. , SCARAGGI F. A. , CINCIONE R. I. , MARGAGLIONE M. , GRANDONE E.
Published: May 2010

Summary.  Factor XI (FXI) deficiency is a rare bleeding disorder, resulting in a wide range of bleeding manifestations, from asymptomatic bleeding to injury‐related bleeding. To identify mutations in FXI‐deficient patients and to establish a possible relationship between clinical phenotype and genotype, we studied two patients from Southern Italy with FXI deficiency. They were identified by presurgical or routine laboratory screening. None of them showed bleeding. Three different mutations were detected (Glu117Stop, Cys118Arg and Trp497Gly); two of them were novel (Cys118Arg and Trp497Gly). One patient (with severe FXI levels) showed a compound heterozygosity (Glu117Stop with Cys118Arg). Two novel missense mutations were highly conserved among different species. In our patients, bleeding tendency did not appear to be correlated with FXI levels or with a single mutation in heterozygosis. On the other hand, the compound heterozygosis might explain low FXI levels, but it is not associated with bleeding. Our data confirm that a severe FXI deficiency is not necessarily associated with bleeding.
Diagnostic accuracy of two pressure ulcer risk scales and a generic nursing assessment tool. A psychometric comparison
Authors: Tannen Antje , Balzer Katrin , Kottner Jan , Dassen Theo , Halfens Ruud , Mertens Elke
Published: May 2010

Aim.  Comparison of the diagnostic accuracy of two pressure ulcer risk assessment scales and one generic nursing assessment tool.

Background.  Guidelines for pressure ulcer prevention recommend an initial risk screening of all patients, followed by appropriate nursing interventions. Additionally, personal and financial resources have to be allocated carefully to avoid excessive or too little treatment. Risk assessments should be accurate and applicable, and some studies showed that generic nursing tools also provide specific information for nursing diagnoses, like risk for pressure ulcer.

Design.  Cross sectional observational study.

Methods.  A total of 1053 adult patients of a university hospital in Germany were investigated. For each patient, the Braden Scale, the Waterlow Scale and the Care Dependency Scale were completed. A skin inspection was conducted by trained nurses. Correlations between the three scales and the mean values of each pressure ulcer risk assessment scales for each Care Dependency Scale value were calculated. To determine the association between susceptibility to pressure ulcer and observed pressure ulcer, the area under the curve was calculated.

Results.  There was a higher correlation between the Braden Scale and the Care Dependency Scale (r = 0·82) than between the two pressure ulcer risk assessment scales (−0·65). The highest area under the curve was reached by the Braden Scale (0·86), followed by the Care Dependency Scale (0·83) and the Waterlow Scale (0·81). Only the Braden Scale (cut‐off 18) and the Care Dependency Scale (cut‐off 65) reached the psychometric requirements of at least 70% sensitivity and 70% specificity.

Conclusions.  The Care Dependency Scale could be used for both a general nursing assessment and as a screening tool for risk for pressure ulcers. The Braden Scale showed the highest association with the occurrence of pressure ulcer.

Relevance to clinical practice.  The Care Dependency Scale is a useful screening tool to identify patients at risk for pressure ulcers. Nursing assessment activities might be reduced by using a generic nursing assessment tool also for specific risk screening.
Breastfeeding and obesity at 21 years: a cohort study
Authors: Shields Linda , Mamun Abdulla A , O’Callaghan Michael , Williams Gail M , Najman Jake M
Published: May 2010

Aims.  To determine the influence of breastfeeding on overweight and obesity, as determined by body mass index in early adulthood.

Background.  Obesity is a contemporary epidemic and linked to increased risk of later cardiovascular disease and type 2 diabetes. The success of long‐term treatment is modest. Protective factors, such as potentially, and breastfeeding, are few and very important. There are uncertainties as to whether breastfeeding has a protective effect, especially in adults, or whether it is a reflection of other markers of obesity that are more linked to cardiovascular disease and diabetes risk. Some studies suggest that breastfeeding is protective in later life for cardiovascular disease and atherosclerosis.

Design.  Epidemiological analysis of longitudinal data set.

Methods.  We collected data about breastfeeding duration, body mass index of children at 21 years and confounding variables from an ongoing longitudinal study of a singleton birth cohort of 7223 children in Brisbane. We assessed the duration of breastfeeding at six months and prevalence of overweight and obesity at 21 years by body mass index. Adjustment for potential confounders was by multivariable multinomial logistic regression.

Results.  Data were available for 2553 young adults. In neither the unadjusted or adjusted analysis was longer duration of breastfeeding associated with reduction in obesity at 21 years.

Conclusions.  Findings of this investigation are consistent with breastfeeding not independently affecting body mass index in young adults.

Relevance to clinical practice.  Breastfeeding has a range of important benefits for infants, mothers and families, although duration of breastfeeding may not play a substantial role in preventing adult onset obesity.
Organisational climate, organisational commitment and intention to leave amongst hospital nurses in Taiwan
Authors: Liou Shwu‐Ru , Cheng Ching‐Yu
Published: May 2010

Aims and objectives.  To examine: (1) Taiwanese nurses’ perceptions of organisational climate, levels of organisational commitment and intention to leave, as well as relationships between these three variables; (2) demographic differences in the levels of these variables; and (3) mediating effects of organisational commitment on the relationship between organisational climate and intention to leave.

Background.  Organisational climate is related to organisational commitment and affects nurses’ performances and attitudes towards an organisation.

Design.  A cross‐sectional, descriptive design.

Method.  Registered nurses working in eight hospitals in southern Taiwan for more than six months were recruited. Data were collected using the Litwin and Stringer’s Organisational Climate Questionnaire, Organizational Commitment Questionnaire and a five‐item scale measuring intention to leave. Questionnaires were distributed to 612 potential participants; 486 valid returned questionnaires were analysed.

Results.  The study’s participants were generally satisfied with their hospital’s climate and yet claimed low commitment to their organisation and, nevertheless, reported low intention to leave their job. Single nurses were more satisfied with their hospital’s climate and were more committed to their hospital and had a lower intention to leave their job compared to married nurses. Nurses working in district hospitals perceived a better hospital climate and had a lower intention to leave than nurses working in teaching or regional hospitals. Staff nurses perceived a better organisational climate than did nurse managers. Organisational climate, organisational commitment and intention to leave were intercorrelated. Organisational climate had almost 60% indirect effect on organisational commitment related to intention to leave.

Conclusions.  Creating a good organisational climate may increase nurses’ organisational commitment and, in turn, decrease their intention to leave.

Relevance to clinical practice.  To motivate nurses’ positive organisational behaviours and to address their diverse needs, hospital administrators are encouraged to understand nurses’ work‐climate perceptions and to address nurses’ varied demographic factors.
Effectiveness of applying empowerment strategies when establishing a support group for parents of preterm infants
Authors: Liu Chung‐Hua , Chao Yi‐Hung , Huang Chiu‐Mieh , Wei Fang‐Chun , Chien Li‐Yin
Published: May 2010

Aims.  The objectives of this study were to apply empowerment strategies to the establishing of a support group for parents of preterm infants who were recently discharged home and to examine its effectiveness in terms of self‐efficacy, perceived stress and depression among the parents.

Background.  While the concept of empowerment has been applied when establishing various patient support groups, it has not been explicitly used for parents of preterm infants.

Design.  This study applied a quasi‐experimental design.

Method.  The inclusion criteria were parents of infants with a birth gestational age of <37 weeks who were expected to be discharged home within one week. A total of 70 parents of preterm infants participated in this study, made up of 35 participants each in the intervention and in the control groups. The intervention group received three months of support applying empowerment strategies, while the control group received usual care only.

Results.  The results, relative to the control group at post‐test, demonstrated that the intervention group showed significantly higher scores for self‐efficacy when using resources as well as significantly decreased scores for depression. For parents of preterm infants with a very low birth weight, the intervention group showed a significant decrease in perceived stress relative to controls, but this was not seen in parents of preterm infants without very low birth weight. There was no significant difference in the scores for self‐efficacy when performing parental roles.

Conclusions.  This study demonstrated the effectiveness of support groups for parents of preterm infants that apply empowerment strategies, which decreased parental depressive symptomatology and increased parental self‐efficacy when utilising resources. The intervention also effectively decreased the perceived stress level in parents of infants with very low birth weight.

Relevance to clinical practice.  Health professionals should apply empowerment strategies when establishing parental support groups for preterm infants.
Anxiety levels of mothers whose infants have been cared for in unit level‐I of a neonatal intensive care unit in Turkey
Authors: Erdem Yurdagül
Published: May 2010

Aim.  In most cases, admission of an infant to the intensive care unit is unexpected and is stressful for their mothers. The aim of this study is to examine factors affecting anxiety level of mothers whose infant is admitted to the neonatal intensive care unit.

Background.  Anxiety disorders figure among the most frequent psychiatric disorders in the population, and anxiety symptoms are among the most common.

Design.  A descriptive correlational design.

Setting.  Neonatal intensive care unit of Women’s Health and Diseases, Education and Research Hospital in Turkey.

Participants.  A total of 151 women who had an infant in NICU.

Methods.  A questionnaire form was used and included two instruments. The first measured characteristics of mothers and infants, and the second was the ‘State‐Trait Anxiety Inventory’.

Results.  Of the mothers, 33·8% were between the ages 25–29, 41·7% of the subjects had a primary education, 89·4% were housewives, 64·9% had social security and 58·9% of subjects had low family incomes. Of the 151 subjects, 75·5% had planned their pregnancy, and 41·7% were primiparas. It was determined that maternal age, education, income; planned pregnancy, having complications of pregnancy, receiving antenatal care, type of labour, gestational age of the infant at birth, reasons for hospitalisation of the infant and birth weight did not affect maternal anxiety levels. Maternal anxiety was significantly (p < 0·05) related to the infants’ gender and duration of hospitalisation, with statistically significant differences.

Relevance to clinical practice.  Anxiety in mothers was significantly higher if their infant was a boy. This finding can be a result of mother’s cultural and religious values. A better understanding of the psychosocial aspects such as cultural values and norms affecting maternal and child health of the perinatal period will contribute to improved health care and better outcomes. Nurses will be better prepared to assist mothers of babies in the NICU to cope with the experience through exploration of these aspects of the mother, infant and experience.
A clinical trial of an individualised intervention programme for family caregivers of older stroke victims in Taiwan
Authors: Shyu Yea‐Ing L , Kuo Li‐Min , Chen Min‐Chi , Chen Sien‐Tsong
Published: May 2010

Aim and objective.  To explore the long‐term effects of a discharge‐preparation programme targeting Taiwanese family caregivers of older patients with stroke.

Background.  Little is known about the effects of interventions for caregivers of patients with stroke in Asian and Chinese families.

Design.  A randomised experimental design was used.

Method.  Participants included 158 older patients with stroke (72 in the experimental group and 86 in the control group) and their family caregivers. A caregiver‐oriented intervention programme was designed to increase caregiver preparedness, to enhance caregiver perception of balance between competing needs and to satisfy specific needs during the transition between hospitalisation and discharge. Long‐term outcomes were measured by caregiver’s health‐related quality of life, quality of care, stroke patient’s self‐care ability, patient’s health‐related quality of life and service utilisation. Longitudinal data were analysed by the generalised estimating equation approach.

Results.  During the 12 months following discharge of older patients with stroke, caregivers in the experimental group provided significantly better quality of care (β = 0·45; p = 0·03) than the control group. Between the sixth–twelfth months following discharge, patients in the control group were more likely to be institutionalised than those in the experimental group (χ2 = 5·11; p = 0·03).

Conclusion.  Using a sample from Taiwan, this intervention programme succeeded in improving quality of care provided by family caregivers to older patients with stroke and in decreasing the likelihood of their institutionalisation.

Relevance to clinical practice.  Older Chinese patients with stroke and their family caregivers can benefit from an individualised programme that prepares caregivers for patient discharge. Similar programmes may be applicable to other countries with Chinese populations.
Impacts of unit‐level nurse practice environment and burnout on nurse‐reported outcomes: a multilevel modelling approach
Authors: Van Bogaert Peter , Clarke Sean , Roelant Ella , Meulemans Herman , Van de Heyning Paul
Published: May 2010

Aim.  To investigate impacts of practice environment factors and burnout at the nursing unit level on job outcomes and nurse‐assessed quality of care in acute hospital nurses.

Background.  Prior research has consistently demonstrated correlations between nurse practice environments and nurses’ job satisfaction and health at work, but somewhat less evidence connects practice environments with patient outcomes. The relationship has also been more extensively documented using hospital‐wide measures of environments as opposed to measures at the nursing unit level.

Design.  Survey.

Method.  Data from a sample of 546 staff nurses from 42 units in four Belgian hospitals were analysed using a two‐level (nursing unit and nurse) random intercept model. Linear and generalised linear mixed effects models were fitted including nurse practice environment dimensions measured with the Revised Nursing Work Index and burnout dimensions of the Maslach Burnout Inventory as independent variables and job outcome and nurse‐assessed quality of care variables as dependent variables.

Results.  Significant unit‐level associations were found between nurse practice environment and burnout dimensions and job satisfaction, turnover intentions and nurse‐reported quality of care. Emotional exhaustion is a predictor of job satisfaction, nurse turnover intentions and assessed quality of care as well besides various nurse work practice environment dimensions. Nurses ‘ratings of unit‐level management and hospital‐level management and organisational support had effects in opposite directions on assessments of quality of care at the unit; this suggests that nurses’ perceptions of conditions on their nursing units relative to their perceptions of their institutions at large are potentially influential in their overall job experience.

Conclusion.  Nursing unit variation of the nurse practice environment and feelings of burnout predicts job outcome and nurse‐reported quality of care variables.

Relevance to clinical practice.  The team and environmental contexts of nursing practice play critical roles in the recruitment and retention of nurses, and as well as in the quality of care delivered. Widespread burnout as a nursing unit characteristic, reflecting a response to chronic organisational stressors, merits special attention from staff nurses, physicians, managers and leaders.
Hand dermatitis among paediatric nurses
Authors: Özyazıcıoğlu Nurcan , Sürenler Semra , Tanrıverdi Gülbu
Published: May 2010

Aims and objectives. Hand dermatitis is regarded as one of the most often observed dermatological disorders among nurses. This study was carried out to investigate the incidence of self‐reported hand dermatitis and related factors among paediatric nurses.

Background. The most common occupational skin disease in the nursing profession is hand dermatitis. Various risk factors are known to exist including the type of soap used at work, the number of hand washes per shift and the nursing job category, among others.

Design. This study was conducted among a group of 158 nurses based in three paediatric hospital departments in Bursa.

Methods. Data were collected using a questionnaire prepared by the investigators. Each nursing unit was visited twice by a single investigator. All nurses working at the time of each visit were questioned and examined.

Results. Of the nurses, 47·5% had hand dermatitis. The damage was not correlated with age or the type of soap used at work, but was significantly correlated with the hospital, unit, number of hand washes (p < 0·05), history of allergy (p < 0·01) and type of hand protection (p < 0·001). Hand dermatitis was more common in the ICU and infectious disease units. Most of the nurses did not apply hand cream at the hospital.

Conclusions. Damage to hands is a common and potentially serious problem among nurses and is associated with unit, glove usage and hand‐washing practices instead of with demographic factors. A high frequency of hand dermatitis was observed among paediatric nurses.

Relevance to clinical practice. The proper preventive programmes should be implemented for those nursing staff working in high‐risk units.
Preparation of parenteral medicines in clinical areas: how can the risks be managed – a UK perspective?
Authors: Beaney Alison M
Published: May 2010

Aims and objectives.  This article provides an overview of preparation of parenteral medicines in clinical areas. It describes the development of a tool to allow preparation of these medicines to be scored for risk. The article shows how this work was adopted by the National Patient Safety Agency (NPSA) and was subsequently issued as Patient Safety Alert 20 (Injectable Medicines).

Background.  Although there are well‐established standards for preparation of parenteral medicines in pharmacy, there were no equivalent standards for their preparation in clinical areas, where risks to patients from medication error and microbiological contamination are greater. Use of a risk assessment process allows highest risk items to be targeted for transfer to pharmacy preparation. Defined standards and competency‐based training should reduce risk for preparation of those items remaining in clinical areas.

Method.  Discursive.

Conclusions.  This article identifies the risks involved in the preparation of parenteral medicines in clinical areas and describes ways in which these risks can be minimised.

Relevance to clinical practice.  Use of risk assessment allows targeted transfer of high‐risk parenteral medicines to pharmacy preparation, where risks of medication error and microbiological contamination are lower. This transfer liberates nursing time for patient benefit.
Predictors of fatigue in patients with heart failure
Authors: Chen Li‐Huan , Li Chung‐Yi , Shieh Shyh‐Ming , Yin Wei‐Hsian , Chiou Ai‐Fu
Published: May 2010

Aims and objectives.  The purpose of this study was to examine the level of fatigue perceived by patients with heart failure and to explore the potential factors influencing fatigue.

Design.  A cross‐sectional, correlational design was used.

Methods.  A convenience sample of 105 patients was recruited between July and September 2003 in northern Taiwan. The patients were interviewed, and their perceived fatigue was assessed with the modified Piper Fatigue Scale. The factors influencing fatigue were determined using a stepwise linear regression model.

Results.  The majority of patients with heart failure experienced mild‐to‐moderate fatigue. Patients with higher levels of fatigue had worse physical functioning and more severe symptomatic and psychological distress. Symptomatic distress, psychological distress (depression and anxiety), New York Heart Association class, activities of daily living (ADL) and appraisal support by health care providers could explain 57·4% of the total variance of fatigue. Symptomatic distress was the strongest predictor of fatigue.

Conclusion.  Higher levels of fatigue were found in patients with heart failure who had symptomatic or psychological distress. Additional research focusing on developing effective methods to reduce fatigue in patients with heart failure is recommended.

Relevance to clinical practice.  Nurses should help patients with heart failure to monitor their symptoms and report them to health care providers. Early management of symptoms and support by health care providers may reduce patients’ fatigue, help maintain their physical functioning and improve their quality of life.
Pressure ulcer guideline development and dissemination in Europe
Authors: Meesterberends Esther , Halfens Ruud , Lohrmann Christa , De Wit Rianne
Published: May 2010

Aims and objectives.  To explore the current state of pressure ulcer guideline development and dissemination, from national to local level (i.e. nursing homes) in six European countries: England, Germany, Italy, the Netherlands, Portugal and Sweden.

Background.  Pressure ulcers are a persistent problem in healthcare institutions. Their prevalence is influenced by many factors, one of them being the development and dissemination of pressure ulcer guidelines. These are difficult and complex processes and it is not clear whether they differ between European countries.

Design.  Literature review and semi‐structured interviews.

Method.  Interviews were conducted in six countries at national and nursing home level.

Results.  Four countries had national pressure ulcer prevention and treatment guidelines. Portugal had no national guidelines and Sweden had shifted the responsibility to regional level. All participating nursing homes had pressure ulcer guidelines except those in Portugal. Control and monitoring of guideline dissemination was carried out only in Sweden and England.

Conclusions.  All countries studied have national or regional pressure ulcer prevention and treatment guidelines, except Portugal. Portugal is also the only country where none of the nursing homes included had pressure ulcer guidelines. Because the dissemination of such guidelines does not imply actual implementation, further research should focus on the implementation process.

Relevance to clinical practice.  Clinical guidelines, like pressure ulcer guidelines, are important tools in guiding the care processes in healthcare institutions. Successful dissemination of guidelines from national level to individual healthcare institutions is a first and necessary step in actually applying them. Monitoring of the guideline dissemination process is therefore essential.
Increasing pressure ulcer rates and changes in delivery of care: a retrospective analysis at a University Clinic
Authors: Stausberg Jürgen , Lehmann Nils , Kröger Knut , Maier Irene , Schneider Helmut , Niebel Wolfgang ,   for the interdisciplinary decubitus project
Published: May 2010

Aim.  To evaluate the relation between pressure ulcers and delivery of care.

Background.  No decrease of pressure ulcer rates could be recognised in acute hospital care, despite intensive efforts in prevention. Furthermore, reports show increasing rates.

Design.  Retrospective analysis of hospital data.

Methods.  The study included all inpatients from year 1 (2003/2004) and 4 (2006/2007) of the interdisciplinary decubitus project. Information on ulcers was recorded at admission, discharge and in case of new events. We analysed the effect of age, length of stay, operation and intensive care episode. In logistic regression, we used the existence of ulcers and the appearance of new ulcers as dependent variables.

Results.  Parallel to a decrease in the number of inpatients, age, length of stay and operation frequency rose between 2003 and 2007. Higher age, longer length of stay, operation, intensive care episode and year 4 raise the odds for ulcers in univariate and with exception of operation in multivariate analyses. With exception of operation and year 4, the same variables raise the odds for new ulcers, too.

Conclusions.  The increase of pressure ulcer frequency could be related to changes in delivery of care. The adverse event pressure ulcer will become more important in hospital care.

Relevance to clinical practice.  There is no decrease in pressure ulcer rates, albeit enormous efforts in prevention. Hospital care has been facing changes in case mix. Age, length of stay and intensive care episodes are related to increasing ulcer rates at a University Clinic. Nursing management has to be aware of additional workload for pressure ulcer management in the future.
Variation in the cellular localization of host‐protective oncospheral antigens inTaenia saginataandTaenia solium
Authors: JABBAR A. , VERÁSTEGUI M. , LACKENBY J. A. , WALDUCK A. K. , GAUCI C. G. , GILMAN R. H. , LIGHTOWLERS M. W.
Published: May 2010

Immunohistochemistry and immunofluorescence with confocal microscopy were used to localize the host‐protective antigens of Taenia saginata (TSA9 and TSA18) and Taenia solium (TSOL16, TSOL18 and TSOL45). In nonactivated oncospheres, TSA9 and TSOL45 antigens were found primarily in the cytoplasm of the penetration gland type one (PG1) cell. A similar pattern of staining was seen for TSOL45 in oncospheres of T. solium that remained within the oncospheral membrane. In addition, there was less intense staining of TSA9 and TSOL45 in the quadri‐nucleate penetration gland type 2 (PG2) cell. TSA18, TSOL16 and TSOL18 were predominantly found in the PG2 cell. In activated oncospheres that had escaped the oncospheral membrane, the antigens (other than TSA9) were seen both in the penetration gland cell locations and throughout the oncospheral parenchyma. Co‐localization analyses revealed that only TSOL16 and TSOL18 antigens were co‐localized in the PG2 cell of oncospheres that had not escaped the oncospheral membrane. However, in activated oncospheres that escaped the oncospheral membrane, all three antigens of T. solium were co‐localized as they were present throughout the parenchyma. No positive staining was observed on the surface of nonactivated or recently activated oncospheres of T. saginata or T. solium.