bluuebunny/crossref_metadata_2025 huggingface dataset:
Electron tunneling spectroscopy study of amorphous films of the gate dielectric candidates LaAlO3 and LaScO3
Authors: Wang M. , He W. , Ma T. P. , Edge L. F. , Schlom D. G.
Published: February 2007

Electron tunneling spectroscopy (ETS) was used to study amorphous LaAlO3 and LaScO3 thin film gate dielectrics for silicon metal-oxide-semiconductor structure. These gate dielectrics were prepared by molecular-beam deposition on (100) Si substrates. The authors have obtained vibrational modes for amorphous LaAlO3 and LaScO3 thin films from the ETS spectra, which provide information about the chemical bonding in these films and the interface with silicon. Traps and defects in amorphous LaAlO3 thin films are revealed in the ETS spectra, and their physical locations and energy levels are identified.
Electric-pulse-induced reversible resistance in doped zinc oxide thin films
Authors: Villafuerte M. , Heluani S. P. , Juárez G. , Simonelli G. , Braunstein G. , Duhalde S.
Published: February 2007

Nonvolatile, electric-pulse-induced resistance switching is reported on S and Co doped ZnO thin films deposited on different substrates using magnetron sputtering and laser ablation. Two resistance states were obtained by applying voltage pulses of different polarity. The switching was observed regardless of the substrate, dopant species, or microstructure of the samples. In the Co doped ZnO samples, the two resistance states are remarkably stable and uniform.
Enhanced photoresponse of a metal-oxide-semiconductor photodetector with silicon nanocrystals embedded in the oxide layer
Authors: Shieh Jia-Min , Lai Yi-Fan , Ni Wei-Xin , Kuo Hao-Chung , Fang Chih-Yao , Huang Jung Y. , Pan Ci-Ling
Published: February 2007

The authors report a two-terminal metal-oxide-semiconductor photodetector for which light is absorbed in a capping layer of silicon nanocrystals embedded in a mesoporous silica matrix on p-type silicon substrates. Operated at reverse bias, enhanced photoresponse from 300to700nm was observed. The highest optoelectronic conversion efficiency is as high as 200%. The enhancements were explained by a transistorlike mechanism, in which the inversion layer acts as the emitter and trapped positive charges in the mesoporous dielectric layer assist carrier injection from the inversion layer to the contact, such that the primary photocurrent could be amplified.
Reproductive biology and diet of the southern fiddler ray, Trygonorrhina fasciata (Batoidea:Rhinobatidae), an important trawl bycatch species
Authors: Marshall Lindsay J. , White William T. , Potter Ian C.
Published: February 2007

The reproductive cycle of Trygonorrhina fasciata females in south-western Australian waters is shown to include a protracted period of embryonic diapause or delayed development. This characteristic is typically regarded as enabling young to be born when conditions are optimal. The birth of T. fasciata occurs in April/May, when water temperatures are still high and conducive to rapid growth. Furthermore, because gut fullness in this and subsequent months was similar to other times of the year, the prey of neonates, i.e. mysids, carids, pinnotherids, amphipods and isopods, were presumably abundant in that period. Ovulation occurs in April/May and embryos grow rapidly between December and birth in April/May. Females grew to greater lengths than males, i.e. 1460 v. 890 mm, and matured (L50) at larger lengths, i.e. 892 v. 678 mm respectively. As body size increased, teleosts, pilumnid and portunid crabs and molluscs became important dietary components. Overall, the diet consisted predominantly of crustaceans, fish, polychaetes and molluscs, with volumetric contributions of 73.4, 17.2, 5.3 and 2.8% respectively. Dietary composition underwent a cyclical seasonal change and differed among locations, indicating some degree of opportunistic feeding. Interspecific comparisons indicate that benthic food resources are partitioned among and within the main batoid species in south-western Australian waters.
The tail of the ParG DNA segregation protein remodels ParF polymers and enhances ATP hydrolysis via an arginine finger-like motif
Authors: Barillà Daniela , Carmelo Emma , Hayes Finbarr
Published: February 2007

The ParF protein of plasmid TP228 belongs to the ubiquitous superfamily of ParA ATPases that drive DNA segregation in bacteria. ATP-bound ParF polymerizes into multistranded filaments. The partner protein ParG is dimeric, consisting of C-termini that interweave into a ribbon–helix–helix domain contacting the centromeric DNA and unstructured N-termini. ParG stimulates ATP hydrolysis by ParF ≈30-fold. Here, we establish that the mobile tails of ParG are crucial for this enhancement and that arginine R19 within the tail is absolutely required for activation of ParF nucleotide hydrolysis. R19 is part of an arginine finger-like loop in ParG that is predicted to intercalate into the ParF nucleotide-binding pocket thereby promoting ATP hydrolysis. Significantly, mutations of R19 abrogated DNA segregation
in vivo
, proving that intracellular stimulation of ATP hydrolysis by ParG is a key regulatory process for partitioning. Furthermore, ParG bundles ParF-ATP filaments as well as promoting nucleotide-independent polymerization. The N-terminal flexible tail is required for both activities, because N-terminal ΔParG polypeptides are defective in both functions. Strikingly, the critical arginine finger-like residue R19 is dispensable for ParG-mediated remodeling of ParF polymers, revealing that the ParG N-terminal tail possesses two separable activities in the interplay with ParF: a catalytic function during ATP hydrolysis and a mechanical role in modulation of polymerization. We speculate that activation of nucleotide hydrolysis via an arginine finger loop may be a conserved, regulatory mechanism of ParA family members and their partner proteins, including ParA-ParB and Soj-Spo0J that mediate DNA segregation and MinD-MinE that determine septum localization.
Age-dependent regulation of chromaffin cell proliferation by growth factors, dehydroepiandrosterone (DHEA), and DHEA sulfate
Authors: Sicard Flavie , Ehrhart-Bornstein Monika , Corbeil Denis , Sperber Simone , Krug Alexander W. , Ziegler Christian G. , Rettori Valeria , McCann Samuel M. , Bornstein Stefan R.
Published: February 2007

The adrenal gland comprises two endocrine tissues of distinct origin, the catecholamine-producing medulla and the steroid-producing cortex. The inner adrenocortical zone, which is in direct contact with the adrenomedullary chromaffin cells, produces dehydroepiandrostendione (DHEA) and DHEA sulfate (DHEAS). These two androgens exhibit potential effects on neurogenesis, neuronal survival, and neuronal stem cell proliferation. Unlike the closely related sympathetic neurons, chromaffin cells are able to proliferate throughout life. The aim of this study was to investigate the effect of DHEA and DHEAS on proliferation of bovine chromaffin cells from young and adult animals. We demonstrated that graded concentrations of leukemia inhibitory factor induced proliferation of chromaffin cells from young animals, whereas EGF had no effect. On the contrary, EGF increased the cell proliferation in cells from adult animals, whereas leukemia inhibitory factor was inactive. In both cases, DHEA decreased the proliferative effect induced by the growth factors. Surprisingly, DHEAS enhanced, in a dose-dependent-manner, the effect of growth factors on proliferation in cells from adult animals but not from young animals. Flutamide, ICI 182,780, and RU 486 had no effect on the action of DHEA or DHEAS on chromaffin cell proliferation. These data show that DHEA and its sulfated form, DHEAS, differentially regulate growth-factor-induced proliferation of bovine chromaffin cells. In addition, the sensitivity of chromaffin cells to different growth factors is age-dependent. Furthermore, these two androgens may act through a receptor other than the classical steroid receptors.
The Influence of Time Pressure on Mood‐Congruent Effects: Evaluating Products With Limited Information1
Authors: Noda Masayo , Takai Jiro , Yoshida Toshikazu
Published: February 2007

This study tested mood effects on product evaluation, varying information type and time pressure. In this experiment, happy or sad moods were induced in participants, then they were asked to evaluate products. The results showed that in the happy mood/non‐time‐pressure condition, a favorable evaluation was seen when complete information was provided compared to incomplete. However, when time pressure was induced, no such difference was observed. On the other hand, in the sad mood/non‐time‐pressure condition, there was no difference in evaluation between complete and incomplete information, but when time pressure was induced, a less favorable evaluation of products was seen under incomplete relative to complete. The results provide support for the process in which participants depend on their mood as a source of information when inferring about missing information under reduced cognitive capacity.
Time as a Variable With Niacin Extended‐Release/Lovastatin vs. Atorvastatin and Simvastatin
Authors: Bays Harold E. , McGovern Mark E.
Published: February 2007

Time may be an important variable when evaluating the efficacy of lipid‐altering drugs. In this analysis of the Advicor Versus Other Cholesterol‐Modulating Agents Trial Evaluation, niacin extended‐release/lovastatin 1000/40 mg was as effective as atorvastatin 10 mg and more effective than simvastatin (both 10 mg and 20 mg) in achieving low‐density lipoprotein cholesterol and non–high‐density lipoprotein cholesterol treatment goals. The titration schedule for this study included the initiation of niacin‐extended release/lovastatin 500/20 mg once a day for 4 weeks, titrated to the starting dose of 1000/40 mg after 4 weeks, and then titrated to the final dose of 2000/40 mg. The titration schedule for both atorvastatin and simvastatin was 10 mg per day for 8 weeks and then titrated to 40 mg per day. Using this schedule, 50% of niacin extended‐release/lovastatin and atorvastatin patients reached low‐density lipoprotein cholesterol and non –high‐density lipoprotein cholesterol treatment goals within approximately 7 weeks, compared with simvastatin, in which 50% reached both treatment goals in 13–14 weeks. These time differences may have potential clinical relevance in reducing coronary heart disease risk.
The Impact of Exercise on Body Composition and Nutritional Intake in Patients With Heart Failure
Authors: Oka Roberta K. , Sanders Mark G.
Published: February 2007

Little is known about the nutritional status of heart failure patients and the potential synergistic effects between nutritional intake and exercise. This small, randomized trial examined the effects of a 3‐month exercise program on body composition and nutritional intake in 31 men (17 exercisers; 14 controls), aged 30–76 years (mean, 56 years) with stable class II–III heart failure. Baseline and 3‐month evaluations included body mass index, body fat mass by triceps skinfold thickness, dietary intake by food frequency questionnaire, and the 6‐minute walk test. Exercise consisted of walking 3 d/wk and resistance exercises 2 d/wk for 40–60 minutes. Dietary recommendations were consistent with the American Heart Association/American College of Cardiology heart failure guidelines. Exercisers decreased body weight (p=0.001), body mass index (p=0.0001), and triceps skinfold thickness (p=0.03) and improved 6‐minute walk test (p=0.01) compared with controls. Exercisers also demonstrated trends toward decreased total caloric and cholesterol intake and a three‐fold higher carbohydrate, fiber, andβcarotene intake vs. controls. In this study population, protein, fiber, andmagnesium intake were below recommended daily allowance. After exercise, body mass index was reduced, accompanied by dietary modifications including greater intake of foods with higher moisture content. Further study is needed to investigate the interaction among diet, exercise, and weight.
Dietary and Nutraceutical Options for Managing the Hypertriglyceridemic Patient
Authors: Pins Joel J. , Keenan Joseph M.
Published: February 2007

Scientific evidence continues to accumulate regarding fasting serum triglycerides as an independent risk factor for coronary heart disease. In response, the National Cholesterol Education Program has revised the acceptable level of fasting triglycerides from <200 mg/dL to <150 mg/dL A significant percentage of Americans suffer from hypertriglyceridemia, and considering the expanding numbers of individuals who are physically inactive, overweight, and suffering from the metabolic syndrome, it is expected that these numbers will continue to rise over the next decade. Fortunately, nutraceutical and lifestyle options have been shown to substantially and consistently reduce this risk factor. This review will focus on management options for the hypertriglyceridemic patient with an emphasis on nicotinic acid, pantethine, fish oils (eicosapentaenoic and docosahexaenoic acids), and modified carbohydrate diets.
Exercise and the Heart Failure Patient: Aerobic vs Strength Training—Is There a Need for Both?
Authors: Gunn Elizabeth , Smith Kelly M. , McKelvie Robert S. , Arthur Heather M.
Published: February 2007

Heart failure (HF) is characterized by general muscular weakness, muscle atrophy, and exercise intolerance that lead to reductions in functional capacity, ability to perform activities of daily living, and health‐related quality of life. Until recently, exercise programs for patients with HF were centered on aerobic exercise training alone. Although many activities of daily living require significant muscle strength, the role of strength training for HF patients, either alone or in combination with aerobic exercise, has not been well studied. There is suggestive evidence that combined strength‐aerobic exercise training may offer additional benefits in terms of health‐related quality of life and functional capacity. Strength training can be targeted to reduce muscle atrophy to a greater extent than aerobic training. Further research is required to isolate the specific role of strength training regarding improvements in prognosis, HF‐related morbidity and hospitalization, and health‐related quality of life for patients with HF.
Tuberculosis in renal transplant recipients
Authors: Ram R. , Swarnalatha G. , Prasad N. , Dakshinamurty K.V.
Published: February 2007

Abstract: Tuberculosis (TB) is a frequent infectious complication in patients on renal replacement therapy, as a result of immunosuppression from uremia and drugs in the post‐transplantation period. A retrospective study of all renal transplantation patients from 1989 to date was conducted. This study tried to examine the prevalence, course, and outcome of TB in renal transplant recipients. A comparison with the occurrence of TB in other modalities of renal replacement therapy was also made. We also discussed the treatment protocols for TB in this group of patients. No difference in the prevalence, age, or male/female ratio of TB was seen among the 3 modes of renal replacement therapy. TB of the lung was the more favored site of infection in patients on hemodialysis (77.3%), when compared with those on CAPD (30%) and renal transplant recipients (33.3%). In renal transplant recipients, no deaths occurred due to TB. In 7 patients there was co‐infection with cytomegalovirus and in 3 patients there was Aspergillus lung infection.
Oral valganciclovir as preemptive therapy for cytomegalovirus infection post allogeneic stem cell transplantation
Authors: Busca A. , De Fabritiis P. , Ghisetti V. , Allice T. , Mirabile M. , Gentile G. , Locatelli F. , Falda M.
Published: February 2007

Abstract: Antiviral compounds including ganciclovir, foscarnet, and cidofovir are routinely used in the treatment of cytomegalovirus (CMV) infection and disease; however, these agents have a poor oral bioavailability and have the inconvenience and expense of intravenous administration.

Aim of the study. To evaluate the safety and efficacy of oral valganciclovir (VGCV) for preemptive treatment of CMV reactivation in the setting of allogeneic hematopoietic stem cell transplantation (HSCT).

Patients and methods. We treated 15 patients receiving allogeneic HSCT from related (n=9) or unrelated (n=6) donors. In all patients, either the donor, host, or both were CMV Ig G positive pretransplant. Indication for therapy was preemptive treatment of CMV infection defined as one or two consecutive positive tests of pp65 antigenemia assay or CMV‐polymerase chain reaction (PCR). VGCV was administered orally in a dosage of 900 mg b.i.d. for 2 weeks, followed by 450 mg b.i.d. for 2 additional weeks.

Results. Patients developed a positive CMV‐PCR after a median of 52 days (range 37–427) post HSCT and a positive pp65 antigenemia after a median time of 74 days (range 37–427) post HSCT. Preemptive treatment with VGCV was started a median time of 56 days (range 37–429) after transplant. In all, 11 patients (73%) completed the 28 days of therapy with VGCV. All patients showed a complete clearance of the virus. The median time to achieve a negative CMV‐PCR was 6 days (range 4–18). A relapse of CMV infection after VGCV preemptive therapy occurred in 6 patients (40%). No patient developed early or late CMV disease. Six patients (40%) presented hematological toxicity including neutropenia and/or thrombocytopenia that required drug discontinuation in 4 cases.

Conclusion. VGCV administered as preemptive therapy for CMV infection in patients receiving an allogeneic HSCT showed promise for treating this frequent complication. Prospective randomized studies in this setting are mandatory to yield more definitive results.
Invasive adenoviral infections in T‐cell‐depleted allogeneic hematopoietic stem cell transplantation: high mortality in the era of cidofovir
Authors: Symeonidis N. , Jakubowski A. , Pierre‐Louis S. , Jaffe D. , Pamer E. , Sepkowitz K. , O'Reilly R.J. , Papanicolaou G.A.
Published: February 2007

Abstract: Background. Adenovirus (ADV) infection occurs in 5–21% of allogeneic hematopoietic stem cell transplants (HSCT). Symptomatic enteritis and hemorrhagic cystitis may be encountered but are seldom fatal. In contrast, mortality rates of up to 75% are reported for adenoviral pneumonia or hepatitis. Cidofovir is currently being increasingly used for treatment of adenoviral infections after HSCT. The efficacy of cidofovir in patients with invasive adenoviral infection is not established.

Findings. We reviewed 687 adult and pediatric patients who received allogeneic HSCT at our institution from 1998 through June 2005. ADV was isolated from 64 (9.3%) patients. Eleven patients received cidofovir for invasive disease occurring at median 39 days (range 3–145) post HSCT. The median age was 40 (range 6–61) years. Seventy‐three percent received a T‐cell‐depleted graft and 18% had grade 3–4 graft‐versus‐host disease (GVHD) of the gut. Three out of 3 (100%) patients with adenoviral pneumonia died. One patient with hepatitis, cholecysitis, and viremia cleared the infection after 3 months. Two out of 7 (28.6%) patients with hemorrhagic colitis or cystitis died of ADV (1 with extensive GVHD).

Conclusion. Mortality rates of ADV pneumonitis after allogeneic HSCT remain high in the era of cidofovir. Clinical trials are needed to evaluate management strategies for this life‐threatening infection.
Determination of Oestrous Cycle of the Rats by Direct Examination: How Reliable?
Authors: Yener T. , Turkkani Tunc A. , Aslan H. , Aytan H. , Cantug Caliskan A.
Published: February 2007

For determination of the oestrous cycle in rats classical Papanicolaou technique has long been used successfully. Instead of using many stains in Papanicolaou, staining the vaginal secretions with only methylene blue has also been defined. Recently a new technique in which vaginal samples are directly examined under light microscope has been introduced. The aim of this study was to assess the reliability of this new technique by comparing it with the classical staining techniques. From 20 Wistar rats 60 vaginal samples were collected with a micropipette, three from each. Briefly, the vagina was flushed two to three times then the fluid was placed onto a glass slide. The fluid was equally distributed onto three glass slides. The glass slides were coded. Two samples were stained with Papanicoloau and methylene blue while the other one was examined directly. Determination of the phases of the oestrous cycle was made by the same histologist who was blinded to the groups and coding system. After determination of the oestrous phase in all samples, the results were compared and it was found that the results were matching. In conclusion, the same results can be obtained with the direct examination technique and this technique is reliable, so there is no need to use relatively time‐consuming, less practical and more expensive techniques such as Papanicolaou or methylene blue.
Registered nurses’knowledge and compliance with regulations relating to the administration of ward recordable medications
Authors: Gill Betty I , Bligh Julie A
Published: February 2007

An anonymous questionnaire assessing nurses’knowledge, attitude and compliance with legally mandated regulations relating to the administration of ward recordable drugs was administered by mail to a random sample of nurses registered in New South Wales, Australia. Sixty‐four per cent of subjects (n=318) responded. Both self‐reported and colleague‐reported compliance rates were less than 50%. A highly significant relationship was evident between knowledge and attitude; knowledge and reported compliance; and attitude and reported compliance. Factors that may influence non‐compliance are discussed and the legal, ethical and policy implications of the findings are briefly explored.
Discovering and affirming knowledge in nursing practice
Authors: Sutton: Fran , Smith: Colleen , Wright: Kathy , Arbon: Paul , Eldredge: Karen , Forbes: Deborah , Robbiliard: Nicholas , Zeitz: Kathryn
Published: February 2007

This paper discusses how the use of care stories or stories derived from clinical nursing practice were used to elucidate the knowledge used in nursing practice. In addition, the processes used to elucidate this knowledge are described and consisted of reflective and critical reflective activity undertaken in both individual and group forms. In describing the processes used the concepts of reflection, critical reflection, narrative and story are discussed with reference to contemporary literature. It is the contention of the authors of this paper that nurses can, by verbalizing care stories with peers, identify knowledge that is either unique to nursing or highly valued by nurses. An additional value, that is concluded in this paper, is that nurses, by the verbalization of care stories, assist other nurses to see what they do, to hear what they do and also to value what they do. By using reflective conversation, as described by D.A. Schon, as a teaching‐learning strategy the authors believe that this process may also enable the generalization of such knowledge and its transmission to peers as well as assisting students to record their knowledge and, in so doing, maintain it within the discipline.
Story as a reflective process for nurses
Authors: Strathie Lynn , Holmes Colin A
Published: February 2007

This paper uses two practice stories (included as appendices) to illustrate the significance and value of story as a reflective technique for nurses. It employs an explicit framework to draw out the importance of story‐telling and suggests that stories can help nurses expose the therapeutic dimension of their work. This aspect is conceived in terms of the concept of ‘therapeutic nursing’. We will draw upon the practice stories of one of the authors (Strathie), and it is that author's experience of story‐telling to which reference is made. Readers are urged to read the practice stories so that they can appreciate the points made in the text of the paper.
Integrating the arts into clinical care
Authors: Ebbott Mary
Published: February 2007

This paper explores the spiritual, intangible dimensions of the creative arts. Their value as a resource for enriching the human situation will also be discussed. The integration of the creative arts into therapeutic nursing will be specifically referred to as a means for the innovative, creative nurse to generate change and sever the bonds of conventional thought. It will be further argued that the primary nursing model of care allows an environment that inspires registered nurses to incorporate creative arts therapies into patient care.
Critical social theory as a grounded process
Authors: Fleming Valerie EM , Moloney Jocelyn A
Published: February 2007

This article reflects upon the research process that uses critical social science as its basis. Some of the common criticisms of critical social science research are rebutted by following the research trail taken by the authors when undertaking their own projects. The similarities and differences of critical social science and the interpretative methodologies are outlined in the selection of study area, the relationship of the researcher and participants, ethical issues, and data collection and analysis. The writers conclude that critical social science research reports that are correctly carried out should be firmly grounded in each of these stages, thereby providing a foundation for nursing and midwifery practice.
Relaxation: With or without imagery?
Authors: Harding Stephen
Published: February 2007

Although the benefits of relaxation are widely recognized, clinicians need to remain cognizant of its possible adverse effects. Equally, some people with mental illness may experience an exacerbation of their symptoms with the injudicious use of relaxation techniques that use imagery. This paper explores two conditions where vivid, often emotionally charged, images are problematic: (i) post traumatic stress disorder; and (ii) hallucinoses. Individuals who have these disorders may have difficulty controlling shifts between these internal and external events, or difficulty even recognising events as internal rather than external. Employing a relaxation technique that encourages imagery is likely to produce a stronger reaction because the impact of the imagery is increased by relaxation. This would result in an increase in arousal, the antithesis of relaxation. This paper suggests that relaxation techniques that avoid imagery or consider the patient's experience would be less likely to provoke unwanted reactions.
Feelings of anger among caregivers of patients with Alzheimer’s disease
Authors: Tabak Nili , Ehrenfeld Mally , Alpert Rachel
Published: February 2007

Tabak N, Ehrenfeld M, Alpert R. International Journal of Nursing Practice 1997; 3: 84–88

Feelings of anger among caregivers of patients with Alzheimer’s disease

The purpose of this article is to examine the caregiver’s feelings of anger, the causes of these feelings as described by the caregivers and their reactions. Twenty female caregivers of Alzheimer’s disease patients participated in a support group at a psychogeriatric centre for 3 years. The group was directed by a registered nurse and a social worker. Frequently, anger was raised as a major issue in the caregiving. The group directors constructed two models that emerged from the support group’s meetings. The first model showed the sources of the anger felt by the caregivers and the second model showed coping strategies. The caregivers said that the most infuriating behaviours of patients Alzheimer’s disease were: aggressive behaviour, sleeplessness and verbal or behavioural repetition. The caregiver’s reactions to the two models are discussed in this paper together with their feelings, which expressed by the women in their own words.
Discovering nursing students’ understandings about aseptic technique
Authors: G Jane
Published: February 2007

Davey JG. International Journal of Nursing Practice 1997; 3: 105–110

Discovering nursing students’ understandings about aseptic technique

This phenomenographic study explored understandings about aseptic technique held by second year undergraduate nurses. Data analysis revealed a range of understandings about aseptic technique from simple to complex, referred to here as global, procedural and principled. The implications of these findings are discussed in relation to safe and effective nursing practice.
Nursing, a bridge to peace in our region: Opinions on mutual co‐operation between Israeli and Palestinian professional nurses and nurse educators
Authors: Raviv Dennie , Bourgstein Dorothy , Kaplan Ruth
Published: February 2007

Raviv D, Bourgstein D, Kaplan R. International Journal of Nursing Practice 1997; 3: 159–165

Nursing: A bridge to peace in our region

The purpose of this study was to assess the activities and future direction of mutual co‐operation of professional nurses from Israel and Judea and Samaria. Questionnaires were distributed to the participants, nurse educators and professional nurses from Judea and Samaria who were attending a workshop in clinical instruction at the Assaf HaRofeh School of Nursing, in Israel. Most of the nurses polled were interested in continued educational dialogue and expanded educational programmes in various nursing specialties both in education and service. The areas that received priority included: intensive care, operating room and emergency room nursing. Areas that received lower priorities included; midwifery, geriatrics and nephrology nursing. The participants expressed positive reactions to continued joint educational activities such as full length courses, workshops, day seminars and joint educational projects. The results showed an overwhelming interest for continued professional ties. Areas in the fields of clinical expertise and nursing education reflected the needs of their respective communities.
The elderly adult in the emergency department
Authors: Oates Jennifer , Heslop Liza , Boord Noreen
Published: February 2007

Oates J, Heslop L, Boord N. International Journal of Nursing Practice 1997; 3: 166–172

The elderly adult in the emergency department

Over 65‐year olds were nominated by emergency staff at a Melbourne regional hospital as a patient group of particular concern. With nurse academics from Monash University, a collaborative study was undertaken of elderly patients and the circumstances of their attendance. The focus of the study was on those elderly patients who were triaged as non‐acute and who may have been disadvantaged by the priority given to acute cases. The triage records obtained over a 5 month period were analyzed, and a survey administered to selected patients. Over 65‐year olds were found to constitute 19% of incoming patients. They figured more prominently in urgent triage categories than those under 65 years of age, were more likely to be referred by a health professional, and more likely to be admitted or transferred. There was no evidence to suggest slower progress through the emergency department for the non‐acute elderly than for their counterparts under 65 years of age.
Breaking a social silence: Registered nurses share their stories about tertiary nursing education
Authors: Glass Nel E
Published: February 2007

Glass N. International Journal of Nursing Practice 1997; 3: 173–177

Breaking the silence: Registered nurses share their stories about tertiary nursing education

This research presents some of the qualitative findings from a mixed methods study exploring the personal and professional effects of tertiary education for post registration women nurses. The researcher combined both qualitative and quantitative approaches. The specific methods employed were survey questionnaire, ‘journalling’ and interviews. The results demonstrated that the participants were able to identify and verbalise personal and professional experiences associated with tertiary study, through multiple voices. A distinctive theme of empowerment emerged in their stories. However, by sharing their stories, it was evident that encounters in their lives were enmeshed with dialectical relationships. In conclusion, the associated tension that characterized their personal and professional relationships, indicated that these women could not control their social worlds and that their experiences were integrally linked to their engendered nature.
The specialist learning disability nurse in Wales
Authors: Fisher Mick
Published: February 2007

Fisher M. International Journal of Nursing Practice 1997; 3: 188–190

The specialist learning disability nurse in Wales

This paper reflects on the development of services for people with learning disabilities within the United Kingdom and focuses on the role of the specialist nurse. The nurse’s contribution to the care of this client group has been the subject of debate and controversy for a number of years. Developments within the learning disability field in Wales in particular are explored, with the All Wales Strategy for People with Learning Disabilities providing the background and context for these developments. An example of how specialist nurses from around Wales came together in order to share good and best practice is discussed. The conclusion is that the specialist learning disability nurse has a great deal to offer, but must be prepared to work together with other professionals as well as service users and their families.
Progression of retinopathy during pregnancy in type 1 diabetes mellitus
Authors: Rahman Waheeda , Rahman Farooq Z , Yassin Sanaa , Al‐Suleiman Suleiman A , Rahman Jessica
Published: February 2007

Abstract

Purpose:  The incidence and risk factors for progression of retinopathy during pregnancy in women with type 1 diabetes mellitus were retrospectively evaluated.

Methods:  Fifty‐four insulin‐dependent diabetic patients at a teaching hospital in Saudi Arabia were followed throughout the pregnancy/puerperium with serial ophthalmic examination. Dilated fundus examination was performed in each trimester and puerperium.

Results:  Progression of diabetic retinopathy in the study occurred in 13/54 (24%) patients – 2/22 (9.1%) patients had no diabetic retinopathy initially, 4/20 (20%) had non‐proliferative diabetic retinopathy (NPDR) and 7/12 (58.3%) had proliferative diabetic retinopathy (PDR). Of the eight patients with PDR who had no laser treatment before pregnancy, six (75%) showed progression but only one of the four patients who had PDR and laser treatment prior to pregnancy experienced progression of retinopathy. Eight patients in total received panretinal photocoagulation to arrest the progression of retinal disease during pregnancy and only one of them had laser treatment prior to pregnancy.

Conclusion:  Laser photocoagulation for severe NPDR or early PDR prior to pregnancy may protect against rapid progression of PDR. Visual impairment resulting from progression of PDR can be prevented by aggressive laser treatment during pregnancy. Duration of diabetes >15 years, poor glycaemic control and hypertension are high‐risk factors in the progression of diabetic retinopathy in pregnancy.
Dose‐response in infants receiving caudal anaesthesia with bupivacaine*
Authors: SPEAR R.M.
Published: February 2007

Caudal epidural anaesthesia was performed in 25 awake or sedated infants, the sensory levels measured and the dose‐response determined (bupivacaine dose [ml kg−1] v. sensory level). The infants were divided into two groups based on body weight, group 1 (1.9–2.6 kg) and group 2 (3.4–7.0 kg). There was a significant difference between the dose‐response when comparing group 1 to group 2 (P < 0.01). Smaller infants require a larger volume (ml kg−1) of local anaesthetic to achieve mid‐thoracic sensory levels than larger infants. In small infants, we recommend increasing the volume of local anaesthetic while still limiting the total bupivacaine dose to 3.25 mg kg−1 by using 1.6 ml kg−1 of bupivacaine 0.20% (3.20 mg kg−1) instead of 1.3 ml kg−1 of bupivacaine 0.25% (3.25 mg kg−1).
Strabismus surgery and post‐operative vomiting: clinical observations and review of the current literature; a medical opinion
Authors: WOODS A.M. , BERRY F.A. , CARTER B.J.
Published: February 2007

This study documents the age‐related incidence of vomiting in paediatric patients following strabismus surgery under a postoperative policy of delayed oral alimentation (3‐6 h), minimized motion and the avoidance of anti‐emetic medications. The incidence of vomiting prior to discharge was 4%. The average time from completion of surgery to discharge home was 84 min. The overall incidence of vomiting in the 24 h following surgery was 43%; almost half of this incidence occurred during the car ride home. Children 3 years of age or older were twice as likely to vomit than those younger than 3 years of age. A literature review finds that no drug has been shown by independent investigators to decrease consistently the incidence of vomiting following strabismus surgery. For most drugs, anti‐emetic efficacy parallels the degree of sedation and prolongs recovery; once the sedative effects have abated, the incidence of vomiting approaches that in untreated patients. Our protocol allows for early discharge with the same expected incidence of post‐discharge vomiting as reported for children receiving pharmacologic anti‐emetic prophylaxis.
A formula for determining the distance from the skin to the lumbar epidural space in infants and children
Authors: A. UEMURA MD  , M. YAMASHITA MD
Published: February 2007

In paediatric epidural anaesthesia, the distance from the skin to the epidural space is of special importance because of the great differences in size of the patients. We measured the distance from the skin to the lumbar epidural space (L3/4) in 355 paediatric patients. The epidural space was punctured using a midline approach under general anaesthesia, and was identified by the micro‐drip infusion technique. There was a good correlation between the distance to the epidural space and body weight.

A clinically useful formula for estimating the distance from the skin to the lumbar epidural space was derived as follows:

D = (W+10) × 0.8

where D = distance from the skin to the lumbar epidural space (L3/4) (mm) and W = body weight (kg).
Acute pulmonary oedema following repair of congenital diaphragmatic hernia
Authors: PAUT O. , GAILLAT F. , DELARUE A. , BONNERU J.J. , CHAUVET V. , CAMBOULIVES J.
Published: February 2007

Re‐expansion pulmonary oedema is a rare form of pulmonary oedema, due to an increased capillary permeability, and is considered to be a reoxygenation injury. The first reported case of the occurrence of a re‐expansion pulmonary oedema following the surgical treatment of a congenital diaphragmatic hernia in a young, healthy, 6‐year‐old child is described.
Leg lengthening in children—a retrospective review of anaesthetic management in 61 children including 14 with achondroplasia
Authors: BRIMACOMBE J.R. , GODDARD J.M.
Published: February 2007

The peri‐operative anaesthetic management of 61 children undergoing leg lengthening procedures on 72 occasions has been analysed retrospectively. The findings are discussed and the operations performed are described. Twenty‐one anaesthetics were administered to 14 achondroplastic children with no major problems. The main challenge for the anaesthetist is the management of postoperative pain to gain the confidence of the patient whose co‐operation is vital during a protracted leg lengthening programme.
An audit of percutaneous central venous catheters in paediatric patients
Authors: FORREST E.T.S. , SILK J.M. , MACKERSIE A.
Published: February 2007

A prospective audit of all central venous catheters placed percutaneously by anaesthetists was conducted at the Hospital for Sick Children over a three‐month period in 1990. A total of 443 attempts at catheter insertion were made of which 394 catheters were successfully sited in 182 children. Patients ranged in weight from 1.5 kg to 83 kg and in age from 12 h to 17 years. 85.8% of catheters were inserted into the internal jugular, 10.1% into the femoral, and 3.5% into the subclavian veins. Complications of insertion occurred with 14.7% of attempts of which 11.0% resulted in failure at that site. Later complications were found with 17.2% of catheters. Failure to cannulate any central vein occurred in 5 patients (1.1% of all attempts).
Blood flow velocity in the femoral artery 1–3 years after catheterization. A prospective study in neonates and children
Authors: SELLDÉN HANS , NYBONDE TRYGVE , NYMAN YVONNE , MORTENSSON WIGHER
Published: February 2007

During the period 1987–1989 femoral artery cannulations were performed in 95 patients of whom 74 were neonates. Catheter sizes were 24 G (n= 28), 22 G (n= 54) and 20 G (n= 13). Median indwelling time was 3 days (range: 1–13 days). Catheter removal was due to perfusion related symptoms in 12 cases, malfunction in 16 cases and because they were no longer needed in 67 cases. One to three years after the catheterization event the systolic peak flow velocity in the femoral artery was analysed with a Doppler sonography system in 28 neonates and in 6 older children. Measurements were performed where the external iliac artery ascends from the pelvic fossa (proximal site) and in the common femoral artery which was considered to be the site for catheter introduction (puncture site). In the neonatal group (n= 28), there was a significant increase in the peak flow velocity at the puncture site in the catheterized leg (P < 0.05), as well as a signficant increase in the quota of the puncture and proximal site values in the catheterized leg (P < 0.05). In the catheterized leg, the peak flow velocity at the puncture site correlated positively with the length of the indwelling time (r= 0.467, P < 0.01). It is concluded that the use of the femoral artery for intra‐arterial monitoring in neonates and children is clinically a safe method. The findings of peak systolic velocity may indicate damage to the vessel and/or adjacent vessel tissue present 1–3 years after the catheterization event.
Anaesthetic management of an insulin‐dependent diabetic child during cardiopulmonary bypass
Authors: STEVENSON G.W. , MODLINSKI M. , SILVERMAN B.L. , HALL S.C.
Published: February 2007

The management of an insulin‐dependent diabetic child presenting for correction of complex congenital heart disease requiring cardiopulmonary bypass is described. A constant rate glucose infusion and variable rate insulin infusion, combined with frequent serum glucose measurements, allowed prompt response to the glucose alterations associated with surgery and cardiopulmonary bypass.
Enalapril‐induced reversible renal failure during surgery in an infant
Authors: DIOP E. , CONSTANT I. , LUPOLD M. , MARTIN C. , MURAT I.
Published: February 2007

Angiotensin‐converting enzyme (ACE) inhibitors are widely used as antihypertensive drugs, and serious complications have been described in adults, particularly in the perioperative period. This report concerns a 14‐months‐old infant who developed prolonged hypotension and reversible renal failure during major surgery for neuroblastoma removal. He was treated for 4 months by the long‐acting ACE inhibitor, enalapril, that had been continued until the morning of surgery. This observation, as well as others in adults, suggests that consideration should be given to discontinue the administration of long‐acting ACE inhibitors preoperatively in children scheduled to undergo extensive surgical procedure involving large blood or fluid shifts.
Nitrous oxide and postoperative vomiting in children undergoing myringotomy as a day case
Authors: WILSON I.G. , FELL D.
Published: February 2007

The effect of avoiding nitrous oxide during anaesthesia for myringotomy as an outpatient procedure in children aged 18 months to 10 yr was investigated. One hundred and four children were allocated randomly to receive either nitrous oxide, oxygen and halothane or oxygen and halothane for maintenance of anaesthesia. Ten of 47 (21%) children receiving nitrous oxide experienced postoperative vomiting, compared with two of 48 (4%) of those that did not receive nitrous oxide (P < 0.05). The possible mechanisms are discussed.
Complications following use of the laryngeal mask airway in children
Authors: ST. CLAIR LOGAN ANDREW , MORRIS PETER
Published: February 2007

Anaesthetic records from 507 children anaesthetized using the laryngeal mask airway (LMA) breathing spontaneously were analysed. Failure to insert the LMA occurred in 10 (2.0%) children and there were difficulties with insertion in 36 (7.1%) children. There was a total of 81 (16%) children with complications in the recovery period. Most of these were not clinically significant. Twenty‐three children showed evidence of trauma to the pharynx or larynx. This study demonstrates that the LMA is a safe and effective tool for use in paediatric anaesthesia. However, the incidence of trauma may be higher than expected and attempts should be made to minimize this with a gentle technique and adequate depth of anaesthesia.
Anaesthetic implications of mucolipidosis
Authors: BAINES D.B. , STREET N. , OVERTON J.H.
Published: February 2007

The anaesthetic implications of mucolipidosis in three siblings is reported. Two of the three children exhibit marked difficulty with their airways under anaesthesia and all three have narrow tracheas. Surgery and anaesthesia should be undertaken with caution in patients with a mucolipidosis.
PCA in paediatric orthopaedic patients: influence of a NSAID on morphine requirement
Authors: TEIRIÄ H. , MERETOJA O.A.
Published: February 2007

Ninety‐seven consecutive children (5‐16 years of age), who underwent a major orthopaedic operation received patient controlled analgesia (PCA) as their main therapy for postoperative pain. A Pharmacia DeltecTM pump was used with a bolus dose of 25 μg·kg−1 of morphine, a lock‐out period of 8 min, and a maximally delivered dose of 0.1 mg·kg−1 in an hour. Two‐thirds of the patients were allocated to receive a concomitant non‐steroidal anti‐inflammatory drug (NSAID), either ibuprofen 40 mg·kg−1 or diclofenac 2 mg·kg−1 daily. Individual morphine requirement varied greatly (range 0.1‐1.6 mg·kg−1 in a day) and could not be predicted preoperatively. It was 29% less in patients receiving a NSAID (0.53 ± 0.35 (SD) vs 0.75 ± 0.28 mg·kg−1 during the first postoperative day, P= 0.002). Patient's age did not influence morphine requirement, but patients with nausea took 23% less morphine than other patients (P= 0.023). Postoperative nausea was more frequent in patients having a NSAID (52 vs 31%, P= 0.027). The principle of PCA made it possible to cover even a wide individual range of postoperative opioid requirement with great patient satisfaction.
Neuromuscular effects of 600 μg·kg−1 of rocuronium in infants during nitrous oxide‐halothane anaesthesia
Authors: WOELFEL SUSAN K. , BRANDOM BARBARA W. , McGOWAN FRANCIS X. , GRONERT BRIAN J. , COOK D. RYAN
Published: February 2007

Rocuronium bromide (Zemuron) is a new steroidal nondepolarizing neuromuscular blocking drug. We were interested in determining the effect of a bolus of rocuronium in infants during halothane anaesthesia as we did previously in older children. Eighteen infants (2‐11 months) received a bolus of 600 μg·kg−1, which is equal to twice the dose of rocuronium estimated to produce 95% depression of neuromuscular function (ED95) in children (2‐12 yr). Neuromuscular blockade was monitored by recording the electromyographic activity of the adductor pollicis muscle resulting from supramaximal stimulation of the ulnar nerve at 2 Hz for 2 s at 10‐s intervals. Time (mean ± SEM, range) from administration of 600 μg·kg−1 rocuronium to 90% (B90) and 100% (B100) neuromuscular block was 37 ± 2 (20‐60) s and 64 ± 10 (20‐180) s, respectively. The time to recovery of neuromuscular transmission to 10% (T10) was 35.3 ± 3.0 (20.7‐57.8) min and to 25% of baseline (T25) was 41.9 ± 3.2 (24.3‐67.7) min. The recovery index (T25‐T75) was 26.6 ± 2.7 (11.7‐44.5) min, and the time to recovery of the train‐of‐four ratio (T4/T1) ± 0.75 was 82.1 ± 6.9 (53.2‐138.3) min. The plasma concentration of rocuronium when T1 had recovered to about 30% was 654 ± 34 (417‐852) ng·ml−1 which is similar to that observed in children. Six‐hundred μg·kg−1 of rocuronium has a rapid onset of effect in infants and prolonged duration of action in infants compared to children.