bluuebunny/crossref_metadata_2025 huggingface dataset:
Ease of care with patient controlled analgesia systems: questionnaire development and validation
Authors: Harding Gale , Vallow Sue , Leidy Nancy K. , Olson William , Hewitt David J. , Polomano Rosemary , Nelson Winnie W. , Schein Jeff R.
Published: August 2007

Title.  Ease of care with patient controlled analgesia systems: questionnaire development and validation

Aim.  This paper is a report of the development and validation of two questionnaires assessing ease of caring for patients receiving patient controlled analgesia from the perspectives of nurses and physical therapists.

Background.  While studies have assessed patient satisfaction with and preference for patient controlled analgesia modalities, no instruments have been developed to assess the ease of providing care (ease of care) for patients receiving patient controlled analgesia from nurses’ and physical therapists’ perspectives.

Method.  Nurses and physical therapists participated in focus groups during 2003 to identify concepts associated with caring for patients receiving intravenous patient controlled analgesia. Based on these discussions, items were developed and included in draft questionnaires. Content validity of draft questionnaires was assessed, and final questionnaires were developed. Psychometric properties of the final questionnaires were assessed using data from 79 nurses and 80 physical therapists from two clinical trials conducted during 2004 and 2005 to compare the efficacy and safety of two modalities of patient controlled analgesia.

Findings.  The Nurse and Physical Therapist Ease of Care Questionnaires had 22 items addressing three aspects of patient care: time‐efficiency (time‐consuming subscale), ease of use/convenience (bothersome subscale), and satisfaction (satisfaction subscale). All subscales on both questionnaires demonstrated evidence of internal consistency reliability, and subscale‐to‐subscale correlations suggested that the time‐consuming and bothersome subscales contribute equally to overall ease of care. The subscales were statistically significantly correlated with clinical measures.

Conclusion.  These instruments may be valuable for assessing the impact of patient controlled analgesia modalities on patient care for these healthcare providers.
Mental health nurse supplementary prescribing: experiences of mental health nurses, psychiatrists and patients
Authors: Jones M. , Bennett J. , Lucas B. , Miller D. , Gray R.
Published: August 2007

Aim.  This paper is a report of a study to explore the views of patients, mental health nurses and psychiatrists involved in mental health nurse supplementary prescribing.

Background.  Medication prescribing by mental health nurses in the United Kingdom is controversial. However, the experience of mental health patients suggests that increasing prescribing capacity could be one strategy to provide a person‐centred prescribing approach.

Method.  A qualitative study was carried out in 2005. Semi‐structured interviews were conducted with 12 psychiatrists, 11 mental health nurses with prescribing authority, and 12 patients who had been prescribed psychiatric medication by a mental health nurse. Participants were interviewed about positive aspects of supplementary prescribing including the extent of it being evidence‐based, person‐centred and clinically focussed.

Findings.  Participants from all three groups had a positive reaction to nurse supplementary prescribing. Mental health nurse prescribing was viewed as evidence‐based, person‐centred and with an additional focus on physical health. Mental health nurses worked within their levels of competency. Barriers to the implementation of mental health nurse prescribing were nurses’ lack of prescribing experience, shortfalls in supervision, insufficient focus on redesigning the service to support the role of the mental health nurse, and preparation for the role.

Conclusion.  Mental health nurse prescribing seems potentially beneficial. However, more rigorous audit and evaluation are needed to confirm its safety, patient satisfaction and health outcomes. Mental health nurse prescribing will require service redesign to ensure that is becomes embedded in the service organizational culture.
Measuring symptom occurrence and symptom distress: development of the symptom experience index
Authors: Fu Mei R. , McDaniel Roxanne W. , Rhodes Verna A.
Published: August 2007

Title. Measuring symptom occurrence and symptom distress: development of the symptom experience index

Aim. This paper is a report of a study to assess reliability and construct validity of revised and refined version of the Adapted Symptom Distress Scale: the Symptom Experience Index (SEI).

Background. The development of the SEI, a 41‐item Likert Scale assessing 20 symptoms, was based on self‐regulation theory and an integrative conceptual analysis of symptom assessment and management. The model emphasizes the difference between the occurrence of a symptom (or multiple symptoms) and the distress (emotional) response to the occurrence of a symptom. It is the distress from symptom occurrence that promotes a person to take action and use known coping strategies to prevent the symptom occurrence or alleviate the distress from the symptom.

Method. A contrast‐group and test‐retest approach was used to assess construct validity and reliability with a convenience sample of 158 patients at United States of America in 2003–2004.

Results. The SEI demonstrated reasonable internal consistency with a Cronbach's alpha of 0·91 for symptom experience, 0·85 for symptom occurrence and 0·84 for symptom distress. Test‐retest reliability was supported by high intra‐class correlation coefficients (symptom experiencer = 0·93; symptom occurrencer = 0·94; symptom distress,r = 0·92). Construct validity was supported by statistically significant differences between patients and healthy adults.

Conclusion. The SEI can be used as a baseline and outcome measure to assess the impact of multiple symptoms on patients, and the effectiveness of interventions to manage these symptoms.
Receiving power through confirmation: the meaning of close relatives for people who have been critically ill
Authors: Engström Åsa , Söderberg Siv
Published: August 2007

Title.  Receiving power through confirmation: the meaning of close relatives for people who have been critically ill

Aim.  This paper is a report of a study to elucidate the meaning of close relatives for people who have been critically ill and received care in an intensive care unit.

Background.  Falling critically ill can bring about a difficult change in life. In previous reports such events are described as frightening experiences, and close relatives are described as an important source of support in this difficult situation.

Method.  A purposive sample of 10 adults, eight men and two women, narrated how they experienced their close relatives during and after the time they were critically ill. The data were collected in 2004. The interview texts were transcribed and interpreted using a phenomenological hermeneutic approach influenced by the philosophy of Ricoeur.

Findings.  One major theme was identified, experiencing confirmation, with six sub‐themes: receiving explanations; a feeling of being understood; a feeling of safety; gaining strength and will‐power; having possibilities and realizing their value. Close relatives served as tools for the person who was ill, facilitating better communication and an increased ability to do various things. Simultaneously, feelings of dependence on the close relatives were expressed. There were descriptions of loneliness and fear in the absence of close relatives and, in order to feel safe, the participants wanted their close relatives to stay near them.

Conclusion.  Close relatives are vital, as they are the ill person's motivation to stay alive and to continue the struggle. Their presence is of great importance for the ill person and must be facilitated by staff.
Paediatric health‐related quality of life instrument for primary school children: cross‐cultural validation
Authors: Laaksonen Camilla , Aromaa Minna , Heinonen Olli J. , Suominen Sakari , Salanterä Sanna
Published: August 2007

Title.  Paediatric health‐related quality of life instrument for primary school children: cross‐cultural validation.

Aim.  This article is a report of a study to validate the Finnish version of the Pediatric Quality of Life InventoryTM (PedsQLTM*) for children aged 8–12 years.

Background.  Promoting and improving health and well‐being of children are the global goals of primary‐day health care. Sophisticated, internationally valid measurement tools are needed for planning, conducting and evaluating interventions to meet these challenges. The PedsQLTM is a promising, relatively new instrument developed in the United States to assess health‐related quality of life (HRQL) in children and adolescents.

Method.  Content validity of the Finnish version of PedsQLTM 4.0 was assessed in 2004 during the translation process and tested by performing cognitive interviews with children aged 8–12 years (n = 7) and their parents (n = 5). Construct validity and reliability of the Finnish version of the PedsQLTM 4.0 were statistically tested on a sample of school children (n = 1097) and their parents (n = 999).

Findings.  Cognitive interviews confirmed that the concepts, questions and response alternatives of the Finnish version are equivalent to the original PedsQLTM 4.0. The Finnish version was easy to understand and complete. The construct validity was good. Cronbach´s alpha values were excellent for the total scale score (Child‐Self Report α = 0·91 and Parent‐Proxy Report α = 0·88) and good for sub‐ and summary scales (Child‐Self Report α = 0·73–0·89 and Parent‐Proxy Report α = 0·69–0·86).

Conclusion.  Results support previous research on validity and reliability of the PedsQLTM 4.0. The Finnish version of the PedsQLTM 4.0 demonstrated good validity and reliability in primary school children. Future research is needed to examine, construct and predictive validity of the Finnish version of the PedsQLTM 4.0.
Closure for patients at the end of a cancer clinical trial: literature review
Authors: Wilson Eleanor , Elkan Ruth , Cox Karen
Published: August 2007

Title.  Closure for patients at the end of a cancer clinical trial: literature review

Aim.  This paper is a report of a literature review to explore theories of psychological closure in order to understand the outcomes of a trial in which nurses attempted to facilitate psychological closure for their patients with cancer.

Background.  Patients’ accounts have highlighted a feeling of abandonment and a need for support after a period of treatment for cancer but this is rarely addressed in the nursing literature or in practice.

Methods.  The British Nursing Index, the CINAHL, Ovid Medline, PsychInfo and EMBASE databases were searched without date limits using the keywords ‘closure’, ‘ending’, ‘finishing’, ‘treatment’, ‘cancer care’, ‘therapeutic relationships’ and ‘transitions’. The search took place concurrently with the implementation of a randomized controlled trial from 2001 to 2005 in which nurses attempted to facilitate closure for patients at the end of a cancer chemotherapy trial.

Results.  Literature on the concept of ‘rites of passage’ enabled us to view nurses as supporting patients’ transition from one life‐stage to another. Literature on debriefing deepened our understanding of patients’ anxieties and needs. Our review also drew attention to power imbalances in the ending of nurse–patient or doctor–patient relationships, and highlighted the importance of good endings and the need to mark endings formally.

Conclusion.  Achieving closure is an important element in promoting patient well‐being when undergoing treatment for cancer. Nurses and other healthcare staff can facilitate this with simple interventions such feedback and discussion at the end of a period of active treatment.
Middle‐Aged Female Rats Lack the Dynamic Changes in GAD67 mRNA Levels Observed in Young Females on the Day of a Luteinising Hormone Surge
Authors: Grove‐Strawser D. , Jimenez‐Linan M. , Rubin B. S.
Published: August 2007

The hypothalamic decapeptide gonadotrophin‐releasing hormone (GnRH), modulates gonadotrophin synthesis and secretion and is essential for the preovulatory luteinising hormone (LH) surge. As females age, there is a gradual attenuation and eventual loss of the preovulatory LH surge and oestrous cyclicity. Data from previous studies have demonstrated evidence of compromised GnRH neuronal function at this time. The present study begins to explore the hypothesis that the age‐related attenuation of the LH surge and decline in GnRH neuronal function are due, in part, to increased inhibitory influences on GnRH neurones. In situ hybridisation (ISH) was used to assess relative levels of mRNA for one isoform of glutamic acid decarboxylase (GAD), the rate‐limiting enzyme for GABA synthesis. Ovariectomised young and middle‐aged rats were injected with oestradiol benzoate and progesterone in a regimen for LH surge induction. Animals were killed at time points prior to, during the ascending phase, and during the peak and early descending phase of the LH surge. Dynamic changes in GAD67 mRNA levels were observed in young but not middle‐aged females in two regions known to be important for LH surge induction, the rostral proeptic area in the region of the organum vasculosum of the lamina terminalis (OVLT) and in the ventral periventricular preoptic area. Furthermore, GAD67 mRNA levels were elevated in middle‐aged relative to young females in the region of the OVLT at the time of LH surge induction and in the ventral periventricular preoptic area prior to surge induction. Age‐related differences were not observed in other brain regions analysed. These data suggest that GABA synthesis may be elevated in middle‐aged relative to young females in specific brain regions at critical times in conjunction with the LH surge, and that the lack of dynamic changes in GABA levels in these regions may contribute to the attenuated LH surge observed in middle‐aged females.
The Type 2 Corticotrophin‐Releasing Hormone Receptor Mediates Orexin A‐Induced Luteinising Hormone Suppression in Ovariectomised Rats
Authors: Iwasa T. , Matsuzaki T. , Kiyokawa M. , Shimizu F. , Minakuchi M. , Kuwahara A. , Maegawa M. , Yasui T. , Irahara M.
Published: August 2007

Orexins are thought to be regulatory factors of the arousal and sleep patterns. They also affect immune, feeding, autonomic and neuroendocrine systems. We have previously shown that intracerebroventricular (i.c.v.) injection of orexin decreases pulsatile luteinising hormone (LH) secretion in ovariectomised (OVX) rats. However, the details of this mechanism have not been fully examined. Intracerebroventricular injection of orexin A also stimulates corticotrophin‐releasing hormone (CRH) systems, which have been implicated in the stress‐induced suppression of reproductive function. In the present study, we investigated the role of CRH systems in orexin‐induced LH suppression. OVX rats were implanted with i.c.v. and intravenous (i.v.) cannulae. After i.c.v. injection of orexin and/or CRH receptor antagonists, blood samples were collected through the i.v. cannula at 6‐min intervals for 120 min for LH measurement. Intracerebroventricular injection of orexin A or B (3 nmol/2.5 µl) suppressed pulsatile LH secretion. Coadministration of orexin A and α‐helical corticotrophic‐releasing factor (CRF), a nonselective CRH receptor antagonist (13 nmol/2.5 µl), or astressin2B, a selective type2 (CRH‐R2) CRH receptor antagonist (28 nmol/2.5 µl), partly restored pulsatile LH secretion. Orexin B‐induced LH suppression was not restored by α‐helical CRF. In addition, i.c.v. injection of orexin A increased CRH and urocortin II (UcnII), but not Ucn mRNA levels, in the hypothalamus. These findings suggest that CRH‐R2 mediates orexin A‐induced LH suppression and it is possible that CRH and UcnII in the hypothalamus are involved in this pathway.
A preliminary report of patients treated with early loaded implants using computerized tomography‐guided surgical stents: flapless versus conventional flapped surgery
Authors: OZAN O. , TURKYILMAZ I. , YILMAZ B.
Published: August 2007

Summary  The objective of this clinical study was to compare the survival rates of early loaded implants placed using flapless and flapped surgical techniques and to determine the bone density in the implant recipient sites using computerized tomography (CT). The study population consisted of 12 patients who were referred implant placement. One group consisted of five patients referred for the placement of 14 implants and treated with a flapless procedure. The other group consisted of seven patients referred for the placement of 45 implants with a conventional flapped procedure. Patients were selected randomly. CT machine was used for pre‐operative evaluation of the jaw bone and the mean bone density value of each implant recipient site was recorded in Hounsfield units (HU). All implants were placed using CT‐guided surgical stents. The early loading protocols included 2 months of healing in the mandible and 3 months of healing in the maxilla. Single‐implant crowns, implant‐supported fixed partial dentures, and implant‐retained over dentures were delivered to the patients. Of 59 implants placed, one was lost in the conventional flapped group within the first month of healing, meaning overall implant survival rate of 98·3% average 9 months later. The highest average bone density value (801 ± 239 HU) was found in the anterior mandible, followed by 673 ± 449 HU for the posterior maxilla, 669 ±346 HU for the anterior maxilla and 538 ± 271 HU for the posterior mandible. The results of this study show that the early loading of implants placed utilizing flapless surgical technique with CT‐guided surgical stents may be possible.
Tracking the sudden oak death pathogen
Authors: COOKE DAVID E. L.
Published: August 2007

Invasive species are, by definition, unwelcome and pathogenic ones, especially so. Tracing the origins and spread of Phytophthora ramorum, the devastating ‘Sudden Oak Death’ pathogen, in the forests and nurseries of Oregon has revealed differences between forest and nursery pathogen populations that suggest discrete sources of primary inoculum initiate each type of outbreak. New information on the ecology and evolution of this pathogen is presented that helps gauge the effectiveness of quarantine and eradication programmes.
Repression of AUXIN RESPONSE FACTOR10 by microRNA160 is critical for seed germination and post‐germination stages
Authors: Liu Po‐Pu , Montgomery Taiowa A. , Fahlgren Noah , Kasschau Kristin D. , Nonogaki Hiroyuki , Carrington James C.
Published: August 2007

AUXIN RESPONSE FACTORS (ARFs) are transcription factors involved in auxin signal transduction during many stages of plant growth development. ARF10, ARF16 and ARF17 are targeted by microRNA160 (miR160) in Arabidopsis thaliana. Here, we show that negative regulation of ARF10 by miR160 plays important roles in seed germination and post‐germination. Transgenic plants expressing an miR160‐resistant form of ARF10, which has silent mutations in the miRNA target site (termed mARF10), exhibited developmental defects such as serrated leaves, curled stems, contorted flowers and twisted siliques. These phenotypes were not observed in wild‐type plants or plants transformed with the targeted ARF10 gene. During sensu stricto germination and post‐germination, mARF10 mutant seeds and plants were hypersensitive to ABA in a dose‐dependent manner. ABA hypersensitivity was mimicked in wild‐type plants by exogenous auxin. In contrast, overexpression of MIR160 (35S:MIR160) resulted in reduced sensitivity to ABA during germination. Transcriptome analysis of germinating ARF10 and mARF10 seeds indicated that typical ABA‐responsive genes expressed during seed maturation were overexpressed in germinating mARF10 seeds. These results indicate that negative regulation of ARF10 by miR160 plays a critical role in seed germination and post‐embryonic developmental programs, at least in part by mechanisms involving interactions between ARF10‐dependent auxin and ABA pathways.
In planta ORFeome analysis by large‐scale over‐expression of GATEWAY®‐compatible cDNA clones: screening of ERF transcription factors involved in abiotic stress defense
Authors: Weiste Christoph , Iven Tim , Fischer Ute , Oñate‐Sánchez Luis , Dröge‐Laser Wolfgang
Published: August 2007

Genomic approaches have generated large Arabidopsis thaliana open reading frame (ORF) collections. However, tools are required to functionally characterize this ORFeome. Here we describe a batch procedure to simultaneously recombine a population of GATEWAY®‐tagged full‐length cDNAs into a plant expression vector. A pool of agrobacteria carrying these constructs has been used in flower‐dip transformation experiments to obtain a collection of transgenic lines that over‐express HA‐tagged ORFs. This AtTORF‐Ex library can be used in various screening approaches to identify particular gene family members involved in plant development or stress responses. The feasibility of the approach was studied using a near‐complete collection of the Arabidopsis ethylene response factor (ERF) transcription factor (TF) family. Quality control performed at each step of the procedure revealed that the complexity of the population is maintained, and that almost all members of the ORF collection are covered by the plant library. The frequency of multiple transformation events has been determined as approximately 4%. Significant transgene expression was detected at the RNA and protein level in more than 60% and 30% of the transgenic plants, respectively. Striking phenotypic alterations were observed in approximately 4% of the plants. Many ERF TFs have been shown to participate in plant stress responses. As a proof of principle, the AtTORF‐Ex library has been used in a selection procedure to isolate TFs involved in enhanced abiotic stress tolerance. The corresponding TF gene can be easily polymerase chain reaction‐amplified using GATEWAY®att site‐specific primers. In summary, we describe here a method that can be generally applied for functional analysis of ORFeomes in planta.
Hypothalamic‐pituitary‐adrenal axis suppression in asthmatic children on inhaled corticosteroids (Part 2) – the risk as determined by gold standard adrenal function tests: A systematic review
Authors: Zöllner Ekkehard Werner
Published: August 2007

The evidence for hypothalamic‐pituitary‐adrenal axis (HPA) suppression by inhaled corticosteroids (ICS) was found to be conflicting. Reviewers have not distinguished between gold standard and basal adrenal function tests. The utility of the latter is limited by physiological and pathological variability as well as by methodological concerns. The risk of HPA suppression in asthmatic children and adolescents treated with ICS, as determined by gold standard adrenal function tests, needs to be established. A systematic review of the literature from January 1973 to July 2005 was performed. The Medline and Cochrane databases were searched, the reference lists of retrieved articles were inspected and pharmaceutical companies were approached. Randomized‐controlled trials, cohort and case–control studies designed to detect HPA suppression caused by ICS, diagnosed by the insulin tolerance test (ITT) or the metyrapone test, performed on asthmatics of all ages not on oral steroids, were included and assessed for methodological quality. Of the 22 identified studies only four met the criteria for inclusion. All of these were published before 1988 and only one was methodologically sound. The cohort study showed that the baseline risk for HPA suppression is 0% while the absolute risk is 100% in asthmatic children treated with a beclomethasone dipropionate metered dose inhaler at a dose of 250–600 μg/m2/day for 6–42 months. As suggested by other observations these results could be generalized to other ICS. They may be of clinical significance especially if children are subjected to stress. Further research is needed to establish the cumulative dose for all ICS at which HPA suppression will be precipitated. Guidelines for future trials are suggested.
Sensitization to serum albumins in children allergic to cow's milk and epithelia
Authors: Vicente‐Serrano J. , Caballero M. L. , Rodríguez‐Pérez R. , Carretero P. , Pérez R. , Blanco J. G. , Juste S. , Moneo I.
Published: August 2007

Patients with persistent milk allergy and specific immunoglobulin E (IgE) to bovine serum albumin (BSA) have a greater risk of rhinoconjunctivitis and asthma because of animal dander. To prove the cross‐reactivity between serum albumin (SA) of different mammals in milk, meat, and epithelia and determine if heat treatment of meats decrease the allergenicity of albumins. The study was performed using SDS‐PAGE and IgE‐immunoblotting using sera from eight patients sensitized to milk, BSA, and animal danders. Sera from non‐allergic and only animal dander allergic subjects served as a control. With one exception, all patients’ sera recognized SA in different meats (beef, lamb, deer, and pork), epithelia (dog, cat, and cow), and cow's milk. Some patients even were only sensitized to SA in meat and epithelia. Danders’ allergic only recognized other proteins in epithelia but not SA. No patients reacted to SA from heated meat extracts. Serum albumin is an important allergen involved in milk, meat, and epithelia allergy. The first contact with SA was through cow's milk and patients developed sensitization to epithelia SA even without direct contact with animals. Patients with both BSA and cow's milk allergy must avoid raw meats and furry pets.
Safety of specific sublingual immunotherapy with SQ standardized grass allergen tablets in children
Authors: Ibañez Maria Dolores , Kaiser Friedrich , Knecht Roland , Armentia Alicia , Schöpfer Helmut , Tholstrup Bente , Bufe Albrecht
Published: August 2007

The aim of the study was to confirm the safety of an orodispersible grass allergen tablet 75,000 SQ‐T (Grazax®, ALK‐Abelló A/S, Hørsholm, Denmark) in children aged 5–12 yr. The study was randomized, double‐blinded and placebo‐controlled. Sixty children aged 5–12 yr suffering from grass pollen‐induced rhinoconjunctivitis (with or without asthma) from five centres in two countries (three in Germany and two in Spain) participated in the study. They were randomized at the ratio of 3:1 as receiving either Grazax or placebo tablet given sublingually once daily for 28 days outside the grass pollen season. A total of 810 treatment‐related adverse events were reported in the Grazax group. The majority of these were local reactions in the mouth or throat and were mostly mild (71%) to moderate (27%) in severity and resolved within days. Thirty‐five (78%) subjects treated with Grazax and five (33%) treated with placebo reported at least one treatment‐related adverse event. Oral pruritus, throat irritation, mouth oedema and ear pruritus appeared as the most frequently reported treatment‐related adverse events. 62% (28 of 45) of the actively treated subjects reported oral pruritus, 36% (16 of 45) throat irritation, 31% (14 of 45) mouth oedema and 22% (10 of 45) ear pruritus. Two actively treated subjects withdrew from the study: one subject due to four adverse events (moderate eye pruritus, moderate pharyngolaryngeal pain, moderate non‐cardiac chest pain and moderate dysphagia) and one subject due to a serious adverse event (asthmatic attack). The subjects recovered completely from the events. In conclusion, in the present study, Grazax was in general tolerated in a paediatric population and considered suitable for further clinical investigations in children.
Comorbid substance use disorder in women with bipolar disorder associated with criminal arrest
Authors: McDermott Barbara E , Quanbeck Cameron D , Frye Mark A
Published: August 2007

Objectives:  Previous research has indicated that comorbid substance abuse in patients with bipolar disorder (BPD) is strongly linked to criminal arrest. This study was conducted to further evaluate possible gender differences in substance use and risk of criminality in BPD.

Methods:  Subjects were selected from all inmates with a DSM‐IV diagnosis of BPD type I at Los Angeles County correctional facility. As a comparison, a sample of Los Angeles County patients with BPD type I who had not been arrested during the course of their psychiatric treatment within LA County was identified. The county's Management Information System (MIS) was utilized to obtain primary and secondary diagnoses as well as demographic information.

Results:  The odds of having a comorbid substance use diagnosis for arrested female patients was more than 38 times that for community female patients (odds ratio = 38.75). Women were more likely to have been arrested for violent and substance use charges; men were more likely to have been arrested for theft and miscellaneous charges.

Conclusions:  Substance abuse appears to be a significant risk factor for arrest in patients with BPD and is especially significant for women with BPD. Our study suggests that comorbid BPD and substance use in women may significantly increase the risk of criminal arrest.
Nutrition and exercise behavior among patients with bipolar disorder1
Authors: Kilbourne Amy M , Rofey Dana L , McCarthy John F , Post Edward P , Welsh Deborah , Blow Frederic C
Published: August 2007

Objectives:  There have been few comprehensive studies of nutrition and exercise behaviors among patients with bipolar disorder (BPD). Based on a national sample of patients receiving care in the Veterans Affairs (VA) health care system, we compared nutrition and exercise behaviors among individuals diagnosed with BPD, others diagnosed with schizophrenia, and others who did not receive diagnoses of serious mental illness (SMI).

Methods:  We conducted a cross‐sectional study of patients who completed the VA's Large Health Survey of Veteran Enrollees section on health and nutrition in fiscal year (FY) 1999 and who either received a diagnosis of BPD (n = 2,032) or schizophrenia (n = 1,895), or were included in a random sample of non‐SMI VA patients (n = 3,065). We compared nutrition and exercise behaviors using multivariable logistic regression, controlling for patient socio‐economic and clinical factors, and adjusting for patients clustered by site using generalized estimating equations.

Results:  Patients with BPD were more likely to report poor exercise habits, including infrequent walking (odds ratio, OR = 1.33, p < 0.001) or strength exercises (OR = 1.28, p < 0.001) than those with no SMI. They were also more likely to self‐report suboptimal eating behaviors, including having fewer than two daily meals (OR = 1.32, p < 0.001) and having difficulty obtaining or cooking food (OR = 1.48, p < 0.001). Patients with BPD were also more likely to report having gained ≥10 pounds in the past 6 months (OR = 1.59, p < 0.001) and were the least likely to report that their health care provider discussed their eating habits (OR = 0.84, p < 0.05) or physical activity (OR = 0.81, p < 0.01).

Conclusions:  Greater efforts are needed to reduce the risk of poor nutrition and exercise habits among patients diagnosed with BPD.
Personality and the predisposition(s) to bipolar disorder: heuristic benefits of a two‐dimensional model
Authors: Murray Greg , Goldstone Eliot , Cunningham Everarda
Published: August 2007

Objectives:  The aim of this study was to model normal personality correlates of the predisposition(s) to bipolar disorder (BD), and in so doing explore the proposition that the tendency to bipolar depression [trait depression (T‐Depression)] and the tendency to mania [trait mania (T‐Mania)] can usefully be viewed as separable but correlated dimensions of BD predisposition.

Methods:  A well student sample (n = 176, modal age 18–25 years, 71% female) completed the NEO Personality Inventory–Revised and the General Behavior Inventory.

Results:  A good‐fitting model (normed χ2 = 0.60, significance of χ2 = 0.73) was identified in which T‐Depression was determined solely by neuroticism, while T‐Mania was determined by extraversion and (negative) agreeableness. The pathway from T‐Depression to T‐Mania was also significant (standardized regression weight = 0.80), with a weaker significant reciprocal path (coefficient = 0.27). A model in which bipolar vulnerability was represented as a single dimension (T‐Bipolarity) also provided a good fit to the data, but provided less heuristic power.

Conclusions:  Predisposition to BD can be usefully understood in terms of two reciprocally related dimensions of vulnerability (T‐Depression and T‐Mania), which can be separated on the basis of their personality correlates.
Stability of self‐esteem in bipolar disorder: comparisons among remitted bipolar patients, remitted unipolar patients and healthy controls1
Authors: Knowles Rebecca , Tai Sara , Jones Steven H , Highfield Julie , Morriss Richard , Bentall Richard P
Published: August 2007

Objectives:  Changes in beliefs about the self are a central feature of bipolar disorder, with grandiose self‐belief common in mania and low self‐esteem evident in periods of depression. We investigated whether unstable self‐esteem is a characteristic of bipolar disorder in remission.

Methods:  We compared 18 patients with DSM‐IV bipolar disorder in remission, 16 patients with unipolar disorder in remission, and 19 healthy controls. The primary measure was a diary kept for one week and completed twice each day, measuring self‐esteem and positive and negative affect. We also administered Winters and Neale's (J Abnorm Psychol 1985; 94: 282–290) implicit measure of attributional style.

Results:  Whereas mean levels of self‐esteem and affect were not abnormal in the remitted bipolar patients, the bipolar patients showed strong fluctuations in these processes. In common with the unipolar patients, they also showed a pessimistic attributional style on the Pragmatic Inference Task (PIT).

Conclusions:  Instability of self‐esteem and affect is present in bipolar patients, even when their symptoms are in remission, and has previously been found in people at genetic risk of the disorder. It may be a marker of vulnerability to the disorder.
Three times more days depressed than manic or hypomanic in both bipolar I and bipolar II disorder1
Authors: Kupka Ralph W , Altshuler Lori L , Nolen Willem A , Suppes Trisha , Luckenbaugh David A , Leverich Gabriele S , Frye Mark A , Keck Paul E , McElroy Susan L , Grunze Heinz , Post Robert M
Published: August 2007

Objectives:  To assess the proportion of time spent in mania, depression and euthymia in a large cohort of bipolar subjects studied longitudinally, and to investigate depression/mania ratios in patients with bipolar I versus bipolar II disorder.

Methods:  Clinician‐adjusted self‐ratings of mood were completed daily for one year for naturalistically treated outpatients with bipolar I (n = 405) or bipolar II (n = 102) disorder. Ratings were analyzed for mean time spent euthymic, depressed, manic, hypomanic, and cycling, and the percentages of time spent ill were compared between the two groups.

Results:  Percentages of time spent ill for bipolar I versus II patients were: euthymia 47.7% versus 50.2%; depression 36.0% versus 37.0%; hypomania 11.5% versus 9.8%; mania 1.0% versus 0.2%; and cycling 3.7% versus 2.8%. The depression/mania ratio was 2.9 in the bipolar I and 3.8 in bipolar II sub‐groups.

Conclusions:  Depression represents the predominant abnormal mood state for treated outpatients with bipolar I and II disorder. In contrast to other studies, we found that depression/mania ratios were of a similar magnitude, suggesting the same tendency towards mood instability in both sub‐groups.
Impaired working memory monitoring in euthymic bipolar patients
Authors: Thompson Jill M , Gray John M , Hughes John H , Watson Stuart , Young Allan H , Nicol Ferrier I
Published: August 2007

Objectives:  Converging evidence suggests that patients with remitted bipolar disorder (BD) have a persistent cognitive deficit in the executive control of working memory (WM). However, the component operations that contribute to this deficit remain unclear. The aim of the present study was to further profile the nature and specificity of WM impairment in euthymic BD.

Methods:  Fifty DSM‐IV‐confirmed patients with euthymic BD and demographically matched controls completed a modified version of the Self‐Ordered Pointing Task (SOPT) and the Cambridge Neuropsychological Test Automated Battery Pattern Recognition Test along with traditional executive and WM tasks [Stroop, initial letter Verbal Fluency (FAS), Trail‐Making, Digits Forwards and Backwards]. Prospective clinical ratings over one month prior to testing confirmed that patients were euthymic at test. Absence of basal hypercortisolaemia was confirmed by serial saliva sampling.

Results:  Error analysis revealed that whilst patients made more errors on the SOPT overall, they were no more likely to perseverate than controls. Patients’ erroneous responses did not proliferate across trials, suggesting that proactive interference did not contribute to their poor performance, but serial position effects were evident where patients’ errors clustered towards the end of a trial. No differences were found on the recognition memory test, in WM capacity, or on two of the three traditional executive procedures (FAS and Trail‐Making). However, patients’ Digits Backwards was impaired.

Conclusions:  These data suggest that patients with BD have a deficit in their ability to monitor the contents of WM. This deficit is not an epiphenomenon of mood, but may be due to enduring brain dysfunction, integral to bipolar illness.
Monitoring adult Eretmocerus mundus, Encarsia lutea and Bemisia tabaci with yellow sticky traps in cotton Gossypium hirsutum
Authors: Karut K. , Kazak C.
Published: August 2007

Abstract:  The efficiency of yellow sticky traps for estimating adult population dynamics of Bemisia tabaci (Genn.) (Hom., Aleyrodidae) and its parasitoids Eretmocerus mundus Mercet, Encarsia lutea (Masi) (Hym., Aphelinidae) was examined in cotton in choice and no‐choice studies in Çukurova, Turkey in 2004 and 2005. In the no‐choice study, traps were suspended individually on the third, fifth or eighth main stem node branches from the tops of cotton plants. For the choice study, three traps were suspended on the same individual node branches on different plants. Trap captures were counted weekly. Mean (±SE) numbers of B. tabaci captured on traps were higher in no‐choice (max.: 697.8 ± 55.6) compared with choice (max.: 533.3 ± 47.4) studies each year. Population fluctuation patterns of E. mundus and E. lutea adults were similar to those of adult B. tabaci on traps with low weekly mean numbers occurring initially and increasing to peak levels in mid‐August, then decreasing in later weeks of the studies. The relationship between weekly mean numbers of B. tabaci and E. lutea was greater than the relationship between B. tabaci and E. mundus. Mean numbers of E. mundus and E. lutea on traps were higher at the third main stem nodes than traps suspended on the fifth or eighth node. Mean numbers of E. lutea pupae were usually higher than E. mundus from the first sampling date throughout the end of the growing season on leaves. The relationship between parasitoid pupae and adults captured in traps is discussed.
Nursing the postmodern body: A touching case
Authors: Hickson Pat , Holmes Colin A.
Published: August 2007

Using touch as a medium for exploring the ways in which it is constructed by nurses, the body is here characterized by a plethora of competing and co‐existing terms: disobedient, obedient, mirroring, stigmatized, sinful, post‐mortem, sanitized, angelic, desexualized, dangerous, dominant, dominating, deceitful, submissive, disciplined, postmodern and communicative. We have tried to be provocative by juxtaposing contradictory messages and evoking conflicting emotions, and we hope that the reader will not assume that we believe everything we write, or that everything may be taken only at face value. There are as many messages and meanings in the paper as each reader thinks there are.
Nursing as textually mediated reality
Authors: Cheek Julianne , Rudge Trudy
Published: August 2007

Nursing and nursing practice both construct and are in turn constructed by the context in which they operate. Texts play a central part in that construction. As such, nursing and nursing practice can be considered to represent a reality that is textually mediated. This paper explores the notion of nursing as a textually mediated reality and offers the reader the possibility of engaging in reflection on what implications this has for nursing and their own nursing practice. The analyses provided draw on aspects of die work of both Foucault and Derrida. Foucault's notion of discourse provides a vehicle for die exploration of nursing as textually mediated, as does Derrida's concept of binary oppositions. The paper thus illustrates some of die possibilities afforded nursing by poststructural analyses. In particular it does this by exploring one of the central textual constructions, impacting on die way that nursing and nursing practice are conceptualized, the mind/body binary opposition.
Florence Nightingale and the Women's Movement: Friend or foe?
Authors: Hektor Lynne M.
Published: August 2007

The historical analysis of the complex and often contradictory views of Florence Nightingale regarding the rights of women is explored in this paper. Feminism and nursing are often viewed as contradictory and antithetical. The relationship between the two is examined through the link between Florence Nightingale and her contemporary, Barbara Leigh‐Smith Bodichon. Leigh‐Smith was founder and primary financier of The English Women's Journal that provided a public platform for the major feminist writings of the period. Its offices in Langham Place formed the administrative centre of the Society for Promoting the Employment of Women. Bodichon and her colleagues were often referred to as the ‘Langham Place Group’. Unexplored prior to this study was the fact that Leigh‐Smith and Nightingale were first cousins. Utilizing techniques of internal and external criticism, primary and secondary sources were surveyed relating to Nightingale and Leigh‐Smith. The views of both women on the subjects of the rights of women, women's suffrage, the employment status of women, and the societal place of women are compared and contrasted. The legacy of both Leigh‐Smith and Nightingale to twentieth century feminism, the status of women, and the profession of nursing is then elaborated. The exploration of the views of both Nightingale and Leigh‐Smith is important to gain a clearer understanding of the existing relationship between nursing and feminism. In keeping with the aims of feminist inquiry, women's experiences, specifically those of Nightingale and Leigh‐Smith, are the major ‘objects’ of investigation. The concluding interpretation provides a synthesis that is emancipatory as well as knowledge generative.
Madness in our methods: nursing research, scientific epistemology
Authors: Horsfall Jan M.
Published: August 2007

This paper is a critique of some research methods evident in contemporary nursing literature. The arguments derive from critical‐feminist, humanist and ethical perspectives. As a consequence of investigating specific aspects of scientific method, an approach to research that is congruent with values intrinsic to an holistic approach to nursing practice is articulated. Such methodologies also render problematic withstatus quopower relations between nurses and other health professionals, as well as between nurses and patients. The central themes in this paper are: the absence of overt conceptual frameworks; an avoidance of complex social contexts within which research subjects live; an apparent lack of empathy; and an apolitical articulation of research problems and data analyses. All four of these difficulties may be traced to scientific methodology by many researchers. Most nurse researchers may not actually adhere to this technique, but I propose that they have been informed by belief systems associated with scientific methodology and diat these have dire consequences for the discipline of nursing. A key argument is diat the apparent lack of conceptual frameworks in the majority of nursing research is due to the epistemology, which therefore provides a pre‐existing, non‐declared conceptual framework, that is incorporated into the research by drawing upon scientific mediodology. A further argument is diat scientific, or scientistic, ways of approaching situations are antithetical to nursing values and to constructive social change for the benefit of patients, nursing and nurses.
Nurses, nursing and representation: an exploration of the effect of viewing positions on the textual portrayal of nursing
Authors: Cheek Julianne
Published: August 2007

Textual portrayals of nursing can be ‘read’ from a number of possible viewing positions, which play a very real part in the way that our reality is constructed and understood. The image depends on which viewing position is chosen by or constructed for the viewer, and how the viewer interacts with that position. Thus without the viewer the image is incomplete. This paper is a beginning exploration of the nature of texts diat portray nursing, and what Kaplan has termed the ‘delicate negotiation’ between the reader and the text in producing, in this case, understandings of nursing. Consequently die discussion focuses on how texts represent nursing, not in terms of what they portray, but how understandings of that portrayal are arrived at. This is to move exploration of portrayals of nursing from the descriptive to the discursive realm. In so doing the aim is to begin to explore and uncover the way in which we are positioned, and position ourselves, as readers of portrayals of nursing in text.
Making sense of the stories that people with Alzheimer's tell: a journey with my mother
Authors: Crisp Jane
Published: August 2007

Making sense of the stories that people with Alzheimer's tell: a journey with my mother

Confabulation or pseudo‐reminiscence of the sort produced by people with Alzheimer's is reconsidered by applying existing theories about the structure of narrative and work on reminiscence, and the construction of a life story to the stories told by the author's mother. This approach provides the basis for going beyond a negative estimate of confabulatory stories based on their apparent confusion of past and present, truth and fantasy., to a more positive estimate of diem as complying with the norms of narrative, and as being functional for their teller as a means both of interaction and of reconstructing an identity. It also allows for identification of certain predominant themes, which may help one to grasp die general sense of such stories.
Rethinking cultural sensitivity
Authors: Swendson Carol , Windsor Carol
Published: August 2007

The concept of cultural sensitivity is located within the tradition of anthropology and the history of colonisation and immigration in Australian society. This history provides a basis for examining the largely uncritical introduction of cultural considerations to the discipline of nursing. This paper argues that contemporary understandings of multiculturalism in nursing and health care policy tend to obscure, ignore and thus perpetuate notions of racial superiority. Recent works in transcultural nursing are med to illustrate the way in which ahistorical and therefore quite arbitrary traits are attributed to particular cultural groups. This perspective, given legitimacy in terms of cultural sensitivity, encourages political neutrality and thereby avoids questioning the discriminatory practices embedded in fundamental social relations.