bluuebunny/crossref_metadata_2025 huggingface dataset:
Kinetics and mechanism of electron transfer in intact photosystem II and in the isolated reaction center: Pheophytin is the primary electron acceptor
Authors: Holzwarth A. R. , Müller M. G. , Reus M. , Nowaczyk M. , Sander J. , Rögner M.
Published: May 2006

The mechanism and kinetics of electron transfer in isolated D1/D2-cyt
b559
photosystem (PS) II reaction centers (RCs) and in intact PSII cores have been studied by femtosecond transient absorption and kinetic compartment modeling. For intact PSII, a component of ≈1.5 ps reflects the dominant energy-trapping kinetics from the antenna by the RC. A 5.5-ps component reflects the apparent lifetime of primary charge separation, which is faster by a factor of 8–12 than assumed so far. The 35-ps component represents the apparent lifetime of formation of a secondary radical pair, and the ≈200-ps component represents the electron transfer to the Q
A
acceptor. In isolated RCs, the apparent lifetimes of primary and secondary charge separation are ≈3 and 11 ps, respectively. It is shown (
i
) that pheophytin is reduced in the first step, and (
ii
) that the rate constants of electron transfer in the RC are identical for PSII cores and for isolated RCs. We interpret the first electron transfer step as electron donation from the primary electron donor Chl
acc D1
. Thus, this mechanism, suggested earlier for isolated RCs at cryogenic temperatures, is also operative in intact PSII cores and in isolated RCs at ambient temperature. The effective rate constant of primary electron transfer from the equilibrated RC* excited state is 170–180 ns
−1
, and the rate constant of secondary electron transfer is 120–130 ns
−1
.
Who are you calling queer? Sticks and stones can break my bones but names will always hurt me
Authors: Vicars Mark
Published: May 2006

Recent evidence suggests that there have been significant increases in the number of problems reported by students who identify as lesbian, gay or bisexual. This paper seeks to describe, by means of autobiographical account, the educational implications of being identified as ‘queer’ within schools. It draws on experiential stories to illustrate the injurious effects of homophobic speech acts and attempts to show how reconstructed narratives of the self can be used in educational research. The stories told in this article speak about the impact of heteronormative practices in education and how a sense of self can become constituted through the authorising, performative utterances of wounding words.
A comparison of teacher/pupil interaction within mathematics lessons in St Petersburg, Russia and the North‐East of England
Authors: Wilson Linda , Andrew Carolyn , Below John
Published: May 2006

The emphasis placed upon interactive teaching in recent years has stimulated considerable debate about its nature. This article attempts to explore some features of teacher/pupil interaction occurring in classrooms in two countries and compares teacher/pupil interaction in mathematics lessons in St Petersburg, Russia with those in the North‐East of England. The research explores the patterns of interaction, both public and private, the number and duration of interactions and the nature of the dialogue, in both locations. Issues which are highlighted are the tension between interaction and cognitive pace, and the tension between collective involvement and response to individual needs. Close examination of the interactions in the two locations highlights differences in sequence and blend which are not immediately apparent, raising questions about the outcomes which are most highly valued in each context.
Predictive value of magnetic resonance imaging signal and contrast-enhancement characteristics on post-embolization volume reduction of uterine fibroids
Authors: Harman M. , ZeteroĞlu Ş. , Arslan H. , Şengül M. , Etlik Ö.
Published: May 2006

Purpose: To assess the magnetic resonance imaging (MRI) signal and contrast-enhancement features of uterine fibroids before and after embolization, and to determine whether or not there are pre-embolization MRI characteristics that predict the volume reduction of fibroids.

Material and Methods: Uterine fibroid embolization (UFE) was carried out in 28 fibroids of 20 patients, all of whom were symptomatic. The patients were prospectively evaluated with T1-weighted, T2-weighted, and gadolinium-enhanced T1 MRI sequences before and 6 months after embolization. The relationship between the characteristics of MRI signal and contrast-enhancement features of fibroids before the procedure and the change in size of the lesions after treatment was investigated.

Results: Before embolization, the mean volume of fibroids was 123 cm3 (8–560 cm3). The decrease rate in fibroid volumes was 44.6% (range 7–70%) 6 months after embolization. Volume reduction was more prominent in fibroids that had a high signal intensity on T2-weighted images and a marked contrast enhancement on T1-weighted images ( P<0.001). However, the volume reduction was insufficient in fibroids with high signal characteristics on pre-contrast T1-weighted images ( P<0.001).

Conclusion: MRI is an effective method for revealing size and signal changes of fibroids after embolization. MRI signal characteristics and the contrast-enhancement pattern of fibroids before embolization can predict tumor volume reduction after embolization.
Correlation of magnetic resonance imaging findings with hexamethylpropyleneamine oxime brain single photon emission computed tomography in ischemic stroke patients in the subacute stage
Authors: Kireşi D. , Taştekin G. , Cengiz Ş. L. , Üstün M. E. , Yürüten B.
Published: May 2006

Purpose: To evaluate the correlation between magnetic resonance imaging (MRI) findings and 99mTc-hexamethylpropyleneamine oxime (HMPAO) brain single photon emission computed tomography (SPECT) during the subacute stage in ischemic stroke patients.

Material and Methods: The T1 and T2-weighted images and brain SPECT findings of 84 patients (mean age 60.69±12.47 years) with subacute cerebral ischemia during the period 1998–2004 were reviewed. All HMPAO SPECT and MRI studies were performed between 3 and 7 days (mean time delay 4.76±1.29 days) after the onset of stroke symptoms.

Results: An ischemic lesion was seen both in T1 and T2-weighted images with perfusion defects above 60% (severe defect) according to count/pixel data of the lesion in HMPAO SPECT studies in 30 (90.9%) of 33 patients. Otherwise, the ischemic lesion was seen only on T2-weighted images with perfusion defects between 30% and 60% (moderate defect) in HMPAO SPECT studies in 25 (89.3%) of 28 patients. In 20 (87%) of 23 patients who had perfusion defects below 30% (mild defect) on HMPAO SPECT, only non-specific findings such as cerebral atrophy and/or periventricular ischemic-gliotic lesions could be seen in MRI. The difference between these ratios was statistically significant ( P<0.01).

Conclusion: Brain 99mTc-HMPAO SPECT findings indicate good correlation with MRI findings. When the ischemic lesions could be seen in both T1 and T2-weighted images, the patients frequently had severe perfusion defects. When only seen in T2-weighted images, the perfusion defect was moderate. When only non-specific findings were revealed by MRI, only mild perfusion defects were found by SPECT.
Diagnostic imaging of carcinomas of the gallbladder and the bile ducts
Authors: Oikarinen H.
Published: May 2006

Early diagnosis and accurate staging of carcinomas of the gallbladder and the bile ducts are helpful in improving the prognosis. Ultrasonography (US), a useful initial modality when exploring the background of jaundice or non-specific gastrointestinal complaints, sensitively reveals bile duct obstruction in particular. In unclear cases, or if US suggests a resectable biliary malignancy, computed tomography (CT), magnetic resonance imaging (MRI) with magnetic resonance cholangiography (MRC) and / or traditional cholangiography often provide additional information, and imaging-guided fine-needle biopsy or an endoscopic brush sample may verify the malignant nature of the tumor. Complementary modalities are usually needed for accurate staging, and traditional cholangiography is often performed for therapeutic purposes as well. Comparative studies of MRI with MRC and multidetector CT in biliary cancers would be welcome.
Delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) of hip joint cartilage: better cartilage delineation after intra-articular than intravenous gadolinium injection
Authors: Boesen M. , Jensen K. E. , Qvistgaard E. , Danneskiold-SamsØe B. , Thomsen C. , Østergaard M. , Bliddal H.
Published: May 2006

Purpose: To investigate and compare delayed gadolinium (Gd-DTPA)-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) in the hip joint using intravenous (i.v.) or ultrasound-guided intra-articular (i.a.) Gd-DTPA injection.

Material and Methods: In 10 patients (50% males, mean age 58 years) with clinical and radiographic hip osteoarthritis (OA; Kellgren score II–III), MRI of the hip was performed twice on a clinical 1.5T MR scanner: On day 1, before and 90–180 min after 0.3 mmol/kg body weight i.v. Gd-DTPA and, on day 8, 90–180 min after ultrasound-guided i.a. injection of a 4 mmol/l Gd-DTPA solution. Coronal STIR, coronal T1 fat-saturated spin-echo, and a cartilage-sensitive gradient-echo sequence (3D T1 SPGR) in the sagittal plane were applied.

Results: Both the post-i.v. and post-i.a. Gd-DTPA images showed significantly higher signal-to-noise (SNR) and contrast-to-noise (CNR) in the joint cartilage compared to the non-enhanced images ( P<0.002). I.a. Gd-DTPA provided significantly higher SNR and CNR compared to i.v. Gd-DTPA ( P<0.01). Furthermore, a better delineation of the cartilage in the synovial/cartilage zone and of the chondral/subchondral border was observed.

Conclusion: The dGEMRIC MRI method markedly improved delineation of hip joint cartilage compared to non-enhanced MRI. The i.a. Gd-DTPA provided the best cartilage delineation. dGEMRIC is a clinically applicable MRI method that may improve identification of early subtle cartilage damage and the accuracy of volume measurements of hip joint cartilage.
Quantitative magnetic resonance imaging of brainstem volumes, plaques, and surface area in the occipital regions of patients with multiple sclerosis
Authors: Alper F. , Kantarci M. , Altunkaynak E. , Varoglu A. O. , Karaman A. , Oral E. , Okur A.
Published: May 2006

Purpose: To determine brainstem volumes, number of plaques, and surface areas in the occipital lobes of patients with relapsing remitting multiple sclerosis (RRMS) and secondary progressive multiple sclerosis (SPMS), and to investigate whether there is any correlation between brainstem volume and the number/surface areas of plaque in the occipital lobes.

Material and Methods: Magnetic resonance imaging was obtained on 14 relapsing-remitting (RR) and 13 secondary progressive (SP) MS patients and 26 female control subjects. The Cavalieri method was used by modern design stereology to measure brainstem volume. The point-counting grid was used to evaluate sclerotic plaque surface areas in the occipital lobe. The number of plaques in the imaging section was calculated.

Results: Brainstem volumes for RR and SP with multiple sclerosis and control subjects were 3647 mm3, 3515 mm3, and 4517 mm3, respectively. Mean number of plaques in the right-left occipital lobe was found to be 2.7–3.4 in RR-MS and 5.2–2.8 in SP-MS. Mean plaque surface area in the right-left occipital lobe was determined to be 58.52–88.24 mm2 in RR MS and 124.3–64.82 mm2 in SP MS. Brainstem volumes were significantly reduced in both groups of patients with MS compared to controls ( P<0.01).

Conclusion: Magnetic-resonance-estimated volume and surface area values in multiple sclerosis may facilitate our understanding of the clinical situation of patients and provide a simple index for evaluating therapeutic efficiency.
Exposure to Terrorism and Israeli Youths' Psychological Distress and Alcohol Use: An Exploratory Study
Authors: Schiff Miriam , Benbenishty Rami , McKay Mary , DeVoe Ellen , Liu Xinhua , Hasin Deborah
Published: May 2006

This study examined the associations between physical and psychological proximity to terrorist attacks and post‐traumatic symptoms (PTS), depressive symptoms, and alcohol use among Israeli youth. Self‐administered questionnaires were completed under anonymous conditions by 1,150 high and junior high school students (51.3% boys and 48.7% girls) in a town in the Tel Aviv metropolitan area. Standardized, validated scales were used to measure psychological symptoms and alcohol use. High levels of exposure to terrorism were reported. Physical and psychological proximity to terrorist attacks were associated with more PTS symptoms and alcohol consumption. Physical proximity was also associated with symptoms of depression. The implications of terror‐associated early drinking for later alcohol problems should be explored.
High Prognostic Specificity of Antisocial Personality Disorder in Patients with Drug Dependence: Results from a Five‐Year Follow‐up
Authors: Fridell Mats , Hesse Morten , Johnson Eva
Published: May 2006

A sample of 125 consecutive patients from a Swedish detoxification unit were followed up at five years. Register data on criminal behavior were retrieved for 99% of all subjects, including those who were deceased at follow‐up, and 76% of living subjects were interviewed. A diagnosis of antisocial personality disorder (ASPD) at intake was associated with incarceration, continuous drug use, dependence on welfare support, and fulfilling criteria of adult ASPD at follow‐up. Regardless of ASPD status, a decline was seen in drug‐related convictions, but subjects with ASPD were found to continue to commit other crimes.
Heroin Use among Youths Incarcerated for Illicit Drug Use: Psychosocial Environment, Substance Use History, Psychiatric Comorbidity, and Route of Administration
Authors: Chiang Shu‐Chuan , Chen Shaw‐Ji , Sun Hsiao‐Ju , Chan Hung‐Yu , Chen Wei J.
Published: May 2006

This study examines differences in psychosocial characteristics, substance use history, and psychiatric comorbidity in relation to heroin use among youths aged 15 to 22 incarcerated in 2003 for illicit drug use in northern Taiwan. Factors associated with heroin use included experiences of child abuse, having friends with illicit drug use, poor school attendance, polydrug use, and early age of drug initiation. Heroin users were found to have more severe clinical manifestation and experiences of conduct and anxiety disorders than non‐heroin users; injection users tended to have a longer heroin history. This information may help guide future prevention programs to reduce heroin problems in youth.
The interference effect in an optical beam deflection detection system of a dynamic mode AFM
Authors: Huang Qiang-Xian , Fei Ye-Tai , Gonda Satoshi , Misumi Ichiko , Sato Osamu , Keem Taeho , Kurosawa Tomizo
Published: May 2006

Optical beam deflection detection is one of the main techniques used to detect the vibrating amplitude of dynamic mode atomic force microscope cantilevers. Due to the limitations of optical beam deflection detection systems and cantilevers, light leakage of the incident laser beam around the cantilevers can occur. An interference effect between the reflected beam from the cantilever and some scattered light from the specimen surface occurs, and an interference error in the probe tip–specimen approaching curve arises from this effect. In this paper, the interference effect in a dynamic atomic force microscope is analysed and observed in different conditions, and the micro-profile measurement error caused by the optical interference is deduced and calculated mathematically. The influence of the interference effect on a grating pattern measurement is then simulated.
The network of sheep movements within Great Britain: network properties and their implications for infectious disease spread
Authors: Kiss Istvan Z , Green Darren M , Kao Rowland R
Published: May 2006

During the 2001 foot and mouth disease epidemic in the UK, initial dissemination of the disease to widespread geographical regions was attributed to livestock movement, especially of sheep. In response, recording schemes to provide accurate data describing the movement of large livestock in Great Britain (GB) were introduced. Using these data, we reconstruct directed contact networks within the sheep industry and identify key epidemiological properties of these networks. There is clear seasonality in sheep movements, with a peak of intense activity in August and September and an associated high risk of a large epidemic. The high correlation between the in and out degree of nodes favours disease transmission. However, the contact networks were largely dissasortative: highly connected nodes mostly connect to nodes with few contacts, effectively slowing the spread of disease. This is a result of bipartite-like network properties, with most links occurring between highly active markets and less active farms. When comparing sheep movement networks (SMNs) to randomly generated networks with the same number of nodes and node degrees, despite structural differences (such as disassortativity and higher frequency of even path lengths in the SMNs), the characteristic path lengths within the SMNs are close to values computed from the corresponding random networks, showing that SMNs have ‘small-world’-like properties. Using the network properties, we show that targeted biosecurity or surveillance at highly connected nodes would be highly effective in preventing a large and widespread epidemic.
Arthropod phylogeny: onychophoran brain organization suggests an archaic relationship with a chelicerate stem lineage
Authors: Strausfeld Nicholas J , Mok Strausfeld Camilla , Loesel Rudi , Rowell David , Stowe Sally
Published: May 2006

Neuroanatomical studies have demonstrated that the architecture and organization among neuropils are highly conserved within any order of arthropods. The shapes of nerve cells and their neuropilar arrangements provide robust characters for phylogenetic analyses. Such analyses so far have agreed with molecular phylogenies in demonstrating that entomostracans+malacostracans belong to a clade (Tetraconata) that includes the hexapods. However, relationships among what are considered to be paraphyletic groups or among the stem arthropods have not yet been satisfactorily resolved. The present parsimony analyses of independent neuroarchitectural characters from 27 arthropods and lobopods demonstrate relationships that are congruent with phylogenies derived from molecular studies, except for the status of the Onychophora. The present account describes the brain of the onychophoranEuperipatoides rowelli, demonstrating that the structure and arrangements of its neurons, cerebral neuropils and sensory centres are distinct from arrangements in the brains of mandibulates. Neuroanatomical evidence suggests that the organization of the onychophoran brain is similar to that of the brains of chelicerates.
Phylogenetic analysis of Sicilian goats reveals a new mtDNA lineage
Authors: Sardina M. T. , Ballester M. , Marmi J. , Finocchiaro R. , Van Kaam J. B. C. H. M. , Portolano B. , Folch J. M.
Published: May 2006

The mitochondrial hypervariable region 1 (HVR1) sequence of 67 goats belonging to the Girgentana, Maltese and Derivata di Siria breeds was partially sequenced in order to present the first phylogenetic characterization of Sicilian goat breeds. These sequences were compared with published sequences of Indian and Pakistani domestic goats and wild goats. Mitochondrial lineage A was observed in most of the Sicilian goats. However, three Girgentana haplotypes were highly divergent from the Capra hircus clade, indicating that a new mtDNA lineage in domestic goats was found.
The internet as a tool in clinical pharmacology
Authors: Castel Josep‐Maria , Figueras Albert , Vigo Joan‐Miquel
Published: May 2006

The invention of the internet and the world‐wide web was a landmark that has affected many aspects of everyday life, but is so recent and dynamic that many of its potential uses are still being explored. Aside from its purely commercial use as a virtual pharmacy (e‐commerce), the internet is useful in at least three aspects related to clinical pharmacology: communication, training and research. In this paper we briefly review several internet applications related to clinical pharmacology and describe, as an example, the logistics of a multicentre research collaboration related to the promotion of rational drug use in the prevention of postpartum haemorrhage.
Herbal product–drug interactions mediated by induction
Authors: Tirona Rommel G. , Bailey David G.
Published: May 2006

Despite their common use, it is not widely recognized that herbal medicines can alter the efficacy of coadministered prescription drugs. Constituents in herbs interact with nuclear receptors to enhance metabolizing enzyme and/or transporter activity leading to reduced drug concentrations. Although St John’s wort was the first and most frequently reported source of induction‐style herb–drug interactions, this knowledge has not yet changed its current availability. This type of interaction is likely to be relevant to other herbal products. Caregivers need to be aware of the issues and options for therapeutic management.
Safe adoptive transfer of virus‐specific T‐cell immunity for the treatment of systemic adenovirus infection after allogeneic stem cell transplantation
Authors: Feuchtinger Tobias , Matthes‐Martin Susanne , Richard Celine , Lion Thomas , Fuhrer Monika , Hamprecht Klaus , Handgretinger Rupert , Peters Christina , Schuster Friedhelm R. , Beck Robert , Schumm Michael , Lotfi Ramin , Jahn Gerhard , Lang Peter
Published: May 2006

During periods of immunosuppression, such as postallogeneic stem cell transplantation (SCT), patients are at significant risk for severe viral infections. Human adenovirus (HAdV) infection is a serious complication post‐SCT, especially in children. Virus‐specific T cells are essential for the clearance of HAdV, as antiviral chemotherapy has revealed limited success. We present feasibility data for a new treatment option using virus‐specific donor T cells for adoptive transfer of immunity to patients with HAdV‐infection/reactivation. Virus‐specific donor T cells were isolated and infused into nine children with systemic HAdV infection after SCT. Isolation was based on γ‐interferon (IFN‐γ) secretion after short in vitro stimulation with viral antigen, resulting in a combination of CD4+ and CD8+ T cells. 1·2–50 × 103/kg T cells were infused for adoptive transfer. Isolated cells showed high specificity and markedly reduced alloreactivity in vitro. Adoptive transfer of HAdV‐specific immunity was successful in five of six evaluable patients, documented by a dose‐independent and sustained in vivo expansion of HAdV‐specific T cells, associated with a durable clearance/decrease of viral copies. T‐cell infusion was well tolerated in all nine patients, except one case with graft‐versus‐host disease II of the skin. In conclusion, induction of a specific T‐cell response through adoptive transfer was feasible and effective. When performed early in the course of infection, adoptive T‐cell transfer may protect from HAdV‐related complications.
Regulatory mechanisms of immunoglobulin E synthesis by human B cells
Authors: Yanagihara Y.
Published: May 2006

Production of antigen‐specific IgE antibodies by B cells contributes to induction and maintenance of allergic inflammation. Antibody diversity is acquired through V (variable)–D (diversity)–J (joining) recombination, which is mediated by the products of recombination‐activating gene (RAG)‐1 and RAG‐2 during the early stages of B cell development. IgE isotype specificity is determined in mature B cells by IL‐4 and IL‐13 and acquired through class switch recombination (CSR), which is induced by three members of the TNF superfamily. CD40 ligand (CD40L) expressed by Th2 cells induces T cell‐dependent CSR, whereas B lymphocyte stimulator (BLyS) and a proliferation‐inducing ligand (APRIL) expressed by dendritic cells induce T cell‐independent CSR. CD40L, BLyS, and APRIL collaborate with IL‐4 and IL‐13 to induce expression of activation‐induced cytidine deaminase (AID), essential for CSR and somatic hypermutation (SHM), and to perform DNA excision and ligation required for IgE class switching. RAG‐1 and RAG‐2 expression is also inducible only in the presence of IL‐4 by CD40L, BLyS, and APRIL. Thus IL‐4, unlike IL‐13, is effective for inducing RAG expression despite many overlapping activities of these cytokines. RAG products expressed by mature B cells are involved in secondary V(D)J recombination, termed receptor revision. Given that receptor revision contributes to affinity maturation in a fashion different from SHM, it is suggested that IgE antibodies induced by IL‐4 may have higher affinity than those induced by IL‐13.
Effectiveness of acupuncture for migraine: critical literature review
Authors: Griggs Chloe , Jensen Jan
Published: May 2006

Aim.  The aim of this paper is to evaluate previous research studies on acupuncture for migraine with reference to the Standards for Reporting Interventions in Controlled Trials of Acupuncture guidelines.

Background.  It is estimated that around 2–15% of the world's population are affected by migraine headaches. Thirteen per cent of adults in the United Kingdom suffer with chronic pain, migraine headaches accounting for 7% of cases. Migraine pain relief is grounded in pharmacology. Acupuncture for migraine has been widely researched. However, inconsistent and low quality results have been produced. Recently, published Standards for Reporting Interventions in Controlled Randomized Trials of Acupuncture guidelines recommend important information that must be included in research in order to be valid and reliable.

Methods.  Searches were conducted between September 2003 and May 2004 using the Ovid Medline 1966–2004, British Medical Journal, Blackwell Synergy, Science Direct, The Lancet and Cochrane Library Issue 1 databases. Searches were limited to the previous 20 years and to publications in the English language only.

Findings.  Thirteen randomized controlled trials met the inclusion criteria and were critically reviewed for methodological quality, reporting of acupuncture needling details, practitioner background, control interventions and use of a diagnostic criterion. Findings agreed with previous literature reviews that the majority of studies of acupuncture for migraine research are of poor quality, with conflicting results. Few studies met the criteria of the Standards for Reporting Interventions in Controlled Trials of Acupuncture recommendations. Overall, the quality of research in this area must be questioned.

Conclusions.  In the light of these findings, practitioners may face a dilemma when considering the use of acupuncture for migraine. Therefore, large, high quality randomized controlled trials of acupuncture for migraine are needed. Until better quality research is published, with verification of the benefits of acupuncture for migraine, provision of this alternative therapy should not be expanded or withdrawn.
Relational conversation as method for creating partnerships: pilot study
Authors: Leenerts Mary Hobbs , Teel Cynthia S.
Published: May 2006

Aim. This paper reports a pilot study testing the intervention, Self‐Care TALK, whose aim was to describe communication skills used by an advanced practice nurse to create partnerships with caregivers. The communication process and examples of skills used in creating partnerships are described.

Background. Decades of exploring nurse–client relationships provide a knowledge base for describing a structure and process for building partnerships. Self‐Care TALK functions as a vehicle for an education and support partnership. Self‐Care TALK, a theory‐derived intervention, is based on the Self‐Care for Health Promotion in Aging model. Implementation of the intervention was evaluated in a pilot study in 2003, with older spouse caregivers of persons with early dementia.

Methods. Pilot testing of Self‐Care TALK followed Lichstein's criteria of tracking three phases of intervention: delivery, receipt and enactment. Henson's communication elements for establishing partnership relationships provided a guide for advanced practice nurse communication. Self‐Care TALK was delivered during six phone conversations with caregivers for a total of 36 phone conversations. All phone conversations were audiotape recorded. Field notes were taken during each conversation. Data analysis followed a qualitative descriptive process of comparative analysis in which communication skills were compared across conversations. Categories of skills were named based on communication elements that dominated the category. Communication skills were compared to literature addressing communication and nurse–client partnerships.

Findings. Communication examples described the structure for interaction (Self‐Care TALK protocol), process of interaction (relational conversation) and caregiver identified outcomes (intentions to enact self‐care).

Conclusion. Conversations to create partnerships depended on one theme: language that supported relational conversation. Four communication skills illustrated the how of relational conversation: listening with intent, affirming emotions, creating relational images, and planning enactment.
Low back problems and possible improvements in nursing jobs
Authors: Vieira Edgar Ramos , Kumar Shrawan , Coury Helenice J.C.G. , Narayan Yogesh
Published: May 2006

Aim.  This paper reports a study that aimed to evaluate the workload, to identify problems leading to the higher incidence rate of work‐related low back injury among nurses in the orthopaedic and intensive care unit departments of the hospital, and to gather information about improvements that the nurses would like in the workplace.

Background.  The literature shows that low back injuries are common among nurses, and intervention programmes are needed to address this problem.

Method.  The hospital injury records were examined in a retrospective study. In addition, a validated questionnaire was administered between January and May 2005 to 47 nurses (23 orthopaedic and 24 intensive care nurses). The questionnaire contained questions on workload, history of back injuries, problems, possible solutions and psychophysical measures of exertion.

Findings.  The life‐time incidence and point prevalence of low back pain were 65% and 30%, respectively, in orthopaedic nurses, and 58% and 25%, respectively, in the intensive care nurses. The mean weight handled was reported to be 47 ± 30 kg by the orthopaedic nurses and 26 ± 10 kg by the intensive care nurses. The low back scored highest for body‐part discomfort – 4·6 and 4·0, respectively, on a 10‐point scale. The rate of perceived job exertion was 6·7 ± 1·8 (very strong), and 5·8 ± 1·9 (strong) on Borg's 10‐point scale. The total effort required by the job, rated on Visual Analogue Scales, was 67 ± 14% and 68 ± 15% of the maximum, respectively. The Borg scores and the total effort according to the Visual Analogue Scale, and the Borg scores and force effort on the Visual Analogue Scale were moderately correlated (r = 0·53, P < 0·01 for both comparisons).

Conclusion.  The methodology proposed here is practical for job evaluation and to design a participatory ergonomic intervention aiming at reducing low back injuries in nursing jobs. There are workload differences between nursing jobs. Lifting devices, biomechanical training, bigger rooms, adequate set‐up and additional staff are suggested improvements.
Testing a classification model for emergency department errors
Authors: Henneman Elizabeth A , Blank Fidela S.J , Gattasso Sandra , Williamson Katherine , Henneman Philip L.
Published: May 2006

Aim.  This paper presents an evaluation of the Eindhoven Classification Model for categorizing healthcare errors.

Background.  The ability to decrease healthcare errors will depend on an understanding of the types and patterns of error that occur in various settings. Research addressing the systematic classification of error is in its infancy.

Methods.  The sample for this study was two existing sets of healthcare error reports obtained from the emergency department of a regional trauma center. Study data were collected in the summer of 2001 and 2002. The errors in these reports were categorized using a coding tool based on the Eindhoven Classification Model. In addition to testing for inter‐rater reliability, the classification model was also evaluated for the number of unclassifiable errors and of categories never selected by the raters (not useful to the error classification model).

Results.  Our findings of poor inter‐rater reliability, large numbers of unclassifiable errors and categories not selected, suggest that the Eindhoven Classification Model, in its current form, cannot be applied to categorizing healthcare errors in an emergency department setting.

Conclusions.  Further study is needed to develop and test error categorization models for use in emergency departments and other healthcare settings.
Normal ageing in adults with Down's syndrome: a longitudinal study
Authors: Devenny D. A. , Silverman W. P. , Hill A. L. , Jenkins E. , Sersen E. A. , Wisniewski K. E.
Published: May 2006

The ubiquitous presence of the neuropathoiogy of Alzheimer disease (AD) in individuals with Down's syndrome (DS) over 40 years of age suggests that this group of people will exhibit a high prevalence of dementia of the Alzheimer type (DAT) as they age. The present study indicates that there is a clear discrepancy between the presumed presence of AD neuropathoiogy and the clinical expression of DAT among older people with DS. In the first 6 years of a longitudinal study, the present authors compared 91 adults (31–63 years of age) with DS and mild or moderate mental retardation to 64 adults (3 l –76 years of age) with other forms of mental retardation (MR) on yearly measures of mental status, short‐and long‐term memory, speeded psychomotor function, and visuospatial organization. The results indicated that, over repeated testing on the verbal long–term memory test, younger participants with DS showed small increases in their scores, while older participants with DS showed very slight decreases. Overall performance scores on this test and a speeded psychomotor task were poorer for both diagnostic groups in individuals aged SO years and older. The magnitude and type of these selective changes in performance were consistent with performance profiles observed in older healthy adults without mental retardation on tests measuring similar cognitive functions. Only four out of the 91 people with DS in the present sample showed changes in funaioning that have led to a diagnosis of possible DAT. and in these individuals, alternative causes of performance declines were concurrently present (e.g, thyroid dysfunction). These findings indicate that some age–associated changes in funaioning are related to ‘normal’ but probably precocious ageing among adults with DS. Furthermore, these findings suggest that adults with DS and mild or moderate mental retardation may be at lower risk for dementia during their fourth and fifth decades of life than previous studies have suggested.
Self‐reported fears: a comparison study of youths with and without an intellectual disability
Authors: Gullone E. , Cummins R. A. , King N. J.
Published: May 2006

Normal fear plays an essential role in human development and experience, and much research attention has been devoted to its study in the general population. In contrast, the normal fears of youths with intellectual disabilities have largely been ignored. The present paper reports the normative fears of 187 youths with mild to moderate intellectual disabilities. Data were also gathered from 372 youths of average intelligence for comparison purposes. All respondents were aged between 7 and 18 years. Fear was assessed using the Fear Survey Schedule for Children‐ll (FSSC‐II), an instrument which has been psychometrically validated in samples with and without disabilities. The youths with disabilities reported significantly higher levels of fearfulness and a greater range of fears than youths without disabilities. The content of their fears was also more likely to resemble those of younger children without disabilities. The fears that best discriminated between the two samples were those related to supernatural phenomena or animals. Included were fears of bees, lizards, ghosts or similar eerie things, and cemeteries. Nevertheless, there was considerable similarity between the two samples. For both samples, females reported a higher level of fearfulness and a greater range of fear than males, and fears of death and danger were endorsed as arousing the strongest fear for all respondents. The theoretical and applied implications of these results are discussed.
Erotomania in a brain‐damaged male
Authors: John S. , Ovsiew F.
Published: May 2006

A 31‐year‐old male presented to a neuropsychiatric service for the first time with an erotomatic delusion among other symptoms. He had suffered significant brain damage several times in the past and experienced a recent loss. After extensive evaluation, a trial of haloperidol resulted in some improvement. However, the erotomanic delusion remained unchanged.
Colocalisation of Dynorphin A and Neurokinin B Immunoreactivity in the Arcuate Nucleus and Median Eminence of the Sheep
Authors: Foradori C. D. , Amstalden M. , Goodman R. L. , Lehman M. N.
Published: May 2006

Dynorphin A (DYN)‐containing cells play a key role in conveying the negative feedback influence of progesterone upon pulsatile gonadotrophin‐releasing hormone (GnRH) secretion in the ewe. A very high percentage of DYN cells in the arcuate nucleus express the progesterone receptor; another population of arcuate nucleus cells that also express steroid receptors in the sheep are those that express the tachykinin peptide, neurokinin B (NKB). Both DYN and NKB fibres have been shown to form close contacts with ovine GnRH cells. Therefore, the present study tested the hypothesis that neurones expressing NKB and DYN represent the same neuronal population in the arcuate nucleus. Confocal microscopic analysis of brain sections processed for dual immunofluorescence revealed that a large majority of DYN neurones in the arcuate nucleus were also immunoreactive for NKB. Likewise, a similar majority of NKB neurones in the arcuate nucleus were immunoreactive for DYN. By contrast, DYN cells in the preoptic area and anterior hypothalamus did not colocalise with NKB, nor did DYN cells in the paraventricular or supraoptic nuclei. Fibres that stained positively for both DYN and NKB were seen in the arcuate nucleus, where they formed close appositions with DYN/NKB‐positive neurones, and in the external zone of the median eminence. Taken together with previous findings, these data suggest that a subpopulation of arcuate nucleus neurones coexpressing DYN and NKB mediate the negative feedback influence of progesterone on pulsatile GnRH secretion in the ewe and may also be involved in other feedback actions of gonadal steroids.
In vivo and in vitro evaluation of marginal fit of class II ceromer inlays
Authors: GEMALMAZ D. , KÜKRER D.
Published: May 2006

summary  The aim of this study was to evaluate the marginal adaptation of class II ceromer (Targis, Vivadent) indirect inlay restorations under both in vivo and in vitro conditions. Twenty Targis inlays were produced for class II inlay cavities (13 mandibular and seven maxillary teeth) in 20 patients. The in vivo adaptation of the inlay to the tooth cavity was evaluated by means of silicone replica technique. For in vitro evaluation, 20 mesio‐occlusocistal (MOD) Targis inlays were made in extracted upper molars. Half of the inlays were cemented with Variolink high‐viscosity resin cement while the other half was cemented with Variolink Ultra. The replica specimens and in vitro samples were sectioned buccolingually and mesiodistally, and marginal adaptation was evaluated at both proximal and occlusal margins at 200× magnification under a light microscope. The data was analyzed with anova (P < 0·05). The in vivo mean film thickness values for occlusal and proximal locations were recorded as 73 and 132 μm respectively. In vitro mean marginal fit values were observed as 48 and 67 μm for occlusal and proximal margins of inlays luted with Variolink II high viscosity. The marginal fit values recorded under in vivo conditions were higher in magnitude than the measurements obtained under in vitro conditions. The use of a highly filled resin luting agent with an ultrasonic insertion technique did not cause an increase in marginal gap width of the inlay.
Evaluation of transitional implant stabilized overdentures: a case series report
Authors: OHKUBO C. , KOBAYASHI M. , SUZUKI Y. , SATO J. , HOSOI T. , KURTZ K. S.
Published: May 2006

summary  Transitional implants (TI) can immediately improve the stability and retention of existing unstable mandibular complete dentures. This study evaluated the improvement of mandibular complete denture stability and retention with the use of TI. Three TIs were placed in the intraforaminal region of the edentulous mandible of seven patients (three men, four women; mean age 69·7 years). The patients’ existing mandibular complete dentures were immediately modified to TI‐stabilized overdentures. Their masticatory movements (mandibular movements during mastication) were measured using a commercially available tracking device (BioPACK, Bioresearch, Japan), both before TI placement and about 1 month after delivery of the TI‐stabilized overdentures. The mean time of each chewing phase (opening, closing, and occluding) and coefficients of variation were calculated. The patients also completed a questionnaire about the foods they could chew and indicated on a 100 mm Visual Analog Scale (VAS) their personal levels of comfort, ease of chewing, speech, and stability. For masticatory movements, there were no significant differences (P > 0·05) between the TI‐stabilized overdentures and existing complete dentures. However, the number of foods that could be chewed increased, and the stability and comfort were reported as improved with the TI‐stabilized overdentures. Using TIs, the stability and comfort of the existing mandibular complete dentures studied in this report could be immediately improved.
High‐efficiency multiplex capillary electrophoresis single strand conformation polymorphism (multi‐CE‐SSCP) mutation screening of SCN5A: a rapid genetic approach to cardiac arrhythmia
Authors: Hofman‐Bang J , Behr ER , Hedley P , Tfelt‐Hansen J , Kanters JK , Haunsøe S , McKenna WJ , Christiansen M
Published: May 2006

Mutations in the SCN5A gene coding for the α‐subunit of the cardiac Na+ ion channel cause long QT syndrome, Brugada syndrome, idiopathic ventricular fibrillation, sick sinus node syndrome, progressive conduction disease, dilated cardiomyopathy and atrial standstill. These diseases exhibit variable expressivity, and identification of gene carriers is clinically important, particularly in sudden infant and adult death syndromes. The SCN5A gene comprises 28 exons distributed over 100 kbp of genomic sequence at chromosome 3p21. Disease‐causing mutations are private and scattered over the DNA sequence, making it difficult to screen for specific mutations. We developed a multiplex capillary‐electrophoresis single‐strand conformation polymorphism (Multi‐CE‐SSCP) mutation screening protocol on the ABI 3100 platform and applied it to 10 previously slab‐gel SSCP identified mutations and SNPs and used it to identify one novel deletion. The method is highly efficient, with a turnover of 23 patients per 24 h and a false positive rate of 0.5% of the analyzed amplicons. Each variant has a particular elution pattern, and all 20 carriers of the H558R polymorphism out of 57 persons were correctly identified. We suggest that the method could become part of routine work‐up of patients with suspicious syncope and of members of families with sudden unexplained death.
The personal experience of juvenile Huntington's disease: an interpretative phenomenological analysis of parents' accounts of the primary features of a rare genetic condition
Authors: Smith JA , Brewer HM , Eatough V , Stanley CA , Glendinning NW , Quarrell OWJ
Published: May 2006

There has been a paucity of research into the psychosocial impact of juvenile Huntington's disease (JHD) on the child and the family. The study reported here is part of larger project that aimed to address this and investigate the social and health care needs of those affected by JHD. Ten semistructured interviews with the main caregiver(s) were carried out and were analyzed using the qualitative methodology interpretative phenomenological analysis. The main themes arising from the analysis are reported here: first becoming aware something is wrong; physical symptoms; speech and communication difficulties; behavioral problems; a slow but relentless process. These are discussed in relation to extant literature. We hope the article will be helpful to clinicians working with families where a child is affected by JHD and also contribute to the general literature on understanding symptoms in childhood illness.
Central nervous system lymphoproliferative disorder in pediatric kidney transplant recipients
Authors: Traum Avram Z. , Rodig Nancy M. , Pilichowska Monika E. , Somers Michael J. G.
Published: May 2006

Abstract: Post‐transplant lymphoproliferative disorder (PTLD) is a complication of transplantation resulting from impaired immune surveillance because of pharmacologic immunosuppression. We present two cases of central nervous system (CNS) PTLD in children on calcineurin‐inhibitor free immunosuppression with dramatically different presentations and outcomes. One patient had brain and spinal cord lymphoma with a rapid and fatal course. The other patient had brain and ocular PTLD that responded to multimodal therapy with reduction of immunosuppression, high‐dose steroids, and rituximab given in a dose‐escalation protocol. This protocol may have enhanced the penetration of rituximab into the CNS. We review the literature on CNS and ocular PTLD and elaborate on the treatments available for both diseases.
Conversion from calcineurin inhibitor to sirolimus in pediatric chronic allograft nephropathy
Authors: Falger Jutta C. , Mueller Thomas , Arbeiter Klaus , Boehm Michael , Regele Heinz , Balzar Egon , Aufricht Christoph
Published: May 2006

Abstract:  Chronic allograft nephropathy is a major cause for allograft loss in renal transplantation. Sirolimus was recently introduced as a potent non‐nephrotoxic alternative to calcineurin inhibitors. In the present study, effects of a conversion protocol were investigated in pediatric chronic allograft nephropathy with declining glomerular filtration rate (GFR), defined by a Schwartz formula clearance below 60 mL/1.73 m2/min, steadily increasing serum creatinine and allograft biopsy. In eight children with a median age of 12.8 yr, sirolimus was started at median 32 months after transplantation with a loading dose of 0.24 mg/kg bodyweight (BW), followed by 0.2 mg/kgBW/day, aimed at trough levels of 15–20 ng/mL. Calcineurin inhibitors were reduced to 50% at the start of sirolimus and discontinued at median 7 days when target levels of sirolimus were reached. Following conversion, changes of GFR significantly stabilized (−2.9 vs. +0.4 mL/min/1.73 m2/month, p = 0.025). Individual GFR increased in five out of eight patients (p = 0.026), and only one child exhibited unaltered progression of graft failure. In the responders, mean serum creatinine improved by 0.3 mg/dL (p = 0.043). Effects were not dependent on GFR at conversion, or on time post‐transplantation. Blood pressure, hematological parameters and proteinuria remained stable during the observation period, and serum lipids increased transiently. About half of the children suffered from infectious complications. No child had to be taken off sirolimus; there was no graft loss during the observation period. In conclusion, conversion from calcineurin inhibitors to sirolimus is an effective protocol with tolerable side effects to stabilize renal graft function for at least one yr in the majority of children with biopsy‐proven chronic allograft nephropathy.