bluuebunny/crossref_metadata_2025 huggingface dataset:
High definition profiling of mammalian DNA methylation by array capture and single molecule bisulfite sequencing
Authors: Hodges Emily , Smith Andrew D. , Kendall Jude , Xuan Zhenyu , Ravi Kandasamy , Rooks Michelle , Zhang Michael Q. , Ye Kenny , Bhattacharjee Arindam , Brizuela Leonardo , McCombie W. Richard , Wigler Michael , Hannon Gregory J. , Hicks James B.
Published: July 2009

DNA methylation stabilizes developmentally programmed gene expression states. Aberrant methylation is associated with disease progression and is a common feature of cancer genomes. Presently, few methods enable quantitative, large-scale, single-base resolution mapping of DNA methylation states in desired regions of a complex mammalian genome. Here, we present an approach that combines array-based hybrid selection and massively parallel bisulfite sequencing to profile DNA methylation in genomic regions spanning hundreds of thousands of bases. This single molecule strategy enables methylation variable positions to be quantitatively examined with high sampling precision. Using bisulfite capture, we assessed methylation patterns across 324 randomly selected CpG islands (CGI) representing more than 25,000 CpG sites. A single lane of Illumina sequencing permitted methylation states to be definitively called for >90% of target sties. The accuracy of the hybrid-selection approach was verified using conventional bisulfite capillary sequencing of cloned PCR products amplified from a subset of the selected regions. This confirmed that even partially methylated states could be successfully called. A comparison of human primary and cancer cells revealed multiple differentially methylated regions. More than 25% of islands showed complex methylation patterns either with partial methylation states defining the entire CGI or with contrasting methylation states appearing in specific regional blocks within the island. We observed that transitions in methylation state often correlate with genomic landmarks, including transcriptional start sites and intron-exon junctions. Methylation, along with specific histone marks, was enriched in exonic regions, suggesting that chromatin states can foreshadow the content of mature mRNAs.
Association of plasma visfatin levels with inflammation, atherosclerosis and acute coronary syndromes (ACS) in humans
Authors: Liu Sheng Wen , Qiao Shu Bin , Yuan Jian Song , Liu Dong Qin
Published: July 2009

Objectives  Visfatin is a new cytokine that act as an insulin analogue on the insulin receptor and may link obesity and insulin resistance. It was recently shown that visfatin plays a role in plaque destabilization. However, the role of visfatin in atherosclerosis remains to be elucidated. We sought to assess whether plasma visfatin level is independently associated with inflammation, atherosclerosis and acute coronary syndromes (ACS).

Design and patients  Two hundred and fifty‐three patients undergoing coronary angiography were divided into three subgroups: chronic coronary artery disease (CAD) (n = 102), ACS (n = 100) and control patients (n = 51). The plasma samples were thawed and analysed for circulating visfatin, monocyte chemoattractant protein 1 (MCP‐1), interleukin‐6 (IL‐6), high sensitivity C‐reactive protein (hs‐CRP). The association of visfatin with risk factors, inflammation, atherosclerosis, and ACS was determined.

Results  Plasma visfatin levels were significantly higher in chronic CAD and ACS compared with control patients. Multiple regression analysis demonstrated that plasma visfatin levels correlated with inflammatory factors and were associated with chronic CAD (odds ratio [OR][95% confidence interval], for second, third and fourth quartiles were 1·74 [0·96–2·69], 1·54 [0·85–2·28] and 1·84 [0·98–2·87], respectively) and ACS (ORs for second, third and fourth quartiles were 2·56 [1·57–3·34], 4·61 [1·94–10·96] and 6·52 [2·34–18·12], respectively) following adjustment for established risk factors and other inflammatory factors.

Conclusions  Plasma visfatin levels are significantly associated with CAD, particularly ACS, independent of well‐known CAD risk factors.
Endogenous sex steroid hormones and measures of chronic kidney disease (CKD) in a nationally representative sample of men
Authors: Yi Stella , Selvin Elizabeth , Rohrmann Sabine , Basaria Shehzad , Menke Andy , Rifai Nader , Guallar Eliseo , Platz Elizabeth A. , Astor Brad
Published: July 2009

Context   Sex steroid hormones may play a role in the pathogenesis of chronic kidney disease (CKD).

Objective   To determine whether sex steroid hormone concentrations are associated with kidney function or kidney damage in men in the general US population. We hypothesized that lower serum testosterone and E2 concentrations are associated with CKD.

Design patients and measurements   Serum sex steroid hormones were measured by electrochemiluminescence immunoassays for 1470 men who attended the morning session of Phase I of the Third National Health and Nutrition Examination Survey (NHANES III). We used two measures of CKD, estimated glomerular filtration rate (eGFR) < 60 ml/min/1·73 m2 calculated using serum creatinine or cystatin C levels and the abbreviated Modification of Diet in Renal Disease Study formulae and urinary albumin : creatinine ratio (UACR) ≥ 17 mg/g.

Results  Mean free testosterone concentration was higher in men with an eGFR < 60 ml/min/1·73 m2 than in men with a higher eGFR. In multivariable adjusted models, the odds of an eGFR < 60 ml/min/1·73 m2 or UACR ≥ 17 mg/g did not differ across tertiles of hormones with the exception of free E2; those in the highest vs. lowest tertile had an elevated odds of decreased eGFR (OR: 3·04, 95% CI (1·22, 7·57); P‐trend = 0·02).

Conclusions  In a nationally representative sample of US adult men, higher free E2 concentration was significantly associated with an eGFR < 60 ml/min/1·73 m2 as assessed by serum creatinine or cystatin C even after multivariable adjustment. These findings are in contrast to the hypothesis that oestrogens may protect against CKD, though reverse causation cannot be ruled out. Longitudinal investigation of the role of oestrogens in kidney haemodynamics, function, and pathophysiology is warranted.
Variable antigen uptake due to different expression of the macrophage mannose receptor by dendritic cells in various inbred mouse strains
Authors: Autenrieth Stella Eugenie , Autenrieth Ingo Birger
Published: July 2009

Antigen uptake by dendritic cells is essential for the induction of antigen‐specific T‐cell responses. Here, we investigate the ability of dendritic cells from different mouse strains to endocytose antigens. The uptake of different fluorescently labelled soluble antigens by bone marrow‐derived dendritic cells from BALB/c, C57BL/6 and C3H/HeN mice was analysed by flow cytometry. Using transferrin as a specific marker for clathrin‐mediated endocytosis, we observed no significant differences of transferrin uptake by dendritic cells from BALB/c, C57BL/6 and C3H/HeN mice. Similar results were obtained by analysing macropinocytosis with lucifer yellow. In contrast, analysing the uptake of ovalbumin, which is predominantly mediated by clathrin‐mediated endocytosis via the macrophage mannose receptor, we found that dendritic cells from C3H/HeN mice take up three‐ to fivefold more ovalbumin than dendritic cells from BALB/c or C57BL/6 mice. Blocking the uptake of ovalbumin via the macrophage mannose receptor by using mannan led to a comparable uptake of ovalbumin by dendritic cells from all three mouse strains. Consistently, dendritic cells from C3H/HeN mice displayed significantly increased expression of the macrophage mannose receptor compared to dendritic cells from BALB/c or C57BL/6 mice. In conclusion, receptors involved in antigen uptake such as the macrophage mannose receptor may be differentially expressed and may explain variations of T‐cell responses after vaccination in different individuals.
Identification and characterization of antimicrobial peptide, defensin, in the taiga tick, Ixodes persulcatus
Authors: Saito Y. , Konnai S. , Yamada S. , Imamura S. , Nishikado H. , Ito T. , Onuma M. , Ohashi K.
Published: July 2009

Ixodes persulcatus is the primary vector for human tick‐borne diseases in Japan. A cDNA library was constructed from whole body homogenates of fed nymphs of I. persulcatus. From this library, one cDNA encoding defensin‐like antimicrobial peptide was identified. The amino‐acid sequence showed high similarity to those of the defensins of other ticks and arthropods. I. persulcatus defensin mRNA transcripts were detected at all life cycle stages of fed ticks and found to be predominantly expressed in the midguts of adult female ticks, but not in the salivary glands, a finding corroborated by Western blotting analysis. To investigate the function of I. persulcatus defensin, we examined its antibacterial activity by evaluation of growth of several bacterial strains in the presence of the synthetic peptide. The defensin from I. persulcatus markedly inhibited the growth of Gram‐positive bacteria including Staphylococcus aureus, Bacillus subtilis and Corynebacterium renale, but not Gram‐negative bacteria except Escherichia coli O157. In conclusion, these results suggest that I. persulcatus defensin may be playing a significant role in the defence against microbes from bloodmeals.
Testing a biological mechanism of the insurance hypothesis in experimental aquatic communities
Authors: Leary Daniel J. , Petchey Owen L.
Published: July 2009

1. The insurance hypothesis predicts a stabilizing effect of increasing species richness on community and ecosystem properties. Difference among species’ responses to environmental fluctuations provides a general mechanism for the hypothesis. Previous experimental investigations of the insurance hypothesis have not examined this mechanism directly.

2. First, responses to temperature of four protist species were measured in laboratory microcosms. For each species, we measured the response of intrinsic rate of increase (r) and carrying capacity (K) to temperature.

3. Next, communities containing pairs of species were exposed to temperature fluctuations. Community biomass varied less when correlation inKbetween species (but notr) was more negative, and this resulted from more negative covariances in population sizes, as predicted. Results were contingent on species identity, with findings differing between analyses including or not including communities containing one particular species.

4. These findings provide the clearest support to date for this mechanism of the insurance hypothesis. Biodiversity, in terms of differences in species’ responses to environmental fluctuations (i.e. functional response diversity) stabilizes community dynamics.
Track analysis of the Mexican species of Buprestidae (Coleoptera): testing the complex nature of the Mexican Transition Zone
Authors: Corona Angélica Ma. , Toledo Víctor H. , Morrone Juan J.
Published: July 2009

Aim We analysed the geographical distributions of species of Buprestidae (Coleoptera) in Mexico by means of a panbiogeographical analysis, in order to identify their main distributional patterns and test the complex nature of the Mexican Transition Zone, located between the Nearctic and Neotropical regions.

Location Mexico.

Methods The geographical distributions of 228 species belonging to 33 genera of Buprestidae were analysed. Localities of the buprestid species were represented on maps and their individual tracks were drawn. Based on a comparison of the individual tracks, generalized tracks were detected and mapped. Nodes were identified as the areas where generalized tracks converged.

Results Thirteen generalized tracks were obtained: one was restricted to the Mexican Transition Zone and five to the Neotropical region (Antillean and Mesoamerican dominions), a further two occurred in both the Nearctic region (Continental Nearctic dominion) and the Mexican Transition Zone, and a further five in both the Neotropical region (Mesoamerican dominion) and the Mexican Transition Zone. Seven nodes were identified at the intersections of the generalized tracks – in the Mesoamerican dominion (Mexican Pacific Coast, Mexican Gulf and Chiapas biogeographical provinces) and the Mexican Transition Zone (Trans‐Mexican Volcanic Belt, Balsas Basin and Sierra Madre Oriental biogeographical provinces).

Main conclusions We conclude that the geographical distribution of Buprestidae is mainly Neotropical, corresponding to the Mesoamerican dominion and the Antillean dominion of the Neotropical region, and the Mexican Transition Zone. Most of the generalized tracks and nodes correspond to the Mexican Transition Zone, thus confirming its complex nature. We suggest that the nodes we have identified could be particularly important areas to choose for conservation prioritization.
Phylogeographic analyses suggest that a deciduous species (Ostryopsis davidiana Decne., Betulaceae) survived in northern China during the Last Glacial Maximum
Authors: Tian Bin , Liu Ruirui , Wang Liuyang , Qiu Qiang , Chen Kangming , Liu Jianquan
Published: July 2009

Aim  Palaeontologial data suggest that all temperate forest species in northern China migrated southwards during the Last Glacial Maximum (LGM) and recolonized post‐glacially within the Holocene. We tested this assumption using phylogeographical studies of a temperate deciduous shrub species (Ostryopsis davidiana Decne., Betulaceae), which has a wide distribution in northern China.

Location  Northern China.

Methods  We sequenced two chloroplast DNA (cpDNA) fragments (trnL–trnF and psbA–trnH, together about 1300 bp in length) of 294 plants from 21 populations across the total distribution range of this species. We used maximum parsimony and haplotype network methods to construct phylogenetic relationships among haplotypes.

Results  The analysis of cpDNA variation identified eight haplotypes. A single haplotype was fixed in all populations except for one population that was polymorphic, having two haplotypes. The population subdivisions were extremely high (GST = 0.972 and NST = 0.974), suggesting very low gene flow between populations. Haplotypes clustered into two tentative clades, both of which occur in the southern region of the species’ range but only one of which occurs in the northern region. Across the sampled populations, the haplotype distributions were differentiated geographically.

Main conclusions  Our analyses suggest that multiple refugia were maintained across the range of O. davidiana in both northern (north of the Qing Mountains) and southern (south of the Qing Mountains) regions during the LGM rather than that the species survived only in the south and subsequently colonized northwards. The extremely low within‐population diversity of this species suggests strong bottleneck or founder effects within each fragmented region during the Quaternary climatic oscillations. These findings provide important clues for understanding range shifts and changes in within‐ and/or between‐population genetic diversity of temperate forests in response to past climatic oscillations in northern China.
Inner power, physical strength and existential well‐being in daily life: relatives’ experiences of receiving soft tissue massage in palliative home care
Authors: Cronfalk Berit Seiger , Strang Peter , Ternestedt Britt‐Marie
Published: July 2009

Aim and objectives.  This article explores relatives’ experiences of receiving soft tissue massage as a support supplement while caring for a dying family member at home.

Background.  In palliative home care, relatives play an important role as carers to seriously ill and dying family members. To improve their quality of life, different support strategies are of importance. Complementary methods, such as soft tissue massage have become an appreciated supplement for these patients. However, only few studies focus on relatives experiences of receiving soft tissue massage as a supplemental support.

Design.  Qualitative design

Method.  Nineteen relatives received soft tissue massage (hand or foot) nine times (25 minutes) in their homes. Open‐ended semi‐structured tape‐recorded interviews were conducted once per relative after the nine times of massage, using qualitative content analysis.

Results.  Soft tissue massage gave the relatives’ feelings of ‘being cared for’, ‘body vitality’ and ‘peace of mind’. For a while, they put worries of daily life aside as they just experienced ‘being’. During massage, it became apparent that body and mind is constituted of an indestructible completeness. The overarching theme was ‘inner power, physical strength and existential well‐being in their daily lives’.

Conclusion.  All relatives experienced soft tissue massage positively, although they were under considerable stress. Soft tissue massage could be an option to comfort and support relatives in palliative home care.

Relevance to clinical practice.  In palliative nursing care, soft tissue massage could present a worthy supplement in supporting caring relatives.
Sleep disturbance experiences among perimenopausal women in Taiwan
Authors: Hsu Hsiu‐Chin , Chen Ning‐Hung , Jou Hei‐Jen , An Chi , Tsao Lee‐Ing
Published: July 2009

Aim.  To generate a descriptive theory framework regarding the experiences of sleep disturbances among perimenopausal women in Taiwan.

Background.  Although studies show that some perimenopausal women are troubled by sleep problems, little information was found about the subjective experiences of sleep disturbances among these women. Research is required to explore women's feelings or perceptions in dealing with their sleep problems. These understandings will be important to help alleviate perimenopausal women's sleep problems.

Design.  A grounded theory research design was applied.

Method.  Twenty‐one Taiwanese sleep disturbed women, aged 46–57 years, participated in in‐depth interviews.

Results.  ‘Getting back a good night’s sleep’ was the core theme for describing and guiding the process of the women’s sleep disturbance experiences. During the process, ‘disturbed sleep’ was identified as the antecedent condition that included subcategories: easy awakening, difficulty falling asleep, inner worries, physical discomfort and genetic and bodily constitution. Analyses showed five categories (some with subcategories) of the sleep disturbed women: (i) worsening health status – physical exhaustion, impaired social interactions, emotional swings and decreased work performance; (ii) living with lonely nights – self‐help and endurance; (iii) a search for resources to relieve sleep difficulties – doctor shopping, trying alternative therapies, exercising and seeking support; (iv) vicious cycle and (v) acceptance of insomnia.

Conclusions.  Women expected to relieve their sleep disturbance by finding comprehensive counselling or by their body constitution responding to treatment. Healthcare providers need to value women’s individual concerns and subjective voices. Providers must seek out sleep counselling instead of simply prescribing drugs for their sleep difficulties.

Relevance to clinical practice.  It is crucial to integrate perimenopausal sleep care by implementing a multidimensional approach such as sleep assessment laboratories, sleep counselling, complementary alternative medicine, sleep strategies and support groups.
Retracted: Investigating factors associated with nurses’ attitudes towards perinatal bereavement care: a study in Shandong and Hong Kong
Authors: Chan Moon Fai , Lou Feng‐lan , Cao Feng‐lin , Li Ping , Liu Li , Wu Lai Har
Published: July 2009

Aims.  To explore nurses’ attitudes towards perinatal bereavement care and to identify factors associated with these attitudes.

Background.  It is likely that the attitude of nursing staff can influence recovery from a pregnancy loss and that nurses with positive attitudes to bereavement care can help bereaved parents to cope during their grieving period.

Design.  Survey.

Method.  Data were collected through a structured questionnaire; 657 nurses were recruited from Obstetrics and Gynaecology units in Hong Kong and Shandong during 2006. Outcome measures included attitudes towards perinatal bereavement care, importance of hospital policy and training support for bereavement care.

Results.  The majority of nurses in this study had a positive attitude to bereavement care. Results show that only 21·6% (n = 141) of the nurses surveyed had bereavement‐related training. In contrast, about 89·8% (n = 300) believed they needed to be equipped with relevant knowledge, skills and understanding in the care and support of bereaved parents and more than 88·5% (n = 592) would share their experiences with their colleagues and seek support when feeling under stress. A regression model showed that age, past experience in handling grieving parents, recent ranking and nurses’ perceived attitudes to hospital policy and training provided for bereavement care were the factors associated with nurses’ attitudes to perinatal bereavement care.

Conclusions.  Nurses in both cities emphasised their need for increased knowledge and experience, improved communication skills and greater support from team members and the hospital for perinatal bereavement care.

Relevance to clinical practice.  These findings may be used by nursing educators to educate their students on issues related to delivery of sensitive bereavement care in perinatal settings and to enhance nursing school curricula.
The impact of illness perception on adherence to therapeutic regimens of patients with hypertension in Taiwan
Authors: Chen Shiah‐Lian , Tsai Jen‐Chen , Lee Wen‐Lieng
Published: July 2009

Aims.  To examine the predictive effects of illness perception on adherence to therapeutic regimens of patients with hypertension.

Background.  Illness perception is an important predictor for adherence to therapeutic regimens. Hypertension is asymptomatic. How the lay views, especially identity and causal attribution, affect the patients’ adherence to therapeutic regimens need to be further explored.

Design.  A cross‐sectional survey.

Methods.  Purposive sampling was conducted at the cardiovascular clinics of two teaching hospitals in central Taiwan. A sample of 277 patients was included in this study. Guided by the Self Regulation Model, a series of variables including socio‐demographic variables, clinical variables, illness representations, identity and causes were evaluated for their relationships with adherence to the antihypertensive regimen and recommendations of self‐management.

Results.  Predictors of adherence to prescribed medications in the hierarchical logistic regressions were treatment control, risk factors and psychological attribution. In the self‐management model, we found that symptoms experienced after a hypertension diagnosis, symptoms for blood pressure prediction, personal control, balance and cultural causal attribution were significant predictors of adherence to self‐management, adding an additional 21% of the variance. The results of analysis of variance showed that those who were unsure if they had experienced symptoms after a hypertension diagnosis were more likely to self‐regulate (increase or decrease) prescribed medications than those without symptoms.

Conclusions.  The findings suggest that the Self Regulation Model may provide a useful framework for understanding and explaining adherence to therapeutic regimens of patients with hypertension across cultures.

Relevance to clinical practice.  Factors that affect the patients’ adherence to prescribed medications and self‐management recommendations differ greatly. Despite its subjectivity, identity showed significantly predictive effects on adherence to self‐management. Understanding patients’ lay views on hypertension allows health professionals providing effective care for better adherence to therapeutic regimens.
Soothing music can increase oxytocin levels during bed rest after open‐heart surgery: a randomised control trial
Authors: Nilsson Ulrica
Published: July 2009

Aim.  To evaluate the effect of bed rest with music on relaxation for patients who have undergone heart surgery on postoperative day one.

Background.  Music intervention has been evaluated as an appropriate nursing intervention to reduce patients ‘pain, stress and anxiety levels in several clinical settings, but its effectiveness in increasing patients’ subjective and objective relaxation levels has not been examined.

Design.  A randomised controlled trial.

Method.  Forty patients undergoing open coronary artery bypass grafting and/or aortic valve replacement surgery were randomly allocated to either music listening during bed rest (n = 20) or bed rest only (n = 20). Relaxation was assessed during bed rest the day after surgery by determining the plasma oxytocin, heart rate, mean arterial blood pressure, PaO2, SaO2 and subjective relaxation levels.

Results.  In the music group, levels of oxytocin increased significantly in contrast to the control group for which the trend over time was negative i.e., decreasing values. Subjective relaxation levels increased significantly more and there were also a significant higher levels of PaO2 in the music group compared to the control group. There was no difference in mean arterial blood pressure, heart rate and SaO2 between the groups.

Conclusion.  Listening to music during bed rest after open‐heart surgery has some effects on the relaxation system as regards s‐oxytocin and subjective relaxations levels. This effect seems to have a causal relation from the psychological (music makes patients relaxed) to the physical (oxytocin release).

Relevance to clinical practice.  Music intervention should be offered as an integral part of the multimodal regime administered to the patients that have undergone cardiovascular surgery. It is a supportive source that increases relaxation.
Health literacy and functional health status in Korean older adults
Authors: Kim Su Hyun
Published: July 2009

Aims and objectives.  The aim of the study was to investigate the relationships of health literacy to chronic medical conditions and the functional health status among community‐dwelling Korean older adults.

Background.  In the literature, limited health literacy has been reported to have adverse effect on health outcomes. However, the link between health literacy to health status among Korean older adults needs to be clarified.

Design.  A cross‐sectional survey.

Methods.  A cross‐sectional survey of 103 community‐dwelling Korean older adults was conducted from June 2007–September 2007. Health literacy was measured using the Korean Functional Health Literacy test and functional health status was measured using the subscales of the Medical Outcomes Study 12‐item Short‐Form Health Survey.

Results.  Individuals with a low health literacy had significantly higher rates of arthritis and hypertension. After adjusting for age, education and income, older individuals with low health literacy had higher limitations in activity and lower subjective health. In a model adjusting for age and income only, older individuals with low health literacy were more likely to report lower levels of physical function and subjective health and higher levels of limitations in activity and pain.

Conclusions.  Among community‐dwelling Korean older adults, limited health literacy is associated independently with higher rates of chronic medical conditions and lower subjective health status.

Relevance to clinical practice.  Nurses are key to providing health education to older adults. The understanding of the relationship of health literacy to health status is essential to develop communication and health education efforts for older adults in nursing practice.
Older people and falls: health status, quality of life, lifestyle, care networks, prevention and views on service use following a recent fall
Authors: Roe Brenda , Howell Fiona , Riniotis Konstantinos , Beech Roger , Crome Peter , Ong Bie Nio
Published: July 2009

Aim and objective.  This study has investigated older people’s experiences of a recent fall, its impact on their health, lifestyle, quality of life, care networks, prevention and their views on service use.

Background.  Falls are common in older people and prevalence increases with age. Falls prevention is a major policy and service initiative.

Design.  An exploratory, qualitative design involving two time points.

Method.  A convenience sample of 27 older people from two primary care trusts who had a recent fall. Taped semi structured qualitative interviews were conducted and repeated at follow up to detect change over time and repeat falls. Data were collected on their experience of falls, health, activities of living, lifestyle, quality of life, use of services, prevention of falls, informal care and social networks. Content analysis of transcribed interviews identified key themes.

Results.  The majority of people fell indoors (n = 23), were repeat fallers (n = 22) with more than half alone when they fell (n = 15). For five people it was their first ever fall. Participants in primary care trust 1 had a higher mean age than those in primary care trust 2 and had more injurious falls (n = 12, mean age 87 years vs. n = 15, mean age 81 years). The majority of non‐injurious falls went unreported to formal services. Falls can result in a decline in health status, ability to undertake activities of living, lifestyle and quality of life.

Conclusions.  Local informal care and support networks are as important as formal care for older people at risk of falls or who have fallen. Access to falls prevention programmes and services is limited for people living in more rural communities.

Relevance to practice.  Falls prevention initiatives and services should work with local communities, agencies and informal carers to ensure equitable access and provision of information, resources and care to meet the needs of older people at risk or who have fallen.
Nursing students’ knowledge, attitude and readiness to work for clients with sexual health concerns
Authors: Kong Sarah Kit Fong , Wu Lai Ha , Loke Alice Yuen
Published: July 2009

Aims.  To investigate nursing students’ knowledge, attitude and readiness to work for clients with sexual health concerns and to identify strategies to help students develop as they take up their role in sexual health‐related care.

Background.  There is an increasing global demand for improving sexual health. A better understanding of nursing students’ attitude and readiness to work for clients with sexual health concerns is the beginning of this endeavour. The need to explore strategies for developing competent health care practitioners is timely.

Design.  A cross‐sectional survey.

Methods.  Nursing students (n = 377) studying in pre‐ and postregistration programmes were surveyed at a university in Hong Kong using a questionnaire with open‐ and closed‐ended questions about their knowledge, attitude and self‐perception on readiness to work for clients with sexual health concerns.

Results.  Students’ knowledge of sexual health was satisfactory. They were positive in acknowledging the nursing role in sexual health care, but hesitant in taking up an active role in practice. Students’ readiness to participate in related activities was below satisfactory. Their perception of inadequate knowledge, feelings of anxiety, worries about colleagues’ and clients’ possible adverse responses and inadequate exemplars were major factors affecting their readiness. This paper also highlighted some important learning areas and strategies that could help in enhancing students’ knowledge and confidence in sexual health care practices.

Conclusion.  Improving the educational programme and clinical practice for nursing students is necessary but may not be adequate. Valuing the affective aspect of education, formal recognition of this extended role and advancing related education to a postexperience level would also benefit the development of sexual health care.

Relevance to clinical practice.  Preparing more mentors as exemplars, inviting clinicians and managers as partners in sexual health‐related care would help nursing students to work efficiently for clients with sexual health concerns.
Disability and pain management methods of Taiwanese arthritic older patients
Authors: Chiou Ai‐Fu , Lin Hsiao‐Yi , Huang Hsiao‐Yun
Published: July 2009

Aim.  This study aims to investigate the prevalence of disability, factors influencing disability and pain self‐management techniques employed by older arthritis patients in Taiwan.

Background.  Arthritis is the most common chronic disease in older people. It may result in pain, stiffness and joint deformity, which ultimately lead to disability. Understanding the factors influencing disability is needed to help arthritis sufferers to achieve optimal health status.

Design.  A cross‐sectional design was employed for this study.

Methods.  One hundred and fifty‐one older persons diagnosed with either rheumatoid arthritis or osteoarthritis were interviewed in the rheumatology clinics located in two medical centres in northern Taiwan. Six questionnaires were administered: Barthel Index, Instrumental Activity of Daily Living, Rapid Assessment of Disease Activity in Rheumatology, the Chinese version of Pain Management Inventory, Geriatric Depression Scale and Life Satisfaction Index.

Results.  Disability was found in 11% of Taiwanese individuals diagnosed with either rheumatoid arthritis or osteoarthritis. Those in disability reported more severe disease activity, pain, depression and lower life satisfaction. Hierarchical multiple regression analysis revealed that 31–46% of the total variance of disability could be explained by age, gender, marriage, joint pain score, diagnosis, disease activity, depression and pain management. Patients with rheumatoid arthritis had significantly higher levels of disability, disease activity during the preceding six months, more depression and less life satisfaction than patients with osteoarthritis.

Conclusion.  Higher disability was explained by older age, female, unmarried, diagnosed with rheumatoid arthritis, more joint pain, more disease severity, more depression and more use of pain management strategies in arthritis patients.

Relevance to clinical practice.  Nurses are urged to recognise the individual differences among the factors that are thought to contribute most to disability. An individualised, multidimensional and comprehensive treatment plan with informational support is essential to maximise pain management skills of arthritic older people to achieve improvement in pain, level of disability and mental health.
Turkish children loved distraction: using kaleidoscope to reduce perceived pain during venipuncture
Authors: Güdücü Tüfekci Fatma , Çelebioğlu Ayda , Küçükoğlu Sibel
Published: July 2009

Aim.  To assess the effect of distraction (looking through kaleidoscopes) to reduce perceived pain, during venipuncture in healthy school‐age children.

Background.  Distraction has been noted to be an effective method to help children cope with painful procedures. In the studies carried out, although it was found out that distraction made with different distracters reduced the pain of venipuncture, there is only one study confirming analgesic effect of distracters.

Design.  The study was carried out as an intervention–control group design.

Method.  Children (n = 206), in whom venipuncture was applied in a laboratory for examination between the dates January–September 2006, were included in the study. The data were obtained by a form determining introductory features of the children and Wong–Baker FACES Pain Rating Scale and Visual Analogue Scale evaluating the pain. Descriptive statistics was used in the assessment of the data and t‐test was used in comparisons of dependent‐independent groups.

Results.  Pain levels of the children according to both scales in intervention group were lower than those of control group. But, it was detected that the distinction between score averages of intervention and control group of Wong–Baker FACES Pain Rating Scale, not Visual Analogue Scale, was statistically significant (p < 0·001).

Conclusion.  It was detected that the distraction made with kaleidoscope effectively reduced the pain related to venipuncture in healthy school children and that some features of the children influenced the perception of pain.

Relevance to clinical practice.  Distraction with kaleidoscope is a method, which the nurse will be able to use for venipuncture to obtain optimal pain control. In addition, it is important for a nurse to know some features about the children for a pain free and positive experience.
Anxiety in the operating theatre: a study of frequency and environmental impact in patients having local, plexus or regional anaesthesia
Authors: Haugen Arvid S , Eide Geir E , Olsen Marit V , Haukeland Berit , Remme Åsa R , Wahl Astrid K
Published: July 2009

Aims. To estimate the frequency of intraoperative anxiety, the influence of environmental factors on intraoperative anxiety and to study the relationship between intraoperative anxiety and generalised anxiety and depression.

Background. Previous research has documented that surgery is associated with increased stress and anxiety, which have an adverse effect on patient outcomes. Few studies have been conducted to obtain patients’ perspectives about the influence of the operating theatre environment on anxiety.

Design. The study used a survey design including questionnaires.

Method. Clinical variables were noted from the anaesthesia medical records. The sample (n = 119) comprised patients undergoing elective surgery and emergency operations within 24 hours of admission. Anxiety was assessed by the Jakobsen’s questionnaire and the Hospital Anxiety and Depression scale.

Results. Twenty‐three per cent felt anxious on arrival at the operating theatre, 35% were anxious at induction of anaesthesia, while 12% felt anxious after induction. At start of surgery 15% experienced anxiety and during surgery 9% were anxious. Continuous information reduced the experience of anxiety in 49% of the patients and the opportunity to ask questions during the intraoperative period reduced anxiety in 55%. The sight of technical equipment and surgical instruments was reported to increase anxiety in 9% and 6% of the sample, respectively. Patients with higher levels of general anxiety and depression also experienced significantly higher levels of anxiety in the intraoperative period.

Conclusions. In this study patients experience highest level of anxiety at induction of anaesthetics. The operating theatre environments impact on patients’ anxiety are in less degree influenced by the sight and hearing of the technical equipment and the surroundings. Continuous information and opportunity to ask questions reduces patients’ anxiety. Results indicate that there is a significant positive relationship between generalised anxiety and depression prior to admission and anxiety experienced during the intraoperative period.

Relevance to clinical practice. Generalised anxiety and depression prior to surgery should be identified to implement nursing interventions to reduce anxiety in the operating theatre.
Perceived control and involvement in self care in patients with colorectal cancer
Authors: Kidd Lisa , Hubbard Gill , O’Carroll Ronan , Kearney Nora
Published: July 2009

Aim.  This paper reports the qualitative findings from a mixed methods study which explored patients’ understandings of perceived control in relation to their self care during chemotherapy for colorectal cancer.

Background.  A greater degree of patient involvement in self care is increasingly being encouraged; however, little is known about how factors such as perceived control influence patients’ active involvement in self care.

Design.  Qualitative, longitudinal study.

Methods.  Semi structured interviews were conducted with 11 patients before and after six months of chemotherapy treatment for colorectal cancer in a Scottish cancer centre between March 2005–June 2006. The interviews, conducted as part of a larger study, explored patients’ understandings of their perceived control over managing treatment‐related side effects and how this influenced their attitudes toward, and role preferences in, self care.

Results.  Patients fell into one of two groups: ‘high’ or ‘low’ perceived controllers. High‐perceived controllers were more likely to view their active involvement in self care positively, as being necessary in managing treatment‐related effects and were less likely to rely on nurses to take overall responsibility for the management of treatment‐related side effects. Low‐perceived controllers were less likely to believe in the importance or necessity of their active involvement in self care and more likely to perceive nurses as being the ones responsible for the management of treatment‐related side effects.

Conclusions.  Perceived control during treatment for cancer influences patients’ perceptions toward, and role preferences in, self care.

Relevance to clinical practice.  Clinical interventions designed to enhance involvement in self care would benefit from focussing on enhancing patients’ perceived control and understanding their role preferences in self care. Patients with different understandings of perceived control may require different help and support to encourage their involvement in self care.
Caspase‐dependent induction of apoptosis in barramundi, Lates calcarifer (Bloch), muscle cells by grouper iridovirus
Authors: Chiou P P , Chen Y‐C , Lai Y‐S
Published: July 2009

We recently reported that grouper iridovirus (GIV) can induce apoptosis in barramundi, Lates calcarifer, muscle (BM) and swim bladder (BSB) cell lines. In this paper, we further characterize the molecular mechanism underlying apoptotic death in BM cells triggered by GIV. DNA‐laddering and apoptotic cells were observed in BM cells infected with UV‐irradiated or untreated GIV but was absent in cells infected with heat‐inactivated GIV, indicating the involvement of viral protein in the apoptosis event. In GIV‐infected BM cells, the conversion of procaspase‐3 to caspase‐3 was evident and the level of caspase‐8 and ‐9 increased as early as 30 min post‐infection. When treated with a pancaspase inhibitor, the GIV‐induced apoptosis event was abolished. These observations indicate that GIV‐induced apoptosis is caspase‐dependent, and that both the external and internal routes in the caspase‐dependent pathway are likely involved in the apoptosis process.
Effect of hypnosis on oral function and psychological factors in temporomandibular disorders patients
Authors: ABRAHAMSEN R. , ZACHARIAE R. , SVENSSON P.
Published: July 2009

Summary  This study investigated the effect of hypnosis in patients with temporomandibular disorders (TMD) with focus on oral function and psychological outcomes. Forty women (mean age ± s.d.: 38·6 ± 10·8 years) suffering from TMD (mean duration 11·9 ± 9·9 years) were randomized to four individual 1‐hour sessions of either hypnotic intervention or a control condition of simple relaxation. Pain intensity was assessed three times daily on a 0–10 Numerical Rating Scale. Additional outcomes were TMD‐associated symptoms assessed by the Research Diagnostic Criteria examination form and questionnaire, psychological symptoms (Symptom Check List 60), pain coping strategies (Coping Strategies Questionnaire), sleep difficulties (Pittsburgh Sleep Quality Index) and use of analgesics. Data were analyzed with between‐groups within‐subjects anovas. The hypnosis group significantly reduced the daily NRS pain scores from 4·5 ± 2·1 at baseline to 2·9 ± 2·4 after treatment (P < 0·001) compared to the control group where no significant changes were found (4·2 ± 1·4 to 3·9 ± 1·5) (P = 0·733). Number needed to treat for a 50% pain reduction was 4·0. The hypnosis group also increased use of the coping strategy ‘reinterpreting pain sensations’ from 5·2 ± 6·9 to 10·3 ± 6·8 (P < 0·001). Both groups exhibited significant reductions in the number of painful muscle palpation sites and pain on palpation (P < 0·004), in number of awakenings due to pain (P < 0·006), and in somatization, obsessive compulsive symptoms and anxiety (P < 0·004). Hypnosis thus appears to effectively reduce some aspects of complex TMD pain.
Effects of a natural parasitical infection (Lernanthropus kroyeri) on the immune system of European sea bass, Dicentrarchus labrax L
Authors: HENRY M. A. , ALEXIS M. N. , FOUNTOULAKI E. , NENGAS I. , RIGOS G.
Published: July 2009

The immune response of European sea bass, Dicentrarchus labrax, to a natural infection by the copepod parasite Lernanthropus kroyeri was evaluated for the first time in vivo. The results clearly demonstrated the triggering of the fish immune system by the parasite. Lysozyme activity and alternative complement pathway were involved in the early action against the parasitical infection, whilst classical complement and respiratory burst (RB) activity took over in the later stages of infection. It was hypothesized that the levels of alternative and classical complement and RB stimulation indexes may determine the resistance capacity of the fish to the parasite. It is not clear how parasites can survive despite the strong immunological arsenal deployed by the fish. The continual increase of prevalence and severity of parasite infection suggested that the parasite’s mechanism of evasion of the immune system was extremely successful. The contrasting decrease in the negative effects of parasites on the fish health (such as gills anaemia) suggested that an equilibrium between the parasites and their hosts was reached in chronic infection. These dynamic interactions between parasites and fish hosts were probably the main determinant of host specificity.
Post‐transplant diabetes mellitus in pediatric liver transplantation
Authors: Hathout Eba , Alonso Estella , Anand Ravinder , Martz Karen , Imseis Essam , Johnston Joyce , Lopez James , Chinnock Richard , McDiarmid Sue ,   on behalf of the SPLIT study group
Published: July 2009

Abstract: To determine the characteristics of pediatric liver transplant recipients who develop GI and/or PTDM, data on children undergoing their first liver transplant from the SPLIT database were analyzed (n = 1611). Recipient and donor characteristics that were evaluated included age at transplant, gender, race, primary disease, hospitalization status at transplant, BMI, recipient and donor CMV status, donor type, donor age, and primary immunosuppression. GI/PTDM was found in 214 individuals (13%) of whom 166 (78%) were diagnosed within 30 days of transplantation (early GI/PTDM). Multivariate analyses suggests that age >5 yr at transplant, hospitalization at transplant, a primary diagnosis other than BA, early steroid use, and tacrolimus use are associated with increased incidence of early GI. Routine monitoring for the development of GI and post‐transplant diabetes is indicated in the short‐ and long‐term care of children after liver transplantation.