bluuebunny/crossref_metadata_2025 huggingface dataset:
Vital Aspects of Fallopian Tube Physiology in Pigs
Authors: Hunter RHF
Published: March 2003

Contents

This essay reviews four topical aspects of Fallopian tube physiology that bear on either successful fertilization or early development of the zygote. An initial focus is on glycoprotein secretions of the duct that accumulate as a viscous mucus in the caudal isthmus. Because this is the site of the pre‐ovulatory sperm reservoir, an involvement of the secretions is considered in: preventing uterine and ampullary tubal fluids from entering the functional sperm reservoir; removing residual male secretions from the sperm surface; deflecting spermatozoa towards endosalpingeal organelles and reducing flagellar beat before ovulation. The subtle prompting of flagellar movement with impending ovulation is examined in terms of potential reactivation mechanisms, with overall control attributed to increasing secretion of progesterone. The site of full capacitation and the acrosome reaction in a fertilizing spermatozoon is then debated, with strong arguments pointing to completion of these processes in the specific fluids at the ampullary‐isthmic junction. Finally, the synthetic activity of cumulus cells released at ovulation as a paracrine tissue in the Fallopian tube is highlighted with reference to steroid hormones, peptides and cytokines. Not only does the suspension of granulosa‐derived cells influence the process of fertilization, but also it may amplify oocyte or embryonic signals to the endosalpinx and ipsilateral ovary.
Comparison of Stereoscopy, Light Microscopy and Ultrastructural Methods for Evaluation of Bovine Embryos
Authors: Aguilar MM , Galina CS , Merchant H , Montiel F , Canseco R , Márquez YC
Published: March 2003

Contents

The most important point in embryo transfer success is the evaluation of the stage of development and quality of embryos. Therefore, the purpose of this study was to compare the morphological evaluation of embryos using stereoscopy, light microscopy and electron microscopy in order to establish the accuracy of former method compared with more invasive and accurate procedures. For this purpose, 23 Brahman × Swiss cows were used and synchronized with Norgestomet 6 mg plus, 5 mg Estradiol valerate (Syncromate B®, Rhone Merieux, Mexico, Mexico City) and superovulated with Folltropin‐V 240 mg (Vetrepharm, Mexico, Mexico City). Non‐surgical embryo collection was performed 7.5 days after insemination. Descriptive statistics analysis was used to assess the data. Seventy‐eight embryos were collected and classified by stereoscopic microscopy, finding 51.2% (40) of good quality, 25.6% (20) fair and 24.3% (19) poor. Later, under light microscopy observation, evaluation of the same embryos resulted in 25.6% (20) good, 32.0% (25) fair and 42.3% poor quality. Finally, in the evaluation of embryos under electron microscopy 24.3% (19) were found to be of good quality, 29.3% (23) fair and 46.1% (36) poor. Evaluation of embryos with stereoscopic microscopy was found to be very subjective, as nearly 50% of embryos classified by this method as good quality, showed features of degenerative stages under light and electron microscopy. Embryos with these features are generally frozen and transferred, which could be one of the reasons for having low fertility rate in embryo transfer programmes.
The Use of HOS Test to Evaluate Membrane Functionality of Boar Sperm Capacitated in vitro
Authors: Lechniak D , Kedzierski A , Stanislawski D
Published: March 2003

Contents

The functional and structural integrity of sperm membrane are crucial for the viability of spermatozoa. The commonly used staining test (eosin + nigrosin) for assessing sperm membrane measures only its structural integrity. The hypoosmotic swelling test (HOS) originally developed for human sperm (Jeyendran et al. 1984) has been also applied to several species of domestic animals (bull, pig, horse, dog). The test enables to evaluate the functional status of the sperm membrane. The principle of HOS is based on water transport across the sperm tail membrane under hypoosmotic conditions. It has previously been used to assess the semen quality (Revell and Mrode 1994), to analyse fertilizing capacity (Rota et al. 2000; Perez‐Llano et al. 2001) and also to detect viable, immotile cells for ICSI (Intra‐cytoplasmic sperm injection) in human (Zeyneloglu et al. 2000).

There are two procedures commonly used for sperm capacitation in the pig‐sperm washing and incubation before insemination (Nagai 1994). Capacitation involves several changes like removing molecules coating the sperm head membrane, changes in membrane fluidity and intracellular ion concentration (Green and Watson 2001). Thus the membrane integrity as well as functionality may be affected as shown by Harrison (1996).

The aim of the present study was to analyse changes in sperm membrane integrity after in vitro capacitation by use of the HOS test.
Cytokine‐directed therapies in multiple sclerosis and experimental autoimmune encephalomyelitis
Authors: Ruuls Sigrid R , Sedgwick Jonathon D
Published: March 2003

Secreted and cell surface molecules that control the nature of immune responses or directly mediate tissue damage are important targets for therapeutic intervention of autoimmune inflammatory disorders. The precise aetiology of multiple sclerosis (MS), an inflammatory demyelinating disease of the central nervous system is unknown and therapeutic interventions for this disease are limited. However, as it is believed that MS is autoimmune in nature, it seems likely that targeting of the immune system, either to deviate it down a more benign pathway or to directly block tissue damaging effector mechanisms, may enable this disease to be controlled. In this overview we examine three alternative approaches to therapy of MS: cytokine‐directed immune deviation, immunoregulation by type I interferons and blockade of TNF. Underlying rationales for the application of these approaches to the treatment of MS are based largely on studies in the disease model experimental autoimmune encephalomyelitis. These studies are reviewed.
Predicted and inferred waiting times for key mutations in the germinal centre reaction: Evidence for stochasticity in selection
Authors: Radmacher Michael D , Kelsoe Garnett , Kepler Thomas B
Published: March 2003

The germinal centre reaction (GCR) is a fundamental component of the immune response to T‐dependent antigens, during which the immunoglobulin (Ig) genes of B cells experience somatic hypermutation and selection. A maximum‐likelihood method on DNA sequence data from 16 individual germinal centres was used to infer that the waiting time for position 33 key (high‐affinity) mutations in the anti‐(4‐hydroxy‐3‐nitrophenyl) acetyl (NP) response is 8.3 days. This is in marked contrast to the prediction of a key mutant each generation (waiting time about 1/3 day) obtained from a simple model and parameters available in the literature. This disagreement is resolved in part by the finding that the targeted base occurs in a cold spot for hypermutation, raising the predicted waiting time to 2.3 days, although this value remains significantly lower than that inferred from the sequence data. It is proposed that the remaining disparity is attributable to some further stochastic process in the GCR: many early key mutations arise but fail to ‘take root’ within the GC, either due to emigration or failure of cognate T cell/B cell interaction. Furthermore, it is argued that the frequency with which position 33 mutations are found in secondary responses to NP indicates the presence of selection after the GCR.
Cytokines: Principles and prospects
Authors: Kelso Anne
Published: March 2003

Cytokines participate in the induction and effector phases of all immune and inflammatory responses. They are therefore obvious tools and targets for strategies designed to promote, inhibit or redirect these responses. However, the complexity of the cytokine network has hindered the widespread clinical application of many cytokines and it has become clear that a deeper understanding of the normal operation of this system in health and disease is needed for the therapeutic potential of cytokines to be fully realized. This review summarizes some of the principles that are now thought to underlie the diverse functions of the interleukins, interferons, colony‐stimulating factors and tumour necrosis factors in immune and inflammatory reactions in vivo. Genetic and structural relationships between these cytokines, the regulation of their synthesis, and the structures and functions of their receptors are outlined. Current knowledge of these parameters suggests ways in which multiple positive and negative regulatory mechanisms are integrated to balance cytokine benefits and harm under physiological conditions and offers new prospects for rational exploitation of this system.
Drug resistance results in alterations in expression of immune recognition molecules and failure to express Fas (CD95)
Authors: Bhushan A , Kupperman JL , Stone JE , Kimberly PJ , Calman NS , Hacker MP , Birge RB , Tritton TR , Newell MK
Published: March 2003

It is demonstrated that methotrexate/cisplatin‐sensitive L1210 cells express low levels of major histocompatibility complex (MHC) class II relative to the high levels expressed on methotrexate (MTX)/cisplatin‐resistant L1210/DDP cells. L1210 cells express cell‐surface Fas, while the L1210/DDP cells express no cell‐surface Fas. Expression of costimulatory molecules B7‐1/B7‐2 and Fas is increased on L1210 cells, but not L1210/DDP, in the presence of methotrexate or trimetrexate (TMTX). Therefore, a component of the mechanism of action of some anti‐cancer agents may be to facilitate immune recognition and T cell‐directed, Fas‐induced cell death. Loss of cell‐surface Fas expression and failure of Fas (CD95)‐dependent apoptotic death has been observed when cells develop drug resistance. The defect in apoptosis can be overcome by anti‐cancer agents or experimental manipulation that induce Fas expression on the drug‐resistant cells.
Osteoprotegerin ligand: A common link between osteoclastogenesis, lymph node formation and lymphocyte development
Authors: Kong Young‐Yun , Boyle William J , Penninger Josef M
Published: March 2003

The TNF‐family molecule osteoprotegerin ligand (OPGL; also known as TRANCE, RANKL or ODF) has been identified as the osteoclast differentiation factor and a regulator of T cell–dendritic cell interactions in the immune system. Surprisingly, the same molecule was identified as a crucial factor in early lymphocyte development and lymph node organogenesis. We will discuss the role of OPGL in bone remodelling and the immune system.
Anti‐oxidants as modulators of immune function
Authors: De La Fuente M , Victor Vm
Published: March 2003

In order to confirm the hypothesis of the immunomodulating action of anti‐oxidants (bringing back altered immune function to more optimum values), the possibility that anti‐oxidants may be useful in two experimental models of altered immune function has been studied. The first is a pathological model, that is, lethal murine endotoxic shock caused by an LPS injection of 100 mg/kg, in which the lymphocytes show increased adherence and depressed chemotaxis. The injection of N‐acetylcysteine (150 mg/kg), which increased both functions in control animals, decreased adherence and increased chemotaxis in mice with endotoxic shock. The second is a physiological model; aged human subjects (70 ± 5‐year‐old men) who, in their largest segment of population (‘standard’ group) showed an increased lymphocyte adherence and decreased lymphoproliferative response to mitogens compared with younger adults. The ingestion of vitamin E (200 mg daily for 3 months in this standard group) lowered adherence and stimulated lymphoproliferation. However, a smaller segment of the human population tested showed ‘non‐standard’ values in these lymphocyte functions, that is, very low adherence and very high proliferation. In those subjects, vitamin E showed the opposite effects, namely adherence increase and depressed lymphoproliferation. In both age groups of men, these functions reached adult levels after vitamin E ingestion. These data suggest that anti‐oxidants preserve adequate function of immune cells against homeostatic disturbances such as those caused by endotoxic shock and ageing.
Survival and therapeutic potential of probiotic organisms with reference to Lactobacillus acidophilus and Bifidobacterium spp.
Authors: Kailasapathy Kaila , Chin James
Published: March 2003

The present paper provides an overview on the use of probiotic organisms as live supplements, with particular emphasis on Lactobacillus acidophilus and Bifidobacterium spp. The therapeutic potential of these bacteria in fermented dairy products is dependent on their survival during manufacture and storage. Probiotic bacteria are increasingly used in food and pharmaceutical applications to balance disturbed intestinal microflora and related dysfunction of the human gastrointestinal tract. Lactobacillus acidophilus and Bifidobacterium spp. have been reported to be beneficial probiotic organisms that provide excellent therapeutic benefits. The biological activity of probiotic bacteria is due in part to their ability to attach to enterocytes. This inhibits the binding of enteric pathogens by a process of competitive exclusion. Attachment of probiotic bacteria to cell surface receptors of enterocytes also initiates signalling events that result in the synthesis of cytokines. Probiotic bacteria also exert an influence on commensal micro‐organisms by the production of lactic acid and bacteriocins. These substances inhibit growth of pathogens and also alter the ecological balance of enteric commensals. Production of butyric acid by some probiotic bacteria affects the turnover of enterocytes and neutralizes the activity of dietary carcinogens, such as nitrosamines, that are generated by the metabolic activity of commensal bacteria in subjects consuming a high‐protein diet. Therefore, inclusion of probiotic bacteria in fermented dairy products enhances their value as better therapeutic functional foods. However, insufficient viability and survival of these bacteria remain a problem in commercial food products. By selecting better functional probiotic strains and adopting improved methods to enhance survival, including the use of appropriate prebiotics and the optimal combination of probiotics and prebiotics (synbiotics), an increased delivery of viable bacteria in fermented products to the consumers can be achieved.
Targeted intracellular delivery of photosensitizers to enhance photodynamic efficiency
Authors: Rosenkranz Andrey A , Jans David A , Sobolev Alexander S
Published: March 2003

Photodynamic therapy (PDT) is a novel treatment, used mainly for anticancer therapy, that depends on the retention of photosensitizers (PS) in tumour cells and irradiation of the tumour with appropriate wavelength light. Photosensitizers are molecules such as porphyrins and chlorins that, on photoactivation, effect strongly localized oxidative damage within target cells. The PS used for PDT localize in various cytoplasmic membranous structures, but are not found in the most vulnerable intracellular sites for reactive oxygen species, such as the cell nucleus. The experimental approaches discussed in the present paper indicate that it is possible to design highly efficient molecular constructs, PS carriers, with specific modules conferring cell‐specific targeting, internalization, escape from intracellular vesicles and targeting to the most vulnerable intracellular compartments, such as the nucleus. Nuclear targeting of these PS‐carrying constructs results in enhanced photodynamic activity, maximally about 2500‐fold that of free PS. Future work is intended to optimize this approach to the point at which tumour cells can be killed rapidly and efficiently, while minimizing normal cell and tissue damage.
Prevention of a chronic progressive form of experimental autoimmune encephalomyelitis by an antibody against mucosal addressin cell adhesion molecule‐1, given early in the course of disease progression
Authors: Kanwar Jagat R , Kanwar Rupinder K , Wang Dongmao , Krissansen Geoffrey W
Published: March 2003

A role for α4 and β7 integrins in mediating leucocyte entry into the central nervous system in the multiple sclerosis (MS)‐like disease experimental autoimmune encephalomyelitis (EAE) has been demonstrated. However, the individual contributions of their respective ligands mucosal addressin cell adhesion molecule‐1 (MAdCAM‐1), vascular cell adhesion molecule‐1 (VCAM‐1) and E‐cadherin expressed on the blood–brain barrier has not been determined. In the present paper, it is shown that an antibody directed against MAdCAM‐1, the preferential ligand for α4β7, effectively prevented the development of a progressive, non‐remitting, form of EAE, actively induced by injection of myelin oligodendrocyte glycoprotein peptide (MOG35–55) autoantigen. Combinational treatment with both anti‐MAdCAM‐1, VCAM‐1, and intercellular adhesion molecule‐1 (ICAM‐1) (ligand for integrin lymphocyte function‐associated antigen (LFA)‐1) mAbs led to more rapid remission than that obtained with anti‐MAdCAM‐1 antibody alone. However, neither MAdCAM‐1 monotherapy, nor combinational antibody blockade was preventative when administered late in the course of disease progression. In conclusion, MAdCAM‐1 plays a major contributory role in the progression of chronic EAE and is a potential therapeutic target for the treatment of MS. Critically, antivascular addressin therapy must be given early in the course of disease prior to the establishment of irreversible damage if it is to be effective, as a single treatment modality.
Enhancing the immunogenicity and modulating the fine epitope recognition of antisera to a helical group A streptococcal peptide vaccine candidate from the M protein using lipid‐core peptide technology
Authors: Hayman Wendy A , Toth Istvan , Flinn Nicholas , Scanlon Martin , Good Michael F
Published: March 2003

A conserved helical peptide vaccine candidate from the M protein of group A streptococci, p145, has been described. Minimal epitopes within p145 have been defined and an epitope recognized by protective antibodies, but not by autoreactive T cells, has been identified. When administered to mice, p145 has low immunogenicity. Many boosts of peptide are required to achieve a high antibody titre (> 12 800). To attempt to overcome this low immunogenicity, lipid‐core peptide technology was employed. Lipid‐core peptides (LCP) consist of an oligomeric polylysine core, with multiple copies of the peptide of choice, conjugated to a series of lipoamino acids, which acts as an anchor for the antigen. Seven different LCP constructs based on the p145 peptide sequence were synthesized (LCP1→LCP7) and the immunogenicity of the compounds examined. The most immunogenic constructs contained the longest alkyl side‐chains. The number of lipoamino acids in the constructs affected the immunogenicity and spacing between the alkyl side‐chains increased immunogenicity. An increase in immunogenicity (enzyme‐linked immunosorbent assay (ELISA) titres) of up to 100‐fold was demonstrated using this technology and some constructs without adjuvant were more immunogenic than p145 administered with complete Freund's adjuvant (CFA). The fine specificity of the induced antibody response differed for the different constructs but one construct, LCP4, induced antibodies of identical fine specificity to those found in endemic human serum. Opsonic activity of LCP4 antisera was more than double that of p145 antisera. These data show the potential for LCP technology to both enhance immunogenicity of complex peptides and to focus the immune response towards or away from critical epitopes.
Mast cells induce upregulation of P‐selectin and intercellular adhesion molecule 1 on carotid endothelial cells in a new in vitro model of mast cell to endothelial cell communication
Authors: Torres R , de Castellarnau C , Ferrer LL , Puigdemont A , Santamaría LF , de Mora F
Published: March 2003

It is suggested that mast cells contribute to cell recruitment in inflammation through the upregulation of endothelial adhesion molecules. P‐selectin and intercellular adhesion molecule (ICAM)‐1 are two key adhesion molecules that have been associated indirectly with mast cell activity. The canine C2 mastocytoma cell line and primary cultures of canine carotid endothelial cells were used to establish a new in vitro model to help study the interaction between mast cells and endothelial cells. Carotid endothelial cells were incubated with mast cell mediators to uncover their effect on endothelial ICAM‐1 and P‐selectin expression. To assess the relative contributions of tumour necrosis factor (TNF)‐α and histamine to such effect, an H1 antihistamine and a TNF‐α blocking antibody were used. Prior to activation by mast cell mediators, P‐selectin was expressed only within the cytoplasm, and ICAM‐1 was constitutively expressed on the surface of the canine carotid endothelial cells. Both adhesion molecules were enhanced significantly and strongly upon mast cell activation at various time points. Unstored TNF‐α was fully responsible for ICAM‐1 upregulation. P‐selectin was up‐regulated by both preformed and newly synthesized mast cell mediators, but neither histamine nor TNF‐α accounted for such an effect. Therefore, a new model is proposed in which the pro‐inflammatory effect of mast cells on endothelial cells can be studied in vitro. In this model, it has been demonstrated that only TNF‐α accounts for the overexpression of ICAM‐1 induced by mast cells, and that mast cells up‐regulate P‐selectin expression through a histamine‐independent mechanism.
Possible mechanism for the alpha subunit of the interleukin‐2 receptor (CD25) to influence interleukin‐2 receptor signal transduction
Authors: Ellery Jonathan M , Nicholls Peter J
Published: March 2003

The receptors for interleukin 2 (IL‐2) and interleukin 15 (IL‐15) in T cells share the IL‐2Rβ subunit (CD122) and γC subunit but have private α subunits. Despite utilizing the same receptor chains known to be necessary and sufficient to transduce IL‐2 signals the two cytokines manifest different cellular effects. It is commonly held that the α subunit of the IL‐2R (CD25) is involved solely in the generation of a high affinity receptor complex. This is questioned by the development of autoimmune diseases in instances where the expression of CD25 is absent. The timely expression of CD25 in the thymus has been linked with clonal deletion. Evidence from peripheral T cells indicates that survival signals arising from the intermediate affinity IL‐2R (lacking CD25) do not require the activation of Janus kinase 3 (Jak3) but do require the presence of the membrane proximal region of the γC chain. This particular signalling pathway is not observed in the high affinity receptor complex where Jak3 is activated. Recent data point to CD25 having a surface distribution consistent with it being localized within membrane microdomains. Here we suggest that in the absence of CD25 expression, IL‐2R activation occurs within the soluble membrane fraction. This membrane environment and the absence of CD25 promotes Jak3 independent signal transduction and induction of antiapoptotic mechanisms. T cell antigen receptor (TCR) signalling leads to the induction of CD25 expression, which localizes to membrane microdomains. There is a dynamic pre‐association of CD25 and CD122 leading to the loose association of the heterodimer with membrane microdomains. High affinity IL‐2R signalling in the context of CD25 and the microdomain environment is characterized by Jak3 activation. The relative levels of high to intermediate affinity receptor signalling determines whether a cell proliferates or undergoes activation induced cell death dependent upon cell status.
Immunity to asexual blood stage malaria and vaccine approaches
Authors: Wipasa Jiraprapa , Elliott Salenna , Xu Huji , Good Michael F
Published: March 2003

The development of a malaria vaccine seems to be a definite possibility despite the fact that even individuals with a life time of endemic exposure do not develop sterile immunity. An effective malaria vaccine would be invaluable in preventing malaria‐associated deaths in endemic areas, especially amongst children less than 5 years of age and pregnant women. This review discusses our current understanding of immunity against the asexual blood stage of malaria − the stage that is responsible for the symptoms of the disease − and approaches to the design of an asexual blood stage vaccine.
The interplay of dendritic cell subsets in systemic lupus erythematosus
Authors: Palucka A Karolina , Banchereau Jacques , Blanco Patrick , Pascual Virginia
Published: March 2003

Dendritic cells (DC) control immunity and tolerance. Hence, we surmised that systemic lupus erythematosus (SLE), a systemic autoimmune disease with autoreactive T and B cells, might be due to DC alterations. Based on our findings, we are proposing a model of SLE where autoimmune responses are driven by unabated activation of myeloid DC through IFN‐α produced by plasmacytoid DC. Thus, interplay between DC subsets might represent a key component of SLE pathogenesis.
New approaches to health and well‐being for dementia day‐care clients, family carers and day‐care staff
Authors: Kilstoff Kathleen , Chenoweth Lynn
Published: March 2003

Kilstoff K, Chenoweth L. International Journal of Nursing Practice 1998; 4: 70–83

New approaches to health and well‐being for dementia

day‐care clients, their family carers and day‐care staff

This study was conducted in one multicultural dementia day‐care centre over a period of 18 months. It introduced a gentle hand treatment for clients using three essential oils. The study evolved out of the process of action research where the family carers and day‐care staff participated with the researchers to choose, design, develop and evaluate a hand treatment programme. Data was collected through in‐depth interviews pre‐and post‐treatment, focus group discussions, client observation logbooks and a disability scale. The findings indicate a positive strengthening of the relationship between the person with dementia and their family carer, and an improvement in feelings of health and well‐being for both. The specific improvements for clients include increased alertness, self‐hygiene, contentment, initiation of toileting, sleeping at night and reduced levels of agitation, withdrawal and wandering. Family carers have reported less distress, improved sleeping patterns and feelings of calm. They also found the treatment useful in helping them manage the difficult behaviours exhibited by their relative with dementia. The benefits of this treatment for nursing practice are that it is safe, effective and easily administered by staff in any setting.
Analysis of the stressful effects of hospitalisation and source isolation on coping and psychological constructs
Authors: Gammon
Published: March 2003

Gammon J. International Journal of Nursing Practice 1998; 4: 84–96

Analysis of the stressful effects of hospitalisation and source isolation on coping and

psychological constructs

This quantitative research has attempted to investigate the psychological effects of hospitalisation and source isolation, and assessed whether were they influential in affecting a patient’s cognitive coping with these two stressors. The research evaluated whether isolating a person because of an infection was a more stressful event (causing negative effects on four measured psychological constructs) than routine hospital admission. The research was conducted in two large District General Hospitals and one elderly care hospital. Individuals admitted to one of the research sites, and who satisfied the sample criteria, were adopted. The total number of subjects was 40. The research design was quasi experimental (post test only control group design), using a quantitative approach. Following a period of hospitalisation or isolation subjects in the control group (Group 1, hospitalised subjects, n=20) and subjects in the experimental group (Group 2, isolated subjects, n=20) were given the following to complete: the Hospital Anxiety and Depression Scale1, the Health Illness (Powerlessness) Questionnaire2, and the Self Esteem Scale3. These measured four psychological constructs: anxiety, depression, self esteem and sense of control. The quantitative data generated were analysed using descriptive statistics and the Student’s t‐test. The findings confirmed and validated previous research that hospitalisation results in many negative feelings that have detrimental effects on psychological well being and coping. However, more significantly, infected subjects who were isolated demonstrated feelings of anxiety, and depression that were significantly higher, and feelings of self esteem and sense of control that were significantly lower than those demonstrated by hospitalised subjects. Thus it could be argued that isolation has an even greater negative effect on their coping. Further research therefore needs to examine how specific nurse interventions can ameliorate the identified negative effects of isolation and so facilitate effective coping and positive psychological well being.
The transforming power of research on practice: Involving practitioners in analysis
Authors: Stainton M. Colleen , Harvey Sheila , McNeil Deborah , Emmanuel Elizabeth , Johnson Caroline M.
Published: March 2003

The transforming power of research on practice: Involving practitioners in analysis

Nurses were invited to participate in the interpretation of transcribed interviews during the data analysis phase of a phenomenological study. They worked with the investigators in learning and using hermeneutic methods to identify and interpret meanings embedded in exemplars. Their expert clinical knowledge of the field of practice added rigor to the analytical process and depth to the understanding achieved. As the analysis progressed, the nurses began to spontaneously describe transformation occurring in their practice. Involving nurses in data analysis has transformative power on practice.
Moral distress, advocacy and burnout: Theorising the relationships
Authors: Rn Deborah Sundin‐Huard , Rn Kathleen Fahy
Published: March 2003

Burnout is a major contributor to shortages of experienced nurses. The research literature shows a correlation between moral distress and burnout in critical care nurses. This paper reports on part of an interpretive interactionist study concerning nurses’ experiences of moral distress which prompted attempts to advocate for vulnerable patients. One critical incident is used as an example of the qualitative findings of the study. In this paper, we theorise about what happened when nurses advocated for their patients by challenging medical treatments which the nurses believed to be both inappropriate and to contributing to patient suffering. When attempts at advocacy were unsuccessful, the nurses experienced intensified moral distress, frustration and anger. Being an unsuccessful advocate resulted in nurses being relocated within the hospital, nurses being scapegoated and/or burning out. The theoretical links which this paper makes between advocacy, moral distress and burnout are supported by empirical data from the study.
European snapshot homeless survey: Results of questions asked of passers‐by in 11 European cities
Authors: Brandon David , Khoo Richard , Maglajlic Rea , Abuel‐Ealeh Mohammed
Published: March 2003

Passers‐by were interviewed outside McDonalds restaurants in 11 European cities during November and December 1998. Eight questions were asked, mainly exploring the stigma levels of a particularly socially and economically excluded group (homeless people) and also the preferred remedies for homelessness. Answers varied, especially between the countries in Western Europe and those in the former Warsaw Pact countries. Stigma levels were very high in Bucharest, Kiev and Zagreb, presumably making resettlement work difficult. People in these cities saw homeless people as ‘dangerous’: repositories of infectious disease and likely to make unprovoked attacks. Most passers‐by also believed homeless people were under threat, especially from the police, sometimes from other passers‐by, from exposure to the winters and, in Cambridge, Vienna and Zagreb, from malnutrition. Suggested remedies were increased employment, improved training and increased affordable housing, rather than the imprisonment of beggars.
Work of art dialogues: An educational technique by which students discover personal knowledge of empathy
Authors: Wikström Britt‐Maj
Published: March 2003

The visual art programme was an approach used to facilitate students’ discovery of personal knowledge of empathy. The research programme constituted the first phase of an existing theory course in empathy. It involved a visual‐verbal‐writing process in which a reproduction of Edvard Munch'sThe Sick Childwas studied and interpreted with a focus on personal knowledge of empathy. Data were collected from two university colleges of health sciences in Sweden during a period of 4 years (1995–1998). Student nurses (n= 428) in the undergraduate programme served as the study population. In the first stage, the students worked alone on written reports. Then, in small‐groups, they discussed whether the picture facilitated the discovery of a personal knowledge of empathy. The results showed that the visual art programme stimulated the students to discuss and write about empathy. The ambiguity in the painting and the relaxed study situation was favourable to the students' discovery of their personal knowledge of empathy.
Individualized music played for agitated patients with dementia: Analysis of video‐recorded sessions
Authors: Ragneskog Hans , Asplund Kenneth , Kihlgren Mona , Norberg Astrid
Published: March 2003

Many nursing home patients with dementia suffer from symptoms of agitation (e.g. anxiety, shouting, irritability). This study investigated whether individualized music could be used as a nursing intervention to reduce such symptoms in four patients with severe dementia. The patients were video‐recorded during four sessions in four periods, including a control period without music, two periods where individualized music was played, and one period where classical music was played. The recordings were analysed by systematic observations and the Facial Action Coding System. Two patients became calmer during some of the individualized music sessions; one patient remained sitting in her armchair longer, and the other patient stopped shouting. For the two patients who were most affected by dementia, the noticeable effect of music was minimal. If the nursing staff succeed in discovering the music preferences of an individual, individualized music may be an effective nursing intervention to mitigate anxiety and agitation for some patients.
Longitudinal study of the intensity of memorized labour pain
Authors: Kabeyama Kiyoko , Miyoshi Masamitsu
Published: March 2003

This study was designed to investigate various factors affecting the intensity of memorized labour pain. The study assessed 101 primiparas' and 95 multiparas' labour pain and related factors, such as physical, psychological and living environmental factors at three periods post‐delivery: (i) within 24 h; (ii) at 1 month; and (iii) in year 1–2. The rate of the high group, whose intensity of memorized labour pain was larger than mean + 1SD during the three postpartum phases, was 24.0%. The rate of the low group, whose intensity of memorized labour pain was smaller than mean + 1SD, was 9.7%. In the high group, the length of labour was longer than that in the low group, the rate of pregnancy disorder was higher, the self‐control score during labour and delivery was worse and the rate of women with difficult birth was higher and that for those with low birth weight was lower. The high group obtained more family support but needed a longer time to adjust to childcare. There were significant differences between the high and low groups in all the factors.
Australian implantable cardiac defibrillator recipients: Quality‐of‐life issues
Authors: RN Dianne Pelletier , RN Robyn Gallagher , BA Suzanne Mitten‐Lewis , RN Sharon McKinley , RGN Jill Squire
Published: March 2003

Implantable cardioverter defibrillators (ICDs) have become a well‐established therapy for people experiencing potentially lethal dysrhythmias. Australian recipients’ quality of life and adjustment to the device over time, device‐related complications, shock and associated sensations, and potential sequelae have not been widely explored. This paper reports a longitudinal prospective study of Australian ICD recipients (n = 74) to determine their responses to the device, health‐related quality of life over time and shock experiences. A questionnaire designed for the study and the Medical Outcomes Trust Quality of Life Instrument, the SF36, were completed by recipients prior to and at 3 and 12 months post insertion. Results show that quality of life decreased for general health and social function between 3 and 12 months. Nearly half (49%) of the recipients received shocks within 12 months and the majority (92%) of these experienced sequelae that could make driving hazardous. Half of the population (49%) were driving at 3 months and 69% by 12 months, including 67% of those who had been shocked. Twenty‐seven percent were hospitalized with device‐related complications. Driving, the shock experience and rehospitalization, the shock experience and driving behaviour are significant issues for those with the implanted device. While it is a limitation of the study that partners and carers were not included, these findings will also be of interest to them.
Amy's Chat Room: Health promotion programmes for community dwelling elderly adults
Authors: Imamura Emiko
Published: March 2003

Clinical nurse specialists in community health nursing promote wellness and quality of life in elderly adults who live within the community. Major health concerns including inappropriate knowledge of chronic diseases, improper eating habits and inadequate nutrition, lack of exercise, and poor social relationships among elderly adults residing in a government‐supported apartment complex in north‐eastern Ohio were identified using Neuman's Systems Model. ‘Amy's Chat Room’, a series of health education programmes on disease prevention, including appropriate nutrition and exercise, was developed and implemented based on the PRECEDE–PROCEED programme‐planning model. Evaluation of the programmes indicated positive results for the older adults that increased their knowledge and awareness of disease prevention and modifications in lifestyle, and were encouraged to promote supportive relationships. Implications for clinical nurse specialist roles within community health nursing were discussed.
K–Ar ages of the Akan‐Shiretoko volcanic chain lying oblique to the Kurile trench: Implications for tectonic control of volcanism
Authors: Goto Yoshihiko , Funayama Atsushi , Gouchi Nobuo , Itaya Tetsumaru
Published: March 2003

The Akan‐Shiretoko volcanic chain, situated in the Southwestern Kurile arc, consists mainly of nine subaerial andesitic stratovolcanoes and three calderas. The chain extends in a SW–NE direction for 200 km, situated oblique to the Kurile trench at an angle of 25 degrees. Thirty‐seven new K–Ar ages, plus previous data, suggest that volcanic activity along the Akan‐Shiretoko volcanic chain began at ca 4 Ma at Akan, at the southwestern end of the chain, and systematically progressed northeastward, resulting in the southwest‐northeast‐trending volcanic chain. This spatial and temporal distribution of volcanoes can be explained by anticline development advancing northeastward from the Akan area, accompanied by magma rising through northeast‐trending fractures that developed along the anticlinal axis. The northeastward development of the anticline caused uplifting of the Akan‐Shiretoko area and changed the area from submarine to subaerial conditions. Anticline formation was likely due to deformation of the southwestern Kurile arc, with southwestward migration of the Kurile forearc sliver caused by oblique subduction of the Pacific plate. The echelon topographic arrangement of the Shiretoko, Kunashiri, Etorofu and Urup was formed at ca 1 Ma.
Quartz microstructures and deformation conditions in the Hatagawa shear zone, north‐eastern Japan
Authors: Shigematsu Norio , Yamagishi Hiraku
Published: March 2003

Abstract Meso‐ and microscale structural analyses were carried out in the Hatagawa shear zone, north‐eastern Japan. The shear zone is a sinistral strike–slip ductile shear zone, and has a 1‐km wide north‐south trending region where quartz mean grain size of approximately 35 μm does not vary significantly. Two types of quartz microstructures, A and B, occur in the western and eastern part of the shear zone, respectively. The lattice preferred orientation (LPO) patterns are characterized by a type I crossed girdle in the samples with the quartz microstructure A, and a Y maximum in the samples with the quartz microstructure B. The microstructures under optical and transmission electron microscopes indicates that the quartz recrystallization occurred predominantly by progressive subgrain rotation in microstructure A, and by both progressive subgrain rotation and grain boundary migration in microstructure B. This suggests different deformation conditions in the western and eastern parts of the shear zone. Quartz LPO patterns, presence of myrmekite, feldspar compositions, and dislocation density also suggest difference in the deformation conditions. The syn‐deformation temperature in the western part of the shear zone was lower than that of the eastern part of the shear zone. The stress in the western part of the shear zone was higher than that of the eastern part of the shear zone. The difference in the deformation conditions would affect not only the quartz microstructure, but also the quartz LPO patterns and the presence of myrmekite around K‐feldspar porphyroclasts.
Petrology of the greenstones of the Lower Sorachi Group in the Sorachi–Yezo Belt, central Hokkaido, Japan, with special reference to discrimination between oceanic plateau basalts and mid‐oceanic ridge basalts
Authors: Nagahashi Tohru , Miyashita Sumio
Published: March 2003

Abstract  The Lower Sorachi Group of the Sorachi–Yezo Belt in central Hokkaido, Japan is a peculiar accretionary complex characterized by numerous occurrences of greenstones (metabasalts and diabases), which are mostly composed of aphyric basalts. Clinopyroxene‐rich phenocryst assemblage in phyric basalts is different from olivine–plagioclase assemblage in mid‐oceanic ridge basalts (MORB). The greenstones are geochemically uniform, and show a lower‐Ti trend than MORB in an FeO*/MgO‐TiO2 diagram, mostly plotting on the island arc tholeiite (IAT) field in a TiO2−10MnO−10P2O5 diagram. In a MORB‐normalized spider diagram, the greenstones show a flat pattern from P to Y, which are lower than those of normal mid‐oceanic ridge basalt (N‐MORB). These indicate that the greenstones were derived by a higher degree of partial melting from a depleted mantle similar to a N‐MORB source, and experienced olivine–clinopyroxene fractional crystallization. However, a positive spike of Nb in the spider diagram cannot be explained, and may be attributed to mantle heterogeneity. These characteristics are analogous to those of oceanic plateau basalts (OPB) such as in Ontong Java Plateau, Manihiki Plateau and Nauru Basin, suggesting that the greenstones in the Lower Sorachi Group are of oceanic plateau origin. The present study proposes new field divisions to distinguish OPB from MORB in the conventional FeO*/MgO–TiO2 and TiO2−10MnO−10P2O5 diagrams.
Management of viral hepatitis C
Authors: LEUNG NANCY WY
Published: March 2003

The hepatitis C virus was first identified in 1989. It causes chronic hepatitis, cirrhosis and hepatocellular carcinoma. Global anti‐HCV prevalence is 1–3%. Contaminated blood product, dirty needles and instruments, and injection drug use are the main parenteral routes of transmission. Cultural practices, such as acupuncture, tattoo, body piercing and scarring, also play a role. Universal precaution is the mainstay for prevention before vaccine is developed. Therapy for chronic hepatitis C (CHC) with interferon (IFN) is not satisfactory. Non‐response and early relapse reduce sustained response (SR). In 1997, National Institute of Health consensus recommended IFN therapy only for selected patients with compensated CHC, raised ALT and moderate to severe histologic disease activity; 15–20% SR is expected. Major advances in CHC therapy is combination therapy. Ribavirin in combination with IFN significantly increases SR to 30–40%. Even patients with high viral load, genotype 1, significant fibrosis or cirrhosis respond better. EASL and APASL Consensus in 1999 recommended IFN‐ribavirin combination as the first line therapy. Recent data on pegylated IFN showed very encouraging results. Combined with ribavirin, 60% SR was achieved. It benefits patients with severe bridging necrosis and also cirrhosis. However, 23–27% of patients receiving combination therapy with either IFN type, experienced adverse events and required therapy discontinuation. Many important issues remained unsolved. Therapy for children, the elderly, patients with comorbidity and extra–hepatic syndromes need to be addressed. Therapy is too expensive and not affordable to the majority of patients in developing countries.
New optical technologies for earlier endoscopic diagnosis of premalignant gastrointestinal lesions
Authors: DACOSTA RALPH S , WILSON BRIAN C , MARCON NORMAN E
Published: March 2003

Gastrointestinal malignancies continue to be the second leading cause of cancer‐related deaths in the developed world. The early detection and treatment of gastrointestinal preneoplasms has been demonstrated to significantly improve patient survival. Conventional screening tools include standard white light endoscopy (WLE) and frequent surveillance with biopsy. Well‐defined endoscopic surveillance biopsy protocols aimed at early detection of dysplasia and malignancy have been undertaken for groups at high risk. Unfortunately, the poor sensitivity associated with WLE is a significant limitation. In this regard, major efforts continue in the development and evaluation of alternative diagnostic techniques. This review will focus on notable developments made at the forefront of research in modern gastrointestinal endoscopy based on novel optical endoscopic modalities, which rely on the interactions of light with tissues. Here we present the ‘state‐of‐the‐art’ in fluorescence endoscopic imaging and spectroscopy, Raman spectroscopy, optical coherence tomography, light scattering spectroscopy, chromoendoscopy, confocal fluorescence endoscopy, and immunofluorescence endoscopy. These new developments may offer significant improvements in the diagnosis of early lesions by allowing for targeted mucosal excisional biopsies, and perhaps may even provide ‘optical biopsies’ of equivalent histological accuracy. This enhancement of the endoscopist’s ability to detect subtle preneoplastic changes in the gastrointestional mucosa in real time and improved staging of lesions could lead to curative endoscopic ablation of these lesions and, in the long term, improve patient survival and quality of life.