bluuebunny/crossref_metadata_2025 huggingface dataset:
Elderly patients: still clean and sitting quietly
Authors: Armstrong‐Esther C.A. , Browne K.D. , McAfee J.G.
Published: February 2006

This study investigates the activities and interactions of elderly patients in an acute medical geriatric unit and a psychiatric unit. The Clifton Assessment Procedures for the Elderly were used to measure cognitive and behavioural functioning, and the 24 subjects studied were divided into three groups: lucid, confused, and demented. Information about subjects' activities and interactions with nursing staff was gained from time sampling by non‐participant direct observation. The results reveal very low levels of staf‐patient interaction outside of expected routines of patient care. At no time during the observation periods did staff engage patients in social activities or prolonged informal conversations. Yet 306 nurses, of various grades, completed a questionnaire in which they ranked talking to patients as ‘enjoyable’, ‘important’, ‘rewarding’, and an ‘objective’ for themselves and the unit.
Problems of service assessment ab intra: research and evaluation relating to a new early intervention community psychiatric nursing service
Authors: Holdsworth Nicholas , Guy William
Published: February 2006

This paper summarizes a Id‐month evaluation of an emergency assessment and community care psychiatric nursing service to demonstrate the possibility and desirability of health service providers evaluating their own service provision. The radical question central to such an assessment is: ‘What would have been the case if the service assessed had not existed?’ This question is more difficult to answer than might at first appear. However, recent changes in UK legislation concerning health care in general, and community care of the mentally ill in particular, make the assessment of new services of great importance. What is most needed in making such assessments is not technical expertise in data collection and analysis but non‐specialized critical acumen in making inferences from data routinely collected in the course of providing any service. This is illustrated using the example of a community psychiatric nursing service which afforded an opportunity to consider the impact of a new project on established services.
How should holism guide the setting of educational standards?
Authors: Jacono Brenda J. , Jacono John J.
Published: February 2006

What do the ideas about freedom implicit in holism indicate about the setting of standards in nursing, particularly nursing education? This is the question explored in this paper. In addition, the authors attempt to demonstrate that standards are a part of holism and that a more flexible view of standards is required, given the ideas inherent in the concept of holism. Finally, factors which might militate against a holistic approach and might contribute to an unduly arbitrary setting of standards are explored.
Sources of stress and psychological well‐being in high‐dependency nursing
Authors: Tyler Patrick A. , Ellison Rachel N.
Published: February 2006

The present study examined occupational stress in four areas of high‐dependency nursing: theatres, live/rend, haematology/oncology and elective surgery. A total of 60 nurses from one large NHS hospital completed questionnaires on sources and levels of stress, psychological well‐being and ways of coping; interviews with a small sub‐sample were carried out. The results indicated that the amount of stress experienced was similar across all four departments, but its sources varied. Theatre nurses experienced less stress through patients' death and dying. Other factors which influenced both the level and sources of stress included post‐qualification training, number of children and partnership‐status. Nurses with post‐qualification training perceived higher levels of stress. Social support was found to influence psychological well‐being. Nurses who were living with a partner or were married experienced fewer stress symptoms than those with no partner, and nurses with two children experienced significantly less stress through dealing with patients and relatives. Reactions to stress elicited a range of adaptive and maladaptive coping styles. Nurses sampled indicated universal support for the introduction of ‘nurse‐for‐a‐day’ and management ‘swap‐overs’ as practised in Boston, USA. This study recommends sending nurses on management and administration courses and stress‐management programmes.
Telephone triage: how experienced nurses reach decisions
Authors: Edwards Bernard
Published: February 2006

The purpose of this study was to elicit the components of diagnostic reasoning utilized by experienced triage nurses when making triage dispositions via the telephone. Five first‐level nurses triaged two simulated calls portrayed by the author. The resultant interactions were recorded on an answer‐phone and subsequently replayed to the relevant participant. The tape was stopped after each question or comment made by the nurse who was then asked to say what she was thinking at the time. These verbalizations were audio‐taped, transcribed and subjected to analysis using grounded theory. Although deprived of the opportunity for methodical deliberation, nurses, when making decisions, did so within a systematic and identifiable framework. The process was found to centre around five major considerations; the most likely cause of the presenting problem, the impact of the problem upon the caller, the accessibility of alternative sources of health care, the ability of the nurse to control the reactions of the caller and the nurses' perception of their vulnerability. The final triage disposition was made through balancing the most probable outcome against the worst possible outcome.
Mentorship: perceptions and pitfalls for nursing practice
Authors: Woodrow Philip
Published: February 2006

Mentorship is currently a much used, and abused, term within nursing. This study explores some implications, burdens and benefits created through mentorship. Discussion is focused on developments within health care in the United Kingdom. Emphasis is placed on its use within Project 2000 and other recent developments of nurse education. Literature review and personal experience offer insights on current practice of mentorship, enabling discussion around various aspects, and some necessarily tentative conclusions.
Turnover, age and length of service: a comparison of nurses and other staff in the National Health Service
Authors: Gray Alastair M. , Phillips V.L.
Published: February 2006

Using information collected from more than 100 district health authorities in England for the year 1989–1990, this paper examines turnover rates amongst a range of nursing and other staff groups in the National Health Service (NHS), and their relationship to the age and length of service characteristics of the labour force. The evidence collected suggests that the NHS employs a significantly younger workforce than is found in the economy as a whole. The age profile of nurses is even more skewed towards younger age groups than that of non‐nursing staff working in the NHS. Nurses tend on average to have longer lengths of service than non‐nursing staff groups, and it would seem that the average length of service has increased over the last 20 years, certainly amongst registered nurses. Overall, the study found an annual turnover rate amongst all NHS staff of 13.6%. Turnover rates were significantly higher among full‐time staff than part‐time, and amongst non‐nursing staff groups compared with nurses. Broadly, turnover rates decline with age then rise close to retirement. However, there is a more complex relationship between length of service and turnover: turnover rates tend to be high in the first year of service, and to remain high or even rise during the second year of service, before declining. Turnover remains a poorly understood issue in the NHS. The evidence presented here should move some aspects of debate onto a more solid empirical foundation.
Learning through experience: an evaluation of ‘Hospital at Home’
Authors: Jennings Penny
Published: February 2006

A Hospital at Home service for children was begun in April 1991 in a rural health authority in England. After 18 months a mainly qualitative evaluation has shown that the children and parents concerned have been very satisfied with the service and would choose the same type of care again. General practitioners and health visitors felt it was to the benefit of the whole family for the child to be at home while ill. They acknowledge a high standard of care received by the children but were critical of poor liaison between hospital and community and the loose arrangements for medical responsibility. These areas of strength and weakness are known to have been experienced in other districts establishing paediatric home care. Here, proposals have been made to improve the weaker aspects of the service as a direct response to the evaluation. These are now being put into practice, with one new appointee already in post. It is suggested that the proposals are applicable to other districts planning similar services and could help them to avoid the same pitfalls and establish a more credible service with good community integration from the start.
Power tactics and their potential impact on nursing
Authors: Jacono Brenda , Jacono John
Published: February 2006

Much has been written about power which seems to be of interest to the various professions including nursing. One theory, which asserts that the urge to dominate (i.e. the imbalance of power over love) is the source of most difficulty in human relationships, seems to have received little attention. The authors, therefore, decided to examine the nursing literature for evidence of power/love imbalances. Such evidence was discovered and, in this paper, this evidence is presented and the potential impact of such imbalances on nursing, particularly nursing research, theory and practice is considered.
Establishing rigour in qualitative research: the decision trail
Authors: Koch Tina
Published: February 2006

The aim of this paper is to show the way in which the decision trail of a qualitative research process can be maintained. It is argued that the trustworthiness (rigour) of a study may be established if the reader is able to audit the events, influences and actions of the researcher. The actual study containing the recording of this decision trail aimed to express the concerns of older patients who were admitted to the acute care sector. The study took place in two care of the elderly wards in a 1000‐bed National Health Service hospital in the UK, in 1991. Eventually, 14 patients were interviewed, each on several occasions, and their concerns are expressed in themes, namely: routine geriatric style of care, depersonalization, care deprivation and geriatric segregation. I describe the preparations that were undertaken before patient interviews could commence. The literature recording the process of the interviewer's experience as data in qualitative research is scarce. I show the researcher's participation in making the data as part of an existential phenomenological research process. Existential phenomenology relies on recording influences while generating data such as significant literature, media reports, my value position ‐ and journal data.
Leadership and its transition among nursing administration graduate departments
Authors: Kippenbrock Thomas , Fisher Mary , Huster Gertrude
Published: February 2006

The researchers surveyed nursing administration department chairs about their roles and their department functions. Chairs defined their roles mostly in the academic realm, and they were most satisfied with their role as teacher. They also reported that they lacked the necessary preparation and experiences in several academic and management functions. Furthermore, they expected their successors would need more experience than themselves for all functions of the chair, except teaching and advising students. They also believed the most qualified person in the department was not as experienced as needed, although only 67% of the respondents could identify a potential successor from within the department.
Further validity testing of the Abu‐Saad Paediatric Pain Assessment Tool
Authors: Abu‐Saad H.H. , Pool H. , Tulkens B.
Published: February 2006

This paper reports on the results of two studies conducted to further validate the Abu‐Saad Paediatric Pain Assessment Tool, a Dutch‐language questionnaire developed to assess pain in school‐age children. Children of 5 to 15 years of age reported in the first study their post‐operative pain before and after the administration of analgesic medication using word descriptors of pain, the 10‐cm scale, the Oucher, and a visual analogue scale (VAS). Lower mean pain scores at 4‐hourly intervals post‐analgesia supported the construct validity of the tool. Convergent validity was supported in both studies when scores on all concurrently administered measures positively correlated with the pain tool. In the second study, the correlations between pain and fear, a concurrently used measure with the pain instruments, were low, substantiating the discriminant validity of the pain tool. The significance of the results in relation to instrument development and multidimensional pain assessment in children are further discussed and elaborated.
Specialized home care for patients with AIDS: an experiment in Rotterdam, The Netherlands
Authors: Moons Marian , Kerkstra Ada , Biewenga Tineke
Published: February 2006

Patients with AIDS are permanently dependent on medical and technical nursing care. During a certain phase of the disease some of the patients have to visit the out‐patient clinic of the hospital for regular treatment. It was noticed that AIDS patients find these visits a severe burden. Therefore in Rotterdam an experiment has been started to provide them the technical‐medical and nursing care at home instead of at the out‐patient clinic. During the experiment, specialized hospital nurses visited the patients at home. They worked in close collaboration with the community nurses. An exploratory study was carried out to assess the prospects and difficulties of this new kind of home care for AIDS patients from a medical, psycho‐social and organizational point of view. The results suggested that it is possible to relocate the technical‐medical and nursing care from the out‐patient clinic to the patients' home. This specialized home care is seen as desirable from the perspectives of the AIDS patients and informal and professional caregivers. However, some organizational aspects, like the co‐ordination and communication among caregivers and the availability of the specialized hospital nurses during the weekend, must be improved in the future.
Patients' decision making in major surgery: the case of total colectomy
Authors: Kelly Michael P.
Published: February 2006

Qualitative interview data concerning patients' decision making in major surgery (total colectomy and ileostomy) are reported. Unsurprisingly, these procedures are not recommended lightly by the medical profession and the medical and surgical consensus is that patients should be involved in the decision making which leads to the surgery. Data relating to that involvement are presented. It is argued that the decision making is a process which involves changes in identity and self and that the tensions between identity and self account for some of the emotional and other problems attaching thereto.
The quality of assessment visits in community nursing
Authors: Kerkstra Ada , Beemster Frank
Published: February 2006

The aim of this study was the measurement of the quality of assessment visits of community nurses in The Netherlands. Process criteria were derived for the quality of the assessment visits from the quality standards of community nursing care established by Appelman et al. Over a period of 8 weeks, a representative sample of 108 community nurses and 49 community nursing auxiliaries at 47 different locations paid a total number of 433 assessment visits. The nursing activities were recorded for each visit. The results suggested that most assessment visits (88%) were paid by community nurses. During the assessment visits, community nurses more often paid attention to questions and expectations of the patient than nursing auxiliaries did. Furthermore, the quality of taking case histories in the actual practice of assessment appeared to be high in general. However, nearly half of the nurses did not enquire whether the patient received care from other health care professionals. The drafting of the care plan was, on average, of a lesser quality. In particular, the re‐assessment of patients was not systematically planned.
Patients' experiences of emergency admission: how elevant is the British government's Patients Charter?
Authors: Britten Nicky , Shaw Adrienne
Published: February 2006

This paper evaluates the British government's Patients Charter from the perspective of patients admitted via accident and emergency departments. It uses qualitative data obtained about issues of concern to these patients to judge whether the standards set out in the Charter are appropriate to their priorities and, conversely, if there are issues of importance to these patients which the Charter overlooks. Semi‐structured interviews were conducted with 83 patients admitted to two London hospitals. It is concluded that the rights and standards outlined in the Patients Charter are generally appropriate to these patients' experiences, although some are defined too narrowly. The study identified a number of issues of importance to patients which are not mentioned in the Patients Charter: pain relief, giving information, receiving information, reception staff, examinations and investigations, physical environment, and other people in casualty. The patient wants rather more than recent British government documents suggest.
Student supervision: myth or reality?
Authors: Marrow Carol E. , Tatum Sue
Published: February 2006

This paper is based on the early findings of a qualitative longitudinal study using a grounded theory approach to analysis. A cohort of Project 2000 students and their clinical supervisors were observed in 10 different ward settings and interviewed prior to leaving the setting. A non‐participant observation technique was utilized, noting the students' interactions with their deemed supervisors. The students and the supervisors were then interviewed using a semi‐structured question format to explore supervision issues. The findings suggest that both students and supervisors in the study believe that supervision is an important learning strategy. However, what is believed in theory would not always appear to hold true in practice. The study identifies a limited knowledge by the supervisors of the skills and models of supervision, indicating the need for greater role preparation and a more clearly defined role specification. Supervision tended to focus upon tasks rather than issues. Furthermore, the role conflicts experienced by the supervisors was perceived as inhibiting facilitation of student learning. It is recommended that, for supervision to be more effective within the present operational constraints, it should utilize a more problem‐solving approach, thus encouraging critical reflection on practice.
The relationship between yellowhammer breeding performance, arthropod abundance and insecticide applications on arable farmland
Authors: HART J. D. , MILSOM T. P. , FISHER G. , WILKINS V. , MOREBY S. J. , MURRAY A. W. A. , ROBERTSON P. A.
Published: February 2006

The UK population of yellowhammers has declined since the mid‐1980s. Concurrent increases in the use of pesticides are believed to have reduced the availability of food resources for farmland birds, including yellowhammers. To mitigate the consequences of insecticide applications on yellowhammer productivity, the relationships between insecticide application, arthropod food abundance and breeding success require quantification.

We studied nesting yellowhammers on a lowland arable farm in North Yorkshire between 2001 and 2003, to examine the effects of food abundance on breeding success and the effects of insecticide on food abundance. Arthropod abundances around individual nests were sampled and the timing and location of insecticide applications were recorded.

Nestling condition and mass on day 6 after hatching were positively correlated with the abundance of arthropods important in the diet of nestling yellowhammers. Greater mean body mass and condition corresponded with a lower incidence of brood reduction.

The abundance of arthropods important in the diet of nestling yellowhammers increased between mid‐May and the end of July. However, arthropod samples collected within 20 days of an insecticide application did not show this seasonal increase in abundance and were depressed at levels likely to affect yellowhammer breeding performance adversely.

Synthesis and applications. We have demonstrated how insecticide applications can depress yellowhammer breeding productivity. We provide the requisite data for a framework that enables predictions to be made about the probable population effects of particular pesticide products. If the risk of indirect effects can be predicted accurately then appropriate mitigation and compensation measures could be incorporated into pesticide regulatory procedures and/or agri‐environment schemes.
Stress trajectories in mothers of young children with Down syndrome
Authors: Most D. E. , Fidler D. J. , Laforce‐Booth C. , Kelly J.
Published: February 2006

Background  In this study, we investigated the early development of stress in mothers of children with Down syndrome, compared with mothers of children with developmental disabilities of mixed aetiologies. Growth modelling analyses were used to explore: (1) whether mothers of children with Down syndrome demonstrated distinct patterns of stress during their children’s early development, compared with mothers of children with other developmental disabilities; and (2) whether there was a relation between child behavioural characteristics and the level and rate of change in stress observed in each population.

Method  The stress trajectories of mothers of young children with Down syndrome (n = 25) and a mixed‐aetiology comparison group (n = 49) were estimated, using growth modelling on data collected at ages of 15, 30 and 45 months.

Results  On average, stress in the mixed comparison group was higher at Time 1 and remained unchanged over time, while stress in the Down syndrome group was lower at Time 1 but increased steadily. After taking diagnostic group membership into account, more advanced cognitive‐linguistic functioning and lower levels of maladaptive behaviours at all time points were associated with lower levels of maternal stress.

Conclusions  These findings suggest that the cognitive‐linguistic and behavioural trajectory observed in early development in Down syndrome may contribute to the changes in maternal stress levels observed throughout these early years. Implications for developing targeted and time‐ sensitive family interventions for families of children with Down syndrome are discussed.
Cardiac diseases in people with intellectual disability
Authors: Van Den Akker M. , Maaskant M. A. , Van Der Meijden R. J. M.
Published: February 2006

Background In people with ID there is more morbidity than in the general population, including cardiac diseases. Dutch figures on this subject are scarce.

Methods Descriptive study of the prevalence of cardiac diseases in 436 residential clients in Echt, the Netherlands, and comparisons between men and women, age groups, and level and aetiology of ID, were carried out.

Results It was found that the total prevalence of cardiac diseases was 14%, with a higher prevalence among women, the elderly, and people with mild/moderate ID.

Conclusions The prevalence of cardiac diseases in residential clients is substantial. With the increasing number of ageing people with ID and people with ID living more independently in community‐integrated residences, it is expected that the morbidity and mortality from cardiac diseases will increase further.
The ComFor: an instrument for the indication of augmentative communication in people with autism and intellectual disability
Authors: Noens I. , Van Berckelaer‐Onnes I. , Verpoorten R. , Van Duijn G.
Published: February 2006

Background  The ComFor (Forerunners in Communication) is an instrument to explore underlying competence for augmentative communication. More specifically, it measures perception and sense‐making of non‐transient forms of communication at the levels of presentation and representation. The target group consists primarily of individuals with autism and intellectual disability (ID) without or with only limited verbal communication. The ComFor is suitable for children and adults with a developmental level between 12 and 60 months. This paper describes the theoretical framework and structure of the ComFor, the results of a study on its psychometric properties and its clinical uses.

Method  The ComFor was tested on a sample of 623 children and adults from the Netherlands and Flanders: a group with autism and ID (n = 310); a group with ID without autism (n = 174); and a control group of typically developing children (n = 139).

Results  The data generally support the reliability and validity of the ComFor. Internal consistency, inter‐rater and test–retest reliability were found to be good. Construct validity (internal structure, convergent and divergent patterns) was established in different ways. The criterion‐related validity has yet to be established, as predictive data are not available at the moment.

Conclusion  Taken together, the results indicate that the ComFor is a promising instrument to explore underlying competence for augmentative communication. Areas for future research are outlined and the clinical relevance is discussed.
A CH3CN and HCO+ survey towards southern methanol masers associated with star formation
Authors: Purcell C. R. , Balasubramanyam R. , Burton M. G. , Walsh A. J. , Minier V. , Hunt-Cunningham M. R. , Kedziora-Chudczer L. L. , Longmore S. N. , Hill T. , Bains I. , Barnes P. J. , Busfield A. L. , Calisse P. , Crighton N. H. M. , Curran S. J. , Davis T. M. , Dempsey J. T. , Derragopian G. , Fulton B. , Hidas M. G. , Hoare M. G. , Lee J.-K. , Ladd E. F. , Lumsden S. L. , Moore T. J. T. , Murphy M. T. , Oudmaijer R. D. , Pracy M. B. , Rathborne J. , Robertson S. , Schultz A. S. B. , Shobbrook J. , Sparks P. A. , Storey J. , Travouillion T.
Published: February 2006

We present the initial results of a 3-mm spectral-line survey towards 83 methanol maser-selected massive star-forming regions. Here, we report observations of the J = 5–4 and 6–5 rotational transitions of methyl cyanide (CH3CN) and the J = 1–0 transition of HCO+ and H13CO+.

CH3CN emission is detected in 58 sources (70 per cent of our sample). We estimate the temperature and column density for 37 of these using the rotational diagram (RD) method. The temperatures we derive range from 28–166 K, and are lower than previously reported temperatures, derived from higher J transitions. We find that CH3CN is brighter and more commonly detected towards ultracompact H ii (UCH ii) regions than towards isolated maser sources. Detection of CH3CN towards isolated maser sources strongly suggests that these objects are internally heated and that CH3CN is excited prior to the UCH ii phase of massive star formation.

HCO+ is detected towards 82 sources (99 per cent of our sample), many of which exhibit asymmetric line profiles compared to H13CO+. Skewed profiles are indicative of inward or outward motions, however, we find approximately equal numbers of red- and blue-skewed profiles among all classes. Column densities are derived from an analysis of the HCO+ and H13CO+ line profiles.

80 sources have mid-infrared (mid-IR) counterparts: 68 seen in emission and 12 seen in absorption as ‘dark clouds’. Seven of the 12 dark clouds exhibit asymmetric HCO+ profiles, six of which are skewed to the blue, indicating infalling motions. CH3CN is also common in dark clouds, where it has a 90 per cent detection rate.
An energy algorithm improves symptoms in some patients with gastroparesis and treated with gastric electrical stimulation
Authors: Abidi N. , Starkebaum W. L. , Abell T. L.
Published: February 2006

Abstract  Gastric electrical stimulation (GES) is effective to improve symptoms of nausea and vomiting in most patients, but very little is known about the effect of varying stimulation parameters. We analysed stimulation parameters in a pilot study of 22 patients (12 idiopathic, four diabetic and four postsurgical) with drug‐refractory gastroparesis who did not respond optimally to initial settings. Patients underwent high‐frequency/lowenergy GES using identical initial stimulation parameters: 5 mA of current, 330 μs pulse width, 14 Hz for 0.1 s on and 5.0 s off. Due to lack on optimal response, 22 patients underwent alteration of an algorithm using stimulation parameters. At follow‐up (mean of 4.3 years) a dose–response relationship for charge, power and energy were compared with baseline for the whole group and for each diagnostic subgroup by anovadata are reported as mean ± SE. Based on the mean of individual dose–response curves, differences in data are charge, current per pulse and energy per pulse were noted for the whole group at follow up vs baseline. The subgroup of patients with postsurgical gastroparesis required the most energy using the algorithm. In conclusion, an algorithmic approach to identify optimal stimulation parameters in GES for individual patients is associated with symptom improvement. Also, certain subgroups appear to have different energy parameters. Based on this preliminary data, the use of an algorithm for some patients with GES is feasible and may have potential for clinical application. A randomized‐controlled trial of different stimulation parameters for GES seems warranted.
The Arabidopsis thaliana multifunctional protein gene (MFP2) of peroxisomal β‐oxidation is essential for seedling establishment
Authors: Rylott Elizabeth L. , Eastmond Peter J. , Gilday Alison D. , Slocombe Steve P. , Larson Tony R. , Baker Alison , Graham Ian A.
Published: February 2006

The multifunctional protein (MFP) of peroxisomal β‐oxidation catalyses four separate reactions, two of which (2‐trans enoyl‐CoA hydratase and l‐3‐hydroxyacyl‐CoA dehydrogenase) are core activities required for the catabolism of all fatty acids. We have isolated and characterized five Arabidopsis thaliana mutants in the MFP2 gene that is expressed predominantly in germinating seeds. Seedlings of mfp2 require an exogenous supply of sucrose for seedling establishment to occur. Analysis of mfp2‐1 seedlings revealed that seed storage lipid was catabolized more slowly, long‐chain acyl‐CoA substrates accumulated and there was an increase in peroxisome size. Despite a reduction in the rate of β‐oxidation, mfp2 seedlings are not resistant to the herbicide 2,4‐dichlorophenoxybutyric acid, which is catabolized to the auxin 2,4‐dichlorophenoxyacetic acid by β‐oxidation. Acyl‐CoA feeding experiments show that the MFP2 2‐trans enoyl‐CoA hydratase only exhibits activity against long chain (C18:0) substrates, whereas the MFP2 l‐3‐hydroxyacyl‐CoA dehydrogenase is active on C6:0, C12:0 and C18:0 substrates. A mutation in the abnormal inflorescence meristem gene AIM1, the only homologue of MFP2, results in an abnormal inflorescence meristem phenotype in mature plants (Richmond and Bleecker, Plant Cell 11, 1999, 1911) demonstrating that the role of these genes is very different. The mfp2‐1 aim1double mutant aborted during the early stages of embryo development showing that these two proteins share a common function that is essential for this key stage in the life cycle.
Quantitative effects of vernalization on FLC and SOC1 expression
Authors: Sheldon Candice C. , Jean Finnegan E. , Dennis Elizabeth S. , James Peacock W.
Published: February 2006

Prolonged exposure to cold results in early flowering in Arabidopsis winter annual ecotypes, with longer exposures resulting in a greater promotion of flowering than shorter exposures. The promotion of flowering is mediated through an epigenetic down‐regulation of the floral repressor FLOWERING LOCUS C (FLC). We present results that provide an insight into the quantitative regulation of FLC by vernalization. Analysis of the effect of seed or plant cold treatment on FLC expression indicates that the time‐dependent nature of vernalization on FLC expression is mediated through the extent of the initial repression of FLC and not by affecting the ability to maintain the repressed state. In the over‐expression mutant flc‐11, the time‐dependent repression of FLC correlates with the proportional deacetylation of histone H3. Our results indicate that sequences within intron 1 and the activities of both VERNALIZATION1 (VRN1) and VERNALIZATION2 (VRN2) are required for efficient establishment of FLC repression; however, VRN1 and VRN2 are not required for maintenance of the repressed state during growth after the cold exposure. SUPPRESSOR OF OVER‐EXPRESSION OF CO 1 (SOC1), a downstream target of FLC, is quantitatively induced by vernalization in a reciprocal manner to FLC. In addition, we show that SOC1 undergoes an acute induction by both short and long cold exposures.
The Mechanics of Duetting in a New Zealand Endemic, the Kokako (Callaeas cinerea wilsoni): Song at a Snail's Pace
Authors: Molles Laura E. , Hudson Jeff D. , Waas Joseph R.
Published: February 2006

New Zealand's endemic, duetting kokako (Callaeas cinerea wilsoni) produce one of the longest known bird songs (ca 30 s) and duets that differ strikingly from those of most duetters in their unusual length and non‐repetitive structure, long pauses between component phrases, and the great flexibility in sex roles. Here we present a structural analysis of the vocalizations of 17 kokako pairs collected during natural song bouts and in response to conspecific playback, to gain insight into the functional role of this extraordinary vocal behavior. Males tend to sing a greater proportion of the duet than females. Like many duetting species, kokako have a moderately sized repertoire of phrases (mean repertoire size =18) and pair members tend to sing antiphonally rather than in unison. Sharing of phrase types is high among neighboring kokako ( = 86%) and repertoires are not sex specific, as is typical of some but not all duetting species. Timing characteristics, broad sharing of phrase types, and countersinging behavior strongly suggest that kokako duets play an important role in territory defense. Additionally, differences in pairs’ sex role and phrase sequence flexibility suggest that these aspects of duet performance may reflect pair‐bond length or commitment, and require a time investment by pair members.
Social Organization in Woodchucks (Marmota monax) and its Relationship to Growing Season
Authors: Maher Christine R.
Published: February 2006

Among sciurids, delayed dispersal may result from slow rates of maturation associated with short growing seasons and large body mass. However, woodchucks (Marmota monax) experience a range of ecological conditions and display behavioral flexibility, often ignored in models of sociality. To investigate relationships between social organization and growing season, I collected data on interaction rates, timing of dispersal, and body mass of woodchucks in southern Maine, and I gathered comparative data from the literature. Interaction rates peaked in spring then declined, with agonistic interactions exceeding amicable interactions in adults and in yearling males. Adult males and females weighed comparable amounts early and late in the season, but female weights lagged behind those of males in early summer. Woodchucks did not attain adult mass until after their second hibernation period. Nearly 50% of juveniles postponed dispersal beyond their first summer, and nearly half of those individuals remained philopatric in the following year. Populations faced with longer growing seasons matured more slowly, but timing of dispersal did not correspond to growing season or maturation rate. Other ecological factors, including burrow density, or benefits associated with joint hibernation, may influence timing of dispersal and degree of sociality and deserve further study.
Review of genetic and epigenetic alterations in hepatocarcinogenesis
Authors: HERATH NIRMITHA I , LEGGETT BARBARA A , MACDONALD GRAEME A
Published: February 2006

Abstract  Hepatocellular carcinoma (HCC) is associated with multiple risk factors and is believed to arise from pre‐neoplastic lesions, usually in the background of cirrhosis. However, the genetic and epigenetic events of hepatocarcinogenesis are relatively poorly understood. HCC display gross genomic alterations, including chromosomal instability (CIN), CpG island methylation, DNA rearrangements associated with hepatitis B virus (HBV) DNA integration, DNA hypomethylation and, to a lesser degree, microsatellite instability. Various studies have reported CIN at chromosomal regions, 1p, 4q, 5q, 6q, 8p, 10q, 11p, 16p, 16q, 17p and 22q. Frequent promoter hypermethylation and subsequent loss of protein expression has also been demonstrated in HCC at tumor suppressor gene (TSG), p16, p14, p15, SOCS1, RIZ1, E‐cadherin and 14–3‐3 σ. An interesting observation emerging from these studies is the presence of a methylator phenotype in hepatocarcinogenesis, although it does not seem advantageous to have high levels of microsatellite instability. Methylation also appears to be an early event, suggesting that this may precede cirrhosis. However, these genes have been studied in isolation and global studies of methylator phenotype are required to assess the significance of epigenetic silencing in hepatocarcinogenesis. Based on previous data there are obvious fundamental differences in the mechanisms of hepatic carcinogenesis, with at least two distinct mechanisms of malignant transformation in the liver, related to CIN and CpG island methylation. The reason for these differences and the relative importance of these mechanisms are not clear but likely relate to the etiopathogenesis of HCC. Defining these broad mechanisms is a necessary prelude to determine the timing of events in malignant transformation of the liver and to investigate the role of known risk factors for HCC.
Clinical features of hepatocellular carcinoma that occur after sustained virological response to interferon for chronic hepatitis C
Authors: IKEDA MASAFUMI , FUJIYAMA SHIGETOSHI , TANAKA MOTOHIKO , SATA MICHIO , IDE TATSUYA , YATSUHASHI HIROSHI , WATANABE HIROSHI
Published: February 2006

Background and Aim:  This study investigated the clinical features of hepatocellular carcinoma in patients with sustained virological response to interferon for hepatitis C viral (HCV) infection.

Methods:  A total of 7715 patients with HCV infection were treated with interferon and followed up for more than 1 year after withdrawal of interferon in 64 Japanese hospitals and clinics between July 1988 and August 2001. Sustained virological response was obtained in 2515 (32.6%) patients. Of these 2515 patients, clinical data were collected for 38 patients in whom hepatocellular carcinoma developed. Sustained virological response was defined as HCV RNA negativity more than 6 months after the termination of interferon.

Results:  All patients were HCV RNA negative at the time of diagnosis of hepatocellular carcinoma. The median period until the detection of hepatocellular carcinoma was 4.7 years (range 1.4–9.0 years). There were significant improvements in hepatic function including serum albumin, aspartate aminotransferase, alanine aminotransferase, indocyanine green test, platelet count and histological activity grade in comparison with those before interferon therapy and at the onset of hepatocellular carcinoma. The maximum tumor size in patients without medical follow‐up for 1 year or more (median: 60 mm) was significantly larger than in patients who were periodically followed up for 6 months or less (median: 25 mm) (P = 0.002).

Conclusions:  The present findings emphasize the importance of regular medical follow up of patients with HCV infection, as even patients showing a sustained virological response to interferon and in whom hepatic function has improved have the potential to develop hepatocellular carcinoma.
Dietary influence on electrogastrography and association of alterations in gastric myoelectrical activity with symptoms in patients with functional dyspepsia
Authors: LEE KWANG JAE , KIM JIN HONG , CHO SUNG WON
Published: February 2006

Background and Aim:  It is unclear which type of meal is adequate in measuring electrogastrography and which parameter of electrogastrography is of clinical relevance. The aims of the present study were to compare the influence of water and a nutrient drink on electrogastrography in patients with functional dyspepsia (FD) and in healthy volunteers, and to investigate the association of alterations of electrogastrography with symptoms.

Method:  In 30 patients with FD and 12 healthy volunteers, the recording of electrogastrography with symptom assessments was performed preprandially and postprandially. Subjects ingested the same volume of water and a nutrient drink at a fixed rate, which was performed in a randomized cross‐over design.

Results:  Unlike water, the power ratio after/before a nutrient drink was significantly lower in patients compared to controls. Patients had more severe bloating and epigastric pain after nutrient ingestion than after water intake. Absent postprandial increase of power was observed in seven of the 30 patients after nutrient intake, and in three of the 30 patients after water intake. The former patients had significantly more severe fullness and bloating. Irrespective of a test meal, the percentage rates of normogastria significantly decreased postprandially in the patient group, but not in the control group. No differences in symptom severity were observed between patients with and without abnormally low percentage rates of normogastria.

Conclusions:  Decreased postprandial rates of normogastria and absent postprandial increase of power are electrogastrographic abnormalities found in a subset of patients with FD. A nutrient drink is more adequate for the detection of such alterations than water. The lack of a postprandial increase of power is associated with the severity of some dyspeptic symptoms, but decreased postprandial rates of normogastria are not.
Enteral versus parenteral nutritional support in acute pancreatitis: A clinical review
Authors: THOMSON ANDREW
Published: February 2006

Abstract  A critical analysis of the trials comparing enteral with parenteral nutritional support in acute pancreatitis is presented with particular scrutiny of the clinical endpoints in each trial. The heterogeneity of the trials and the discrepancies in caloric intake between enterally and parenterally fed patients are discussed. The hazards of each route of nutritional support are highlighted and the concept of ‘nutritional bioavailability’ in the context of acute pancreatitis is introduced. It is concluded that although there is evidence to support enteral feeding as the preferred option, both routes have a role.
Mucosal mast cell counts correlate with visceral hypersensitivity in patients with diarrhea predominant irritable bowel syndrome
Authors: PARK JUNG HO , RHEE POONG‐LYUL , KIM HYUN SEO , LEE JUN HAENG , KIM YOUNG‐HO , KIM JAE JUN , RHEE JONG CHUL
Published: February 2006

Background and Aim:  Although increased mast cells in the gut and their role in visceral hypersensitivity in irritable bowel syndrome have been postulated, this relationship remains unclear. Our aim was to determine whether a relationship exists between the number of mucosal mast cells in the gut and visceral hypersensitivity.

Method:  Eighteen patients with diarrhea predominant irritable bowel syndrome (D‐IBS) (eight females, 10 males aged 25–65 years; mean 42.6 years) with symptoms meeting the Rome‐II criteria, and 15 healthy controls (five females, 10 males aged 31–57 years; mean 41.4 years) were recruited. Participants completed a questionnaire for bowel symptoms and psychological distress. Colonic mucosal mast cells were identified immunohistochemically and quantified by image analysis, and maximally tolerable pressures were evaluated using barostat test.

Results:  Numbers of mast cells were significantly greater in the terminal ileum, ascending colon and rectum of D‐IBS patients compared with controls (P < 0.01). A multivariate analysis of the barostat test showed that maximally tolerable pressures of D‐IBS patients were significantly lower than those of controls (P < 0.01). When patients were divided into the rectal hypersensitivity (+) and (–) groups by the distension level of 34 mmHg, mast cell counts were significantly higher in the rectal hypersensitivity (–) group than in the rectal hypersensitivity (+) group for the terminal ileum, ascending colon and rectum (P < 0.05, respectively).

Conclusions:  Rectal sensitivity was enhanced in D‐IBS patients with moderately increased mucosal mast cells, but it was attenuated in patients with markedly increased ones. This study might provide evidence for an important role of mast cells in visceral hypersensitivity.
A pilot study to evaluate a new combination therapy for gastric ulcer: Helicobacter pylori eradication therapy followed by gastroprotective treatment with rebamipide
Authors: TERANO AKIRA , ARAKAWA TETSUO , SUGIYAMA TOSHIRO , YOSHIKAWA TOSHIKAZU , HARUMA KEN , ASAKA MASAHIRO , SHIMOSEGAWA TOORU , SAKAKI NOBUHIRO , ISHII HIROMASA , SAKAMOTO CHOITSU , TAKAHASHI SHIN‐ICHI , KINOSHITA YOSHIKAZU , FUJIOKA TOSHIO , KOBAYASHI KENZO
Published: February 2006

Background and Aim:  Controversies remain over the need for antiulcer treatment following 1‐week eradication triple therapy for Helicobacter pylori‐positive peptic ulcers. The usefulness of combination therapy for gastric ulcers in Japanese patients, which consists of H. pylori eradication followed by gastroprotective therapy with rebamipide, was therefore evaluated.

Methods:  The study was conducted in 52 H. pylori‐positive patients with an endoscopically‐proven open gastric ulcer. All patients received 1‐week triple therapy (lansoprazole, amoxicillin and clarithromycin) followed by 7‐week rebamipide therapy. After completion of the combination therapy, all patients underwent evaluation of ulcer healing by endoscopy, gastric ulcer symptoms and H. pylori eradication by rapid urease test and 13C‐urea breath test.

Results:  The ulcer healing rates were 85.7% (36/42) at 8 weeks, 83.3% (30/36) in eradicated patients and 100% (6/6) in non‐eradicated patients. The overall gastrointestinal symptom‐free rate improved from 19.0% at baseline to 88.1% at 8 weeks. H. pylori was effectively eradicated in 85.7% (36/42) of patients.

Conclusions:  The results suggested that the combination therapy for open gastric ulcer was safe, well‐tolerated and effective. However, data from a double‐blind placebo‐controlled study is necessary to confirm these findings.