bluuebunny/crossref_metadata_2025 huggingface dataset:
Coupled Ocean–Atmosphere Interactions between the Madden–Julian Oscillation and Synoptic-Scale Variability over the Warm Pool
Authors: Batstone Crispian P. , Matthews Adrian J. , Stevens David P.
Published: June 2005

A principal component analysis of the combined fields of sea surface temperature (SST) and surface zonal and meridional wind reveals that the dominant mode of intraseasonal (30 to 70 day) covariability during northern winter in the tropical Eastern Hemisphere is that of the Madden–Julian oscillation (MJO). Regression calculations show that the submonthly (30-day high-pass filtered) surface wind variability is significantly modulated during the MJO. Regions of increased (decreased) submonthly surface wind variability propagate eastward, approximately in phase with the intraseasonal surface westerly (easterly) anomalies of the MJO. Because of the dependence of the surface latent heat flux on the magnitude of the total wind speed, this systematic modulation of the submonthly surface wind variability produces a significant component in the intraseasonal latent heat flux anomalies, which partially cancels the latent heat flux anomalies due to the slowly varying intraseasonal wind anomalies, particularly south of 10°S.

A method is derived that demodulates the submonthly surface wind variability from the slowly varying intraseasonal wind anomalies. This method is applied to the wind forcing fields of a one-dimensional ocean model. The model response to this modified forcing produces larger intraseasonal SST anomalies than when the model is forced with the observed forcing over large areas of the southwest Pacific Ocean and southeast Indian Ocean during both phases of the MJO. This result has implications for accurate coupled modeling of the MJO. A similar calculation is applied to the surface shortwave flux, but intraseasonal modulation of submonthly surface shortwave flux variability does not appear to be important to the dynamics of the MJO.
Variability of Warm-Season Cloud Episodes over East Asia Based on GMS Infrared Brightness Temperature Observations
Authors: Wang Chung-Chieh , Chen George Tai-Jen , Carbone Richard E.
Published: June 2005

The present study has used the Geostationary Meteorological Satellite (GMS) IR brightness temperature observations to investigate the regional and intraseasonal variability of east Asian warm-season cloud/precipitation episodes (in distance–time space) due to land–sea contrast and latitudinal effects. The data period was May–August 1998–2001, and harmonic analysis was employed as the major tool for analysis. The full domain of study (20°–40°N, 95°–145°E) was divided into northern and southern zones, and into eastern and western sectors, and statistics of episodes in each subregion were derived and compared.

For latitudinal effects, episodes were found to be significantly larger in span and duration in northern (30°–40°N) than in southern (20°–30°N) zones. In the northern zone, the propagation characteristics were also stronger and remain evident even in midsummer, while episodes south of 30°N reversed in direction and traveled westward in July and August. For land–sea contrast, the May–August transition over land (western sector, 95°–120°E) was mainly characterized by an increase in diurnal activities, while that over ocean (eastern sector, 120°–145°E) was characterized by decreased overall activities instead. Over the land itself, significant regional variability also existed, with strongest diurnal signals over the eastern Tibetan Plateau near 100°E, and increased diurnal activities over mountain areas in southeastern China since June. Between the two bands, near 107°E, semidiurnal signals were relatively strong and became dominant in June. This double-peaked structure in the diurnal cycle resulted from overlying signals of convection propagating eastward off the plateau with those induced locally in late afternoon, and the phenomenon was more evident in May–June. Over the ocean, on the other hand, both diurnal and semidiurnal waves had small amplitudes, and the regional variability was much weaker. For intraseasonal transition, the number of large episodes was reduced from May through July, as was mean propagation speed. In August, however, some larger events started to reappear over east Asia.
Simulation of ENSO in the New NCEP Coupled Forecast System Model (CFS03)
Authors: Wang Wanqiu , Saha Suranjana , Pan Hua-Lu , Nadiga Sudhir , White Glenn
Published: June 2005

A new global coupled atmosphere–ocean forecast system model (CFS03) has recently been developed at the National Centers for Environmental Prediction (NCEP). The new coupled model consists of a T62L64 version of the operational NCEP Atmospheric Global Forecast System model and the Geophysical Fluid Dynamics Laboratory Modular Ocean Model version 3, and is expected to replace the current NCEP operational coupled seasonal forecast model. This study assesses the performance of the new coupled model in simulating El Niño–Southern Oscillation (ENSO), which is considered to be a desirable feature for models used for seasonal prediction. The diagnoses indicate that the new coupled model simulates ENSO variability with realistic frequency. The amplitude of the simulated ENSO is similar to that of the observed strong events, but the ENSO events in the simulation occur more regularly than in observations. The model correctly simulates the observed ENSO seasonal phase locking with the peak amplitude near the end of the year. On average, however, simulated warm events tend to start about 3 months earlier and persist longer than observed. The simulated ENSO is consistent with the delayed oscillator, recharge oscillator, and advective–reflective oscillator theories, suggesting that each of these mechanisms may operate at the same time during the ENSO cycle. The diagnoses of the simulation indicate that the model may be suitable for real-time prediction of ENSO.
Two Prophecy Formulas for Assessing the Reliability of Item Response Theory-Based Ability Estimates
Authors: Raju Nambury S. , Oshima T. C.
Published: June 2005

Two new prophecy formulas for estimating item response theory (IRT)-based reliability of a shortened or lengthened test are proposed. Some of the relationships between the two formulas, one of which is identical to the well-known Spearman-Brown prophecy formula, are examined and illustrated. The major assumptions underlying these formulas are outlined and discussed. Both prophecy formulas appear to provide comparable estimates of reliability in the IRT context as well as in the classical test theory context.
Employment-Related Motivational Distortion: Its Nature, Measurement, and Reduction
Authors: Hakstian A. Ralph , Ng Ee-Ling
Published: June 2005

The behavioral variable employment-related motivational distortion (EMD) was defined and measured. In Study 1, a sample of 250 undergraduates completed the California Psychological Inventory (CPI), Form 434, on two separate occasions in which they responded (a) honestly and (b) as if applying for a job they valued. Four different change measures indexed participants’ response changes between the two conditions on a CPI-based scale measuring counter productivity (CPI-Cp). A composite of these four measures provided an EMD criterion, which enabled the development, in Study 2, of a 56-item CPI-based EMD predictor scale. On the basis of eight samples comprising a total Nof 2,074, internal consistency and test-retest reliability estimates for the CPI-EMD scale ranged between .72 and .86. Correlations with NEO PI-R domain and facet scales provided construct information about EMD. In Study 3, CPI-Cp scale scores adjusted for EMD manifested (a) reliability ranging from .71 to .87 over eight samples and (b) somewhat different correlations than for the unadjusted scale with Big Five personality scales. In addition, some evidence was found for gains in criterion correlations with EMD adjustments.
An Approach to Ancova that Allows Multiple Covariates, Nonlinearity, and Heteroscedasticity
Authors: Wilcox Rand R.
Published: June 2005

It is known that nonnormality, a heteroscedastic error term, or a nonlinearassociation can create serious practical problems when using the conventional analysis of covariance (ANCOVA) method. This article describes a simple ANCOVA method that allows heteroscedasticity, nonnormality, nonlinearity, and multiple covariates. When standard assumptions are met, all indications are that the power of the proposed method compares very favorably with that of the conventional technique.
Item Parameter Recovery, Standard Error Estimates, and Fit Statistics of the Winsteps Program for the Family of Rasch Models
Authors: Wang Wen-Chung , Chen Cheng-Te
Published: June 2005

This study investigates item parameter recovery, standard error estimates, and fit statistics yielded by the WINSTEPS program under the Rasch model and the rating scale model through Monte Carlo simulations. The independent variables were item response model, test length, and sample size. WINSTEPS yielded practically unbiased estimates for the difficulty parameters under the Rasch model and the overall difficulty parameters under the rating scale model. However, the estimates for the intersection parameters under the rating scale model were substantially biased, especially for short tests. The standard errors of the overall difficulties and intersection parameters were slightly underestimated. The cube root-transformed weighted and unweighted item fit statistics did not follow the standard normal distribution in that their empirical sampling variances were much smaller than the expected value of unity. Correction procedures were proposed to make them follow approximately the standard normal distribution so that the usual critical ranges at the α nominal level could be used to screen the misfitting items.
A Two-Level Confirmatory Factor Analysis of a Modified Rosenberg Self-Esteem Scale
Authors: Zimprich Daniel , Perren Sonja , Hornung Rainer
Published: June 2005

Classical factor analysis assumes independent and identically distributed observations. Educational data, however, are often hierarchically structured, with, for example, students being nested within classes. In this study, data on self-esteem gathered in a sample of 1,107 students within 72 school classes in Switzerland were analyzed using two-level confirmatory factor analysis. Considering a sequence of two-level confirmatory factor models, the results indicate that a one-factor model of self-esteem with an additional orthogonal method or response-style factor of negatively worded items adequately described within-class (individual) differences in self-esteem. By contrast, at the between-class level, a general factor of self-esteem was sufficient to capture school class differences in self-esteem. Thus, apart from other influences, for students, the social context (school class) seems to matter in forming their self-esteem. At the same time, the findings imply that studies examining self-esteem using samples of clustered observations should account for multiple levels of analysis (i.e., separate within- and between-class variances).
The Survey of Attitudes Toward Statistics Scale: A Construct Validity Study
Authors: Cashin Susan E. , Elmore Patricia B.
Published: June 2005

The purpose of the present study is to investigate evidence of the validity of Survey of Attitudes Toward Statistics Scale (SATS) scores and their relationship with scores from two other measures of attitudes toward statistics, the Attitude Toward Statistics Scale (ATS) and the Statistics Attitude Survey. The pre- and postcourse responses of 342 graduate and undergraduate students enrolled in inferential statistics courses at a large midwestern university were analyzed. Internal consistency reliability estimates were greater than .90 for total scores and greater than .70 for subscale scores for all instruments. Regression analyses confirmed the importance of SATS subscale scores over and above demographic variables in a theoretical model predicting statistics course achievement. Factor analyses suggested that both the ATS and the SATS have two domains, which is contrary to the four-factor solution proposed by the developers of the SATS.
Helping and Coping Attributions: Development of the Attribution of Problem Cause and Solution Scale
Authors: Stepleman Lara M. , Darcy Maria U.A. , Tracey Terence J.G.
Published: June 2005

A measure of Brickman, Rabinowitz, Karuza, Cohn, and Kidder’s structure of helping and coping orientations was developed, and its relation to a variety of counseling variables was investigated. A sample of 202 college students completed the Attribution of Problem Cause and Solution Scale (APCSS), an additional measure of attribution, and measures of coping and self-efficacy. The findings indicate that scores obtained using the APCSS have sound reliability and factor structure and are related to coping style and self-efficacy in the hypothesized manners. The APCSS has clinical implications with regard to client problem-solving efficacy and preferred means of coping.
Motivational and Skills, Social, and Self-Management Predictors of College Outcomes: Constructing the Student Readiness Inventory
Authors: Le Huy , Casillas Alex , Robbins Steven B. , Langley Ronelle
Published: June 2005

The authors used a rational-empirical approach to construct the Student Readiness Inventory, measuring psychosocial and academic-related skill factors found to predict two important college outcomes, academic performance and retention, in a recent meta-analysis. The initial item pool was administered to 5,970 first-year college students and high school seniors to empirically validate and cross-validate the underlying factor structure. Ten first-order and 3 second-order factors were derived, partially resembling the original conceptual model. Future study is needed to explore the criterion and predictive validities of the factors constituting this inventory.
Reliability Generalization of the Patterns of Adaptive Learning Survey Goal Orientation Scales
Authors: Ross Margaret E. , Blackburn Marcy , Forbes Sean
Published: June 2005

A reliability generalization study was completed on the Patterns of Adaptive Learning Survey achievement goal orientation scales to assess the prediction of (a) the different orientation scales, (b) the adaptation of items to meet research needs, (c) the number of respondents completing the instrument, and (d) the publication date cited for the manual used on reliability variation in articles that reported sample specific reliability coefficients. The results of analyses suggested that the evolution of the scales has improved the consistency of the scores derived, lending more credence to inferences that are based on the scores from the more recent versions of the instrument. Nevertheless, examples of poor to marginal coefficients were observed in some cases.
Myth and Symbol in Nursing Theories
Authors: Pilkington F. Beryl
Published: June 2005

Nursing theories are like myths, in that they contain symbolic representations that tell a story about nursing, and these stories represent or explain nursing’s image, worldview, beliefs, and practices. Five theories are analyzed to identify the myths that they represent. It is proposed that uncovering the myth in nursing theories will help to communicate nursing brands that convey the essence and value of nursing.
Symbols and Ethics: Integrity and the Discipline of Nursing
Authors: Milton Constance L.
Published: June 2005

Symbols give meaning to phenomena coconstituted in the human-universe-health process. There are many common symbols of ethics found in the discipline of nursing. Symbols of ethics may take the form of codes, oaths, pledges, resolutions, or position statements that represent notions of what one ought to do in a discipline or profession. Ethical symbols are intended to guide a particular discipline in practice, research, and education. What is their importance to the discipline of nursing? What are the possible implications of integrity for nursing when viewing the application of ethical symbols from a nursing theoretical perspective?
Influences on Advancement of Nursing Knowledge
Authors: Fawcett Jacqueline , Alligood Martha Raile
Published: June 2005

This column presents a dialogue between Martha Raile Alligood and Jacqueline Fawcett about the factors that have facilitated and factors that have impeded the growth of nursing knowledge, as well as comments on strategies for effective teaching of nursing conceptual models and theories.
Grieving a Loss: The Lived Experience for Elders Residing in an Institution
Authors: Pilkington F. Beryl
Published: June 2005

Grieving a loss is a profound and universal human experience. This phenomenological-hermeneutic study was an inquiry into the lived experience of grieving a loss. The nursing perspective was Parse’s human becoming theory. Participants were 10 elderly persons residing in a long-term care facility. The study finding specifies the structure of the lived experience of grieving a loss as aching solitude amid enduring cherished affiliations, as serene acquiescence arises with sorrowful curtailments. Findings are discussed in relation to the guiding theoretical perspective and related literature. Recommendations for additional research and insights for practice are presented.
Unity of Knowledge in the Advancement of Nursing Knowledge
Authors: Giuliano Karen K. , Tyer-Viola Lynda , Lopez Ruth Palan
Published: June 2005

During the past 20 years, we have witnessed an explosion in nursing knowledge providing the discipline with diverse and multifaceted theoretical frameworks and paradigms. One knowledge theme that pervades the dialogue in the scholarly literature is that of multiple ways of knowing. With the acknowledgement that the fundamental nature of nursing knowledge is grounded in the understanding of human nature and its response to its environment, comes an imperative for a consilience of knowledge. The purpose of this article is to present such a unified worldview by articulating a vision of nursing knowledge, a meaning of unity of knowledge, and a challenge to the discipline to embrace inclusive rather than exclusive ways of knowing.
Orem’s Self-Care Deficit Nursing Theory: Pediatric Asthma as Exemplar
Authors: Cox Karen R. , Taylor Susan G.
Published: June 2005

Asthma is the most frequent reason for preventable hospital admissions among children regardless of race or socioeconomic status. Since hospitalizations are preventable, a reasonable assumption is that parents are not optimally managing their child’s asthma. Using Orem’s self-care deficit nursing theory, 14 conditions were uncovered in the pediatric asthma literature that influence development of competency by parents. Twelve of the 14 antecedent conditions are influenced by factors partly or completely controlled by the healthcare system. Healthcare system gaps associated with asthma symptom control have come to light through the articulation of the pediatric asthma literature and Orem’s theory.
Standing at the Doorway Looking In
Authors: Baumann Steven L.
Published: June 2005

The challenges and opportunities for nurses who work with people from diverse backgrounds are considered. The task for a nurse from the dominant culture working with persons from minority cultures requires patience, sensitivity, humility, and imagination, but it can be well worth the effort for all involved.
Common (Mis)Perceptions About IRB Review of Human Subjects Research
Authors: Lynn Mary R. , Nelson Daniel K.
Published: June 2005

Every researcher who conducts research involving human subjects for their data has experiences with one or more institutional review boards. Some view their institutional review board experiences as helpful; others view them as painful and obstructive. However, there are many misperceptions about institutional review boards and their operation. Some common misperceptions are presented and discussed in an effort to correct false views held by researchers.
Adaptation to Cesarean Birth: Implementation of an International Multisite Study
Authors: Fawcett Jacqueline , Aber Cynthia , Weiss Marianne , Haussler Susan , Myers Sheila Taylor , King Charlette , Newton Jennifer , Silva Virginia
Published: June 2005

The purpose of this column is to describe the implementation of an international multisite Roy adaptation model-based study of women’s perceptions of and responses to cesarean birth. The need for the study arose from the concern that women’s childbearing needs may not be met to their full satisfaction, especially if the infant is born by cesarean. Serendipity and networking played a part in the selection of four study sites in the United States (Boston, Milwaukee, Norfolk, Oklahoma City) and two in other countries (Finland, Australia). Data were collected by nursing students and staff nurses. Post-hoc consideration of the diversity of study sites revealed opportunities for examination of the influence of the contextual stimuli of culture and geographic region on the women’s adaptation to cesarean birth. Strategies used to foster integration of teaching, practice, and research are discussed.
Human Becoming Theory With Children
Authors: Karnick Paula M.
Published: June 2005

As a nurse practitioner, I am often challenged with providing care for children in the traditional medical model. Struggling with these challenges has created new ways of being with patients and their families. Working with children is gratifying, stimulating, and life changing. Living true presence with children as they draw images of their realities gives rise to a powerful interconnectedness that facilitates greater understanding of their meaning about what is important to them as they create new ways of seeing health opportunities. Bearing witness to children as they use art and words to describe their feelings encourages and fosters new ways of becoming for the nurse and the child and the child’s family. This column describes a dialogical-engagement of this nurse practitioner and a young child and how this process transformed the nurse practitioner as she moves to be with children and families in new ways.
Nursing Practice With Aboriginal Communities: Expanding Worldviews
Authors: Arnold Othmar F. , Bruce Anne
Published: June 2005

Through advances in interpretive inquiry, diverse ways of knowing and experiencing reality are increasingly made explicit in nursing literature. Nevertheless, the privileges of empiricism continue alongside a lack of language to consider other realms of reality. In this column, Aboriginal ways of constituting health and reality are explored. Morley’s four categorizations of health belief systems provide a useful tool for understanding diverse worldviews. In contrast, Atleo drew on Nuu-chah-nulth origin stories to address the complexities and ambiguities of Aboriginal health beliefs. Approaches for bridging cultural differences are explored with a view toward inclusive healthcare and nursing practice.
The Experience of the Novice Nurse: A Human Becoming Perspective
Authors: Yancey Nan Russell
Published: June 2005

The well-publicized current shortage of nurses and nurse faculty to teach future generations of nurses intensifies the need to recruit and retain nurses engaged in professional practice. This suggests the importance of being concerned with the quality of the work and professional life of the practicing professional nurse. In this column, the stories of 10 new graduates of baccalaureate nursing programs are explored, illuminating experiences of novice nurses. Themes of the new graduates were identified. The themes are: learning a new culture, sharing a journey, being unsure with changing views, considering the possibilities, and being respected. It is hoped that this column will further the dialogue and promote projects among nurses to explore possibilities in originating new ways of being and becoming in nursing practice.
CD14 C-159T and early infection with Pseudomonas aeruginosa in children with cystic fibrosis
Authors: Martin AC , Laing IA , Zhang G , Brennan S , Winfield K , Sly PD , Stick SM , Goldblatt J , LeSouef PN
Published: June 2005

Early acquisition of Pseudomonas aeruginosa is associated with a poorer prognosis in patients with cystic fibrosis. We investigated whether polymorphisms in CD14, the lipopolysaccharide receptor, increase the risk of early infection. Forty-five children with cystic fibrosis were investigated with annual bronchoalveolar lavage (BAL) and plasma sCD14 levels. Plasma sCD14 levels were significantly lower in children from whom P.aeruginosa was subsequently isolated (492.75 μg/ml vs. 1339.43 μg/ml, p = 0.018). Those with the CD14 -159CC genotype had a significantly increased risk of early infection with P.aeruginosa suggesting that CD14 C-159T plays a role in determining the risk of early infection with P.aeruginosa.
Sequence signature analysis of chromosome identity in three Drosophila species
Authors: Stenberg Per , Pettersson Fredrik , Saura Anja O , Berglund Anders , Larsson Jan
Published: June 2005

Background

All eukaryotic organisms need to distinguish each of their chromosomes. A few protein complexes have been described that recognise entire, specific chromosomes, for instance dosage compensation complexes and the recently discovered autosome-specific Painting of Fourth (POF) protein in Drosophila. However, no sequences have been found that are chromosome-specific and distributed over the entire length of the respective chromosome. Here, we present a new, unbiased, exhaustive computational method that was used to probe three Drosophila genomes for chromosome-specific sequences.

Results

By combining genome annotations and cytological data with multivariate statistics related to three Drosophila genomes we found sequence signatures that distinguish Muller's F-elements (chromosome 4 in D. melanogaster) from all other chromosomes in Drosophila that are not attributable to differences in nucleotide composition, simple sequence repeats or repeated elements. Based on these signatures we identified complex motifs that are strongly overrepresented in the F-elements and found indications that the D. melanogaster motif may be involved in POF-binding to the F-element. In addition, the X-chromosomes of D. melanogaster and D. yakuba can be distinguished from the other chromosomes, albeit to a lesser extent. Surprisingly, the conservation of the F-element sequence signatures extends not only between species separated by approximately 55 Myr, but also linearly along the sequenced part of the F-elements.

Conclusion

Our results suggest that chromosome-distinguishing features are not exclusive to the sex chromosomes, but are also present on at least one autosome (the F-element) in Drosophila.
Immunization of mice with YscF provides protection from Yersinia pestis infections
Authors: Matson Jyl S , Durick Kelly A , Bradley David S , Nilles Matthew L
Published: June 2005

Background

Yersinia pestis, the causative agent of plague, is a pathogen with a tremendous ability to cause harm and panic in populations. Due to the severity of plague and its potential for use as a bioweapon, better preventatives and therapeutics for plague are desirable. Subunit vaccines directed against the F1 capsular antigen and the V antigen (also known as LcrV) of Y. pestis are under development. However, these new vaccine formulations have some possible limitations. The F1 antigen is not required for full virulence of Y. pestis and LcrV has a demonstrated immunosuppressive effect. These limitations could damper the ability of F1/LcrV based vaccines to protect against F1-minus Y. pestis strains and could lead to a high rate of undesired side effects in vaccinated populations. For these reasons, the use of other antigens in a plague vaccine formulation may be advantageous.

Results

Desired features in vaccine candidates would be antigens that are conserved, essential for virulence and accessible to circulating antibody. Several of the proteins required for the construction or function of the type III secretion system (TTSS) complex could be ideal contenders to meet the desired features of a vaccine candidate. Accordingly, the TTSS needle complex protein, YscF, was selected to investigate its potential as a protective antigen. In this study we describe the overexpression, purification and use of YscF as a protective antigen. YscF immunization triggers a robust antibody response to YscF and that antibody response is able to afford significant protection to immunized mice following challenge with Y. pestis. Additionally, evidence is presented that suggests antibody to YscF is likely not protective by blocking the activity of the TTSS.

Conclusion

In this study we investigated YscF, a surface-expressed protein of the Yersinia pestis type III secretion complex, as a protective antigen against experimental plague infection. Immunization of mice with YscF resulted in a high anti-YscF titer and provided protection against i.v. challenge with Y. pestis. This is the first report to our knowledge utilizing a conserved protein from the type III secretion complex of a gram-negative pathogen as a candidate for vaccine development.
Benzodiazepine prescribing behaviour and attitudes: a survey among general practitioners practicing in northern Thailand
Authors: Srisurapanont Manit , Garner Paul , Critchley Julia , Wongpakaran Nahathai
Published: June 2005

Background

Over-prescribing of benzodiazepines appears common in many countries, a better understanding of prescribing practices and attitudes may help develop strategies to reduce prescribing. This study aimed to evaluate benzodiazepine prescribing behaviour and attitudes in general practitioners practising in Chiang Mai and Lampoon, Thailand.

Methods

Questionnaire survey of general practitioners in community hospitals, to estimate: i) use of benzodiazepines for anxiety/insomnia, panic disorder, depression, essential hypertension, and uncomplicated low back pain and ii) views on the optimal duration of benzodiazepine use.

Results

Fifty-five of 100 general practitioners returned the completed questionnaires. They reported use of benzodiazepines for anxiety/insomnia (n = 51, 93%), panic disorder (n = 43, 78%), depression (n = 26, 43%), essential hypertension (n = 15, 27 %) and uncomplicated low back pain (n = 10, 18%). Twenty-eight general practitioners would prescribe benzodiazepines for non-psychiatric conditions, 17 for use as muscle relaxants. Seventy-five per cent, 62% and 29% of the general practitioners agreed or totally agreed with the use of benzodiazepines for insomnia, anxiety and depression, respectively. Practitioners agreed that prescribing should be less than one week (80%); or from 1 week to 1 month (47%); or 1 to 4 months (16%); or 4 to 6 months (5%) or more than 6 months (2%). Twenty-five general practitioners (45%) accepted that they used benzodiazepines excessively in the past year.

Conclusion

A considerable proportion of general practitioners in Chiang Mai and Lampoon, Thailand inappropriately use benzodiazepines for physical illnesses, especially essential hypertension and uncomplicated low back pain. However, almost half of them thought that they overused benzodiazepines. General practitioner's lack of time, knowledge and skills should be taken into account in improving prescribing behaviour and attitudes.
Thresholds for perception of direction of linear acceleration as a possible evaluation of the otolith function
Authors: Kingma H
Published: June 2005

Background

Previous attempts to measure otolith function using ocular counter-rolling have shown poor sensitivity and specificity, thereby hindering a useful clinical application. We have conducted a study to investigate whether thresholds for the perception of the direction of linear acceleration might be an alternative for the clinical evaluation of otolith or statolith function.

Methods

Perception of the direction of motion was evaluated in 28 healthy subjects while all external auditory and visual cues were eliminated. Whole body motion stimulus was generated by a motor driven linear sled at a stimulus frequency of 1 Hz at a linear acceleration ranging from 0 to maximum 40 cm/ s2. Subjects were required to correctly indicate the direction of motion (anterior-posterior or lateral) or whether they were stationary. Both velocity and acceleration thresholds were measured.

Results

The median acceleration thresholds for the perception of direction of linear movement for anterior-posterior movement was 8.5 cm/s2 and for lateral movement 6.5 cm/s2. According to the literature, acceleration thresholds depend on the stimulus profile whereas velocity thresholds do not. The median velocity thresholds for the perception of direction of linear movement for anterior-posterior movement was 13.5 cm/s and for lateral movement was 10.4 cm/s. The median velocity thresholds for the perception of direction of linear movement for anterior-posterior movement increased linearly with age, whereas the median velocity threshold for lateral movement was not correlated with age.

Conclusion

The thresholds found in this study are lower than reported in the literature before which may be due to the repetative predictive sinusoidal stimulus which makes it relatively easy to lower the threshold by learning already within one test prophile.

The variablity is large in line with the previous literature, but our experiments indicate that variability decreases after a training session. We interprete the literature and our current results that linear velocity thresholds after some training might reflect the sensitivity of the otolith system per se.
A randomised controlled trial to explore attitudes to routine scale and polish and compare manual versus ultrasonic scaling in the general dental service in Scotland [ISRCTN99609795]
Authors: Bonner Brian C , Young Linda , Smith Patricia A , McCombes Wendy , Clarkson Jan E
Published: June 2005

Background

To investigate, within general dental practice, patients' and vocational dental practitioners' (VDP) attitudes towards the benefits and costs of a simple scale and polish and to compare the experience of using manual versus ultrasonic instruments to scale teeth.

Methods

28 VDPs and 420 patients participated. Patients were randomly allocated to either group. Patients' and VDPs' attitudes towards, and experience of, the scale and polish were elicited by means of self-administered questionnaires.

Results

The majority of patients (99%) believed a scale and polish was beneficial. VDPs considered ultrasonic treatment to be appropriate on significantly more occasions than they did for manual scale and polish (P < 0.001). Patient discomfort: with ultrasonic scaling 69.2% felt 'a little uncomfortable' or worse compared with 60% of those undergoing manual treatment (P = 0.072). VDPs considered treatment charges were appropriate for 77% of patients.

Conclusion

Routine scaling and polishing is considered beneficial by both patients and vocational trainees. The majority of patients, regardless of treatment method, experience some degree of discomfort when undergoing a scale and polish. VDPs showed a preference for the ultrasonic treatment method.
Hypertensive crisis associated with high dose soy isoflavone supplementation in a post-menopausal woman: a case report [ISRCTN98074661]
Authors: Hutchins Andrea M , McIver Imogene E , Johnston Carol S
Published: June 2005

Background

Isoflavones are gaining popularity as alternatives to hormone replacement therapy. However, few guidelines exist to inform the public as to an appropriate dose. This case involves a postmenopausal woman who experienced a hypertensive crisis while consuming a high-dose isoflavone supplement as part of a research protocol.

Case Presentation

The participant was part of a placebo-controlled crossover trial to investigate the potential synergism of the antioxidant activity of soy isoflavones and vitamin C. Upon entry into the study, this healthy, well-nourished, normotensive postmenopausal woman (51 years old), consumed the first of four randomly assigned treatments (500 mg vitamin C plus 5 mg/kg body weight soy isoflavones). During this treatment, the participant's systolic blood pressure spiked to a recorded 226/117 mmHg, necessitating medical intervention and discontinuation of study participation. Two plausible mechanisms for this hypertensive crisis are discussed.

Conclusion

Due to the availability and increasing popularity of soy supplements, practitioners should be aware of the potential side effects associated with their use. Practitioners counseling clients who are consuming soy isoflavone supplements should advise them that elevated blood pressure may be a potential side-effect to consider and monitor.
Huge parathyroid carcinoma: Clinical considerations and literature review
Authors: Chiofalo Maria Grazia , Scognamiglio Francesco , Losito Simona , Lastoria Secondo , Marone Ugo , Pezzullo Luciano
Published: June 2005

Background

Parathyroid carcinoma is a rare malignancy, with an incidence of 0.5 to 4% of all cases of primary hyperparathyroidism. Surgery is the only curative treatment.

Case presentation

We report the case of a 66-year-old man referred for a large suspicious substernal goitre associated with severe hypercalcemia due to hyperparathyroidism. After normalization of serum calcium levels, patient underwent surgery. The voluminous cervicomediastinal firm mass could not be removed through the cervical incision; therefore a cervicothoracic approach was employed. Histopathology revealed a giant parathyroid cancer of 450 grams. A review of the literature was also undertaken to summarize the current treatment approaches for this rare malignancy.

Conclusion

Parathyroid cancer is usually not recognized either preoperatively or intra-operatively.En blocresection of the tumour with the adjacent tissue is the treatment of choice and it is very important to avoid the rupture of the capsule during operation. Neither tumour size, nor the lymph node status appears to play a role in prognosis. The management of parathyroid carcinoma is a challenge even for experienced surgeons.
Transhiatal and transthoracic resection in adenocarcinoma of the esophagus: Does the operative approach have an influence on the long-term prognosis?
Authors: Gockel Ines , Heckhoff Sina , Messow Claudia M , Kneist Werner , Junginger Theodor
Published: June 2005

Background

The goal of the present analysis was to investigate the long-term prognosis for adenocarcinoma of the esophagus treated with either the transhiatal (TH) or the transthoracic (TT) operative approach.

Methods

Between September 1985 and March 2004, esophageal resection due to carcinoma was performed on a total of 424 patients. This manuscript takes into account the 150 patients suffering from adenocarcinoma of the esophagus in whom a transhiatal resection of the esophagus was performed. In the event of transmural tumor growth and a justifiable risk of surgery, the transthoracic resection was selected. An extended mediastinal lymph node dissection, however, was only carried out in the course of the transthoracic approach.

Results

The transthoracic resection of the esophagus demonstrated a higher rate of general complications (p = 0.011) as well as a higher mortality rate (p = 0.011). The mediastinal dissection of the lymph nodes, however, revealed no prognostic influence. Considering all of the 150 patients with adenocarcinoma, as well as only those patients who had undergone curative resections (R0), the transhiatal approach was seen to demonstrate a better five-year survival rate of 32.1% versus 35.1%, with a median survival time of 24 versus 28 months, as compared with those who had undergone a transthoracic approach with a five-year survival rate of 13.6% (all patients) versus 17.7% (R0 resection) with a median survival time of 16 versus 17 months (p < 0.05).

Conclusion

The prognosis in patients with adenocarcinoma of the esophagus is influenced by the depth of the tumor (pT) and the pM-category, as shown in the multivariate analysis. The present analysis did not demonstrate a relevant difference in survival for patients with N0 and N1 stages undergoing transhiatal or transthoracic esophagectomy. It is questionable, if a more extensive mediastinal lymph node dissection, in addition to the clearance of abdominal lymph nodes, offers prognostic advantages in adenocarcinoma of the esophagus. However, the morbidity and mortality associated with the transthoracic approach is higher.
Age-related human small intestine methylation: evidence for stem cell niches
Authors: Kim Jung Yeon , Siegmund Kimberly D , Tavaré Simon , Shibata Darryl
Published: June 2005

Background

The small intestine is constructed of many crypts and villi, and mouse studies suggest that each crypt contains multiple stem cells. Very little is known about human small intestines because mouse fate mapping strategies are impractical in humans. However, it is theoretically possible that stem cell histories are inherently written within their genomes. Genomes appear to record histories (as exemplified by use of molecular clocks), and therefore it may be possible to reconstruct somatic cell dynamics from somatic cell errors. Recent human colon studies suggest that random somatic epigenetic errors record stem cell histories (ancestry and total numbers of divisions). Potentially age-related methylation also occurs in human small intestines, which would allow characterization of their stem cells and comparisons with the colon.

Methods

Methylation patterns in individual crypts from 13 small intestines (17 to 78 years old) were measured by bisulfite sequencing. The methylation patterns were analyzed by a quantitative model to distinguish between immortal or niche stem cell lineages.

Results

Age-related methylation was observed in the human small intestines. Crypt methylation patterns were more consistent with stem cell niches than immortal stem cell lineages. Human large and small intestine crypt niches appeared to have similar stem cell dynamics, but relatively less methylation accumulated with age in the small intestines. There were no apparent stem cell differences between the duodenum and ileum, and stem cell survival did not appear to decline with aging.

Conclusion

Crypt niches containing multiple stem cells appear to maintain human small intestines. Crypt niches appear similar in the colon and small intestine, and the small intestinal stem cell mitotic rate is the same as or perhaps slower than that of the colon. Although further studies are needed, age-related methylation appears to record somatic cell histories, and a somatic epigenetic molecular clock strategy may potentially be applied to other human tissues to reconstruct otherwise occult stem cell histories.
The influence of long chain polyunsaturate supplementation on docosahexaenoic acid and arachidonic acid in baboon neonate central nervous system
Authors: Diau Guan-Yeu , Hsieh Andrea T , Sarkadi-Nagy Eszter A , Wijendran Vasuki , Nathanielsz Peter W , Brenna J Thomas
Published: June 2005

Background

Docosahexaenoic acid (DHA) and arachidonic acid (ARA) are major components of the cerebral cortex and visual system, where they play a critical role in neural development. We quantitatively mapped fatty acids in 26 regions of the four-week-old breastfed baboon CNS, and studied the influence of dietary DHA and ARA supplementation and prematurity on CNS DHA and ARA concentrations.

Methods

Baboons were randomized into a breastfed (B) and four formula-fed groups: term, no DHA/ARA (T-); term, DHA/ARA supplemented (T+); preterm, no DHA/ARA (P-); preterm and DHA/ARA supplemented (P+). At four weeks adjusted age, brains were dissected and total fatty acids analyzed by gas chromatography and mass spectrometry.

Results

DHA and ARA are rich in many more structures than previously reported. They are most concentrated in structures local to the brain stem and diencephalon, particularly the basal ganglia, limbic regions, thalamus and midbrain, and comparatively lower in white matter. Dietary supplementation increased DHA in all structures but had little influence on ARA concentrations. Supplementation restored DHA concentrations to levels of breastfed neonates in all regions except the cerebral cortex and cerebellum. Prematurity per se did not exert a strong influence on DHA or ARA concentrations.

Conclusion

1) DHA and ARA are found in high concentration throughout the primate CNS, particularly in gray matter such as basal ganglia; 2) DHA concentrations drop across most CNS structures in neonates consuming formulas with no DHA, but ARA levels are relatively immune to ARA in the diet; 3) supplementation of infant formula is effective at restoring DHA concentration in structures other than the cerebral cortex. These results will be useful as a guide to future investigations of CNS function in the absence of dietary DHA and ARA.
Are chronic low back pain outcomes improved with co-management of concurrent depression?
Authors: Middleton Peter , Pollard Henry
Published: June 2005

Objective

To discuss the role of depression in chronic lower back pain and comment on appropriate methods of screening and co-management.

Data Sources

The current scientific literature was investigated using the online web databases CINAHL, Medline/PUBMED, Proquest, Meditext and from manual library searches.

Data Extraction

Databases were searched from 1980 to the present (2005). Articles were searched with the key words "depression" and "low back pain". Over three hundred articles were sourced and articles were then selected on their relevance to the chronic spinal pain states that present to manual therapy practitioners.

Data synthesis

Pain is a subjective awareness of peripheral nociceptive stimulation, projected from the thalamus to the cerebral cortex with each individual's pain experience being mediated by his or her psychological state. Thus a psychological component will often be associated with any painful experience. A number of studies suggest (among other things) that the incidence of depression predicts chronicity in lower back pain syndromes but that chronic lower back pain does not have the reciprocal action to predict depression.

Conclusion

The aetiology of chronic pain is multifactorial. There is sufficient evidence in the literature to demonstrate a requirement to draw treatment options from many sources in order to achieve a favourable pain relief outcome. The treatment should be multimodal, including mental and emotional support, counseling and herbal advice. While a strong correlation between depression and chronic low back pain can be demonstrated, an apparent paucity of literature that specifically addresses the patient response to chiropractic treatment and concurrent psychotherapy identifies the need for prospective studies of this nature to be undertaken. It is likely that multimodal/multidisciplinary treatment approaches should be encouraged to deal with these chronic lower back pain syndromes.