bluuebunny/crossref_metadata_2025 huggingface dataset:
Fusion protein consisting of the first immunoglobulin‐like domain of porcine nectin‐1 and Fc portion of human IgG1 provides a marked resistance against pseudorabies virus infection to transgenic mice
Authors: Tomioka Yukiko , Morimatsu Masami , Amagai Keiko , Kuramochi Minako , Watanabe Yuki , Kouda Shigeto , Wada Toshio , Kuboki Noritaka , Ono Etsuro
Published: January 2009

Nectin‐1 is a Ca2+‐independent Ig‐like cell–cell adhesion molecule and an alphaherpesvirus receptor that binds to virion glycoprotein D by the first Ig‐like domain. We have investigated the antiviral potentials of soluble forms of porcine nectin‐1 to PRV infection by generating transgenic mice expressing different types of fusion protein. Previously, we reported that mice transgenic for a chimera that carried the entire ectodomain of porcine nectin‐1 fused to the Fc portion of porcine IgG1 were more resistant than those transgenic for a chimera that carried the first Ig‐like domain fused to the Fc portion. Recently, we generated transgenic mice expressing a fusion protein made of the first Ig‐like domain fused to the Fc portion of human IgG1, and reported that they showed a microphthalmia. Here, two transgenic mouse lines expressing the fusion protein were challenged with PRV for comparing their resistances with those of transgenic mice expressing different types of fusion protein. Surprisingly, both transgenic mouse lines showed a high resistance to the viral infection, especially via the i.n. route. Significant resistance of the embryonic fibroblasts was also observed. Altogether, these findings indicated that the fusion protein consisting of the first Ig‐like domain fused to the human Fc portion provided a marked resistance against PRV infection to the transgenic mice.
Genetic stability (in vivo) of the attenuated oral rabies virus vaccine SAD B19
Authors: Beckert Aline , Geue Lutz , Vos Ad , Neubert Andreas , Freuling Conrad , Müller Thomas
Published: January 2009

The distribution of oral rabies vaccine baits containing replication‐competent live viruses poses certain environmental safety risks; among others, the possibility of reversion to or an increase in virulence. Hence, the genetic stability of the complete genome of the most widely used oral rabies vaccine virus, SAD B19, was examined after four and 10 serial i.c. passages in foxes and mice, respectively. It was shown that the consensus strain of SAD B19 was extremely stable in vivo. After 10 consecutive passages in mice not a single mutation was observed. In foxes, seven single nucleotide exchanges were found between the first and fourth passage, of which only one resulted in an amino acid exchange at position 9240 of the L‐gene. This mutation was not observed during the first three passages and, furthermore, it was shown that this mutation was not linked to enhanced virulence.
Non‐human primate surrogate model of hepatitis C virus infection
Authors: Akari Hirofumi , Iwasaki Yuki , Yoshida Tomoyuki , Iijima Sayuki
Published: January 2009

More than 170 million people worldwide are chronically infected by HCV, which is the causative agent of chronic hepatitis C, cirrhosis, and finally liver cancer. Although animal models of viral hepatitis are a prerequisite for the evaluation of antiviral and vaccine efficacy, the restricted host range of HCV has hampered the development of a suitable small animal model of HCV infection. Use of the chimpanzee, the only animal known to be susceptible to HCV infection, is limited by ethical and financial restrictions. In this regard GBV‐B, being closely related to HCV, appears to be a promising non‐human surrogate model for the study of HCV infection. This review describes the characteristic of GBV‐B infection of New World monkeys, and discusses current issues concerning the GBV‐B model and its future directions.
Multiplex real‐time PCR for the simultaneous detection of herpes simplex virus, human herpesvirus 6, and human herpesvirus 7
Authors: Wada Kaoru , Mizoguchi Sachiko , Ito Yoshinori , Kawada Jun‐ichi , Yamauchi Yohei , Morishima Tsuneo , Nishiyama Yukihiro , Kimura Hiroshi
Published: January 2009

A simultaneous detection system to quantify HSV, HHV‐6, and HHV‐7 DNA via multiplex real‐time PCR using different fluorochromes was developed. The minimum quantitative level established via this multiplex assay was four copies per reaction for HSV type 1, four copies for HHV‐6, and three copies for HHV‐7, respectively. The dynamic range encompassed at least six orders of magnitude. The system was specific and reproducible even in the presence of large amounts of other viral DNA. We then applied this multiplex real‐time PCR assay to 105 CSF specimens obtained from subjects less than 15 years old in whom a diagnosis of viral encephalitis/encephalopathy was suspected on clinical grounds. The detection rate for each viral DNA was 6.7% for HSV, 9.5% for HHV‐6, and 1.9% for HHV‐7. These results indicate that our system is reliable and may be useful for the rapid diagnosis of viral encephalitis/encephalopathy.
Modeling mood variation associated with smoking: an application of a heterogeneous mixed‐effects model for analysis of ecological momentary assessment (EMA) data
Authors: Hedeker Donald , Mermelstein Robin J. , Berbaum Michael L. , Campbell Richard T.
Published: January 2009

Aims Mixed models are used increasingly for analysis of ecological momentary assessment (EMA) data. The variance parameters of the random effects, which indicate the degree of heterogeneity in the population of subjects, are considered usually to be homogeneous across subjects. Modeling these variances can shed light on interesting hypotheses in substance abuse research.

Design We describe how these variances can be modeled in terms of covariates to examine the covariate effects on between‐subjects variation, focusing on positive and negative mood and the degree to which these moods change as a function of smoking.

Setting The data are drawn from an EMA study of adolescent smoking.

Participants Participants were 234 adolescents, either in 9th or 10th grades, who provided EMA mood reports from both random prompts and following smoking events.

Measurements We focused on two mood outcomes: measures of the subject's negative and positive affect and several covariates: gender, grade, negative mood regulation and smoking level.

Findings and conclusions Following smoking, adolescents experienced higher positive affect and lower negative affect than they did at random, non‐smoking times. Our analyses also indicated an increased consistency of subjective mood responses as smoking experience increased and a diminishing of mood change.
A comparison of the effectiveness of group‐based and pharmacy‐led smoking cessation treatment in Glasgow
Authors: Bauld Linda , Chesterman John , Ferguson Janet , Judge Ken
Published: January 2009

Aim  To compare the characteristics and outcomes of users accessing pharmacy and group‐based smoking treatment.

Design  Observational study of administrative information linked with survey data.

Setting  Glasgow, Scotland.

Participants  A total of 1785 service users who set a quit date between March and May 2007.

Intervention  Smoking treatment services based in pharmacies providing one‐to‐one support, and in the community offering group support.

Measurements  Routine monitoring data included information about basic demographic characteristics, deprivation category of residence, nature of intervention and smoking status at 4‐week follow‐up determined by carbon monoxide (CO) readings ≤10. These data were supplemented by information about socio‐economic status and smoking‐related behaviours obtained from consenting service recipients by treatment advisers.

Findings  In the pharmacy‐based service 18.6 % of users (n = 1374) were CO‐validated as a quitter at 4 weeks, compared with 35.5 % (n = 411) in the group‐based service. In a multivariate model, restricted to participants (n = 1366) with data allowing adjustment for socio‐demographic and behavioural characteristics and including interaction terms, users who accessed the group‐based services were almost twice as likely (odds ratio 1.980; confidence interval 1.50–2.62) as those who used pharmacy‐based support to have quit smoking at 4‐week follow‐up.

Conclusions  Specialist‐led group‐based services appear to have higher quit rates than one‐to‐one services provided by pharmacies but the pharmacy services treat many more smokers. More research is needed to determine what can be done to bring the success rates of pharmacy services up to those of specialist‐led groups and how to expand access to group‐based services.
Problematic heroin use incidence trends in Spain
Authors: Sánchez‐Niubò Albert , Fortiana Josep , Barrio Gregorio , Suelves Josep Maria , Correa Juan Francisco , Domingo‐Salvany Antònia
Published: January 2009

Aims  To estimate the annual incidence of heroin use in Spain.

Participants and design  Data on individuals' year of first heroin use (from 1971 to 2005), year of first heroin treatment between 1991 and 2005 and most frequent route of heroin administration when presenting to treatment were obtained from the Spanish Drug Observatory Register and used to calculate the delay between onset and treatment. By using a log‐linear model approach it was possible to correct for missing observations (heroin users who presented for treatment before 1991 and those who had still not presented by the end of 2005) and to estimate heroin incidence over time.

Findings  The estimated incidence of problematic heroin use in the population aged 15–44 peaked at 190 per 100 000 in 1980—after rising rapidly from less than 40 per 100 000 in 1971—and fell subsequently to about 8 per 100 000 in 2005. On average, incidence was five times higher in men. Injecting heroin incidence peaked and declined rapidly from 1980; as heroin smoking did not decline as rapidly, from 1985 onwards its estimated incidence has remained above that of heroin injecting. The delay between starting heroin use and entering treatment had a median of 3 years.

Conclusions  We demonstrate the utility of a method to estimate heroin incidence from analysis of observed trends in presentations at specialist drug treatment facilities. The estimates suggest that incidence of heroin use, especially injecting, has fallen since 1980 and is now lower than in the early 1970s.
A randomized controlled trial of adding the nicotine patch to rimonabant for smoking cessation: efficacy, safety and weight gain
Authors: Rigotti Nancy A. , Gonzales David , Dale Lowell C. , Lawrence Daniel , Chang Yuchiao
Published: January 2009

Aims Because smoking cessation rates might be improved by combining drugs and by reducing post‐cessation weight gain, we tested the smoking cessation efficacy, safety and effect on body weight of adding the nicotine patch to rimonabant, a cannabanoid type‐1 receptor antagonist that reduces body weight.

Design Randomized double‐blind placebo‐controlled trial.

Setting Fifteen US research centers.

Participants A total of 755 smokers (≥15 cigarettes/day).

Intervention Rimonabant (20 mg daily) was given open‐label for 9 weeks. The 735 participants completing week 1 were randomized at day 8 (target quit day) to add a nicotine patch (n = 369) or placebo patch (n = 366) for 10 weeks (21 mg daily for 8 weeks plus a 2‐week taper). Participants received weekly smoking counseling and were followed for 24 weeks.

Measurements Biochemically validated 4‐week continuous abstinence at end‐of‐treatment (weeks 6–9; primary end‐point); 7‐day point prevalence abstinence at weeks 9 and 24; sustained abstinence (weeks 6–24); change in body weight; and adverse events.

Findings Rimonabant plus nicotine patch was superior to rimonabant plus placebo in validated continuous abstinence at weeks 6–9 (39.0% versus 21.3%; odds ratio 2.36, 95% confidence interval: 1.71–2.37;P < 0.01) and in all other efficacy measures. Mean end‐of‐treatment weight gain among quitters did not differ between groups (0.04 kg for combination versus 0.49 kg for rimonabant only,P = 0.15) and was similar in weight‐concerned smokers. Serious adverse event rates did not differ between groups. Depression‐ and anxiety‐related adverse events occurred in 32 (4.2%) and 44 (5.8%) subjects, respectively; eight (1.1%) and nine (1.2%) subjects stopped the drug due to depression and anxiety, respectively.

Conclusions Adding a nicotine patch to rimonabant was well tolerated and increased smoking cessation rates over rimonabant alone. There was little post‐cessation weight gain in either group, even among weight‐concerned smokers, during drug treatment.
Buprenorphine tapering schedule and illicit opioid use
Authors: Ling Walter , Hillhouse Maureen , Domier Catherine , Doraimani Geetha , Hunter Jeremy , Thomas Christie , Jenkins Jessica , Hasson Albert , Annon Jeffrey , Saxon Andrew , Selzer Jeffrey , Boverman Joshua , Bilangi Richard
Published: January 2009

Aims To compare the effects of a short or long taper schedule after buprenorphine stabilization on participant outcomes as measured by opioid‐free urine tests at the end of each taper period.

Design This multi‐site study sponsored by Clinical Trials Network (CTN, a branch of the US National Institute on Drug Abuse) was conducted from 2003 to 2005 to compare two taper conditions (7 days and 28 days). Data were collected at weekly clinic visits to the end of the taper periods, and at 1‐month and 3‐month post‐taper follow‐up visits.

Setting Eleven out‐patient treatment programs in 10 US cities.

Intervention Non‐blinded dosing with Suboxone® during the 1‐month stabilization phase included 3 weeks of flexible dosing as determined appropriate by the study physicians. A fixed dose was required for the final week before beginning the taper phase.

Measurements The percentage of participants in each taper group providing urine samples free of illicit opioids at the end of the taper and at follow‐up.

Findings At the end of the taper, 44% of the 7‐day taper group (n = 255) provided opioid‐free urine specimens compared to 30% of the 28‐day taper group (n = 261;P = 0.0007). There were no differences at the 1‐month and 3‐month follow‐ups (7‐day = 18% and 12%; 28‐day = 18% and 13%, 1 month and 3 months, respectively).

Conclusion For individuals terminating buprenorphine pharmacotherapy for opioid dependence, there appears to be no advantage in prolonging the duration of taper.
The humanized CD40 antibody SGN‐40 demonstrates pre‐clinical activity that is enhanced by lenalidomide in chronic lymphocytic leukaemia
Authors: Lapalombella Rosa , Gowda Aruna , Joshi Trupti , Mehter Najma , Cheney Carolyn , Lehman Amy , Chen Ching‐Shih , Johnson Amy J. , Caligiuri Michael A. , Tridandapani Susheela , Muthusamy Natarajan , Byrd John C.
Published: January 2009

Antibody‐based therapies, such as rituximab and alemtuzumab, have contributed significantly to the treatment of Chronic Lymphocytic leukaemia (CLL). The CD40 antigen is expressed predominantly on B‐cells and represents a potential target for immune‐based therapies. SGN‐40 is a humanized IgG1 monoclonal antibody currently in Phase I/II clinical trials for indolent lymphomas, diffuse large B cell lymphomas and Multiple Myeloma. Its biological effect on CLL cells has not been studied. The present study demonstrated that SGN‐40 mediated modest apoptosis in a subset of patients with secondary cross‐linking but did not mediate complement‐dependent cytotoxicity. SGN‐40 also mediated antibody‐dependent cellular cytotoxicity (ADCC) predominantly through natural killer (NK) cells. Previous studies by our group and others have demonstrated that lenalidomide upregulates CD40 expression on primary B CLL cells and activates NK‐cells. We therefore examined for the combinatorial effect of lenalidomide and SGN‐40 and demonstrated that both enhanced direct apoptosis and ADCC against primary CLL B cells. These data together provide justification for clinical trials of SGN‐40 and lenalidomide in combination for CLL therapy.
O‐Mannosylation is required for the solubilization of heterologously expressed human β‐amyloid precursor protein in Saccharomyces cerevisiae
Authors: Murakami‐Sekimata Akiko , Sato Ken , Sato Ken , Takashima Akihiko , Nakano Akihiko
Published: January 2009

In an attempt to express human β‐amyloid precursor protein (APP) in yeast, we fortuitously found that this protein is only O‐glycosylated in yeast. APP was effectively expressed in yeast, processed by yeast α‐secretases, members of the Yapsin family, to produce N‐terminal (sAPPα) and C‐terminal (CTFα) domains, when its signal sequence was replaced by that of the yeast α‐mating factor. APP is known to acquire N‐ and O‐glycosylation through the endoplasmic reticulum (ER) and the Golgi apparatus and is transported to the plasma membrane in mammalian cells. In spite of the presence of canonical N‐glycosylation consensus sequences, APP was not N‐glycosylated in the yeast system. Pulse‐chase experiments demonstrated that APP received only O‐mannosylation in yeast. Examination of yeast pmt mutants, which are defective in the initiation of O‐mannosylation in the ER, revealed that Pmt4p is most responsible for the oligosaccharide modification of APP. Maturation of APP was slowed down and aggregated forms of APP were observed by sucrose density gradient fractionation of the Δpmt4 mutant lysate. This caused decreased production of CTFα. We conclude that O‐mannosylation is required for the solubilization of exogenously expressed human APP.
Activities of Escherichia coli ribosomes in IF3 and RMF change to prepare 100S ribosome formation on entering the stationary growth phase
Authors: Yoshida Hideji , Ueta Masami , Maki Yasushi , Sakai Akiko , Wada Akira
Published: January 2009

The canonical ribosome cycle in bacteria consists of initiation, elongation, termination, and recycling stages. After the recycling stage, initiation factor 3 (IF3) stabilizes ribosomal dissociation by binding to 30S subunits for the next round of translation. On the other hand, during the stationary growth phase, it has been elucidated that Escherichia coli ribosomes are dimerized (100S ribosome formation) by binding ribosome modulation factor (RMF) and hibernation promoting factor (HPF), leading to a hibernation stage. This indicates that 100S ribosomes are formed after these factors are scrambled for ribosomes concomitantly with transition from the log phase to the stationary phase. In this study, to elucidate the ribosomal events before 100S ribosome formation, the relationships between protein factors (RMF and HPF) involved in 100S ribosome formation and IF3 involved in initiation complex formation were examined. As a result of in vitro assays, it was found that ribosomal dissociation activity by IF3 fell, and that ribosomal dimerization activity by RMF and HPF was elevated more when using stationary‐phase ribosomes than when using log‐phase ribosomes. This suggests that ribosomes change into forms which are hard to bind with IF3 and easy to form 100S ribosomes by RMF and HPF concomitantly with transition from the log phase to the stationary phase.
Treeline shifts in the Ural mountains affect soil organic matter dynamics
Authors: KAMMER ADRIAN , HAGEDORN FRANK , SHEVCHENKO ILYA , LEIFELD JENS , GUGGENBERGER GEORG , GORYACHEVA TAMARA , RIGLING ANDREAS , MOISEEV PAVEL
Published: January 2009

Historical photographs document that during the last century, forests have expanded upwards by 60–80 m into former tundra of the pristine Ural mountains. We assessed how the shift of the high‐altitude treeline ecotone might affect soil organic matter (SOM) dynamics. On the gentle slopes of Mali Iremel in the Southern Urals, we (1) determined the differences in SOM stocks and properties from the tundra at 1360 m above sea level (a.s.l.) to the subalpine forest at 1260 m a.s.l., and (2) measured carbon (C) and nitrogen (N) mineralization from tundra and forest soils at 7 and 20 °C in a 6‐month incubation experiment. C stocks of organic layers were 3.6±0.3 kg C m−2 in the tundra and 1.9±0.2 kg C m−2 in the forest. Mineral soils down to the bedrock stored significantly more C in the forest, and thus, total soil C stocks were slightly but insignificantly greater in the forest (+3 kg C m−2). Assuming a space for time approach based on tree ages suggests that the soil C sink due to the forest expansion during the last century was at most 30 g C m−2 yr−1. Diffuse reflective infrared spectroscopy and scanning calorimetry revealed that SOM under forest was less humified in both organic and mineral horizons and, therefore, contained more available substrate. Consistent with this result, C mineralization rates of organic layers and A horizons of the forest were two to four times greater than those of tundra soils. This difference was similar in magnitude to the effect of increasing the incubation temperature from 7 to 20 °C. Hence, indirect climate change effects through an upward expansion of forests can be much larger than direct warming effects (Δ0.3 K across the treeline). Net N mineralization was 2.5 to six times greater in forest than in tundra soils, suggesting that an advancing treeline likely increases N availability. This may provide a nutritional basis for the fivefold increase in plant biomass and a tripling in productivity from the tundra to the forest. In summary, our results suggest that an upward expansion of forest has small net effects on C storage in soils but leads to changes in SOM quality, accelerates C cycling and increases net N mineralization, which in turn might stimulate plant growth and thus C sequestration in tree biomass.
The role of climate in the dynamics of a hybrid zone in Appalachian salamanders
Authors: WALLS SUSAN C.
Published: January 2009

I examined the potential influence of climate change on the dynamics of a previously studied hybrid zone between a pair of terrestrial salamanders at the Coweeta Hydrologic Laboratory, U.S. Forest Service, in the Nantahala Mountains of North Carolina, USA. A 16‐year study led by Nelson G. Hairston, Sr. revealed thatPlethodon teyahaleeandPlethodon shermanihybridized at intermediate elevations, forming a cline between ‘pure’ parentalP. teyahaleeat lower elevations and ‘pure’ parentalP. shermaniat higher elevations. From 1974 to 1990 the proportion of salamanders at the higher elevation scored as ‘pure’P. shermanideclined significantly, indicating that the hybrid zone was spreading upward. To date there have been no rigorous tests of hypotheses for the movement of this hybrid zone. Using temperature and precipitation data from Coweeta, I re‐analyzed Hairston's data to examine whether the observed elevational shift was correlated with variation in either air temperature or precipitation from the same time period. For temperature, my analysis tracked the results of the original study: the proportion of ‘pure’P. shermaniat the higher elevation declined significantly with increasing mean annual temperature, whereas the proportion of ‘pure’P. teyahaleeat lower elevations did not. There was no discernable relationship between proportions of ‘pure’ individuals of either species with variation in precipitation. From 1974 to 1990, low‐elevation air temperatures at the Coweeta Laboratory ranged from annual means of 11.8 to 14.2 °C, compared with a 55‐year average (1936–1990) of 12.6 °C. My re‐analyses indicate that the upward spread of the hybrid zone is correlated with increasing air temperatures, but not precipitation, and provide an empirical test of a hypothesis for one factor that may have influenced this movement. My results aid in understanding the potential impact that climate change may have on the ecology and evolution of terrestrial salamanders in montane regions.
Clinical evaluation after 1 year of 153‐samarium hydroxyapatite synovectomy in patients with haemophilic arthropathy
Authors: CALEGARO J. U. , MACHADO J. , DE PAULA J. C. , DE ALMEIDA J. S. C. , CASULARI L. A.
Published: January 2009

Summary.  The aim is to evaluate the efficiency of the treatment with 153‐samarium hydroxyapatite (153‐Sm‐HA) in haemophilic arthropathy. Thirty‐one patients (30 males) with ages ranging from 8 to 34 years (average age = 20.6 years) were treated with fixed intra‐articular dose of 185 MBq (5 mCi) and divided into two groups: infantile‐juvenile (13 patients with up to 18 years of age, an average age of 12.7 years and arthropathy evolution of 7.8 years), and adult (18 patients older than 18 years, an average age of 24 years and arthropathy evolution of 18.7 years). The clinical evaluation before and after 1 year of synovectomy used the following criteria: subjective (pain through visual scale, articulation inspection), objective (articular movement through flexion level, sensitivity to palpation and leakage through joint circumference), reduction on the use of the coagulation factor, number of haemarthrosis, and the occurrence of adverse effects. The results were classified as: 1, good (remission from 70% to 100% of manifestations); 2, moderate (remission from 40% to 69%); and 3, poor (remission from 0% to 39%). Seventy‐eight joints were tested: 15 knees, 36 elbows, 24 ankles, 1 shoulder and 2 hips. Early scintigraphic (1–2 h) and late scintigraphic (24–72 h) studies were performed after synoviorthesis. The cost of the procedure per joint was also estimated. No significant difference in the synoviorthesis result between groups was observed. The results were good for 75% of elbows, 87.5% of ankles and 40% of knees; the reduction in haemarthrosis and use of the coagulation factor was respectively 78% and 80% for elbows, 82% and 85% for ankles and 30% and 35% for knees. Four cases of reactional synovitis were observed in the 31 patients. The scintigraphic control showed homogeneous distribution of the material with no articular escape. The use of 153 Sm‐HA in the treatment of the haemophilic arthropathy is effective for intermediate‐size joints (elbows and ankles), but less effective for knees. Moreover, this treatment presents an excellent safety profile and accessible cost.
Cardiac surgery in patients with haemophilia B: a case report and review of the literature
Authors: KRAKOW E. F. , WALKER I. , LAMY A. , ANDERSON J. A. M.
Published: January 2009

Summary.  Cardiac surgery for coronary heart disease, and for calcific and degenerative valvular heart disease, will likely become more frequent with an ageing haemophilia population. Our report describes the successful management of an individual with mild haemophilia B undergoing elective aortic valve replacement using a continuous infusion of recombinant factor IX. Emphasis is placed on the multidisciplinary coordination of care required across three hospital sites to ensure an uncomplicated peri‐ and postoperative course. We also provide a review of the current literature on cardiac surgery in patients with haemophilia B.
A web‐based clinical record ‘xl’Emofilia®’ for outpatients with haemophilia and allied disorders in the Region of Emilia‐Romagna: features and pilot use
Authors: PATTACINI C. , RIVOLTA G. F. , DI PERNA C. , RICCARDI F. , TAGLIAFERRI A. ,   ON BEHALF OF HAEMOPHILIA CENTRES NETWORK OF EMILIA‐ROMAGNA REGION
Published: January 2009

Summary.  The treatment of haemophilia in developed countries is based on home self‐infusion of concentrates. Improving communication between haemophilia centres (HC) and patients is very important. The Hub Centre (Parma) designed a new outpatient clinical record, ‘xl’Emofilia®’, as part of a project ‘Web Connections of the Region’s HC’ funded by Emilia‐Romagna Health Authority. It is a web‐based application suited to the needs of HC, which shares the databases of the region’s HC, integrated with regional and national registries that can be accessed from anywhere. Data are managed with the ‘https’ protocol. Significant innovations are ‘pathways’ that help with the entry of data and ‘problem list’, which is a summary (updated automatically) of the patient’s clinically significant data that can be consulted at a glance. With a ‘web identity’ (a personal USB key for secure web access), patients can record bleeds and home infusions, consult their own data and allow access to their general practitioners or in emergency departments anywhere in the world (also in English language). In December 2006, the HC started to use ‘xl’Emofilia®’ and 673 clinical records are now active. Since April 2007, 50 pilot patients have been trained and are successfully using the system. A questionnaire administered to these patients on their level of satisfaction with the system and its ease of use gave excellent results. Our web‐based system facilitates communication between patients and HC, improves the quality of care and enables patients to use these information at any time and from anywhere in the world.
Nurse practitioners substituting for general practitioners: randomized controlled trial
Authors: Dierick‐van Daele Angelique T.M. , Metsemakers Job F.M. , Derckx Emmy W.C.C. , Spreeuwenberg Cor , Vrijhoef Hubertus J.M.
Published: January 2009

Title.  Nurse practitioners substituting for general practitioners: randomized controlled trial.

Aim.  This paper is a report of a study conducted to evaluate process and outcomes of care provided to patients with common complaints by general practitioners or specially trained nurse practitioners as first point of contact.

Background.  Studies in the United States of America and Great Britain show that substituting nurse practitioners for general practitioners results in higher patient satisfaction and higher quality of care. As the American and British healthcare system and settings differ from that in the Netherlands, a Dutch trial was conducted.

Methods.  A total of 1501 patients in 15 general practices were randomized to consultation by a general practitioner or a nurse practitioner. Data were collected over a 6‐month period in 2006 by means of questionnaires, extracting medical records from practice computer systems and recording the length of consultations.

Findings.  In both groups, the patients highly appreciated the quality of care. No statistically significant differences were found in health status, medical resource consumption and compliance of practical guidelines in primary care in the Netherlands. Patients in the NP intervention group were more often invited to re‐attend, had more follow‐up consultations and their consultations took statistically significantly longer.

Conclusion.  Nurse practitioners and general practitioners provide comparable care. Our findings support an increased involvement of specially trained nurse practitioners in the Dutch primary care and contribute to knowledge of the effectiveness of care provision by nurse practitioners from a national and international perspective.
Jordanian nurses’ knowledge and practice of breast self‐examination
Authors: Alkhasawneh Israa M. , Akhu‐Zaheya Laila M. , Suleiman Samah M.
Published: January 2009

Title.  Jordanian nurses’ knowledge and practice of breast self‐examination.

Aim.  This paper is a report of a study to evaluate the knowledge and practice of Jordanian nurses in relation to breast self‐examination.

Background.  Studies have shown that women who have learned about breast self‐examination have positive attitudes toward breast cancer and practise breast self‐examination more frequently, and that nurses who teach their clients about methods of early detection and breast self‐examination are more knowledgeable about breast cancer screening and breast self‐examination techniques than those who do not. Therefore, it is important to understand nurses’ knowledge about breast cancer and its early detection.

Methods.  A cross‐sectional design was used, with a convenience sample of 347 Registered Nurses at three large cities in Jordan (response rate 95%). Data collection took place in 2005 using a self‐administrated questionnaire with three parts and based on the American Cancer Society’s guidelines: demographics, knowledge, and practice of breast self‐examination.

Results.  Nurses reported high levels of knowledge of breast self‐examination (M = 7·6, sd. 2·7). A high proportion of nurses reported doing breast self‐examination in the past 12 months (85%), but only 17·7% reported doing so on a monthly basis. None of the demographic characteristics was found to be associated with the practice of breast self‐examination.

Conclusion.  More health education about monthly breast self‐examination and prevention strategies is needed for nurses and their women patients, especially for Arabic women.
Patient and public involvement: models and muddles
Authors: Forbat Liz , Hubbard Gill , Kearney Nora
Published: January 2009

Aims and objectives.  This paper explores the range of models of involvement which are drawn upon in an empirical study and which are invoked in the literature and policy. The results and discussion of the study help to excavate and explore the muddle of conceptualisations of involvement and how this leads to difficulties for practitioners, patients and managers in implementing the relevant policy.

Background.  Patient and public involvement has developed an important profile internationally within health and social care policy. However, its importance as a rhetorical device has not been accompanied by adequate developments in how it is operationalised.

Design.  Cross‐sectional study, with an intervention conducted at three sites, and non‐intervention measures taken at two control sites.

Methods.  This paper draws on an empirical study of involvement. Focus groups were conducted with a lung cancer team and people affected by cancer at five health boards across Scotland. Chief executives of each of these five health boards also took part in individual interviews. Participants were asked to describe their ideas of what involvement is and their application of it.

Results.  A range of ways of conceptualising involvement were apparent. Few of these moved beyond the use of patient satisfaction questionnaires. At times, troubling understandings were articulated, for example, using public meetings to communicate decisions about service closures to the public.

Conclusion.  The slow escalation of involvement is in part because of the myriad ways in which it is conceptualised and discussed. Thus, we conclude that one of the greatest barriers to truly integrating patient involvement into health services, policy and research is the conceptual muddle with which involvement is articulated, understood and actioned.

Relevance to clinical practice.  Clinicians need to be supported to seek clarity in the use and operationalisation of involvement if the agenda is to be truly adopted and strengthened.
Menstrual and menarche experience among pubescent female students in Taiwan: implications for health education and promotion practice
Authors: Chang Yu‐Ting , Chen Yueh‐Chih , Hayter Mark , Lin Mei‐Ling
Published: January 2009

Aims and objectives.  This study aimed to explore the menarche and menstruation experiences of young females aged 10–12 years in elementary education in Taiwan.

Background.  Menarche is a significant milestone in a woman’s life and for female adolescents it is a sharply defined biological event that can be a traumatic and uncomfortable time. If used, school nurses can make a significant contribution in educating young people and help to ameliorate these problems. Understanding how young women feel about menstruation is a central element to sexual health education practice.

Design.  A qualitative research design was employed using focus groups.

Methods.  Data were collected from 20 female students, aged between 10–12 years. Focus groups were recorded, transcribed and subject to a thematic analysis.

Results.  Three themes emerged from the data analysis reflecting the menstrual experience of participants. These were: ‘Changing bodies: the physical effects of menarche and menstruation’, ‘Emotional issues: the psychological impact of menarche and menstruation’ and ‘Social dimensions of the menarche and menstruation’.

Conclusion.  Our findings show that young females can experience significant physical and emotional difficulties around menstruation – many of which stem from poor information and the reactions of their peer group to menstrual activity. The potential for school nurses to contribute to this education is significant and schools should explore the manner in which nurses can contribute to this area of health education.

Relevance to clinical practice.  Nurses involved in health education work with young people and ensure that menstruation education addresses the social and psychological impact of the menarche as well as the physical elements of menstruation. Boys should not be absent from this education and the impact of their attitudes towards menstruation upon their female peers should be addressed in health education work.
Factors influencing women in seeking help from a health care professional on self discovery of a breast symptom, in an Irish context
Authors: O’Mahony Mairin , Hegarty Josephine
Published: January 2009

Aim.  To identify the extent of delay and the factors influencing women in seeking help from a health care professional on self discovery of a breast symptom, in an Irish context.

Background.  Breast cancer is the most common malignancy among women in the developed world. In Ireland, 2700 women are diagnosed with breast cancer and over 900 die from it annually. A longer delay in presenting with breast symptoms is associated with a lower rate of survival from breast cancer. However, many women wait for longer than three months before presenting to a health care professional on self discovery of a breast symptom.

Design.  A quantitative correlational design was used.

Methods.  Data were collected using the ‘Women’s help seeking for breast symptoms’ questionnaire. Women were recruited in the breast clinic prior to their visit with the consultant.

Results.  A total of 100 women participated, 99 of whom fully completed the questionnaire. Mean age was 40 years. It was found that 72·7% (n = 73) of women visited their GP within one month, 14·1% (n = 14) within one to three months and 10% (n = 12) after three months. Delay time was significantly related to women’s knowledge and beliefs and social issues. Conversely, help seeking also correlated to women’s knowledge and beliefs about the symptom and the anxiety surrounding the initial symptom discovery period.

Conclusion.  Despite breast health promotion campaigns, many women delay for one month or more, in seeking help from a health care professional for self discovered breast symptoms. Prolonged delay has potential to impact on survival from breast cancer. This highlights the need for continued education and breast health promotion for women.

Relevance to clinical practice.  Health care professionals need to be aware of possible reasons for delay in seeking help for self discovered breast symptoms and explore new ways to address these barriers.
Relationship between familiar environment and wandering behaviour among Korean elders with dementia
Authors: Hong Gwi‐Ryung Son , Song Jun‐Ah
Published: January 2009

Aim.  To explore the relationship between wandering behaviour and familiar environment in community‐residing persons with dementia in Korea.

Background.  Numerous non‐pharmacological interventions have been developed to decrease behavioural symptoms and to increase the quality of life among persons with dementia. Although the concept of familiarity is very important and environmental interventions using the concept should have been developed for persons with dementia, no study examining even the direct relationship between familiar environment and wandering has yet been published.

Design.  A descriptive, cross‐sectional survey design.

Methods.  A convenience sample was gathered of 77 non‐institutionalised, community‐dwelling persons with dementia and their family caregivers in Seoul and Wonju, South Korea. Descriptive statics, Pearson’s correlations, t‐tests, and multiple regressions were used in the data analysis.

Results.  The mean age of persons with dementia was 76·9 years (SD 8·0) and their mean cognitive level score using the Mini‐Mental State Examination was 13·51 (SD 6·10). Most persons with dementia (71·4%) had been diagnosed with known types of dementia such as Alzheimer’s disease, multiple infarct dementia, mixed type or Parkinson’s disease with dementia. A familiar feeling with the environment was associated with cognitive impairment (r = 0·32, p < 0·01) and physical dependency in activities of daily living (r = −0·38, p <0·01). In addition, a familiar feeling with the environment (r = −0·56, p < 0·001) and physical dependency in activities of daily living (r = 0·56, p < 0·001) were strongly related to wandering behaviour. Familiarity and physical dependency in activities of daily living were the significant predictors for overall wandering and they explained 45% of the total variance. Cognitive impairment was the only significant predictor on the subscale of spatial disorientation.

Conclusions.  It was found that a familiar feeling with the environment was an important factor affecting persons with dementia’s cognitive and functional abilities as well as specific features of wandering. However, future research using a more reliable method is necessary to confirm the findings obtained in this study.

Relevance to clinical practice.  This study suggested that providing persons with dementia with a familiar feeling in daily clinical practice through establishment of familiar physical as well as psychosocial environment may have benefit to decrease wandering behaviour.
Cardiovascular disease in China: an urgent need to enhance the nursing role to improve health outcomes
Authors: Cao Yingjuan , Davidson Patricia M , DiGiacomo Michelle
Published: January 2009

Aims.  This paper reviews the role of cardiac nursing in China and the potential of this professional group to take an important role in secondary and tertiary prevention initiatives.

Background.  China is undergoing unprecedented economic growth, yet globalisation of Chinese society has caused an increase in the prevalence of chronic conditions, particularly cardiovascular disease. Studies recognise that health providers and members of the public are not fully aware of the risks associated with cardiovascular disease and consequently are not equipped to deal with this looming epidemic.

Design.  Position paper.

Method.  This position paper summarises and discusses the burden of cardiovascular disease in China within the context of evidence for nurse‐coordinated interventions. Barriers and facilitators to developing the nursing role in contemporary China are discussed.

Conclusions.  A key strategy for promoting the role of nurse‐led programmes in China is increasing research skills among Chinese nurses to promote independent, collaborative interdisciplinary research. Promoting doctoral education in China, increasing the status of nursing in interdisciplinary teams, collaborating with cardiovascular nurses internationally and increasing the public’s awareness of cardiovascular disease are critical steps in promoting nurse‐led programmes to improve the health and well‐being of the community.

Relevance to clinical practice.  Given the positive relationship between knowledge and skill levels of nurses and clinical outcomes, China’s investment in the education and training of its nursing workforce is critical in improving practice and outcomes in cardiovascular disease.
A psychometric evaluation of the Chinese version of the stage of change‐readiness and treatment‐eagerness scale
Authors: Yeh Mei‐Yu
Published: January 2009

Aims.  The present study analysed the psychometric properties of a Chinese version of the stage of change‐readiness and treatment‐eagerness scale among alcohol‐dependent patients and investigated whether a three‐factor structure fit the data.

Background.  The stage of change‐readiness and treatment‐eagerness scale is a 19‐item instrument designed to measure alcohol‐dependent patients’ motivation for change. However, this instrument had not been translated and validated for use in Taiwan.

Design.  Survey.

Methods.  A sample of 161 alcohol‐dependent patients receiving alcohol‐related treatment in psychiatric hospital outpatient and inpatient units was included. Confirmatory factor analyses were conducted on three‐factor measurement models of the stage of change‐readiness and treatment‐eagerness scale.

Results.  Confirmatory factor analyses supported the presence of a three‐factor modified model (ambivalence, recognition and taking steps) among alcohol‐dependent patients. Higher internal item consistency was found for the recognition and taking step factors, while the ambivalence factor was shown to have lower internal consistency. Convergent, discriminant and concurrent validity were obtained for the assessment of severity of alcohol dependence.

Conclusions.  The results indicated that the 11‐item, three‐factor modified Chinese version of the stage of change readiness and treatment eagerness scale provided best goodness of fit for the data in this study. This study demonstrated that the Chinese version of the stage of change readiness and treatment eagerness scale is a reliable and valid self‐report measure for the assessment of changing motivation in alcohol‐dependent patients.

Relevance to clinical practice.  The Chinese version of stage of change readiness and treatment eagerness scale is applicable for use in clinical treatment and research, predicting motivation for change and evaluating intervention outcomes in Taiwan.
Method to deterministically study photonic nanostructures in different experimental instruments
Authors: HUSKEN B.H. , WOLDERING L.A. , BLUM C. , VOS W.L.
Published: January 2009

We describe an experimental method to recover a single, deterministically fabricated nanostructure in various experimental instruments without the use of artificially fabricated markers, with the aim to study photonic structures. Therefore, a detailed map of the spatial surroundings of the nanostructure is made during the fabrication of the structure. These maps are made using a series of micrographs with successively decreasing magnifications. The graphs reveal intrinsic and characteristic geometric features that can subsequently be used in different setups to act as markers. As an illustration, we probe surface cavities with radii of 65 nm on a silica opal photonic crystal with various setups: a focused ion beam workstation; a scanning electron microscope (SEM); a wide field optical microscope and a confocal microscope. We use cross‐correlation techniques to recover a small area imaged with the SEM in a large area photographed with the optical microscope, which provides a possible avenue to automatic searching. We show how both structural and optical reflectivity data can be obtained from one and the same nanostructure. Since our approach does not use artificial grids or markers, it is of particular interest for samples whose structure is not known a priori, like samples created solely by self‐assembly. In addition, our method is not restricted to conducting samples.
Optimization of a FIB/SEM slice‐and‐view study of the 3D distribution of Ni4Ti3 precipitates in Ni–Ti
Authors: CAO S. , TIRRY W. , VAN DEN BROEK W. , SCHRYVERS D.
Published: January 2009

The 3D morphology and distribution of lenticular Ni4Ti3 precipitates in the austenitic B2 matrix of a binary Ni51Ti49 alloy has been investigated by a slice‐and‐view procedure in a dual‐beam focused ion beam/scanning electron microscope system. Due to the weak contrast of the precipitates, proper imaging conditions need to be selected first to allow for semi‐automated image treatment. Knowledgeable imaging is further needed to ensure that all variants of the precipitates are observed with equal probability, regardless of sample orientation. Finally, a volume ratio of 10.2% for the Ni4Ti3 precipitates could be calculated, summed over all variants, which yields a net composition of Ni50.27Ti49.73 for the matrix, leading to an increase of 125 degrees for the martensitic start temperature. Also, the expected relative orientation of the different variants of the precipitates could be confirmed.