bluuebunny/crossref_metadata_2025 huggingface dataset:
Merchant houses as spectacles of modernity in Rajasthan and Tamil Nadu
Authors: Hardgrove Anne
Published: June 2007

This article examines the production of visually spectacular ancestral houses by migrant merchants in colonial South Asia between 1860 and 1930, as well as the recent transformation of these now-abandoned homes into sites of tourism. I primarily consider the elaborately painted houses belonging to the migrant Marwari traders of north India in the Shekhawati region of eastern Rajasthan, and comment upon the south Indian ornamental houses built by the Chettiar merchants in Madras Presidency, now known as Tamil Nadu. I argue that these empty mansions are being rapidly appropriated into new objects of visual consumption through international tourism, thereby transforming spaces of the private into spaces of public access. Visual practices in India have to be understood as part of a global and capitalist modernity, and not just in terms of India's pre-modern past. Through practices of tourism, spatial geographies of diasporic identity formation are being re-created through a visual orientation of the past.
An Empirical and Theoretical Review of Articles in The Journal of Black Psychology: 1974-1980
Authors: Steele Robert E. , Davis Sherry E.
Published: June 2007

This study reviews the empirical and theoretical articles published in The Journal of Black Psychology from 1974-1980. A standard coding form consisting of 28 vari ables was developed and pretested. Two independent raters examined 62 articles. The data were analyzed using descrip tive statistics and univariate analysis of variance (ANOVA) to examine trends over time. The results indicated (a) an increase in empirically-based research articles and a decline in the number of political/idealogical ones, (b) a small but significant increase in the number of articles that used the traditional deficit orientation to explain Black behavior, and (c) major methodological problems in several articles. Find ings focus on the need for explanatory models of behavior based on Afro-graphic experiences of Black people, on the need to recognize the cultural diversity of the Black com munity, and on the necessity for greater attention to method ological issues.
Delamination Detection of a Laminated Beam Using Magnetostrictive Composite Sensor and Actuator
Authors: Tan Ping , Tong Lyong
Published: June 2007

This article presents an analytical dynamic model to study the feasibility of sensing a delamination embedded in a cantilever laminated composite beam, which is bonded with an integrated or distributed magnetostrictive layer. The model that includes parameters characterizing a delamination is developed using the classical beam theory and the assumption of constant peel and shear strains through the bond line thickness. A movable sensing and actuation coil is employed to excite the beam system and then to measure the magnetic flux passing through the sensing and actuation coil. Two types of moveable sensing and actuation coil, namely integrated sensing and actuation coil and separated sensing and actuation coil, are introduced in this investigation. Using the present model, the magnetic flux passing through the coil is predicted. Thus, by monitoring the difference of the predicted magnetic flux passing through the coils which encircles the beams with and without a delamination, the presence, location, and size of the delamination embedded in a laminated composite beam will be identified. Finally, a numerical study is conducted to investigate the influence of major parameters on delamination detection sensitivity, and a comparison of the first- and third-order frequencies between the present analytical and finite element analysis models is carried out to verify the present analytical model.
Public Health/Government Service as an Alternate Practice of Pharmacy
Authors: Gottrich Ronald W.
Published: June 2007

Public health and governmental service are discussed as alternate forms of the practice of pharmacy. The author discusses his employment with the Illinois Department of Public Health in the areas of drug product selection, drug, medical device, and cosmetic establishment inspections, and long-term care. Aspects of the author's employment as consultant pharmacist for the state Medicaid program are related. Events leading to the author's selection of the field of public health pharmacy practice are described. The benefits of a pharmacy education in this field, rewards and frustrations of government employment, and the future prospects for public health pharmacy are highlighted.
Justification for Hospital-Based Nuclear Pharmacy Services
Authors: Laven David L. , Martin William R.
Published: June 2007

Diversification is the greatest survival strategy available to hospital pharmacy today. Nuclear pharmacy is a growing field within institutional pharmacy practice and can help ensure the profession's participation in new technologies and clinical support roles. Nuclear pharmacy practice parallels hospital pharmacy practice in many areas including procurement, compounding, dispensing, quality assessment, and drug use review. Particularly important to the practice of pharmacy are the clinical contributions by nuclear pharmacists in areas such as product selection, drug interactions and interferences, and assisting the physician in the interpretation of nuclear medicine imaging data. Hospital-based nuclear pharmacy services are closely allied with nuclear medicine and radiology, which have felt the effects of changing trends in third party reimbursement. It has been shown repeatedly that nuclear pharmacists can make an impact on the quality of nuclear medicine services, while improving the cost effectiveness of these services. For the past several years, only a few hospital pharmacies have made attempts to provide services to nuclear medicine or radiology departments. Pharmacy has a professional responsibility and obligation to become involved with the use of legend drugs routinely used (or soon to be introduced) within these departments. Nuclear pharmacy is an area in the hospital where pharmacy can make a solid financial impact and broaden its scope of recognition and value.
Pharmacy Involvement With Positron-Emitting Radiopharmaceuticals
Authors: Manning Ronald G. , Wolfangel Robert G.
Published: June 2007

Positron emission tomography (PET) is an imaging process that relies on positron-emitting nuclides with very short physical half-lives (ranging from seconds to minutes). Exceptional resolution in PET imaging enables studies of the CNS (eg, highlighting deviant cell metabolism), and cardiovascular system (eg, identifying areas of reduced blood flow before coronary artery bypass surgery), among others. Increasing in popularity, PET radiopharmaceuticals pose a unique challenge to the nuclear pharmacist relative to product synthesis and quality control testing. Establishment of process validation programs with emphasis on quality, purity, and safety is all important. Various elements of process validation and quality control testing are discussed as they pertain to PET radiopharmaceuticals and the professional role of the nuclear pharmacist.
Postmarketing Surveillance of Drugs: An Overview
Authors: Michel Daniel J. , Dahl Joann M. , Campbell H. Eloise , Farolino Denise A. , Platek Thomas E.
Published: June 2007

The complete safety profile of a drug cannot be made before marketing because of the limited scope of the controlled clinical trials. Postmarketing surveillance (PMS) is the collection and analysis of information about a drug after it has been marketed. A PMS system ideally must be able to detect a rare event, determine its incidence, and validate the causality. Because an ideal system has not been devised, a combination of methods is used. The advantages and limitations of various methods of adverse drug reaction (ADE) reporting are described, and problems and concerns associated with ADE reporting are discussed. Postmarketing surveillance will continue to benefit from spontaneous reporting of ADEs by clinicians (ie, literature reports, reports to manufacturers and national regulatory agencies) to detect rare events and will be complemented by the selective use of formal PMS methods in appropriate circumstances. Increased clinician awareness of serious, potentially drug-related events together with comprehensive and complete reporting of these events will begin to address the problems of underreporting, assessment of causality, and misclassification of events.
Adverse Effects of Corticosteroids
Authors: O'Donnell James
Published: June 2007

Currently, adrenal corticosteroids (steroids) are used for a wide variety of clinical conditions. Steroids are known to cause many pathologic effects, including chemically induced diabetes, psychological changes, musculoskeletal (including avascular) necrosis, suppression of the adrenals, and significant effects on the eye. Considering the important risk factors involved with the use of these toxic, yet essential medications, pharmacists have a serious responsibility to monitor their use for indications, dosage, interactions, and side effects.
The Joint Commission (JCAHO) and Nuclear Pharmacy
Authors: Chilton Henry M.
Published: June 2007

One of the central themes of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) review process involves emphasis on quality assurance of provided services with the goal of high quality patient outcomes. Within nuclear pharmacy practice, quality assurance activities are planned, systematic actions involving radiopharmaceuticals and equipment (and associated record-keeping functions for each) as well as cognitive clinical services. Concerns for appropriate quality assurance activities are voiced by other regulatory agencies (such as the Nuclear Regulatory Commission) and echoed by the JCAHO. The present discussion will highlight selected areas of nuclear pharmacy practice as it pertains to quality assurance of radiopharmaceutical receipt, preparation, and distribution, as well as equipment usage associated with these functions.
Endocrinologic Warfare: The Role of Angiotensin-Converting Enzyme Inhibitors in Congestive Heart Failure
Authors: Munger Mark A. , Gardner Stephanie F. , Jarvis Robert C.
Published: June 2007

The angiotensin-converting enzyme (ACE) inhibitors represent the gold standard of vasodilator therapy for congestive heart failure through blunting of the endocrinologic manifestations of heart failure. The future role of these agents may be in the asymptomatic and mild stages of heart failure. ACE inhibitors have been shown to decrease morbidity and mortality with the natural history of this disease being altered. The future will bring many new ACE inhibitors to market, with the challenge for physicians and pharmacists to understand the important distinctions of each specific agent. © 1990 by W.B. Saunders Company.
Transitivity and ergativity in 'The Lotos-Eaters'
Authors: Benson James D. , Greaves William S. , Stillar Glenn
Published: June 2007

This article argues that Bakhtin's repeated assertions that poetry, unlike the novel, is inherently monologic can be questioned in the light of a clear case of dialogism in Tennyson's 'The Lotos-Eaters'. A discussion of its dialogism is formalised by an analysis of grammatical function-structures of the Experiential component of the Ideational function of clause structure, following Halliday (1985), in the tradition of Systemic Functional Linguistics. In particular, the paper discusses the significance of the instantiation of transitivity and ergativity. It incorporates modifications suggested by Davidse (1992a) to the analysis of Material process types and argues that these modifications are useful for foregrounding the different worlds construed by the poem. The analysis reveals three worlds or voices in the poem: (1) the transitive:effective, or Deed and Extension paradigm of the outside world; (2) the transitive:middle/ergative, or Instigation of Process paradigm of lotos-land; and (3) the Behavioural/ Mental:Perceptive paradigm of the mariners-in-Lotos-land. It is argued that the mariners oppose (1), wish to ally themselves with (2), but settle for (3) as a strategy.
Ideology in crisis on a South African campus1
Authors: Geslin Nicole
Published: June 2007

This article offers a close reading of two texts produced at a time of crisis on a South African campus. The framework used is that of Halliday's systemic-functional grammar, which enables us to analyse how the modes of discourse create their own reading contexts, while influencing, and being influenced by, the context of situation. In addition, Halliday's concept of 'antilanguage' is used to show how the second text creates, through language, a new context for interaction and constructs an opposing world-view to that of the first text.
Imagism's metaphors - a test case
Authors: Crisp Peter
Published: June 2007

Imagism is centered on the image metaphor, and so is a valuable resource for studying this kind of metaphor. Image metaphor raises questions for any theory that sees metaphor as something conceptual. Such theories entail the rejection of truth-conditional semantics and are thus rejected by proponents of truth conditionalism, such as Donald Davidson. Imagism embodies an extreme form of image metaphor that avoids generating any clear propositional entailments. The problem it poses for conceptual theories of metaphor is thus considerable. The solution lies in the concept of the image schema as the basis of propositional reasoning. Image metaphor can be seen as displaying the matrix out of which conceptual metaphor proper itself develops. Image metaphor shows that matrix to be bound up with the nature of aesthetic affect. It thus points the way to a view of poetry that does justice to its aesthetic passion without opposing it in some absolute way to the rationality of logic and science.
Linguistic signals and interpretative strategies: linguistic models in performance, with special reference to free indirect discourse.1
Authors: Fludernik Monika
Published: June 2007

In this article I explore the consequences of the recent linguistic paradigm shift towards pragmatics which has initiated a broader range of methods and areas of investigation within linguistics. Using accounts of free indirect discourse as a test case I will attempt to illustrate how this paradigm shift has made it possible to further bridge the divide between the literary and the linguistic outlook on language.
How come silence is sweet but sweetness is not silent: a cognitive account of directionality in poetic synaesthesia
Authors: Shen Yeshayahu , Cohen Michal
Published: June 2007

Synaesthesia (e.g. 'sweet silence') consists of the mapping of properties from one modality to another. The present article introduces a cognitive account regarding the directionality of the mapping in poetic discourse. Firstly, we suggest that mapping from lower modalities onto higher ones (e.g. from 'touch' onto 'sight') is more frequently used in poetic discourse than the opposite mapping (i.e. from higher to lower modalities). The findings of a textual analysis of a large-scale poetic corpus are introduced, which support this proposal, and reveal that the 'low to high' mapping is more frequently used than its inverse, and that this tendency is a universal one (across national boundaries and historical periods).

Secondly, we propose a cognitive account for this universal tendency according to which the 'low to high' mapping conforms to (while its inverse violates) the following cognitive constraint: mapping from a more accessible concept onto a less accessible one is more natural than its inverse. The findings of an interpretation experiment are introduced, which provide some support for this account by suggesting that the more frequently used structure (i.e. the mapping from the more accessible to the less accessible sense) is easier to comprehend than its inverse.

We conclude by proposing that aspects of poetic language are themselves constrained by general cognitive constraints.
A Case Report of Twiddler's Syndrome in a Pediatric Patient
Authors: Servetar Ellen M.
Published: June 2007

Twiddler's syndrome, the migration of a catheter tip out of a vessel by intentional or unintentional self-manipulation, is presented in a case report of a young child with Langerhans' cell histiocytosis. Since this migration is a potentially serious complication of internal venous catheters, an overview compares and contrasts the differences between internal and external central venous catheters. The need to consider Twiddler's syndrome in an assessment of a patient with an internal venous catheter is emphasized.
Pain in the Pediatric Oncology Patient
Authors: Patterson Katherine L.
Published: June 2007

Pediatric oncology nurses face many challenges in treating the pain associated with childhood cancer. The type and severity of pain children with cancer experience varies from acute, short-term, procedure-related pain to the progressive chronic pain associated with terminal illness. In addition, the unfounded fears of using strong narcotic analgesics and the underutilization of psychological techniques to treat pain in children limit the effectiveness of pain management. Armed with objective data, pediatric oncology nurses can work with other members of the cancer treatment team to provide relief from the pain associated with the diagnosis and treatment of childhood cancer.
Description of Posterior Fossa Syndrome in Children After Posterior Fossa Brain Tumor Surgery
Authors: Kirk Elizabeth A. , Howard Vanessa C. , Scott Cheryl A.
Published: June 2007

Brain tumors are the second most common malignancy in children less than 15 years of age and the most common solid tumor of childhood. Approximately 60% to 70% of pediatric brain tumors originate in the posterior fossa. Since 1989, the two hospitals that comprise the setting for this study have treated 121 children with posterior fossa brain tumors. A postoperative syndrome, labeled posterior fossa syndrome, has been identified in certain children. This syndrome involves a variety of signs and symptoms including mutism or speech disturbances, dysphagia, decreased motor movement, cranial nerve palsies and, emotional lability. These signs and symptoms develop from an average range of 24 to 107 hours after surgery and may take weeks to months to resolve. The exact etiology of the syndrome is unknown. The purpose of this retrospective medical records review of 19 children diagnosed with posterior fossa syndrome is to describe the symptoms of the syndrome. Early recognition of this syndrome could facilitate preventive and restorative patient care, prevent subsequent complications, decrease length of hospital stays, and promote patient and family understanding of and coping with the syndrome.
Central Nervous System Toxicity of Cancer Therapy in Children
Authors: Moore Ida M.
Published: June 2007

Cancer treatment of the central nervous system has contributed positively to long-term disease-free survival from childhood cancers such as acute leukemia and medulloblastoma. However, intrathecal chemotherapy and whole brain radiation are associated with acute, subacute, and delayed toxicities. The purpose of this review article is to summarize what is known about critical events in prenatal and postnatal brain development; the pathophysiology of radiation and chemotherapy neurotoxicity and clinical manifestations and risk factors for acute, subacute, and delayed toxicities. The importance of long-term follow-up and for multidisciplinary interventions that focus on prevention as well as management of identified problems are addressed.
Promoting Parental Use of Nonpharmacologic Techniques With Children During Lumbar Punctures
Authors: Pederson Carol
Published: June 2007

A pretest and posttest with control group design was used to examine the effect of teaching eight children with acute leukocytic leukemia, aged 6 to 14 years, and their parents about selected nonpharmacologic techniques, then to support their use of these techniques during children's lumbar punctures. Children's distress behaviors were observed and recorded during the procedures. A Visual Analogue Scale was used to obtain children's self-report and parents' and staff nurses' perceptions of children's pain during the procedure. Posttest comparison of four subjects in the treatment group with four subjects in the control group indicated that the treatment group had fewer expressions of verbal resistance (P = .04), less muscular rigidity (P = .04), and more parent interventions (P = .06). Preintervention with postintervention comparison of all eight subjects indicated that following intervention, children had lower levels of self-reported pain (P = .09), fewer requests for emotional support (P = .07), fewer expressions of verbal fear (P = .10), and fewer information-seeking questions (P = .10). Comments from children and parents indicate that children benefitted from nonpharmacologic techniques.
Japanese tourists' perceptions of their tour guides: Australian experience
Authors: Reisinger Yvette , Waryszak Robert
Published: June 2007

This small exploratory study examines Japanese tourists' expectations and perceptions of service provided by their Australian tour guides prior to and after receiving the service. In total, the service expectations and perceptions of 80 Japanese tourists were measured on arrival and on departure from Australia. Ten areas of service provided were analysed, ie being professional, friendly, polite, informative, helpful, able to fulfil tourists' needs, capable of speaking Japanese, able to solve problems, knowledgeable of Japanese history and culture, and knowledgeable of Australian history and culture. The difference between torrrists' expectations and perceptions was evident in one out of ten areas of service, that is, of information giving. On departure, Japanese tourists perceived the Australian tour guides as less informative than they expected prior to their arrival in Australia. The implications of this finding for the Australian tour guides and the importance of quality of service measurement for marketing purposes are discussed.
Deployment of computer networks in leisure-packaged tour marketing in the United States
Authors: Moon R. David
Published: June 2007

Increasingly, travel and tourism providers are being offered the option of distributing their products and services electronically. At present, most providers use call centre processing as their primary means of reaching the retail travel agent and executing a sale. Many providers also participate in one or more electronic networks for distribution of the travel product, and a very few rely solely on these networks as their only means for product distribution. Due to increasing cost pressures coupled with ever-expanding capabilities offered by network providers, participation in electronic distribution is accelerating. This paper examines the opportunities in electronic distribution from the provider/participant's point of view, and outlines the issues associated with introducing existing, call centre-supported products into the arena of electronic distribution.
The role of customer databases in package tour development
Authors: Morris Chris
Published: June 2007

Economic changes driven by the late 1980s boom and the high interest levies of the early 1990s have caused shifts in the profile of consumers of tour packages. Such trends have happened before, perhaps on a smaller scale, and in all likelihood will happen again in a cyclical industry.

The tourism industry is not alone in facing the challenges to marketers of high ticket value products and services. In many of the forward-thinking organisations in these industries, however, sourcing customer feedback and targeting promotions to incentivise uptake to specific segments of an operator's customers, is having a positive effect on profits and securing control in otherwise stormy seas. This is the role of the customer database in package tour development.
Societal marketing — implications for tourism destinations
Authors: Mill Robert Christie
Published: June 2007

This paper examines the concept of societal marketing within a tourism destination framework. It points out the marketing implications for tourism destinations if they are to balance the marketing concept of customer satisfaction with the societal marketing orientation of consumer and societal well-being.
The attributes and potential of secondary Australian destinations through the eyes of Korean travel industry executives
Authors: King Brian E. M. , Hew Jong Choi
Published: June 2007

This paper examines the attitudes of key travel industry executives in South Korea to secondary destinations in Australia with particular reference to the prospects for special interest travel. It was found that according to most key criteria, executives regard Australia as a desirable tourist destination for Koreans and as being well matched with their expectations. Cleanliness and safety are regarded as key strengths by industry executives, whilst the cost of travel and the relative inaccessibility are regarded as weaknesses.

As Korea continues to mature as a tourist generating country, the prospects for special interest travel will improve and this will have particular relevance for secondary tourism des tinations such as Melbourne. While Sydney's status as the hub destination will remain unchallenged, Melbourne has a competitive advantage in certain special interest markets, such as honeymooners, backpackers and luxury travellers. Tour quality is emerging as a key issue because of fierce discounting. Accessibility will remain a problem for regions and cities, such as Melbourne, not currently serviced by direct flights.
Sunday horseracing — new raceday, new racegoers
Authors: Richardson Lee W.
Published: June 2007

Until 1995, horseracing with betting in Britain was not allowed, by law, to take place on a Sunday, reckoned by many observers to have become the most popular leisure day of the week. This clearly put horseracing — a multi-billion-pound live spectator sport, and betting medium, watched by millions off- and on-course annually — at a significant competitive disadvantage when compared with other sporting and leisure attractions.

Following a 30-year-long lobbying campaign to Governement, a change in the law, through the Deregulation Bill, was gained in May 1994, allowing the British Horseracing Board (BHB), the newly-appointed governing authority for the industry, to plan 24 Sunday fixtures, on 12 Sundays, for 1995. Research undertaken by both the industry and the BHB had identified an ageing and static pool of racegoers, who were making fewer visits to the racecourse. There was also a longstanding belief among many industry observers that racecourses needed to expand, and adopt, more innovative and up-to-date promotional techniques and ideas in order to compete more effectively for its share of leisure spending in the 1990s.

This case study explores the resultant coordinated promotional strategy that was designed to appeal to a new, younger and more family-oriented audience, and to stimulate trial of the attractions of 'a day at the races'. It also examines the results achieved, and the wider implications for the industry in the promotion of racegoing as a leisure activity.
Continuing dilemma in health-care research
Authors: Avis Mark , Robinson Jane
Published: June 2007

How can nurse researchers reconcile the conflicting arguments on the value of quantitative versus qualitative research? The authors evaluate the evidence on both sides and propose a way forward
Measuring psychiatric nursing interventions
Authors: Robinson David K.
Published: June 2007

The nursing process was introduced to develop the contribution of nursing and adopt a more systematic approach to care delivery. Few in-depth studies have yet described its true impact and level of implementation. The study reported in this article examines the status of individualised care and makes comparisons with nursing care in other locations. It also describes the nature and context of forensic/psychiatric care and its relationship with findings of two decades ago [ NT Research 1996; 1: 1, 13-21 ]
Individualised patient care
Authors: Redfern Sally
Published: June 2007

It is assumed that individualised patient care benefits both patients and nurses. This study set out to clarify what individualised patient care means to nurses and how they practise it as well as how it is experienced by patients. With some exceptions, individualised patient care was not practised widely in the seven wards that were used as case studies. Even in the wards where individualised patient care was more common, there were some examples of bad practice. Factors that facilitated individualised patient care were: the personal qualities of the nurses themselves; a shared understanding among the ward team of the goals of nursing care and what constitutes good practice; levels of staffing and skill mix; and effective leadership and management of nursing work [ NTResearch 1996; 1: 1, 22-33]
Post-tonsillectomy pain relief following discharge from hospital
Authors: Stone Carrie
Published: June 2007

Patients undergoing a tonsillectomy are usually discharged from hospital within 24 hours of the procedure. This study aimed to assess the amount of pain one group of patients experienced in the following five days. Twenty-two patients with a mean age of 23 years completed a verbal rating scale for the first five postoperative days on the severity of pain experienced in order to assess: intensity of pain in relation to days postoperatively; the amount and type of pain information given to patients before discharge; and the type and frequency of analgesia taken. The study identified a correlation between pain intensity in relation to postoperative days in patients having undergone tonsillectomy. Almost two-thirds (63%) experienced severe/unbearable pain on Day 2 but by Day 5, this proportion had decreased to one-fifth (21%). The vast majority (84%) of patients experienced pain either most or all of the time, even having taken the recommended analgesia and having received the information on pain relief before discharge [ NTResearch 1996; 1: 1, 57-65]
Pictorial art as a teaching strategy in death education
Authors: Levi Sara , Gilad Rivka , Friedman-Kalmovitcz Aviva
Published: June 2007

Caring for cancer patients in advanced stages of the disease is a professional challenge for the nurse. At the same time, the close proximity with death and dying may call forth in the nurse feelings of anxiety and apprehension, leading to inner struggle and stress. One mode of alleviating stress is through self-expression by means of pictorial art. In the study described here, senior student nurses drew their perception of death before and after a three-month seminar on coping with life-threatening situations. The aim was two-fold: to make students aware of their perception of death, and to examine whether their attitude towards the concept of death had been altered as a result of the seminar. Comparison of the pre- and post-seminar drawings showed that their perception of death and dying had undergone a change, in that the concept had lost something of its ominous power. [ NT Research 1996; 1: 3, 198-203]
The use of two-dimensional grid patterns to limit hazardous ambulation in elderly patients with Alzheimer's disease
Authors: Hewawasam Lucksri C.
Published: June 2007

The ambulation of demented patients into potentiafiy dangerous areas or away from areas where they can be monitored is a problem for the care-providers of such patients in psychiatric settings for the elderly. Current methods of controlling patients likely to move into hazardous areas usually involve physical interventions such as restraint, locked ward doors and sometimes medication. Such methods can be costly, counterproductive and take carers away from other tasks. It has been observed that patients with Alzheimer's disease appear to be affected by certain visual stimuli that do not affect the ambulation of non-demented people or staff members. Such visual stimuli can be a simple two-dimensional grid pattern, which patients with Alzheimer's disease tend to perceive as a barrier. This effect is not usually seen in other types of dementia. Capitalising on this observation, black insulation tapes in two different grid configurations were laid out in an attempt to prevent these patients ambulating through exit doors. Ten demented patients with differential diagnoses participated in this study. It was found that the use of a horizontal grid reduced exit door contact up to 97% for four of these patients with a diagnosis of Alzheimer's disease. As had been predicted, the grid was less effective for patients with other types of dementia. Advantages and inherent dangers in this approach to managing hazardous ambulation by Alzheimer's patients are discussed. [ NT Research 1: 2, 217-227]
On developing an agenda to influence policy in health-care research for effective nursing: A description of a national R&D priority-setting exercise
Authors: Kitson Alison , McMahon Ann , Rafferty Anne Marie , Scott Elizabeth
Published: June 2007

This paper describes a national initiative to establish a co-ordinated and systematic method for identifying priorities for research and development, jointly set up by the Royal College of Nursing and the Centre for Policy in Nursing Research. It uses an explicit policy-making model described by Lomas1 to outline the stages of the project. This model is also used to consider how nursing is influencing the current national clinical effectiveness and research and development agendas. Consideration is given as to whether the priority- setting exercise could make a difference to this wider policy agenda.
Nursing and the wider R&D agenda: Influence and contribution
Authors: McKenna Hugh , Mason Carolyn
Published: June 2007

This paper suggests that the goal of nursing research in Northern Ireland should be to carry out rigorous, systematic inquiry designed to make significant contributions to knowledge. Such knowledge should impact positively on the physical, mental and social well-being of the population. There are, however, contrasting views about the content and direction of nursing research and how nursing can contribute to and influence the wider reasearch and development (R&D) agenda. These and other perspectives will be examined.

It is the authors' contention that nursing has a series of key roles to play in health service research at strategic and operational levels. It will be argued that while research policy is framed by government, it should retain the flexibility to allow for projects that focus on issues and phenomena that are predominantly the concern of the nursing profession. In order to do this the profession should use the influence it has to make a worthwhile contribution to patient care.
Prepared for practice? Exploring the experiences of newly qualified Project 2000 Child Branch staff nurses
Authors: Bradley Susan
Published: June 2007

The passage from student to staff nurse is identified by the UKCC as being a major transition (UKCC, 1993). This small, qualitative study (n=6) was designed to explore the experience of being a newly qualified staff nurse following Project 2000 Child Branch education. Participants were also asked to reflect on Project 2000 as preparation for nursing practice.

The overall experience of participants was reported as positive. Challenges and stresses had been encountered, however, all staff describing initial feelings of fear, the impact of their new responsibilities, and areas where they felt they lacked adequate experience. Comments were made concerning Project 2000 in relation to clinical preparation and experience, course content and structure, and the emphasis given to the Common Foundation Programme. They felt that they had moved successfully through the transition experience because of the degree of support they had received, because they were prepared to ask questions and because they had the ability to learn quickly. All members felt that the Project 2000 programme prepared them well for practice.
Identification and expression analysis of genes associated with bovine blastocyst formation
Authors: Goossens Karen , Van Soom Ann , Van Poucke Mario , Vandaele Leen , Vandesompele Jo , Van Zeveren Alex , Peelman Luc J
Published: June 2007

Background

Normal preimplantation embryo development encompasses a series of events including first cleavage division, activation of the embryonic genome, compaction and blastocyst formation.

First lineage differentiation starts at the blastocyst stage with the formation of the trophectoderm and the inner cell mass. The main objective of this study was the detection, identification and expression analysis of genes associated with blastocyst formation in order to help us better understand this process. This information could lead to improvements of in vitro embryo production procedures.

Results

A subtractive cDNA library was constructed enriched for transcripts preferentially expressed at the blastocyst stage compared to the 2-cell and 8-cell stage. Sequence information was obtained for 65 randomly selected clones. The RNA expression levels of 12 candidate genes were determined throughout 3 stages of preimplantation embryo development (2-cell, 8-cell and blastocyst) and compared with the RNA expression levels of in vivo "golden standard" embryos using real-time PCR. The RNA expression profiles of 9 (75%) transcripts (KRT18, FN1, MYL6, ATP1B3, FTH1, HINT1, SLC25A5, ATP6V0B, RPL10) were in agreement with the subtractive cDNA cloning approach, whereas for the remaining 3 (25%) (ACTN1, COPE, EEF1A1) the RNA expression level was equal or even higher at the earlier developmental stages compared to the blastocyst stage. Moreover, significant differences in RNA expression levels were observed between in vitro and in vivo produced embryos. By immunofluorescent labelling, the protein expression of KRT18, FN1 and MYL6 was determined throughout bovine preimplantation embryo development and showed the same pattern as the RNA expression analyses.

Conclusion

By subtractive cDNA cloning, candidate genes involved in blastocyst formation were identified. For several candidate genes, important differences in gene expression were observed between in vivo and in vitro produced embryos, reflecting the influence of the in vitro culture system on the embryonic gene expression. Both RNA and protein expression analysis demonstrated that KRT18, FN1 and MYL6 are differentially expressed during preimplantation embryo development and those genes can be considered as markers for bovine blastocyst formation.
Essential and non-essential DNA replication genes in the model halophilic Archaeon, Halobacterium sp. NRC-1
Authors: Berquist Brian R , DasSarma Priya , DasSarma Shiladitya
Published: June 2007

Background

Information transfer systems in Archaea, including many components of the DNA replication machinery, are similar to those found in eukaryotes. Functional assignments of archaeal DNA replication genes have been primarily based upon sequence homology and biochemical studies of replisome components, but few genetic studies have been conducted thus far. We have developed a tractable genetic system for knockout analysis of genes in the model halophilic archaeon, Halobacterium sp. NRC-1, and used it to determine which DNA replication genes are essential.

Results

Using a directed in-frame gene knockout method in Halobacterium sp. NRC-1, we examined nineteen genes predicted to be involved in DNA replication. Preliminary bioinformatic analysis of the large haloarchaeal Orc/Cdc6 family, related to eukaryotic Orc1 and Cdc6, showed five distinct clades of Orc/Cdc6 proteins conserved in all sequenced haloarchaea. Of ten orc/cdc6 genes in Halobacterium sp. NRC-1, only two were found to be essential, orc10, on the large chromosome, and orc2, on the minichromosome, pNRC200. Of the three replicative-type DNA polymerase genes, two were essential: the chromosomally encoded B family, polB1, and the chromosomally encoded euryarchaeal-specific D family, polD1/D2 (formerly called polA1/polA2 in the Halobacterium sp. NRC-1 genome sequence). The pNRC200-encoded B family polymerase, polB2, was non-essential. Accessory genes for DNA replication initiation and elongation factors, including the putative replicative helicase, mcm, the eukaryotic-type DNA primase, pri1/pri2, the DNA polymerase sliding clamp, pcn, and the flap endonuclease, rad2, were all essential. Targeted genes were classified as non-essential if knockouts were obtained and essential based on statistical analysis and/or by demonstrating the inability to isolate chromosomal knockouts except in the presence of a complementing plasmid copy of the gene.

Conclusion

The results showed that ten out of nineteen eukaryotic-type DNA replication genes are essential for Halobacterium sp. NRC-1, consistent with their requirement for DNA replication. The essential genes code for two of ten Orc/Cdc6 proteins, two out of three DNA polymerases, the MCM helicase, two DNA primase subunits, the DNA polymerase sliding clamp, and the flap endonuclease.
Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review
Authors: Jeurnink Suzanne M , van Eijck Casper HJ , Steyerberg Ewout W , Kuipers Ernst J , Siersema Peter D
Published: June 2007

Background

Gastrojejunostomy (GJJ) is the most commonly used palliative treatment modality for malignant gastric outlet obstruction. Recently, stent placement has been introduced as an alternative treatment. We reviewed the available literature on stent placement and GJJ for gastric outlet obstruction, with regard to medical effects and costs.

Methods

A systematic review of the literature was performed by searching PubMed for the period January 1996 and January 2006. A total of 44 publications on GJJ and stents was identified and reported results on medical effects and costs were pooled and evaluated. Results from randomized and comparative studies were used for calculating odds ratios (OR) to compare differences between the two treatment modalities.

Results

In 2 randomized trials, stent placement was compared with GJJ (with 27 and 18 patients in each trial). In 6 comparative studies, stent placement was compared with GJJ. Thirty-six series evaluated either stent placement or GJJ. A total of 1046 patients received a duodenal stent and 297 patients underwent GJJ. No differences between stent placement and gastrojejunostomy were found in technical success (96% vs. 100%), early and late major complications 7% vs. 6% and 18% vs. 17%, respectively) and persisting symptoms (8% vs. 9%). Initial clinical success was higher after stent placement (89% vs. 72%). Minor complications were less frequently seen after stent placement in the patient series (9% vs. 33%), however the pooled analysis showed no differences (OR: 0.75, p = 0.8). Recurrent obstructive symptoms were more common after stent placement (18% vs. 1%). Hospital stay was prolonged after GJJ compared to stent placement (13 days vs. 7 days). The mean survival was 105 days after stent placement and 164 days after GJJ.

Conclusion

These results suggest that stent placement may be associated with more favorable results in patients with a relatively short life expectancy, while GJJ is preferable in patients with a more prolonged prognosis. The paucity of evidence from large randomized trials may however have influenced the results and therefore a trial of sufficient size is needed to determine which palliative treatment modality is optimal in (sub)groups of patients with malignant gastric outlet obstruction.
Prenatal diagnosis of a rare form of congenital mid-ureteral stricture: a case report and literature revisited
Authors: Brugnara Milena , Cecchetto Mariangela , Manfredi Riccardo , Zuffante Michele , Fanos Vassilios , Pietrobelli Angelo , Zaffanello Marco
Published: June 2007

Background

Congenital mid-ureteral stricture is a rare malformation of the ureter leading to prenatal and neonatal hydronephrosis. Site characterization of the narrowing is important to optimize the surgical approach to the newborn affected by hydronephrosis.

Case presentation

We report a female EM with a rare form of hydronephrosis, (i.e. mid-ureteral stricture) which was detected early during pregnancy by imaging techniques. During fetal life both conventional fetal Ultrasound and maternal Magnetic Resonance Imaging (MRI) were used to diagnose the obstruction. Magnetic Resonance pyelography and retrograde Ureteropyelography were performed after delivery and before surgical correction and confirmed the finding.

Furthermore, we revisited the literature using online MEDLINE and EMBASE databases. The literature reported only a few cases of prenatal diagnosis of early onset mid-ureteral stricture.

Conclusion

Mid-ureteral stricture is a rare cause of prenatal hydronephrosis. The diagnosis should not be delayed in order to apply the appropriate surgical approach. As a result, we showed the usefulness of fetal MRI and postnatal Magnetic Resonance pyelography, in the event that radionuclide renography with Tc-MAG3 was less informative, to allow the detection of the site of ureteral narrowing. Intrasurgical retrograde ureteropyelography confirmed these findings.
Marker tolerant, immunocompetent animals as a new tool for regenerative medicine and long-term cell tracking
Authors: Odörfer Kathrin I , Unger Nina J , Weber Karin , Sandgren Eric P , Erben Reinhold G
Published: June 2007

Background

Immune-mediated rejection of labeled cells is a general problem in transplantation studies using cells labeled with any immunogenic marker, and also in gene therapy protocols. The aim of this study was to establish a syngeneic model for long-term histological cell tracking in the absence of immune-mediated rejection of labeled cells in immunocompetent animals. We used inbred transgenic Fischer 344 rats expressing human placental alkaline phosphatase (hPLAP) under the control of the ubiquitous R26 promoter for this study. hPLAP is an excellent marker enzyme, providing superb histological detection quality in paraffin and plastic sections.

Results

Transplantation of cells from hPLAP transgenic (hPLAP-tg) F344 rats into wild-type (WT) F344 recipients failed because of immune-mediated rejection. Here we show that this problem can be overcome by inducing tolerance to the marker gene by transplantation of bone marrow from hPLAP-tg F344 rats into WT F344 hosts after lethal irradiation, or by neonatal exposure of WT F344 rats to hPLAP-tg F344 cells. As proof-of-principle, we injected bone marrow cells (BMC) from hPLAP-tg rats into the knee joint of marker tolerant, bone marrow-transplanted WT rats, and found successful engraftment and differentiation of donor cells. In addition, hPLAP-tg BMC injected intravenously in neonatally tolerized WT F344 hosts could be traced in lymph nodes, 2 months post-injection.

Conclusion

In combination with the excellent marker hPLAP, marker tolerant animals may open up new perspectives for all experiments requiring long-term histological tracking of genetically labeled cells.