bluuebunny/crossref_metadata_2025 huggingface dataset:
Nursing advocacy in an Australian multidisciplinary context: findings on medico‐centrism
Authors: McGrath Pam , Holewa Hamish , McGrath Zoe
Published: November 2006

As a follow‐up to a recent study which highlighted the existence of medical dominance in multi‐disciplinary team (MDT) meetings, this paper presents research findings from an Australian study which shows that medico‐centrism is a key cause of tension within MDTs. The findings are from a 1‐year qualitative study in a regional hospital that explored the ethical decision‐making of health professionals within an acute care medical unit. This exploration was conducted through an iterative, phenomenological, qualitative research methodology that consisted of open‐ended interviews with a multi‐disciplinary representation of health professionals and a sample of consumers for whom they care. The paper situates the notion of nursing advocacy within the context of medico‐centrism and examines how the nursing profession interfaces with other disciplines. The findings indicate that the professional framework of nursing includes the language of advocacy, whilst the framework of doctors centres around the medical decision‐making process. All professional groups made reference to the MDT as the modus operandi for patient‐centred care. All participants noted that time and familiarity with patients and their families is essential for patient‐centred care and this could be achieved through MDT collaboration. However, doctors who have scant time to spend with patients saw it as their responsibility to direct the decisions of the MDT and viewed the MDT as adding confusion to the decision‐making process. Nurses reported that the limited amount of time spent by doctors in patient consultation translated into the need for advocacy. Professional and clinical confidence and experience are noted as necessary to successfully engage in the process of advocacy. The findings of this article indicate that the adoption of an advocacy role by nurses represents an important means through which MDT operation can be enhanced, medico‐centrism limited and patient‐centred care improved.
‘Give me a break’– respite care for older carers of mentally ill persons
Authors: Jeon Yun‐Hee , Brodaty Henry , O'Neill Colleen , Chesterson Jon
Published: November 2006

Background: The concept of respite care has been widely accepted and used throughout most developed countries, although primarily in connection with frail elderly, people with dementia, people with developmental disability or children. This paper aims at exploring older family carers’ needs for, access to and use of respite services when caring for people with a mental illness (excluding dementia) in the community.

Method: Data were collected through: semi‐structured interviews with 26 mental health professionals, 21 family carers aged over 55 years and 25 respite service providers; demographic questionnaires; field notes; and local area, state and national documents relating to respite care services. Demographic data were analysed using descriptive statistics. All 72 interviews, field notes and other documents were analysed using content analysis.

Results: Current respite services are not adequate to meet the needs of mentally ill patients and older carers. The unique aspects of respite care for older carers of persons with mental illness are poorly understood.

Conclusion: Bringing these issues to light creates the potential to address the unmet needs of older carers, improve provision of respite services, enhance quality of life of those who can benefit from respite services, and assist mental health professionals to work better with carers.
Experiences of Swedish community health nurses working with health promotion and a patient‐held health record
Authors: Jerdén Lars , Hillervik Charlotte , Hansson Ann‐Christin , Flacking Renée , Weinehall Lars
Published: November 2006

Community health nurses have a tradition of preventive care, and might therefore be a key group in the introduction of new health‐promotion methods. The aim of this study was to describe Swedish community health nurses’ experiences in working with health promotion and a patient‐held record as an integrated tool in their health‐promotion work. Interviews were performed with 12 nurses at primary healthcare centres in the county of Dalarna, Sweden. A qualitative content analysis applying aspects of the grounded theory approach was performed. Central to the analysis was the nurses’ struggle for balance, in being both a doer of practical disease‐oriented tasks and a health‐promotion communicator. Descriptions of the nurses’ struggles to balance their work were grouped into three themes: (i) working alone and as a part of a team; (ii) nurse‐related and patient‐related interests; and (iii) patient's responsibility and shared responsibility between patient and nurse. The findings indicated that the structural organization in the primary healthcare centres was important for the community health nurses’ means to work with health promotion and the patient‐held record. In addition, the community health nurses’ cognitive and emotional needs also affected this balance. In conclusion, the struggle of community health nurses to find a balance between being doers and health‐promotion communicators is valuable in understanding health promotion in primary health care. The study indicates that it is not enough to develop health‐promotion methods acceptable to community health nurses. A comprehensive examination of working conditions and the content of daily work is needed to ensure an emphasis on health promotion, including long‐term usage of patient‐held records.
Health in patients with Type 2 diabetes: an interview study based on the Welfare Theory of Health
Authors: Snellman Ingrid , Wikblad Karin
Published: November 2006

Background:  In his Welfare Theory of Health Nordenfelt describes health as a person's ability to fulfil vital goals in different life areas. In order to use the theory in nursing, a semi‐structured interview guide was constructed including questions about which vital goals Type 2 diabetic patients have and believe are important for their own welfare in different life areas.

Aim:  The aim of the study was to carry out preliminary validation of the interview guide. Two hypotheses were formulated: (i) Dissatisfied or unhealthy diabetic persons score lower on health‐related quality of life (HRQL) than do those classified as healthy; (ii) A person with diabetes who uses avoidance as his/her main coping strategy restructures his/her vital goals in order to avoid failure and thereby dissatisfaction increases.

Methods:  Interviews with 155 randomly selected Type 2 diabetic patients were conducted using the interview guide. HRQL and coping were also measured. The interview data were analysed using content analysis.

Results:  The results were in accordance with the health theory, i.e. a person with Type 2 diabetes may be unhealthy, but still satisfied with life as a whole. Our two hypotheses were confirmed: Dissatisfied or unhealthy subjects with Type 2 diabetes had HRQL scores in all domains but physical functioning and bodily pain that were lower than scores of those who were satisfied or healthy, and a person with Type 2 diabetes who uses avoidance as his/her main coping strategy does seem to restructure his/her vital goals to avoid failure.

Conclusion:  The theory‐based interview guide tested in this study seemed to reflect the notion that health includes fulfilment of vital goals.
Isolation and characterization of microsatellite loci from Macadamia
Authors: SCHMIDT A. L. , SCOTT L. , LOWE A. J.
Published: November 2006

Thirty‐three microsatellite loci were isolated for the Australian rainforest tree Macadamia integrifolia. Genotyping across a test panel of 43 commercial cultivars generated an average polymorphic information content of 0.480. Five loci showed no polymorphism across cultivars. Significant linkage disequilibrium was detected in 10 pairwise comparisons, including two pairs of loci identified from the same clone sequence. The 33 microsatellite loci represent a significant tool for genome mapping and population genetic studies.
Isolation and characterization of 49 polymorphic microsatellite loci in the ayu,Plecoglossus altivelis
Authors: IWATA H. , WATANABE K. , TAKESHIMA H. , IGUCHI K. , NISHIDA M.
Published: November 2006

A total of 49 novel polymorphic microsatellite markers in the ayu fish,Plecoglossus altivelis, were successfully isolated and characterized. The number of alleles per locus, observed heterozygosity, and expected heterozygosity ranged from two to 25 (11.3 on average), from 0.125 to 1.000 (0.648 on average), and from 0.123 to 0.957 (0.751 on average), respectively. These microsatellite markers will be useful for both studying population structure and identifying quantitative trait loci that control evolutionarily and economically important traits of ayu.
The window and mechanisms of major age‐related decline in the production of new neurons within the dentate gyrus of the hippocampus
Authors: Rao Muddanna S. , Hattiangady Bharathi , Shetty Ashok K.
Published: November 2006

While it is well known that production of new neurons from neural stem/progenitor cells (NSC) in the dentate gyrus (DG) diminishes greatly by middle age, the phases and mechanisms of major age‐related decline in DG neurogenesis are largely unknown. To address these issues, we first assessed DG neurogenesis in multiple age groups of Fischer 344 rats via quantification of doublecortin‐immunopositive (DCX+) neurons and then measured the production, neuronal differentiation and initial survival of new cells in the subgranular zone (SGZ) of 4‐, 12‐ and 24‐month‐old rats using four injections (one every sixth hour) of 5′‐bromodeoxyuridine (BrdU), and BrdU–DCX dual immunostaining. Furthermore, we quantified the numbers of proliferating cells in the SGZ of these rats using Ki67 immunostaining. Numbers of DCX+ neurons were stable at 4–7.5 months of age but decreased progressively at 7.5–9 months (41% decline), 9–10.5 months (39% decline), and 10.5–12 months (34% decline) of age. Analyses of BrdU+ cells at 6 h after the last BrdU injection revealed a 71–78% decline in the production of new cells per day between 4‐month‐old rats and 12‐ or 24‐month‐old rats. Numbers of proliferating Ki67+ cells (putative NSCs) in the SGZ also exhibited similar (72–85%) decline during this period. However, the extent of both neuronal differentiation (75–81%) and initial 12‐day survival (67–74%) of newly born cells was similar in all age groups. Additional analyses of dendritic growth of 12‐day‐old neurons revealed that newly born neurons in the aging DG exhibit diminished dendritic growth compared with their age‐matched counterparts in the young DG. Thus, major decreases in DG neurogenesis occur at 7.5–12 months of age in Fischer 344 rats. Decreased production of new cells due to proliferation of far fewer NSCs in the SGZ mainly underlies this decline.
Disparate patterns of age‐related changes in lipid peroxidation in long‐lived naked mole‐rats and shorter‐lived mice
Authors: Andziak Blazej , Buffenstein Rochelle
Published: November 2006

A key tenet of the oxidative stress theory of aging is that levels of accrued oxidative damage increase with age. Differences in damage generation and accumulation therefore may underlie the natural variation in species longevity. We compared age‐related profiles of whole‐organism lipid peroxidation (urinary isoprostanes) and liver lipid damage (malondialdehyde) in long living naked mole‐rats [maximum lifespan (MLS) > 28.3 years] and shorter‐living CB6F1 hybrid mice (MLS ∼3.5 years). In addition, we compared age‐associated changes in liver non‐heme iron to assess how intracellular conditions, which may modulate oxidative processes, are affected by aging. Surprisingly, even at a young age, concentrations of both markers of lipid peroxidation, as well as of iron, were at least twofold (P < 0.005) greater in naked mole tats than in mice. This refutes the hypothesis that prolonged naked mole‐rat longevity is due to superior protection against oxidative stress. The age‐related profiles of all three parameters were distinctly species specific. Rates of lipid damage generation in mice were maintained throughout adulthood, while accrued damage in old animals was twice that of young mice. In naked mole‐rats, urinary isoprostane excretion declined by half with age (P < 0.001), despite increases in tissue iron (P < 0.05). Contrary to the predictions of the oxidative stress theory, lipid damage levels did not change with age in mole‐rats. These data suggest that the patterns of age‐related changes in levels of markers of oxidative stress are species specific, and that the pronounced longevity of naked mole‐rats is independent of oxidative stress parameters.
Trade‐offs between longevity and pathogen resistance in Drosophila melanogaster are mediated by NFκB signaling
Authors: Libert Sergiy , Chao Yufang , Chu Xiaowen , Pletcher Scott D.
Published: November 2006

The innate immune response protects numerous organisms, including humans, from the universe of pathogenic molecules, viruses and micro‐organisms. Despite its role in promoting pathogen resistance, inappropriate activation and expression of NFκB and other immunity‐related effector molecules can lead to cancer, inflammation, and other diseases of aging. Understanding the mechanisms leading to immune system activation as well as the short‐ and long‐term consequences of such activation on health and lifespan is therefore critical for the development of beneficial immuno‐modulating and longevity‐promoting interventions. Mechanisms of innate immunity are highly conserved across species, and we take advantage of genetic tools in the model organism, Drosophila melanogaster, to study the effects of acute and chronic activation of immunity pathways on pathogen resistance and general fitness of adult flies. Our findings indicate that fat body specific overexpression of a putative pathogen recognition molecule, peptidoglycan recognition protein (PGRP‐LE), is sufficient for constitutive up‐regulation of the immune response and for enhanced pathogen resistance. Primary components of fitness are unaffected by acute activation, but chronic activation leads to an inflammatory state and reduced lifespan. These phenotypes are dependent on the NFκB‐related transcriptional factor, Relish, and they establish a mechanistic basis for a link between immunity, inflammation, and longevity.
The FRIENDS Emotional Health Programme: Initial Findings from a School‐Based Project
Authors: Stallard Paul , Simpson Neil , Anderson Sue , Hibbert Sarah , Osborn Caroline
Published: November 2006

Emotional disorders in children are common and although effective interventions are available comparatively few receive specialist help. School nurses were trained to deliver an evidence‐based emotional health cognitive behaviour therapy programme, FRIENDS, to 106 non‐referred children aged 9–10 attending three schools. Levels of anxiety and self‐esteem were stable in the 6‐month period before FRIENDS. Three months after completing FRIENDS, anxiety had significantly decreased and self‐esteem increased. Children with the most severe emotional problems benefited from the programme. The value of delivering standardised evidence based programmes in schools by school nurses is discussed and the need for further research highlighted.
Developing Services with Limited Resources: Establishing a CAMHS in Pakistan
Authors: Syed Ehsan Ullah , Hussein Sajida Abdul , Yousafzai Abdul Wahab
Published: November 2006

Background:  There are very few mental health services in Pakistan. In 2002, the Department of Psychiatry at Aga Khan University Hospital started a separate clinic for children under the age of 15 years to meet the population needs. This service took direct referrals from other physicians as well as from parents and schools.

Method:  A DSM‐IV based semi‐structured interview with a uniform written format was used for an initial evaluation by a child psychiatrist. Data regarding demographic characteristics, referral source, diagnoses and treatment were collected.

Results:  A total of 290 new referrals were made to the clinic over 3 years. The most common reason for referral was aggressive behaviour, although this possibly masked other kinds of mental health problems, as indicated by the assessment. Attention deficit‐hyperactivity disorder was the most frequent diagnosis, made in 25% of children.

Conclusions:  Despite the limited resources and the high level of need in developing countries, resources can be used effectively within the framework of their health and educational systems, so maximising protective factors within their communities.
Outpatient high‐dose melphalan in multiple myeloma patients
Authors: Kassar Mohamad , Medoff Erin , Seropian Stuart , Cooper Dennis L.
Published: November 2006

BACKGROUND: The brief period of neutropenia and limited nonmarrow toxicity after high‐dose melphalan (HDM) provide a rationale for outpatient treatment.

STUDY DESIGN AND METHODS: Our experience with HDM (140‐200 mg/m2) in 90 consecutive transplant episodes was retrospectively reviewed. Most patients were treated in an outpatient setting. Patients without a primary care provider (PCP) were electively admitted before the anticipated onset of neutropenia. Ceftriaxone was added to ciprofloxacin at the onset of neutropenia. All febrile patients were admitted.

RESULTS: The median time from peripheral blood progenitor cell infusion to onset of neutropenia was 5 days (range, 4‐6 days), and the mean duration of neutropenia was 5 days (range, 4‐7 days). Thirty‐eight transplants (42%) were performed entirely in the outpatient setting. The mean duration of hospitalization was 2.2 days in patients not electively admitted. The use of ceftriaxone was associated with a decreased risk for fever (39% vs. 79%) and reduced duration of hospitalization (1.6 days vs. 4.5 days) for nonelectively admitted patients. There was no treatment‐related mortality.

CONCLUSION: Ambulatory therapy with HDM is safe and can be achieved in a general outpatient setting. The predictable time to neutropenia allows even poor candidates for outpatient therapy to be admitted electively on Day +4. The apparent beneficial effect of ceftriaxone needs to be confirmed in randomized trials.
Comparison and stability of ADAMTS13 activity in therapeutic plasma products
Authors: Scott Erik A. , Puca Kathleen E. , Pietz Bradley C. , DuChateau Brian K. , Friedman Kenneth D.
Published: November 2006

BACKGROUND: The von Willebrand factor (VWF)‐cleaving protease, ADAMTS13, is often deficient in cases of thrombotic thrombocytopenic purpura (TTP). The primary treatment of TTP is therapeutic plasma exchange (TPE) utilizing a variety of plasma products that help restore ADAMTS13 activity. However, multiple replacement products are available to choose from. Thawed plasma products have a variable refrigerated shelf life depending on the product type; stability of ADAMTS13 in thawed products stored at 1 to 6°C has not been determined.

STUDY DESIGN AND METHODS: ADAMTS13 activity was measured in three types of plasma products and cryoprecipitate. Fresh‐frozen plasma (FFP) aliquots and cryoprecipitate‐poor plasma (CPP) products were produced from 10 whole‐blood (WB) donations. Twenty‐four‐hour plasma products were manufactured from 10 additional WB donations. ADAMTS13 activity in these products at time of thaw and after 5 days of storage at 1 to 6°C was measured with a modified version of the FRETS‐VWF73 fluorogenic assay. ADAMTS13 activity at time of thaw was measured in 10 units of cryoprecipitate and five related CPP products.

RESULTS: ADAMTS13 is present in similar amounts in FFP, CPP, and 24‐hour plasma products. Storage at 1 to 6°C for up to 5 days did not significantly diminish ADAMTS13 activity. The concentration of ADAMTS13 in cryoprecipitate was significantly higher than that observed in plasma products.

CONCLUSION: FFP, CPP, and 24‐hour plasma products should be equally effective for ADAMTS13 restoration through TPE and should remain so for the duration of the shelf life of the thawed products.
Generation of inflammatory cytokines and chemokines from peripheral blood mononuclear cells by HLA Class II antibody–containing plasma unit that was associated with severe nonhemolytic transfusion reactions
Authors: Sakagawa Hisako , Miyazaki Toru , Fujihara Mitsuhiro , Sato Shinichiro , Yamaguchi Miki , Fukai Kanji , Morioka Masanobu , Kato Toshiaki , Azuma Hiroshi , Ikeda Hisami
Published: November 2006

BACKGROUND: HLA Class II antibodies are thought to be involved in severe transfusion reactions including transfusion‐related acute lung injury (TRALI). The activation of monocytes by HLA Class II antibody may play an important role in the etiology of TRALI.

CASE REPORT: An 81‐year‐old man with non‐Hodgkin's lymphoma (Clinical Stage IIIA) received a plateletpheresis unit containing at least 4 × 1011 platelets because of thrombocytopenia and a bleeding tendency. Approximately 30 minutes after the start of transfusion, he developed chills, tachycardia, dyspnea, lumber, and abdominal pain and then a fever (40.3°C). His SaO2 dropped to 70 percent. The transfusion was discontinued immediately. His symptoms disappeared after treatment with oxygen and the administration of corticosteroid and aminophyrine. A chest X‐ray showed no sign of pulmonary edema.

RESULTS: The donor serum sample had HLA‐DR antibodies against multiple DR antigens including DR13, the recipient's HLA‐DR type. The cross‐match between the patient's lymphocytes and the donor serum was positive. The treatment of peripheral blood mononuclear cells from healthy subjects bearing DR13 antigen with the donor plasma caused the secretion of inflammatory cytokines (i.e., interleukin [IL]‐1β, IL‐6, and tumor necrosis factor‐α) and neutrophil‐activating chemokines (i.e., IL‐8 and CXCL1/GRO‐α) in a cognate antigen‐antibody relationship. In addition, the secretion of inflammatory cytokines appeared to require the involvement of CD32 and/or CD16.

CONCLUSION: HLA‐DR antibodies, detected in this case, had biologic functions to induce production of not only inflammatory cytokines but also neutrophil‐attractant chemokines in vitro, which could contribute to the etiology of severe nonhemolytic transfusion reactions.
Does Spatial Variation in Heterogeneity Matter? Assessing the Adoption Patterns of Business Improvement Districts
Authors: Brooks Leah
Published: November 2006

Because they supplement the municipal provision of local public goods, Business Improvement Districts (BIDs) provide an opportunity to examine the space, scope, and determinants of the provision of local public goods. A BID is formed when a group of merchants or commercial property owners in a neighborhood vote in favor of package of self‐assessments and local public goods to be funded with those assessments. These districts solve a collective action problem in the provision of public goods because once a majority has voted in favor, participation is compulsory for all merchants or commercial property owners in the neighborhood. I use a unique dataset on adoption patterns of BIDs in California to test two main claims suggested by the theoretical literature: first, that businesses respond to individual heterogeneity that determines the quality of local public goods, and second, that the type of heterogeneity—overall or spatial—matters. In contrast to the literature on residents, this study finds at best a weak correlation between a city's adoption of a BID and heterogeneity. In addition, despite the theoretical preference for spatial over overall heterogeneity, BIDs are not more likely to be adopted by spatially heterogeneous cities.
Tiebout Sorting in Metropolitan Areas
Authors: Bickers Kenneth , Engstrom Richard N.
Published: November 2006

In this article, we tackle the issue of sorting at the metropolitan area by utilizing an alternative methodological approach that permits us to avoid problems plaguing earlier studies. For this analysis, we take two Metropolitan Statistical Areas (MSAs) as our test cases: the Houston MSA and the Atlanta MSA. For each metropolitan area, we employ Monte Carlo computer simulations to randomly create a large number of metropolitan “jurisdictional” groupings. Based upon these Monte Carlos, we are able to estimate the level of jurisdictional homogeneity that is attributable to random chance. The observed levels of sorting, including the increasing homogeneity as populations decrease, are entirely consistent with what one might find if clusters of households were randomly grouped together into municipalities.
Elastic Properties of Titanium Monoboride Measured by Nanoindentation
Authors: Cao Guojian , Geng Lin , Naka Masaaki
Published: November 2006

In order to measure the elastic properties of titanium monoboride (TiB), which are not well known, a Ti/TiB composite with 95% volume fraction of TiB was fabricated by the powder metallurgy route. After compacting mixed Ti+TiB2 powders by a hot unidirectional pressure (1200°C, 25 MPa, 60 min, <10−2 Pa), annealing at 1200°C was performed for 48 h, after which the main phase in the material was TiB. The elastic properties of TiB were directly measured by using the nanoindentation technique. The polycrystalline modulus and hardness of the TiB were 450 and 27.5 GPa, respectively.
Analysis of Phase Coexistence in Fe2O3‐Doped 0.2PZN–0.8PZT Ferroelectric Ceramics by Raman Scattering Spectra
Authors: Zhu Man‐Kang , Lu Peng‐Xian , Hou Yu‐Dong , Song Xue‐Mei , Wang Hao , Yan Hui
Published: November 2006

In this work, we suggested a method to evaluate quantitatively the effect of doping oxide on the phase coexistence of PbZr1−xTixO3 (PZT)‐based ceramics through the analysis of the Raman scattering spectra. Theoretically, the degenerated T3u mode in the cubic phase of PZT will transform as A1(3) and E(4) modes in the tetragonal phase or as rhombohedral (R) modes in the rhombohedral phase below the Curie temperature, which set up the theoretical base to study the phase coexistence in ferroelectric materials. Through separation by fitting of the Raman bands, the shifts and intensities of different Raman vibration modes were determined. A calculation equation representing the phase coexistence was put forward based on the theoretical analysis of the degenerated T3u modes. The results showed that a turning point appears at the Fe2O3 addition of 0.3%. The variation in the electrical properties of the Fe2O3‐doped Pb(Zn1/3Nb2/3)O3 (PZN)–PZT ceramics also affirmed the turning point of the phase evolution as the addition of Fe2O3.
Effect of Sintering Additives on Microstructure and Mechanical Properties of Porous Silicon Nitride Ceramics
Authors: Yang Jun , Yang Jian‐Feng , Shan Shao‐Yun , Gao Ji‐Qiang , Ohji Tatsuki
Published: November 2006

Porous silicon nitride (Si3N4) ceramics with about 50% porosity were fabricated by pressureless sintering of α‐Si3N4 powder with 5 wt% sintering additive. Four types of sintering aids were chosen to study their effect on the microstructure and mechanical properties of porous Si3N4 ceramics. XRD analysis proved the complete formation of a single β‐Si3N4 phase. Microstructural evolution and mechanical properties were dependent mostly on the type of sintering additive. SEM analysis revealed the resultant porous Si3N4 ceramics as having high aspect ratio, a rod‐like microstructure, and a uniform pore structure. The sintered sample with Lu2O3 sintering additive, having a porosity of about 50%, showed a high flexural strength of 188 MPa, a high fracture toughness of 3.1 MPa·m1/2, due to fine β‐Si3N4 grains, and some large elongated grains.
Effect of bimatoprost on intraocular pressure after phacoemulsification in eyes with exfoliation syndrome
Authors: Takmaz Tamer , Can İzzet , Gürdal Canan , Kürkçüoǧlu Piraye , Aşık Şenay
Published: November 2006

Purpose:  To evaluate the effect of bimatoprost 0.03% on intraocular pressure (IOP) after phacoemulsification in eyes with exfoliation syndrome.

Methods:  This prospective, randomized, masked study comprised 90 eyes of 90 patients scheduled for phacoemulsification. The patients were divided into three groups (group 1 = without exfoliation, group 2 = with exfoliation syndrome, group 3 = exfoliation syndrome + bimatoprost). Immediately after phacoemulsification, one drop of bimatoprost was instilled in eyes in group 3. Baseline IOP was measured 1 day before surgery and routine follow‐ups were performed at 6 hours, 20–24 hours and 1 week postoperatively.

Results:  Preoperative IOP was 15.0 ± 2.7 mmHg in group 1, 15.6 ± 3.2 mmHg in group 2 and 16.1 ± 3.2 mmHg in group 3 (p = 0.372). Six hours postoperatively, there was a significant difference between the groups (p = 0.013): IOP in group 2 (22.4 ± 7.3 mmHg) was higher than in group 1 (18.4 ± 4.4 mmHg) (p = 0.018) and group 3 (18.9 ± 4.9 mmHg) (p = 0.044). In all groups, IOP values at 6 hours postoperatively were higher than preoperative values (p < 0.001), but IOP values at 20–24 hours and 1 week after surgery were not significantly different from baseline values (p > 0.05). The change in IOP in group 2, from baseline to 6 hours postoperatively, was greater than the equivalent changes in group 1 (p = 0.048) and group 3 (p = 0.016).

Conclusions:  Transient IOP increase and spikes were more common in eyes with exfoliation syndrome. Postoperative application of bimatoprost was effective in reducing IOP and preventing IOP spikes ≥ 30 mmHg in eyes with exfoliation syndrome in the early postoperative period.
Immediate loading of dental implants placed in severely resorbed edentulous mandibles reconstructed with autogenous calvarial grafts
Authors: Chiapasco Matteo , Gatti Claudio , Gatti Fulvio
Published: November 2006

Objective: The aim of this prospective study was to present the clinical outcome of immediately loaded dental implants placed in edentulous, severely atrophied mandibles, after reconstruction with autogenous multilayered calvarial grafts.

Materials and methods: Six patients, two males and four females, aged 40–67 years (mean: 56 years) presenting with severely atrophied edentulous mandibles (Cawood and Howell class VI), were reconstructed with multilayered calvarial bone grafts placed in the intraforaminal area of the mandible. Five to 8 months afterwards, 23 dental implants were placed in the reconstructed areas (three to four implants per patient) and immediately loaded with implant‐supported overdentures. Patients were followed with clinical and radiographic controls annually.

Results: Recovery after the reconstruction was uneventful in all patients. All 23 implants were osseointegrated 1–3 years after the start of immediate loading. The survival and success rates of implants were 100% and 95.7%, respectively.

Conclusion: Results from this study showed that immediate loading of dental implants placed in severely atrophied edentulous mandibles reconstructed with calvarial bone grafts is a predictable procedure, which permits a successful dental rehabilitation with a shortening of treatment times.
Patients with a Non‐dysferlin Miyoshi Myopathy have a Novel Membrane Repair Defect
Authors: Jaiswal Jyoti K. , Marlow Gareth , Summerill Gillian , Mahjneh Ibrahim , Mueller Sebastian , Hill Maria , Miyake Katsuya , Haase Hannelore , Anderson Louise V. B. , Richard Isabelle , Kiuru‐Enari Sari , McNeil Paul L. , Simon Sanford M. , Bashir Rumaisa
Published: November 2006

Two autosomal recessive muscle diseases, limb girdle muscular dystrophy type 2B (LGMD2B) and Miyoshi myopathy (MM), are caused by mutations in the dysferlin gene. These mutations result in poor ability to repair cell membrane damage, which is suggested to be the cause for this disease. However, many patients who share clinical features with MM‐type muscular dystrophy do not carry mutations in dysferlin gene. To understand the basis of MM that is not due to mutations in dysferlin gene, we analyzed cells from patients in one such family. In these patients, we found no defects in several potential candidates – annexin A2, caveolin‐3, myoferlin and the MMD2 locus on chromosome 10p. Similar to dysferlinopathy, these cells also exhibit membrane repair defects and the severity of the defect correlated with severity of their disease. However, unlike dysferlinopathy, none of the conventional membrane repair pathways are defective in these patient cells. These results add to the existing evidence that cell membrane repair defect may be responsible for MM‐type muscular dystrophy and indicate that a previously unsuspected genetic lesion that affects cell membrane repair pathway is responsible for the disease in the non‐dysferlin MM patients.
Nuclear Export of Influenza A Virus mRNAs Requires Ongoing RNA Polymerase II Activity
Authors: Amorim Maria‐Joao , Read Eliot K. , Dalton Rosa M. , Medcalf Liz , Digard Paul
Published: November 2006

Influenza A virus transcribes its segmented negative sense RNA genome in the nuclei of infected cells in a process long known to require host RNA polymerase II (RNAP‐II). RNA polymerase II synthesizes pre‐mRNAs whose 5′‐cap structures are scavenged by the viral RNA‐dependent RNA polymerase during synthesis of viral mRNAs. Drugs that inhibit RNAP‐II therefore block viral replication, but not necessarily solely by denying the viral polymerase a source of cap‐donor molecules. We show here that 5,6‐dichloro‐1‐β‐D‐ribofuranosyl‐benzimidazole (DRB), a compound that prevents processive transcription by RNAP‐II, inhibits expression of the viral HA, M1 and NS1 genes at the post‐transcriptional level. Abundant quantities of functionally and structurally intact viral mRNAs are made in the presence of DRB but with the exception of NP and NS2 mRNAs, are not efficiently translated. Taking M1 and NP mRNAs as representatives of DRB‐sensitive and insensitive mRNAs, respectively, we found that the block to translation operates at the level of nuclear export. Furthermore, removal of DRB reversed this block unless a variety of chemically and mechanistically distinct RNAP‐II inhibitors were added instead. We conclude that influenza A virus replication requires RNAP‐II activity not just to provide capped mRNA substrates but also to facilitate nuclear export of selected viral mRNAs.
Targeting of TMV Movement Protein to Plasmodesmata Requires the Actin/ER Network; Evidence From FRAP
Authors: Wright Kathryn M. , Wood Nicola T. , Roberts Alison G. , Chapman Sean , Boevink Petra , MacKenzie Katrin M. , Oparka Karl J.
Published: November 2006

Fluorescence recovery after photobleaching (FRAP) was used to study the mechanism by which fluorescent‐protein‐tagged movement protein (MP) of tobacco mosaic virus (TMV) is targeted to plasmodesmata (PD). The data show that fluorescence recovery in PD at the leading edge of an infection requires elements of the cortical actin/endoplasmic reticulum (ER) network and can occur in the absence of an intact microtubule (MT) cytoskeleton. Inhibitors of the actin cytoskeleton (latrunculin and cytochalasin) significantly inhibited MP targeting, while MT inhibitors (colchicine and oryzalin) did not. Application of sodium azide to infected cells implicated an active component of MP transfer to PD. Treatment of cells with Brefeldin A (BFA) at a concentration that caused reabsorption of the Golgi bodies into the ER (precluding secretion of viral MP) had no effect on MP targeting, while disruption of the cortical ER with higher concentrations of BFA caused significant inhibition. Our results support a model of TMV MP function in which targeting of MP to PD during infection is mediated by the actin/ER network.
Depressive Symptoms in Adults With Mild to Moderate Intellectual Disability and Their Relation to Maternal Well‐Being
Authors: Esbensen Anna J. , Seltzer Marsha Mailick , Greenberg Jan S.
Published: November 2006

Abstract  Little is known about the impact on the family of caring for an individual with both intellectual disability and a mental‐health problem. We examined the relationship between depressive symptoms in adults with mild to moderate intellectual disability and concurrent maternal well‐being as measured by depression, pessimism, subjective burden, and the mother’s perception of the quality of the relationship with her son or daughter. We also examined the extent to which the adult’s depressive symptoms predicted later maternal well‐being after controlling for behavior problems and identified covariates. Seventy‐one interviews were conducted with mothers regarding their own well‐being and their children’s behavior problems as part of a larger longitudinal study of mothers more than 55 years old caring for a coresiding adult son or daughter with intellectual disability. The adult with mild to moderate intellectual disability was interviewed about his or her depressive symptoms. The depressive symptoms of the adult with intellectual disability were correlated with concurrent maternal depression, and were predictive of future maternal depression, pessimism, and subjective burden. They also predict some measures of maternal well‐being, and do so beyond what is predicted by behavior problems. These findings suggest that raising an adult child with a dual diagnosis may be more stressful than raising an adult child with intellectual disability only.
Family Quality of Life and Older Families
Authors: Jokinen Nancy S.
Published: November 2006

Abstract  This paper highlights the circumstances of older families of adults with an intellectual disability (ID) using scenarios drawn from current research, the practice literature pertaining to older families, and basic tenets of family quality of life as a field of study. Specific issues discussed include the propensity in the literature to emphasize negative aspects of prolonged coresidence of older parents and adults with an ID; evidence‐based practice often dominated by a focus on future planning, particularly in regard to transitions from home, financial issues, and guardianship; and little research or practice identifying a planning process that considers the older family as a whole, taking into account and addressing the needs and concerns of all family members affected by ageing circumstances. Additionally, scant literature on the involvement of family in the lives of middle‐aged and older adults already living in residential services is available to guide practice to successfully maintain family involvement under these circumstances. The author concludes that there is a need to expand evidence‐based practice beyond work with older parents cohabiting with a son or daughter with an ID and future planning, and that a family quality of life approach has the potential to identify proactive strategies that strengthen family relations and actively engage older families in the development of policy and practice.
Older Parents’ Perceptions of Ambivalence in Relationships With Their Children
Authors: Peters Cheryl L. , Hooker Karen , Zvonkovic Anisa M.
Published: November 2006

Abstract: This qualitative study explores older parents’ ambivalent perceptions of their relationships with their adult children. Interviews with 17 mothers and fathers (aged 67+) provided reports on 75 relationships (43 sons, 32 daughters). Two predominant sources of ambivalence emerged when parents discussed their current relationships. The first identified source of ambivalence relates to children being busy, so that parents were dissatisfied with the frequency and quality of time spent together. Help exchanges are also discussed in light of children’s busyness. The second identified source of ambivalence explores parents’ ambivalent perceptions about their children’s romantic partners and parenting styles. Results are integrated into the developing theory of intergenerational ambivalence and practice implications for family communication are discussed.
Adult Children as Informants About Parent’s Psychosocial Preferences
Authors: Carpenter Brian D. , Lee Monica , Ruckdeschel Katy , Van Haitsma Kimberly S. , Feldman Penny H.
Published: November 2006

Abstract: Utilizing data from 80 adult children–older parent dyads, this study examined the degree to which adult children could predict the psychosocial preferences of their older parents. Overall, children demonstrated good knowledge about parent preferences, although there was wide variability within the sample and across preference domains. Children underestimated how important parents considered continued enrichment and personal growth. Knowledge was associated with parents’ functional status and mood. Parent, but not child, perceptions of family flexibility and cohesion were related to children’s knowledge. Findings suggest that family life education and intervention programs need to address contextual factors as a means to improve intergenerational knowledge and enhance the likelihood that parent preferences are considered in care planning.
Just Like Raising Your Own? Grandmothers’ Perceptions of Parenting a Second Time Around*
Authors: Dolbin‐MacNab Megan L.
Published: November 2006

Abstract: A defining characteristic of grandparents raising grandchildren is parenting a second generation of children. To learn how grandmothers compare parenting their grandchildren to parenting their children, 40 custodial grandmothers were interviewed. Results of a qualitative analysis indicated that grandmothers perceived themselves as wiser, more relaxed, and more involved with their grandchildren. Grandmothers also perceived added challenges such as having limited energy, negotiating changing family roles, and parenting in a toxic social environment. In terms of parenting behaviors and emotional bonds, some grandmothers saw similarities in parenting their children and grandchildren. Findings suggest that custodial grandmothers would benefit from parent education and training that takes into account their previous parenting experience yet still addresses the unique challenges associated with parenting grandchildren.
Breaking the Chain: How Grandparents Moderate the Transmission of Maternal Depression to Their Grandchildren
Authors: Silverstein Merril , Ruiz Sarah
Published: November 2006

Abstract:Drawing on family systems theory, this study examined whether social cohesion with grandparents moderated the intergenerational transmission of depressive symptoms from mothers to their adolescent and young adult children. We analyzed data from 2,280 grandchildren and their mothers who participated in two waves of the National Survey of Families and Households. Results revealed that grandchildren who were least integrated with their grandparents resembled their mothers in the severity of depressive symptoms. Grandchildren who were more integrated with their grandparents bore no such resemblance. We conclude that grandparents are consequential family actors who, by conditioning parent‐child dynamics, influence the long‐term emotional well‐being of their grandchildren. Results are discussed in terms of intergenerational interdependence and the untapped resource that older adults represent.
Intimate Partner Violence of Rural Aging Women*
Authors: Teaster Pamela B. , Roberto Karen A. , Dugar Tyler A.
Published: November 2006

Abstract: Although reports of intimate partner violence (IPV) decrease with age, a significant number of aging women experience IPV in their relationships. The structure and culture of rural environments may inadvertently conceal violence against aging women and inhibit prevention and treatment efforts. Guided by an ecological community framework, 3 focus groups involving 24 professionals working with victims of IPV in rural Kentucky and in‐depth interviews with 10 aging rural women who had experienced IPV were conducted to examine the trajectory of, and community responses to, violence in late life. Findings revealed multiple interacting influences on IPV of aging women in rural areas including the women’s families and resources, culture and locality, religion, community support, and government entities.
Resources for Advancing Family Gerontology Education and Practice*
Authors: Price Christine A. , Brosi Whitney A.
Published: November 2006

Abstract: The unprecedented growth in the older adult population combined with increased scholarly interest in family dynamics has resulted in the gradual expansion of family gerontology as its own area of study. Consisting of both university faculty and practitioners, family gerontology educators integrate multiple disciplines in order to teach about later life families and are responsible for training diverse audiences. To increase awareness about family gerontology and encourage the advancement of this interdisciplinary field, we conducted a comprehensive review of educational resources specific to family gerontology. Our goal was to enable a wide range of educators to introduce or expand their emphasis on families in later life and to incorporate new resources, topics, and teaching strategies that promote family gerontology education.
Following the Affect: Learning to Observe Emotional Regulation
Authors: Delaney Kathleen R.
Published: November 2006

On inpatient psychiatric units, staff deal with children and adolescents whose affect escalates quickly and intensely. These same children experience strong emotions that they can neither understand nor explain. To intervene effectively, inpatient staff must understand the regulation issues underneath the escalated behaviors. Emotion Regulation theory and the developmental line of emotional understanding are useful concepts in assessing and intervening with these children and adolescents. Presented here are criteria to guide inpatient staff's assessment of children and adolescents with emotion regulation difficulties. The assessment cues are based in concepts of Emotion Regulation and emotional understanding and are accompanied by suggested intervention strategies.
Top 10 Milieu Interventions for Inpatient Child/Adolescent Treatment
Authors: Delaney Kathleen R.
Published: November 2006

Presented in this article are 10 interventions to deal with children and adolescents on inpatient psychiatric units. The 10 are divided into three categories: behavioral, cognitive, and affective. The interventions discussed are particularly relevant to staff in their efforts to help children and adolescents achieve control over their thoughts, feelings, and behaviors. Each intervention includes a summary of the theory that supports its efficacy, a brief explanation of the intervention, and methods for applying the technique in clinical situations.
The Undervalued Role of Over‐regulation in Autism: Chaos Theory as a Metaphor and Beyond
Authors: Cashin Andrew , Waters Cheryl
Published: November 2006

TOPIC:  A triad of impairment that consists of impaired communication, impaired social skills and over‐regulated behavior characterizes autism. Causality of autism is yet to be identified. Therapy has been devised to apply to the work with children and adolescents with a diagnosis of autism in the domains of impaired communication and impaired social skills. Little attention has been paid to the importance of the over‐regulated behavior that forms part of the triad of impairment.

PURPOSE:  This paper considers this point of over‐regulation in the triad of impairment in autism through the lens of Chaos theory.

SOURCES:  Contemporary literature on autism and Chaos theory.

CONCLUSIONS:  Implications for nursing practice and research are raised.
RHEOLOGY OF DIFFERENT FORMULATIONS OF MILK CHOCOLATE AND THE EFFECT ON COATING THICKNESS
Authors: KARNJANOLARN RATTANA , MCCARTHY KATHRYN L.
Published: November 2006

This work characterized the flow properties and investigated the effect of grind, emulsifier type and emulsifier level on the coating thickness of milk chocolate. Rheological properties were characterized using a concentric cylinder viscometer according to the method recommended by the International Confectionery Association. The thickness of the chocolate on dip‐coated acrylic plates was obtained by a gravimetric method. A three‐way analysis of variance was performed for the coating thickness. All three factors were significant; the thickness of the chocolate coating was greater for fine grind, soy lecithin for emulsifier and for low concentrations of emulsifier. The thicknesses were well predicted using the model with the Casson model parameters from the rheological characterization.