bluuebunny/crossref_metadata_2025 huggingface dataset:
Losses disguised as wins in modern multi‐line video slot machines
Authors: Dixon Mike J. , Harrigan Kevin A. , Sandhu Rajwant , Collins Karen , Fugelsang Jonathan A.
Published: August 2010

Aims  Players can wager on multiple lines of modern slot machines. When they spin and fail to gain any credits, the machine goes into a state of relative quiet. By contrast, when they spin and win, these spins are accompanied by reinforcing sights and sounds. Such reinforcement also occurs when the amount won is less than the spin wager. We sought to show that these ‘losses disguised as wins’, or LDWs, would be as arousing as wins, and more arousing than regular losses.

Measurement and participants  We measured skin conductance response (SCR) amplitudes and heart‐rate changes following wins, LDWs and losses for 40 novices playing a multi‐line slot machine.

Findings  SCR amplitudes were similar for wins and LDWs—both were significantly larger than for regular losses.

Conclusions  For novice players, the reinforcing sights and sounds of the slot machine triggered arousal on wins, where the number of credits gained was greater than the spin wager, but also on ‘losses disguised as wins’ where the amount ‘won’ was less than the spin wager. Despite the fact that players lost money on these spins, these outcomes were more arousing than regular losses where no credits were gained. Although these findings involve novice players, the heightened arousal associated with these losses may have implications for the development of problem gambling, as arousal has been viewed as a key reinforcer in gambling behaviour.
Sun‐downing and integration for the advancement of science and therapeutics: the National Institute on Substance Use Disorders (NISUD)
Authors: Grabowski John
Published: August 2010

The National Institutes of Health (NIH) is the most prominent funding source for scientific research in the world. It is also a complex and diverse organization, having multiple institutes, centers and offices. NIH emphasizes the need for innovation and collaboration in research to discover critical knowledge, enhance health and prevent disease. Advancement in science requires not only sophisticated methods, but also logical organization. Here, an overview of ‘behavioral research’ (writ large) at NIH is presented, focusing upon the common trinity of ‘alcohol, tobacco/nicotine and other drugs’ and programmatic overlap across entities. Consideration is also given to the origins of institutes and their historical movement across organizational boundaries. Specific issues, concerns and advantages of integration of the National Institute on Drug Abuse and National Institute on Alcoholism and Alcohol Abuse are addressed. It is concluded that advances in understanding, treating and preventing substance use disorders would best be served by (1) review and integration of all related research throughout NIH, (2) logical placement of leadership for this activity in a single institute, here entitled the National Institute on Substance Use Disorders, and (3) close collaboration of this institute with its complementary partner, the National Institute on Mental Health. Thus, NIH can establish an organizational structure and collaborations reflecting the realities of the scientific and disease/health domains. This would make a prominent statement to the world scientific and health communities regarding NIH recognition of the need for innovation (scientific and organizational) and focus upon these myriad interrelated and costly problems.
Dilated intercellular space in chronic laryngitis and gastro‐oesophageal reflux disease: at baseline and post‐lansoprazole therapy
Authors: Vaezi M. F. , Slaughter J. C. , Smith B. S. , Washington M. K. , Jerome W. G. , Garrett C. G. , Hagaman D. , Goutte M.
Published: August 2010

Aliment Pharmacol Ther 2010; 32: 916–924

Background  Dilation of intercellular spaces is reported to be an early morphological marker in gastro‐oesophageal reflux. It remains unknown if this marker is useful in diagnosing reflux‐related chronic laryngitis.

Aim  To determine histopathology and electron microscopic changes in oesophageal and laryngeal epithelium in chronic laryngitis.

Methods  In this prospective blinded study, we enrolled 53 participants: 15 controls, 20 patients with GERD and 18 patients with chronic laryngitis. The latter two groups were subsequently treated with lansoprazole 30 mg bid for 12‐weeks. Baseline and postacid suppressive therapy biopsies were obtained from distal oesophagus and laryngeal postcricoid areas. Biopsy specimens were evaluated for histopathology and dilated intercellular space changes.

Results  There was no significant increase in oesophageal or laryngeal epithelium intercellular spaces among GERD or laryngitis patients compared with controls at baseline or postacid suppressive therapy. Only patients with GERD had significantly (P = 0.03) higher proportion of moderate‐to‐severe oesophageal spongiosis and basal cell hyperplasia, which normalized postacid suppressive therapy.

Conclusions  There was no increase in the width of intercellular spaces in the oesophagus or larynx in GERD or chronic laryngitis at baseline or postacid suppressive therapy. Our findings question the uniform presence of dilated intercellular space in patients with GERD.
A comparison of the respiratory effects of oxycodone versus morphine: a randomised, double‐blind, placebo‐controlled investigation*
Authors: Chang S. H. , Maney K. M. , Phillips J. P. , Langford R. M. , Mehta V.
Published: August 2010

Oxycodone’s respiratory profile (particularly the extent of respiratory depression in comparison to morphine) remains to be fully characterised in the peri‐operative period. We randomly assigned ASA 1‐2 adults for elective surgery under general anaesthesia to receive saline, morphine 0.1 mg.kg−1, or oxycodone 0.05 mg.kg−1, 0.1 mg.kg−1, or 0.2 mg.kg−1. Results were obtained from six patients in the saline group, 12 patients in the groups receiving morphine 0.1 mg.kg−1, oxycodone 0.05 mg.kg−1and 0.1 mg.kg−1, and from 10 patients who received oxycodone 0.2 mg.kg−1. Patients were breathing spontaneously and minute ventilation monitored with a wet wedge spirometer for 30 min. All active groups demonstrated significant respiratory depression compared to saline (p < 0.0001 for all groups). The mean (SD) reduction in minute volume from baseline was 22.6% (10.4%) for the morphine 0.1 group and 53.3% (27.2%), 74.4% (12.9%) and 88.6% (13.5%) for the oxycodone 0.05, 0.1 and 0.2 groups, respectively, with significant dose dependent differences between oxycodone groups (p = 0.0007). The extent and speed of onset of oxycodone induced respiratory depression was dose dependent and greater than an equivalent dose of morphine.
Serum total tryptase levels are increased in patients with active chronic urticaria
Authors: Ferrer M. , Nuñez‐Córdoba J. M. , Luquin E. , Grattan C. E. , De la Borbolla J. M. , Sanz M. L. , Schwartz L. B.
Published: August 2010

Background
We have demonstrated previously mast cell histamine release upon incubation with chronic urticaria (CU) sera, presumably by degranulation.

Objective
To explore total and mature tryptase in order to assess whether any increase in total tryptase levels is due in part to mast cell degranulation or to mast cell burden. We also wanted to explore differences between the autoimmune groups called idiopathic (serum unable to activate basophils), and to correlate total and mature tryptase levels with different urticaria features.

Methods
We measured total and mature tryptase serum levels in 81 CU patients, 16 atopic donors and 21 healthy control sera. We assessed autoimmunity by measuring the CD63 expression in normal basophil donors upon incubation with CU sera.

Results
We found significantly higher levels of total tryptase in the sera of CU patients (6.6 ±4.1 μg/L) than in sera from healthy non‐atopic subjects (4.4 ±2.8 μg/L) and from atopic subjects (4.5 ±1.7 μg/L). Mature tryptase levels were undetectable (<1 ng/mL). Total tryptase levels in the autoimmune urticaria group were significantly higher (9.8 ±5.4 μg/L) than the idiopathic urticaria group (4.4 ±2.2 μg/L). A significant difference in total tryptase was found between symptomatic patients (7.3 ±4.1 μg/L) compared with asymptomatic ones (5.7 ±4.1 μg/L) at the time of venesection. No difference was found in mature tryptase levels either.

Conclusion
Total elevated tryptase levels are not accompanied by an elevated mature tryptase levels, as might be expected if the serum levels reflected mast cell degranulation.

Cite this as: M. Ferrer, J. M. Nuñez‐Córdoba, E. Luquin, C. E. Grattan, J. M. De la Borbolla, M. L. Sanz, L. B. Schwartz, Clinical & Experimental Allergy, 2010 (40) 1760–1766.
Use of bioluminescence imaging to track neutrophil migration and its inhibition in experimental colitis
Authors: Murphy C T , Moloney G , Hall L J , Quinlan A , Faivre E , Casey P , Shanahan F , Melgar S , Nally K
Published: August 2010

Inflammatory bowel disease (IBD) is associated with neutrophil infiltration into the mucosa and crypt abscesses. The chemokine interleukin (IL)-8 [murine homologues (KC) and macrophage inflammatory protein (MIP)-2] and its receptor CXCR2 are required for neutrophil recruitment; thus, blocking this engagement is a potential therapeutic strategy. In the present study, we developed a preclinical model of neutrophil migration suitable for investigating the biology of and testing new drugs that target neutrophil trafficking. Peritoneal exudate neutrophils from transgenic β-actin-luciferase mice were isolated 12 h after intraperitoneal injection with thioglycollate, and were assessed phenotypically and functionally. Exudate cells were injected intravenously into recipients with dextran sodium sulphate (DSS)-induced colitis followed by bioluminescence imaging of whole-body and ex vivo organs at 2, 4 and 16–22 h post-transfer. Anti-KC antibody or an isotype control were administered at 20 µg/mouse 1 h before transfer, followed by whole-body and organ imaging 4 h post-transfer. The peritoneal exudate consisted of 80% neutrophils, 39% of which were CXCR2+. In vitro migration towards KC was inhibited by anti-KC. Ex vivo bioluminescent imaging showed that neutrophil trafficking into the colon of DSS recipients was inhibited by anti-KC 4 h post-cell transfer. In conclusion, this study describes a new approach for investigating neutrophil trafficking that can be used in preclinical studies to evaluate potential inhibitors of neutrophil recruitment.
The T helper type 17/regulatory T cell imbalance in patients with acute Kawasaki disease
Authors: Jia S , Li C , Wang G , Yang J , Zu Y
Published: August 2010

The study is designed to investigate the changes and roles of T helper type 17/regulatory T cells (Th17/Treg) in the immunological pathogenesis of Kawasaki disease (KD). In addition, we explore the alteration and significance of Th17 cells in patients with intravenous immune globulin-resistant KD. Real-time polymerase chain reaction (PCR) was used to evaluate the mRNA levels of interleukin (IL)-17A/F, retinoic acid-related orphan receptor (ROR)-γt and forkhead box P3 (FoxP3) in CD4-positive cells. The proportions of Th17 cells and CD4+CD25+FoxP3high Tregs were analysed by flow cytometry. Plasma cytokine [IL-17A, IL-6, IL-23 and transforming growth factor (TGF)-β] concentrations were measured by sandwich enzyme-linked immunosorbent assay. Our data demonstrate that Th17 proportions and expression levels of cytokines (IL-17, IL-6 and IL-23) and transcription factors (IL-17A/F, ROR-γt) were up-regulated significantly, while Treg proportions and expression levels of Treg transcription factor (FoxP3) were down-regulated significantly in children with acute KD (P < 0·01). Compared with the sensitive group, the Th17 proportions were up-regulated significantly during the acute phase in immune globulin-resistant KD (P < 0·01). The plasma IL-17A, IL-6 and IL-23 concentrations in patients with KD were significantly higher compared with the concentrations in normal controls (NC) and infectious disease (ID). Plasma TGF-β concentrations were markedly lower in the KD group than the NC and ID groups (P < 0·05). These results suggest that Th17/Treg cells imbalance exists in the patients with KD. Th17/T cells imbalance may be important factors causing disturbed immunological function and resulting in immunoglobulin-resistant KD.
A prospective study of the associations between 25‐hydroxy‐vitamin D, sarcopenia progression and physical activity in older adults
Authors: Scott David , Blizzard Leigh , Fell James , Ding Changhai , Winzenberg Tania , Jones Graeme
Published: August 2010

Objective  Low 25‐hydroxyvitamin D (25OHD) levels may be associated with both sarcopenia (the age‐related decline in muscle mass and function) and low physical activity (PA). Our objective was to describe prospective associations between 25OHD, muscle parameters, and PA in community‐dwelling older adults.

Design  Prospective, population‐based study with a mean follow‐up of 2·6 ± 0·4 years.

Patients  Six hundred and eighty‐six community‐dwelling older adults (49% women; mean ± SD 62 ± 7 years old).

Measurements  Appendicular lean mass percentage (%ALM) and body fat assessed by Dual‐energy X‐ray Absorptiometry, leg strength by dynamometer, leg muscle quality (LMQ), PA assessed by pedometer, self‐reported sun exposure by questionnaire, and serum 25OHD measured by radioimmunoassay.

Results  Participants with 25OHD ≤50 nm had lower mean %ALM, leg strength, LMQ and PA (all P < 0·05). As a continuous function, baseline 25OHD was a positive independent predictor of change in leg strength (β = 5·74 kg, 95% CI 0·65, 10·82) and LMQ (β = 0·49 kg/kg, 95% CI 0·17, 0·82). Also, change in 25OHD was positively predicted by baseline %ALM (β = 2·03 pm/p.a., 95% CI 0·44, 3·62) leg strength (β = 0·30 pm/p.a., 95% CI 0·06, 0·53), LMQ (β = 4·48 pm/p.a., 95% CI 0·36, 8·61) and PA (β = 2·63 pm/p.a., 95% CI 0·35, 4·92) after adjustment for sun exposure and body fat.

Conclusions  25OHD may be important for the maintenance of muscle function, and higher skeletal muscle mass and function as well as general PA levels may also be beneficial for 25OHD status, in community‐dwelling older adults.
Interactions among gender, age, hypertension and C‐reactive protein in coronary vasospasm
Authors: Hung Ming‐Yow , Hsu Kuang‐Hung , Hung Ming‐Jui , Cheng Chi‐Wen , Cherng Wen‐Jin
Published: August 2010

Eur J Clin Invest 2010; 40 (12): 1094–1103

Background  Coronary vasospasm (CVsp) has been reported to be an inflammatory disease, reflected by elevated high‐sensitivity C‐reactive protein (hs‐CRP). We investigated the interactions among gender, age, hypertension and hs‐CRP in patients with CVsp.

Materials and methods  We retrospectively examined 722 Taiwanese patients with or without CVsp during an 8‐year period. None of the patients had obstructive coronary artery disease. Serum hs‐CRP levels were examined in a subset of 375 patients to evaluate the interactions of hs‐CRP with gender, age, smoking and hypertension in the development of CVsp.

Results  In women, only the highest hs‐CRP tertile (> 3 mg L−1) was independently associated with CVsp. In men, age > 58 years and the highest hs‐CRP tertile were independently associated with CVsp. In women, elevated risk was only demonstrated in patients ≤ 58 years of age with hs‐CRP levels in the highest tertile. In men, a positively monotonic trend was demonstrated between hs‐CRP levels and CVsp in those > 58 years of age. The odds ratios of CVsp in both women and men with hs‐CRP in the highest tertile reduced from 6·01 to 1·48 and 6·35–2·69 respectively, if they had hypertension.

Conclusion  The relationship between hs‐CRP and CVsp differed between men and women. Our findings that there is a non‐threshold model in men and a threshold model in women provide evidence that more smokers in men (life‐style) and age (induction time) contribute to the natural history of CVsp development. The negative effect of hypertension on CVsp suggests that the pathogenesis of CVsp differs from that of coronary atherosclerosis.
Value of exercise echocardiography for predicting mortality in elderly patients
Authors: Bouzas‐Mosquera Alberto , Peteiro Jesús , Broullón Francisco J. , Álvarez‐García Nemesio , Méndez Elizabet , Pérez Alberto , Mosquera Victor X. , Castro‐Beiras Alfonso
Published: August 2010

Eur J Clin Invest 2010; 40 (12): 1122–1130

Background  Elderly patients with suspected or known coronary artery disease are often referred for pharmacological stress testing. Data on the value of exercise echocardiography (ExEcho) for predicting outcome (particularly all‐cause mortality) in these patients are scarce.

Methods  Peak treadmill ExEcho was performed in 2159 patients ≥ 70 years of age with known or suspected coronary artery disease. Left ventricular wall motion was evaluated at baseline and with exercise, and the increase in wall motion score index from rest to peak exercise (ΔWMSI) was calculated. Ischaemia was diagnosed when new or worsening wall motion abnormalities developed with exercise. The end points were all‐cause mortality and major cardiac events (cardiac death or myocardial infarction).

Results  Ischaemia developed in 844 patients (38·6%) during exercise. Over a mean follow‐up of 3·5 ± 3·1 years, 439 deaths occurred. The cumulative 5‐year mortality rate was 29·3% in patients with ischaemia versus 16·8% in those without ischaemia (P < 0·001). After covariate adjustment, ΔWMSI remained an independent predictor of mortality [hazard ratio (HR) 2·37, 95% confidence interval (CI) 1·66–3·39, P < 0·001] and major cardiac events (HR 3·48, 95% CI 2·11–5·74, P < 0·001). These results remained significant even in patients with chronotropic incompetence. When added to a model with clinical, resting echocardiographic and exercise electrocardiogram variables, ExEcho results provided incremental value for the prediction of both end points (P < 0·001).

Conclusions  ExEcho is feasible in elderly patients with suspected or known coronary artery disease and provides useful information for risk stratification in these patients.
Evidence that cleavage factor Im is a heterotetrameric protein complex controlling alternative polyadenylation
Authors: Kim Sol , Yamamoto Junichi , Chen Yexi , Aida Masatoshi , Wada Tadashi , Handa Hiroshi , Yamaguchi Yuki
Published: August 2010

Recent estimates indicate that ∼60% of human genes include alternative polyadenylation sites. Hence, control of alternative polyadenylation can have a great impact on gene expression and cellular function. Cleavage factor (CF) Im is a 3′‐end processing factor that is essential for in vitro processing. CFIm purified from HeLa cells is associated with three polypeptides of 25, 59 and 68 kD, and it is generally thought to be a heterodimer composed of the 25‐kD subunit and one of the larger subunits. Previously, we serendipitously discovered that knockdown of CFIm25 causes an upstream shift in the utilization of alternative polyadenylation sites. Here, we investigated whether this is because of an inherent property of the CFIm complex and, if so, what structural elements are important for its function. The major conclusions of this study are that (i) contrary to previous assumptions, CFIm forms stable heterotetramers through dimerization of CFIm25 and (ii) the CFIm complex per se is responsible for the control of alternative polyadenylation. (iii) However, the structurally related CFIm68 and CFIm59 are functionally redundant and (iv) CFIm68 appears to have a higher specific activity. Thus, this study establishes that CFIm not only plays a general role in 3′‐end processing but also plays a regulatory role in poly(A) site selection.
Evaluation seedling biomass and its components as selection criteria for improving salt tolerance in Buffel grass genotypes
Authors: Griffa S. , Ribotta A. , López Colomba E. , Tommasino E. , Carloni E. , Luna C. , Grunberg K.
Published: August 2010

Damage produced by salt stress (300 mm NaCl) under hydroponic greenhouse conditions in seedlings of eight Buffel grass (Cenchrus ciliaris L. Syn. Pennisetum ciliare Link) genotypes was estimated through different component characters of total fresh weight damage (DTFW). Coefficient of genetic determination (CGD) was estimated for each character as well as their direct and indirect contribution to damage to total fresh weight, considered as biomass production loss. Americana and Biloela were the most salt‐tolerant cultivars, whereas sexual line and Texas 4464 were the genotypes most susceptible to salt stress. Damage to fresh weight of aerial part (DFWA) was the only component with a direct effect on DTFW and with a high CGD. Therefore, DFWA could be used in breeding programmes as an indirect selection criterion for tolerance and better productivity.
Impact of HIV on liver fibrosis in men with hepatitis C infection and haemophilia
Authors: RAGNI M. V. , MOORE C. G. , SOADWA K. , NALESNIK M. A. , ZAJKO A. B. , CORTESE‐HASSETT A. , WHITESIDE T. L. , HART S. , ZEEVI A. , LI J. , SHAIKH O. S. ,   THE HHH STUDY GROUP
Published: August 2010

Summary.  Hepatitis C virus (HCV) is the major cause of liver disease in haemophilia. Few data exist on the proportion with liver fibrosis in this group after long‐term HCV and HIV co‐infection. We conducted a cross‐sectional multi‐centre study to determine the impact of HIV on the prevalence and risk factors for fibrosis in haemophilic men with chronic hepatitis C. Biopsies were independently scored by Ishak, Metavir and Knodell systems. Variables were tested for associations with fibrosis using logistic regression and receiver operating curves (ROC). Of 220 biopsied HCV(+) men, 23.6% had Metavir ≥F3 fibrosis, with higher mean Metavir fibrosis scores among HIV/HCV co‐infected than HCV mono‐infected, 1.6 vs. 1.3 (P = 0.044). Variables significantly associated with fibrosis included AST, ALT, APRI score (AST/ULN × 100/platelet × 109/L), alpha‐fetoprotein (all P < 0.0001), platelets (P = 0.0003) and ferritin (P = 0.0008). In multiple logistic regression of serum markers, alpha‐fetoprotein, APRI and ALT were significantly associated with ≥F3 fibrosis [AUROC = 0.77 (95% CI 0.69, 0.86)]. Alpha‐fetoprotein, APRI and ferritin were significant in HIV(−) [AUROC = 0.82 (95% CI 0.72, 0.92)], and alpha‐fetoprotein and platelets in HIV(+) [AUROC = 0.77 (95% CI 0.65, 0.88]. In a multivariable model of demographic and clinical variables, transformed (natural logarithm) of alpha‐fetoprotein (P = 0.0003), age (P = 0.006) and HCV treatment (P = 0.027) were significantly associated with fibrosis. Nearly one‐fourth of haemophilic men have Metavir ≥3 fibrosis. The odds for developing fibrosis are increased in those with elevated alpha‐fetoprotein, increasing age and past HCV treatment.
Secondary prophylaxis treatment versus on‐demand treatment for patients with severe haemophilia A: comparisons of cost and outcomes in Taiwan
Authors: LIOU W.‐S. , TU T.‐C. , CHENG S.‐N. , CHOU T.‐Y. , LEE C.‐F. , LIN T.‐K. , CHUNG M.‐I. , CHAM T.‐M.
Published: August 2010

Summary.  This study compared secondary prophylaxis treatment with on‐demand treatment for severe haemophilia A in Taiwan. Fifty patients from one medical centre were evaluated over a 5‐year period. Differences in annual bleed rates and factor VIII (FVIII) utilization were assessed between patients receiving secondary prophylaxis and patients receiving FVIII concentrates on‐demand. Results were then used as inputs in a pharmacoeconomic model to predict outcomes of future haemophilia therapy strategies in Taiwan. The median annual number of total bleeding episodes was significantly lower in the 13 (26%) patients who received secondary prophylaxis than in the 37 patients who received FVIII on‐demand (7.76 vs. 31.91, P < 0.0001). The between‐group difference in median annual factor VIII utilization was statistically significant (1824.41 IU kg−1 for the prophylaxis group and 1324.81 IU kg−1 for the on‐demand group, P < 0.01). It was estimated that approximately $2 million (USD) per year would be added to the cost of treatment by having all severe haemophilia A patients in Taiwan receive secondary prophylaxis instead of on‐demand therapy while 12 566 bleeding will be prevented. It is recommended that National Health Insurance officials utilize these data to evaluate the benefits of enhanced treatment strategies and before making substantial policy changes to haemophilia care in Taiwan.
Transcriptional profiling of Anopheles gambiae mosquitoes for adult age estimation
Authors: Cook P. E. , Sinkins S. P.
Published: August 2010

The age distribution of female mosquitoes in the field is a critical component of vectorial capacity because of the extrinsic incubation period of mosquito‐borne pathogens. However this parameter has not been well characterized in malaria vectors because of methodological difficulties; transcriptional profiling provides a potential new approach for age determination. In Anopheles gambiae, microarrays were used to examine global gene expression over adult life. Nine genes were selected from the 2714 gene transcripts that displayed age‐related transcription patterns, and quantitative reverse transcription PCR used to select the four best performing genes. The resulting age estimation assay was able to predict female age from lab‐reared samples with sufficient accuracy to provide a potentially useful tool for studies of malaria epidemiology and control.
Influence of bacterial growth modes on the susceptibility to light‐activated disinfection
Authors: Upadya M. H. , Kishen A.
Published: August 2010

Upadya MH, Kishen A. Influence of bacterial growth modes on the susceptibility to light‐activated disinfection. International Endodontic Journal, 43, 978–987, 2010.

Aim  To evaluate the efficacy of light‐activated disinfection (LAD) using methylene blue (MB) and a non‐coherent light source on gram‐positive and gram‐negative bacteria in different growth modes. The influence of different photosensitizer (PS) formulations in the MB‐mediated LAD of biofilms was also evaluated.

Methodology  Light‐activated disinfection using MB was tested on Enterococcus faecalis in a planktonic suspension, coaggregated suspension and mono‐species biofilms and on Pseudomonas aeruginosa in a planktonic suspension and mono‐species biofilms. Further, the difference in susceptibility of E. faecalis and P. aeruginosa biofilms to LAD with modified PS formulations was assessed by conventional culturing methods and confocal laser scanning microscopy (CLSM).

Results  Higher energy dose was required for LAD of bacteria in a coaggregated suspension and in biofilm compared to their planktonic counterparts. Biofilm mode of growth offered the greatest resistance to LAD in both the tested strains of pathogens (P < 0.001). Gram‐positive E. faecalis was more susceptible to LAD than the gram‐negative P. aeruginosa, and the use of modified PS formulations was found to enhance the efficacy of LAD to destroy the biofilm (P < 0.001).

Conclusions  Bacterial growth modes play a vital role in influencing the susceptibility to LAD in a dose‐dependent manner. The nature of the PS formulation influences the susceptibility of biofilms to LAD.
Cigarette dependence questionnaire: development and psychometric testing with male smokers
Authors: Huang Chih‐Ling , Lin Hsi‐Hui , Wang Hsiu‐Hung
Published: August 2010

huang c.‐l., lin h.‐h. & wang h.‐h. (2010) Cigarette dependence questionnaire: development and psychometric testing with male smokers.Journal of Advanced Nursing 66(10), 2341–2349.

Aim. This paper is a report of a study conducted to develop and test a theoretically derived Cigarette Dependence Questionnaire for adult male smokers.

Background. Fagerstrom questionnaires have been used worldwide to assess cigarette dependence. However, these assessments lack any theoretical perspective. A theory‐based approach is needed to ensure valid assessment.

Methods. In 2007, an initial pool of 103 Cigarette Dependence Questionnaire items was distributed to 109 adult smokers in Taiwan. Item analysis was conducted to select items for inclusion in the refined scale. The psychometric properties of the Cigarette Dependence Questionnaire were further evaluated 2007–08, when it was administered to 256 respondents and their saliva was collected and analysed for cotinine levels. Criterion validity was established through the Pearson correlation between the scale and saliva cotinine levels. Exploratory factor analysis was used to test construct validity. Reliability was determined with Cronbach’s alpha coefficient and a 2‐week test–retest coefficient.

Results. The selection of 30 items for seven perspectives was based on item analysis. One factor accounting for 44·9% of the variance emerged from the factor analysis. The factor was named as cigarette dependence. Cigarette Dependence Questionnaire scores were statistically significantly correlated with saliva cotinine levels (r = 0·21,P = 0·01). Cronbach’s alpha was 0·95 and test–retest reliability using an intra‐class correlation was 0·92.

Conclusion. The Cigarette Dependence Questionnaire showed sound reliability and validity and could be used by nurses to set up smoking cessation interventions based on assessment of cigarette dependence.
Insomnia Severity Index: psychometric properties with Chinese community‐dwelling older people
Authors: Yu Doris S.F.
Published: August 2010

yu d.s.f. (2010) Insomnia Severity Index: psychometric properties with Chinese community‐dwelling older people. Journal of Advanced Nursing 66(10), 2350–2359.

Aim.  This paper is a report of a study to evaluate the psychometric properties of the Chinese version of the Insomnia Severity Index.

Background.  Despite the high prevalence of insomnia in older people and its detrimental impact on well‐being and healthcare costs, this problem is almost always undetected and consequently under‐treated. The Insomnia Severity Index is psychometrically sound in measuring perceived insomnia severity. However, it has had very limited application in non‐White populations.

Methods.  An instrument validation study was carried out between October 2008 and April 2009. The Insomnia Severity Index was translated into Chinese using Brislin’s model and administered to a convenience sample of 585 older Chinese people recruited from three community centres for elders. Other instruments were also administered, including the Chinese version of the Pittsburgh Sleep Quality Index and the Geriatric Depression Scale.

Results.  Cronbach’s alpha of the Chinese version of the Insomnia Severity Index was 0·81, with item‐to‐total correlations in the range of 0·34–0·67. Construct validity was supported by its moderate relationship with the Chinese Pittsburgh Sleep Quality Index and sleep efficiency. The Chinese version of the Insomnia Severity Index also indicated more severe level of insomnia in older people who reported depressed mood on the Geriatric Depression Scale. Discriminant validity was supported as the Chinese version of the Insomnia Severity Index could discriminate poorer sleepers from normal sleepers. Exploratory factor analysis identified a two‐factor structure for the Chinese version of the Insomnia Severity Index in measuring the severity and impacts of insomnia on the Chinese older people.

Conclusion.  The Chinese version of the Insomnia Severity Index is a culturally‐relevant and psychometrically‐sound instrument for assessing severity and impact of insomnia in Chinese community‐dwelling older people. Nurses can use this tool to assess older people’s perceptions of insomnia.
The HIV Medication Taking Self‐efficacy Scale: psychometric evaluation
Authors: Erlen Judith A. , Cha Eun Seok , Kim Kevin H. , Caruthers Donna , Sereika Susan M.
Published: August 2010

erlen j.a., cha e.s., kim k.h., caruthers d. & sereika s.m. (2010) The HIV Medication Taking Self‐efficacy Scale: psychometric evaluation. Journal of Advanced Nursing 66(11), 2560–2572.

Aim.  This paper is a report of an examination of the psychometric properties of the HIV Medication Taking Self‐efficacy Scale.

Background.  Self‐efficacy is a critically important component of strategies to improve HIV medication‐taking; however, valid and reliable tools for assessing HIV medication‐taking self‐efficacy are limited.

Method.  We used a cross‐sectional, correlational design. Between 2003 and 2007, 326 participants were recruited from sites in Pennsylvania and Ohio in the United States of America. Six self‐report questionnaires administered at baseline and 12 weeks later during ‘Improving Adherence to Antiretroviral Therapy’ were used to examine the variables of interest. Means and variances, reliability, criterion, and construct validity of the HIV Medication Taking Self‐efficacy Scale were assessed.

Findings.  Participants reported high self‐confidence in their ability to carry out specific medication‐related tasks (mean = 8·31) and in the medication’s ability to effect good outcomes (mean = 8·56). The HIV Medication Taking Self‐efficacy Scale and subscales showed excellent reliability (α = 0·93∼0·94). Criterion validity was well‐established by examining the relationships between the HIV Medication Taking Self‐efficacy Scale and selected physiological and psychological factors, and self‐reported medication adherence (r = −0·20∼0·58). A two‐factor model with a correlation between self‐efficacy belief and outcome expectancy fitted the data well (model χ2 = 3871·95, d.f. = 325, P < 001; CFA = 0·96; RMSEA = 0·046).

Conclusion.  The HIV Medication Taking Self‐efficacy Scale is a psychometrically sound measure of medication‐taking self‐efficacy for use by researchers and clinicians with people with HIV. The findings offer insight into the development of interventions to promote self‐efficacy and medication adherence in persons with HIV.
Nursing care for patients requesting euthanasia in general hospitals in Flanders, Belgium
Authors: Dierckx de Casterlé Bernadette , Denier Yvonne , De Bal Nele , Gastmans Chris
Published: August 2010

dierckx de casterlé b., denier y., de bal n. & gastmans c. (2010) Nursing care for patients requesting euthanasia in general hospitals in Flanders, Belgium. Journal of Advanced Nursing 66(11), 2410–2420.

Aim.  This paper is a report of a study exploring nurses’ involvement in the care process for mentally competent, terminally ill patients requesting euthanasia in general hospitals in Flanders, Belgium.

Background.  International literature shows that nurses are involved in the care process surrounding euthanasia, regardless of the legal status of euthanasia in the country being studied. However, their actual involvement remains unclear.

Methods.  A grounded theory approach was used. Data were collected over a 20‐month period in 2005 and 2006, using individual in‐depth interviews. The sample included 18 Registered Nurses employed in nine general hospitals geographically spread over the five provinces of Flanders, Belgium.

Results.  The care process for patients requesting euthanasia is complex and dynamic, consisting of several stages. Major themes characterized nurses’ involvement: being on the alert for a euthanasia request; open and active listening; multidisciplinary team cooperation and analysis of the group dynamics; continuously providing maximum palliative care; multi‐tasking; organizing and directing the euthanasia; and finally, providing support for the family, colleagues and oneself.

Conclusion.  Nurses make a unique and indispensable contribution to making the euthanasia care process a good care process. This has to do with their specific form of knowledge, expertise and responsibilities, and their willingness to personally, continually and fully care for the patients requesting euthanasia and for their relatives.
Turnover and trends in butterfly communities on two British tidal islands: stochastic influences and deterministic factors
Authors: Dennis Roger L. H. , Dapporto Leonardo , Sparks Tim H. , Williams Steven R. , Greatorex‐Davies J. Nick , Asher Jim , Roy David B.
Published: August 2010

Aim  Community trends were investigated for two small islands and two local mainland butterfly communities within the UK over a period of 20–30 years.

Location  Hilbre Island off the Wirral Peninsula at 53.33° N, 3.10° W; Lindisfarne, an island off the Northumberland coast at 56.41° N, 1.48° W; Leighton Moss at 54.08° N, 2.26° W; Wyre Forest at 52.23° N, 2.14° W, UK.

Methods  Butterfly species data were collected on Hilbre and two mainland sites (Leighton Moss and Wyre Forest) from 1983 to 2006, and on Lindisfarne from 1977 to 2006, as part of the National Habitat Survey, the UK Butterfly Monitoring Scheme and ‘Butterflies for the New Millennium Atlas’ recording. Matrices of associations (Sokal and Michener’s matching coefficient SSM; resemblance coefficient) were computed between years and subject to non‐metric multidimensional scaling (NMDS) and Mantel tests. The pattern of extinctions and colonizations at sites were examined, their heterogeneity tested by applying a Friedman test to fractional incidences for the same years. Regression analysis (multiple regression and logit regression) was used to relate butterfly numbers and incidences to climate variables, time and previous records.

Results  Significant community trends based on population counts and species’ incidences were found for all four sites. There was a significant climatic signal for Hilbre; although this was not apparent for the remaining sites, significant associations occurred between records for a number of species and climatic variables at all sites. Substantial turnover of species on the islands was inversely related to numbers of records for species but not to their conspicuousness to recorders.

Main conclusions  We argue that time trends are widespread in butterfly communities, even for relatively short periods; they are largely generated by stochastic influences rather than by more substantive factors such as climate change. Potential biases in surveying and recording history are shown to be unlikely. A clear climate signal was found only for the small Hilbre Island, for which there was also evidence for the significant influence of colonization capability of individual source species. We conclude that for many species, small islands will be sinks or pseudosinks and their ‘populations’ vulnerable to small changes in source–sink dynamics.
Student experiences in learning person‐centred care of patients with Alzheimer’s disease as perceived by nursing students and supervising nurses
Authors: Skaalvik Mari W , Normann Hans Ketil , Henriksen Nils
Published: August 2010

Aims and objectives.  The aims and objectives of this paper are to illuminate and discuss the experiences and perceptions of nursing students and supervising nurses regarding the students’ learning of person‐ centred care of patients with Alzheimer’s disease in a teaching nursing home. This information is then used to develop recommendations as to how student learning could be improved.

Background.  The clinical experiences of nursing students are an important part of learning person‐centred care. Caring for patients with Alzheimer’s disease may cause frustration, sadness, fear and empathy. Person‐centred care can be learned in clinical practice.

Design.  A qualitative study.

Methods.  The study was performed in 2006 using field work with field notes and qualitative interviews with seven‐fifth‐semester nursing students and six supervising nurses.

Results.  This study determined the variation in the perceptions of nursing students and supervising nurses with regards to the students’ expertise in caring for patients with Alzheimer’s disease. The nursing students experienced limited learning regarding person‐centred approaches in caring for patients with Alzheimer’s disease. However, the supervising nurses perceived the teaching nursing home as a site representing multiple learning opportunities in this area.

Conclusions.  Nursing students perceived limited learning outcomes because they did not observe or experience systematic person‐centred approaches in caring for patients with Alzheimer’s disease. It is important that measures of quality improvements in the care of patients with Alzheimer’s disease are communicated and demonstrated for nursing students working in clinical practices in a teaching nursing home.

Relevance to clinical practice.  Introduction of person‐centred approaches is vital regarding learning outcomes for nursing students caring for patients with Alzheimer’s disease.
Literature review: should antipyretic therapies routinely be administered to patient fever?
Authors: Carey Jane V
Published: August 2010

Aims and objectives.  To determine whether the practices of routinely treating fever with antipyretic medications or physical cooling methods are supported by the literature.

Background.  Fever is one of the commonest symptoms presented to caregivers. Previous research suggests that treating fever with antipyretic medications or physical cooling methods is often routine practice. This article considers that fever and the febrile response may have been preserved through evolution because of its advantage for host defences and that fever may have an adaptive value. It is questioned whether the administration of antipyretic therapies could prolong the duration of illness, as interventions to lower body temperature are acting against the body’s natural response to infection.

Design.  Literature review.

Method.  Electronic databases and the Internet were searched, supplemented by citation tracking. Articles were eligible if the participants studied had received pharmacological or physical cooling interventions to reduce their body temperature during fever. The interventions were evaluated in regard to whether they prolonged duration of illness.

Results.  Results were inconsistent. None of the studies found that antipyretic therapies reduced duration of illness in patients with fever. Evidence suggests that antipyretic therapies do not reduce the duration of illness, but can prolong it.

Conclusions.  The evidence on which to base recommendations for practice is weak but does not support the current practice of administering antipyretic therapies routinely to patients with fever. Physical cooling methods alone should never be used. Nurses should assess patients with fever on an individualised basis and use antipyretic therapies selectively.

Relevance to clinical practice.  The administration of antipyretics to patients with fever is an important issue, and nurses are at the forefront of decision‐making. Evidence‐based care delivery is expected by the NMC. A protocol to assist decision‐making when caring for patients with pyrexia is suggested.
Decibel levels and noise generators on four medical/surgical nursing units
Authors: Pope Diana
Published: August 2010

Aims and objectives.  The study was designed to determine daytime decibel levels on the hospital’s four medical/surgical nursing units, daytime decibel levels in patient rooms in corresponding nursing units, whether the nursing unit noise levels differed and to identify what generated noise on those units.

Background.  Nurses are responsible for components of patients’ physical environments, particularly those that promote patient safety and well‐being. Numerous studies have linked hospital noise to negative physiological outcomes for both patients and staff. However, decisions related to managing patient acoustic environments continue to rely on nursing judgment, rather than objective evidence.

Design.  Non‐human subject, observational/descriptive design.

Method.  Using noise dosimeters, weekday day shift decibel levels were measured on four nursing units, sequentially. Measures were made continuously over 12 hours, in three patient rooms and over five minutes every 45 minutes, at the corresponding nurses’ station. Noise generators were documented at the nurses’ station.

Results.  Nursing units had average measured sound levels of 62·2, 63·3, 61·7 and 64·6 decibels, respectively, and were not significantly different from one another (p = 0·07). Nurses’ designation of ‘quiet’, ‘typical’ and ‘noisy’ patient rooms was not consistently confirmed by the measured decibel levels. The range of minimum to maximum decibel levels was significantly greater in patient rooms than the nurses’ station (54·4 versus 27·7 decibels, p < 0·01), and on average, more than 12 noise generators were identified during any one‐five‐minute study period.

Conclusions.  Patient care areas in today’s hospitals are as noisy as a busy office. Nursing judgment is not sufficient to make informed decisions directed towards controlling inpatients’ acoustic environment. Standards applied across studies to measure and characterise acoustic environments are urgently needed.

Relevance to clinical practice.  Objective measures, not nursing judgment alone, are required to assess acoustic environments and to direct interventions that improve them.
Analysis of pelvic floor musculature function during pregnancy and postpartum: a cohort study
Authors: De Souza Caroci Adriana , Riesco Maria Luiza Gonzalez , Da Silva Sousa Wesllanny , Cotrim Ana Carolina , Sena Edinéia Maria , Rocha Nelly Lima , Fontes Cintia Najara Caroci
Published: August 2010

Aim.  To compare the measurements of women’s pelvic floor musculature strength (PFMS) during pregnancy and postpartum period.

Background.  Pregnancy and childbirth can have an influence on the muscles and pelvic floor and can cause morbidities of women’s genito‐urinary tract.

Design.  A prospective cohort study.

Methods.  There were included 226 primigravidae women, attended by community health services in the city of Itapecerica da Serra, Sao Paulo, Brazil. The participants were followed in four stages: (1) within 12 weeks of pregnancy; (2) between 36–40 weeks of pregnancy; (3) within 48 hours after childbirth; (4) 42‐60 days after childbirth. Data were collected from February 2007–August 2008. The pelvic floor musculature strength was evaluated by perineometry and digital vaginal palpation in stages 1, 2 and 4. The final sample included 110 women who completed all four stages of the study.

Results.  The pelvic floor musculature strength of the women did not change significantly during pregnancy or after delivery (anova: p = 0·78). In all three examined stages, a low‐intensity pelvic floor musculature strength was prevalent (in mmHg: stage 1 = 15·9; stage 2 = 15·2, stage 4 = 14·7), with scores from 0–3 on the Oxford scale. The pelvic floor musculature strength did not differ in relation to maternal age, skin colour, conjugal status, dyspareunia, stool characteristics, type of delivery, or conditions of the perineum. An interaction between maternal nutritional state and newborn’s weight may affect the pelvic floor musculature strength (manova: p = 0·04).

Conclusion.  Pregnancy and childbirth did not reduce significantly pelvic floor musculature strength. The perineometry and digital vaginal palpation used to assess the pelvic floor musculature strength were well accepted by the women.

Relevance to clinical practice.  In clinical practice, digital vaginal palpation is effective for supporting the diagnosis of urinary, intestinal and sexual dysfunctions. Perineometry use is particularly important together with the performance of perineal exercises with biofeedback in the treatment these disorders.