bluuebunny/crossref_metadata_2025 huggingface dataset:
Very low or undetectable intact parathyroid hormone levels in patients with surgically verified parathyroid adenomas
Authors: Bhadada S. K. , Cardenas M. , Bhansali A. , Mittal B. R. , Behera A. , Chanukya G. V. , Nahar U. , Sudhaker Rao D.
Published: February 2008

Objectives  To report and explore potential reasons for undetectable or low‐normal serum intact PTH levels in patients with surgically verified primary hyperparathyroidism with parathyroid adenomas, review the relevant literature, and offer suggestions for management of such patients occasionally encountered in clinical practice. For future research, to help understand mechanisms underlying ‘undetectable’ or inappropriately low serum intact PTH levels.

Methods  Serum intact PTH levels were measured pre‐ and postoperatively by immunochemiluminescent assay (ICMA) and the results were confirmed by at least two repeated measurements on different occasions in each patient.

Patients  We encountered two unusual patients with primary hyperparathyroidism who had suggestive biochemical and/or clinical features of primary hyperparathyroidism. However, serum intact PTH levels were either very low or undetectable in the context of hypercalcaemia, with no other obvious cause. A 99mTc sestamibi scan showed increased uptake in one of the parathyroid glands, suggesting a single adenoma in each case that was confirmed at surgery.

Results  In the first patient, from India, mean ± SD serum calcium was 2·6 ± 0·32 mmol/l (reference range 2·12–2·74 mmol/l) with intact PTH of 0·11 pmol/l (reference range 1·1–7·59 pmol/l). In the second patient, from the USA, mean ± SD serum calcium and intact PTH were 2·9 ± 0·07 mmol/l (reference range 2·17–2·51 mmol/l) and 1·35 pmol/l (reference range 1·1–7·59 pmol/l), respectively. Following curative parathyroidectomy, serum calcium levels normalized in both patients. By contrast, serum intact PTH levels, which were either suppressed or very low before surgery, rose into the low‐normal reference range in all patients.

Conclusions  When the clinical suspicion is high, the diagnosis of primary hyperparathyroidism should be pursued despite suppressed or low‐normal serum intact PTH levels after carefully excluding other causes of hypercalcaemia. Further research on various intact PTH molecular species secreted by parathyroid adenomas or post‐translational changes in the intact PTH molecule that might interfere with in vitro measurements should be undertaken to understand the precise reason(s) for such anomalous findings.
Influence of birth size and body composition on bone mineral density in early adulthood: the PROGRAM study
Authors: Leunissen R. W. J. , Stijnen T. , Boot A. M. , Hokken‐Koelega A. C. S.
Published: February 2008

Background/objectives  Low bone mineral density (BMD) may lead to osteoporosis and is associated with increased fracture risk. Associations between BMD and various factors have been reported. Our objective was to investigate whether birth size, lean body mass (LBM) and fat mass (FM) are determinants of BMD of the total body (BMDTB) and the lumbar spine (BMDLS).

Methods  In the PROgramming factors for GRowth And Metabolism (PROGRAM) study of a cohort of 312 young adults aged 18–24 years, BMDTB and BMDLS were determined by dual‐energy X‐ray absorptiometry (DXA). Subsequently, differences in BMDTB and BMDLS were analysed in four subgroups: young adults born small for gestational age with short stature (SGA‐S) or with catch‐up growth (SGA‐CU), or born appropriate for gestational age (AGA) with idiopathic short stature (ISS) or with normal stature (controls).

Results  Adult weight, LBM, FM and weight gain during childhood were the main positive determinants for BMDTB in early adulthood, whereas birth size had no influence (adjusted R2 = 0·50). Gender, adult weight, LBM, FM and weight gain were the significant determinants of BMDLS. In the subgroups, after correction for age, gender and adult body size, the ISS group had a significantly lower BMDTB than controls but there was no difference in BMDLS between the subgroups.

Conclusions  Prenatal growth has no significant influence on BMDTB and BMDLS in early adulthood. Gender and postnatal growth, particularly weight gain, are the main positive determinants. To achieve a normal BMD in adulthood, healthcare workers should aim for a normal weight gain in children.
Compositional relationships between organic matter in a grassland soil and its drainage waters
Authors: Hayes T. M. , Hayes M. H. B. , Skjemstad J. O. , Swift R. S.
Published: February 2008

We present a novel study of the compositional relationships between soil organic components extractable in aqueous extractants and those in sub‐soil drainage and surface runoff waters from the soil. The surface soil (0–20 cm) of a stagnogley in long‐term grassland was sequentially and exhaustively extracted in aqueous media at pH values of 7, 10.6 and 12.6. Extracts from the soils and their runoff and drainage waters were processed by the procedures of the International Humic Substances Society (IHSS), and fractionated into humic, fulvic, and XAD‐4 acids. Elemental, δ13C, δ15N, sugar, amino acids, and solid state CPMAS 13C NMR analyses were used to identify similarities and differences between the fractions from the different extracts. There were few differences between the compositions of drainage water samples taken 1 year apart, and these had compositional features similar to those from the more highly oxidized fractions isolated from the soil at pH 7. There were significant differences between the humic components from the drainage waters and isolated from the soil at pH 7 and those of the humic fractions isolated at the higher pH values whose compositions are more clearly related to origins in plants. The compositions of the surface runoff waters indicate origins in transformed plant and animal manures on the soil surface, whereas those of the deep drainage waters originate in more extensively transformed materials, including products of microbial metabolism. The resin technique used in the fractionation allowed the isolation of novel humic acid fractions from the soil extracts, in particular at pH 7 and 12.6. These fractions clearly originated in microbial sources, were rich in saccharides and amino acids (peptides), and low in lignin‐derived components.
Standardised removal and sectioning locations for shovelnose sturgeon fin rays
Authors: KOCH J. D. , SCHRECK W. J. , QUIST M. C.
Published: February 2008

Abstract  Fin rays are a common structure used in age and growth analyses, but many inconsistencies exist regarding removal and processing methodology. The purpose of this study was to evaluate precision of age estimates obtained from shovelnose sturgeon, Scaphirhynchus platorynchus (Rafinesque) fin rays sectioned at different locations. Fin rays were examined from 203 shovelnose sturgeon sampled from Pools 9, 13 and 14 of the Mississippi River. Three readers provided age estimates for sections acquired from five locations along fin rays to determine the optimum location for removing and sectioning fin rays. Precision and readability were generally greater for fin ray sections close to the articulating process on the fin ray (i.e. proximal) and decreased as sections approached the tip (i.e. distal). Based on these results, it is recommended that scientists remove shovelnose sturgeon fin rays at the articulating process and section immediately distal to the conspicuous curve in the fin ray close to the articulating process of the ray.
Septic arthritis in males with haemophilia
Authors: ASHRANI A. A. , KEY N. S. , MICHAEL SOUCIE J. , DUFFY N. , FORSYTH A. , GERAGHTY S. ,   THE UNIVERSAL DATA COLLECTION PROJECT INVESTIGATORS
Published: February 2008

Summary.  We used data collected as part of the Universal Data Collection (UDC) surveillance project in haemophilia treatment centers (HTC) to study the incidence, risk factors and impact of septic arthritis among males with haemophilia. Patients participating in UDC on two or more occasions were included. Cases were defined as patients with documented joint infection. Characteristics of the cases were compared with those of haemophilia patients without infection. Among the 8026 eligible patients with 36 015 person‐years of follow‐up, 30 (0.37%) had a documented joint infection (incidence rate 83 per 100 000 person‐years). In a logistic regression model, only increasing age (OR = 6.1 for age ≥30), race/ethnicity other than white (OR = 3.9), presence of inhibitor (OR = 3.9), invasive procedure in the past year (OR = 2.7) and presence of one or more target joints (OR = 3.2) remained statistically significant. Central venous access devices use and hepatitis C virus and HIV infection were not associated with septic arthritis risk after adjusting for potential confounders. Study limitations include possible underestimation of septic arthritis rate in this population and its retrospective design. We conclude that septic arthritis is an uncommon complication of haemophilia occurring primarily in joints most affected by bleeding and reparative surgical interventions.
Evaluation of desmopressin effects on haemostasis in children with congenital bleeding disorders
Authors: HANEBUTT F. L. , ROLF N. , LOESEL A. , KUHLISCH E. , SIEGERT G. , KNOEFLER R.
Published: February 2008

Summary.  Desmopressin (DDAVP) affects haemostasis by the release of von Willebrand factor and coagulation factor VIII from endothelium. The aim of the study was to evaluate the results of DDAVP testing in paediatric patients with congenital bleeding disorders. Forty‐one patients consisting of children with von Willebrand’s disease (VWD, n = 26) and platelet function defects (PFD, n = 15) received DDAVP intravenously at a dosage of 0.3 μg/kg over 30 min. FVIII activity (FVIII), von Willebrand factor antigen (VWF:Ag), collagen‐binding activity (VWF:CB) and PFA 100® closure times (CT) were measured before, 60, 120 and 240 min after DDAVP. In VWD, the VWF:Ag increased threefold until 60 min and then it decreased continuously. Compared with baseline, VWF:Ag was significantly higher at 60 and 120 min but not at 240 min. In contrast, in PFD, the peak of VWF:Ag was reached after 120 min. Two hundred and forty minutes after DDAVP, the mean was still significantly elevated compared with baseline values. The course of VWF:CB corresponded to that of VWF:Ag. In patients with VWD and PFD, FVIII rose two‐ to threefold within 2 h after DDAVP. CT in patients with VWD shortened markedly within 120 min and then rose again. In all children with PFD, except one non‐responder, the CT shortened within 240 min after DDAVP. Two non‐responders with VWD were identified by the failed increase of VWF:Ag, VWF:CB and by prolonged CT. Haemostatic effects of DDAVP differ interindividually and dependent on the coagulation disorder. DDAVP was effective in most, but not in all patients. DDAVP testing is recommended to determine the individual haemostatic response.
Changes in total carotenoid content at different stages of traditional processing of yellow‐fleshed cassava genotypes
Authors: Maziya‐Dixon Busie , Dixon Alfred G. O. , Ssemakula Gorrettie
Published: February 2008

The changes in content of total carotenoid at each stage of processing cassava storage roots were investigated with three improved yellow‐fleshed cassava varieties (TMS 94/0006, TMS 01/1235 and TMS 01/1371) grown in 2005/2006 in a randomised complete block design with two replications at Ibadan, Nigeria. When the cassava roots were grated to a mash, results obtained indicate that there was a significant reduction in total carotenoid content for all the genotypes. The reduction was highest for TMS 01/1235 (1.20 μg g−1), intermediate for TMS 01/1371 (0.78 μg g−1) and least for TMS 94/0006 (0.35 μg g−1). In most cases, we observed higher total carotenoid concentration, especially when the intermediate step involved pressing to remove excess water, and during roasting compared with the initial concentration in the raw cassava storage roots. In conclusion, grating, drying and cooking to a paste resulted in reduction of total carotenoid content, while roasting and pressing resulted in higher carotenoid concentration. A change in total carotenoid content during processing depends on variety, processing method, especially unit operation and the initial total carotenoid content of the variety.
Day healthcare services for family caregivers of older people with stroke: needs and satisfaction
Authors: Park Yeon‐Hwan
Published: February 2008

Title.  Day healthcare services for family caregivers of older people with stroke: needs and satisfaction

Aim.  This paper is a report of a study to identify family caregivers’ needs and satisfaction levels in adult day healthcare services for older adults with stroke.

Background.  With a growing number of older people suffering from chronic illnesses, the demand for adult day care is growing worldwide. However, in Asia, caregivers face unique challenges in selecting and using culturally acceptable models of care for older people with stroke, and there are still unmet needs in adult day healthcare services.

Method.  A cross‐sectional descriptive survey was carried out in 2006 with a convenience sample of 119 family caregivers from nine centres in Korea. The questionnaire included the Modified Caregiver Satisfaction Scale.

Findings.  Korean family caregivers of older people with stroke were moderately satisfied with the adult day healthcare services. In particular, health management was an area with a high level of needs but with a low level of satisfaction. Respondents also had unmet needs such as speech therapy, patient‐tailored exercise and physical therapy. There was a statistically significant difference in degree of satisfaction according to whether or not Registered Nurses delivered care at the centres.

Conclusion.  It is important to reflect family caregivers’ needs by providing quality care, which is culture‐specific adult day healthcare services and focuses on health management and skilled nursing care.
Correlates of mood disturbance in women with breast cancer: patterns over time
Authors: Von Ah Diane , Kang Duck‐Hee
Published: February 2008

Title.  Correlates of mood disturbance in women with breast cancer: patterns over time

Aim.  This study examined factors associated with mood disturbance prior to, during and after adjuvant therapy.

Background.  Breast cancer is the most common cancer in women worldwide. Mood disturbance affects between 20% and 30% of women with breast cancer and is associated with other debilitating symptoms. However, factors associated with mood disturbance across the breast cancer diagnosis–treatment trajectory are not clearly understood.

Method.  A stress‐coping framework guided this longitudinal study. A convenience sample of 49 American women with newly diagnosed breast cancer aged 37–77 years completed questionnaires assessing age, optimism, disease stage, type of adjuvant therapy, lymph node status, emotional support, aid (tangible) support, perceived stress and mood disturbance. Data were collected over an 18‐month period in 2002–2003 at three time points: prior to, during and after adjuvant therapy. Descriptive statistics, Pearson’s correlation and multiple regression were used.

Findings.  At all three time points, higher stress was significantly related to greater mood disturbance. Perceived stress mediated the relationship between (1) emotional support and mood disturbance prior to and after adjuvant therapy and between (2) aid support and mood disturbance during adjuvant therapy. In addition, the type of support that was most important to mood disturbance varied over time. Emotional support was related to reduced mood disturbance prior to and after adjuvant therapy, whereas aid support was most important during adjuvant therapy.

Conclusions.  Nurses may use this information to develop interventions that bolster appropriate types of support to reduce stress and ultimately lower mood disturbance. Further research across cultures is needed.
Quality of life and its predictors among Hong Kong Chinese patients with diabetes
Authors: Shiu Ann TY , Thompson David R , Wong Rebecca YM
Published: February 2008

Aim. To adapt, cross‐culturally, an established quality of life (QoL) scale for Hong Kong Chinese patients with diabetes; to measure their QoL and to identify the predictors of QoL in this population.

Background. Healthcare providers are called on to assess and enhance the QoL of patients with diabetes. However, there is a lack of empirical QoL data pertaining to such individuals in China.

Methods. The diabetes‐specific QoL scale (DQoL) developed by Jacobson and the Diabetes Control and Complications Trial research group was cross‐culturally adapted for use in a sample of 206 Hong Kong Chinese patients recruited from a diabetes specialist outpatient clinic. Demographic and clinical data were also collected.

Results. The cross‐cultural adaptation process produced a Hong Kong Chinese version of the DQoL scale with 37 items (HKC‐DQoL‐37) that demonstrated good internal consistency (α = 0·87) and acceptable test‐retest validity (ICC 0·70, 95% CI 0·36–0·87). Discriminant validity was confirmed by comparing QoL scores between patients with and without insulin treatment. The QoL status of this sample (Mean = 2·2, SD = 0·5) is similar to that of Chinese immigrants and Caucasians in North America. Multiple regression analyses identified four predictors of poor QoL: (i) younger age, (ii) with diabetes complications, (iii) with admission due to hypoglycaemia, (iv) on insulin treatment.

Conclusions. Findings provide preliminary evidence on the validity and reliability of the HKC‐DQoL‐37. The four predictors of poor DQoL in Hong Kong Chinese patients are consistent with those identified in the West.

Relevance to clinical practice. Understanding these predictors of poor QoL could help nurses and others to design and deliver appropriate interventions to these patients.
Anxiety, depression and pain intensity in patients with low back pain who are admitted to acute care hospitals
Authors: Mok Long Chau , Lee Iris Fung‐Kam
Published: February 2008

Aim.  This study examines the relationship between anxiety, depression and pain intensity in patients with low back pain who are newly admitted to an acute care hospital setting.

Background.  Previous studies have supported the idea that anxiety and depression play a significant role in chronic low back pain, but the relationship between anxiety, depression and pain intensity in patients with low back pain who are newly admitted to hospital has not been adequately explored.

Method.  The study reported here was descriptive correlational in design. The sample was 102 Chinese patients with low back pain who were newly admitted to an acute care hospital in Hong Kong. Data were collected through individual interviews, using an 11‐point numerical pain rating scale and the Hospital Anxiety and Depression Scale. In addition, demographic data were identified from the medical record.

Results.  There were 48 male and 54 female adult participants in the study. The average anxiety and depression level of the participants was 19·46 (SD 9·02) on a scale of 0–42, which is higher than the normal level. The level of anxiety and depression was significantly positively correlated with pain intensity (r = 0·471, p < 0·0005) and was also a significant predictor of pain intensity (t = 3·918, p < 0·0005, 95% CI 0·050–0·154).

Conclusion.  The results of this study showed that anxiety and depression are not only associated with pain intensity but that they also, partly, predict pain intensity in patients with low back pain who are newly admitted to an acute care hospital.

Relevance to clinical practice.  The results of this study support the assessment of and intervention in anxiety and depression symptoms in the provision of pain‐relief nursing treatment in patients with low back pain who are admitted to acute care hospitals.
Communicating stroke survivors’ health and further needs for support in care‐planning meetings
Authors: Hedberg Berith , Johanson Marita , Cederborg Ann‐Christin
Published: February 2008

Aims and objectives.  This study will illustrate how stroke survivors, their relatives and different professionals communicated in care‐planning meetings when planning care for patients after their discharge from hospital. We wanted to know what topics participants were talking about, to what extent they were involved in the discussion and how the communication was organized.

Background.  Communication in health care is sometimes problematic because of the participants’ asymmetrical positions when negotiating how to understand the patients’ future care.

Methods.  A qualitative and a quantitative design were adopted with a sample of 14 authentic audio‐recorded care‐planning meetings. The transcribed meetings were, together with observational notes, analysed from a data‐driven approach.

Findings.  Five topics emerged. The professionals tended to dominate the discourse space even if their involvement varied depending on the topic talked about. The most noteworthy finding was the patients’ need of communicative alliances with other participants when negotiating their needs and desires of further care. When making decisions two approaches emerged. The ‘aim‐driven’ approach was characterized by alliances between those participants who seemed to share a common goal for the patient's further care. When the participants used the ‘open‐minded’ approach they merged information and discussed different solutions leading to a goal step by step.

Conclusions.  The importance of strengthening stroke survivors’ participation in care‐planning meetings is highlighted. Professionals have to increase their knowledge about how to involve the patients as well as their awareness of how to avoid power struggles between various professionals, patients and relatives.

Relevance to clinical practice.  This study shows the necessity for professionals to involve relatives when negotiating these patients’ need of further care and to learn more about how to advocate stroke survivors.
Effects of music therapy on psychological health of women during pregnancy
Authors: Chang Mei‐Yueh , Chen Chung‐Hey , Huang Kuo‐Feng
Published: February 2008

Aims and objectives.  The purpose of this study was to examine the effects of music therapy on stress, anxiety and depression in Taiwanese pregnant women.

Background.  The value of music therapy is slowly being realized by nurses in various clinical areas, including obstetrics. Previous studies have demonstrated a high prevalence of psychological stress during pregnancy. Few studies have examined the effects of music therapy on reducing psychological stress during pregnancy.

Design.  A randomized experimental study design was developed and implemented.

Methods.  Two hundred and thirty‐six pregnant women were randomly assigned to music therapy (n = 116) and control (n = 120) groups. The music therapy group received two weeks of music intervention. The control group received only general prenatal care. Psychological health was assessed using three self‐report measures: Perceived Stress Scale (PSS), State Scale of the State‐Trait Anxiety Inventory (S‐STAI) and Edinburgh Postnatal Depression Scale (EPDS).

Results.  In a paired t‐test, the music therapy group showed significant decrease in PSS, S‐STAI and EPDS after two weeks. The control group only showed a significant decrease in PSS after two weeks. This decrease was not as substantial as in the experimental group. An ancova test with the pretest scores as the control revealed that the changes in PSS, S‐STAI and EPDS after two weeks were significantly decreased in the experimental group compared with the control group.

Conclusions.  This controlled trial provides preliminary evidence that two‐week music therapy during pregnancy provides quantifiable psychological benefits.

Relevance to clinical practice.  The findings can be used to encourage pregnant women to use this cost‐effective method of music in their daily life to reduce their stress, anxiety and depression. Further research is needed to test the long‐term benefits.
Parental fever phobia and its evolutionary correlates
Authors: Purssell Edward
Published: February 2008

Aims.  This study aimed to identify parental views of fever in their children aged 1–6 years and to consider these and associated behaviours from an evolutionary perspective.

Background.  Fever is a common symptom of illness in children; however, many parents express high levels of anxiety. This has previously been reported in several countries, most notably the USA. The purpose behind this study was to look at parental views and examine these from an evolutionary perspective to explain the persistence and ubiquity of parental fears of fever.

Method.  A questionnaire was administered to 181 parents of children attending a paediatric outpatients department at a London teaching hospital.

Results.  Many parents expressed high levels of worry and its possible complications. These manifest themselves in the frequency with which parents measured their child's temperature, and the aggressive nature of their treatment. Many reported over‐using antipyretic drugs, or using non‐evidence based practices such as sponging. However, in many cases they were also making appropriate behavioural alterations, for example, encouraging fluids and rest.

Conclusion.  While many parents expressed high levels of worry about fever and used inappropriate treatments, this must be balanced against benefits such as increased vigilance and close attention to hydration. Lay health beliefs, such as those reported in this study, may be judged unduly negatively if individual aspects are seen in isolation.

Relevance to clinical practice.  High levels of worry have been reported internationally, suggesting that they may form part of a conserved response to fever. Although many parents reported aggressive treatment of fever, they also used appropriate symptomatic interventions. Nurses and other healthcare professionals should act to reduce the fear of fever and concentrate upon accurate diagnosis and the appropriate treatment of the underlying illness.
A literature review of spirituality in coping with early‐stage Alzheimer's disease
Authors: Beuscher Linda , Beck Cornelia
Published: February 2008

Aims.  This paper presents a literature review focusing on the use of spirituality in coping by older persons with early‐stage Alzheimer's disease from their perspectives. The purpose of this literature review is to examine the existing body of knowledge about spirituality in coping with Alzheimer's disease and to apply a spiritual framework of coping in organizing the literature to identify themes and gaps in knowledge.

Background.  Despite the abundance of Alzheimer's disease research, little is known about how older persons with this devastating disease cope with the consequential losses. Maintaining a sense of normalcy and preserving self‐worth are coping strategies reported by older persons with early‐stage Alzheimer's disease. As spirituality is an effective coping resource for older persons with numerous psychological and personal losses in their lives, it may be an important coping resource for person with Alzheimer's disease.

Method.  A literature search was conducted to find research published between 1990–2006 aimed at understanding spirituality in coping with early‐stage Alzheimer's disease.

Conclusions.  Six research studies were reviewed. Findings suggest that persons with early‐stage Alzheimer's disease draw from their spirituality and faith to find meaning and courage in facing the challenges of cognitive losses. Furthermore, they are able to provide rich information about their spirituality and the psychosocial aspects of living with Alzheimer's disease. Limited empirical knowledge compels the need for future research to explore how spirituality is utilized in coping with early‐stage Alzheimer's disease.

Relevance to clinical practice.  Enhancing persons’ abilities to cope effectively with their diseases is an important goal of nursing care. Understanding how older persons with Alzheimer's disease cope with their memory loss is critical to the development of evidence‐based interventions to minimize the stress of living with this disease.
Nurses in Australian general practice: implications for chronic disease management
Authors: Halcomb Elizabeth J , Davidson Patricia M , Salamonson Yenna , Ollerton Richard , Griffiths Rhonda
Published: February 2008

Aims.  The purpose of this study was to describe the demographic and employment characteristics of Australian practice nurses and explore the relationship between these characteristics and the nurses’ role.

Background.  Nursing in general practice is an integral component of primary care and chronic disease management in the United Kingdom and New Zealand, but in Australia it is an emerging specialty and there is limited data on the workforce and role.

Design.  National postal survey embedded in a sequential mixed method design.

Methods.  284 practice nurses completed a postal survey during 2003–2004. Descriptive statistics and factor analysis were utilized to analyse the data.

Results.  Most participants were female (99%), Registered Nurses (86%), employed part‐time in a group practice, with a mean age of 45·8 years, and had a hospital nursing certificate as their highest qualification (63%). The tasks currently undertaken by participants and those requiring further education were inversely related (R2 = −0·779). Conversely, tasks perceived to be appropriate for a practice nurse and those currently undertaken by participants were positively related (R2 = 0·8996). There was a mismatch between the number of participants who perceived that a particular task was appropriate and those who undertook the task. This disparity was not completely explained by demographic or employment characteristics. Extrinsic factors such as legal and funding issues, lack of space and general practitioner attitudes were identified as barriers to role expansion.

Conclusion.  Practice nurses are a clinically experienced workforce whose skills are not optimally harnessed to improve the care of the growing number of people with chronic and complex conditions.

Relevance to clinical practice.  Study data reveal a need to overcome the funding, regulatory and interprofessional barriers that currently constrain the practice nurse role. Expansion of the practice nurse role is clearly a useful adjunct to specialist management of chronic and complex disease, particularly within the context of contemporary policy initiatives.
A literature review of the potential effects of having a parent with chronic renal failure
Authors: Coldstream Frances , May Andreé le
Published: February 2008

Aims and objectives.  This review aims to answer the question ‘What are the possible effects on children of having a parent with chronic renal failure?’

Background.  Chronic illness affects the whole family, not just the individual with the illness. It would appear that little research has been undertaken to consider the potential effects on children when a parent has chronic renal failure.

Method.  Systematic review.

Conclusions.  There are many potential effects of parental chronic renal failure that have been documented. These are both negative, for example depression and under achievement and positive, for example – enhanced self‐esteem. Children, in particular, appear to have a need for information that is not being met. The review has helped to refine a project looking at the information needs of children who have a parent with chronic renal failure, from the perspective of the child.

Relevance to clinical practice.  There appears to be a lack of information to direct nursing practice in this area. Practitioners need to be aware that chronic parental illness impacts on the whole family. Appropriate referral mechanisms for the child and family are necessary, in addition to an understanding of the needs of these children.
Haemodialysis: the effects of using the empowerment concept during the development of a mutual‐support group in Taiwan
Authors: Chen Yu‐Chi , Pai Jui‐Sheng , Li I‐Chuan
Published: February 2008

Aims and objective.  To determine the effectiveness of using the empowerment concept during the development of a mutual‐help group for haemodialysis.

Background.  Haemodialysis has different impacts on patients' physical, psychological and social health. The effects of mutual‐support group have been found in groups of chronic disease patients. However, none of them were for haemodialysis patients.

Design.  An intervention‐evaluation design was used for this study. The intervention process was divided into four phases: (1) assessment, (2) planning, (3) action and (4) evaluation/feedback. As part of this study, a mutual‐help group was formed that met eight times for group activities over a three‐month study period.

Results.  There were three indicators of empowerment outcomes. Physical symptoms decreased significantly after the patients had participated in the mutual‐help group (z = −2·893, p < 0·05), especially symptoms such as itchy skin, insomnia and spasms. In terms of the patients’ social network and social functions, social support increased significantly (z = −3·412, p < 0·05). The total score for the patients’ quality of life also showed a significant improvement (z = −3·408, p < 0·05) with the emotional and health dimensions improving the most.

Conclusion.  This study provides evidence that supports the use of mutual‐help groups as a means of aiding patients with chronic illness to cope with their illness. Mutual‐help groups are a necessary future direction in nursing that will improve the quality of health care for patients’ with chronic illness.

Relevance to clinical practice.  The study found that a mutual‐help group not only can improve patient's illness adaptability, but also brought about a range of other empowerment outcomes. It also had many positive impacts for the hospital. Therefore, it will be beneficial for the patients with a chronic illness if health care professionals can be sensitive to relevant factors and construct mutual‐support groups based on the empowerment concept.
Carbon flux from plants to soil: roots are a below‐ground source of phenolic secondary compounds in an alpine ecosystem
Authors: Meier Courtney L. , Suding Katharine N. , Bowman William D.
Published: February 2008

Phenolics are an important, biologically reactive component of the carbon (C) pool that moves from plants to soil. Once in soil, phenolics can regulate plant–soil feedbacks because of their influence on soil nitrogen biogeochemistry.

Roots are a largely overlooked potential source of below‐ground phenolic C. We examined phenolic fluxes from plants to soil in an alpine ecosystem, where phenolics are associated with slow rates of nutrient cycling. Using a phenolic‐rich forb (Acomastylis rossii) and a grass with low tissue phenolics (Deschampsia caespitosa), we asked whether leaves, leaf litter or roots are the dominant source of soil phenolics during the growing season. We also determined whether the composition of root‐derived phenolics differed from that of leaf litter.

Both labile low molecular weight phenolics and tannins disappeared from A. rossii leaf litter over the winter. Evidence from this study and others indicates litter phenolics are not a significant source of labile C for soil microbes throughout the growing season.

In the field, levels of phenolics were higher under A. rossii canopies than under D. caespitosa canopies throughout the growing season. We also estimated significantly higher phenolic fluxes into soils for A. rossii than for D. caespitosa in the glasshouse. Field and glasshouse results suggest roots are an important source of these compounds. Furthermore, the phenolic chemistry of roots was different from that of leaf litter, indicating that the effects of root phenolics on soil processes and neighbouring plant growth may differ from those associated with leaves.

Synthesis. Based on our results, labile phenolic inputs from roots are likely to have a more important influence on soil nutrient dynamics during the alpine growing season than phenolic inputs from leaf litter. We suggest that roots may be the dominant input of labile phenolics to soil during the growing season in other ecosystems with seasonal patterns of plant growth and senescence. These observations are critical to our understanding of how phenolic‐rich species may interact with soil microbes to influence soil nutrient cycling and shape the soil resource environment.
The influence of coastal topography, circulation patterns, and rafting in structuring populations of an intertidal alga
Authors: MUHLIN J. F. , ENGEL C. R. , STESSEL R. , WEATHERBEE R. A. , BRAWLEY S. H.
Published: February 2008

Understanding the dispersal processes that influence genetic structure in marine species requires estimating gene flow in a dynamic, fluid environment that is often poorly characterized at scales relevant to multiple dispersive stages (e.g. spores, gametes, zygotes, larvae, adults). We examine genetic structure in the marine alga Fucus vesiculosus L., which inhabits moderately exposed shores in the northern Atlantic but releases gametes only under sunny, calm conditions. We predicted genetic structure would correlate with coastal topography because weather frequently varies across coastal promontories on the Maine shore when F. vesiculosus is reproductive, which causes one side to experience high levels of water motion (= no gamete release) while one side is calm (= gamete release). Furthermore, we expected that the effect of low dispersal capacities of gametes and zygotes would result in spatial genetic structure over short distances. Using surface drifters, we characterized near‐shore circulation patterns around the study sites to investigate whether directionality of gene flow was correlated with directionality of currents. We found significant genetic differentiation among sites sampled at two different peninsulas, but patterns of differentiation were unrelated to coastal topography and there was no within‐site spatial structuring. Our genetic and near‐shore circulation data, combined with an examination of gamete longevity, support the dependency of gene flow on storm‐detached, rafting, reproductive adults. This study highlights the significance of rafting as a mechanism for structuring established populations of macroalgae and associated biota and demonstrates the importance of coupling population genetics’ research with relevant hydrodynamic studies.
The Great American Interchange in birds: a phylogenetic perspective with the genus Trogon
Authors: DACOSTA JEFFREY M. , KLICKA JOHN
Published: February 2008

The ‘Great American Interchange’ (GAI) is recognized as having had a dramatic effect on biodiversity throughout the Neotropics. However, investigation of patterns in Neotropical avian biodiversity has generally been focused on South American taxa in the Amazon Basin, leaving the contribution of Central American taxa under‐studied. More rigorous studies of lineages distributed across the entire Neotropics are needed to uncover phylogeographical patterns throughout the area, offering insights into mechanisms that contribute to overall Neotropical biodiversity. Here we use mitochondrial DNA sequence data and intensive geographical sampling from the widespread Neotropical avian genus Trogon to investigate the role of the GAI in shaping its phylogeographical history. Our results show that genetic diversity in Trogon exceeds the perceived biodiversity, and that the GAI resulted in lineage diversification within the genus. Despite greater diversity in South America, a Central American centre of origin with multiple and independent dispersals into South America is indicated. These dispersals were followed by the evolution of divergent lineages associated with the Andes Mountains and other South American geographical features. According to our phylogenetic reconstructions, several species, which were originally defined by morphological characters, are nonmonophyletic. In sum, our results elucidate the evolutionary history of Trogon, reveal patterns obscured by extant biodiversity, and serve as a biogeographical model to consider in future studies.
Recombination and genetic differentiation among natural populations of the ectomycorrhizal mushroom Tricholoma matsutake from southwestern China
Authors: XU JIANPING , SHA TAO , LI YAN‐CHUN , ZHAO ZHI‐WEI , YANG ZHU L.
Published: February 2008

Effective conservation and utilization strategies for natural biological resources require a clear understanding of the natural populations of the target organisms. Tricholoma matsutake is an ectomycorrhizal mushroom that forms symbiotic associations with plants and plays an important ecological role in natural forest ecosystems in many parts of the world. It is also an economically very important gourmet mushroom. Because no artificial cultivation is available, natural populations of this species are under increasing threats, primarily from habitat disturbance and destruction. Despite its economical and ecological importance, little is known about its genetics and population biology. Here, using 14 polymerase chain reaction–restriction fragment length polymorphism markers, we analysed 154 strains from 17 geographical locations in southwestern China, a region where over 25% of the global T. matsutake harvest comes from. Our results revealed abundant genetic variation within individual populations. The analyses of gene and genotype frequencies within populations indicated that most loci did not deviate from Hardy–Weinberg equilibrium in most populations and that alleles among loci were in linkage equilibrium in the majority of the local populations. These results are consistent with the hypothesis that sexual reproduction and recombination play an important role in natural populations of this species. Our analyses indicated low but significant genetic differentiation among the geographical populations, with a significant positive correlation between genetic distance and geographical distance. We discuss the implications of our results to the ecology and resource management of this species.
Biliprotein maturation: the chromophore attachment
Authors: Scheer H. , Zhao K.‐H.
Published: February 2008

Biliproteins are a widespread group of brilliantly coloured photoreceptors characterized by linear tetrapyrrolic chromophores, bilins, which are covalently bound to the apoproteins via relatively stable thioether bonds. Covalent binding stabilizes the chromoproteins and is mandatory for phycobilisome assembly; and, it is also important in biliprotein applications such as fluorescence labelling. Covalent binding has, on the other hand, also considerably hindered biliprotein research because autocatalytic chromophore additions are rare, and information on enzymatic addition by lyases was limited to a single example, an EF‐type lyase attaching phycocyanobilin to cysteine‐α84 of C‐phycocyanin. The discovery of new activities for the latter lyases, and of new types of lyases, have reinvigorated research activities in the subject. So far, work has mainly concentrated on cyanobacterial phycobiliproteins. Methodological advances in the process, however, as well as the finding of often large numbers of homologues, opens new possibilities for research on the subsequent assembly/disassembly of the phycobilisome in cyanobacteria and red algae, on the assembly and organization of the cryptophyte light‐harvesting system, on applications in basic research such as protein folding, and on the use of phycobiliproteins for labelling.
Negative regulation of pPS10 plasmid replication: origin pairing by zipping‐up DNA‐bound RepA monomers
Authors: Gasset‐Rosa Fátima , Díaz‐López Teresa , Lurz Rudi , Prieto Alicia , Fernández‐Tresguerres M. Elena , Giraldo Rafael
Published: February 2008

In many plasmid replicons of Gram‐negative bacteria, Rep protein dimers are transcriptional self‐repressors of their genes, whereas monomers are initiators of DNA replication. Switching between both functions implies conformational remodelling of Rep, and is promoted by Rep binding to the origin DNA repeats (iterons) or chaperones. Rep proteins play another key role: they bridge together two iteron DNA stretches, found either on the same or on different plasmid molecules. These so‐called, respectively, ‘looped’ and ‘handcuffed’ complexes are thought to be negative regulators of plasmid replication. Although evidence for Rep‐dependent plasmid handcuffing has been found in a number of replicons, the structure of these Rep–DNA assemblies is still unknown. Here, by a combination of proteomics, electron microscopy, genetic analysis and modelling, we provide insight on a possible three‐dimensional structure for two handcuffed arrays of the iterons found at the origin of pPS10 replicon. These are brought together in parallel register by zipping‐up DNA‐bound RepA monomers. We also present evidence for a distinct role of RepA dimers in DNA looping. This work defines a new regulatory interface in Rep proteins.
Peptide inhibitor of cytokinesis during sporulation in Bacillus subtilis
Authors: Handler Aaron A. , Lim Joo Eun , Losick Richard
Published: February 2008

Cytokinesis in bacteria is mediated by the tubulin‐like protein FtsZ, which forms a Z‐ring at the division site. Using FtsZ as bait in a two‐hybrid screen, we discovered a 40‐amino‐acid peptide, termed MciZ, from Bacillus subtilis that appeared to interact with FtsZ. Cells engineered to produce MciZ during growth formed aseptate filaments that lacked Z‐rings. A mutant resistant to the toxic effects of MciZ during growth harboured an amino acid substitution near the GTP binding pocket of FtsZ. Synthetic MciZ inhibited the GTPase activity of FtsZ and its ability to polymerize. MciZ was produced during sporulation under the control of the transcription factor σE. In the absence of MciZ, the mother‐cell compartment of the sporangium aberrantly formed a Z‐ring at a time in development when cytokinetic events normally have ceased. We conclude that MciZ is a previously unrecognized inhibitor of FtsZ that prevents inappropriate Z‐ring formation during sporulation. MciZ showed little sequence similarity to other peptides in the databases, except the mouse antimicrobial peptide CRAMP, which we speculate works in part by inhibiting cytokinesis.
Analysis of innervation of human mesenteric vessels in non‐inflamed and inflamed bowel – a confocal and functional study
Authors: Birch D. , Knight G. E. , Boulos P. B. , Burnstock G.
Published: February 2008

Abstract We investigated the distribution and density of perivascular nerves in human mesenteric arteries and veins and their responses to noradrenaline (NA), ATP and neuropeptide Y (NPY) in control (non‐inflamed) and inflamed bowel, using confocal microscopy andin vitropharmacology. The density of innervation at the adventitial‐medial border of arteries and within the medial muscle coat of veins was increased in inflammatory bowel disease (IBD). Expression of markers for both sympathetic nerves and sensory‐motor nerves was significantly increased in IBD. Calcitonin gene‐related peptide‐containing sensory‐motor nerves were present in control arteries and IBD, but not in control veins. The density of 5‐hydroxytryptamine‐containing nerves was variable in controls, but consistently increased (three to four times) in IBD. Vasoactive intestinal peptide (VIP) expression increased (doubled) in arteries and veins. Arteries and veins contracted to NA and ATP, but only veins constricted to NPY. ATP contractions were reduced in arteries and veins in IBD, while contractions to NA were only slightly reduced. Neuropeptide Y induced significantly greater (20%) contractions of IBD veins. In summary, the density of sympathetic and sensory‐motor innervation of both mesenteric arteries and veins was increased in IBD. Both 5‐hydroxytryptamine and VIP immunoreactivity were also increased. The responses of both arteries and veins to ATP, and to a lesser extent NA, were reduced in IBD while responses to NPY were greater in veins. Decreased responses to ATP indicate changes in purinergic‐mediated transmission in the pathological state.