bluuebunny/crossref_metadata_2025 huggingface dataset:
Annual rainfall in England since 1725
Authors: Craddock J. M.
Published: February 2007

Representative annual rainfall totals, expressed as percentages of appropriate standards, are given for most of the years from 1725 to the present for each of 11 regions covering most of England. The evidence for these values is discussed, and their relationships examined as groundwork for the production of long series of monthly rainfall totals for regions covering almost the whole of Great Britain.
Job stress and work attitudes between temporary and permanently employed nurses
Authors: Yeh Ying‐Jung Yvonne , Ko Jyh‐Jer Roger , Chang Yu‐Shen , Chen Chun‐Hsi Vivian
Published: February 2007

The authors examine job stress and work attitudes among temporary (i.e. fixed‐term) and permanently employed nurses, using data collected via a structured questionnaire filled out by 249 nurses in two hospitals in northern Taiwan. Temporary nurses in the sample were generally younger, less experienced, unmarried, or married without children. Questionnaire responses also indicate that they suffer from greater job stress and lower affective organizational and occupational commitments compared to their permanent counterparts. A positive correlation was found between perceived contract breaches and job stress and a negative correlation was identified between perceived contract breaches and affective occupational commitment. In both cases the effects were more intense among full‐time, permanently employed nurses. The paper ends with a discussion of implications for decision makers and researchers of non‐standard work arrangements. Copyright © 2007 John Wiley & Sons, Ltd.
NTP‐PoCT: a conformance test tool for push‐to‐talk over cellular network
Authors: Lin Yi‐Bing , Wang Chun‐Chieh , Lu Chih‐Hung , Hsu Miao‐Ru
Published: February 2007

This paper describes a conformance test tool for push‐to‐talk over cellular network developed on an Open Mobile Alliance Service Interoperability Test Platform. Based on the TTCN‐3 specifications, we show how PoC test cases can be efficiently implemented on the test platform. Copyright © 2007 John Wiley & Sons, Ltd.
Chronisch-entzündliche Krankheiten
Authors: Schreiber S.
Published: February 2007

Morbus Crohn und Colitis ulcerosa sind die wesentlichen Formen der chronisch entzündlichen Darmerkrankungen (CED). Die systematische Aufklärung von Suszeptibilitätsgenen für diese komplexen Krankheitsbilder hat das pathophysiologische Verständnis wesentlich verändert. Die Vervollständigung der genetischen Risikokarte wird zukünftig zu einer Neuausrichtung von Therapien führen.
Church, State and Civil Partners
Authors: Lord Falconer of Thoroton
Published: February 2007

The Civil Partnership Act 2004 is a groundbreaking piece of legislation, giving legal recognition to same-sex relationships and providing equality of treatment in regard to inheritance and other financial matters with that enjoyed by married couples. The legislation was opposed by certain religious communities for a variety of reasons. This article is the text of an address delivered by Lord Falconer of Thoroton to the annual conference of the Ecclesiastical Law Society on 1 April 2006. It provides a personal reflection on the nature of the legislation and the necessity for its enactment, and seeks to demonstrate that the concept of civil partnership does not undermine the nature of marriage. It also discusses the Act in the context of law and social attitudes with particular reference to the Hart/Devlin debate of the 1950s and 1960s.
Did Meditating Make Us Human?
Authors: Rossano Matt J.
Published: February 2007

Campfire rituals of focused attention created Baldwinian selection for enhanced working memory among our Homo sapiens ancestors. This model is grounded in five propositions: the emergence of symbolism occurred late in the archaeological record; this emergence was caused by a fortuitous genetic mutation that enhanced working memory capacity; a Baldwinian process where genetic adaptation follows somatic adaptation was the mechanism for this emergence; meditation directly affects brain areas critical to attention and working memory; and shamanistic healing rituals were fitness-enhancing in our ancestral past. Each proposition is discussed and defended. Supporting evidence and potential future tests are presented.
One Thing After Another: the Date of the Ascott-under-Wychwood Long Barrow
Authors: Bayliss Alex , Benson Don , Galer Dawn , Humphrey Louise , McFadyen Lesley , Whittle Alasdair
Published: February 2007

Forty-four radiocarbon results are now available from the Ascott-under-Wychwood long barrow, and are presented within an interpretive Bayesian statistical framework. Three alternative archaeological interpretations of the sequence are given, each with a separate Bayesian model. In our preferred model, pre-barrow occupation including small timber structures and a midden was followed by a gap long enough to allow a turfline to form. Cists and the primary barrow were then initiated and the first human remains inserted into the cists; there was subsequently a secondary extension to the barrow. In the Bayesian model for this interpretation, occupation goes back to the fortieth century cal. bc, the midden being quite short-lived in the latter part of the fortieth or first part of the thirty-ninth century cal. bc. The gap was very probably not less than 50 years long, in the latter part of the thirty-ninth century cal. bc and the first half of the thirty-eighth century cal. bc. The barrow was begun between 3760–3695 cal. bc and extended in 3745–3670 cal. bc, probably within a generation. The first bodies were inserted in 3755–3690 cal. bc, contemporaneously with the primary barrow, and the last remains were probably deposited in the 3640s or 3630s cal. bc. The use of the monument probably did not exceed three to five generations. In an alternative interpretation of the sequence, greater continuity is seen between the underlying timber structures and midden on the one hand and the cists on the other, which could have preceded the initiation of the barrow itself. The Bayesian model for this interpretation suggests the gap between occupation and barrow was much shorter, probably of only 1–40 years' duration. It gives slightly different other estimates for the sequence but agrees with the main model in suggesting an overall short span of use for the whole monument. In a third interpretation, some of the human remains are interpreted as older than the cists and barrow. The Bayesian model for this again gives slightly different estimates but suggests that such putatively ancestral remains would not have been more than a decade or two older than the initiation of cists and barrow. Results are briefly discussed in relation to the overall sequence from occupation and midden to monument, the brevity of monument use, and issues of remembrance.
Somatic cell nuclear transfer using transported in vitro-matured oocytes in cynomolgus monkey
Authors: Chen N. , Liow S-L. , Abdullah R. Bin , Wan Embong WK. Khadijah , Yip W-Y. , Tan L-G. , Tong G-Q. , Ng S-C.
Published: February 2007

Somatic cell nuclear transfer (SCNT) is not successful so far in non-human primates. The objective of this study was to investigate the effects of stimulation cycles (first and repeat) on oocyte retrieval and in vitro maturation (IVM) and to evaluate the effects of stimulation cycles and donor cell type (cumulus and fetal skin fibroblasts) on efficiency of SCNT with transported IVM oocytes. In this study, 369 immature oocytes were collected laparoscopically at 24 h following human chorionic gonadotrophin (hCG) treatment from 12 cynomolgus macaque (Macaca fascicularis) in 24 stimulation cycles, and shipped in pre-equilibrated IVM medium for a 5 h journey, placed in a dry portable incubator (37 °C) without CO2 supplement. A total of 70.6% (247/350) of immature oocytes reached metaphase II (MII) stage at 36 h after hCG administration, MII spindle could be seen clearly in 80.6% (104/129) of matured IVM oocytes under polarized microscopy. A total of 50.0% (37/74) of reconstructive SCNT embryos cleaved after activation; after cleavage, 37.8% (14/37) developed to the 8-cell stage and 8.1% (3/37) developed to morula, but unfortunately none developed to the blastocyst stage. Many more oocytes could be retrieved per cycle from monkeys in the first cycle than in repeated cycles (19.1 vs. 11.7, p < 0.05). There were no significant differences in the maturation rate (70.0 vs. 71.4%, p > 0.05) and MII spindle rate under polarized microscopy (76.4 vs. 86.0%, p > 0.05) between the first and repeat cycles. There were also no significant differences in the cleavage rate, and the 4-cell, 8-cell and morula development rate of SCNT embryos between the first and repeat cycles. When fibroblast cells and cumulus cells were used as the donor cells for SCNT, first cleavage rate was not significantly different, but 4-cell (50.0 vs. 88.9%, p < 0.05) and 8-cell (0 vs. 51.9%, p < 0.01) development rate were significantly lower for the former. In conclusion, the number of stimulation cycles has a significant effect on oocyte retrieval, but has no effect on maturation and SCNT embryo development; however, different donor cell types (cumulus and fibroblast) resulted in different developmental potentials of SCNT embryos.
Complementary reductions for two qubits
Authors: Petz Dénes , Kahn Jonas
Published: February 2007

Reduction of a state of a quantum system to a subsystem gives partial quantum information about the true state of the total system. In connection with optimal state determination for two qubits, the question was raised about the maximum number of pairwise complementary reductions. The main result of the paper tells that the maximum number is 4, that is, if A1,A2,…,Ak are pairwise complementary (or quasiorthogonal) subalgebras of the algebra M4(C) of all 4×4 matrices and they are isomorphic to M2(C), then k⩽4. The proof is based on a Cartan decomposition of SU(4). In the way to the main result, contributions are made to the understanding of the structure of complementary reductions.
Fuchs’ solution of Painlevé VI equation by means of Jacobi’s last multiplier
Authors: Nucci M. C. , Leach P. G. L.
Published: February 2007

We use the known relationship between the Lagrangian and Jacobi’s [Vorlesungen über Dynamik. Nebst fünf hinterlassenen Abhandlungen desselben herausgegeben von A Clebsch (Druck und Verlag von Georg Reimer, Berlin, 1886)] last multiplier of second-order ordinary differential equations to determine two first integrals and their Noether [Nachr. Ges. Wiss. Goettingen Math. Phys. Kl. 2, 235 (1918)] symmetries for the Fuch’s solution [C. R. Acad. Sci. 141, 555 (1905)] of Painlevé VI after finding two Lagrangians in addition to known Hamiltonian given by Malmquist [Ark. Mat. Astr. Fys. 17, 1 (1922)]. The general solution follows and we show it to be the same as given by Fuchs.
Energy dependence of the roaming atom pathway in formaldehyde decomposition
Authors: Lahankar Sridhar A. , Chambreau Steven D. , Zhang Xiubin , Bowman Joel M. , Suits Arthur G.
Published: February 2007

Recently, a new mechanism of formaldehyde decomposition leading to molecular products CO and H2 has been discovered, termed the “roaming atom” mechanism. Formaldehyde decomposition from the ground state via the roaming atom mechanism leads to rotationally cold CO and vibrationally hot H2, whereas formaldehyde decomposition through the conventional molecular channel leads to rotationally hot CO and vibrationally cold H2. This discovery has shown that it is possible to have multiple pathways for a reaction leading to the same products with dramatically different product state distributions. Detailed investigations of the dynamics of these two pathways have been reported recently. This paper focuses on an investigation of the energy dependence of the roaming atom mechanism up to 1500cm−1 above the threshold of the radical channel, H2CO→H+HCO. The influence of excitation energy on the roaming atom and molecular elimination pathways is reported, and the branching fraction between the roaming atom channel and molecular channel is obtained using high-resolution dc slice imaging and photofragment excitation spectroscopy. From the branching fractions and the reaction rates of the radical channel, the overall competition between all three dissociation channels is estimated. These results are compared with recent quasiclassical trajectory calculations on a global H2CO potential energy surface.
The NASA Spitzer Space Telescope
Authors: Gehrz R. D. , Roellig T. L. , Werner M. W. , Fazio G. G. , Houck J. R. , Low F. J. , Rieke G. H. , Soifer B. T. , Levine D. A. , Romana E. A.
Published: February 2007

The National Aeronautics and Space Administration’s Spitzer Space Telescope (formerly the Space Infrared Telescope Facility) is the fourth and final facility in the Great Observatories Program, joining Hubble Space Telescope (1990), the Compton Gamma-Ray Observatory (1991–2000), and the Chandra X-Ray Observatory (1999). Spitzer, with a sensitivity that is almost three orders of magnitude greater than that of any previous ground-based and space-based infrared observatory, is expected to revolutionize our understanding of the creation of the universe, the formation and evolution of primitive galaxies, the origin of stars and planets, and the chemical evolution of the universe. This review presents a brief overview of the scientific objectives and history of infrared astronomy. We discuss Spitzer’s expected role in infrared astronomy for the new millennium. We describe pertinent details of the design, construction, launch, in-orbit checkout, and operations of the observatory and summarize some science highlights from the first two and a half years of Spitzer operations. More information about Spitzer can be found at http://spitzer.caltech.edu/.
Interface modulated structure of highly epitaxial (Pb,Sr)TiO3 thin films on (001) MgO
Authors: Jiang J. C. , Meletis E. I. , Yuan Z. , Chen C. L.
Published: February 2007

The interface of epitaxial (Pb0.35Sr0.65)TiO3 films on MgO substrates grown by pulsed laser ablation was studied using transmission electron microscopy (TEM). Cross-section TEM studies revealed that the epitaxial films have a lattice mismatch of −6.2% with respect to the substrates. Electron diffraction pattern and high-resolution TEM image of the plan-view (Pb0.35Sr0.65)TiO3∕MgO interface present evidence of a modulated structure on the film plane. This allowed obtaining the actual lattice mismatch of −7.14% at the interface. Plan-view TEM of the interface is able to provide fundamental information that cannot be obtained by the cross-section TEM alone, and its advantages in studying such epitaxial films are addressed.
Recombination processes in undoped and rare-earth doped MAl2O4 (M=Ca,Sr) persistent phosphors investigated by optically detected magnetic resonance
Authors: Schweizer Stefan , Henke Bastian , Rogulis Uldis , Yen William M.
Published: February 2007

The authors present magneto-optical measurements on single-crystal MAl2O4 (M=Ca and Sr) persistent phosphors that are nominally pure or doped with Eu and Nd or Dy, respectively. Their recombination luminescence (RL) and microwave-induced changes in the RL in a high magnetic field (RL-EPR) were investigated after ultraviolet excitation at low temperatures. Wavelength dependent RL-EPR measurements indicate that only one intrinsic donor but at least two different intrinsic acceptors are involved in the recombination process. The donor-acceptor recombination energy is either emitted directly (undoped samples) or almost completely transferred to the rare-earth activators (doped samples).
Pattern pluralism and the Tree of Life hypothesis
Authors: Doolittle W. Ford , Bapteste Eric
Published: February 2007

Darwin claimed that a unique inclusively hierarchical pattern of relationships between all organisms based on their similarities and differences [the Tree of Life (TOL)] was a fact of nature, for which evolution, and in particular a branching process of descent with modification, was the explanation. However, there is no independent evidence that the natural order is an inclusive hierarchy, and incorporation of prokaryotes into the TOL is especially problematic. The only data sets from which we might construct a universal hierarchy including prokaryotes, the sequences of genes, often disagree and can seldom be proven to agree. Hierarchical structure can always be imposed on or extracted from such data sets by algorithms designed to do so, but at its base the universal TOL rests on an unproven assumption about pattern that, given what we know about process, is unlikely to be broadly true. This is not to say that similarities and differences between organisms are not to be accounted for by evolutionary mechanisms, but descent with modification is only one of these mechanisms, and a single tree-like pattern is not the necessary (or expected) result of their collective operation. Pattern pluralism (the recognition that different evolutionary models and representations of relationships will be appropriate, and true, for different taxa or at different scales or for different purposes) is an attractive alternative to the quixotic pursuit of a single true TOL.
Inorganic polyphosphate essential for lytic growth of phages P1 and fd
Authors: Li Li , Rao Narayana N. , Kornberg Arthur
Published: February 2007

Transduction frequency with phage P1 had been observed to be very low in
Escherichia coli
K-12 mutants lacking the operon (
ppk1-ppx
) responsible for the synthesis of inorganic polyphosphate (poly P). We now find that these mutants, for lack of poly P, are lysogenic for P1 and when infected with phage P1 produce only ≈1% the number of infective centers compared with the WT host. Both phage adsorption and release were unaffected. The host-encoded P1 late-gene transcriptional activator, SspA, failed to show the transcriptional increase in the mutant, observed in the WT. UV induction of a P1-infected mutant resulted in a 200-fold increase in the production of infectious phage particles. The lysogenized P1 (P1
mut
) and P1 progeny from the mutant host (Δ
ppk1-ppx
) produced plaques of differing morphologies, whereas P1 progeny from the WT yielded only small, clear plaques. Two discernable variants, one producing small and clear plaques (P1
small
) and the other large plaques with turbid rims (P1
large
), had broader host range and produced larger burst sizes in WT compared with P1. Transmission electron microscopy showed P1
mut
had contractile sheath defects. Thus, the lack of poly P/PPK1 in the mutant host resulted in the formation of defective P1 particles during intracellular growth. A filamentous phage, fd, also failed to produce plaques on a mutant lawn. Although fd adsorbed to the F-pilus, its DNA failed to enter the mutant host.
Supraventricular Arrhythmias: An Electrophysiology Primer
Authors: Chen‐Scarabelli Carol
Published: February 2007

Supraventricular arrhythmias are the most widespread group of arrhythmias and affect all age groups. Atrial fibrillation is the most common arrhythmic disorder and is even more prevalent among the elderly. Due to their prevalence, it is imperative for the clinician to be informed about these arrhythmias and treatment considerations. This paper presents a basic review of the incidence, pathophysiology, diagnosis, and treatment of supraventricular arrhythmias, along with gender differences, and discusses important implications for the health care provider. A summary of common electrocardiogram findings in supraventricular arrhythmias is presented along with a brief overview of pharmacologic agents.
The Mediterranean Diet: Is It Cardioprotective?
Authors: Bautista Marita C. , Engler Marguerite M.
Published: February 2007

Coronary heart disease is one of the leading causes of morbidity and mortality in the United States. Dietary interventions are first‐line therapy for coronary heart disease prevention and treatment. Increasing scientific evidence suggests that the traditional Mediterranean diet may reduce the risk of cardiovascular disease. The cardiovascular benefits of this whole‐diet approach may outweigh those of typically prescribed low‐fat diets. The burden of coronary heart disease is enormous, and nutritional approaches that optimize cardiovascular health are essential. Clinical trial evidence supporting the role of the Mediterranean diet in cardiovascular health is presented with an emphasis on the physiological effects of omega‐3 fatty acids. Implications for clinical practice and future research are also discussed.
Differential expression of the human α‐enolase gene in oral epithelium and squamous cell carcinoma
Authors: Ito Satoshi , Honma Takayoshi , Ishida Kosei , Wada Naoyuki , Sasaoka Shunsuke , Hosoda Masaru , Nohno Tsutomu
Published: February 2007

α‐Enolase and c‐myc promoter binding protein 1 are encoded by a single gene, ENO1, and are synthesized from the same transcript through alternative use of translational start sites. We have investigated the localization of ENO1 gene transcripts detected as proteins with an immunohistochemical method and also as mRNA with an in situ hybridization method on tissue sections of oral epithelium and oral squamous cell carcinoma, and demonstrated the differential distribution of the gene transcripts in normal oral epithelium and oral squamous cell carcinoma in humans. Expression of the ENO1 transcript was detectable in the region from the basal cell layers to the lower granular cell layers. Three patterns of ENO1 localization were observed with immunostaining in the epithelia: cytoplasm, nuclei, and both nuclei and cytoplasm. These patterns were observed randomly within the same specimen. In contrast to normal oral epithelium, ENO1 protein was not detectable in the nuclei of carcinoma cells. Our results indicate that differential subcellular localization of ENO1 products may be closely related to carcinogenesis of the oral epithelium. (Cancer Sci 2007; 98: 499–505)
The response of photosynthesis and stomatal conductance to rising [CO2]: mechanisms and environmental interactions
Authors: AINSWORTH ELIZABETH A. , ROGERS ALISTAIR
Published: February 2007

This review summarizes current understanding of the mechanisms that underlie the response of photosynthesis and stomatal conductance to elevated carbon dioxide concentration ([CO2]), and examines how downstream processes and environmental constraints modulate these two fundamental responses. The results from free‐air CO2 enrichment (FACE) experiments were summarized via meta‐analysis to quantify the mean responses of stomatal and photosynthetic parameters to elevated [CO2]. Elevation of [CO2] in FACE experiments reduced stomatal conductance by 22%, yet, this reduction was not associated with a similar change in stomatal density. Elevated [CO2] stimulated light‐saturated photosynthesis (Asat) in C3 plants grown in FACE by an average of 31%. However, the magnitude of the increase in Asat varied with functional group and environment. Functional groups with ribulose‐1,5‐bisphosphate carboxylase/oxygenase (Rubisco)‐limited photosynthesis at elevated [CO2] had greater potential for increases in Asat than those where photosynthesis became ribulose‐1,5‐bisphosphate (RubP)‐limited at elevated [CO2]. Both nitrogen supply and sink capacity modulated the response of photosynthesis to elevated [CO2] through their impact on the acclimation of carboxylation capacity. Increased understanding of the molecular and biochemical mechanisms by which plants respond to elevated [CO2], and the feedback of environmental factors upon them, will improve our ability to predict ecosystem responses to rising [CO2] and increase our potential to adapt crops and managed ecosystems to future atmospheric [CO2].
Two cases of hepatic zygomycosis in allogeneic stem cell transplant recipients and review of literature
Authors: Padmanabhan S. , Battiwalla M. , Hahn T. , Ball D. , Paplham P. , Brown K. , Segal B.H. , McCarthy P. , Almyroudis N.G.
Published: February 2007

Abstract: Gastrointestinal zygomycosis is a rare condition with a high mortality rate. We present 2 fatal cases of hepatic zygomycosis following allogeneic hematopoietic stem cell transplantation and review the literature.
Reflective midwifery practice: Facilitating midwives’practice insights using a distance education reflective practitioner model
Authors: Taylor Bev , Stewart Julia , King Virginia
Published: February 2007

A study was undertaken to evaluate a reflective practitioner model with midwives, who self‐selected into the project when they were studying the Bachelor of Health Science (Nursing) unit NR278, Advanced Nursing Practice, Midwifery. The theoretical assumptions that influenced the research were those forwarded by Schon (1983) and Boud, Keogh and Walker (1985), who argued that practitioners are often unaware of the sophisticated knowledge they have regarding the intricacies of their practice, but that this personal knowledge can be made explicit through reflective processes. The aim of the study was to research the use of a distance education reflective practitioner process that encouraged midwives to examine their practice with a view to making changes where necessary. All the research objectives were met to some extent, although each experience of the research process was particular to the individual participant. Analysis consisted of: interpretation of the participant's insights into their individual experiences; the researcher's interpretations of participant's experiences; and collective themes arising out of the research. This paper concentrates mainly on the participant's insights into their individual experiences of practising midwifery, using a reflective practitioner model.
Innovations in dementia care
Authors: Flood Doreen
Published: February 2007

Creating a homelike environment in an institutional setting that caters for dementia sufferers requires flexibility, understanding and insight. A homelike environment frequently only addresses the physical appearance of the facility without ever considering what was homelike for the resident prior to coming into care. The use of chemical and mechanical restraints to overcome adverse behaviour has been the accepted norm in many nursing homes without consideration being given to the diverse effects of these management tools. The use of the clinical type setting for routines and policies has been in place for many years, yet it is these very routines that have been found to cause the most distress to dementia sufferers. The challenge of change is the greatest reason for maintaining the status quo but change can bring its rewards with the improved quality of life experienced by those residents who lived in a nursing home. This paper describes a programme that addresses the advantages of changing the environment for dementia sufferers and demonstrates that an improved quality of life can be achieved by removing the need for chemical and mechanical restraints.
Being a clinical nurse consultant: A hermeneutic phenomenological reflection
Authors: Walters Allan John
Published: February 2007

This paper describes the lived experiences of clinical nurse consultants. The research approach was that of hermeneutic phenomenology, and the participants in the study were 10 clinical nurse consultants who work in a range of clinical specialty services in a large Sydney referral hospital. The paper provides a phenomenological account of two themes that emerged from the study: the experience of diversity, and the experience of working with people. The experience of diversity relates to the different clinical specialties in which nurse consultants are employed and to the diverse nature of the role. The experience of working with people requires that nurse consultants focus on particular disease symptoms while simultaneously caring for the whole person.
A survey of people with diabetes in northern New South Wales: Problems with self‐care
Authors: Lo Ruth , MacLean Doug
Published: February 2007

People with diabetes mellitus (DM) completed a questionnaire (n= 255) which surveyed the management of their disease and its complications. The questionnaire sought information on: (i) frequency of testing blood and urine; (ii) management of diet and weight control; and (iii) the incidence of smoking and alcohol consumption among people with diabetes. The aims of the study included the identification of the prevalence of coronary heart disease (CHD) among people with diabetes in the northern rivers region of New South Wales; to investigate the problems encountered by people with diabetes in the management of their disease and whether or not there were differences as a function of age and gender. Results indicated that females visited their dietitians more recently and consumed less alcohol than males. Males exercised a great deal more, both in frequency and duration than females. Older respondents tested their blood and urine less frequently, and had less difficulty adhering with diet requirements than younger respondents. Younger respondents expressed greater difficulty in living appropriately with their condition and reducing alcohol consumption. Differences between patients with DM and those with added heart complications indicated that the amount of alcohol consumed was higher and exercise was more likely to be prescribed by medical practitioners for those with CHD. They also found it more difficult to exercise regularly. The role of the health professionals in facilitating self‐care is discussed in the light of these findings.
Topical anaesthesia in haemodialysis: Evaluation of topical anaesthesia with lidocaine during vascular access in children undergoing long‐term haemodialysis for chronic renal failure
Authors: Türkmen Mehmet , Kavukçu Salih , Soylu Alper , Ay Naim , Sevinç Nilgün , Sersan Ruhsan
Published: February 2007

Türkmen M, Kavukçu S, Soylu A, Ay N, Sevinç N, Sersan R. International Journal of Nursing Practice 1997; 3: 79–83

Topical anaesthesia in haemodialysis: Evaluation of topical anaesthesia with lidocaine during vascular access in children undergoing long‐term haemodialysis for chronic renal failure

Children with chronic renal failure are frequently exposed to painful invasive procedures. Ointments containing lignocaine‐prilocaine, when used before intravenous punctures, have been reported to lessen the pain sensation. The aim of this study was to interpret the effectiveness of lidocaine 2.5% ointment in preventing pain when used before venous and arterial punctures in children undergoing a haemodialysis programme for chronic renal failure. Eight children were included in this study. The pain level was identified by the patients using a linear analogue scale. When topical anaesthetic and placebo were compared, there was no statistical difference in interpretation of pain during arterial (P>0.4), venous (P>0.375) or both (P>0.4) procedures. We conclude that lidocaine 2.5% ointment is not effective in preventing pain in children undergoing long‐term haemodialysis. In these patients some other factors, like psychological factors, puncture technique and needle size must be taken into consideration for the prevention of pain.
Age‐related hearing loss in the dependent elderly population: A model for nursing care
Authors: Tolson Debbie , Stephens Dafydd
Published: February 2007

Tolson D & Stephens D. International Journal of Nursing Practice 1997; 3: 224–230

Age‐related hearing loss in the dependent elderly population: A model for nursing care

Advancing nursing care through the implementation of evidence‐based practice is a legitimate professional ideal. In reality there are many complex issues that need be addressed before such a goal can be achieved. This paper takes an intermediate step towards the realization of this aim in one aspect of continuing care nursing through the presentation of a procedural model. The presented model is designed to stimulate debate as to what could be, and arguably should be the role of the nurse in relation to meeting the auditory rehabilitative needs of dependent elderly patients. The model is based upon a published management model which outlines the auditory rehabilitative process within a psychosocial framework. The original model has been modified as a result of knowledge synthesis from a range of specialist disciplines including nursing. The Audiological Care Model for Nursing is intended to offer an accessible guide to this often neglected aspect of care.
Development of a constipation risk assessment scale
Authors: Duffy Jackie , Zernike Wendy
Published: February 2007

Duffy J, Zernike W. International Journal of Nursing Practice 1997; 3: 260–263

Development of a constipation risk assessment scale

This clinical report details a project conducted to facilitate nurses in their assessment of patients who were ‘at risk’ of becoming constipated and to inform and guide nurses of appropriate strategies of intervention based on their assessment.
FLAT ADENOMAS
Authors: Speake Doug , Biyani Deepak , Frizelle Frank A. , Watson Angus J. M.
Published: February 2007

This article was presented at the conjoint CSSA and RACS (colorectal section) spring meeting Queensland, Australia, September 2004. The adenoma–carcinoma sequence describes a succession of events from polypoid adenoma to colorectal cancer. However, this model only accounts for up to two‐thirds of colorectal cancers. There is growing evidence that flat adenomas are precursor lesions to a flat type of colorectal cancer and certain subtypes of these polyps are at greater risk of malignant transformation. If confirmed, the implications for screening, endoscopic recognition and management will become of increasing importance if we are to decrease the incidence of colorectal cancer.
Evaluation of current paediatric guidelines for fluid therapy using two different dextrose hydrating solutions
Authors: HONGNAT J.M. , MURAT I. , SAINT‐MAURICE C.
Published: February 2007

Simplified guidelines for intra‐operative fluid therapy were evaluated in two groups of children (aged 3 months‐10 years) undergoing minor non‐haemorrhagic surgical procedures, randomly assigned to receive either 5% or 2.5% dextrose in 0.3% or 0.4% normal (N) saline. Blood samples were obtained at the time of induction and upon arrival in the recovery room. Fasting time was on average greater than 10 h and hypoglycaemia, defined as blood glucose less than 3.5 mmol?l−1, was observed in 7.4% of the children at the time of induction. In both groups, blood glucose increased at the end of surgery, this increase being more significant in children receiving 5% dextrose than in those receiving 2.5% dextrose. In both groups, post‐operative blood glucose values were higher in children of less than 4 years of age than in those aged 4 and over. Blood glucose changes were associated with a decrease in plasma sodium, this decrease being greater in children receiving 5% dextrose in 0.3 N saline, especially in those less than 4 years of age. This study suggests that the use of a 5% dextrose hydrating solution in 0.3 N saline is more likely to result in hyperglycaemia and hyponatraemia than a 2.5% dextrose in a 0.4 N saline, particularly in children younger than 4 years of age.
Topical anaesthesia of the skin: a review
Authors: FREEMAN J.A. , DOYLE E. , TEE IM NG , MORTON N.S.
Published: February 2007

The ability to provide painless venepuncture and venous cannulation is a major advance in paediatric practice. Topical local anaesthesia of the skin can allow such procedures to be carried out with little or no discomfort in children of all ages. This has obvious psychological benefits for children, particularly those subjected to repeated procedures. The techniques for anaesthetizing the skin to be effective and safe must be based upon an understanding of the anatomy and physiology of the skin, the pharmacology of local anaesthetic agents and their behaviour when applied to the skin. Although eutectic mixture of local anaesthetics (EMLA cream) (Astra Pharmaceuticals) is the market leader, promising new preparations are being evaluated with the aim of decreasing the onset time of effective analgesia. New clinical applications for topical anaesthesia of the skin are appearing and it is likely that these will be increasingly used in the future.
The influence of cold on pain during intravenous induction of anaesthesia with propofol in children
Authors: BORGEAT A. , FUCHS T. , WILDER‐SMITH O.H.G. , ROUGE J.C. , GEMPERLE G. , TASSONYI E.
Published: February 2007

Pain on injection and quality of induction were compared in 74 children (5–12 years) randomly assigned to receive either 5 mg·kg−1 of cold propofol (group A), 5 mg·kg−1 of cold propofol mixed with lignocaine 1% (group B) or 5 mg·kg−1 of propofol at room temperature (22–23°C) mixed with lignocaine 1% (group C). The group receiving cold propofol had to be stopped due to a very high incidence of pain (70%). The incidence of pain on injection was 3% in group B and 17% in group C (not significant). Quality of induction and side‐effects were similar in the two groups.
Asthma and isoflurane
Authors: GRIFFITHS D.E. , MATTHEWS A.J.
Published: February 2007

We present a case report of a young child who had developed severe asthma by the age of 18 months and, in whom an acute exacerbation, required successful prolonged mechanical ventilation with isoflurane when conventional treatment had failed.
Anaesthesia and the Kearns‐Sayre syndrome
Authors: ESTES R. , GINSBERG B. , BLOCH E.C.
Published: February 2007

A six‐month‐old infant presented for anaesthesia with, unbeknown to us, some of the manifestations of the Kearns‐Sayre Syndrome. This syndrome is one of the clinical presentations in patients with mitochondral myopathy. The anaesthetic related events and aspects of mitochondral myopathy are described and caveats are suggested for the management of anaesthesia for patients with this type of myopathy.
Ketamine boluses with continuous low‐dose fentanyl for paediatric sedation during diagnostic cardiac catheterization
Authors: RAUTIAINEN PAULA , MERETOJA OLLI A.
Published: February 2007

During cardiac catheterization, 202 children aged 1 month to 16 yrs were sedated intravenously half an hour after oral premedication with flunitrazepam 0.1 mg·kg−1 (maximum dose 2 mg) to maintain spontaneous breathing and stable and calm conditions for the investigation. Standard fentanyl doses for induction and maintenance were 1 μg·kg−1 and 1 μg·kg−1·h−1, respectively, for all patients. Requirements for supplementary ketamine for induction and maintenance of stable sedation were studied in five age groups (≤0.5 yr, >0.5–2 yr, >2.0–5.0 yr, >5.0–10.0 yr and >10.0 yr). Ketamine doses for induction were 1.5 ± 0.1, 1.5 ± 0.1, 1.2 ± 0.1, 0.9 ± 0.1 and 0.2 ± 0.1 (mean ± SEM) mg·kg−1 in these age groups, respectively. Ketamine requirements for maintenance of sedation were 1.9 ± 0.1, 1.7 ± 0.1, 1.4 ± 0.1, 1.1 ± 0.1 and 0.2 ± 0.1 mg·kg−1·h−1 in the same age groups, respectively. Age dependency of ketamine requirement was shown; the older the patient the less was the need for supplementation. Intravenous sedation with low‐dose fentanyl and ketamine after flunitrazepam premedication provided favourable anaesthesia for cardiac catheterization.
Complications of short term multilumen central venous cannulation in children—a prospective study
Authors: DUMONT S.W. , RALSTON C.
Published: February 2007

A prospective study of the incidence of complications, when using multiple lumen central venous catheters in a paediatric intensive care unit, undertook to survey the normal practice of central venous cannulation at the Birmingham Children's Hospital, using a variety of devices and approaches over a period of a year from May 1991. Ninety five percent of the total of 252 devices used were triple lumen, the rest being double lumen catheters. There were 19 failures to secure access at the initial site chosen, but central venous access was secured in all cases. The complication rate during insertion was 18.5%. There were three major and 20 minor non‐infective complications with a total incidence of 7.9%. Twenty seven cases (10.8%) suffered infective complications. The incidence of all complications were comparable to those obtained in studies involving the use of single lumen devices. This fact, coupled with the high success rate in catheter placement by operators of varying experience, suggests that multiple lumen central venous devices can be considered as a safe alternative to single lumen catheters for short term use in children.
Atracurium in the neonate. Dose‐response with halothane
Authors: FFARCS A.J. CHARLTON , FFARCS N.J.N. HARPER , WILSON A.C. , HUNT L.P.
Published: February 2007

Atracurium in doses of 40, 65, 85 or 100 μg·kg−1 was given to four groups of five neonates anaesthetized with nitrous oxide and halothane. The dose‐response relationship was determined by measurement of the EMG response to train‐of‐four stimulation. The doses calculated to produce 50 and 95% depression of the first twitch response were 56.3 and 101.3 μg·kg−1 respectively. These values are lower than those reported during nitrous oxide/oxygen/narcotic anaesthesia in neonates and older children breathing halothane. The change in train‐of‐four ratio during onset appeared similar to that observed in adults.
Removal of laryngeal mask airway: airway complications in children, anaesthetized versus awake*
Authors: LAFFON M. , PLAUD B. , DUBOUSSET A. M. , BEN HAJ'HMIDA R. , ECOFFEY C.
Published: February 2007

The laryngeal mask airway (LMA) must be inserted during deep anaesthesia. There are no guidelines concerning the removal of LMA, i.e., in awake or anaesthetized patients. The aim of this randomized prospective study was to compare the incidence of respiratory complications after LMA removal in anaesthetized or awake paediatric patients. Sixty children (ASA PS I or II), ranging from 4 months to 12 years of age, were studied. In patients breathing spontaneously, anaesthesia was induced and maintained with nitrous oxide, oxygen and halothane. Patients were randomly divided into two groups: group 1 removal of LMA in awake patients, or group 2 removal of LMA in anaesthetized patients, i.e., in patients receiving halothane at an alveolar concentration of 2 MAC adjusted for age and oxygen for 5 min. In both groups, patients received 100% oxygen after removal of LMA. After removal the incidence of respiratory complications was highest (P < 0.05) in group 1. Therefore, in healthy children undergoing elective surgery, the authors conclude that it is safer to perform the LMA removal in anaesthetized patients.
Clinical management of infants and newborn babies undergoing major surgery utilizing a rapid infusion device
Authors: BEEBE DAVID S. , BECK DANIEL , BELANI KUMAR G.
Published: February 2007

In this paper we describe the perioperative management of a premature infant who underwent excision of a giant sacrococcygeal teratoma, a newborn infant who had a partial hepatectomy for a haemangioendothelioma of the liver and an 18‐month‐old infant who had repair of abdominal aortic, renal and iliac arterial aneurysms. In each case a rapid infusion device was used to deliver warm, washed and ventilated blood to replace massive intraoperative blood loss. Although the blood loss in each operation was in excess of twice the total blood volume of the patient, losses were replaced effectively with the rapid infusion device without any significant hypovolaemic episodes. Successful management of newborn babies and infants undergoing surgery with large and potentially hazardous blood loss can be provided using the rapid infusion device. Paediatric anaesthesiologists should strongly consider using this technology when caring for a baby or infant during surgery where massive haemorrhage may occur.
Barotrauma due to obstruction of the breathing system during a CT‐scan examination in a child
Authors: GRIFFITH N. , MILLAR C.L.
Published: February 2007

A case of pulmonary barotrauma is described in a child undergoing a CT scan in the prone position. Anaesthesia was uneventful until the final exiting movement from the scanner when inadvertent total occlusion of the expiratory limb of a Jackson‐Rees modification of the Ayre's T‐piece occurred. The rapid rise in intrapulmonary pressure caused bilateral pneumothoraces despite the use of an uncuffed tracheal tube. The unusual demands of anaesthesia in the X‐ray department may have contributed to this uncommon complication of the use of an Ayre's T‐piece.
Continuous caudal anaesthesia during inguinal hernia repair in an awake, 1440 g infant
Authors: TOBIAS JOSEPH D. , HERSEY SHANNON
Published: February 2007

The physiological immaturity of respiratory musculature and central respiratory control centres leads to an increased risk of apnoea and respiratory complications following general anaesthesia in the neonate. Regional anaesthetic techniques such as caudal epidural anaesthesia may obviate the need for general anaesthesia and lessen the risks of perioperative morbidity. Although these techniques have been used frequently in neonates, we are unaware of previous reports of continuous caudal anaesthesia in infants less than 2000 g. We present our experience with continuous caudal anaesthesia using 3% chloroprocaine in a 1440 g infant during repair of bilateral inguinal hernias.
Bone marrow harvesting in children managed without allogenic blood
Authors: DE SÁ V. PEREZ , BÉKASSY A. , SCHOU H. , WERNER O.
Published: February 2007

Eleven children undergoing bone marrow harvesting were studied on 15 occasions to assess whether preoperative haemodilution and the acceptance of a transiently low haemoglobin concentration (5 g·dl−1) during anaesthesia, would obviate the need for giving allogenic blood. Before harvesting, 20 (8–28) ml·kg−1 of blood (median (range)) was collected in citrate‐phosphate‐dextrose (CPD) bags and replaced isovolaemically with dextran‐60 in Ringer's acetate. Replacement of the harvested volume (26 (17–42) ml·kg−1) was done with the same solution. The bag content was reinfused before awakening; red cells recovered during processing of the bone marrow 2–4 h postoperatively. The preoperative haemoglobin concentration (Hb) was 10.3 (8.7–12.3) g·dl−1 and central venous oxygen saturation (Scvo2) 82 (70–94)%. Hb decreased to 5.4 (4.7–8.4) g·dl−1 (P < 0.01) at the end of harvest, and Scvo2 to 76 (60–92)% (P < 0.05). Retransfusion from the CPD bags increased Hb to 6.8 (5.8–9.5) g·dl−1 (P < 0.05). After extubation Scvo2 decreased to 67 (55–79)% (P < 0.05). Reinfusing the harvested red cells increased Hb to 8.6 (6.6–10.5) g·dl−1 and Scvo2 to 74 (59–78)%. Hb one week after the harvest was 11.0 (7.4–12.7) g·dl−1. The authors conclude that the combination of preoperative and intraoperative haemodilution was well tolerated as judged from haemodynamics, Scvo2 and pH and allowed large volumes of bone marrow to be harvested without the need for allogenic blood.
Inhaled nitric oxide (NO) in the management of severe pulmonary hypertension following open heart surgery
Authors: WEIMANN JOERG , MOTSCH JOHANN , FRESENIUS MICHAEL , BROWNE ANGELA , MARTIN EIKE
Published: February 2007

The use of inhaled nitric oxide (NO) in a five‐year‐old boy following cardiac surgery for a complex lesion is reported. Pulmonary hypertension causing right ventricular failure and severe hypoxaemia was dramatically reversed by 40 ppm NO added to the inhaled gases. The patient eventually died from the results of left ventricular failure.