bluuebunny/crossref_metadata_2025 huggingface dataset:
Character displacement from the receiver's perspective: species and mate recognition despite convergent signals in suboscine birds
Authors: Seddon Nathalie , Tobias Joseph A.
Published: April 2010

Many social animals use long-distance signals to attract mates and defend territories. They face the twin challenges of discriminating between species to identify conspecific mates, and between individuals to recognize collaborators and competitors. It is therefore often assumed that long-distance signals are under strong selection for species-specificity and individual distinctiveness, and that this will drive character displacement when closely related species meet, particularly in noisy environments. However, the occurrence of signal stereotypy and convergence in rainforest species seems to contradict these ideas, and raises the question of whether receivers in these systems can recognize species or individuals by long-distance signals alone. Here, we test for acoustically mediated recognition in two sympatric antbird species that are known to have convergent songs. We show that male songs are stereotyped yet individually distinctive, and we use playback experiments to demonstrate that females can discriminate not only between conspecific and heterospecific males, but between mates and strangers. These findings provide clear evidence that stereotypy and convergence in male signals can be accommodated by fine tuning of perceptual abilities in female receivers, suggesting that the evolutionary forces driving divergent character displacement in animal signals are weaker than is typically assumed.
A seasnake's colour affects its susceptibility to algal fouling
Authors: Shine R. , Brischoux F. , Pile A. J.
Published: April 2010

Evolutionary transitions from terrestrial to aquatic life modify selective forces on an animal's coloration. For example, light penetrates differently through water than air, and a new suite of predators and visual backgrounds changes the targets of selection. We suggest that an aquatic animal's coloration may also affect its susceptibility to algal fouling. In a colour-polymorphic field population of seasnakes (
Emydocephalus annulatus
) in New Caledonia, black individuals supported higher algal cover than did banded conspecifics. In experimental tests, black snake models (plastic tubes) accumulated more algae than did banded models. Algal cover substantially reduced snake activity (in the field) and swimming speeds (in the laboratory). Effects of algal cover on a snake's hydrodynamic efficiency and/or its rate of cutaneous gas exchange thus may impose selection on the colours of aquatic organisms.
A 250-year index of first flowering dates and its response to temperature changes
Authors: Amano Tatsuya , Smithers Richard J. , Sparks Tim H. , Sutherland William J.
Published: April 2010

Widespread concerns about global biodiversity loss have led to a growing demand for indices of biodiversity status. Today, climate change is among the most serious threats to global biodiversity. Although many studies have revealed phenological responses to climate change, no long-term community-level indices have been developed. We derived a 250-year index of first flowering dates for 405 plant species in the UK for assessing the impact of climate change on plant communities. The estimated community-level index in the most recent 25 years was 2.2–12.7 days earlier than any other consecutive 25-year period since 1760. The index was closely correlated with February–April mean Central England Temperature, with flowering 5.0 days earlier for every 1°C increase in temperature. The index was relatively sensitive to the number of species, not records per species, included in the model. Our results demonstrate how multi-species, multiple-site phenological events can be integrated to obtain indices showing trends for each species and across species. This index should play an important role in monitoring the impact of climate change on biodiversity. Furthermore, this approach can be extended to incorporate data from other taxa and countries for evaluating cross-taxa and cross-country phenological responses to climate change.
Contribution of human melanopsin retinal ganglion cells to steady-state pupil responses
Authors: Tsujimura Sei-ichi , Ukai Kazuhiko , Ohama Daisuke , Nuruki Atsuo , Yunokuchi Kazutomo
Published: April 2010

The recent discovery of melanopsin-containing retinal ganglion cells (mRGCs) has led to a fundamental reassessment of non-image forming processing, such as circadian photoentrainment and the pupillary light reflex. In the conventional view of retinal physiology, rods and cones were assumed to be the only photoreceptors in the eye and were, therefore, considered responsible for non-image processing. However, signals from mRGCs contribute to this non-image forming processing along with cone-mediated luminance signals; although both signals contribute, it is unclear how these signals are summed. We designed and built a novel multi-primary stimulation system to stimulate mRGCs independently of other photoreceptors using a silent-substitution technique within a bright steady background. The system allows direct measurements of pupillary functions for mRGCs and cones. We observed a significant change in steady-state pupil diameter when we varied the excitation of mRGC alone, with no change in luminance and colour. Furthermore, the change in pupil diameter induced by mRGCs was larger than that induced by a variation in luminance alone: that is, for a bright steady background, the mRGC signals contribute to the pupillary pathway by a factor of three times more than the L- and M-cone signals.
Storms drive altitudinal migration in a tropical bird
Authors: Boyle W. Alice , Norris D. Ryan , Guglielmo Christopher G.
Published: April 2010

Although migration is a widespread and taxonomically diverse behaviour, the ecological factors shaping migratory behaviour are poorly understood. Like other montane taxa, many birds migrate along elevational gradients in the tropics. Forty years ago, Alexander Skutch postulated that severe storms could drive birds to migrate downhill. Here, we articulate a novel mechanism that could link storms to mortality risks via reductions in foraging time and provide, to our knowledge, the first tests of this hypothesis in the White-ruffed Manakin (Corapipo altera), a small partially migratory frugivore breeding on the Atlantic slope of Costa Rica. As predicted, variation in rainfall was associated with plasma corticosterone levels, fat stores, plasma metabolites and haematocrit. By collecting data at high and low elevation sites simultaneously, we also found that high-elevation residents were more adversely affected by storms than low elevation migrants. These results, together with striking temporal capture patterns of altitudinal migrants relative to storms, provide, to our knowledge, the first evidence that weather-related risks incurred by species requiring high food intake rates can explain altitudinal migrations of tropical animals. These findings resolve conflicting evidence for and against food limitation being important in the evolution of this behaviour, and highlight how endogenous and exogenous processes influence life-history trade-offs made by individuals in the wild. Because seasonal storms are a defining characteristic of most tropical ecosystems and rainfall patterns will probably change in ensuing decades, these results have important implications for understanding the ecology, evolution and conservation of tropical animals.
Evolutionary trajectory of the VP1 gene of human enterovirus 71 genogroup B and C viruses
Authors: van der Sanden Sabine , van der Avoort Harrie , Lemey Philippe , Uslu Gökhan , Koopmans Marion
Published: April 2010

From 1963 to 1986, human enterovirus 71 (HEV71) infections in the Netherlands were successively caused by viruses of subgenogroups B0, B1 and B2. A genogroup shift occurred in 1987, after which viruses of subgenogroups C1 and C2 were detected exclusively. This is in line with HEV71 typing in Australia, Europe and the USA, but is distinct from that in the Asian Pacific region, where HEV71 subgenogroups B3–B5 and C4–C5 have caused large outbreaks since 1997. To understand these observations in HEV71 epidemiology, the VP1-encoding regions of 199 HEV71 strains isolated in the Netherlands between 1963 and 2008 were used to study the detailed evolutionary trajectory and population dynamics of HEV71. Genogroup B viruses showed an epochal evolution, whereas genogroup C viruses evolved independently, which is in line with the co-circulation of C1 and C2 viruses in the Netherlands since 1997. Considering that strains from the Netherlands are interspersed phylogenetically with GenBank reference strains, the evolution of B1–B2, C1–C2 viruses has a global nature. Phylodynamic analysis confirmed that increased reporting of HEV71 infections in 1986 and 2007 reflected true epidemics of B2 and C2 viruses, respectively. Sequence analysis of the complete capsid region of a subset of isolates revealed several (sub)genogroup-specific residues. Subgenogroup B2-specific rabbit antiserum showed cross-neutralization of B0, B1 and B2 viruses, but not of subgenogroup C1 or C2 viruses, probably explaining the global shift to genogroup C in 1987 following a B2 epidemic. Anti-C1 rabbit serum neutralized both genogroup B and C viruses. Global herd immunity against C1 and C2 viruses possibly explains why epidemics with subgenogroups B4 and C4 are restricted to the Asian Pacific region.
Hepatitis B virus polymerase inhibits RIG-I- and Toll-like receptor 3-mediated beta interferon induction in human hepatocytes through interference with interferon regulatory factor 3 activation and dampening of the interaction between TBK1/IKKϵ and DDX3
Authors: Yu Shiyan , Chen Jieliang , Wu Min , Chen Hui , Kato Nobuyuki , Yuan Zhenghong
Published: April 2010

Hepatitis B virus (HBV) infection remains one of the most serious health problems worldwide. Whilst studies have shown that HBV impairs interferon (IFN) production from dendritic cells in chronic hepatitis B patients, it remains unknown whether HBV inhibits IFN production in human hepatocytes. Using transient transfection assays in a primary human hepatocyte cell line (PH5CH8), this study demonstrated that HBV polymerase inhibits IFN-β promoter activity induced by Newcastle disease virus, Sendai virus or poly(I : C) in a dose-dependent manner, whilst ectopic expression of the HBV core and X proteins had no effect on IFN-β promoter activity. In addition, HBV polymerase blocked cellular IFN-β expression and consequent antiviral immunity revealed by an infection protection assay. Furthermore, overexpression of key molecules on the IFN-β induction axis, together with HBV polymerase, resulted in a block of IFN-β promoter activity triggered by RIG-I, IPS-1, TRIF, TBK1 and IKKϵ, but not by an IFN regulatory factor 3 dominant-positive mutant (IRF3-5D), suggesting that HBV polymerase prevents IFN-β expression at the TBK1/IKKϵ level. Further studies showed that HBV polymerase inhibited phosphorylation, dimerization and nuclear translocation of IRF3, in response to Sendai virus infection. Finally, it was shown that HBV polymerase-mediated dampening of the interaction between TBK1/IKKϵ and DDX3 may be involved in the inhibitory effect on IFN-β induction. Taken together, these findings reveal a novel role of HBV polymerase in HBV counteraction of IFN-β production in human hepatocytes.
CD8+ T-cell recognition of human cytomegalovirus latency-associated determinant pUL138
Authors: Tey Siok-Keen , Goodrum Felicia , Khanna Rajiv
Published: April 2010

Recent studies have shown that long-term persistence of human cytomegalovirus (HCMV) in mononuclear cells of myeloid lineage is dependent on the UL138 open reading frame, which promotes latent infection. Although T-cell recognition of protein antigens from all stages of lytic HCMV infection is well established, it is not clear whether proteins expressed during latent HCMV infection can also be recognized. This study conducted an analysis of T-cell response towards proteins associated with HCMV latency. Ex vivo analysis of T cells from healthy virus carriers revealed a dominant CD8+ T-cell response to the latency-associated pUL138 protein, which recognized a non-canonical 13 aa epitope in association with HLA-B*3501. These pUL138-specific T cells displayed a range of memory phenotypes that were in general less differentiated than that previously described in T cells specific for HCMV lytic antigens. Antigen-presentation assays revealed that endogenous pUL138 could be presented efficiently by HCMV-infected cells. However, T-cell recognition of pUL138 was dependent on newly synthesized protein, with little presentation from stable, long-lived protein. These data demonstrate that T cells targeting latency-associated protein products exist, although HCMV may limit the presentation of latent proteins, thereby restricting T-cell recognition of latently infected cells.
Reactivation of lymphocryptovirus (Epstein–Barr virus chimpanzee) and dominance in chimpanzees
Authors: Yamamoto Rain , Teramoto Migaku , Hayasaka Ikuo , Ikeda Koki , Hasegawa Toshikazu , Ishida Takafumi
Published: April 2010

Nine male chimpanzees originally reared in solitary cages were set up to form a group. Plasma viral load of the lymphocryptovirus (LCV) of chimpanzee [Epstein–Barr virus chimpanzee (EBVcmp)] was measured by real-time PCR. In the group formation (Form) period, the first-ranking male showed an imminent increase in plasma EBVcmp load compared with 1 week before (pre-Form) and 3 months after (post-Form) group formation. Other upper-ranking males such as the second-, third- and fourth-male also showed the highest level of viral load in the Form period. The kinetics of EBVcmp load in the Form period were statistically different from other periods (against pre-Form,t=−4.878,P<0.001; against post-Form,t=6.434,P<0.001). The effect of the male dominance rank did not differ between the pre-Form and post-Form periods (t=−1.557,P=0.12). Reactivation of LCV (EBV) as an immunological stress marker for humans might also be applied to chimpanzees.
The Optics of Organic Photovoltaics: Fiber-Based Devices
Authors: Li Yuan , Nie Wanyi , Liu Jiwen , Partridge Ashton , Carroll D. L.
Published: April 2010

Recently, there has been great interest in fiber-based photovoltaic (PV) cells for improving the performance of organic absorbers. Fiber-based solar cells are a subset of a larger class of PVs that have been fabricated to have enhanced optical performance when used with low optical density absorbers. In this paper, we compare and contrast the different approaches to the optical engineering of organic PVs. Unlike most other architectures, the fiber-based solar cell confines the radiation modes of the fiber to achieve “ideal” absorption across the absorption band of the polymer. This yields the optimum performance for a given absorber. We also present a route to the large-scale fabrication of such devices, which is cost competitive with other organic PV platforms.
European Academy of Paediatrics Research in Ambulatory Setting network (EAPRASnet): a multi‐national general paediatric research network for better child health
Authors: Del Torso S. , Van Esso D. , Gerber A. , Drabik A. , Hadjipanayis A. , Nicholson A. , Grossman Z.
Published: April 2010

Background  In 2008, the European Academy of Paediatrics launched a paediatric‐based research network – EAPRASnet (European Academy of Paediatrics Research in Ambulatory Setting network). The network has recruited primary care and general paediatricians from European and Mediterranean countries.

Methods  Every paediatrician joining the network has been asked to complete a recruitment survey. The aims of the survey were to characterize paediatrician's demographics, practice arrangements and patient's demographics, to define main incentives for research, and to learn what paediatricians view as unsolved issues that need to be studied.

Results  A total of 156 paediatricians from 19 countries were recruited with 144 completing the questionnaire (92%). Majority of respondents (89%) were general paediatricians for more than half of their time. Practice arrangement of 47% of paediatricians was solo practice, with 40% in group practice. Electronic medical records were being used by 72% of respondents. Over 70% of the paediatricians had more than 1000 patients under their clinical care, and patients younger than 6 years old contributed nearly half of the patient population. Areas of most interest for research were: quality of care indicators, communication with parents, obesity, attention deficit hyperactivity disorder and effective well child care. Main incentives for participation in a research project were interest in the topic (81%) and effort to improve quality of care (71%). Lack of time was the leading reported obstacle for research activity (72%). EAPRASnet is growing, and the network's structure, operation and funding are described. Methods for joining the network and the process of study development are presented.

Conclusion  A core group of EAP general paediatricians are committed to research in their practices. The information gathered will serve for future planning of research projects in the EAPRASnet to harmonize and optimize the care given to children in the primary care setting in Europe.
Cholinergic stimulation of the immune system protects against lethal infection bySalmonella entericaserovar Typhimurium
Authors: Fernandez‐Cabezudo Maria J. , Lorke Dietrich E. , Azimullah Sheikh , Mechkarska Milena , Hasan Mohammed Y. , Petroianu Georg A. , al‐Ramadi Basel K.
Published: April 2010

The cholinergic nervous system has been demonstrated to attenuate the inflammatory response during sepsis via the inhibitory action of acetylcholine (ACh) on macrophages. These findings were largely based on experimental sepsis models using endotoxin as the inducing agent. Herein, however, we report that the specific inhibition of acetylcholinesterase (AChE) renders animals more resistant to infection by a virulent strain ofSalmonella entericaserovar Typhimurium, a Gram‐negative enteric pathogen. Inhibition of AChE was induced by a subchronic exposure to paraoxon, a potent anti‐cholinesterase metabolite of the organophosphorous compound parathion. Our findings indicate that inhibition of AChE enhanced survival of infected mice in a dose‐dependent fashion and this correlated with efficient control of bacterial proliferation in target organs. Immunologically, inhibition of AChE enabled the animals to mount a more effective inflammatory anti‐microbial response, and to secrete higher levels of interleukin‐12, a key T helper type 1‐promoting cytokine. The ACh‐induced enhancement in resistance to infection was abrogated by co‐administration of an oxime which can reactivate AChE. Hence, in a model of Gram‐negative bacterial infection, cholinergic stimulation is shown to enhance the anti‐microbial immune response leading to effective control of bacterial proliferation and enhanced animal survival.
Ectopic expression of an endoparasitic wasp venom protein in Drosophila melanogaster affects immune function, larval development and oviposition
Authors: Thomas P. , Yamada R. , Johnson K. N. , Asgari S.
Published: April 2010

Endoparasitic hymenoptera inject maternal factors into the host, along with their eggs, to subvert the host immune system. The venom protein, Vn50, previously characterized from the wasp Cotesia rubecula inhibits prophenoloxidase activation in its host Pieris rapae and in another lepidopteran, Manduca sexta. We generated a stable line in the model insect, Drosophila melanogaster, which ectopically expresses Vn50. Results indicated that Vn50 expression accelerates larval development, increases oviposition and reduces melanization in the haemolymph of the transgenic flies. Since melanization is known to be an important facet of the insect immune response, we examined the impact of Vn50 expression on susceptibility to pathogens. Transgenic Vn50 flies challenged with the fungus Beauveria bassiana had increased mortality compared with control flies, but there was no significant change in survival in flies challenged with the pathogenic bacteria, Serratia marcescens. Interestingly, mortality induced by the natural pathogen Drosophila C virus was significantly delayed in Vn50 expressing flies. This indicates a wider range of potential hosts that may be affected by Vn50 and its potential for manipulation of immune system in insects.
Latitudinal variation in breeding time reaction norms in a passerine bird
Authors: Gienapp Phillip , Väisänen Risto A. , Brommer Jon E.
Published: April 2010

1. The timing of phenological events, as flowering time in plants or migration and breeding time in animals, is related to environmental conditions, e.g. local ambient temperature, and varies considerably between years. The relationship between the relevant environmental condition(s) and phenology can be described by a reaction norm.

2. Apart from variation among years phenology also varies geographically and the timing of phenological events is generally later at higher latitudes. However, whether this latitudinal trend is caused by a single reaction norm (and locally varying conditions) or whether reaction norms differ spatially is largely unknown.

3. Avian breeding time is determined by a variety of internal and external factors, e.g. photoperiod and temperature. The corresponding reaction norms are normally described by a regression of annual mean against temperatures averaged over a certain period. We circumvented problems inherent in this approach by using proportional hazards models to describe the relationship between breeding time and local temperature and day length.

4. The proportional hazards model describes a ‘time to event’, e.g. survival or in this case time until laying of the first egg, by modelling the probability that the event will occur per unit time as a function of an unspecified baseline hazard and fixed or time‐dependent variables. Any variable that changes its value during the ‘time to event’, e.g. ambient temperature, can be included as time‐dependent variable.

5. Applying this approach to a large data set of Finnish great tit (Parus major) egg laying dates from populations spanning about 700 km in latitude, we found that temperature‐ and day length‐reaction norms vary with latitude.

6. Optimal reaction norms likely differ between populations and the observed variation in reaction norms among populations may thus reflect local adaptation. Under environmental change, local reaction norms may become suboptimal, and latitude‐specific breeding time reaction norms may represent a source of variation that could benefit a species to adapt to such changes.
Lived experience of epilepsy from the perspective of children in Taiwan
Authors: Chen Hsiu‐Jung , Chen Yueh‐Chih , Yang Hui‐Chuan , Chi Ching‐Shiang
Published: April 2010

Aims.  The purpose of this study was to explore the lived experiences of school‐aged children with epilepsy in Taiwan.

Background.  Epilepsy affects many people worldwide, especially school‐aged children, but few studies have examined children’s viewpoints of their experiences with epilepsy.

Design.  An exploratory, phenomenological interview design was used.

Methods.  Children (ages 7–12 years) with well‐controlled epilepsy and no developmental delay were recruited from a hospital in central Taiwan. Data were collected from 15 children using a semi‐structured interview guide. Interviews were tape‐recorded with permission from parents and children. Verbatim transcripts were analysed using Colazzi’s phenomenological method.

Results.  Two themes emerged from the analysis. The first theme, ‘living with epilepsy’, had two subthemes: disease‐related experiences and school‐related issues. The second theme, ‘coping with epilepsy’, had two subthemes: developing strategies to manage or reduce seizures and seeking support from family members.

Conclusions.  Taiwanese children with epilepsy had similar lived experiences as their counterparts in Western culture, e.g. unpleasant somatic symptoms, difficulty learning and troubled peer relationships. Taiwanese children also coped similarly with epilepsy by taking medications to control seizures, but they differed from their Western counterparts in trying to self‐manage seizures and seeking support from family members.

Relevance to clinical practice.  Public health and school nurses can apply our findings to educate schoolteachers and parents about epilepsy and encourage activities that allow children with and without epilepsy to interact, thus improving peer relationships and reducing stigmatisation. Children with and without epilepsy would also benefit from an age‐appropriate education manual that includes causes of epilepsy, treatment, dealing with seizures and psychological and social adaptation.
Recognising our role: improved confidence of general nurses providing care to young people with a mental illness in a rural paediatric unit
Authors: Moxham Lorna , Dwyer Trudy , Happell Brenda , Reid‐Searl Kerry , Kahl Julie , Morris Jodie , Wheatland Narelle
Published: April 2010

Objective.  To implement and evaluate strategies suggested by general nurses to improve management of children and adolescents with mental health problems admitted to a paediatric unit of a general hospital.

Background.  The first phase of a study using a Participatory Action Research approach identified several concerns associated with general nurses providing care to young people with mental disorders in paediatric units of general hospitals, together with suggestions for strategies to address these issues. This paper describes the second and third phase of the Participatory Action Research study, involving the implementation and evaluation of these strategies.

Design.  Participatory Action Research.

Methods.  Actions that occurred during phase two of the Participatory Action Research study included revision and introduction of policies and procedures for mental health care in the unit, education and training sessions for paediatric nursing staff and opportunities to strengthen communication between existing mental health services. In phase three, two focus groups were conducted to explore current perceptions of mental health care delivery in the unit and evaluate change, following phase two.

Results.  Changes in clinical practice for paediatric mental health care were acknowledged by participants. Reflection has assisted nurses to better understand their strengths and weaknesses and to acknowledge and challenge the assumptions on which their ideas, feelings and actions about patients with mental health issues are based. Participants also recognised the existing skills and expertise they possess that are relevant to the management of young people with a mental health problem, although they continue to seek ongoing education and support in this field.

Conclusions.  This study demonstrates that through Participatory Action Research it is possible to enhance mental health nursing care in a rural paediatric unit.

Relevance to clinical practice.  Such changes have the potential to improve the experience of young people and their families whilst receiving treatment for mental health conditions in a general paediatric unit.
An Australian investigation of emotional work, emotional well‐being and professional practice: an emancipatory inquiry
Authors: Rose Jayln , Glass Nel
Published: April 2010

Aims and objectives.  This study set out to explore the relationship between emotional work, emotional well‐being and professional practice of generalist community health nurses who provided palliative care to clients living at home.

Background.  Research suggests that palliative care practice is emotionally demanding and at times challenging. Whilst nurses find their palliative practice a source of job satisfaction the associated stresses can impact on nurses emotional well‐being.

Design.  A qualitative emancipatory methodology informed this study.

Methods.  Semi‐structured interviews/storytelling and reflective journaling were the two methods applied. Sixteen community health nurses including the researcher participated. Thematic analysis of the data was undertaken.

Results.  The concept of emotional well‐being is associated with nurses’ feelings of being balanced or out of balance. There is a pervasive interconnectedness between emotional work, emotional well‐being and professional practice that is influenced by factors such as organisational and workplace issues; communication with health professionals, professional boundaries; education and professional development. Three major interwoven themes emerged highlighting that palliative care provision was demanding and rewarding, yet dependent on the nurse’s comfortability within practice. Self‐care is also important to the generalist nurses and strategies to enhance well‐being include healthy lifestyle choices, debriefing, self‐validation, assertiveness and emotional support.

Conclusions.  Emotional well‐being is complex and multifaceted. The value of emotional well‐being to professional practice is important. Palliative care provision is associated with demands, rewards and comfortability. It is essential that attention be given to the experiences of generalist community health nurses who engage in palliative care provision.

Relevance to clinical practice.  As the demand for community palliative care increases, the issues that limit and enhance the emotional well‐being of generalist palliative care nurses’ become critical. The findings have international relevance to generalist and specialist palliative care nurses, academics and researchers alike.
Women’s perceptions of chemotherapy‐induced cognitive side affects on work ability: a focus group study
Authors: Munir Fehmidah , Burrows Jodie , Yarker Joanna , Kalawsky Katryna , Bains Manpreet
Published: April 2010

Aims and objectives.  To investigate women’s awareness of chemotherapy‐induced cognitive changes, their perception of cognitive limitations in carrying out daily tasks and subsequent return to work decisions and perceptions of work ability.

Background.  Evidence suggests that women diagnosed with breast cancer experience cognitive changes as a consequence of chemotherapy treatment. Although these changes tend to be subtle deficits in memory, concentration and the ability to organise information, there has been no published research identifying how they can impact patient’s ability to work and subsequent employment decisions.

Design.  This was a qualitative study.

Method.  Data were collected from breast cancer survivors using semi‐structured interviews with two focus groups (n = 6, n = 7). Interviews were transcribed verbatim and analysed using template analysis.

Results.  Data were categorised into four main themes: (1) awareness of cognitive changes during and following chemotherapy, (2) cognitive ability and confidence in return to work, (3) impact of cognitive changes on work ability and (4) information on the cognitive side effects of chemotherapy.

Conclusions.  The views and experiences of breast cancer survivors towards returning to work and subsequent work ability were affected by chemotherapy‐induced cognitive impairment. More specifically the appraisal of returning to work and ability to manage work were influenced by three interrelated factors: (1) actual cognitive ability following chemotherapy, (2) awareness of cognitive failures by the women and their families and (3) the subsequent impact on their confidence in carrying out daily tasks including work tasks.

Relevance to clinical practice.  More information and support is needed to help patients with cancer to manage chemotherapy‐induced cognitive impairments in home and workplace. Nurses are increasingly asked about the impact of cancer and its treatment on work and are therefore well positioned to offer this advice. Subsequently, nurses require additional knowledge and guidance to provide this information and support.
Night admission to the emergency department: a factor delaying time to surgery in patients with head injury
Authors: Kim Young‐Ju
Published: April 2010

Aim.  To investigate factors influencing time from patient’s arrival at the emergency department to surgery in patients with head injury.

Background.  A better understanding of factors influencing variation in time from patient’s arrival at the emergency department to surgery for patients with head trauma could reduce mortality and morbidity associated with injury.

Design.  A cross‐sectional study of secondary data.

Methods.  The sample represented 493 patients with head injury requiring surgery from the 17 level I and II trauma centres. Data were extracted from the National Trauma Data Bank version 4.0. Two‐level hierarchical models were used to analyse data at the patient level while incorporating a unique random effect for each trauma centre. Factors entered in the models included patient characteristics and trauma centre characteristics.

Results.  Patients with a Glasgow coma scale score of 3–8 in the first ED assessment had earlier time to surgery compared with those with a Glasgow coma scale of 13–15 (β = −0·31, 95% CI = −0·43–0·18). Patients who arrived at the hospital during the nighttime (6pm–8am) had a significantly delayed time to surgery than those who arrived during the daytime (8am–6pm) (β = −0·15, 95% CI = −0·26 to −0·04).

Conclusions.  The more severely the injured patients were the faster surgery was performed. The time, when patients arrived to the emergency department was found to be a significant factor influencing time to surgery. Patients who arrived at emergency department at night had longer time to surgery than those who arrived during daytime, despite they were more severely head injured than those who arrived during the day.

Relevance to clinical practice.  When surgical intervention in head‐injured patients is anticipated, especially during the night shift, time from patient’s arrival at emergency department to surgery should be consistently assessed to identify opportunities for improvement in the structure and process of trauma care.
The lifestyle behaviours and psychosocial well‐being of primary school students in Hong Kong
Authors: Lee Regina LT , Loke Alice Yuen , Wu Cynthia ST , Ho Amy PY
Published: April 2010

Aims.  To examine the lifestyle behaviours and psychosocial well‐being of primary school students in Hong Kong.

Background.  The establishment of healthy lifestyle habits and maintenance of psychosocial well‐being during early adolescence can prevent the morbidity and mortality caused by unhealthy practices.

Design.  A cross‐sectional study.

Methods.  A questionnaire was used to solicit information on primary school students’ lifestyle behaviours and psychosocial well‐being using the Chinese version of the Adolescent Lifestyle Questionnaire (C‐ALQ).

Results.  Out of 249 primary school students, 241 returned their questionnaires (a response rate of 96·8%). Results on the lifestyle behaviours of students indicated that nearly half of them ‘play sports at least three times a week’ (n = 111, 46·1%), ‘try not to eat foods high in fats/salt’ (n = 112, 46·5%), ‘report unusual bodily changes to nurses, parents, friends or physician’ (n = 136, 56·4%) and ‘avoid doing drugs’ (n = 186, 77·2%). Results for the psychosocial well‐being of students showed that nearly half ‘use helpful strategies to deal with stress’ (n = 104, 43·2%), are ‘confident about [their] own beliefs and values in life’ (n = 143, 59·3%) and ‘enjoy spending time with friends’ (n = 169, 70·1%). Male students were found less likely than females to demonstrate ‘health awareness’ (t = 4·87, p = 0·028) and ‘social support’(t = 4·17, p = 0·042) and to have better overall psychosocial well‐being (t = 5·43, p = 0·021).

Conclusions.  Primary school students have various health education needs related to lifestyle behavioural choices and the maintenance of psychosocial well‐being. Lifestyle choices are formed in early adolescence; therefore, health education must begin as early as possible to influence healthy behaviours.

Relevance to clinical practice.  School nurses should assess health needs across the school‐age population and develop programmes to address these overall needs. School nurses are needed to cater for the needs of students, particularly boys, to establish health programmes for lifelong healthy lifestyles and psychosocial well‐being and to monitor their health status.
Adolescents’ perceptions of quality of life: what it is and what matters
Authors: Helseth Sølvi , Misvær Nina
Published: April 2010

Aim.  The aim of this study is to explore and describe adolescents’ own perceptions of quality of life; what it is and what matters.

Background.  Quality of life has become an important concept in evaluating health care, in both child and adult populations. As nurses concerned with quality of life and well‐being, it is important for us to identify the main factors that contribute to the promotion and sustenance of young people’s well‐being.

Design.  A qualitative hermeneutic design was chosen.

Method.  The method was in‐depth interviews with 31 healthy adolescents (14–15 years) in the school health service. The interviews were taped, transcribed and analysed as text according to Kvale’s three contexts of interpretation: self‐understanding, critical common sense and theory.

Results.  According to the adolescents, quality of life is about the positive cycles of life. Feeling good, being satisfied with oneself and having an overall positive attitude are in most cases described as the starting points of a positive cycle. To get into and stay in the positive cycle, a positive self‐image, good friends and good family relations are important. Consequently, adolescents’ quality of life is threatened when these factors are negative. Friends seem to be the most significant factor. It is extremely difficult to be without friends and none of the adolescents would admit that they were, not even to themselves, although it was rather obvious in some cases. Self‐image and popularity are factors associated with the ability to get friends.

Conclusions.  Understanding the adolescents’ view of quality of life emphasises the importance of focusing on their psychosocial health and in particular their peer relations, to promote and sustain their quality of life.

Relevance to clinical practice.  Knowledge about the factors most significant to adolescents’ quality of life is applicable to all clinical settings where nurses meet adolescents; i.e., hospitals, outpatient clinics and school health services.
The effectiveness of a programme of enhancing resiliency by reducing family boundary ambiguity among children with epilepsy
Authors: Mu Pei‐Fan , Chang Kai‐Ping
Published: April 2010

Aim and objectives.  The aim of the study was to examine the effect of a programme designed to reduce family boundary ambiguity in families who care for children with epilepsy.

Background.  When parents are caring for an epileptic child, they may experience unclear perceptions about whether the child is psychologically included in the family and develop unclear expectations regarding role performance in the family. Some studies have identified boundary ambiguity as a possible antecedent to relationship problems that are associated with negative outcomes in the areas of parental well‐being and family functioning. There is a need to develop family nursing interventions that will reduce family boundary ambiguity when the family is caring for children with epilepsy.

Design.  A pretest, post‐test, one group, quasi‐experimental design was used in this study.

Methods.  This study was made up of three phases: first, the establishing of a parental needs checklist and the development of a parental education information handbook; second, the carrying out of a family assessment including the analysis of the meaning of their experiences and needs and the construction of an educational dialogue and finally, an outcomes evaluation after three months. Seventeen mothers participated in the study.

Results.  The study found that there were statistically significant improvements in family boundary ambiguity and maternal depression was reduced.

Conclusions.  This study illustrates nursing intervention that involves the integrating of phenomenological principles into the nursing care process. Specifically, Husserlian phenomenology is able to be helpful to nursing practice, especially the concepts of intentionality, intersubjectivity, empathy and bracketing.

Relevance to clinical practice.  This study supported the conceptual framework involved in the construction of the meaning of the situation, the enhancement of mastery over the situation and reconstruction of identity. These items are resiliency factors that provided a mechanism that helps to reduce boundary ambiguity when a family is caring for a child with epilepsy.
In the know: cognitive and social factors in mental health nursing assessment
Authors: MacNeela Padraig , Scott Anne , Treacy Pearl , Hyde Abbey
Published: April 2010

Aims and objectives. To develop an integrated cognitive and social understanding of assessment in mental health nursing.

Background. Assessment is a vital component of nursing care for mental health service users, largely driven by a tacit, experiential model of assessment; this approach is at variance with an evidence‐based approach to assessment.

Design. A qualitative design was employed in the study, with a thematic analysis carried out on transcripts of focus groups with mental health nurses.

Method. Ten focus groups were carried out, guided by questions on nurses’ contribution to care and the problems patients present with. Fifty‐nine registered mental health nurses were sampled from eight acute and community mental health services across urban and rural regions in Ireland.

Results. References to assessment were identified (how nurses acquired information, how it was made sense of and used in the system of care). Assessment talk was characterised by reliance on a experientially based clinical schema and recognition of the task environment’s shaping influence. Nurses’ clinical knowledge was a pragmatic tool that permitted nurses to assess risk, promote patient engagement and work with doctors.

Conclusions. Nurses strived to ‘know the patient’, while having to ‘work the system’, with implications for patient care and decision‐making quality. Reliance on experiential knowledge is a professional trait, but one that renders nursing assessment ‘invisible’ in significant ways.

Relevance to clinical practice. Cognitive and social aspects of nursing decision‐making have been considered apart from one another, whereas cognitions about mental health conditions are, in fact, applied in a pragmatic, task‐oriented organisational system. Nurses believed that spending time with the service user led to a privileged position of knowledge in comparison with doctors (‘knowing the person’), but this knowledge is frequently applied to the task of ‘knowing the patient’, assessing the person as a source of risk and danger.
The impact of psychosocial factors on adherence to compression therapy to prevent recurrence of venous leg ulcers
Authors: Finlayson Kathleen , Edwards Helen , Courtney Mary
Published: April 2010

Aims. To identify self‐care activities undertaken and to determine relationships between self‐efficacy, depression, quality of life, social support and adherence to compression therapy in a sample of patients with chronic venous insufficiency.

Background. Up to 70% of venous leg ulcers recur after healing. Compression hosiery is a primary strategy to prevent recurrence; however, problems with adherence to this strategy are well documented and an improved understanding of how psychosocial factors influence patients with chronic venous insufficiency will help guide effective preventive strategies.

Design. Cross‐sectional survey and retrospective medical record review.

Method. All patients previously diagnosed with a venous leg ulcer that healed between 12–36 months prior to the study were invited to participate. Data on health, psychosocial variables and self‐care activities were obtained from a self‐report survey and data on medical and previous ulcer history were obtained from medical records. Multiple linear regression modelling was used to determine the independent influences of psychosocial factors on adherence to compression therapy.

Results. In a sample of 122 participants, the most frequently identified self‐care activities were application of topical skin treatments, wearing compression hosiery and covering legs to prevent trauma. Compression hosiery was worn for a median of four days/week (range 0–7). After adjustment for all variables and potential confounders in a multivariable regression model, wearing compression hosiery was found to be significantly positively associated with participants’ knowledge of the cause of their condition (p = 0·002), higher self‐efficacy scores (p = 0·026) and lower depression scores (p = 0·009).

Conclusion. In this sample, depression, self‐efficacy and knowledge were found to be significantly related to adherence to compression therapy.

Relevance to clinical practice. These findings support the need to screen for and treat depression in this population. In addition, strategies to improve patient knowledge and self‐efficacy may positively influence adherence to compression therapy.
Cardiac risk factors and quality of life in patients with coronary artery disease
Authors: Sevinç Sibel , Akyol Asiye D
Published: April 2010

Aims.  The study aimed to determine the quality of life and the relationship between cardiac risk factors and the quality of life in subjects diagnosed with coronary artery disease.

Background.  Coronary artery disease is the leading cause of adult deaths. The main goal of the therapy is to stop the progression of atherosclerotic coronary disease, ensure its regression and protect individuals from possible complications, increase quality of life and survival period by providing optimal physical, psychological and social conditions.

Design and method.  The sample population was 270 outpatients who were diagnosed Coronary artery disease at the Cardiology Policlinics of State Hospital during 21 May–20 July 2007.

Socio‐demographic information and risk factors were inquired during the period of data collection with two forms as the ‘Demographic Characteristics Questionnaire’ and ‘Mac New Quality of Life Scale’.

Results.  According to the results of the study, it was found that 22·2% of the patients were under the age of risk group, 27·8% had diabetes, 47·5% had hypertension, 36·7% were smokers, and 40·7% had hyperlipidemia. It was established that 31·1% had four risk factors, no patients were risk‐free, and the mean number of risk factors was 3·7 (SD 1·28). For the scores of the quality of life scale domains of the patients, the physical field, emotional field, social field and total quality were estimated to be 60·85, 69·34, 68·31 and 130·42, respectively.

Conclusions.  It was found that there was a negatively statistically significant relation between the quality of life and hypertension and early familial Coronary artery disease history and that quality of life declined as the risk factors increased.

Relevance to clinical practice.  Risk‐factor modification and organisation of training programmes with ensured participation of patients and their relatives are of critical importance in improving their quality of life.