bluuebunny/crossref_metadata_2025 huggingface dataset:
Membrane curvature controls dynamin polymerization
Authors: Roux Aurélien , Koster Gerbrand , Lenz Martin , Sorre Benoît , Manneville Jean-Baptiste , Nassoy Pierre , Bassereau Patricia
Published: February 2010

The generation of membrane curvature in intracellular traffic involves many proteins that can curve lipid bilayers. Among these, dynamin-like proteins were shown to deform membranes into tubules, and thus far are the only proteins known to mechanically drive membrane fission. Because dynamin forms a helical coat circling a membrane tubule, its polymerization is thought to be responsible for this membrane deformation. Here we show that the force generated by dynamin polymerization, 18 pN, is sufficient to deform membranes yet can still be counteracted by high membrane tension. Importantly, we observe that at low dynamin concentration, polymer nucleation strongly depends on membrane curvature. This suggests that dynamin may be precisely recruited to membrane buds’ necks because of their high curvature. To understand this curvature dependence, we developed a theory based on the competition between dynamin polymerization and membrane mechanical deformation. This curvature control of dynamin polymerization is predicted for a specific range of concentrations (∼0.1–10 μM), which corresponds to our measurements. More generally, we expect that any protein that binds or self-assembles onto membranes in a curvature-coupled way should behave in a qualitatively similar manner, but with its own specific range of concentration.
ATM signals to TSC2 in the cytoplasm to regulate mTORC1 in response to ROS
Authors: Alexander Angela , Cai Sheng-Li , Kim Jinhee , Nanez Adrian , Sahin Mustafa , MacLean Kirsteen H. , Inoki Ken , Guan Kun-Liang , Shen Jianjun , Person Maria D. , Kusewitt Donna , Mills Gordon B. , Kastan Michael B. , Walker Cheryl Lyn
Published: February 2010

Ataxia-telangiectasia mutated (ATM) is a cellular damage sensor that coordinates the cell cycle with damage-response checkpoints and DNA repair to preserve genomic integrity. However, ATM also has been implicated in metabolic regulation, and ATM deficiency is associated with elevated reactive oxygen species (ROS). ROS has a central role in many physiological and pathophysiological processes including inflammation and chronic diseases such as atherosclerosis and cancer, underscoring the importance of cellular pathways involved in redox homeostasis. We have identified a cytoplasmic function for ATM that participates in the cellular damage response to ROS. We show that in response to elevated ROS, ATM activates the TSC2 tumor suppressor via the LKB1/AMPK metabolic pathway in the cytoplasm to repress mTORC1 and induce autophagy. Importantly, elevated ROS and dysregulation of mTORC1 in ATM-deficient cells is inhibited by rapamycin, which also rescues lymphomagenesis in
Atm
-deficient mice. Our results identify a cytoplasmic pathway for ROS-induced ATM activation of TSC2 to regulate mTORC1 signaling and autophagy, identifying an integration node for the cellular damage response with key pathways involved in metabolism, protein synthesis, and cell survival.
Salt bridge integrates GPCR activation with protein trafficking
Authors: Janovick Jo Ann , Conn P. Michael
Published: February 2010

G protein–coupled receptors (GPCRs) play central roles in almost all physiological functions; mutations in GPCRs are responsible for more than 30 disorders. There is a great deal of information about GPCR structure but little information that directly relates structure to protein trafficking or to activation. The gonadotropin releasing hormone receptor, because of its small size among GPCRs, is amenable to preparation of mutants and was used in this study to establish the relation among a salt bridge, protein trafficking, and receptor activation. This bridge, between residues E
90
[located in transmembrane segment (TM) 2] and K
121
(TM3), is associated with correct trafficking to the plasma membrane. Agonists, but not antagonists, interact with residue K
121
, and destabilize the TM2–TM3 association of the receptor in the plasma membrane. The hGnRHR mutant E
90
K has a broken salt bridge, which also destabilizes the TM2–TM3 association and is typically retained in the endoplasmic reticulum. We show that this mutant, if rescued to the plasma membrane by either of two different means, has constitutive activity and shows modified ligand specificity, revealing a role for the salt bridge in receptor activation, ligand specificity, trafficking, and structure. The data indicate that destabilizing the TM2–TM3 relation for receptor activation, while requiring an intact salt bridge for correct trafficking, provides a mechanism that protects the cell from plasma membrane expression of constitutive activity.
Reactogenicity of live-attenuated
Vibrio cholerae
vaccines is dependent on flagellins
Authors: Rui Haopeng , Ritchie Jennifer M. , Bronson Roderick T. , Mekalanos John J. , Zhang Yuanxing , Waldor Matthew K.
Published: February 2010

Cholera is a severe diarrheal disease caused by the motile Gram-negative rod
Vibrio cholerae
. Live-attenuated
V. cholerae
vaccines harboring deletions of the genes encoding cholera toxin have great promise for reducing the global burden of cholera. However, development of live vaccines has been hampered by the tendency of such strains to induce noncholeric reactogenic diarrhea in human subjects. The molecular bases of reactogenicity are unknown, but it has been speculated that reactogenic diarrhea is a response to
V. cholerae
’s flagellum and/or the motility that it enables. Here, we used an infant rabbit model of reactogenicity to determine what
V
.
cholerae
factors trigger this response. We found that
V. cholerae ctx
mutants that produced flagellins induced diarrhea, regardless of whether the proteins were assembled into a flagellum or whether the flagellum was functional. In contrast, ∼90% of rabbits infected with
V. cholerae
lacking all five flagellin-encoding genes did not develop diarrhea. Thus, flagellin production, independent of flagellum assembly or motility, is sufficient for reactogenicity. The intestinal colonization and intraintestinal localization of the nonreactogenic flagellin-deficient strain were indistinguishable from those of a flagellated motile strain; however, the flagellin-deficient strain stimulated fewer mRNA transcripts coding for proinflammatory cytokines in the intestine. Thus, reactogenic diarrhea may be a consequence of an innate host inflammatory response to
V
.
cholerae
flagellins. Our results suggest a simple genetic blueprint for engineering defined nonreactogenic live-attenuated
V. cholerae
vaccine strains.
Severe oxidative stress induces protein mistranslation through impairment of an aminoacyl-tRNA synthetase editing site
Authors: Ling Jiqiang , Söll Dieter
Published: February 2010

Oxidative stress arises from excessive reactive oxygen species (ROS) and affects organisms of all three domains of life. Here we present a previously unknown pathway through which ROS may impact faithful protein synthesis. Aminoacyl-tRNA synthetases are key enzymes in the translation of the genetic code; they attach the correct amino acid to each tRNA species and hydrolyze an incorrectly attached amino acid in a process called editing. We show both in vitro and in vivo in
Escherichia coli
that ROS reduced the overall translational fidelity by impairing the editing activity of threonyl-tRNA synthetase. Hydrogen peroxide oxidized cysteine182 residue critical for editing, leading to Ser-tRNA
Thr
formation and protein mistranslation that impaired growth of
Escherichia coli
. The presence of major heat shock proteases was required to allow cell growth in medium containing serine and hydrogen peroxide; this suggests that the mistranslated proteins were misfolded.
IL-33 augments substance P–induced VEGF secretion from human mast cells and is increased in psoriatic skin
Authors: Theoharides Theoharis C. , Zhang Bodi , Kempuraj Duraisamy , Tagen Michael , Vasiadi Magdalini , Angelidou Asimenia , Alysandratos Konstantinos-Dionysios , Kalogeromitros Dimitris , Asadi Shahrzad , Stavrianeas Nikolaos , Peterson Erika , Leeman Susan , Conti Pio
Published: February 2010

The peptide substance P (SP) has been implicated in inflammatory conditions, such as psoriasis, where mast cells and VEGF are increased. A relationship between SP and VEGF has not been well studied, nor has any interaction with the proinflammatory cytokines, especially IL-33. Here we report that SP (0.1–10 μM) induces gene expression and secretion of VEGF from human LAD2 mast cells and human umbilical core blood-derived cultured mast cells (hCBMCs). This effect is significantly increased by coadministration of IL-33 (5–100 ng/mL) in both cell types. The effect of SP on VEGF release is inhibited by treatment with the NK-1 receptor antagonist 733,060. SP rapidly increases cytosolic calcium, and so does IL-33 to a smaller extent; the addition of IL-33 augments the calcium increase. SP-induced VEGF production involves calcium-dependent PKC isoforms, as well as the ERK and JNK MAPKs. Gene expression of IL-33 and histidine decarboxylase (HDC), an indicator of mast cell presence/activation, is significantly increased in affected and unaffected (at least 15 cm away from the lesion) psoriatic skin, as compared with normal control skin. Immunohistochemistry indicates that IL-33 is associated with endothelial cells in both the unaffected and affected sites, but is stronger and also associated with immune cells in the affected site. These results imply that functional interactions among SP, IL-33, and mast cells leading to VEGF release contribute to inflammatory conditions, such as the psoriasis, a nonallergic hyperproliferative skin inflammatory disorder with a neurogenic component.
Standard virtual biological parts: a repository of modular modeling components for synthetic biology
Authors: Cooling M. T. , Rouilly V. , Misirli G. , Lawson J. , Yu T. , Hallinan J. , Wipat A.
Published: February 2010

Motivation: Fabrication of synthetic biological systems is greatly enhanced by incorporating engineering design principles and techniques such as computer-aided design. To this end, the ongoing standardization of biological parts presents an opportunity to develop libraries of standard virtual parts in the form of mathematical models that can be combined to inform system design.

Results: We present an online Repository, populated with a collection of standardized models that can readily be recombined to model different biological systems using the inherent modularity support of the CellML 1.1 model exchange format. The applicability of this approach is demonstrated by modeling gold-medal winning iGEM machines.

Availability and Implementation: The Repository is available online as part of http://models.cellml.org. We hope to stimulate the worldwide community to reuse and extend the models therein, and contribute to the Repository of Standard Virtual Parts thus founded. Systems Model architecture information for the Systems Model described here, along with an additional example and a tutorial, is also available as Supplementary information. The example Systems Model from this manuscript can be found at http://models.cellml.org/workspace/bugbuster. The Template models used in the example can be found at http://models.cellml.org/workspace/SVP_Templates200906.

Contact:  m.cooling@auckland.ac.nz

Supplementary information:  Supplementary data are available at Bioinformatics online.
BIS-Vista™ Occipital Montage in Patients Undergoing Neurosurgical Procedures during Propofol–Remifentanil Anesthesia
Authors: Dahaba Ashraf A. , Xue Ji Xiu , Zhao Guo Guang , Liu Qing Hai , Xu Guo Xun , Bornemann Helmar , Rehak Peter H. , Metzler Helfried
Published: February 2010

Background

Neurosurgical procedures that require a frontal approach could be an impediment for a successful Bispectral Index (BIS) frontal sensor placement. The aim of this study was to explore the utility of using the new BIS-Vista monitor (Aspect Medical Systems, Newton, MA) for occipital sensor placement in the patients undergoing brain neurosurgical procedures during propofol-remifentanil anesthesia.

Methods

Two BIS Quatro sensors (Aspect Medical Systems, Newton, MA) mounted on the occipital and frontal regions were connected to two BIS-Vista monitors at three anesthesia states: before induction, during anesthesia maintenance, and recovery.

Results

There were significant differences before induction (P = 0.0002) and at anesthesia maintenance (P = 0.0014) between mean +/- SD occipital (83.4 +/- 4.8, 66.7 +/- 7.2) and frontal (93.1 +/- 3.4, 56.9 +/- 9.1) BIS-Vista values. During anesthesia recovery, there was no difference (P = 0.7421) between occipital (54.6 +/- 9.3) and frontal (53.1 +/- 7.3) BIS-Vista values. Bland and Altman analysis revealed a BIS-Vista negative-bias (limits of agreement) of -9.7 (+1.1, -20.5) before anesthesia induction, +9.8 positive-bias (+22.8, -1.7) during anesthesia maintenance, and -0.9 bias (+10.9, -12.8) during anesthesia recovery.

Conclusion

We demonstrated that not only the regional limits of agreement are too wide to allow data of the two montages to be used interchangeably but also the variation is a function of anesthetic depth. However, keeping in mind a relatively consistent BIS-Vista -10 bias before induction and +10 bias during anesthesia maintenance with limits of agreement of approximately +/-11 BIS units, approximately double the clinically acceptable less than 10 BIS units level of agreement, BIS-Vista off-label occipital montage might be helpful in following a trend of propofol-remifentanil anesthesia in individual cases where frontal access is particularly difficult.
Analytical methods for quantifying environmental connectivity for the control and surveillance of infectious disease spread
Authors: Remais Justin , Akullian Adam , Ding Lu , Seto Edmund
Published: February 2010

The sustained transmission and spread of environmentally mediated infectious diseases is governed in part by the dispersal of parasites, disease vectors and intermediate hosts between sites of transmission. Functional geospatial models can be used to quantify and predict the degree to which environmental features facilitate or limit connectivity between target populations, yet typical models are limited in their geographical and analytical approach, providing simplistic, global measures of connectivity and lacking methods to assess the epidemiological implications of fine-scale heterogeneous landscapes. Here, functional spatial models are applied to problems of surveillance and control of the parasitic blood flukeSchistosoma japonicumand its intermediate snail hostOncomelania haupensisin western China. We advance functional connectivity methods by providing an analytical framework to (i) identify nodes of transmission where the degree of connectedness to other villages, and thus the potential for disease spread, is higher than is estimated using Euclidean distance alone and (ii) (re)organize transmission sites into disease surveillance units based on second-order relationships among nodes using non-Euclidean distance measures, termed effective geographical distance (EGD). Functional environmental models are parametrized using ecological information on the target organisms, and pair-wise distributions of inter-node EGD are estimated. A Monte Carlo rank product analysis is presented to identify nearby nodes under alternative distance models. Nodes are then iteratively embedded into EGD space and clustered using ak-means algorithm to group villages into ecologically meaningful surveillance groups. A consensus clustering approach is taken to derive the most stable cluster structure. The results indicate that novel relationships between nodes are revealed when non-Euclidean, ecologically determined distance measures are used to quantify connectivity in heterogeneous landscapes. These connections are not evident when analysing nodes in Euclidean space, and thus surveillance and control activities planned using Euclidean distance measures may be suboptimal. The methods developed here provide a quantitative framework for assessing the effectiveness of ecologically grounded surveillance systems and of control and prevention strategies for environmentally mediated diseases.
Structural dynamics of photoinduced molecular switching in the solid state
Authors: Cailleau Hervé , Lorenc Maciej , Guérin Laurent , Servol Marina , Collet Eric , Buron-Le Cointe Marylise
Published: February 2010

Fast and ultra-fast time-resolved diffraction is a fantastic tool for directly observing the structural dynamics of a material rearrangement during the transformation induced by an ultra-short laser pulse. The paper illustrates this ability using the dynamics of photoinduced molecular switching in the solid state probed by 100 ps X-ray diffraction. This structural information is crucial for establishing the physical foundations of how to direct macroscopic photoswitching in materials. A key feature is that dynamics follow a complex pathway from molecular to material scales through a sequence of processes. Not only is the pathway indirect, the nature of the dynamical processes along the pathway depends on the timescale. This dictates which types of degrees of freedom are involved in the subsequent dynamics or kinetics and which are frozen or statistically averaged. We present a recent investigation of the structural dynamics in multifunctional spin-crossover materials, which are prototypes of molecular bistability in the solid state. The time-resolved X-ray diffraction results show that the dynamics span from subpicosecond molecular photoswitching followed by volume expansion (on a nanosecond timescale) and additional thermoswitching (on a microsecond timescale).
Planning for the persistence of river biodiversity: exploring alternative futures using process‐based models
Authors: TURAK EREN , FERRIER SIMON , BARRETT TOM , MESLEY EDWINA , DRIELSMA MICHAEL , MANION GLENN , DOYLE GAVIN , STEIN JANET , GORDON GEOFF
Published: February 2010

1. Planning for the conservation of river biodiversity must involve a wide range of management options and account for the complication that the effects of many actions are spatially removed from these actions. Reserve design algorithms widely used in conservation planning today are not well equipped to address such complexities.

2. We used process‐based models to estimate the expected persistence of river biodiversity under alternative catchment‐wide management scenarios and applied it in the Hunter Region (37 000 km²) in southeastern Australia.

3. The biological condition of 12 197 subcatchments was estimated using a multiple linear regression model that related assessments of the integrity of macroinvertebrate assemblages to human‐induced disturbances at river sites. The best‐fit model (R2 = 0.76) used measures of both local and catchment‐wide disturbances as well as elevation and distance from source as predictor variables. Based on the outputs of this model, we estimated that substantial loss of river biodiversity had occurred in some parts of the coastal fringes and the lower parts of the larger river systems. The most affected river type was small, low‐gradient streams.

4. The predicted biodiversity condition together with river types based on macroinvertebrate assemblages and abiotic attributes was used to estimate a biodiversity persistence index (BDI).

5. A priority value for each subcatchment was calculated for different actions by changing the disturbance values for that subcatchment and calculating the resulting marginal change in regional BDI. Maps were thereby created for three different types of priority: catchment protection priority, catchment restoration priority and river section conservation priority.

6. The subcatchments of high catchment protection priority for river biodiversity were mostly in the uplands and within protected areas. The river sections of high conservation priority included many coastal lowland rivers in and around protected areas as well as many upland headwater streams. Subcatchments of high priority for catchment restoration were mostly in coastal areas or lowland floodplains.

7. This approach may be particularly well suited to guide the integrated implementation of three place‐based protection strategies proposed for freshwaters: focal areas, critical management zones and catchment management zones.
Peer learning partnerships: exploring the experience of pre‐registration nursing students
Authors: Christiansen Angela , Bell Amelia
Published: February 2010

Aims and objectives.  This paper explores the impact of a peer learning initiative developed to facilitate, purposefully, mutually supportive learning relationships between student nurses in the practice setting.

Background.  Finding effective strategies to support learning in the practice setting has been the focus of professional concern for a considerable time. In the UK clinical mentorship is seen as pivotal to ensuring fitness to practice; however, recent debate on the nature of learning has revealed the clinical workplace as a rich learning environment where learning occurs not only through hierarchical relationships, but also from a network of peer relationships. Formalising peer relationships through peer assisted learning is increasingly suggested as a strategy to support workplace learning and support novice students’ transition to the clinical setting. Despite the developing literature in this field there is limited understanding about how students experience facilitated peer relationships.

Design.  An interpretive qualitative design.

Methods.  Focus group interviews were used to collect interactive and situated discourse from nursing students who had recently participated in peer learning partnerships (n = 54). Narrative data were analysed thematically.

Results.  Findings suggest that active support from a fellow student reduced the feelings of social isolation experienced by novice students in initial clinical placements, helping them to deal more effectively with the challenges faced and reducing the factors that have an impact on attrition. In addition, the reciprocity of the peer learning partnerships facilitated understanding of mentorship and created a heightened sense of readiness for registration and professional practice.

Conclusions.  Peer learning partnerships facilitated by mentors in clinical practice can support the transition to nursing for first year students and can help more experienced students gain a confidence and a heightened readiness for mentorship and registered practice.

Relevance to practice.  Facilitated peer learning partnerships can enhance the student experience in the practice setting and can help maximise opportunities for learning and support. This suggests that peer assisted learning is a legitimate area for innovation and further research.
The effectiveness of brief interventions in the clinical setting in reducing alcohol misuse and binge drinking in adolescents: a critical review of the literature
Authors: Wachtel Tracey , Staniford Mabel
Published: February 2010

Aims and objectives.  To investigate the effectiveness of brief interventions for adolescent alcohol misuse and to determine if these interventions are useful in reducing alcohol consumption. To determine if brief interventions could be used successfully by nurses in the clinical setting.

Background.  Australian adolescents are consuming risky levels of alcohol in ever increasing numbers. The fiscal, health‐related and social costs of this alcohol misuse are rising at an alarming rate and must be addressed as a matter of priority. Brief interventions have been used with some success for adult problem drinkers in the clinical setting. Brief interventions delivered in the clinical setting by nurses who are ‘on the scene’ are therefore a potential strategy to redress the epidemic of adolescent alcohol misuse.

Design.  Literature review.

Methods.  Multiple databases were searched to locate randomised controlled trials published within the past 10 years, with participants aged 12–25 years. Included studies used brief intervention strategies specific to alcohol reduction. Fourteen studies met these criteria and were reviewed.

Results.  A range of different interventions, settings, participant age‐ranges and outcome measures were used, limiting generalisability to the studied populations. No trials were carried out by nurses and only one took place in Australia. Motivational interviewing (one form of brief intervention) was partially successful, with the most encouraging results relating to harm minimisation. Long‐term follow‐up trials using motivational interviewing reported significant reductions in alcohol intake and harmful effects, but this may be partially attributed to a normal maturation trend to a steady reduction in alcohol consumption.

Conclusions.  No single intervention could be confidently recommended due to confounding evidence. However, successful elements of past studies warrant further investigation. These include face‐to‐face, one‐session, motivational interviewing‐style brief interventions, focusing on harm minimisation and all with long‐term follow‐up.

Relevance to clinical practice.  The introduction of brief interventions in the hospital setting has the potential to address the epidemic of adolescent alcohol misuse. Nurses are well placed to deliver these interventions, but a standardised approach is required to ensure consistency. Further research is urgently needed to ensure clinical practice is based on the best available evidence and to ensure findings are more relevant to Australian adolescents and to nurses in a clinical setting.
The relationship between social support and loneliness in Turkish patients with cancer
Authors: Yildirim Yasemin , Kocabiyik Seher
Published: February 2010

Aims and objectives.  The aim of this study was to examine the relationship between family social support and loneliness in Turkish patients with cancer.

Background.  Loneliness is a major problem affecting about 50% of adult cancer patients. Adequate social support may cause a reduced cancer‐related mortality in patients with cancer.

Design.  A cross‐sectional, descriptive and correlational design was used.

Method.  Cancer patients undergoing treatment in the outpatient chemotherapy unit at a university hospital between January–April 2007 were enrolled. After inclusion and exclusion processes, a total of 144 patients with solid cancer comprised the final sample of the study. The Perceived Social Support from Family Scale, the Revised University of California, Los Angeles‐Loneliness Scale and a demographic data form were used. Data were analysed by using descriptive statistics, student t‐test, one‐way variance analysis and Pearson’s correlation test.

Results.  The mean age was 51·76 (SD 12·14). Ninety‐two patients (63·9%) were female and most were married. The mean social support score and the mean loneliness score were 15·92 (SD 3·22) and 33·09 (SD 0·17), respectively. There were significant differences between the mean scores for the marital status (p < 0·01) and living style (p < 0·001) characteristics. There was a moderately significant negative correlation between the mean social support scores and the loneliness scores (r = −0·492, p < 0·001). The loneliness level of the patients was reduced by increasing social support.

Conclusions.  The results suggest that the Turkish cancer patients have experienced a relatively low level of loneliness and there is a significant negative correlation between their loneliness scores and their social support scores. Loneliness can be reduced by increasing social support from family members.

Relevance to clinical practice.  In planning patients’ care, nurses should evaluate physiological, psychological and socio‐demographic statuses of patients to increase the patients’ social support and to decrease their loneliness. Determining and improving family social support of cancer patients should be an essential part of nursing practice. To prevent cancer patients’ social isolation, nurses may also encourage family members to enlarge their social support networks.
Where is nursing in academic nursing? disciplinary discourses, identities and clinical practice: a critical perspective from Ireland
Authors: McNamara Martin S
Published: February 2010

Aim.  To elicit the languages of legitimation of senior nursing academics and national leaders and to investigate the extent to which distinctive disciplinary identities and discourses are embedded in them.

Background.  Over six years after Irish nursing education became established in the higher education sector, an investigation into the disciplinary maturity of the field is overdue.

Design.  A constructivist–structuralist research design was used; data were elicited by means of naturalistic professional conversations and subjected to critical discourse analytic methods to interrogate their structuring and structured character. The focus here is on the latter.

Methods.  The languages of legitimation of Irish nursing’s key disciplinary custodians were elicited and subjected to a critical discourse analysis informed by a theoretical framework that helps to explicate the bases of claims to academic legitimacy embedded in these languages.

Results.  Clinical practice figures as a problematic component of Irish nursing’s academic identity and disciplinary discourse. Yet a focus on clinical practice is seen as central to the autonomy, integrity and distinctiveness of nursing as an academic discipline as well as to the legitimacy and credibility of those who claim to profess it. The overall consensus on the state of academic nursing in Ireland is that of a field characterised by low autonomy, high density, weak specialisation and disciplinary immaturity.

Conclusions.  The analysis highlights the need for academic nursing to reconfigure its relationships with clinical nursing, increase its intellectual autonomy, enhance its internal coherence, strengthen the epistemic power of its knowledge base and critically evaluate the ways the past should inform current and future practices and identities.

Relevance to clinical practice.  The production and dissemination of knowledge for nursing policy and practice provides the foundation for nursing education. If clinical practice is not central to the educational and research activities of nurse academics, the relevance of academic nursing to its professional base and its status and future trajectory as a distinct presence in academia, will continue to be questioned.
Investigating the health profile of patients with end‐stage renal failure receiving peritoneal dialysis: a cluster analysis
Authors: Chan MF , Wong Frances KY , Chow Susan KY
Published: February 2010

Aim.  To determine whether the patients with end stage renal failure can be differentiated into several subtypes based on five main variables.

Background.  There is a lack of interventional research linking to clinical outcomes among the patients with end stage renal failure in Hong Kong and with no clear evidence of differences in terms of their clinical/health outcomes and characteristics.

Design.  A cross‐sectional survey.

Method.  Data were collected using a structured questionnaire. One hundred and fifty‐three patients with end stage renal failure were recruited during 2007 at three renal centres in Hong Kong. Five main variables were employed: predisposing characteristic, enabling resources, quality of life, symptom control and self‐care adherence.

Results.  A cluster analysis yielded two clusters. Each cluster represented a different profile of patients with end stage renal failure. Cluster A consisted of 49·7% (n = 76) and Cluster B consisted of 50·3% (n = 77) of the patients. Cluster A patients, more of whom were women, were older, less educated, had higher quality of life scores, a better adherence rate and more had received nursing care supports than patients in Cluster B.

Conclusions.  We have identified two groupings of patients with end stage renal failure who were experiencing unique health profile. Nursing support services may have an effect on patient health outcomes but only on a group of patients whose profile is similar to the patients in Cluster A and not for patients in Cluster B. A clear profile may help health care professional make appropriate strategies to target a specific group of patients to improve patient outcomes.

Relevance to clinical practice.  The identification of risk for future health‐care use could enable better targeting of interventional strategies in these groups. The results of this study might provide health care professionals with a model to design specified interventions to improve life quality for each profile group.
Recovering from an acute cardiac event – the relationship between depression and life satisfaction
Authors: Page Karen N , Davidson Patricia , Edward Karen‐leigh , Allen Josh , Cummins Robert A , Thompson David R , Worrall‐Carter Linda
Published: February 2010

Aims.  This study sought to measure the rates and trajectory of depression over six months following admission for an acute cardiac event and describe the relationship between depression and life satisfaction.

Background.  Co‐morbid depression has an impact on cardiac mortality and is associated with the significant impairment of quality of life and well‐being, impairments in psychosocial function, decreased medication adherence and increased morbidity.

Design.  This was a descriptive, correlational study.

Method.  The study was undertaken at a large public hospital in Melbourne. Participants were asked to complete a survey containing the cardiac depression scale (CDS) and the Personal Well‐being Index.

Results.  This study mapped the course of depression over six months of a cohort of patients admitted for an acute cardiac event. Significant levels of depressive symptoms were found, at a level consistent with the literature. A significant correlation between depressive symptoms as measured by the CDS and the Personal Well‐being Index was found.

Conclusions.  Depression remains a significant problem following admission for an acute coronary event. The Personal Well‐being Index may be a simple, effective and non‐confrontational initial screening tool for those at risk of depressive symptoms in this population.

Relevance to clinical practice.  Despite the known impact of depression on coronary heart disease (CHD), there is limited research describing its trajectory. This study makes a compelling case for the systematic screening for depression in patients with CHD and the importance of the nursing role in identifying at risk individuals.
Nurses’ perspectives on feeding decisions for nursing home residents with advanced dementia
Authors: Lopez Ruth Palan , Amella Elaine J , Mitchell Susan L , Strumpf Neville E
Published: February 2010

Aim.  To develop a broad understanding of nursing beliefs, knowledge and roles in feeding decisions for nursing home residents with advanced dementia.

Background.  Concern is growing about the common use of feeding tubes in nursing home residents with advanced dementia. Nurses can play an important role in providing information and guiding family members through difficult feeding decisions. Little is known about nurses’ perspectives on feeding decisions.

Design.  Qualitative descriptive.

Methods.  In‐depth semi‐structured interviews of 11 licensed nurses who were experienced in caring for nursing home residents with dementia.

Results.  Analysis of the interview transcripts revealed three themes: insufficient empirical information, ambiguous role in feeding decisions and uncertainty about moral agency in decisions about the placement of feeding tubes.

Conclusions.  Despite views that family members would benefit from guidance in decisions regarding the placement of feeding tubes, nurses were, nevertheless, reluctant to become involved in these difficult decisions.

Relevance to clinical practice.  If nurses are to guide family members in decisions about the use of feeding tubes, they need more education about evidence‐based practice as well as support in exercising their nursing responsibilities.
A controlled, randomised trial comparing single to multiple application lidocaine analgesia in paediatric patients undergoing urethral catheterisation procedures
Authors: Boots Brenda K , Edmundson Elizabeth E
Published: February 2010

Aims and objectives.  The aim of this study was to evaluate if discomfort levels are statistically significant when two different topical and intraurethral precatheterisation analgesia strategies are used. The primary objective of this research project was to examine methods to decrease pain experienced by paediatric cystogram patients.

Background.  Paediatric patients undergoing urinary catheterisations frequently report discomfort. To alleviate catheterisation discomfort in children, some institutions have either used sedation techniques or topical analgesia strategies. Standardisation of topical anaesthetic application prior to paediatric urinary catheterisation has not been demonstrated in the research literature.

Design.  A prospective, single‐blind, randomised, controlled trial.

Methods.  The trial was performed with infants and children aged two months–eight years. The first group received one application of lidocaine five minutes prior to catheterisation. The control group received two applications, spaced five minutes apart prior to catheterisation. The FLACC pain score, as the primary outcome variable, was assessed at the time of the catheterisation. Secondary outcome variables including pre‐ and postcatheterisation heart rate and parental perception were also measured.

Conclusions.  Two hundred children between two months–eight years of age were randomly assigned for study inclusion with 91 patients enrolled into the two application groups and 109 patients into the single application group. No statistically significant differences (p = 0·779) in the mean FLACC pain score at the time of the catheterisation between the intervention (single application) group (mean = 3·30) and the control (two application) group (mean = 3·39), heart rate or parental perceptions were observed.

Relevance to clinical practice.  Topical and intraurethral lidocaine analgesia strategies prior to urinary catheterisation provide an important tool in reducing discomfort for paediatric patients undergoing urinary catheterisation procedures. This study confirms that multiple applications of intraurethral lidocaine gel add little additional benefits in reducing discomfort over single intraurethral application techniques.
Measuring mealtime difficulties: eating, feeding and meal behaviours in older adults with dementia
Authors: Aselage Melissa B
Published: February 2010

Aims and objectives.  The purpose of this integrative review is to examine the instruments currently available for clinical use specifically to assess mealtime difficulties, a concept subsuming the domains of eating, feeding and meal behaviours in older adults with dementia; and to determine the quality and practicality of those instruments for use in clinical practice.

Background.  Dementia is a leading cause of death globally and the 5th leading cause of death in the USA for adults over 65. Nutritional status is vital to well‐being, therefore, instruments to measure eating, feeding and meal behaviours are important. Instruments measuring these behaviours can be used to plan effective interventions to alleviate the behaviours and improve oral intake.

Design.  Integrative review.

Method.  Database searches of EBSCOHost, PubMed, CINAHL, ScienceDirect, AgeLine and HaPI using various keyword combinations related to meal, eating and feeding behaviours in dementia as well as keywords related to instruments, scales or measurement. Abstracts and articles were analysed to identify instruments used in research and clinically to measure eating, feeding and meal behaviours in dementia.

Results.  Twelve observational instruments were identified and organised into categories of eating, feeding and meal behaviours for older adults with dementia. Instruments were described by concepts measured.

Conclusions.  The majority of instruments identified do not report adequate psychometric testing in the literature. One instrument is identified reporting extensive testing for reliability and validity and has been recommended for clinical practice – The Edinburgh Feeding Evaluation in Dementia (EdFED) scale.

Relevance to clinical practice.  The EdFED has been identified as a valid and reliable instrument for measuring feeding difficulties and is available for use in clinical practice. In using the EdFED, interventions can be planned to monitor feeding difficulties and promote nutritional status of older adults with dementia.
Paediatric nurses' understanding of the process and procedure of double‐checking medications
Authors: Dickinson Annette , McCall Elaine , Twomey Bernadette , James Natalie
Published: February 2010

Aims and objectives.  To understand paediatric nurses’ understanding and practice regarding double‐checking medication and identify facilitators and barriers to the process of independent double‐checking (IDC).

Background.  A system of double‐checking medications has been proposed as a way of minimising medication error particularly in situations involving high‐risk medications, complex processes such as calculating doses, or high‐risk patient populations such as infants and children. While recommendations have been made in support of IDC in paediatric settings little is known about nursing practice and the facilitators and barriers to this process.

Design.  A descriptive qualitative design was used.

Methods.  Data were collected via three focus group interviews. Six to seven paediatric nurses participated in homogenous groups based on level of practice. Data were analysed using thematic analysis.

Conclusions.  This study demonstrates that, while IDC is accepted and promoted as best practice in a paediatric setting, there is a lack of clarity as to what this means. This study supports other studies in relation to the influence of workload, distraction and environmental factors on the administration process but highlights the need for more research in relation to the impact of the power dynamic between junior and senior nurses. The issue of automaticity has been unexplored in relation to nursing practice but this study indicates that this may have an important influence on how care is delivered to patients.

Relevance to clinical practice.  While the focus of this study was in the paediatric setting, the findings have relevance to other settings and population groups. The adoption of IDC in health care settings must have in place: policy and guidelines that clearly define the process of checking, educational support, an environment that supports peer critique and review, well‐designed medication areas and accessible resources to support drug administration.
Malnutrition in hospitalised neurological patients approximately doubles in 10 days of hospitalisation
Authors: Hafsteinsdóttir Thóra B , Mosselman Machteld , Schoneveld Coby , Riedstra Yvette D , Kruitwagen Cas LJJ
Published: February 2010

Aims and objectives.  To measure the nutritional status of neurological patients during admission and after 10 days, with a special focus on those with malnutrition and those at risk of malnutrition, and to measure the association of clinical variables and nutritional status, which may be important for the early detection of patients at risk of malnutrition.

Background.  Studies have shown high prevalence of malnutrition in hospitalised patients and recommend structured screening and nutritional intervention for these patients. There is a lack of information concerning the nutritional status of neurological patients.

Design.  A prospective descriptive study.

Method.  Neurological patients (n = 196) were included from departments of neurology and neurosurgery in Dutch university hospital. Nutritional status was measured with the Mini Nutritional Assessment and functional status with the Barthel Index and the Rankin Scale at admission to the hospital and after 10 days.

Result.  Of the patients, 34% were at risk of malnutrition, 7% were malnourished, whereas 59% of the patients were well nourished according to the MNA. After 10 days, 57% were at risk of malnutrition, 22% were malnourished and 21% were well nourished. The total group of patients malnourished and at risk of malnutrition was 41% at admission, which had grown to 79% in 10 days. Significant association was found between various clinical variables and nutritional status.

Conclusions.  A large group of neurological patients is malnourished and at risk of malnutrition during hospital admission, and the nutritional status of most patients worsens in 10 days. Various clinical variables may be of importance in detecting malnourished patients.

Relevance to clinical practice.  Nurses need to observe the symptoms of malnutrition and provide evidence‐based nutritional interventions to these patients. Improved education of nurses and good collaboration between the professionals and the facilitation of hospital management is essential to improve nutritional care of neurological patients.
Social capital, empowerment and educational change: a scenario of permeation of one‐to‐one technology in school
Authors: Li S.C.
Published: February 2010

The standard model of technology diffusion argues that changing teachers' perceptions and epistemological beliefs about the value of an innovation is conducive to successful implementation. It is believed that teachers' receptiveness to technology and a re‐conceptualization of its role in teaching and learning can drive the development of new pedagogies and curricula and eventually, bring about a new learning experience. In this paper, we argued that changing teachers' conceptions does not necessarily effect change in their practices and student learning. The results of our case study indicated that the impetus for change comes from the social capital and informal social forces in the school, and that parental support, permeation of technology in student learning and teacher empowerment are pivotal to the success of the implementation.
Global eradication of poliomyelitis: Is the end of the campaign in sight?
Authors: Adams Tony
Published: February 2010

“The world may be on the brink of achieving a great public health victory. Progress towards eradication of poliomyelitis is outlined highlighting remaining problems.”
Maternal HIV seroconversion at delivery without transmission
Authors: Goldwater Paul N , Bhatia Vineesh , Cooper Celia
Published: February 2010

A case of HIV seroconversion associated with high viral load occurring at or near delivery is described. The management of the case in terms of prevention of mother‐to‐child‐transmission is described and discussed in terms of the published literature and guidelines. From this instructive case a constructive strategy for delivery and immediate post‐natal care is derived.
A STOCHASTIC ORDERING FOR RANDOM VARIABLES WITH APPLICATIONS
Authors: López‐Díaz Miguel
Published: February 2010

A new univariate stochastic ordering is introduced. Some characterization results for such an ordering are stated. It is proved that the ordering is an integral stochastic ordering, obtaining a maximal generator. By means of this generator, the main properties of the ordering are deduced. A method for introducing univariate stochastic orderings, suggested by the new ordering, is analysed. Relationships with other stochastic orderings are also developed. To conclude, an example of an application of the new ordering to the field of medicine is proposed.
ESTIMATION OF THE NUMBER OF PEOPLE IN A DEMONSTRATION
Authors: Yip Paul S. F. , Watson Ray , Chan K. S. , Lau Eric H. Y. , Chen Feng , Xu Ying , Xi Liqun , Cheung Derek Y. T. , Ip Brian Y. T. , Liu Danping
Published: February 2010

It is of interest to estimate the size of a crowd in a demonstration. We propose a practical method to obtain an estimate of the size of the crowd and its standard error. This method has been implemented in practice and, compared with other counting methods, is found to be more efficient, more timely and have less scope for bias. The method described in this paper was motivated by the annual 1 July demonstrations in Hong Kong, and data from the 2006 demonstration are used as an example of the proposed method.