bluuebunny/crossref_metadata_2025 huggingface dataset:
Milrinone and levosimendan during porcine myocardial ischemia – no effects on calcium overload and metabolism
Authors: AXELSSON B. , JOHANSSON G. , ABRAHAMSSON P. , GUPTA A. , TYDÉN H. , WOUTERS P. , HANEY M.
Published: March 2013

Background

Although inotropic stimulation is considered harmful in the presence of myocardial ischaemia, both calcium sensitisers and phosphodiesterase inhibitors may offer cardioprotection. We hypothesise that these cardioprotective effects are related to an acute alteration of myocardial metabolism. We studied in vivo effects of milrinone and levosimendan on calcium overload and ischaemic markers using left ventricular microdialysis in pigs with acute myocardial ischaemia.

Methods

Anaesthetised juvenile pigs, average weight 36 kg, were randomised to one of three intravenous treatment groups: milrinone 50 μg/kg bolus plus infusion 0.5 μg/kg/min (n = 7), levosimendan 24 μg/kg plus infusion 0.2 μg/kg/min (n = 7), or placebo (n = 6) for 60 min prior to and during a 45 min acute regional coronary occlusion. Systemic and myocardial haemodynamics were assessed, and microdialysis was performed with catheters positioned in the left ventricular wall. 45Ca2+ was included in the microperfusate in order to assess local calcium uptake into myocardial cells. The microdialysate was analysed for glucose, lactate, pyruvate, glycerol, and for 45Ca2+ recovery.

Results

During ischaemia, there were no differences in microdialysate‐measured parameters between control animals and milrinone‐ or levosimendan‐treated groups.

In the pre‐ischaemic period, arterial blood pressure decreased in all groups while myocardial oxygen consumption remained stable.

Conclusions

These findings reject the hypothesis of an immediate energy‐conserving effect of milrinone and levosimendan during acute myocardial ischaemia. On the other hand, the data show that inotropic support with milrinone and levosimendan does not worsen the metabolic parameters that were measured in the ischaemic myocardium.
Safety and Efficiency of Calcium Channel Blockers Versus Beta‐blockers for Rate Control in Patients With Atrial Fibrillation and No Acute Underlying Medical Illness
Authors: Scheuermeyer Frank Xavier , Grafstein Eric , Stenstrom Rob , Christenson Jim , Heslop Claire , Heilbron Brett , McGrath Lorraine , Innes Grant
Published: March 2013

Objectives

Many patients with atrial fibrillation (AF) are not candidates for rhythm control and may require rate control, typically with beta‐blocking (BB) or calcium channel blocking (CCB) agents. Although these patients appear to have a low 30‐day rate of stroke or death, it is unclear if one class of agent is safer or more effective. The objective was to determine whether BBs or CCBs would have a lower hospital admission rate and to measure 30‐day safety outcomes including stroke, death, and emergency department (ED) revisits.

Methods

This retrospective cohort study used a database from two urban EDs to identify consecutive patients with ED discharge diagnoses of AF from April 1, 2006, to March 31, 2010. Comorbidities, rhythms, management, and immediate outcomes were obtained by manual chart review, and patients with acute underlying medical conditions were excluded by predefined criteria. Patients managed only with rate control agents were eligible for review, and patients receiving BB agents were compared to those receiving CCB agents. The primary outcome was the proportion of patients requiring hospital admission; secondary outcomes included the ED length of stay (LOS), the proportion of patients having adverse events, the proportion of patients returning within 7 or 30 days, and the number of patients having a stroke or dying within 30 days.

Results

A total of 259 consecutive patients were enrolled, with 100 receiving CCBs and 159 receiving BBs. Baseline demographics and comorbidities were similar. Twenty‐seven percent of BB patients were admitted, and 31.0% of CCB patients were admitted (difference = 4.0%, 95% confidence interval [CI] = −7.7% to 16.1%), and there were no significant differences in ED LOS, adverse events, or 7‐ or 30‐day ED revisits. One patient who received metoprolol had a stroke, and one patient who received diltiazem died within 30 days.

Conclusions

In this cohort of ED patients with AF and no acute underlying medical illness who underwent rate control only, patients receiving CCBs had similar hospital admission rates to those receiving BBs, while both classes of medications appeared equally safe at 30 days. Both CCBs and BBs are acceptable options for rate control.
Incremental Value of Objective Cardiac Testing in Addition to Physician Impression and Serial Contemporary Troponin Measurements in Women
Authors: Diercks Deborah B. , Mumma Bryn E. , Frank Peacock W. , Hollander Judd E. , Safdar Basmah , Mahler Simon A. , Miller Chadwick D. , Counselman Francis L. , Birkhahn Robert , Schrock Jon , Singer Adam J. , Nagurney John T.
Published: March 2013

Objectives

Guidelines recommend that patients presenting to the emergency department (ED) with chest pain who are at low risk for acute coronary syndrome (ACS) receive an objective cardiac evaluation with a stress test or coronary imaging. It is uncertain whether all women derive benefit from this process. The study aim was to determine the incremental value of objective cardiac testing after serial cardiac markers and physician risk assessment.

Methods

Women enrolled in the 18‐site Myeloperoxidase in the Diagnosis of Acute Coronary Syndrome (MIDAS) study had serial troponin I measured at time 0 and 90 minutes and physician risk assessment for the presence of ACS. Risk estimates obtained at the time of ED evaluation were dichotomized as high or non–high risk. The primary outcome was the composite of acute myocardial infarction (AMI) or revascularization at 30 days. Logistic regression with receiver operator characteristic (ROC) curves and net reclassification index were used to determine the diagnostic accuracy for the composite outcome of 30‐day MI or revascularization for two models: 1) troponin I results and physician risk assessment alone and 2) troponin I results, physician risk assessment, and objective cardiac testing.

Results

A total of 460 women with a median age 58 years (interquartile range [IQR] = 48.5 to 68 years) were included, and 32 (6.9%) experienced AMI or revascularization by 30 days. Comparison of the area under the ROC curves (AUC) showed that the addition of objective cardiac testing to the combination of troponin I results and physician risk assessment did not significantly improve prediction of 30‐day AMI or revascularization (AUC = 0.85 vs. 0.89; p = 0.053). Using a threshold of 1%, net reclassification index showed that the addition of objective cardiac testing to troponin I results and physician risk assessment worsened the prediction for 30‐day AMI and revascularization. All of the reclassified patients were false positives, with nine (2.1%) patients incorrectly reclassified from <1% risk to ≥1% risk of 30‐day AMI or revascularization.

Conclusions

In the era of contemporary troponin assays, objective cardiac testing after an ED clinician risk assessment of non–high risk and negative troponin I results at 0 and 90 minutes does not improve the prediction of 30‐day AMI or revascularization in women presenting with chest pain or other symptoms of cardiac ischemia.
Imaging cytometry for counting circulating tumor cells: comparative analysis of the CellSearch vs ImageStream systems
Authors: López‐Riquelme Natividad , Minguela Alfredo , Villar‐Permuy Flori , Ciprian Daniel , Castillejo Adela , Álvarez‐López María‐Rocio , Soto José‐Luis
Published: March 2013

Circulating tumor cell (CTC) enumeration is important clinically for identifying prognostic and predictive factors in patients with solid cancers. The CellSearch device (Veridex) is an immunomagnetic CTC selection and enumeration system used in clinical practice. The ImageStream (Amnis) combines the strengths of flow cytometry and fluorescent microscopy in a single platform and has potential application for CTC counting. The performance in CTC enumeration was compared between the ImageStream and CellSearch systems.

Various numbers of PANC‐1 tumor cells were spiked into 7.5 mL of peripheral blood from a healthy donor. Before cell analysis by the ImageStream, tumor cell enrichment was performed by immunomagnetic selection with anti‐EpPCAM. Anti‐CD45 and anti‐CK markers were used to discriminate between tumor cells and leukocytes. The ratios of tumor cells recovered from each dilution were calculated for both methods. The Wilcoxon rank test was applied to compare the results of the two methods and the reference value.

The results of the two tested methods differed significantly from the reference value, but did not differ between them. Nevertheless, lower level of trueness and precision was observed in ImageStream when fewer numbers of CTCs were analyzed.

Our results suggest that ImageStream platform for CTC enumeration has a potential value for the early diagnosis of disseminated disease, but needs an improvement of precision for the enumeration of low number of CTC.
Novel anti‐biofilm mechanism for wireless capsule endoscopy in the urinary tract: preliminary study in a sheep model
Authors: Neheman Amos , Schulman Claude , Yossepowitch Ofer
Published: March 2013

Objective

To develop and test the safety and feasibility of a novel anti‐biofilm mechanism configured for wireless capsule endoscopy (WCE) in a sheep bladder model.

Materials and Methods

A WCE mechanism, designed for long‐term bladder monitoring, was developed and introduced into a sheep bladder for 5 months.

The transparency of the surface was assessed by evaluating a resolution target placed inside the capsule at serial intervals using cystoscopy under general anaesthesia.

Animal behaviour, voiding patterns and urine cultures were monitored throughout the study.

At study termination, the capsule was extracted and assessed using scanning electron microscopy.

Results

The resolution target was visualized clearly at all investigation points.

No notable adverse effects were noted during the entire follow‐up period and no urinary tract infection occurred.

Scanning electron microscopy confirmed the efficacy of the technology to prevent biofilm formation and surface encrustation.

Conclusions

We report a novel technology that effectively prevents biofilm formation on the outer surface of foreign objects in the urinary tract.

Further studies are under way to test the applicability of this technology in bladder WCE to enable high‐quality wireless image transmission.
VIP and PACAP: neuropeptide modulators of CNS inflammation, injury, and repair
Authors: Waschek JA
Published: March 2013

Inflammatory processes play both regenerative and destructive roles in multiple sclerosis, stroke, CNS trauma, amyotrophic lateral sclerosis and aging‐related neurodegenerative diseases such as Alzheimer's, Parkinson's and Huntington's. Endogenous defence mechanisms against these pathologies include those that are directly neuroprotective, and those that modulate the expression of inflammatory mediators in microglia, astrocytes, and invading inflammatory cells. While a number of mechanisms and molecules have been identified that can directly promote neuronal survival, less is known about how the brain protects itself from harmful inflammation, and further, how it co‐opts the healing function of the immune system to promote CNS repair. The two closely related neuroprotective peptides, vasoactive intestinal peptide (VIP) and pituitary adenylyl cyclase‐activating peptide (PACAP), which are up‐regulated in neurons and immune cells after injury and/or inflammation, are known to protect neurons, but also exert powerful in vivo immunomodulatory actions, which are primarily anti‐inflammatory. These peptide actions are mediated by high‐affinity receptors expressed not only on neurons, but also astrocytes, microglia and peripheral inflammatory cells. Well‐established immunomodulatory actions of these peptides are to inhibit macrophage and microglia production and release of inflammatory mediators such as TNF‐α and IFN‐γ, and polarization of T‐cell responses away from Th1 and Th17, and towards a Th2 phenotype. More recent studies have revealed that these peptides can also promote the production of both natural and inducible subsets of regulatory T‐cells. The neuroprotective and immunomodulatory actions of VIP and PACAP suggest that receptors for these peptides may be therapeutic targets for neurodegenerative and neuroinflammatory diseases and other forms of CNS injury.
Potential enhancing effects of histamine H1 agonism/H3 antagonism on working memory assessed by performance and bold response in healthy volunteers
Authors: van Ruitenbeek P , Mehta M A
Published: March 2013

Background and Purpose

Schizophrenia is a highly debilitating disorder characterized by hallucinations and delusions, but also impaired cognition such as memory. While hallucinations and delusions are the main target for pharmacological treatment, cognitive impairments are rarely treated. Evidence exists that histamine has a role in the cognitive deficits in schizophrenia, which could be the basis of the development of a histamine‐type treatment. Histamine H3 antagonists have been shown to improve memory performance in experimental animals, but these effects have been little investigated in humans within the context of impaired cognition in schizophrenia and using sensitive measures of brain activity. In the present study, the effects of betahistine (H3 antagonist/H1 agonist) on learning and memory, and associated brain activity were assessed.

Experimental Approach

Sixteen healthy volunteers (eight female) aged between 18 and 50 years received two p.o. doses of betahistine (48 mg) or placebo separated by 30 min, on separate days according to a two‐way, double‐blind, crossover design. Volunteers performed an N‐back working memory task and a spatial paired associates learning task while being scanned using a MRI scanner.

Key Results

Task‐related activity changes in well‐defined networks and performance were observed. No betahistine‐induced changes in brain activity were found in these networks. Alternatively, liberal whole‐brain analyses showed activity changes in areas outside task networks, like the lateral geniculate nucleus.

Conclusions and Implications

Clear effects of betahistine on working memory could not be established. Future studies should use higher doses and explore the role of histamine in visual information processing.

Linked Articles

This article is part of a themed issue on Histamine Pharmacology Update. To view the other articles in this issue visit http://dx.doi.org/
10.1111/bph.2013.170.issue‐1
NC‐6300, an epirubicin‐incorporating micelle, extends the antitumor effect and reduces the cardiotoxicity of epirubicin
Authors: Takahashi Amane , Yamamoto Yoshiyuki , Yasunaga Masahiro , Koga Yoshikatsu , Kuroda Jun‐ichiro , Takigahira Misato , Harada Mitsunori , Saito Hiroyuki , Hayashi Tatsuyuki , Kato Yasuki , Kinoshita Taira , Ohkohchi Nobuhiro , Hyodo Ichinosuke , Matsumura Yasuhiro
Published: March 2013

Epirubicin is widely used to treat various human tumors. However, it is difficult to achieve a sufficient antitumor effect because of dosage limitation to prevent cardiotoxicity. We hypothesized that epirubicin‐incorporating micelle would reduce cardiotoxicity and improve the antitumor effect. NC‐6300 comprises epirubicin covalently bound to PEG polyaspartate block copolymer through an acid–labile hydrazone bond. The conjugate forms a micellar structure of 40–80 nm in diameter in an aqueous milieu. NC‐6300 (10, 15 mg/kg) and epirubicin (10 mg/kg) were given i.v. three times to mice bearing s.c. or liver xenograft of human hepatocellular carcinoma Hep3B cells. Cardiotoxicity was evaluated by echocardiography in C57BL/6 mice that were given NC‐6300 (10 mg/kg) or epirubicin (10 mg/kg) in nine doses over 12 weeks. NC‐6300 showed a significantly potent antitumor effect against Hep3B s.c. tumors compared with epirubicin. Moreover, NC‐6300 also produced a significantly longer survival rate than epirubicin against the liver orthotopic tumor of Hep3B. With respect to cardiotoxicity, epirubicin‐treated mice showed significant deteriorations in fractional shortening and ejection fraction. In contrast, cardiac functions of NC‐6300 treated mice were no less well maintained than in control mice. This study warrants a clinical evaluation of NC‐6300 in patients with hepatocellular carcinoma or other cancers.
Synthesis and In Vitro Evaluation of N‐Aryl Pyrido‐Quinazolines Derivatives as Potent Epidermal Growth Factor Receptor Inhibitors
Authors: Singh Vinay K. , Sharma Himanshu , Singh Sanjay K. , Gangwar Lakshmi
Published: March 2013

A series of pyrido‐quinazolines have been synthesised, characterized, and tested for their in vitro epidermal growth factor receptor (EGFR) tyrosine kinase inhibitory activity. The compounds were prepared from Alkylideno/arylideno‐bis‐ureas. Their final structure of the compounds was elucidated on the basis of spectral studies (IR, 1H NMR, FT‐IR, and EI‐MS). The cellular EGFR internalization response of selected compounds was evaluated using HeLa cells. Most of the synthesized compounds displayed potent EGFR‐TK inhibitory activity and structurally halogenated derivatives had a pronounced effect in inhibiting EGFR internalization.
Improved spatial estimates of climate predict patchier species distributions
Authors: Storlie C. J. , Phillips B. L. , VanDerWal J. J. , Williams S. E.
Published: March 2013

Aim

Correlative species distribution models (SDMs) combined with spatial layers of climate and species' localities represent a frequently utilized and rapid method for generating spatial estimates of species distributions. However, an SDM is only as accurate as the inputs upon which it is based. Current best‐practice climate layers commonly utilized in SDM (e.g. ANUCLIM) are frequently inaccurate and biased spatially. Here, we statistically downscale 30 years of existing spatial weather estimates against empirical weather data and spatial layers of topography and vegetation to produce highly accurate spatial layers of weather. We proceed to demonstrate the effect of inaccurately quantified spatial data on SDM outcomes.

Location

The Australian Wet Tropics.

Methods

We use Boosted Regression Trees (BRTs) to generate 30 years of spatial estimates of daily maximum and minimum temperature for the study region and aggregate the resultant weather layers into ‘accuCLIM’ climate summaries, comparable with those generated by current best‐practice climate layers. We proceed to generate for seven species of rainforest skink comparable SDMs within species; one model based on ANUCLIM climate estimates and another based on accuCLIM climate estimates.

Results

Boosted Regression Trees weather layers are more accurate with respect to empirically measured temperature, particularly for maximum temperature, when compared to current best‐practice weather layers. ANUCLIM climate layers are least accurate in heavily forested upland regions, frequently over‐predicting empirical mean maximum temperature by as much as 7°. Distributions of the focal species as predicted by accuCLIM were more fragmented and contained less core distributional area.

Conclusion

Combined these results reveal a source of bias in climate‐based SDMs and indicate a solution in the form of statistical downscaling. This technique will allow researchers to produce fine‐grained, ground‐truthed spatial estimates of weather based on existing estimates, which can be aggregated in novel ways, and applied to correlative or process‐based modelling techniques.
Influence of glucocorticoids and growth hormone on insulin sensitivity in humans
Authors: Yuen K. C. J. , Chong L. E. , Riddle M. C.
Published: March 2013

The seminal concept proposed by Sir Harold Himsworth more than 75 years ago that a large number of patients with diabetes were ‘insulin insensitive’, now termed insulin resistance, has now expanded to include several endocrine syndromes, namely those of glucocorticoid excess, and growth hormone excess and deficiency. Synthetic glucocorticoids are increasingly used to treat a wide variety of chronic diseases, whereas the beneficial effects of recombinant growth hormone replacement therapy in children and adults with growth hormone deficiency have now been well‐recognized for over 25 years. However, clinical and experimental studies have established that increased circulating levels of glucocorticoids and growth hormone can also lead to worsening of insulin resistance, glucose intolerance, overt diabetes mellitus and cardiovascular disease. Improved understanding of the physiological 24‐h rhythmicity of glucocorticoid and growth hormone secretion and its influence on the dawn phenomenon and the Staub‐Trauggot effect has therefore led to renewed interest in studies on the mechanisms of insulin resistance induced by exogenous administration of glucocorticoids and growth hormone in humans. In this review, we describe the physiological events that result from the presence of resistance to insulin action at the level of skeletal muscle, adipose tissue, and liver, describe the known mechanisms of glucocorticoid‐ and growth hormone‐mediated insulin resistance, and provide an update of the contributions of glucocorticoids and growth hormone to understanding the pathophysiology of insulin resistance and its effects on several endocrine syndromes.
Hospital admission due to infections in multiple sclerosis patients
Authors: Montgomery S. , Hillert J. , Bahmanyar S.
Published: March 2013

Background and purpose

Multiple sclerosis (MS) patients are at increased infection risk. Here the influences of susceptibility, severity and surveillance bias on infection‐related hospital admission are assessed.

Methods

Swedish registers identified 20 276 patients with MS, matched with 203 951 people from the general population without MS. Risk of first hospital admission for infection and mortality over 36 years was estimated by Poisson regression.

Results

Multiple sclerosis was associated with an increased hospital admission risk for all infections, with an adjusted relative risk (and 95% confidence interval) of 4.26 (4.13–4.40). A proportion of this raised risk was probably due to surveillance and referral bias, although a raised risk remained when MS was compared with other immune‐mediated diseases. The 1‐month mortality rate following hospital admission for infection was higher in MS patients than in the comparison cohort, with a relative risk of 4.69 (4.21–5.22). There was no clear temporal trend in the results, and risks were higher in males and varied by MS phenotype.

Conclusions

Higher hospital admission rates among MS patients for infection are likely to be due to a combination of surveillance bias, cautious medical management and greater susceptibility to severe infections. MS‐related functional limitations may increase infection risk and this should be considered in MS management.
Cap1p attenuates the apoptosis of Candida albicans
Authors: Dai Bao‐Di , Wang Yan , Zhao Lan‐Xue , Li De‐Dong , Li Ming‐Bang , Cao Yong‐Bing , Jiang Yuan‐Ying
Published: March 2013

Candida albicans is the most common opportunistic fungal pathogen and its apoptosis is inducible by environmental stress. Based on our previous finding that transcription factor Cap1p was involved in baicalein‐induced apoptosis, the present study aimed to further clarify the role of Cap1p in apoptosis by observing the impact of CAP1 deletion on cell fate. It was found that apoptotic stimulation with amphotericin B, acetic acid and hydrogen peroxide increased the number of apoptotic and necrotic cells, caspase activity and the accumulation of reactive oxygen species, whereas it decreased the mitochondrial membrane potential and intracellular ATP level in the cap1Δ/Δ mutant. The cell fate was, at least partly, caused by glutathione depletion and attenuation of the expression of the glutathione reductase gene in the cap1Δ/Δ mutant. Collectively, our data suggest that Cap1p participated in the apoptosis of C. albicans by regulating the expression of the glutathione reductase gene and glutathione content.
Rapid long‐distance migration in Norwegian Lesser Black‐backed Gulls Larus fuscus fuscus along their eastern flyway
Authors: Bustnes Jan O. , Moe Børge , Helberg Morten , Phillips Richard A.
Published: March 2013

We studied the long‐distance migration of Lesser Black‐backed Gulls Larus fuscus fuscus breeding in northern Norway along their eastern flyway using geolocators in 2009 and 2010. The majority of birds wintered in lakes in East Africa and the southeast Mediterranean was the most important stopover area. Larus f. fuscus along the eastern flyway travelled at a net travel speed of 399 and 177 km/day during the autumn and spring migration, respectively, higher than published travel speeds for Dutch Larus fuscus migrating along the western flyway. The results suggest that the long‐distance migratory Norwegian L. f. fuscus seek to minimize time spent in transit, whereas lower travel speed during northerly spring migration may reflect differences in wind patterns or food conditions between spring and autumn.
Impacts of logging and conversion of rainforest to oil palm on the functional diversity of birds in Sundaland
Authors: Edwards Felicity A. , Edwards David P. , Hamer Keith C. , Davies Richard G.
Published: March 2013

Commercial selective logging and the conversion of primary and degraded forests to agriculture are the biggest threats to tropical biodiversity. Our understanding of the impacts of these disturbances and the resulting local extinctions on the functional roles performed by the remaining species is limited. We address this issue by examining functional diversity (FD), which quantifies a range of traits that affect a species' ecological role in a community as a single continuous metric. We calculated FD for birds across a gradient of disturbance from primary forest through intensively logged forest to oil palm plantations on previously forested land in Borneo, Southeast Asia, a hotspot of imperilled biodiversity. Logged rainforest retained similar levels of FD to unlogged rainforest, even after two logging rotations, but the conversion of logged forest to oil palm resulted in dramatic reductions in FD. The few remaining species in oil palm filled a disproportionately wide range of functional roles but showed very little clustering in terms of functional traits, suggesting that any further extinctions from oil palm would reduce FD even further. Determining the extent to which the changes we recorded were due to under‐utilization of resources within oil palm or a reduction in the resources present is an important next step. Nonetheless our study improves our understanding of the stability and resilience of functional diversity in these ecosystems and of the implications of land‐use changes for ecosystem functioning.
Nest predators of southeast Asian evergreen forest birds identified through continuous video recording
Authors: Pierce Andrew J. , Pobprasert Korakoch
Published: March 2013

Using continuous video recording, we identified predation as the main cause of nest failure of understorey‐nesting birds in an intact evergreen forest in northeastern Thailand. Our dataset of 87 predation events is the largest recorded in the tropics. The main predators were macaques (n = 38; 43.7%), nocturnal snakes (n = 19; 21.8%), non‐raptorial birds (n = 12; 13.8%), raptors (n = 6; 6.9%), squirrels (n = 5; 5.7%) and tree shrews (n = 4; 4.6%). The two most important predators, Pig‐tailed Macaque Macaca nemistrina and Green Cat Snake Boiga cinerea, showed no preference for nest type, nest stage or nest height and we found no difference in their relative predation rates among years. Predation was predominantly diurnal (73.6%), suggesting that visual cues may be important for predators at this site.
The relative roles of habitat heterogeneity and disturbance in drosophilid assemblages (Diptera,Drosophilidae) in theCerrado
Authors: Alves Da Mata Renata , Tidon Rosana
Published: March 2013

The Brazilian Cerrado, a vegetation mosaic considered to be a unique savannah hotspot, contains a great diversity of insects. It is uncertain how communities of insects in the Cerrado respond, at local scale, to the strong heterogeneity of the biome or to the increasing levels of anthropogenic disturbance.

This study examines the relative importance of habitat heterogeneity and human disturbance for the structure of drosophilid assemblages in this biome.

Our results are based on standardised monthly sampling at 25 sites (3 conserved forests, 4 disturbed forests, 8 conserved savannahs, and 10 disturbed savannahs) throughout 1 year.

The assemblage compositions differed across habitats. The conserved forests had a singular drosophilid assemblage characterised by typical narrow‐ranging neotropical species. Assemblages from savannahs and disturbed forests contained more exotic species than those from conserved forests. The assemblages of disturbed forests were more similar to those of the savannahs than to those of the conserved forests. Savannah assemblages did not differ from each other; these assemblages shared a great number of both exotic and neotropical species widespread in neotropical regions.

At the reserve scale, the strong natural heterogeneity of the Cerrado is the primary factor impacting the structure of drosophilid assemblages. Nevertheless, disturbance explained the differences in assemblage structure between the conserved and disturbed forests. Even low disturbance levels in forests could cause a decrease in heterogeneity and begin to impoverish these environments, leading to the biotic homogenisation of this currently rich biome.
THE WELFARE STATE SOURCES OF BANK INSTABILITY: DISPLACING THE CONDITIONS OF WELFARE STATE FISCAL CRISIS UNDER PRESSURES OF MACROECONOMIC FINANCIALIZATION
Authors: WATSON MATTHEW
Published: March 2013

The post‐financial crisis decision‐making of Britain's Labour Government represents an interesting case of the more general tensions embedded in welfare reform strategies under macroeconomic pressures of financialization. It continued to find additional sources of funding out of current taxation to finance enhanced levels of short‐term frontline services, yet this was always against the backdrop of attempting to facilitate greater long‐term affordability through negotiating the switch to increasingly self‐sufficient welfare citizens. These twin policy objectives provided the backdrop for New Labour's opposition to the Bank of England's post‐financial crisis arguments for forcibly separating banks' trading practices from their depository business. It was in this way that increasing welfare state sources of future bank instability became apparent. In Britain at least, attempts to juggle conflicting short‐term and long‐term policy priorities have resulted in the displacement of the most obvious manifestations of welfare state fiscal crisis into other areas of the public finances.
RETHINKING E‐GOVERNMENT PERFORMANCE ASSESSMENT FROM A CITIZEN PERSPECTIVE
Authors: BARBOSA ALEXANDRE FERNANDES , POZZEBON MARLEI , DINIZ EDUARDO HENRIQUE
Published: March 2013

The use of information and communication technology (ICT), particularly that related to the consolidation of the internet as a social and business networking medium, has impelled governments towards enabling e‐government (e‐gov) programs to transform the future of the delivery of public services. E‐gov has a clear economic, social, and political impact that should be monitored in order to steer the design of effective public policies. In this article, we argue that evaluating the impact of e‐gov entails a complex process of e‐gov performance assessment that should take into account the perspective of citizens. Supported by a framework that combines two theoretical views, namely the structurationist view of technology and the social shaping of technology, we propose a model that consolidates nine performance dimensions. This model is the result of empirical work based on an in‐depth analysis of interviews with relevant social groups regarding their perceptions of the technological artefacts of e‐gov.
Interrater Variability in a Modified Norton Scale
Authors: Ek Anna‐Christina , Bjurulf Per
Published: March 2013

ABSTRACT. The Norton scale was devised in 1960 to provide nurses with a means to predict and prevent pressure sore development. The modified Norton scale now used comprises mental condition, activity, mobility, food intake, fluid intake, incontinence and general physical condition. Eleven wards were asked to participate. In every ward two registered nurses (RN) and two practical nurses (PN), all selected from the ordinary staff, were asked to evaluate ten patients concurrently yet independently. The patients were a random sample from 30 patients within the ward. Some variables in the Norton scale have predictive capacity for the development of pressure sores. In most of the variables a high level of interrater agreement was found. There were, however, some consistent differences between the two categories (RNs and PNs) in their evaluations. Thus for more reliable measurements it is recommended that only one category be used
Altered States of Consciousness, State‐dependent Learning and Patient Education
Authors: Lindstrøm Torill Christine
Published: March 2013

ABSTRACT. Evidence as to the existence of various altered states of consciousness are referred to from various fields of research. The effect of mental and physiological states on learning and retrieving is also documented. This evidence is combined to shed a new light on problems in patient education. Problems here are usually explained as stemming from various intellectual or motivational shortcomings in patients, or from pedagogic shortcomings in health personnel. It is hypothesised that part of the problem may stem from the phenomenon of state‐dependent learning in cases where patients' state of consciousness has been altered as a consequence of psychological and/or somatic changes.
Cognitive Processes Nurses and Doctors Use in the Administration of PRN (at need) Analgesic Drugs
Authors: Di Giulio Paola , Crow Rosemary
Published: March 2013

The report is a descriptive, comparative study of the cognitive processes used by doctors and nurses when deciding whether or not to administer prn drugs to postoperative cancer patients. Simulations, together with the think aloud technique to provide verbal protocols was the method chosen. The theoretical framework chosen for the analysis was the information processing theory. Five doctors and 5 nurses, each with at least 5 years of working experience were interviewed. The interviews were transcribed so that a content analysis could be performed. The main findings were the following: doctors and nurses generated hypotheses early in the interview; the only statistically significant difference between the two groups was the wider use of theory and/or experience as a source of information by doctors. Although differences are not statistically significant, nurses appear to collect more information on and from the patient and more information on vital signs and symptoms other than pain than the doctors. Differences derived from analysis of the statements expressed by the subjects suggested that nurses pay more attention to the patient's psychological problems and that, while doctors' main concern was to make the right diagnosis, the nurses' main concern were patients' reactions and collaboration.
Needs as Expressed by Women after Breast Cancer Surgery in the Setting of a Short Hospital Stay
Authors: Boman Lena , Andersson Jan‐Ulf , Björvell Hjördis
Published: March 2013

The aim of this study was to describe needs as expressed by a group of women after surgery for breast cancer in the setting of a short hospital stay. Ten days after surgery, 97 women answered an open‐ended question about their perception of the care given. A content analysis inspired by the method of Grounded Theory was used. Satisfaction with the personal treatment and feelings of abandonment were identified as the two main themes. Expressed needs (n = 113) were classified in five categories: Trust, Information, Practical Assistance, Personal Treatment and Emotional Support, of which Trust appeared to be the core concept. In addition, time and space emerged as two dimensions that were interwoven with the categories of needs. The patients' perception of trust in the staff was interpreted as depending on whether the needs in the other categories were satisfied or not. It is hypothesized that, to fulfil the patients' need of trust, the patients have to be satisfied at least with information, practical assistance, personal treatment and emotional support. We consider that, in an organization with a high degree of continuity, when the patients are aware of the physician and nurse responsible, the possibilities for trust are increased, especially in short hospital stays.
Recovery and Quality of Life One Year after Coronary Artery Bypass Grafting
Authors: Jaarsma Tiny , Kastermans Marijke C.
Published: March 2013

In order to study recovery and quality of life after bypass surgery, both objective and subjective data were collected during structured interviews. A total of 56 patients participated in the study. Data were collected during hospital admission and during two home visits at 6 and 12 months after Coronary Artery Bypass Grafting (CABG). Patients reported improved state of health and quality of life. Most of the changes occurred within the first six months after discharge. However, for most patients life had more or less returned to normal one year after CABG. It was also found that few of the patients changed their risk behaviour after surgery.
How Do Nurse Educators Respond to the Challenges and Changes in Their Working Life in Finland?
Authors: Harri Marja
Published: March 2013

In the present study nurse educators were asked to comment via a questionnaire on the characteristics deriving from earlier results and how they experience the present situation in their working life, and how they see the future. Data from 65 (63% of 104) educators were analysed. The earlier results, in the form of statements describing the best and the worst things in nurse educators' working life, were generally corroborated by respondents. The best things were students, freedom and challenges, and the worst things were workload, inadequacy of personal resources and administrative issues at work. Agreement was most clear on the workload being the worst thing in nurse educators' working life (52 out of 65). The explanations for agreement and disagreement were much the same as those given in previous studies. Regarding the present situation and the most important thing that needs attention in nurse educators' working life in Finland, nurse educators named continuous and too rapid changes. These results are related to workload, excessive demands and stress, competition, feelings of insecurity, and everlasting pressure to educate oneself. On the other hand, one's perception of working life is a very personal issue, and some educators who cope with it keep challenges as possibilities and enjoy them.
Relations in Families with a Mentally Retarded Child from the Perspective of the Siblings
Authors: Andersson Egil A. D.
Published: March 2013

Nowadays most handicapped children in Sweden live with their families. In this study some of the consequences of the normalisation of their lives are analysed, focusing on young siblings of mentally retarded children. Sixteen siblings, aged 5–11, were tested with the Family Relations Test and Kvebaek Family Sculpture Technique, as were siblings in a control group in which each child was chosen to match a sibling in the target group with respect to age and family constellation. The results show few differences between the two groups. According to the Family Relations Test, however, the emotional involvement in the eldest non‐retarded sibling differs statistically significant from that of the corresponding child in the control group and especially so with respect to negative incoming feelings. Young siblings also show a tendency to unconsciously place the mentally retarded child at larger distances from themselves than they place the other siblings with respect to the Kvebaek Family Sculpture Technique.

The results indicate that siblings of mentally retarded children have another frame of reference when judging family relations compared with that of the children in the control group. Thus siblings of mentally retarded children seem to adapt to changes in the family because of the mentally retarded child and qualitatively alter their thinking in relation to the family members.
Limitations of the Sense of Coherence Scale in a Swedish Pentecostal Population
Authors: Benzein Eva , Norberg Astrid , Saveman Britt‐Inger
Published: March 2013

The Sense of Coherence Scale is used frequently world‐wide and is thought to be appropriate to any population. The purpose of this study was to highlight some of the potential limitations of the scale. Fifteen members of the Pentecostal Movement described several difficulties in completing the scale, especially items measuring manageability and comprehensibility. The following three statements indicate the nature of their interpretation of the items and the ambiguity of their answers as they argued that: (1) the concept of ‘I’ was interpreted as ‘I and God’, (2) it is not necessary to understand everything in life, because it is enough that God understands, and (3) life is meaningful in itself because of the salvation. According to this interpretation of the items, every proposed answer could be suitable and consequently, the scores can readily be misconstrued. Many of the respondents proposed additions or changes in the wording to make the scale more suitable. The strong ego‐centred items seem to be inappropriate for the participants in this study and other populations might also be confronted with similar difficulties.
Music and Other Strategies to Improve the Care of Agitated Patients with Dementia
Authors: Ragneskog Hans , Kihlgren Mona
Published: March 2013

Many patients with dementia symptoms display forms of agitation such as the repeating of words, restlessness and aggression. These forms of behaviour may inflict strain on the co‐patients and the caregivers. In this study, 17 experienced formal caregivers from nursing homes and collective residential units were interviewed about their experiences of agitated patients with dementia and strategies to improve their care. The questions were open except for specific questions about sound, music, and opinions about pharmacological treatment. A calm atmosphere and a slow pace emerged as important strategies to control agitation. Fixed routines could develop this. The mixing of lucid and agitated dementia patients appeared as a major problem, because some lucid patients became angry when patients with dementia displayed agitation. Irritability in one patient could trigger agitation in other patients but was possible to stop at an early stage. Several responders had successfully used music to calm individual agitated patients. Music seemed to be an underestimated nursing intervention to control agitation in daily life, but uncontrolled sound could cause agitation in the patients and stress in the nursing staff.
Abduction—A Way to Deeper Understanding of the World of Caring
Authors: Eriksson Katie , Lindström Unni Å.
Published: March 2013

In this article, abduction is discussed as a possible way of developing an epistemology for an autonomous caring science based on an ontology that requires deeper understanding of the world of caring. The intention is to elicit a more distinct caring‐scientific pattern of knowledge based on the innermost core and historical conditions of caring. Abduction makes it possible to perceive connections on a deeper level and to penetrate in a way that reveals a richness of meaning, reflecting the true being in the dynamic process which is expressed in clinical reality. In the tradition of knowledge developed by Peirce, a synthesis of Hume's and Kant's tradition of knowledge, abduction is a fundamental idea. Peirce sees abduction as an operation of thought in which the recognition of underlying patterns makes a complex reality comprehensible. We regard the triad of abduction, induction and deduction as the basis for developing a caring‐scientific epistemology where abduction makes a synthesizing abstraction possible and may implement understanding of deeper patterns.
Parental Education as Viewed by Nurses
Authors: Petersson Kerstin , Håkansson Anders , Petersson Christer
Published: March 2013

This interview study of nurses in three health centres in Växjö municipality in Sweden sought to find out how they perceived their work with parental education. The aim was to study the possibilities of and any obstacles to achieving the goals of good parenthood training on equal terms for all people. The results showed areas where further development is needed. It appears to be difficult to achieve the goals. Parents' needs for educational measures differed depending on social, cultural, and gender differences. Young single mothers rarely took part in the parents' groups. They belonged to a minority whose needs and problems differed from those of the majority of parents. Also immigrant parents rarely participated in parents' groups. According to the nurses, this may have been due to cultural differences in child care and difficulties with the Swedish language. To give fathers more scope and opportunity to take part, it was suggested that special fathers' groups should be set up. To sum up, families with specific needs should be given more individual education and guidance by nurses. This study, confined to one geographical area, has only shed light on a few nurses' perceptions of parental education, so the findings merely serve to indicate a trend. More general knowledge would require further research‐oriented trial projects with the focus on the parents' perspective.
Deciding Not to Resuscitate
Authors: Löfmark Rurik , Nilstun Tore
Published: March 2013

After discussing the decision with the staff, physicians should investigate the conditions for a do‐not‐resuscitate (DNR) order, make the decision, and inform the patient and the family. But, according to the present and other studies, they are not taking the full responsibility for these tasks. Nurses are supposed to participate in the discussions with the physicians prior to a DNR decision, but not to make the decision or to inform the patient and the family. Physicians and nurses have different opinions about their legitimate roles when DNR orders are initiated and made. However, 8% of the nurses in the present study state that they have made a DNR decision and 37% declare that the nurse should do so. We propose a model where the skills of the responsible physician (to make the diagnosis and prognosis) and the skills of the responsible nurse (to communicate with the patients by virtue of their close relationship) are combined. Accordingly, future guidelines should stress the joint responsibility of physicians and nurses to investigate the conditions precedent for a DNR order, to make the DNR decision, and to inform the patients and the family.