bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Influencing Preventive Behaviors for Dengue Infection Among Housewives in Colombo, Sri Lanka
Authors: Chanyasanha Charnchudhi , Guruge Geethika Rathnawardana , Sujirarat Dusit
Published: August 2014

Dengue is an infectious disease prevalent in Sri Lanka. Some factors may influence preventive behaviors. This cross-sectional study aimed to determine the knowledge, attitude, and preventive behaviors associated with dengue and analyzed the factors influencing preventive behaviors among housewives in Colombo, Sri Lanka. The analytical study was designed, and data were collected using a structured questionnaire. The χ2 test and binary logistic regression were used to analyze data. The mean age of housewives was 39.41 years, 91% were married, 52% were Buddhist, and 46.5% had a family monthly income of 15 000 to 25 000 rupees. The knowledge of dengue preventive behaviors was 69.2%. The majority (91.5%) had a positive attitude toward dengue prevention. Only 39.3% used a mosquito net, and 89.3% had water storage container covers. Overall, 58.5% were knowledgeable about preventive measures. Age, religion, family income, education, knowledge, and attitude were associated with preventive behaviors. These findings are useful for dengue control in Colombo.
Factors Influencing Implementation of Developmental Care Among NICU Nurses in China
Authors: Zhang Xin , Lee Shih-Yu , Chen Jingli , Liu Huaping
Published: August 2014

The main aim of this article is to describe current developmental care nursing practices among registered nurses (RNs) working in neonatal intensive care units (NICUs) in China and to explore selected personal and unit characteristics related to developmental care implementation. A convenience sample of 207 RNs participated in this descriptive, cross-sectional exploratory study. A tool of Practice Standards for Individualized, Family-Centered Developmental Care was used to collect the data. The findings indicate that Chinese NICU nurses are not implementing developmental care consistently. Higher patient caseloads, fewer work hours per day, higher level of education, and fewer years worked in NICUs are the significant predictors for lower implementation of developmental care. NICU nurses in China currently carry out developmental care based mainly on their accumulated clinical experience rather than their educational experience. More systematic developmental care training for NICU nurses and more support at both unit and hospital levels are necessary in China.
Construct Validity of the Five Factor Borderline Inventory
Authors: DeShong Hilary L. , Lengel Gregory J. , Sauer-Zavala Shannon E. , O’Meara Madison , Mullins-Sweatt Stephanie N.
Published: August 2014

The Five Factor Borderline Inventory (FFBI) is a new self-report measure developed to assess traits of borderline personality disorder (BPD) from the perspective of the Five Factor Model of general personality. The current study sought to first replicate initial validity findings for the FFBI and then to further validate the FFBI with predispositional risk factors of the biosocial theory of BPD and with commonly associated features of BPD (e.g., depression, low self-esteem) utilizing two samples of young adults ( N = 87; 85) who have engaged in nonsuicidal self-injury. The FFBI showed strong convergent and discriminant validity across two measures of the Five Factor Model and also correlated strongly with measures of impulsivity, emotion dysregulation, and BPD. The FFBI also related to two measures of early childhood emotional vulnerability and parental invalidation and measures of depression, anxiety, and self-esteem. Overall, the results provide support for the FFBI as a measure of BPD.
Genetic polymorphisms, Biochemical Factors, and Conventional Risk Factors in Young and Elderly North Indian Patients With Acute Myocardial Infarction
Authors: Kaur Rupinder , Das Reena , Ahluwalia Jasmina , Kumar Rohit Manoj , Talwar K. K.
Published: August 2014

This study compared genetic polymorphisms (factor V Leiden [ FVL] 1691G/A, factor VII [ FVII] 10976G/A, FVII HVR4, platelet membrane glycoproteins GP1BA 1018C/T, GP1BA VNTR, integrin ITGB3 1565T/C, ITGA2 807C/T and methylenetetrahydrofolate reductase [ MTHFR] 677C/T), biochemical (fibrinogen and homocysteine), and conventional risk factors in 184 young and 166 elderly north Indian patients with acute myocardial infarction (AMI). Univariate analysis revealed higher prevalence of hypertension and obesity in elderly patients while smoking, alcohol intake, and low socioeconomic status in young patients ( P < .001). Although mean fibrinogen predominated ( P = .01) in elderly patients, mean homocysteine was higher ( P < .001) among young patients. Prevalence of hyperhomocysteinemia was greater in young than in elderly patients (odds ratio: 2.8, 95% confidence interval: 1.8-4.4, P < .001); however, genetic polymorphisms were equally prevalent in young and elderly patients. Multiple logistic regression analysis showed smoking ( P < .001), alcohol intake ( P = .046), and hyperhomocysteinemia ( P = .001) to be associated with AMI in the young patients while hypertension ( P = .006) in elderly patients. To conclude, smoking, alcohol intake, and elevated homocysteine are the risk factors for AMI among young while hypertension among elderly patients.
Maternal Drinking and Risky Sexual Behavior in Offspring
Authors: De Genna Natacha M. , Cornelius Marie D.
Published: August 2014

Teenage mothers are more likely to use drugs, and their children are more likely to use substances and become pregnant during adolescence. Teenage mothers’ substance use may play a role in the intergenerational risk for adolescent pregnancy. Pregnant adolescents (12-18 years) were seen during pregnancy and postnatal years 6, 10, 14, and 16 ( n = 332). Teenage mothers reported on substance use and family characteristics. The offspring reported substance use (starting at age 10) and sexual behavior (ages 14 and 16). Prenatal alcohol exposure was associated with offspring (a) having a risky first sex partner and (b) multiple sex partners in the past year. Heavy maternal drinking during childhood was associated with offspring reports of a risky first sex partner and early teenage pregnancy. Findings from this unique birth cohort have implications for alcohol prevention efforts with girls during and after a teenage pregnancy and interventions to prevent risky sex in high-risk youth.
A Replication of “Counting Chickens When They Hatch” (Economic Journal 2012)
Authors: Roodman David
Published: August 2014

Clemens, Radelet, Bhavnani, and Bazzi (CRBB) argue that the most-cited cross-country studies of the impact of foreign aid can be reconciled if changed in certain ways. The shared finding is then, in the CRBB view, that more aid is followed on average by more growth. I exactly replicate the estimation results of CRBB and then question these results with additional specifications and tests. One CRBB step, restricting the aid variable to assistance most likely to affect growth in the short run, does not make much difference. Two other changes—lagging the aid variables and differencing the data to remove fixed effects—fail to remove contemporaneous endogeneity. Addressing this issue produces evidence of zero or negative Granger causation from aid/(gross domestic product) to growth. And the regressions embodying all of CRBB’s changes do not peg the impact of aid as statistically significant.
Angiotensin converting enzyme intron 16 insertion/deletion genotype is associated with plasma C-reactive protein concentration in uteroplacental dysfunction
Authors: Häupl Thomas , Zimmermann Mathias , Kalus Ulrich , Yürek Salih , Koscielny Jürgen , Hoppe Berthold
Published: August 2014

Introduction:

Disturbance of the uteroplacental circulation (UPC) and the renin-angiotensin system are involved in the pathogenesis of preeclampsia. In women with history of preeclampsia persistently elevated C-reactive protein (CRP) levels have been described. The angiotensin-converting enzyme (ACE) intron 16 insertion/deletion (I/D) genotype is associated with ACE activity and assumed to be a risk factor for preeclampsia. As ACE generates proinflammatory angiotensin II, we analysed, whether ACE intron 16 I/D genotype is associated with CRP and whether this association exhibited a relation to uteroplacental dysfunction.

Materials and methods:

A total of 639 women have been followed during pregnancy with repeated measurements of CRP levels (observations: n=2333). ACE intron 16 I/D genotype was determined, and its association with CRP was assessed with adjustment for non-independent observations.

Results:

CRP levels of ACE D allele carriers were significantly higher than those of the ACE II (wild-type) genotype ( p=0.0003, padj=0.04). This relation was allele-dose dependent ( p<10−4, padj<0.02). Association between ACE I/D and CRP was significantly restricted to patients presenting with impaired UPC in univariate ( p<0.04) and multivariate analyses ( p=0.01).

Conclusions:

The ACE I/D genotype is significantly associated with CRP elevations during pregnancies complicated by disturbed UPC. Whether this effect on CRP is involved in pathogenesis of preeclampsia has to be elucidated.
Meta-analysis of the association between angiotensin-converting enzyme I/D polymorphism and aortic aneurysm risk
Authors: Song Yan , Miao Renying , Wang Hanjie , Qin Xiaoyu , Zhang Yonggan , Miao Chaofeng , Wang Zifan
Published: August 2014

Background:

Angiotensin-converting enzyme (ACE) I/D polymorphism has been indicated to be correlated with aortic aneurysm (AA) susceptibility, but study results are still debatable. Thus, a meta-analysis was conducted.

Methods:

Databases including PubMed, Embase, Web of Science, and Chinese National Knowledge Infrastructure (CNKI) were searched. Data were extracted and pooled odds ratios (OR) with 95% confidence intervals (CI) were calculated.

Results:

Ten studies with 3557 cases and 5231 controls were included in this meta-analysis. The association between ACE I/D genotype and AA risk was significant (OR=1.30; 95%CI, 1.07–1.57; p<0.01; I2=68%). When stratified by ethnicity, a significantly elevated risk was observed in Caucasians (OR=1.31; 95%CI, 1.07–1.61; p<0.01; I2=71%). In the abdominal AA subgroup, a significantly increased risk was observed (OR=1.29; 95%CI, 1.03–1.62; p=0.02; I2=73%). However, ACE I/D polymorphism was not associated with thoracic AA risk (OR=1.33; 95%CI, 0.85–2.07; p=0.21; I2=52%). Subgroup analysis on blood pressure status showed that an increased risk was found in hypertensive patients (OR=1.52; 95%CI, 1.02–2.26; p=0.04; I2=0%) but not in normotensive subjects (OR=1.46; 95%CI, 0.72–2.96; p=0.30; I2=25%).

Conclusions:

In conclusion, this meta-analysis suggested that ACE I/D polymorphism is a risk factor for AA.
What Does Nurse Turnover Rate Mean and What Is the Rate?
Authors: Kovner Christine T. , Brewer Carol S. , Fatehi Farida , Jun Jin
Published: August 2014

Registered nurse turnover is an important indicator of the nurse job market. Despite its wide use as a measure for health-care system analysis, there is a lack of consistency in the definition of turnover. Some definitions include any nurse leaving an organization; others may include involuntary and voluntary leaving. These inconsistent definitions also result in various turnover rates. The RN Work Project is a 10-year panel study of new nurses. Data were collected from the new nurses, rather than from a specific organization. About 17.5% of new nurses leave their first job within 1 year of starting their jobs. Consistent and accurate measurement of turnover is an important step in addressing organizational work environments and policies about the nursing workforce.
Impact of risk factors on the timing of first postpartum venous thromboembolism: a population-based cohort study from England
Authors: Abdul Sultan Alyshah , Grainge Matthew J. , West Joe , Fleming Kate M. , Nelson-Piercy Catherine , Tata Laila J.
Published: August 2014

Key Points

For women with preeclampsia, BMI >30 kg/m2, infection, or those having cesarean delivery, VTE risk remained elevated for 6 weeks postpartum. For women with postpartum hemorrhage or preterm birth, the relative rate of VTE was only increased for the first 3 weeks postpartum.
Effects of intervertebral disc disorders of low back on the mandibular kinematic: kinesiographic study
Authors: Spadaro Alessandro , Ciarrocchi Irma , Masci Chiara , Cozzolino Vincenzo , Monaco Annalisa
Published: August 2014

Background

Intervertebral disc disorders are one of the most common causes of low back pain. Neuromuscular dysfunction frequently is present in patients with lumbar disc herniation.

When considering joint dysfunction, it is important to remember that the spine functions as a unit. Dysfunction on one level can trigger compensatory changes in other spinal levels or in other areas of the musculoskeleton. Findings demonstrated the relationship between stomatognathic and postural systems justifying the hypothesis that muscular-skeletal impairment in one system could affect the other one. However, evidence that a lumbar intervertebral disc herniation could influence the mandibular kinematics is still lacking. Aim of this study was to analyse the effects that intervertebral disc herniation of low back could have on the mandibular kinematics.

Findings

Kinesiographic evaluations of the mandibular dynamics of 23 adult patients suffering L4/L5 and L5/S1 lumbosacral disc hernation were compared with a non pathological control group. A statistically significant difference of maximal mouth opening (p < .05) and of maximal mouth opening velocity (p < .03) was found comparing the study patients with the control subjects.

Conclusion

Lumbosacral disc herniation appears to be associated with changes in the activity of mandibular kinematics both in rate and quality of movement. The study suggests the existence of connections between masticatory system and lumbar disk herniation.
Modulation of Cerrena unicolor laccase and manganese peroxidase production
Authors: Kachlishvili Eva , Metreveli Eka , Elisashvili Vladimir
Published: August 2014

Among seven carbon sources tested, glycerol and glucose favored theCerrena unicolorlaccase production (18.8-20.3 U/mL); in addition, glycerol ensured the highest manganese peroxidase (MnP) activity (2 U/mL). Substitution of glycerol with the ethanol production residue (EPR) gave the highest laccase (90.1 U/mL) activity, while the walnut pericarp provided the highest MnP activity (7.4 U/mL). Supplementation of medium with 1 mM copper and 1 mM xylidine at appropriate time caused significant additive effect on laccase expression (333.2 U/mL) in shake-flask experiments. Overproduction of laccase activity (507 U/mL) and secretion of MnP activity was obtained whenC. unicolorwas cultivated in stirred-tank fermenter.C. unicolorshowed several distinctive and attractive technological features: it is capable to synthesize high levels of oxidases under high carbon and high nitrogen conditions and it secretes high laccase activity during trophophase.
The role of nuclear cardiac imaging in redefining neurogenic stunned myocardium in subarachnoid hemorrhage: a deeper look into the heart
Authors: Papanikolaou John , Makris Demosthenes , Zakynthinos Epaminondas
Published: August 2014

Subarachnoid hemorrhage may be complicated by neurogenic stunned myocardium, a catecholamine-induced transient cardiomyopathy that displays a wide clinical spectrum of cardiac abnormalities, including electrocardiographic changes, arrhythmias, myocardial necrosis, and left ventricular systolic and diastolic dysfunction. However, less is known about the cardiac metabolic consequences of acute subarachnoid hemorrhage. Prunet and coworkers’ recent study provides scintigraphic evidence suggesting that glucose metabolism and sympathetic cardiac innervation are severely and globally depressed during the acute phase of the disease. Metabolic and innervation abnormalities are largely overlapped and are probably not causally related to myocardial ischemia, suggesting that impaired glucose metabolism is probably neurogenic in nature. The scintigraphic defects seem to reverse slowly, within months of the onset of cerebral bleeding. Interestingly, scintigraphic evidence of metabolic myocardial alterations may exist even in the absence of clinical features of cardiac disease, possibly representing a subclinical type of neurogenic stunned myocardium.
Large hypomethylated blocks as a universal defining epigenetic alteration in human solid tumors
Authors: Timp Winston , Bravo Hector Corrada , McDonald Oliver G , Goggins Michael , Umbricht Chris , Zeiger Martha , Feinberg Andrew P , Irizarry Rafael A
Published: August 2014

Background

One of the most provocative recent observations in cancer epigenetics is the discovery of large hypomethylated blocks, including single copy genes, in colorectal cancer, that correspond in location to heterochromatic LOCKs (large organized chromatin lysine-modifications) and LADs (lamin-associated domains).

Methods

Here we performed a comprehensive genome-scale analysis of 10 breast, 28 colon, nine lung, 38 thyroid, 18 pancreas cancers, and five pancreas neuroendocrine tumors as well as matched normal tissue from most of these cases, as well as 51 premalignant lesions. We used a new statistical approach that allows the identification of large hypomethylated blocks on the Illumina HumanMethylation450 BeadChip platform.

Results

We find that hypomethylated blocks are a universal feature of common solid human cancer, and that they occur at the earliest stage of premalignant tumors and progress through clinical stages of thyroid and colon cancer development. We also find that the disrupted CpG islands widely reported previously, including hypermethylated island bodies and hypomethylated shores, are enriched in hypomethylated blocks, with flattening of the methylation signal within and flanking the islands. Finally, we found that genes showing higher between individual gene expression variability are enriched within these hypomethylated blocks.

Conclusion

Thus hypomethylated blocks appear to be a universal defining epigenetic alteration in human cancer, at least for common solid tumors.
Response to `Peptidyl arginine deiminase type IV (PADI4) haplotypes interact with shared epitope regardless of anti-cyclic citrullinated peptide antibody or erosive joint status in rheumatoid arthritis: a case control study'
Authors: Ikari Katsunori , Yano Koichiro , Yoshida Shinji , Taniguchi Atsuo , Yamanaka Hisashi , Momohara Shigeki
Published: August 2014

No abstract
Automated determination of bone age and bone mineral density in patients with juvenile idiopathic arthritis: a feasibility study
Authors: Anink Janneke , Nusman Charlotte M , van Suijlekom-Smit Lisette WA , van Rijn Rick R , Maas Mario , van Rossum Marion AJ
Published: August 2014

Introduction

Chronic inflammation combined with glucocorticoid treatment and immobilization puts juvenile idiopathic arthritis (JIA) patients at risk of impaired growth and reduced bone mineral density (BMD). Conventional methods for evaluating bone age and BMD are time-consuming or come with additional costs and radiation exposure. In addition, an automated measurement of bone age and BMD is likely to be more consistent than visual evaluation. In this study, we aimed to evaluate the feasibility of an automated method for determination of bone age and (cortical) bone mineral density (cBMD) in severely affected JIA patients. A secondary objective was to describe bone age and cBMD in this specific JIA population eligible for biologic treatment.

Methods

In total, 69 patients with standard hand radiographs at the start of etanercept treatment and of calendar age within the reliability ranges (2.5 to 17 years for boys and 2 to 15 years for girls) were extracted from the Dutch Arthritis and Biologicals in Children register. Radiographs were analyzed using the BoneXpert method, thus automatically determining bone age and cBMD expressed as bone health index (BHI). Agreement between measurements of the left- and right-hand radiographs and a repeated measurement of the left hand were assessed with the intraclass correlation coefficient (ICC). Regression analysis was used to identify variables associated with Z-scores of bone age and BHI.

Results

The BoneXpert method was reliable in the evaluation of radiographs of 67 patients (radiographs of 2 patients were rejected because of poor image quality). Agreement between left- and right-hand radiographs (ICC = 0.838 to 0.996) and repeated measurements (ICC = 0.999 to 1.000) was good. Mean Z-scores of bone age (-0.36, P = 0.051) and BHI (-0.85, P < 0.001) were lower compared to the healthy population. Glucocorticoid use was associated with delayed bone age (0.79 standard deviation (SD), P = 0.028), and male gender was associated with a lower Z-score of BHI (0.65 SD, P = 0.021).

Conclusions

BoneXpert is an easy-to-use method for assessing bone age and cBMD in patients with JIA, provided that radiographs are of reasonable quality and patients’ bone age lies within the age ranges of the program. The population investigated had delayed bone maturation and lower cBMD than healthy children.
Differences in the labor market entry of second-generation immigrants and ethnic Danes
Authors: Datta Gupta Nabanita , Kromann Lene
Published: August 2014

Our study is one of the first to take search friction and cross-firm differences in factor productivity into account when investigating firm behavior towards second-generation immigrants in Denmark. We ensure sub-sample homogeneity in search models by matching second-generation immigrants to their ethnic Danish twins according to parental characteristics and informal network quality. We find that second-generation immigrants with a high-school or primary school education, in particular females, perform as well or better than their ethnic counterparts. Second generation immigrants with vocational education, in particular males, face lower arrival rates when unemployed and higher layoff rates than those of their twins.
A high color purity red emitting phosphor CaYAlO4:Mn4+ for LEDs
Authors: Chen Yan , Wang Meng , Wang Jing , Wu Mingmei , Wang Chengxin
Published: August 2014

An intense red phosphor, CaYAlO4:Mn4+, was developed by solid state reaction. The photoluminescence excitation and emission spectra, concentration effect, thermal-dependent luminescence quenching properties and decay curves are investigated. The results show Mn4+ ion exhibits a broadband excitation extending from 250 to 550 nm and emits an intense red light at 710 nm with high color purity and stable chromaticity coordinates. These results demonstrate that Mn4+ ion can play a role of activator in narrow red emitting phosphor potentially useful in UV (~370 nm) GaN-base or Blue (~460 nm) InGaN-base LED.
Randomized Phase III Trial of Concurrent Accelerated Radiation Plus Cisplatin With or Without Cetuximab for Stage III to IV Head and Neck Carcinoma: RTOG 0522
Authors: Ang K. Kian , Zhang Qiang , Rosenthal David I. , Nguyen-Tan Phuc Felix , Sherman Eric J. , Weber Randal S. , Galvin James M. , Bonner James A. , Harris Jonathan , El-Naggar Adel K. , Gillison Maura L. , Jordan Richard C. , Konski Andre A. , Thorstad Wade L. , Trotti Andy , Beitler Jonathan J. , Garden Adam S. , Spanos William J. , Yom Sue S. , Axelrod Rita S.
Published: August 2014

Purpose

Combining cisplatin or cetuximab with radiation improves overall survival (OS) of patients with stage III or IV head and neck carcinoma (HNC). Cetuximab plus platinum regimens also increase OS in metastatic HNC. The Radiation Therapy Oncology Group launched a phase III trial to test the hypothesis that adding cetuximab to the radiation-cisplatin platform improves progression-free survival (PFS).

Patients and Methods

Eligible patients with stage III or IV HNC were randomly assigned to receive radiation and cisplatin without (arm A) or with (arm B) cetuximab. Acute and late reactions were scored using Common Terminology Criteria for Adverse Events (version 3). Outcomes were correlated with patient and tumor features and markers.

Results

Of 891 analyzed patients, 630 were alive at analysis (median follow-up, 3.8 years). Cetuximab plus cisplatin-radiation, versus cisplatin-radiation alone, resulted in more frequent interruptions in radiation therapy (26.9% v 15.1%, respectively); similar cisplatin delivery (mean, 185.7 mg/m2v 191.1 mg/m2, respectively); and more grade 3 to 4 radiation mucositis (43.2% v 33.3%, respectively), rash, fatigue, anorexia, and hypokalemia, but not more late toxicity. No differences were found between arms A and B in 30-day mortality (1.8% v 2.0%, respectively; P = .81), 3-year PFS (61.2% v 58.9%, respectively; P = .76), 3-year OS (72.9% v 75.8%, respectively; P = .32), locoregional failure (19.9% v 25.9%, respectively; P = .97), or distant metastasis (13.0% v 9.7%, respectively; P = .08). Patients with p16-positive oropharyngeal carcinoma (OPC), compared with patients with p16-negative OPC, had better 3-year probability of PFS (72.8% v 49.2%, respectively; P < .001) and OS (85.6% v 60.1%, respectively; P < .001), but tumor epidermal growth factor receptor (EGFR) expression did not distinguish outcome.

Conclusion

Adding cetuximab to radiation-cisplatin did not improve outcome and hence should not be prescribed routinely. PFS and OS were higher in patients with p16-positive OPC, but outcomes did not differ by EGFR expression.
Risk of Diabetes Mellitus in Long-Term Survivors of Hodgkin Lymphoma
Authors: van Nimwegen Frederika A. , Schaapveld Michael , Janus Cecile P.M. , Krol Augustinus D.G. , Raemaekers John M.M. , Kremer Leontien C.M. , Stovall Marilyn , Aleman Berthe M.P. , van Leeuwen Flora E.
Published: August 2014

Purpose

Recently, an increased risk of diabetes mellitus (DM) was observed after abdominal irradiation for childhood cancer. Because many Hodgkin lymphoma (HL) survivors have also been treated with infradiaphragmatic radiotherapy, we evaluated the association between HL treatment and DM risk.

Patients and Methods

Our study cohort comprised 2,264 5-year HL survivors, diagnosed before age 51 years and treated between 1965 and 1995. Treatment and follow-up information was collected from medical records and general practitioners. Radiation dosimetry was performed to estimate radiation dose to the pancreas. Cumulative incidence of DM was estimated, and risk factors for DM were evaluated by using Cox regression.

Results

After a median follow-up of 21.5 years, 157 patients developed DM. Overall cumulative incidence of DM after 30 years was 8.3% (95% CI, 6.9% to 9.8%). After para-aortic radiation with ≥ 36 Gy, the 30-year cumulative incidence of DM was 14.2% (95% CI, 10.7% to 18.3%). Irradiation with ≥ 36 Gy to the para-aortic lymph nodes and spleen was associated with a 2.30-fold increased risk of DM (95% CI, 1.54- to 3.44-fold) whereas para-aortic radiation alone with ≥ 36 Gy was associated with a 1.82-fold increased risk (95% CI, 1.02- to 3.25-fold). Lower doses (10 to 35 Gy) did not significantly increase risk of DM. The risk of DM significantly increased with higher mean radiation doses to the pancreatic tail (P < .001).

Conclusion

Radiation to the para-aortic lymph nodes increases the risk of developing DM in 5-year HL survivors. Screening for DM should be considered in follow-up guidelines for HL survivors, and treating physicians should be alert to this increased risk.
Hematopoietic Stem-Cell Transplantation for Advanced Systemic Mastocytosis
Authors: Ustun Celalettin , Reiter Andreas , Scott Bart L. , Nakamura Ryotaro , Damaj Gandhi , Kreil Sebastian , Shanley Ryan , Hogan William J. , Perales Miguel-Angel , Shore Tsiporah , Baurmann Herrad , Stuart Robert , Gruhn Bernd , Doubek Michael , Hsu Jack W. , Tholouli Eleni , Gromke Tanja , Godley Lucy A. , Pagano Livio , Gilman Andrew , Wagner Eva Maria , Shwayder Tor , Bornhäuser Martin , Papadopoulos Esperanza B. , Böhm Alexandra , Vercellotti Gregory , Van Lint Maria Teresa , Schmid Christoph , Rabitsch Werner , Pullarkat Vinod , Legrand Faezeh , Yakoub-agha Ibrahim , Saber Wael , Barrett John , Hermine Olivier , Hagglund Hans , Sperr Wolfgang R. , Popat Uday , Alyea Edwin P. , Devine Steven , Deeg H. Joachim , Weisdorf Daniel , Akin Cem , Valent Peter
Published: August 2014

Purpose

Advanced systemic mastocytosis (SM), a fatal hematopoietic malignancy characterized by drug resistance, has no standard therapy. The effectiveness of allogeneic hematopoietic stem-cell transplantation (alloHCT) in SM remains unknown.

Patients and Methods

In a global effort to define the value of HCT in SM, 57 patients with the following subtypes of SM were evaluated: SM associated with clonal hematologic non–mast cell disorders (SM-AHNMD; n = 38), mast cell leukemia (MCL; n = 12), and aggressive SM (ASM; n = 7). Median age of patients was 46 years (range, 11 to 67 years). Donors were HLA-identical (n = 34), unrelated (n = 17), umbilical cord blood (n = 2), HLA-haploidentical (n = 1), or unknown (n = 3). Thirty-six patients received myeloablative conditioning (MAC), and 21 patients received reduced-intensity conditioning (RIC).

Results

Responses in SM were observed in 40 patients (70%), with complete remission in 16 patients (28%). Twelve patients (21%) had stable disease, and five patients (9%) had primary refractory disease. Overall survival (OS) at 3 years was 57% for all patients, 74% for patients with SM-AHNMD, 43% for those with ASM, and 17% for those with MCL. The strongest risk factor for poor OS was MCL. Survival was also lower in patients receiving RIC compared with MAC and in patients having progression compared with patients having stable disease or response.

Conclusion

AlloHCT was associated with long-term survival in patients with advanced SM. Although alloHCT may be considered as a viable and potentially curative therapeutic option for advanced SM in the meantime, given that this is a retrospective analysis with no control group, the definitive role of alloHCT will need to be determined by a prospective trial.
Hospice Admissions for Cancer in the Final Days of Life: Independent Predictors and Implications for Quality Measures
Authors: O'Connor Nina R. , Hu Rong , Harris Pamela S. , Ache Kevin , Casarett David J.
Published: August 2014

Purpose

To define patient characteristics associated with hospice enrollment in the last 3 days of life, and to describe adjusted proportions of patients with late referrals among patient subgroups that could be considered patient-mix adjustment variables for this quality measure.

Methods

Electronic health record–based retrospective cohort study of patients with cancer admitted to 12 hospices in the Coalition of Hospices Organized to Investigate Comparative Effectiveness network.

Results

Of 64,264 patients admitted to hospice with cancer, 10,460 (16.3%) had a length of stay ≤ 3 days. There was significant variation among hospices (range, 11.4% to 24.5%). In multivariable analysis, among patients referred to hospice, patients who were admitted in the last 3 days of life were more likely to have a hematologic malignancy, were more likely to be male and married, and were younger (age < 65 years). Patients with Medicaid or self-insurance were less likely to be admitted to hospice within 3 days of death.

Conclusion

Quality measures of hospice lengths of stay should include patient-mix adjustments for type of cancer and site of care. Patients with hematologic malignancies are at especially increased risk for late admission to hospice.
A Dopamine Receptor D2-Type Agonist Attenuates the Ability of Stress to Alter Sleep in Mice
Authors: Jefferson F. , Ehlen J. C. , Williams N. S. , Montemarano J. J. , Paul K. N.
Published: August 2014

Although sleep disruptions that accompany stress reduce quality of life and deteriorate health, the mechanisms through which stress alters sleep remain obscure. Psychological stress can alter sleep in a variety of ways, but it has been shown to be particularly influential on rapid eye movement (REM) sleep. Prolactin (PRL), a sexually dimorphic, stress-sensitive hormone whose basal levels are higher in females, has somnogenic effects on REM sleep. In the current study, we examined the relationship between PRL secretion and REM sleep after restraint stress to determine whether: 1) the ability of stress to increase REM sleep is PRL-dependent, and 2) fluctuating PRL levels underlie sex differences in sleep responses to stress. Because dopamine D2 receptors in the pituitary gland are the primary regulator of PRL secretion, D2 receptor agonist, 1-[(6-allylergolin-8β-yl)-carbonyl]-1-[3-(dimethylamino) propyl]-3-ethylurea (cabergoline), was used to attenuate PRL levels in mice before 1 hour of restraint stress. Mice were implanted with electroencephalographic/electromyographic recording electrodes and received an ip injection of either 0.3-mg/kg cabergoline or vehicle before a control procedure of 1 hour of sleep deprivation by gentle handling during the light phase. Six days after the control procedure, mice received cabergoline or vehicle 15 minutes before 1 hour of restraint stress. Cabergoline blocked the ability of restraint stress to increase REM sleep amount in males but did not alter REM sleep amount after stress in females even though it reduced basal REM sleep amount in female controls. These data provide evidence that the ability for restraint stress to increase REM sleep is dependent on PRL and that sex differences in REM sleep amount may be driven by PRL.
Maternal Early-Pregnancy Thyroid Function Is Associated With Subsequent Hypertensive Disorders of Pregnancy: The Generation R Study
Authors: Medici Marco , Korevaar Tim I. M. , Schalekamp-Timmermans Sarah , Gaillard Romy , de Rijke Yolanda B. , Visser W. Edward , Visser Willy , de Muinck Keizer-Schrama Sabine M. P. F. , Hofman Albert , Hooijkaas Herbert , Bongers-Schokking Jacoba J. , Tiemeier Henning , Jaddoe Vincent W. V. , Visser Theo J. , Peeters Robin P. , Steegers Eric A. P.
Published: August 2014

Context:

Hypertensive disorders during pregnancy are associated with a wide range of maternal and fetal complications, and only a few risk factors are known for the development of these disorders during pregnancy. Conflicting and limited data are available on the relationship between thyroid (dys)function and the risk of hypertensive disorders of pregnancy.

Objective:

The objective of the investigation was to study the associations between early-pregnancy thyroid dysfunction, thyroid function within the normal range, and the risk of hypertensive disorders.

Design, Setting, and Participants:

In early pregnancy, serum TSH, free T4 (FT4), and thyroperoxidase antibody (TPOAb) levels were determined in 5153 pregnant women. No interventions were done. The associations of thyroid function with the risk of hypertensive disorders were studied.

Main Outcome Measures:

Mean blood pressures and hypertensive disorders, including pregnancy-induced hypertension (n = 209) and preeclampsia (n = 136), were measured.

Results:

Hyperthyroid mothers had a higher risk of hypertensive disorders [odds ratio (OR) 3.40 [95% confidence interval (CI) 1.46–7.91], P = .005], which was mainly due to an increased risk of pregnancy-induced hypertension [OR 4.18 (95% CI 1.57–11.1), P = .004]. Hypothyroidism and hypothyroxinemia were not associated with hypertensive disorders. Within the normal range, the high-normal FT4 levels were associated with an increased risk of hypertensive disorders [OR 1.62 (95% CI 1.06–2.47), P = .03], which was mainly due to an increased risk of preeclampsia [OR 2.06 (95% CI 1.04–4.08), P = .04]. The TPOAb status was not associated with hypertensive disorders.

Conclusions:

We show that biochemical hyperthyroidism and also high-normal FT4 levels during early pregnancy are associated with an increased risk of hypertensive disorders. These data demonstrate that these associations are even seen for a mild variation in thyroid function within the normal range.
Subarachnoid haemorrhage: a critical care case study
Authors: McLeod Anne , Salmons Geraldine
Published: August 2014

The critical care management of someone who has had a life-threatening subarachnoid haemorrhage is focused on preventing further injury, such as secondary brain injury, and controlling the consequences of the bleed. Therefore the intensive care team needs to be proactive and vigilant in their treatment of this patient group. This article uses a patient case study to illustrate the care required following a subarachnoid haemorrhage in the intensive care setting.
Fast track: early thrombolysis
Authors: Flisher Denise
Published: August 2014

The reduction of cardiac muscle damage post myocardial infarction depends on how fast intravenous thrombolytic therapy can be administered. This article looks at how the appropriately trained nurse can facilitate this early treatment.
Unemployment and health
Authors: Cooper Sue
Published: August 2014

The relationship between unemployment and health continues to be the subject of much debate. Unemployment levels in the UK are high and this has major consequences for both the individual and the nation. This article reviews the current literature, offers some explanations and outlines the main methodological problems with research in this area, which should be considered by nurses when planning health care.
Enrolled nurses: do they have a role?
Authors: Castledine George
Published: August 2014

Issues surrounding enrolled nurses (ENs) are currently hitting the headlines (Brown, 1995). Recently, there have been calls for the UKCC to remove Rule 18(2) which states: ‘Courses leading to a qualification, the successful completion of which shall enable an application to be made for admision to Part 2,4, 6 or 7 of the register, shall be designed to prepare the student to undertake nursing care under the direction of a person registered in Part 1, 3, 5 or 8 of the register.’
Stress and nursing
Authors: Farrington Andy
Published: August 2014

This article looks at definitions and models of stress and examines sources of stress in nursing and the assessment and measurement of stress factors.
A guide to the Harvard referencing system
Authors: Dwyer Maureen
Published: August 2014

This article explains how to reference an academic work using the Harvard system. Instructions comply with the relevant British standards, i.e. BS 5605:1990, BS 1629:1989 and BS 6371:1983. The importance of referencing in an approved manner is discussed and problem areas such as joint authors, corporate authorship and unpublished works are examined. The issue of second-hand references that are not addressed by the standards is also explained.
Management of hypoglycaemia
Authors: Gallichan Marilyn
Published: August 2014

Hypoglycaemia is usually a side-effect of the medication for diabetes. This article explains the mechanisms of hypoglycaemia and the factors which may precipitate it. It outlines the treatment of mild, moderate and severe reactions and describes how hypoglycaemia can often be prevented by forward planning.
The development of advanced nursing practice: 1
Authors: Elliott Patricia Anne
Published: August 2014

The PREPP report became a reality in April 1995. This article, the first of two parts, analyses the role of the advanced nursing practitioner and outlines some of the changes in nursing that have led to the need to reorganise clinical practice.
The evolving role of the clinical nurse specialist
Authors: McSharry Monica
Published: August 2014

There is still a great deal of confusion surrounding the role of specialist nurses. These individuals are often the most confused as to the contribution they can make to nursing as a continually evolving profession of the 1990s. By clarifying the relationship between research, theory and education, their role identity is enhanced.
Developing a centre for health information and promotion
Authors: Glasper Edward Alan , Lowson Susan , Manger Rachel , Phillips Linaa
Published: August 2014

Following the successful application for nursing development unit funding, the children's outpatient department within the Child Health Directorate of the University Hospital, Southampton, has developed a number of ambitious plans to promote nursing initiatives, one of which was the creation of a centre for health informatioii and promotion. This article describes this development.
Stigmatisation of people with learning disabilities in general hospitals
Authors: Shanley Eamon , Guest Catherine
Published: August 2014

Stigmatisation of people with learning disabilities is a barrier to good nursing care. In general, hospital nurses are likely to possess negative attitudes to those with learning disabilities. Stuctures and direct contact can minimise stigmatisation.
Student nurses' attitudes towards people with learning disabilities
Authors: Slevin Eamonn
Published: August 2014

This article reports a study in which the attitudes towards people with learning disabilities held by three groups of student nurses (two Project 2000 groups and one traditional group) are measured and compared. Findings indicate significantly more positive attitudes towards people who have learning disabilities by the Project 2000 students who had placement experience with this client group.
Common problems in wound care: wound and ulcer measurement
Authors: Vowden Kathryn
Published: August 2014

Accurate measurement is an important part of wound assessment. Wounds vary considerably in their nature, shape and site. Many measurement techniques exist. It is important to choose the correct technique for a specific wound and to understand the degreee of accuracy obtained from the measurements.
Bottomley's swan song gives nurses little recognition
Authors: Castledine George
Published: August 2014

Virginia Bottomley's (1995) recent lecture at the Royal Society of Medicine in London, entitled ‘The new NHS: continuity and change’, began with a review of how the NHS has developed and grown over the years, and then highlighted reforms such as Griffiths, before ending on what she felt she had achieved.
Psychological and educational support for CAPD patients
Authors: Cook Suzanne
Published: August 2014

Following the development of a small dedicated renal team and the implementation of a new educational and psychological support programme for patients undergoing continuous ambulatory peritoneal dialysis (CAPD), several improvements in outcome measures have become apparent. These changes are also associated with improved patient compliance and overall wellbeing of patients and their families.
Supervision: clinical development or management control?
Authors: Burrow Stephen
Published: August 2014

Traditionally, supervision among health professionals was a somewhat esoteric forum for a privileged few practitioners who would examine clinical case material in order to elicit and improve their therapeutic skills. Today's professional climate demands a supervisory process, beyond such a purist model, which examines virtually all areas of professional activity. This article does not argue for or against the retention of a purist model of clinical supervision but examines some of the hazards of an alternative framework.
Youth unemployment: effects on health and happiness
Authors: Price Bob
Published: August 2014

The relationship between youth unemployment, health and happiness is complex. Stress associated with loss of work in adults may not be experienced in the same way, or at all, by teenagers. Nurses, therefore, need to keep an open mind in assessing the mental health needs of. younger clients.
The UKCC's criteria for specialist and advanced nursing practice
Authors: Wallace Maggy , Gough Pippa
Published: August 2014

This article examines the development of the UKCC's position on specialist and advanced practice. It considers the evolution of the work within the overall context of postregistration, education and practice.
Use of humour in patient care
Authors: Harries Gill
Published: August 2014

Laughter and humour are an intrinsic part of our daily lives, but do nurses recognise the importance of humour in reducing stress and promoting feelings of wellbeing for patients and fellow staff members?
The case for village communities for people with learning disabilities
Authors: Cox Caroline
Published: August 2014

This article puts forward the arguments for the establishment of village communities for some people with learning disabilities (mental handicap) and shows how they can provide a safe living environment for residents, while at the same time enhancing their quality of life.
Role of questioning skills in patient assessment
Authors: Holt Paula
Published: August 2014

This article is a critical analysis of the literature on patient assessment, nurses' questioning skills and effective methods of teaching questioning skills. Current practice and rituals are highlighted and recommendations regarding the search for excellence are included.
Maintaining nurses' job satisfaction and morale
Authors: Nolan Mike , Nolan Janet , Grant Gordon
Published: August 2014

In this article those factors which influence the job satisfaction and morale of nurses are considered. It is suggested that action is needed if the profession is to continue to grow and develop.
Minor injuries clinics: dealing with trauma
Authors: Cable Stuart
Published: August 2014

This article examines the emerging development of nurse-led minor injuries units. It considers the impact of this on doctor-nurse relationships and the factors that need to be assessed and planned when initiating such a service.
Pain assessment in the elderly
Authors: Hayes Raymond
Published: August 2014

A major increase in the elderly population presumes a proportionate increase in chronic brain syndrome sufferers, who may have chronic pain. This article discusses the difficulties in assessing pain in this care group, with specific reference to those who are confused and nonverbal. Areas for further research are highlighted.
Care study: Treating post-traumatic stress disorder using Riehl's Interaction Model
Authors: Finnegan Alan P
Published: August 2014

Following a succinct overview of posttraumatic stress disorder (PTSD), this article highlights the benefit of using Riehl's conceptual model, in conjunction with a cognitive behavioural approach, to help a serviceman suffering from PTSD. The case history and treatment are presented.
Common problems with wound care: infection with HIV
Authors: Kiernan Martin , Young Trudie
Published: August 2014

The issue of the care required by wounded patients infected with human immunodeficiency virus should be addressed by all nursing personnel. The virus can be transmitted through blood, blood products or wound exudate. Promotion of universal precautions should greatly minimise the risk. The patient's infection status is not always known and the problem may not be a major wound but an associated condition.
Dissemination and application of mental health nursing research
Authors: McKenna Hugh P
Published: August 2014

Various government reports recognize that research is not informing practice. This article discusses the reasons for this and what organizations and individuals can do about it.
Development and application of social learning theory
Authors: Price Vincent , Archbold John
Published: August 2014

This article traces the development of social learning theory over the last 30 years, relating the developments to clinical nursing practice. Particular attention is focused on the contribution of Albert Bandura, the American psychologist, and his work on modelling.
Interaction analysis: a therapeutic tool
Authors: Conlon Margaret MM
Published: August 2014

This short interaction has been selected as being representative of a generic psychiatric nurse's caseload practice. The aim of the exercise is to allow the practitioner to reflect on the therapeutic process and identify its strengths and weaknesses. The content of the session can be analyzed in terms of therapeutic approach, counselling and Communication skills. The process can be used as a tool for skill development and evaluation.