bluuebunny/crossref_metadata_2025 huggingface dataset:
How uncertainties in future climate change predictions translate into future terrestrial carbon fluxes
Authors: Berthelot Marie , Friedlingstein Pierre , Ciais Philippe , Dufresne Jean‐Louis , Monfray Patrick
Published: May 2005

We forced a global terrestrial carbon cycle model by climate fields of 14 ocean and atmosphere general circulation models (OAGCMs) to simulate the response of terrestrial carbon pools and fluxes to climate change over the next century. These models participated in the second phase of the Coupled Model Intercomparison Project (CMIP2), where a 1% per year increase of atmospheric CO2was prescribed. We obtain a reduction in net land uptake because of climate change ranging between 1.4 and 5.7 Gt C yr−1at the time of atmospheric CO2doubling. Such a reduction in terrestrial carbon sinks is largely dominated by the response of tropical ecosystems, where soil water stress occurs. The uncertainty in the simulated land carbon cycle response is the consequence of discrepancies in land temperature and precipitation changes simulated by the OAGCMs. We use a statistical approach to assess the coherence of the land carbon fluxes response to climate change. The biospheric carbon fluxes and pools changes have a coherent response in the tropics, in the Mediterranean region and in high latitudes of the Northern Hemisphere. This is because of a good coherence of soil water content change in the first two regions and of temperature change in the high latitudes of the Northern Hemisphere.

Then we evaluate the carbon uptake uncertainties to the assumptions on plant productivity sensitivity to atmospheric CO2and on decomposition rate sensitivity to temperature. We show that these uncertainties are on the same order of magnitude than the uncertainty because of climate change. Finally, we find that the OAGCMs having the largest climate sensitivities to CO2are the ones with the largest soil drying in the tropics, and therefore with the largest reduction of carbon uptake.
Relationships between air swallowing, intragastric air, belching and gastro‐oesophageal reflux
Authors: Bredenoord A. J. , Weusten B. L. A. M. , Timmer R. , Akkermans L. M. A. , Smout A. J. P. M.
Published: May 2005

Abstract  Background  With each swallow a certain amount of air is transported to the stomach. The stomach protects itself against excessive distention by swallowed air through belching (gas reflux). The mechanism of belching (transient lower oesophageal sphincter relaxation) is also one of the mechanisms underlying gastro‐oesophageal reflux.

Aim  To investigate whether swallowing of air leads to an increase in size of the intragastric air bubble and to gastro‐oesophageal reflux.

Methods  Multichannel intraluminal impedance mea‐surement was used to quantify the incidence of swallowing of air in 20 healthy volunteers before and after a meal. Radiography was used to measure the size of the intragastric air bubble. Gastro‐oesophageal reflux was assessed by concurrent impedance and pH measurement.

Results  The rate of air swallowing was correlated to the size of the intragastric air bubble postprandially and to the rate of gaseous gastro‐oesophageal reflux. The number of air swallows and the size of the intragastric air bubble did not correlate with the number of liquid acid and non‐acid reflux episodes.

Conclusions  In healthy subjects, air swallowing promotes belching but does not facilitate acid reflux.
Effect of E. coli Nissle 1917 on post‐inflammatory visceral sensory function in a rat model
Authors: Liebregts T. , Adam B. , Bertel A. , Jones S. , Schulze J. , Enders C. , Sonnenborn U. , Lackner K. , Holtmann G.
Published: May 2005

Abstract  Objective:  Visceral hyperalgesia (VH) plays a key role for the manifestation of functional gastrointestinal (GI) disorders. In a subgroup of patients, the initial manifestation is preceded by GI inflammation. Recent studies have demonstrated an improvement of inflammation and symptoms during treatment with Escherichia coli Nissle 1917 (EcN).

Aim:  We aimed to characterize the effects of EcN on visceral sensitivity in a rat model of post‐inflammatory VH.

Methods:  Male Lewis rats underwent colorectal instillation of trinitrobenzenesulphonic acid (TNBS) plus an equal amount of ethanol (test group) or physiological saline solution (control group). After 28, 35 and 42 days, standardized colorectal distensions were performed and the visceromotor reflex (VMR) of abdominal wall muscles was quantified by electromyographic recording. From day 28 onwards, EcN was administered in drinking water.

Results:  After TNBS, a significant increase of VMR was observed compared with saline controls over all study days. Administration of EcN reduced the TNBS‐induced hyperalgesia [EcN: 863 ± 125 μV vs placebo: 1258 ± 157 μV (P < 0.05)] at day 35, while there were no significant alterations at any other study day.

Conclusion:  The EcN administration caused a significant reduction of VH. Whether EcN might play a role in the treatment of post‐infectious functional bowel disorders remains to be investigated in further studies.
Divergent role for CRF1 and CRF2 receptors in the modulation of visceral pain
Authors: Nijsen M. , Ongenae N. , Meulemans A. , Coulie B.
Published: May 2005

Abstract  Both anti‐ and pro‐nociceptive effects of corticotropin‐releasing factor (CRF) treatment on visceral pain have been reported. Here, this dual action of CRF was differentiated by selective (in)activation of the CRF1 and CRF2 receptor prior to a visceral pain stimulus. Visceral pain was evaluated out of behavioural and visceromotor (abdominal electromyogram) responses to duodenal distension in the freely moving rat. Intraperitoneal (i.p.) CRF (50 μg kg−1) increased the distension‐induced visceromotor and behavioural pain response. The pro‐nociceptive effects of CRF on the behavioural response were attenuated by a selective CRF1 (CP‐154526; 20 mg kg−1) but not a selective CRF2 [antiSauvagine30 (aSVG30); 100 μg kg−1] antagonist. Selective activation of the CRF2 receptor by stresscopin‐related peptide (SRP; i.p. 25 μg kg−1) reduced the distension‐induced visceromotor and behavioural response. Intrathecal injection of CRF (2 μg 10 μL−1) or SRP (20 μg 10 μL−1) decreased the distension‐induced visceromotor and behavioural response. The antinociceptive effects of intrathecal CRF on the behavioural response were attenuated by aSVG30 (20 μg 10 μL−1) but not with CP‐154526 (10 μg 10 μL−1). These findings indicate that the CRF1 receptor is involved in pro‐nociception of visceral pain, whereas the CRF2 receptor is mainly involved in antinociception. This divergent role of the CRF subreceptors may explain the bimodal effects of CRF treatment on visceral nociception.
The placebo effect in irritable bowel syndrome trials: a meta‐analysis1
Authors: Patel S. M. , Stason W. B. , Legedza A. , Ock S. M. , Kaptchuk T. J. , Conboy L. , Canenguez K. , Park J. K. , Kelly E. , Jacobson E. , Kerr C. E. , Lembo A. J.
Published: May 2005

Abstract  Background:  Despite the apparent high placebo response rate in randomized placebo‐controlled trials (RCT) of patients with irritable bowel syndrome (IBS), little is known about the variability and predictors of this response.

Objectives:  To describe the magnitude of response in placebo arms of IBS clinical trials and to identify which factors predict the variability of the placebo response.

Methods:  We performed a meta‐analysis of published, English language, RCT with 20 or more IBS patients who were treated for at least 2 weeks. This analysis is limited to studies that assessed global response (improvement in overall symptoms). The variables considered as potential placebo modifiers were study design, study duration, use of a run‐in phase, Jadad score, entry criteria, number of office visits, number of office visits/study duration, use of diagnostic testing, gender, age and type of medication studied.

Findings:  Forty‐five placebo‐controlled RCTs met the inclusion criteria. The placebo response ranged from 16.0 to 71.4% with a population‐weighted average of 40.2%, 95% CI (35.9–44.4). Significant associations with lower placebo response rates were fulfilment of the Rome criteria for study entry (P = 0.049) and an increased number of office visits (P = 0.026).

Conclusions:  Placebo effects in IBS clinical trials measuring a global outcome are highly variable. Entry criteria and number of office visits are significant predictors of the placebo response. More stringent entry criteria and an increased number of office visits appear to independently decrease the placebo response.
The placebo response in functional bowel disorders: perspectives and putative mechanisms
Authors: Enck P. , Klosterhalfen S.
Published: May 2005

Abstract  The nature and determinants of the placebo response are widely unknown, as are the underlying psychological and biological mechanisms. High placebo response rates in functional bowel disorders (functional dyspepsia, irritable bowel syndrome) are similar to those in non‐intestinal diseases (depression, pain, Parkinson's disease) and not too dissimilar to other organic gastrointestinal diseases (duodenal ulcer, inflammatory bowel diseases). Methodological reasons (regression to the mean, shift in signal detection through manipulation of expectations) and psycho‐biological mechanisms (Pavlovian conditioning of biological processes) are proposed to explain a large component of the response variance in clinical trials. Psychobiological mechanisms of the placebo response in functional and organic diseases can also be identified in brain function studies (such as imaging).
Is tolerance induction the answer to adolescent non‐adherence?
Authors: Dhanireddy Kiran K. , Maniscalco Jennifer , Kirk Allan D.
Published: May 2005

Abstract:  By definition, tolerance will eliminate the problem of adolescent medication non‐adherence. Although adolescents’ propensity toward non‐adherence makes them at first glance to be particularly attractive candidates for tolerance trials, there are also immunologic, psychosocial and ethical barriers that temper enthusiasm for their inclusion at present. Limits in emotional and cognitive maturity are combined during the teenage years with adult‐like immunologic maturity to lessen the potential for successful implementation of tolerance and near tolerance strategies. Alternatively, an interval step to tolerance in adolescents is to eliminate the medications most likely contributing to non‐adherence through harsh side effects such as steroids and calcineurin inhibitors. This manuscript will review the general topic of transplantation tolerance with specific attention given to the application of pro‐tolerant therapies in adolescent recipients.
Developing a worker role: Stories of four people with mental illness
Authors: Kennedy‐Jones Mary , Cooper Joanne , Fossey Ellie
Published: May 2005

Background and Aims: Work plays an important role in adults’ well‐being, irrespective of health status. Vocational rehabilitation can enable people with mental illness to return to open employment. A narrative approach was used to explore how individuals with a mental illness made sense of their work‐related experiences.

Methods and Results: Four Clubhouse members in open employment for at least 6 months completed in‐depth, semistructured interviews, from which narratives were created to reveal events, significant persons and actions that assisted these individuals to resume work. Woven into the participants’ stories were four ‘impelling forces’ contributing to a sense‐of‐self as a worker. These impelling forces were: support from significant others, the personal meaning of work, experiences within the Clubhouse programme, and the ongoing struggle with illness. Implications for occupational therapy practice are discussed.

Conclusion: The findings of this study urge occupational therapists and others to provide opportunities to provide on‐going support to people with a mental illness who seek paid employment.
Injured workers’ perspectives of their rehabilitation process under the New South Wales Workers Compensation System
Authors: Sager Lorraine , James Carole
Published: May 2005

Aim: Occupational injury and the process of rehabilitation can impact significantly on an individual's life. Research on the perspectives of injured workers, and their perceptions of the occupational therapy role, is limited.

Method: A qualitative, phenomenological study explored the experiences of six injured workers, from a large regional area health service, who had undergone occupational rehabilitation within the NSW Workers Compensation System. Data were collected through the use of in‐depth, semistructured interviews and were analysed inductively.

Results: Injured workers have a limited knowledge and understanding of the rehabilitation process, feel unsupported throughout the process, have unsatisfying return‐to‐work duties and often experience negative attitudes from key stakeholders.

Conclusion: The results highlight the opportunity for occupational therapists to increase their role within occupational rehabilitation; however, they need to adopt a more holistic approach to their practice.
Female and male occupational therapists: A comparison of their job satisfaction level
Authors: Meade Ian , Brown G. Ted , Trevan‐Hawke Judith
Published: May 2005

Aim: The purpose of this study was to compare the level of job satisfaction of a group of Queensland female and male occupational therapists.

Methods: A demographic questionnaire and theJob Descriptive Indexwere mailed to all male occupational therapists (n = 65) and selected female occupational therapists (n = 130) who were matched to the male therapists’ based on their residential address and year of graduation.

Results: The survey results indicated that female and male occupational therapists were bothvery satisfiedwith four aspects of their job: work on the job, supervision, co‐workers, and the job in general. Female and male respondents were also on average ‘moderately satisfied’ with the scale of pay. However, female therapists were significantly (P < 0.05) more dissatisfied with regard to opportunities for promotion. Potential future high attrition of both male and female occupational therapists was highlighted, with 60 per cent of the sample group indicating that they would leave the profession within 10 years.

Conclusion: The job satisfaction findings of this study will assist the occupational therapy profession to build on positive outcomes, address problem areas, and improve retention rates.
Discriminant validity of the Developmental Test of Visual–Motor Integration in relation to children with handwriting dysfunction
Authors: Goyen Traci‐Anne , Duff Sharon
Published: May 2005

Background:  The Developmental Test of Visual–Motor Integration (VMI) is commonly used to assess handwriting dysfunction in children. The relationship between handwriting and underlying abilities as measured by the VMI, beyond the writing readiness stage, is unclear. The present study examined the ability of the VMI to discriminate between children with and without handwriting dysfunction.

Methods:  As part of a larger research study, 35 children with handwriting dysfunction from grades 4–6 (as identified by their teachers) and 35 children without handwriting dysfunction were assessed with the VMI.

Results:  The VMI correctly identified only a small number of the children with handwriting dysfunction (sensitivity, 34%).

Conclusion:  The authors caution against the routine use of the VMI to assess older school‐aged children with handwriting dysfunction. Use of a model of practice and clinical reasoning is recommended to guide the assessment of children with handwriting dysfunction.
Signaling pathways in ascidian oocyte maturation: Effects of various inhibitors and activators on germinal vesicle breakdown
Authors: Lambert Charles C.
Published: May 2005

The Ascidiacea, the invertebrate chordates, includes three orders; the Stolidobranchia is the most complex. Until the present study, the onset of oocyte maturation (germinal vesicle breakdown) had been investigated in only a single pyurid (Halocynthia roretzi), in which germinal vesicle breakdown (GVBD) begins when the oocyte contacts seawater (SW); nothing was known about internal events. This study strongly suggests the importance of protein phosphorylation in this process. Herdmania pallida (Pyuridae) functions like H. roretzi; GVBD occurs in SW. Oocytes of Cnemidocarpa irene (Styelidae) do not spontaneously undergo GVBD in SW but must be activated. Herdmania oocytes are inhibited from GVBD by pH 4 SW and subsequently activated by mastoparan (G‐protein activator), A23187 (Ca2+ ionophore) or dimethylbenzanthracene (tyrosine kinase activator). This requires maturation promoting factor (MPF) activity; cyclin‐dependent kinase inhibitors roscovitine and olomoucine are inhibitory. It also entails dephosphorylation as demonstrated by the ability of the phosphatase inhibitor vitamin K3 to inhibit GVBD. GVBD is also inhibited by the tyrosine kinase inhibitors tyrphostin A23 and genistein, and LY‐294002, a phosphatidylinositol‐3‐kinase inhibitor previously shown to inhibit starfish GVBD. LY‐294002 inhibits strongly when activation is by mastoparan or ionophore but not when activated by dimethylbenzanthracene (DMBA). The DMBA is hypothesized to phosphorylate a phosphatase directly or indirectly causing secondary activation, bypassing inhibition.
Specific location of sperm mitochondria in mussel Mytilus galloprovincialis zygotes stained by MitoTracker
Authors: Obata Mayu , Komaru Akira
Published: May 2005

In Mytilidae, mitochondrial DNA (mtDNA) in the offspring is inherited from male and female parents. Sperm mitochondria are only incorporated into the testes. This phenomenon is called doubly uniparental inheritance (DUI). Sperm mitochondria should locate in the primordial germ cell during development to maintain DUI. However, the mechanism of sperm mitochondria localization is still unknown. To reveal the mechanism, we followed the location of sperm mitochondria in Mytilus galloprovincialis zygotes fertilized with sperm stained by MitoTracker. Just after fertilization, sperm mitochondria, which were found to enter eggs from various sites, remained at sperm entry point. Five sperm mitochondria located at the male pronucleus. After pronuclear expansion, sperm mitochondria migrated to the center of the egg together with the male pronucleus. At anaphase of cleavage‐I, the distribution pattern of sperm mitochondria was divided into two patterns. In pattern A, sperm mitochondria located in the equatorial region of the eggs. In pattern B, sperm mitochondria migrated and divided into two groups with chromosomes. From observations of colchicine‐treated eggs, we suggest that sperm mitochondria migration from fertilization to anaphase of cleavage‐I depends on the microtubules. The difference between pattern A and pattern B may be caused by whether sperm mitochondria migrated or not by the microtubules at cleavage‐I.
Management, Theology and Moral Points of View: Towards an Alternative to the Conventional Materialist‐Individualist Ideal‐Type of Management*
Authors: Dyck Bruno , Schroeder David
Published: May 2005

abstract Weber's (1958) argument suggests that there are four ideal‐types of management, and that conventional management is underpinned by a moral‐point‐of‐view associated with a secularized Protestant Ethic, which can be characterized by its relatively high emphasis on materialism (e.g. productivity, efficiency and profitability) and individualism (e.g. competitiveness). Weber calls on management scholars and practitioners to become aware of their own moral‐points‐of‐view, and to develop management theory and practice that de‐emphasizes materialism and individualism. Our paper responds to this challenge, as we draw from an Anabaptist‐Mennonite moral‐point‐of‐view to develop a radical ideal‐type of management that is characterized by its emphasis on servant leadership, stakeholding, job crafting and sustaincentrism. Implications for management theory and practice are discussed.
Narrating the Power of Non‐Standard Employment: The Case of the Israeli Public Sector*
Authors: Benjamin Orly , Goclaw Rona
Published: May 2005

abstract  Applying a critical discourse analysis approach, this study shows how the argument equating non‐standard employment (NSE) with organizational efficiency gains dominance over the contesting argument that views NSE as reducing organizational efficiency. We interviewed 24 senior‐level HR managers in the Israeli public sector, where NSE is used extensively, in order to shed light on the discursive order and the power struggle between these contesting arguments. Findings point to two story‐lines that helped discredit the argument in which NSE reduces organizational efficiency: (1) a statement of loyalty to organizational efficiency, accompanied by a gesture of concern for employees in non‐standard arrangements; and (2) subordinating an implied preference for eliminating NSE to organizational constraints.
Practical Idealism: An Oxymoron?
Authors: Newton Tim
Published: May 2005

abstract  Prasad and Elmes (2005) provide an appealing critique of the ways in which current ‘green’ rhetoric may be used to deliver programmes which do little to protect the natural environment. The following paper will present evidence in support of their argument through reference to recent UK government proposals for the aviation industry. At the same time, it will be suggested that there are a variety of limitations with Prasad and Elmes’ (2005) thesis, including a failure to address critique of the constructionist treatment of nature, an inappropriate use of Alvesson and Karreman's (2000) concept of mega‐discourse, and a lack of attention to the tension between idealism and praxis.
Using images to promote reflection: an action research study in Zambia and Tanzania
Authors: Miles Susie , Kaplan Ian
Published: May 2005

This paper focuses on the use of images to promote reflection and analysis of inclusive practices. The image‐based work was set in the context of a two‐year action research study, which took place in Tanzania and Zambia, 2001–2003, in collaboration with researchers from the Enabling Education Network (EENET), based at the University of Manchester's School of Education. This study, entitled, ‘Understanding Community Initiatives to Improve Access to Education’ involved the use of a wide range of processes to promote reflection, analysis and documentation, including a range of different types of images. We reflect here on the learning, which took place among the researchers in all three countries in using images as a basis for reflection on inclusive education.
Guidelines for Trials of Behavioral Treatments for Recurrent Headache, First Edition: American Headache Society Behavioral Clinical Trials Workgroup
Authors: Penzien Donald B. , Andrasik Frank , Freidenberg Brian M. , Houle Timothy T. , Lake Alvin E. , Lipchik Gay L. , Holroyd Kenneth A. , Lipton Richard B. , McCrory Douglas C. , Nash Justin M. , Nicholson Robert A. , Powers Scott W. , Rains Jeanetta C. , Wittrock David A.
Published: May 2005

Guidelines for design of clinical trials evaluating behavioral headache treatments were developed to facilitate production of quality research evaluating behavioral therapies for management of primary headache disorders. These guidelines were produced by a Workgroup of headache researchers under auspices of the American Headache Society. The guidelines are complementary to and modeled after guidelines for pharmacological trials published by the International Headache Society, but they address methodologic considerations unique to behavioral and other nonpharmacological treatments. Explicit guidelines for evaluating behavioral headache therapies are needed as the optimal methodology for behavioral (and other nonpharmacologic) trials necessarily differs from the preferred methodology for drug trials. In addition, trials comparing and integrating drug and behavioral therapies present methodological challenges not addressed by guidelines for pharmacologic research. These guidelines address patient selection, trial design for behavioral treatments and for comparisons across multiple treatment modalities (eg, behavioral vs pharmacologic), evaluation of results, and research ethics. Although developed specifically for behavioral therapies, the guidelines may apply to the design of clinical trials evaluating many forms of nonpharmacologic therapies for headache.
Proponents Bear the Burden of Proof
Authors: Emery Robert E.
Published: May 2005

Richard Gardner claimed to be able to diagnose parental alienation among contentious parents disputing custody, and asserted that his “syndrome” is supported by scientific and legal authority. Despite influencing many custody proceedings, Gardner's ideas fail to meet even minimal scientific standards. The burden of proving any new hypothesis falls on its proponents, and given the complete absence of objective replication, parental alienation syndrome (PAS) must be viewed as nothing more than a hypothesis. The lack of clear guidance in the law allows concepts like PAS to gain temporary credibility, as judges look to mental health professionals for help in making decisions under the vague best interests standard.
DIVORCE MEDIATION:  Research and Reflections
Authors: Emery Robert E. , Sbarra David , Grover Tara
Published: May 2005

Mediation and other forms of alternative dispute resolution (ADR) grew rapidly in the last few decades as a result of high divorce rates, frequent conflicts between parting parents, the resulting administrative burden on courts, and especially concerns about damaging effects on children and postdivorce family relationships. This article focuses on our longitudinal research involving randomized trials of mediation and adversary settlement to support the conclusions that mediation can: (1) settle a large percentage of cases otherwise headed for court; (2) possibly speed settlement, save money, and increase compliance with agreements; (3) clearly increase party satisfaction; and (4) most importantly, lead to remarkably improved relationships between nonresidential parents and children, as well as between divorced parents—even twelve years after dispute settlement. The key “active ingredients” of mediation are likely to include: (1) the call for parental cooperation over the long run of co‐parenting beyond the crisis of separation, (2) the opportunity to address underlying emotional issues (albeit briefly), (3) helping parents to establish a businesslike relationship, and (4) the avoidance of divisive negotiations at a critical time for family relationships. We call for more research on mediation and other forms of ADR, as well as a renewal of the excitement and optimism of the “first generation” of mediators, qualities that are “active ingredients” in any successful social or psychological intervention.
THE COLLABORATIVE DIVORCE PROJECT:  A Court‐Based Intervention for Separating Parents with Young Children
Authors: Pruett Marsha Kline , Insabella Glendessa M. , Gustafson Katherine
Published: May 2005

The role the legal process of separation and divorce plays in affecting outcomes for young children and their families was examined in the Collaborative Divorce Project (CDP), an intervention designed to assist the parents of children six years old or younger as they begin the separation/divorce process (married and unmarried couples). Evaluation and outcome data were collected from 161 couples, their attorneys, teachers, and court records. In addition to positive evaluations from both parents, intervention families benefited through lower conflict, greater father involvement, and better outcomes for children than the control group. Attorneys and court records indicate that intervention families were more cooperative and were less likely to need custody evaluations and other costly services. The CDP illustrates how prevention programs can be located within the courts, can be systematically evaluated, and can aid in helping the legal system function optimally for families with young children.
FOSTERING RESILIENCE IN THE AFTERMATH OF DIVORCE:  The Role of Evidence‐Based Programs for Children
Authors: Pedro‐Carroll JoAnne L.
Published: May 2005

The negative impact of divorce is a concern with far‐reaching ramifications for children's well‐being. This article reviews divorce‐related risks and protective factors that provide an empirical guide for the content of effective programs for children. The promising potential of child‐focused interventions is highlighted, including examples of programs with evidence of effectiveness. The Children of Divorce Intervention Program is described in greater detail as an example of a preventive program with six controlled studies documenting multiple benefits to children, including reductions in anxiety, behavior problems, somatic symptoms, and increases in their healthy adjustment at home and at school. A vision for future research and practice is discussed, including best practices for adapting children's programs to court‐connected services and a paradigm shift involving systematic preventive outreach to all separating parents with minor children, before difficulties become rooted and chronic.
PROGRAMS FOR PROMOTING PARENTING OF RESIDENTIAL PARENTS:  Moving From Efficacy to Effectiveness
Authors: Wolchik Sharlene A. , Sandler Irwin N. , Winslow Emily , Smith‐Daniels Vicki
Published: May 2005

This article reviews prevention programs that target primary residential parents as change agents for improving children's postdivorce adjustment. First, we review parental risk and protective factors for children from divorced families, including parenting quality, parental mental health problems, interparental conflict, and contact with the nonresidential parent. Following a discussion of brief informational interventions, we describe the findings of evaluations of three multisession, skill‐building interventions for divorced parents. Impressive evidence is presented that parenting is a modifiable protective factor and that improving parenting leads to improvements in children's postdivorce adjustment. We then discuss, in greater detail, the New Beginnings Program, which we highlight because it has shown repeated, immediate effects on children's mental health outcomes as well as long‐term effects on a wide array of other meaningful outcomes, such as diagnosis of mental disorder in the past year, externalizing problems, alcohol and drug use, and academic performance. Also, mediational analyses have shown that program‐induced changes in parenting accounted for changes in mental health outcomes. The remainder of the article describes a research and action agenda that is needed to successfully implement the New Beginnings Program in domestic relations courts.
PREVENTION PROGRAMS FOR DIVORCED NONRESIDENT FATHERS
Authors: Braver Sanford L. , Griffin William A. , Cookston Jeffrey T.
Published: May 2005

Divorced nonresident fathers are a promising target for preventive efforts to assist families after divorce. The research literature suggests that such programs should focus both on the frequency and the quality of the child's contact with the father, as well as the quality of postdivorce mother–father relations. Dads For Life (DFL) is the program for this target group with the most convincing evidence of preventive effects. This eight‐week program centers on professionally made videos. It was tested in a randomized trial with 214 families. In comparison to control families, children in families in which the father participated in DFL had significantly lower internalizing problems. The preventive impact of DFL was strongest for the most troubled youngsters.
INTERPARENTAL CONFLICT AS A RISK FACTOR FOR CHILD MALADJUSTMENT:  Implications for the Development of Prevention Programs
Authors: Grych John H.
Published: May 2005

This article reviews research on the effects of interparental conflict on children and examines its implications for divorce education programs designed to reduce conflict after divorce. Basic research indicates that prevention programs for parents will be most effective in fostering children's adaptation to divorce if they can reduce the level of destructive conflict that children are exposed to, foster good parent–child relationships, and keep children from being caught in the middle of parental tensions and disagreements. Programs for children are likely to be most helpful if they help children learn ways to cope with situations in which they feel pressured to side with one parent against the other and avoid feeling responsible for parental problems. Although psycho‐educational programs are widely available and often court‐mandated, evaluation studies are rare and support for their efficacy is mixed.
SENSITIZING PARENT EDUCATION PROGRAMS TO DOMESTIC VIOLENCE CONCERNS: The Perspective of the New York State Parent Education Advisory Board
Authors: Frazee Hon. Evelyn
Published: May 2005

Education programs for divorcing and separating parents are a valuable vehicle for providing to parents the awareness, knowledge, and skills that can lead to a smoother transition and healthier outcomes for their children. Attention to safety concerns in referral guidelines, administrative protocols, and curriculum content is integral to the efficacious and responsible delivery of parent education. This article examines the recent experience of New York State in developing guidelines for safety and quality assurance in parent education programs.
Spatial and temporal distribution of herbicides and herbicide degradates in a shallow glacial drift aquifer/surface water system, south‐central Michigan
Authors: Unterreiner Gerald A. , Kehew Alan E.
Published: May 2005

Herbicide and herbicide degradate compounds were measured in tile drains, monitoring wells, domestic wells, and in the receiving stream at a farm in south‐central Michigan, in which corn, soybeans, and livestock are the major products. Immunoassay screens of two herbicide groups (triazines and alachlor) in 2000 showed a decrease in the number of detections from June to September, after the well‐known spring flush, of 48% to 26% for alachlor and 62% to 22% for the triazines. Gas chromatography/mass spectrometry and liquid chromatography/mass spectrometry analyses of 2001 samples documented a fall flush as well, mobilizing relatively high levels of both parent and degradate compounds to the tile drain system. The compounds included both metolachlor and atrazine, which were applied on the farm earlier that year, as well as the degradates of alachlor, which had not been applied on the farm for several years. In four tile drain samples, metolachlor was detected at concentrations ranging from 18 to 25 μg/L, whereas atrazine ranged from nondetect to 2.25 μg/L. Contrary to previous studies, metolachlor concentrations were higher than metolachlor ethane sulfonic acid, by a factor of 3 to 7. The high soil permeability, high water table, and shallow screened intervals of monitoring wells directly below the point of application may explain the lesser degree of breakdown at the point of sampling. Although most detections were below maximum contaminant level or health advisory levels, the unknown effects of degradates and the aggregate levels of compounds measured in many samples may pose higher health risks than for individual compounds.
Evidenced‐Based Use of Botanicals, Minerals, and Vitamins in the Prophylactic Treatment of Migraines
Authors: Rios Juanita , Passe Megan M.
Published: May 2005

Purpose

To analyze evidence‐based information about alternative prophylactic pharmacological migraine treatments utilizing feverfew, butter‐bur, magnesium, and riboflavin and to discuss the mechanism of action, dosage recommen‐dations, side effects, and contraindications for each treatment.

Data Sources

Data obtained via electronic databases and professional medical references.

Conclusions

Current clinical data support the use of feverfew, butterbur, magnesium, and riboflavin in migraine prophylaxis; however, studies are limited but promising regarding the participants’ perceived relief. Studies with rigorous methodologies and larger sample sizes are needed to further support the safe and effective use of these treatments.

Implications for Practice

With increased patient access to information regarding alternative migraine treatments, nurse practitioners (NPs) and other health care providers must be knowledgeable about evidence‐based data regarding these alternative treatments to appropriately offer safe patient care.
Perceived Stress Reported by Nurse Practitioner Students
Authors: Maville Janice A. , Tucker Barbara A. , Kranz Peter L.
Published: May 2005

Purpose

To explore the phenomenon of stress as perceived by nurse practitioner (NP)students enrolled in a master of science in nursing program.

Data Sources

The study utilized a qualitative approach for data collection and analysis consistent with grounded theory methodology. We recruited 12 students,4 men and 8 women, during their final year of a university‐based NP program. Data were collected through individual interviews and a demographic questionnaire.

Conclusions

Students reported stress levels ranging from moderate to highest ever in their lives. Although reasons given for becoming an NP included increased autonomy and increased ability, high‐level stress was attributed to high demands and to independent teaching‐learning techniques in the NP courses. Participants also expressed concerns about time management and financial obligations.

Implications for Practice

Knowledge of NP students 'perceptions regarding personal stress can provide insight useful for developing approaches to foster optimum learning.Practicing stress reduction techniques with students would not only facilitate their own stress reduction but would also reinforce their ability to assist clients with this need.
What Is the Nature of Nurse Practitioners’ Lived Experiences Interacting With Patients?
Authors: Kleiman Susan
Published: May 2005

Purpose

To illuminate the nature of the lived experiences of nurse practitioners (NPs)interacting with patients, to discover the essential meanings of those lived experiences, and to articulate a structure gleaned from the essential meanings.

Data Sources

Six NPs provided concrete descriptions of their experiences interacting with patients. Data were collected and analyzed using a descriptive, phenomenological method of inquiry.

Conclusions

The data revealed eight essential meanings for interacting with patients: openness, connection, concern, respect, reciprocity, competence, time, and professional identity. The nature of NPs’ lived experiences interacting with patients is an authentic attending to health‐related concerns, originating and enduring within the context of an intersubjective relationship. Through the dialogues that evolve within the context of intersubjective relationships, both NPs and patients become more as persons, amenable to understanding the meanings each has assigned to his or her life‐world situations, regardless of the outcomes of any health‐related interventions.

Implications for Practice

The NPs in this study valued the relationships that ensued from their interactions with patients. From these relationships they derived both personal and professional growth. Intersubjective relating is the “art of nursing” for the participants in this study.
Osteoporosis Prevention Starts in Adolescence
Authors: Schettler Andrea Ellse , Gustafson Elalne M.
Published: May 2005

Purpose

To review the factors that influence the development of osteoporosis later in life, to relate those factors to adolescent health behaviors, and to provide nurse practitioners (NPs) with information on which to base evaluation and management decisions in primary care.

Data Sources

Review of selected scientific literature with a focus on adolescent health and osteoporosis.

Conclusions

Osteoporosis is a major public health concern that affects more than 10 million people in the United states, resulting in annual costs to our health care system in excess of $13. 5 billion. Approximately 40% of women will experience a fracture due to osteoporosis. NPs should aim osteoporosis prevention efforts toward adolescents by encouraging habits that promote bone growth and development.

Implications for Practice

It is imperative that female adolescents achieve adult peak bone mass prior to the age of 30, and the bone‐building years before the age of 18 are especially important.NPs are ideally positioned to provide the screening and counseling to ensure that adolescents have the best chance to develop the habits that will result in peak adult bone mass.
Caring Behaviors As Perceived by Nurse Practitioners
Authors: Green Ann
Published: May 2005

Purpose

To investigate nurse practitioners' (NPs') perceptions of their own caring behaviors and to examine NPs' demographics as a function of their caring behaviors.

Data Sources

Responses to the Caring Behaviors Inventory (CBI) and a demographic inquiry from 348 NPs in Louisiana.

Conclusions

CBI mean scores and subscale scores were high for all 348 NPs. No statistically significant difference was found between male NPs’ and female NPs’ total mean CBI scores or between urban or rural total mean CBI scores. The interaction between nurse gender and area of practice was not statistically significant.

Implications for Practice

NPs often work in clinic situations where productivity is the most valued characteristic and where little time is afforded for identifying caring behaviors of the NP and/or establishing a caring relationship with the patient. NPs must be extremely conscious of the need not to “throw out the baby with the bathwater” and sacrifice characteristics that are inherent in nursing for those emphasized in primary care practice.As their responsibilities in the health care setting continue to expand, NPs must continually evaluate and validate their roles to ensure quality care that satisfies patients.
Obesity and Physical Activity in College Women: Implications for Clinical Practice
Authors: Clement Jacquelyn M. , Schmidt Cynthia A. , Bernaix Laura W. , Covington N. Kay , Carr T. R.
Published: May 2005

Purpose

To investigate the relationships between levels of physical activity, health attitudes and behaviors, and specific health indicators in women attending college.

Data Sources

A convenience sample of 116 college women, ages 18 to 24 years, participated in this research study at a moderate‐sized midwestern university.The data were obtained through self‐administered questionnaire; trained technicians collected physiological measurements.

Conclusions

The young women in this study had, on average, normal body mass indexes (BMIs) and reported activity levels consistent with or greater than the Centers for Disease Control and Prevention/American College of Sports Medicine guidelines. Items used to assign participants into the appropriate stage of the transtheoretical model of change were correlated with participants’ perceived personal physical activity levels. Similarly, the participants, whose scores fell in the higher stages of the transtheoretical model, reported greater levels of physical activity; consumption of more fruits, vegetables, and water; and less consumption of high‐fat/high‐calorie foods.

Implications for Practice

The years between ages 18 and 24 are a critical time in the lives of young women.During this period, they develop physical activity and nutrition habits that will affect their health across the life span. Because of the sometimes insidious development of major health problems, young women's current health status may not accurately reflect the possible longterm results of negative health habits. Nurse practitioners (NPs) have many opportunities to identify and address major factors that, if unattended, may threaten the life‐long health status of women. Health teaching in the areas of physical activity and dietary habits may be useful even in young women who appear to be healthy, are of normal weight, and are physically active.Poor dietary habits, if unattended, may eventually contribute to the development of obesity and related illnesses.
Characteristics of and Problems With Primary Care Interactions Experienced by an Ethnically Diverse Group of Woman
Authors: Alexander Ivy M.
Published: May 2005

Purpose

To reflect women's voices as they discussed characteristics of health care interactions and spontaneously identified problems in primary care interactions.

Data Sources

Five successive meetings with an ethnically diverse group of eight women were held to discuss primary care interactions with nurse practitioners. Field notes, seating charts, participant interaction notations, session transcripts, and audiotapes were repeatedly reviewed to identify significant statements. These were grouped into common categories to identify essential themes. Results were validated with participants.

Conclusions

Components of primary care interactions included the process of making an appointment, access to the clinic, comfort of the waiting area and clinic rooms, and interactions with staff and clinicians. Problems were identified with interactions. The overarching issue was a lack of caring — a pervasive attitude demonstrated when clinicians failed to show concern, did not listen, were not trustworthy, or treated the women with disrespect or prejudice.

Implications for Practice

The women strongly valued caring clinicians. Caring, according to these women, is demon‐strated when clinicians treat women as equals and show respect for their individual knowledge and life experiences.
Critique of The American Cancer Society Guidelines for Breast Cancer Screening: Update 2003
Authors: Goolsby Mary Jo , Ricalde Leilani
Published: May 2005

The American Cancer Society Guidelines for Breast Cancer Screening: Update 2003 was obtained through the National Guideline Clearinghouse Web site and was critiqued for potential incorporation into practice. The updated guidelines address screening mammography, physical examination, and new technologies and describe how these may be applied to women at average risk, women at high risk, and older women. The new guidelines emphasize educating women and having them take a more active role in decision making.
Obesity in Youth: Implications for the Advanced Practice Nurse in Primary Care
Authors: Berry Diane , Galasso Pamela , Melkus Gail , Grey Margaret
Published: May 2005

Purpose

To discuss the advanced practice nurse's diagnosis and management of obesity in youth in primary care.

Data Sources

Review of current scientific literature, practice guidelines, and a case study.

Conclusions

Obesity in youth is difficult to manage. Recent research suggests a genetic and environmental etiology associated with impaired glucose tolerance, type 2 diabetes, hypertension, hyperlipidemia, and hypertriglyceridemia. Nutrition education, increasing physical activity, decreasing sedentary behaviors, and behavioral modification have been used with varying success. Management is directed at healthy lifestyle behavior change for youth and their families.

Implications for Practice

If obesity, impaired glucose tolerance, hypertension, hypercholesterolemia, and hypertriglyceridemia are left untreated, youth may develop type 2 diabetes and coronary artery disease later in life and suffer early morbidity and mortality.