bluuebunny/crossref_metadata_2025 huggingface dataset:
Attitudes towards, and information needs in relation to, supplementary nurse prescribing in the UK: an empirical study
Authors: Berry Dianne , Courtenay Molly , Bersellini Elisabetta
Published: January 2006

Aims and objectives.  The main aim of the study is to assess the views of people, who have not yet experienced nurse prescribing, to determine their level of confidence in nurse as opposed to doctor prescribing, effects on likely adherence and concerns that they might have. Additionally, the extent to which people would want nurses to provide an explanation for medicine choice and the type of information wanted was examined.

Background.  Nurse prescribing has been successfully implemented in the UK in a number of healthcare settings. Existing research has not addressed effects on people's confidence and likely adherence, nor have people's information needs been established. However, we know that inadequate medicines information provision by health professionals is one of the largest causes of patient dissatisfaction.

Methods.  A convenience sample of 74 members of the general population self‐completed a written questionnaire.

Results.  In general, people would have confidence in the nurse having prescribed the best medicine and say that they would be very likely to take the medicine. Concerns identified did not specifically relate to the nurses’ status. Support is provided for the importance of nurses providing a full explanation about medicines, and some indication about which categories of information should be included. Information about medication side effects was most wanted by participants.

Conclusions.  Independent and Supplementary Prescribing are pivotal to modernizing the NHS. The current study establishes people's initial views and concerns about nurse prescribing and assesses information needs. Support for initiating follow‐on studies with particular patient groups is also provided.

Implications for clinical practice.  People who have not yet experienced nurse prescribing are, in general, positive about nurses adopting this role. It is important that nurses provide appropriate information about the prescribed medicines, in a form that can be understood. This should include information about medication side effects.
Verbal short‐term memory in individuals with congenital articulatory disorders: new empirical data and review of the literature
Authors: Carlesimo G. A. , Galloni F. , Bonanni R. , Sabbadini M.
Published: January 2006

Background  To investigate the nature of the articulatory rehearsal mechanism of the Articulatory Loop in Baddeley's Working Memory model, it seems particularly important to study individuals who developed a deficit (dysarthria) or total abolition (anarthria) of the ability to articulate language following a cerebral lesion.

Method  In this study, a forced‐choice recognition procedure for word sequences of increasing length was used to evaluate verbal short‐term memory in nine individuals with severe congenital motor and verbal disabilities (seven anarthric and two severely dysarthric) and associated intellectual disability (ID) and 30 normal children of comparable mental age.

Results  The normal children exhibited classical phonological similarity effects (better performance on acoustically dissimilar than on similar word lists), word length (greater accuracy on two‐syllable than on four‐syllable word lists) and frequency of occurrence (an advantage of high‐frequency over low‐frequency words). Instead, all of these effects were lacking in the experimental group.

Conclusions  These data suggest that persons with congenital anarthria/dysarthria and ID present defective maturation at many levels of the Articulatory Loop and reduced contribution of semantic‐lexical processing in the temporary retention of phonological sequences. It is likely that in these individuals both communicative deficits and ID play a role in the impaired development of verbal short‐term memory abilities.
In vitro tests for evaluation of the hatchability of the eggs of Psoroptes mites following exposure to acaricidal compounds
Authors: Lekimme M. , Mignon B. , Leclipteux T. , Tombeux S. , Marechal F. , Losson B.
Published: January 2006

Abstract.  Three in vitro assays for the evaluation of the hatchability of the eggs of the mite Psoroptes ovis (Hering) (Acari: Psoroptidae) are described. Preliminary trials showed that hatching occurs at very high rates when eggs are incubated under conditions of high humidity, on a liquid medium and in agarose dishes. These three protocols were compared, taking into account the ease of preparation, follow‐up and accuracy of counting. The best protocol was found to be the use of agarose dishes. It was accurate, easy to carry out and reproducible for further evaluation of existing or potentially new compounds against both adults and eggs of Psoroptes spp. The acaricidal properties of phoxim and amitraz were then evaluated against eggs and adults using the three protocols. Results showed that for both drugs, in vitro adulticidal activity was complete, whereas the in vitro ovicidal activity was only partial. Nevertheless, efficacy of amitraz against both adults and eggs was shown to be higher than that of phoxim.
Phylogeography and population genetics of the maize stalk borer Busseola fusca (Lepidoptera, Noctuidae) in sub‐Saharan Africa
Authors: SEZONLIN M. , DUPAS S. , LE RÜ B. , LE GALL P. , MOYAL P. , CALATAYUD P.‐A. , GIFFARD I. , FAURE N. , SILVAIN J.‐F.
Published: January 2006

The population genetics and phylogeography of African phytophagous insects have received little attention. Some, such as the maize stalk borer Busseola fusca, display significant geographic differences in ecological preferences that may be congruent with patterns of molecular variation. To test this, we collected 307 individuals of this species from maize and cultivated sorghum at 52 localities in West, Central and East Africa during the growing season. For all collected individuals, we sequenced a fragment of the mitochondrial cytochrome b. We tested hypotheses concerning the history and demographic structure of this species. Phylogenetic analyses and nested clade phylogeographic analyses (NCPA) separated the populations into three mitochondrial clades, one from West Africa, and two — Kenya I and Kenya II — from East and Central Africa. The similar nucleotide divergence between clades and nucleotide diversity within clades suggest that they became isolated at about the same time in three different refuges in sub‐Saharan Africa and have similar demographic histories. The results of mismatch distribution analyses were consistent with the demographic expansion of these clades. Analysis of molecular variance (amova) indicated a high level of geographic differentiation at different hierarchical levels. NCPA suggested that the observed distribution of haplotypes at several hierarchical levels within the three major clades is best accounted for by restricted gene flow with isolation by distance. The domestication of sorghum and the introduction of maize in Africa had no visible effect on the geographic patterns observed in the B. fusca mitochondrial genome.
Integrating biogeographic and genetic approaches to investigate the history of bioluminescent colour alleles in the Jamaican click beetle,Pyrophorus plagiophthalamus
Authors: VELEZ SEBASTIAN , FEDER JEFFREY L.
Published: January 2006

Bioluminescent colour in the Jamaican click beetle,Pyrophorus plagiophthalamus, is an ideal system for studies moving from gene to landscape to gain a holistic understanding of the molecular, ecological, and historical bases for adaptation. Previous studies have established the genetics of bioluminescent colour variation in the beetle to the level of the nucleotide base pair in the target geneluciferase. Three differentluciferasecolour alleles affecting ventral light organ colour [yellow‐green (vYG), yellow (vYE), and orange (vOR)] were found segregating inP. plagiophthalamuspopulations. These alleles differ from each other in a number of replacement mutations (14 total), the majority of which (11) have a measurable effect on colour. Phylogenetic analysis revealed a long‐term adaptive trend on Jamaica towards longer wavelength bioluminescence, culminating in the most recently derived vOR allele. Here, we further investigate the historical and geographic context of adaptive colour evolution by testing a vicariance model for the origins of the extant ventral light organ polymorphism: that the vOR allele arose and differentiated in an isolated deme on the east side of Jamaica before spreading westward. Comparisons of colour phenotypes,luciferasecoding sequences, the third intron of the gene, mtDNA, and microsatellite data provided evidence for past population subdivision on Jamaica and ongoing gene flow, as has been found for other island endemics. However, the pattern of differentiation supported the allopatric divergence of vYG and vYE alleles. The vOR gene appears to have arisen relatively recently from a vYE precursor and postdates the period of major biogeographic isolation.We discuss the implications of the results for discerning ecological causation in the adaptive sequence from nucleotide to landscape to population change for bioluminescent colour.
Effects of an osmotically active agent on colonic transit
Authors: Skoog S. M. , Bharucha A. E. , Camilleri M. , Burton D. D. , Zinsmeister A. R.
Published: January 2006

Abstract  It is unknown if sorbitol, a widely used laxative agent, accelerates colonic transit, and if these effects are modified by concomitant meal ingestion. Colonic transit was assessed by 111In scintigraphy in 40 healthy subjects. After a 24‐h scan, subjects received sorbitol (30 mL of 70% solution) or dextrose (30 mL of 70% solution), administered with or without a meal. Colonic transit, breath hydrogen excretion, and symptom scores were recorded for 4 h thereafter. VAS scores for flatulence, but not other symptoms increased (P = 0.004) by 13.1 ± 6.3 mm (mean ± SEM) on a 100 mm scale after sorbitol alone or sorbitol with a meal (by 18.9 ± 7.2 mm), but not after dextrose. After adjusting for GC24, sorbitol accelerated (P < 0.001) colonic transit (GC28 = 3.0 ± 0.3) compared with dextrose (GC28 = 2.2 ± 0.2), regardless of meal ingestion. Breath hydrogen excretion was correlated with the change in colonic transit (r = 0.52, P < 0.01) and with flatulence (r = 0.45, P = 0.003) after sugar ingestion. In healthy subjects, sorbitol accelerated colonic transit and increased flatulence but not other symptoms within 4 h, regardless of meal intake.
Apical vulnerability to dendritic retraction in prefrontal neurones of ageing SAMP10 mouse: a model of cerebral degeneration
Authors: Shimada A. , Tsuzuki M. , Keino H. , Satoh M. , Chiba Y. , Saitoh Y. , Hosokawa M.
Published: January 2006

The SAMP10 mouse is a model of accelerated ageing in which senescence is characterized by age‐related atrophy of the cerebral cortex and limbic structures, poor learning and memory task performance with depressive behaviour and cholinergic and dopaminergic alterations. Here we studied age‐related changes in the dendritic arbors and spine density of pyramidal cells in the medial prefrontal cortex of SAMP10 mice using a quantitative Golgi method. Dendrites of prefrontal neurones gradually retracted with ageing towards the soma with the relative preservation of overall complexity. Apical dendrites were much more severely affected than basal dendrites. The combined length of the apical dendrites and spine density were decreased by 45% and 55%, respectively, in mice at 12 months, compared with mice at 3 months of age. Immunohistochemical and immunoblot analyses indicated that expression of microtubule‐associated protein (MAP) 2, a marker of dendrites, decreased in an age‐related manner not only in the anterior cortex but also in the posterior cortex and olfactory structures in SAMP10 mice. Decreased expression of MAP2 mRNA caused the decrease in MAP2 protein expression. These results suggest that retraction of apical, but not of basal dendrites, with a loss of spines in prefrontal neurones, appears to be responsible for poor learning and memory performance in aged SAMP10 mice. It is also suggested that age‐related dendritic retraction occurs in a wide area including the entire cerebral cortex and olfactory structures.
PECAM‐1 and gelatinase B coexist in vascular cuffs of multiple sclerosis lesions
Authors: Nelissen I. , Gveric D. , Van Noort J. M. , Cuzner M. L. , Opdenakker G.
Published: January 2006

In multiple sclerosis (MS), the matrix metalloprotease (MMP) gelatinase B/MMP‐9 and platelet endothelial cell adhesion molecule (PECAM)‐1 have both been implicated in trans‐endothelial infiltration of leucocytes into the brain, but their functional connection has not yet been investigated. We investigated the expression of gelatinase B and PECAM‐1 in  post mortem brains of MS patients by immunohistochemistry. Because increased soluble PECAM‐1 serum levels have been observed in MS patients, we also tested in vitro whether this could be due to cleavage of PECAM‐1 by gelatinase B or matrilysin‐1/MMP‐7. Constitutive expression of PECAM‐1 was found on brain endothelial cells, whilst in active MS lesions cell‐bound PECAM‐1 was highly up‐regulated on foamy macrophages in perivascular infiltrates and co‐localized with gelatinase B. However, human THP‐1 monocyte‐bound or soluble recombinant PECAM‐1 were both resistant to proteolytic cleavage by gelatinase B or matrilysin‐1 in vitro, as demonstrated by Western blot analysis and flow cytometry. These results suggest that PECAM‐1 and gelatinase B may complement each other during the transmigration of the blood–brain barrier by mononuclear cells.
Canid immunity toEchinococcusspp.: impact on transmission
Authors: TORGERSON P. R.
Published: January 2006

The canid intestinal immune system recognizes the cestode parasiteEchinococcusfollowing infection, but it is still unclear the extent to which protection against reinfection occurs. An increasing number of studies have shown that there are convex age‐related abundance or prevalence rates in naturally infected populations of dogs withE. granulosusand foxes infected withE. multilocularis.Data from dogs naturally infected withE. granulosusgive a better fit to a model that incorporates herd immunity compared to competing models of age‐related changes in infection pressure. A theoretical framework suggests that such herd immunity will act as a stabilizing force forEchinococcuspopulations. Hence a decrease in infection pressure to dogs or foxes will not result in a corresponding decrease in infection pressure to intermediate hosts or to humans. In addition the age structure of the canid population could affect transmission.
Comparison of allergenicity and allergens between fish white and dark muscles
Authors: Kobayashi A. , Tanaka H. , Hamada Y. , Ishizaki S. , Nagashima Y. , Shiomi K.
Published: January 2006

Background:  Fish is one of the most frequent causes of immunoglobulin E (IgE)‐mediated food allergy. Although the fish dark muscle is often ingested with the white muscle, no information about its allergenicity and allergens is available.

Methods:  Heated extracts were prepared from both white and dark muscles of five species of fish and examined for reactivity with IgE in fish‐allergic patients by enzyme‐linked immunosorbent assay (ELISA) and for allergens by immunoblotting. Cloning of cDNAs encoding parvalbumins was performed by rapid amplification cDNA ends. Parvalbumin contents in both white and dark muscles were determined by ELISA using antiserum against mackerel parvalbumin.

Results:  Patient sera were less reactive to the heated extract from the dark muscle than to that from the white muscle. A prominent IgE‐reactive protein of 12 kDa, which was detected in both white and dark muscles, was identified as parvalbumin. Molecular cloning experiments revealed that the same parvalbumin molecule is contained in both white and dark muscles of either horse mackerel or Pacific mackerel. Parvalbumin contents were four to eight times lower in the dark muscle than in the white muscle.

Conclusions:  The fish dark muscle is less allergenic than the white muscle, because the same allergen molecule (parvalbumin) is contained at much lower levels in the dark muscle than in the white muscle. Thus, the dark muscle is less implicated in fish allergy than the white muscle.
Diagnosis of neuromuscular blocking agent hypersensitivity reactions using cytofluorimetric analysis of basophils
Authors: Kvedariene V. , Kamey S. , Ryckwaert Y. , Rongier M. , Bousquet J. , Demoly P. , Arnoux B.
Published: January 2006

Background:  Immunoglobulin E (IgE)‐mediated hypersensitivity reactions to neuromuscular blocking agents (NMBA) are common and life threatening. Basophil activation based upon the expression of CD63 in the presence of specific allergens was found to be of importance for the diagnosis of IgE‐mediated hypersensibility.

Methods:  The Basotest® was evaluated for the diagnosis of NMBA in 47 patients with proven NMBA anaphylaxis, 40 atopic subjects nonallergic to NMBA and five healthy volunteers. Diagnosis of NMBA was made according to international standards on clinical history, skin tests and provocation tests when needed.

Results:  In the NMBA allergic patients, sensitivity of Basotest® was 36.1%, but it increased to 85.7% for reactions which occurred within the last 3 years. The specificity was 93.3%.

Conclusion:  Basotest® may be useful for the diagnosis of NMBA allergy in patients with a suspicion of recent IgE‐mediated hypersensitivity reaction to NMBA.
Basophil allergen threshold sensitivity: a useful approach to anti‐IgE treatment efficacy evaluation
Authors: Nopp A. , Johansson S. G. O. , Ankerst J. , Bylin G. , Cardell L. O. , Grönneberg R. , Irander K. , Palmqvist M. , Öman H.
Published: January 2006

Background:  Monitoring of the allergen sensitivity of a patient is most important for optimal patient care and a basic prerequisite for immunomodulating treatment. The objective of this study was to investigate how basophil allergen sensitivity can be applied in the monitoring of anti‐immunoglobulin E (IgE) treatment.

Methods:  Basophils from timothy grass pollen allergic patients were, by flow cytometry, analysed for allergen threshold sensitivity (CD‐sens) by measuring CD63 up‐regulation on CD203c‐identified basophils. The results were compared with maximal percentage CD63 up‐regulation at one allergen dose (CD‐max), skin prick test end‐point allergen titration, (SPT‐sens), nasal provocation titration tests (nasal provocation titre) and serum IgE and IgE antibody concentrations.

Results:  There was a significant correlation (r = 0.50, P = 0.01) between CD‐sens and SPT‐sens, CD‐sens and the IgE antibody concentration in percentage of ‘total IgE’ (relative IgE antibody concentration) (r = 0.72, P < 0.001) as well as between CD‐sens and nasal provocation titre (r = 0.54, P < 0.05) but, in contrast, CD‐max did not correlate with any of the sensitization parameters, i.e. SPT‐sens, nasal provocation titre, absolute and relative IgE antibody concentration or CD‐sens. CD‐sens could be used to monitor omalizumab treatment efficacy while, based on CD‐max, four of seven symptom‐free patients on omalizumab would have been classified as having ongoing allergy.

Conclusions:  CD‐sens seems to be very useful for the determination of a patient's allergen sensitivity and should be evaluated for the measurement and monitoring of anti‐IgE treatment efficacy. CD‐max, the conventional approach to basophil allergen challenge, which mirrors cell reactivity, gives incorrect information.
Strong allergic patch test reactions may indicate a general disposition for contact allergy
Authors: Brasch J. , Schnuch A. , Uter W. ,   German Contact Dermatitis Research Group (DKG) and the Information Network of Departments of Dermatology (IVDK)
Published: January 2006

Background:  Patch test patients have two or more positive reactions to unrelated allergens more often than to be expected by chance. This study evaluates synchronous patch test reactions to test the hypothesis that in such cases an allergen‐independent disposition for contact sensitization may be involved.

Methods:  Data of 87 834 patients tested with a standard patch test series in 42 centers of a Central European Network were retrospectively evaluated. Analyses were done for synchronous positive reactions of graded strength to nickel sulfate, fragrance mix, and to those five allergens that followed in frequency of positive results. All seven allergens selected were not related by chemical structure or exposure. Descriptive univariate and bivariate analyses as well as a polytomous logistic regression analysis were performed. Odds ratios with 95% confidence intervals were calculated.

Results:  With an increasing strength of a positive reaction to nickel or to fragrance mix the likelihood of further positive reactions to unrelated contact allergens increased significantly, and the mean strength of such additional reactions raised steadily with an increasing strength of a nickel or fragrance reaction.

Conclusions:  Our findings support the idea that patients who respond with a strong patch test reaction may have a particular general disposition to acquire contact sensitivity to additional unrelated allergens. They should therefore not only be advised to avoid their known allergen but in addition to minimize exposure other contact allergens.
Parallel evolution of the sexes? Effects of predation and habitat features on the size and shape of wild guppies
Authors: Hendry A. P. , Kelly M. L. , Kinnison M. T. , Reznick D. N.
Published: January 2006

Environmental gradients often lead to the parallel evolution of populations and species. To what extent do such gradients also lead to parallel evolution of the sexes? We used guppies (Poecilia reticulata) to examine the parallel and independent (sex-specific) aspects of population divergence in response to predation and habitat features. Geometric morphometrics was used to analyse size and shape variation for 1335 guppies from 27 to 31 sites sampled in each of 2 years. Body size showed strong parallel population divergence; both sexes were larger at sites with a more open canopy and with higher flow. Body shape showed a mixture of parallel and independent population divergence. The strongest and most consistent effects were (1) high-predation sites had males with smaller heads and deeper caudal peduncles, (2) open-canopy sites had females with smaller heads and more distended abdomens and (3) high-flow sites had males and females with smaller heads and deeper caudal peduncles.
Genetically idiosyncratic responses of Drosophila melanogaster populations to selection for improved learning ability
Authors: Kawecki T. J. , Mery F.
Published: January 2006

To what extent is adaptive evolution over short timescales repeatable? To address this question, we studied the performance of crosses between replicate Drosophila melanogaster lines previously subject to selection for improved learning response in the context of oviposition substrate choice. Of the 10 pairwise F1 crosses among the five selection lines, four performed in the original learning assay similarly to the parental lines, whereas the remaining six showed learning scores significantly below the average of the parental lines. In particular, four F1 crosses (three involving the same line) showed no detectable learning, on a par with unselected control lines. This indicates that the response to selection in some lines involved allelic substitutions at different loci. Additional assays of crosses between two selection lines indicated that the loss of performance in hybrids generalized to another type of learning assay, and held for both short- and long-term memory. Joint analysis of first- and second-generation crosses between these two lines supported the hypothesis that the response to selection in these different lines was based on the spread of recessive alleles at different loci. These results show that the evolutionary trajectories of populations of the same origin subject to uniform selection may sometimes diverge over very short evolutionary timescales.
The origin and early radiation of the therapsid mammal-like reptiles: a palaeobiological hypothesis
Authors: Kemp T. S.
Published: January 2006

The replacement of the basal synapsid pelycosaurs by the more ‘mammal-like’ therapsids in the Permian was an important event in the history of tetrapods because it initiated the eventual transition to the mammals. It is also an example of taxon replacement in the fossil record that is unusually amenable to explanation, based on a combination of analysis of the biological significance of the inferred character changes, with the stratigraphic, palaeogeographic and palaeoecological circumstances of the time. An hypothesis is presented in which the origin of the therapsids resulted from a correlated progression of character evolution leading to higher levels of metabolic activity and homeostatic regulation of the body. It was a response to the availability of a seasonally arid, savanna-like biome. The subsequent explosive radiation of therapsids was associated with habitat expansion made possible by the Mid-Permian development of geographical continuity between that biome and the temperate biomes. The final extinction of the pelycosaurs was a case of incumbent replacement by the new therapsid lineages.
Going country: Rural student placement factors associated with future rural employment in nursing and allied health
Authors: Playford Denese , Larson Ann , Wheatland Belynda
Published: January 2006

Objective:  To measure the rate and predictors of health science graduates joining the rural health workforce following a rural placement.

Design:  Longitudinal survey including the years immediately prior to and post graduation.

Setting:  Western Australian health sciences graduates contacted by email and/or phone.

Participants:  Allied health and nursing students from urban campuses of three Western Australian universities who had taken a rural placement in their final year of study between 2000 and 2003.

Main outcome measures:  Location of employment six months or more after graduation.

Results:  Of 429 participating allied health and nursing graduates, 25% had entered the rural workforce. Factors with a positive bivariate association with rural employment were: rural background, health discipline, self‐reported value of placement, non‐compulsory rural placement, and placements of four weeks or less. After controlling for rural background, the value and duration of the placement were significantly associated with rural employment.

Conclusions:  This study augments previous work showing that any prior rural background is a significant predictor of rural work. Rural practitioners of both urban and rural origin who undertake voluntary rural placements are more likely to enter rural practice and consequently mandatory placements may not be helpful to increasing the rural workforce. The quality of a placement is a highly significant factor associated with future workplace choice, the details of which need to be further investigated.
Cultural health beliefs in a rural family practice: A Malaysian perspective
Authors: Ariff Kamil M. , Beng Khoo S.
Published: January 2006

Background:  Understanding the sociocultural dimension of a patient's health beliefs is critical to a successful clinical encounter. Malaysia with its multi‐ethnic population of Malay, Chinese and Indian still uses many forms of traditional health care in spite of a remarkably modern rural health service.

Objective:  The objective of this paper is discuss traditional health care in the context of some of the cultural aspects of health beliefs, perceptions and practices in the different ethnic groups of the author's rural family practices. This helps to promote communication and cooperation between doctors and patients, improves clinical diagnosis and management, avoids cultural blind spots and unnecessary medical testing and leads to better adherence to treatment by patients.

Discussion:  Includes traditional practices of ‘hot and cold’, notions of Yin‐Yang and Ayurveda, cultural healing, alternative medicine, cultural perception of body structures and cultural practices in the context of women's health. Modern and traditional medical systems are potentially complementary rather than antagonistic. Ethnic and cultural considerations can be integrated further into the modern health delivery system to improve care and health outcomes.
Astroblastoma: Immunohistochemical and ultrastructural study of distinctive epithelial and probable tanycytic differentiation
Authors: Kubota Toshihiko , Sato Kazufumi , Arishima Hidetaka , Takeuchi Hiroaki , Kitai Ryuhei , Nakagawa Takao
Published: January 2006

We report the clinicopathological findings of astroblastoma found in an 8‐year‐old girl who was subsequently treated for 11 years. The primary superficially circumscribed tumor was located in the frontoparietal lobe, while the recurrent and the second recurrent tumor were restricted to the same region 11 years later. The tumors obtained on these three occasions showed fundamentally the same histological, immunohistochemical and fine structural features. They exhibited astrocytic as well as ependymal tanycytic features with apparent epithelial cell lineage. The tumor cells showed typical features of astroblastoma comprising prominent perivascular pseudorosettes with remarkable vascular sclerosis. The immunohistochemical study revealed intensive positivity of GFAP, vimentin, epithelial membrane antigen (EMA), cytokeratin, connexin 26 and 32, desmocollin 1 and neuronal cadherin. The fine structure revealed divergent types of junctional complexes, some of which were connected with tonofilament bundles. Numerous microvilli protruded and basal lamina abutted on the tumor cell surface. We report these unique histological features, and stress that astroblastoma should be categorized as a specific type of neuroepithelial tumor.
Increased asymmetric pulvinar magnetic resonance imaging signals in Creutzfeldt–Jakob disease with florid plaques following a cadaveric dura mater graft
Authors: Wakisaka Yoshinobu , Santa Naohiko , Doh‐ura Katsumi , Kitamoto Tetsuyuki , Ibayashi Setsuro , Iida Mitsuo , Iwaki Toru
Published: January 2006

A 9‐year‐old Japanese girl received a cadaveric dura mater graft during surgery following a head injury with brain contusion. She continued to do well, but when she became 19‐years‐old, she gradually showed a violent character and was treated in a psychiatric hospital. Another 6 years later, 200 months after the procedure, she developed a progressive gait ataxia, which subsequently led to her death within 10 months of onset. An autopsy showed she had CJD. This patient represents an atypical case of dura‐associated CJD (dCJD) with unusual clinicopathological features including the late occurrence of myoclonus, an absence of periodic synchronous discharges in the electroencephalogram, and the presence of widespread florid plaques. However, our detection of an asymmetrical increase in the MRI‐derived images of pulvinar nuclei has not been previously observed in other atypical cases of dCJD. Because atypical dCJD cases share several clinicopathological features with those of vCJD, and because asymmetrical hyperintense signals in the pulvinar have been observed in some neuropathologically confirmed vCJD cases, we had some difficulty in a differential diagnosis between atypical dCJD and vCJD. This is the first atypical dCJD case showing a pulvinar high signal compared with all other basal ganglia on MRI.
Interleukin‐6 attenuates the development of experimental diabetes‐related neuropathy
Authors: Andriambeloson Emile , Baillet Caroline , Vitte Pierre‐Alain , Garotta Gianni , Dreano Michel , Callizot Noelle
Published: January 2006

Neuropathy is the most severe and the least understood complication of diabetes. We investigated the potential neuroprotective effect of IL‐6 therapy in an experimental model of diabetic neuropathy. A single i.v. injection of streptozotocin (STZ, 55 mg/kg) was used to induce experimental diabetes in adult males. IL‐6 (1, 10 or 30 µg/kg) was administrated either intraperitoneally on a daily basis or subcutaneously (s.c.) on a daily, on a three times or one time per week basis, starting at day 10 post‐STZ. A decrease in sensory nerve conduction velocity (SNCV), indicative of neuropathy, is seen in STZ rats as early as day 10 post‐STZ, a time at which blood glycaemia is already maximal. At later time points, this electrophysiological impairment became severe and clinically apparent by affecting tail flick latency. Motor dysfunction defined by a significant increase in compound muscle action potential (CMAP) latency was also recorded. At the completion of the study (day 40 post‐STZ), histological examination revealed significant axonopathy and myelin loss, along with an increase in the proportion of fibers with abnormal appearance in sciatic nerves of STZ rats. These changes were not observed in non‐diabetic rats and were significantly prevented by IL‐6 treatment. The optimal dose appeared to be 10 µg/kg s.c. three injections per week, which showed a better effect in most of the parameters studied than 4‐methylcatechol, a NGF‐like neuroprotective compound. Once weekly and three times weekly administrations of IL‐6 were as effective as daily treatment. Taken together, these results support the potential neuroprotective actions of IL‐6. The fact that the half‐life of IL‐6 is only approximately 5 h while weekly dosing was neuroprotective strongly suggests activation by IL‐6 of effector molecule(s) with longer duration of action.
Fatigue damage of medium carbon steel under sequential application of axial and torsional loading
Authors: CHEN X. , JIN D. , KIM K. S.
Published: January 2006

Fatigue tests were conducted on S45C steel under fully reversed strain control conditions with axial/torsional (at) and torsional/axial (ta) loading sequences. The linear damage value (n1/N1+n2/N2) was found to depend on the sequence of loading mode (at or ta), sequence of strain amplitude (low/high or high/low) and life fraction spent in the first loading. In general, at loading yields larger damage values than ta loading and the low–high sequence of equivalent strain leads to larger damage values than the high–low sequence. The material exhibits cyclic softening under axial cyclic strain. Cyclic hardening occurs in the torsion part of ta loading, which elevates the axial stress in the subsequent loading, causing more damage than in pure axial fatigue at the same strain amplitude. Fatigue life is predicted based on the linear damage rule, the double linear damage rule, the damage curve approach and the plastic work model of Morrow. Results show that overly conservative lives are obtained by these models for at loading while overestimation of life is more likely for ta loading. A modified damage curve method is proposed to account for the load sequence effect, for which predicted lives are found to lie in the factor‐2 scatter band from experimental lives.
Intraoperative wake‐up test in neonatal neurosurgery
Authors: GOVINDARAJAN RAMASAMY , BABALOLA OLUWASEUN , GAD‐EL‐KAREEM MAGDY , KODALI NAGENDRA S , ARONSON JUDITH , ABADIR ADEL
Published: January 2006

Intraoperative wake‐up test (WPT) still remains the gold standard to monitor anterior spinal cord function during spinal surgery. However, the test requires patient cooperation and hence difficult to perform in very young children or mentally challenged. In this report, we describe a WPT in a newborn during surgical repair of a large myelomeningocele. We relied on mivacurium for intubation and the relaxant effect was allowed to wear‐off to permit the use of intraoperative nerve stimulator. We used desflurane and propofol infusion for rapid titration of the anesthetic depth and BIS monitor to ‘gauge’ the ‘wakefulness’ of the child during the WPT. We employed lidocaine infusion to improve tolerance to the tracheal tube and to bestow beneficial effect on intracranial pressure during surgery and the WPT. The results of the WPT were judged to be satisfactory after confirming flexion and extension of the lower extremities at the hip and knee level, correlating it with the BIS values, and comparing it with the preoperative status. Frequently associated prematurity, higher possibility of remaining intubated in the immediate postoperative period and any new onset neurologic deficit not becoming apparent until after extubation makes intraoperative neuromonitoring relevant in this age group. Our methodology of management has permitted us to perform a delicate test safely and will allow us to repeat the WPT if needed during neonatal neurosurgery.
Clonidine for the prevention of emergence agitation in young children: efficacy and recovery profile
Authors: MALVIYA SHOBHA , VOEPEL‐LEWIS TERRI , RAMAMURTHI RADHAMANGALAM J. , BURKE CONSTANCE , TAIT ALAN R.
Published: January 2006

Background:  Emergence agitation (EA) is a common postoperative problem in young children who have received sevoflurane and isoflurane for general anesthesia. This randomized, double‐blinded study evaluated the efficacy of intraoperative clonidine in reducing EA, and describes its recovery profile.

Methods:  With Institutional Review Board approval and informed consent, children undergoing brief, minimally painful procedures were studied. All children received preemptive analgesia with acetaminophen and ketorolac, sevoflurane for induction, and isoflurane for maintenance of anesthesia. Children received either 2 μg·kg−1 clonidine or placebo intravenously (i.v.) following induction of anesthesia. Children were observed postoperatively for behavior and side effects, and their parents were telephoned the next day to determine postdischarge recovery characteristics.

Results:  One hundred and twenty children were included in this study: 59 of whom received clonidine, and 61 placebo; 41% of those in the placebo group exhibited moderate–severe EA compared with only 22% of those in the clonidine group (P < 0.03). Compared with those who received placebo, children who received clonidine awakened more slowly (22 min vs 14 min), had a longer postanesthesia care unit stay (57 min vs 46 min), and experienced sleepiness more frequently after discharge (75% vs 39%; all comparisons significant at P < 0.03). There were no adverse cardiorespiratory events in either group.

Conclusions:  Findings demonstrate that i.v. clonidine administered after induction of anesthesia significantly reduces the incidence of EA in young children, but is associated with sleepiness postoperatively.
The missing Madagascan mid‐domain effect
Authors: Kerr Jeremy T. , Perring Michael , Currie David J.
Published: January 2006

Species richness varies enormously across geographical gradients, a well‐known phenomenon for which there are many hypothesized explanations. One recent hypothesis uses null models to demonstrate that random re‐distribution of species’ ranges within a given domain leads to a ‘mid‐domain effect’ (MDE): increasing species richness towards the centre of the area. Madagascar is especially well‐suited for empirical evaluation of mid‐domain models by virtue of its large endemic fauna and its clearly defined boundaries. Lees et al. [Biol. J. Linn. Soc.67 (1999) 529] observed patterns of species richness consistent with MDEs in the Madagascan rainforest (a slim, north–south belt). In this study, we test one‐dimensional and two‐dimensional mid‐domain model predictions for the birds and mammals of the entire island of Madagascar. When only latitudinal extents of species’ distribution are considered, patterns of richness in Madagascar show an MDE. However, this pattern disappears for both taxa after accounting for the tendency of latitudinal bands nearer the middle of the country to be larger. Two‐dimensional mid‐domain model predictions of species richness are qualitatively opposite to observed patterns. Instead, island‐wide spatial gradients of species richness in Madagascar relate strongly to patterns of primary productivity and amount of remaining natural habitat. Earlier work that showed a mid‐domain peak within the rainforest biome (effectively after controlling for climate and natural habitat) seems likely to have reflected methodological artefacts. The classic case in which MDEs should occur is, in fact, inconsistent with the mid‐domain hypothesis.
Professional competence: factors described by nurses as influencing their development
Authors: Khomeiran R. Tabari , Yekta Z. P. , Kiger A. M. , Ahmadi F.
Published: January 2006

Aim:  To discuss the results of a study that explored factors that may influence competence development.

Background:  Competence, a controversial issue in health care settings, affects many aspects of the nursing profession, including education, practice and management. Although a number of research and discussion papers have explored the issue, in particular the meaning and assessment of nursing competence, to date little research has explored factors identified by nurses themselves as influencing their development of professional competence.

Methods:  A purposive sample of 27 registered nurses was recruited from two university‐affiliated hospitals. Data collection was by tape‐recorded semi‐structured interviews. Interviews were transcribed verbatim and analysed according to the qualitative methodology of content analysis.

Findings:  Six descriptive categories were identified from the data: experience, opportunities, environment, personal characteristics, motivation and theoretical knowledge.

Conclusions:  The findings suggest that the factors influencing the process of developing professional competence in nursing extend across personal and extra‐personal domains. An understanding of these factors may enhance the ability of nursing managers and educators to enable student and qualified nurses to pursue effective competency development pathways to prepare them to provide a high standard of care. These findings, which may have important implications for nursing practice, management and education, are being further tested in a larger study.
Cultural competency and nursing care: an Australian perspective
Authors: Chenowethm L. , Jeon Y.‐H. , Goff M. , Burke C.
Published: January 2006

Aims:  To propose a process that will facilitate cultural competence in Australian nursing practice.

Background:  Cultural diversity is a prominent feature of the Australian health system and is impacting significantly on nursing care quality. A fictitious, but typical clinical exemplar is profiled that identifies cultural insensitivity in care practices leading to poor quality outcomes for the health consumer and her family. Strategies are proposed that will reverse this practice and promote culturally competent nursing care and that locates overseas qualified nurses in this process.

Conclusion:  This paper contributes to nursing care quality internationally by articulating strategies to achieve cultural competence in practice. Nurses must pay attention to interpersonal relationships and develop respect for the health consumer's value systems and ways of being, in order to protect their rights and avoid the tendency to stereotype individuals from particular cultures. The expertise of qualified nurses from different cultures can greatly assist this process.
Decision making in childbirth: the influence of traditional structures in a Ghanaian village
Authors: Jansen I.
Published: January 2006

Background:  The regional health administration of the Brong‐Ahafo Region in Ghana identified that although informed about the advantages of both aspects of care, pregnant women made use of antenatal services but not of the supervised delivery. Quantitative studies have identified economic factors that influence the decisions of pregnant women.

Aim:  To describe and understand the traditional structures of childbirth in Kwame Danso/Ghana and to explore why the pregnant women do not make use of supervised deliveries in the modern institutions.

Methods:  A mini‐ethnographic study, using participant observation and ethnographic interviews.

Findings:  Cultural and social factors have a significant influence on the decisions related to childbirth. One of the most important factors identified was that the responsible persons for decisions related to a delivery were the older female relatives, rather than the mothers themselves. Older females used rational judgements to weigh up the possibilities of risks, interests and advantages related to their cultural, spiritual and social system. Other factors were staff behaviour that was characterized as unfriendly and lacking for respect as to the living conditions and thinking of the pregnant women in the village.

Conclusions:  Ethnographic research provided an understanding of traditional structures that have an influence on the decisions and behaviour of the community related to childbirth. Appreciation of these structures enabled health promotion and structured health services to be delivered in a more culturally appropriate way.
Dignified dying: phenomenon and actions among nurses in India
Authors: Doorenbos A.Z. , Wilson S.A. , Coenen A. , Borse Nagesh N.
Published: January 2006

Purpose:  This study contributes to the ongoing efforts of the International Classification for Nursing Practice (ICNP®) to describe the phenomenon of dignified dying, to describe nursing actions used to promote dignified dying, and to evaluate the validity of a dignified dying scale among practising nurses in India.

Design and sample:  This descriptive study surveyed 229 nurses who had cared for dying patients and were currently practising in government and private hospitals in India.

Methods:  Nurses were recruited to complete a survey in either Hindi or English. The survey included demographic, open‐ended questions, and a dignified dying scale of Likert‐like items. Nurses also identified nursing interventions used in practice to promote dignified dying.

Findings:  The descriptions of dignified dying phenomenon fit within the three major areas of the Dignity‐Conserving Model of Care. A variety of interventions were reported, with more focusing on spiritual than physical factors. The 14 items selected reliably measured dignified dying, with a Cronbach's alpha of 0.79. Factor analysis yielded a 4‐factor solution, with 11 items accounting for 56% of the variance.

Conclusions:  Nurses in India endorsed spirituality as an essential aspect of the phenomenon of dignified dying. Nursing actions to promote dignified dying supported finding spiritual comfort at end of life. These results contribute to an understanding of nursing phenomena and actions worldwide.
Nursing and midwifery: Millennium Development Goals and the global human resource crisis*
Authors: Green A.
Published: January 2006

The World Health Organization Global Advisory Group for Nurses and Midwives and wider stakeholders met in May 2005 against a background of concern over the disappointing progress being made towards the Millennium Development Goals (MDGs). The meeting considered the urgent need to address human resource issues, particularly those related to nursing and midwifery, if the MDGs are to be achieved.
Neuropsychological assessment with the Visual Gestalt Test: Psychometric properties and differential diagnostic probabilities
Authors: LA COUR PETER , ANDERSEN RUTH
Published: January 2006

The Visual Gestalt Test is a neuropsychological instrument developed for evaluation of learning and memory of visuo‐spatial material. A revised strategy of scoring has motivated the present study, where data from 153 normal persons, 99 epilepsy patients, and 24 depressed patients are presented and compared. The Visual Gestalt Test is observed to discriminate between normal and diagnosed groups in several ways. Additionally it is found to discriminate between depressed and brain damage subgroups of patients. Data are presented in order to supplement previously published ways of scoring and norms. Practical guidelines for the clinical applications of the test are suggested as perspectives.