bluuebunny/crossref_metadata_2025 huggingface dataset:
Lipschitz representations of subsets of the cube
Authors: Mendelson Shahar
Published: February 2007

We show that for any class of uniformly bounded functions

H
H

with a reasonable combinatorial dimension, the vast majority of small subsets of the

n
n

-dimensional combinatorial cube cannot be represented as a Lipschitz image of a subset of

H
H

, unless the Lipschitz constant is very large. We apply this result to the case when

H
H

consists of linear functionals of norm at most one on a Hilbert space.
The Toll‐like receptor 7/8‐ligand resiquimod (R‐848) primes human neutrophils for leukotriene B4, prostaglandin E2 and platelet‐activating factor biosynthesis
Authors: Hattermann Kim , Picard Serge , Borgeat Mathieu , Leclerc Patrick , Pouliot Marc , Borgeat Pierre
Published: February 2007

Toll‐like receptors (TLR) recognize pathogen‐associated molecular patterns and play important roles in the innate immune system. While single‐stranded viral RNA is the natural ligand of TLR7/TLR8, the imidazoquinoline resiquimod (R‐848) is recognized as a potent synthetic agonist of TLR7/TLR8. We investigated the effects of TLR7/8 activation on lipid mediator production in polymorphonuclear leukocytes exposed to R‐848. Although R‐848 had minimal effects by itself, it strongly enhanced leukotriene B4 formation on subsequent stimulation by fMLP, platelet‐activating factor, and the ionophore A23187. R‐848 acted via TLR8 but not TLR7 as shown by the lack of effect of the TLR7‐specific ligand imiquimod. Priming with R‐848 also resulted in enhanced arachidonic acid release and platelet‐activating factor formation following fMLP stimulation, as well as enhanced prostaglandin E2 synthesis following the addition of arachidonic acid. Western blot analysis demonstrated that R‐848 induced the phosphorylation of the cytosolic phospholipase A2α, promoted 5‐lipoxygenase translocation and potently stimulated the expression of the type 2 cyclooxygenase. Bafilomycin A1, an inhibitor of endosomal acidification, efficiently inhibited all R‐848‐induced effects. These studies demonstrate that TLR8 signaling strongly promotes inflammatory lipid mediator biosynthesis and provide novel insights on innate immune response to viral infections.—Hattermann K., Picard, S., Borgeat, M., Leclerc, P., Pouliot, M., Borgeat P. The Toll‐like receptor 7/8‐ligand re‐siquimod (R‐848) primes human neutrophils for leuko‐triene B4, prostaglandin E2 and platelet‐activating factor biosynthesis. FASEB J. 21, 1575–1585 (2007)
Sexual Intent Perceptions: The Role of Perceiver Experience and the Real‐Person Reduction1
Authors: Lindgren Kristen P. , George William H. , Shoda Yuichi
Published: February 2007

What factors influence the amount of sexual intention accorded to a person's behavior? A perceiver's gender and personal experiences, and the nature of the relationship with the perceived were investigated. Two findings emerged. First, perceiver sexual and dating experiences predicted perceptions in addition to and independent of perceiver gender, but only for a “self” target. Second, hypothetical targets were perceived more sexually relative to targets that represented real people. These findings extended previous research suggesting that features of targets and perceivers in addition to gender are predictive of sexual perceptions. These target features (e.g., “self” vs. other, “real” vs. hypothetical) have distinct influences on sexual perceptions, suggesting that the choice of a target in research studies should be considered carefully.
Decreasing LDL Cholesterol and Medication Cost With Every‐Other‐Day Statin Therapy
Authors: Juszczyk Monika A. , Seip Richard L. , Thompson Paul D.
Published: February 2007

Statins are administered daily, but because of their long half‐lives, atorvastatin and rosuvastatin can be given every other day (q.o.d.). We examined the effect of q.o.d. statin therapy in 25 patients treated with either atorvastatin (mean dose, 18.8 mg q.o.d.) or rosuvastatin (mean dose, 9.7 mg q.o.d.). Low‐density lipoprotein cholesterol decreased 43%, triglycerides (mean ± SEM) decreased 22%±6%, and high‐density lipoprotein cholesterol increased 9%±6% with q.o.d. atorvastatin (n=9; p<0.05 for all). Low‐density lipoprotein cholesterol decreased 28%, triglycerides decreased 15%±6%, and high‐density lipoprotein cholesterol increased 10%±5% with rosuvastatin q.o.d. (n=16; p<0.05 for all). We conclude that q.o.d. treatment with long‐acting statins significantly improves serum lipid levels.
The Influence of Age on Acute Myocardial Infarction Symptoms and Patient Delay in Seeking Treatment
Authors: Hwang Seon Young , Ryan Cathy , Zerwic Julie Johnson
Published: February 2007

A secondary analysis was conducted from data gathered from 239 patients with acute myocardial infarction presenting to the emergency departments of three hospitals to explore the influence of age on delay time, experienced symptoms, and factors predicting a delay of >1 hour. During hospitalization, a structured interview about the patients' experience before hospital admission was completed and their medical records were reviewed. The median delay before seeking treatment was not significantly different between older (2.5 hours) and younger patients (2.1 hours). Older patients were significantly less likely to report classic pain in the center of the chest and other associated symptoms such as sweating and nausea; they also used fewer words to describe their discomfort compared with younger patients. Independent predictors of longer delay were: contacted physician, lacked similarity between experienced and expected symptoms, did not use 911 (older adults), lived alone, and contacted physician (younger adults). Primary care providers need to be aware that elderly persons are more likely to have mild or ambiguous acute myocardial infarction symptoms and education is needed for elderly persons regarding not only acute myocardial infarction symptoms but also rapid, action‐centered decisions to attribute symptoms to heart problems and initiate ambulance use.
Cardiovascular Effects of Coffee: Is It a Risk Factor?
Authors: Sudano Isabella , Binggeli Christian , Spieker Lukas , Lüscher Thomas Felix , Ruschitzka Frank , Noll Georg , Corti Roberto
Published: February 2007

Intake of coffee, one of the most common beverages worldwide, is often reported as a cardiovascular risk factor; however, definitive data are lacking. Acute intake of coffee or beverages containing caffeine can increase blood pressure, heart minute volumes, and cardiac index, as well as activate the sympathetic nervous system in nonhabitual coffee drinkers. Interestingly, this is not observed in habitual coffee drinkers. Restriction of coffee or caffeinated beverages is no longer indicated in the seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guidelines for the treatment of hypertension. In fact, no clear association between coffee and the risk of hypertension, myocardial infarction, or other cardiovascular diseases has been demonstrated. In contrast to early studies, recent research indicates that habitual moderate coffee intake does not represent a health hazard and may even be associated with beneficial effects on cardiovascular health.
What's Wrong With Me? Women's Coronary Heart Disease Diagnostic Experiences
Authors: McSweeney Jean C. , Lefler Leanne L. , Crowder Beth F.
Published: February 2007

Most women are unaware that that they may experience atypical coronary heart disease (CHD) symptoms. Women's atypical presentation often results in women having difficulty being diagnosed with CHD or myocardial infarction. Investigating women's CHD diagnostic experiences may reveal vital areas amenable to intervention. This secondary analysis explored women's CHD diagnostic experiences. Forty women completed in‐depth interviews in their homes that were audiotaped and lasted 2–3 hours. Using content analysis and constant comparison, five themes emerged: awareness, seeking treatment, frustration, treatment decisions, and anger. Despite numerous symptoms and visits with clinicians, most women were not diagnosed with CHD before myocardial infarction. During the infarction, women with typical symptoms were easily diagnosed while those with atypical symptoms received a delayed diagnosis. Those who repeatedly sought treatment were angry about not being diagnosed earlier. Further research is needed to promote early symptom recognition, timely diagnosis, and efficacious treatment—keys to improving women's CHD outcomes and to preventing similar negative diagnostic experiences.
Developing a Web‐Based Education and Counseling Program for Heart Failure Patients
Authors: Evangelista Lorraine S. , Strömberg Anna , Westlake Cheryl , Ter‐Galstanyan Alvina , Anderson Nancy , Dracup Kathleen
Published: February 2007

This paper describes a 2‐phase method utilized to develop and evaluate the feasibility of a Web‐based program targeted to the specific learning needs of elderly patients with heart failure. In the first phase, informational resources specific to the needs of elderly patients were identified using aspects of participant‐focused research. Data from 69 patients were obtained through a structured interview and later reviewed with health care providers and patient representatives. Items deemed important by the patients and health care providers were incorporated into the Internet‐based program that was drafted for the study. The second phase of the process entailed obtaining data to support the acceptability and feasibility of the intervention by providing 12 patient volunteers access to the Internet‐based program that was developed. After 2 weeks, the authors contacted the volunteers and asked them about their experiences with accessing and navigating the Web page. The authors found that elderly persons with limited computer skills can and will use Web resources to obtain information when given adequate instructions on how to access the Web pages.
Somatic Symptoms Explain Differences in Psychological Distress in Heart Failure Patients vs a Comparison Group
Authors: Redeker Nancy S.
Published: February 2007

Psychological distress is common among patients with heart failure (HF); however, somatic symptoms are also common and may confound its assessment. Understanding the contributions of symptoms to psychological distress may assist in focusing treatment. The purpose of this study was to evaluate differences between HF patients and a non‐HF comparison group on psychological distress (anxiety and depression); the association of anxiety and depression with common somatic symptoms of HF (fatigue, sleep disturbance, dyspnea, and excessive daytime sleepiness); and the extent to which somatic symptoms and HF diagnosis explain psychological distress. In this cross‐sectional study, 61 stable systolic HF outpatients and a comparison group of 57 persons recruited from the community completed the Centers for the Epidemiological Studies of Depression Scale, Profile of Mood States‐Short Form, Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Multidimensional Assessment of Fatigue Scale, and the Multidimensional Assessment of Dyspnea Scale. The HF patients scored higher on depression, as measured by the Centers for the Epidemiological Studies of Depression Scale, but not on the other depression or anxiety scales. Group‐related differences in depression were explained by sleep disturbance, fatigue, and excessive daytime sleepiness, after accounting for the effects of age, sex, minority status, comorbidity, and physical function.
Partial remission of a newly diagnosed diffuse large B‐cell non‐Hodgkin's lymphoma in a hemodialysis patient after administration of immuno‐chemotherapy with rituximab‐CHOP
Authors: FELDMANN G. , NATTERMANN J. , GERHARDT T. , NÄHLE C. P. , SPENGLER U. , WOITAS R.
Published: February 2007

To date little data exist about treatment of hematologic malignancies in patients with end‐stage renal disease (ESRD). While administration of immunochemotherapy comprising the CD20‐antibody rituximab is a well‐established treatment strategy in patients with normal renal function, little information on safety and efficacy is available in the setting of ESRD. Here we describe for the first time a hemodialysis patient suffering from diffuse large B‐cell Non‐Hodgkin's lymphoma (DLBCL) who was treated with polychemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisone) in combination with rituximab (R‐CHOP). We observed no major adverse events and treatment resulted in a partial remission of the DLBCL. Thus, administration of R‐CHOP may be considered as a safe therapeutic option in this setting. Of note, this patient had a previous history of hairy cell leukemia. A review of the literature was performed and the potential etiologic link of these two B‐cell malignancies is discussed in the light of available information.
Predicting fluctuations of reintroduced ibex populations: the importance of density dependence, environmental stochasticity and uncertain population estimates
Authors: SÆTHER BERNT‐ERIK , LILLEGÅRD MAGNAR , GRØTAN VIDAR , FILLI FLURIN , ENGEN STEINAR
Published: February 2007

Development of population projections requires estimates of observation error, parameters characterizing expected dynamics such as the specific population growth rate and the form of density regulation, the influence of stochastic factors on population dynamics, and quantification of the uncertainty in the parameter estimates.

Here we construct a Population Prediction Interval (PPI) based on Bayesian state space modelling of future population growth of 28 reintroduced ibex populations in Switzerland that have been censused for up to 68 years. Our aim is to examine whether the interpopulation variation in the precision of the population projections is related to differences in the parameters characterizing the expected dynamics, in the effects of environmental stochasticity, in the magnitude of uncertainty in the population parameters, or in the observation error.

The error in the population censuses was small. The median coefficient of variation in the estimates across populations was 5·1%.

Significant density regulation was present in 53·6% of the populations, but was in general weak.

The width of the PPI calculated for a period of 5 years showed large variation among populations, and was explained by differences in the impact of environmental stochasticity on population dynamics.

In spite of the high accuracy in population estimates, the uncertainty in the parameter estimates was still large. This uncertainty affected the precision in the population predictions, but it decreased with increasing length of study period, mainly due to higher precision in the estimates of the environmental variance in the longer time‐series.

These analyses reveal that predictions of future population fluctuations of weakly density‐regulated populations such as the ibex often become uncertain. Credible population predictions require that this uncertainty is properly quantified.
Quality of life and psychological well‐being in GH‐treated, adult PWS patients: a longitudinal study
Authors: Bertella L. , Mori I. , Grugni G. , Pignatti R. , Ceriani F. , Molinari E. , Ceccarelli A. , Sartorio A. , Vettor R. , Semenza C.
Published: February 2007

Background  Prader–Willi syndrome (PWS) is a congenital alteration of chromosome pair 15. It is characterized by short stature, muscular hypotonia, hyperphagia, obesity, behavioural and emotional disturbances, hypogonadism and partial Growth Hormone (GH) deficiency. The aim of this study was to assess the long‐term effect of GH treatment on the psychological well‐being and Quality of Life (QoL) in an adult PWS group.

Methods  A total of 13 PWS patients, their diagnosis confirmed by genetic tests, and their parents were recruited for this study. The participants were administered the 36‐Items Short Form Health Survey (SF‐36) and the Psychological General Well‐Being Index (PGWBI), for the assessment of QoL and psychological well‐being, at the beginning of GH treatment, and at following intervals of 6, 12 and 24 months. Modified versions of the same questionnaires were given to the parents.

Results  Significant improvement with respect to the baseline was found, on both scales, in the evaluation of both physical and psychological well‐being, although the parents’ evaluation was less optimistic than that of the patients.

Conclusion  Our findings suggest that the amelioration of QoL and psychological status is sustained in patients who continue GH treatment.
The role of microRNAs in sensing nutrient stress
Authors: CHIOU TZYY‐JEN
Published: February 2007

Recent studies have demonstrated the novel functions of microRNAs (miRNAs) in regulating plant adaptive responses to nutrient stresses. Plant miRNAs usually down‐regulate the abundance of their target mRNAs by post‐transcriptional cleavage. miR395 and miR399 are up‐regulated during sulphate and phosphate (Pi) deficiency, respectively. miR395 participates in sulphate assimilation and allocation via adjusting the expression of ATP sulphurylase (APS) and a sulphate transporter (AtSULTR2;1). Up‐regulation of miR399 results in the down‐regulation of UBC24 encoding a ubiquitin‐conjugating E2 enzyme. Plants overexpressing miR399 or are defective in UBC24display Pi toxicity because of increased Pi uptake, enhanced root‐to‐shoot translocation and retention of Pi in the old leaves. This observation suggests that the miR399‐mediated regulation of UBC24 expression is critical in Pi homeostasis. Moreover, the existence and conservation of miR395 and miR399 and their target genes among many plant species reveals the evolutionary importance of these miRNA‐mediated nutrient stress responses.
Meningococcal disease in a kidney transplant recipient with mannose‐binding lectin deficiency
Authors: Manuel O. , Tarr P.E. , Venetz J.‐P. , Trendelenburg M. , Meylan P.R. , Pascual M.
Published: February 2007

Abstract: We describe the case of a kidney transplant recipient who developed meningococcemia, without meningeal signs, 2 months after transplantation. Plasma levels of complement components C3, C4, and CH 50 were within the normal range. However, using a method to screen for the functional activity of all 3 pathways of complement, no activation via the mannose‐binding lectin (MBL) pathway could be detected (0%). A subsequent quantification of MBL pathway components revealed normal levels of MASP 2 but undetectable amounts of MBL. To our knowledge, this is the first report of meningococcal disease after organ transplantation in a patient with MBL deficiency.
Comparative Anatomy of the Meniscofemoral Ligament in Humans and some Domestic Mammals
Authors: Gupte C. M. , Bull A. M. J. , Murray R. , Amis A. A.
Published: February 2007

The purpose of this study was to investigate the presence, position and relative sizes of the meniscofemoral ligaments (MFL) in three quadrupeds and humans and relate these to the caudal slope of the lateral tibial plateau. Canine, ovine and equine stifles and human knees were dissected to identify the presence of MFLs, their obliquity in relation to the caudal cruciate ligaments (CCL), the relative size and shape of the MFLs compared with the CCL, the points of femoral attachment of the MFLs and CCL, and the distance between the MFLs and CCL at their midpoints. The lateral tibial condyle was divided sagittally with a handsaw and the caudal slope was measured. An MFL was present in all quadrupeds. It was caudal to the CCL, being analogous to the human posterior MFL. There was no structure analogous to the human anterior MFL, a structure that has a different femoral attachment from the human posterior MFL and MFLs in other species examined. The meniscotibial attachments were of varying sizes. The size ratio between the MFL and CCL was greater in all three quadrupeds than it was in the human knee. The MFL lies more obliquely than the CCL in all species examined. The caudal tibial slope was steeper in the quadrupeds. In the stifle joints of quadrupeds, the MFL is a substantial structure and appears to be related to the caudal tibial slope. It is known to resist caudal translation of the tibia in conjunction with the lateral meniscus. This must be borne in mind when considering its function in the human knee.
Development of the Mesonephros in Camel (Camelus dromedarius)
Authors: Aly K. H.
Published: February 2007

The study of the development of the mesonephros in the camel (Camelus dromedarius) was carried out on 16 embryos ranging from 0.9 to 8.6 cm crown vertebral rump length (CVRL). At 0.9 cm CVRL, the mesonephros is represented by a narrow strip along the roof of the thoracolumbar part of the vertebral column. At 1.4 cm CVRL, some of the mesonephric tubules are canalized but others are still solid. The mesonephric corpuscles are well developed at 1.9 cm CVRL and occupy almost the entire abdominal cavity in between the liver and the gut. Histologically, the glomeruli occupy the ventromedial aspect of the mesonephros while the mesonephric tubules become numerous, larger and more coiled. At 3 cm CVRL, the metanephros is invaginated in the caudal pole of the mesonephros, and the mesonephric tubules in some areas are differentiated into secretory and collecting tubules. At 3.5 cm CVRL the mesonephros is related dorsally to the postcardinal vein and ventrally to the subcardinal vein. At 4.7 cm CVRL continuous regression of the mesonephros from cranialwards to caudalwards is observed. At 5.3–5.5 cm CVRL, the cranial part of the mesonephros is divided into medial and lateral regions, and later the medial region completely disappears and is replaced by the primordium of the adrenal gland. At 8.6 cm CVRL, the caudal part of the mesonephros completely disappears.
Comparison of Computer‐assisted Sperm Motility Analysis Parameters in Semen from Belgian Blue and Holstein–Friesian Bulls
Authors: Hoflack G , Opsomer G , Rijsselaere T , Van Soom A , Maes D , De Kruif A , Duchateau L
Published: February 2007

Contents

Subjective microscopic sperm motility results have recently been demonstrated to differ between Holstein–Friesian (HF) and Belgian Blue (BB) bulls. However, such assessments are rather imprecise. In the present study, sperm motility was assessed objectively by means of the Hamilton Thorne CEROS version 12.2c computer‐assisted sperm motility analyser (CASA), and differences between the BB and HF breed could also be demonstrated. Higher percentages of both totally (p < 0.0001) and progressively (p < 0.0001) motile spermatozoa were encountered in the HF breed compared with the BB breed. Furthermore, a lower kinetic efficiency of the BB spermatozoa, evidenced by a lower beat cross‐frequency (p = 0.0007) combined with a higher lateral head displacement (p = 0.0015), was the basis for the lower velocity of BB sperm cells. Additionally, BB spermatozoa move less straight forward, resulting in a lower straightness (p < 0.0001). No sperm motility differences were observed between age groups within the BB breed. The breed differences were observed in the examined bull populations residing at AI centres, in Belgium for the BB bulls and in the Netherlands for the HF bulls. However, these bull populations are selected for fertility. A similar pattern was observed in an unselected bull population of both breeds, although these differences were mostly non‐significant for the different CASA parameters. Nevertheless, these data suggest that a genetic component might be responsible for the observed sperm motility breed differences.
Fluorescent Stain Method for the Simultaneous Determination of Mitochondrial Potential and Integrity of Plasma and Acrosomal Membranes in Boar Sperm
Authors: De Andrade AFC , De Arruda RP , Celeghini ECC , Nascimento J , Martins SMMK , Raphael CF , Moretti AS
Published: February 2007

Contents

The purpose of this study was to validate a technique for simultaneous evaluation of the plasma, acrosomal and mitochondrial membranes in boar spermatozoa, using an association of fluorescent probes: Propidium iodide (PI), fluorescein isothiocyanate‐conjugated Pisum sativum agglutinin (FITC‐PSA) and JC‐1. Three ejaculates from each of four different boars, all showing motility ≥80% and abnormal morphology ≤10%, were diluted in TALP medium and split into two aliquots. One of the aliquots was flash frozen in liquid nitrogen and thawed in three continuous cycles, to induce damage in cellular membranes and to disturb mitochondrial function. Three treatments were prepared with the following fixed ratios of fresh semen : flash frozen semen; 100 : 0 (T100), 50 : 50 (T50), and 0 : 100 (T0). The samples were then submitted to a stain technique. To a 150‐μl aliquot of diluted semen it was added 3 μl of PI (0.5 mg/ml), 2 μl of JC‐1 (153 μm) and 50 μl of FITC‐PSA (100 μg/ml). Samples were incubated at 38.5 °C for 8 min, in the dark. An 8‐μl sample was put on a slide, coverslipped and immediately evaluated by epifluorescent microscopy. The association of fluorescent probes was divided into eight cell classes, according to plasma membrane integrity, intact acrosome and mitochondrial function. For plasma membrane integrity, detected by PI probe, the equation: (p < 0.0001) and R2 = 0.97 was obtained. The intact acrosome, verified by the FITC‐PSA probe, produced the equation: (p < 0.0001) and R2 = 0.98. The mitochondrial potential, marked by JC‐1, was estimated by the equation: (p < 0.001) and R2 = 0.99. The group of spermatozoa with combined intact plasma membrane, intact acrosome and high mitochondrial potential (IPIAH), was estimated by the equation: (p < 0.0001) and R2 = 0.97. The resulting linear equations demonstrate that this technique is efficient and practical for the simultaneous evaluations of the plasma, acrosomal and mitochondrial membranes in boar spermatozoa.
The ‘expert’nurse comforter: Perceptions of medical/surgical patients
Authors: Walker Annette Clare
Published: February 2007

An interpretative study of Australian adult medical—surgical patients’experiences and perceptions of comfort and discomfort in hospital uncovered a number of themes. One theme, patients’perceptions of and experiences with nurses they called ‘good’or ‘expert’, is the subject of this paper. Informants provided brief vignettes of ‘expert’nurses and glimpses of skilled nursing that depicted nurses as important sources of comfort and well‐being. Nurses who ‘knew what they were doing’in intensive‐care units and in high‐dependency, medical—surgical, postnatal and short‐stay wards were reassuring, caring and ‘expert’. Informants’descriptions of expert nursing are briefly compared with descriptions found in the professional nursing literature. Because nursing work is poorly understood and because it is immensely comforting for patients to know that nurses are both competent and caring, nursing comfort and safety work deserve to have a higher profile in the public perception of nursing.
A journey towards continence through emancipatory action research
Authors: Frey‐Hoogwerf Lucienne J.R.
Published: February 2007

Emancipatory action research was used to assist four women in developing an understanding of the feelings and reactions associated with urinary incontinence. The four participants initially expressed feelings of anger, embarrassment and frustration towards their urinary incontinence, perceiving it as a threat to their self‐esteem. Through reflection they discovered that they held several misconceptions about urinary incontinence. They believed that it was a result of childbirth and ageing, and that little to nothing could be done to treat it. During the study, which took place over a period of 5 months, the women's level of knowledge, confidence and trust increased leading to the formulation of new insights. This enabled them to actively deal with their concerns and to initiate change. The resulting action plans incorporated conservative treatment plans and the development of a support group. Six weeks after commencement of the study, three of the four women regained continence. The fourth participant reported a significant improvement in both frequency of incontinence episodes and quality of life.
A comparative study of teacher directed and self directed methods of teaching clinical skills to undergraduate nursing students
Authors: Nixon Maureen , Morgan Lyn , BAppSc(Nursing) Judith Forsyth , RN Denise Ellis
Published: February 2007

The undergraduate nursing degree has within its curriculum a practical component that enables students to gain the skills required to function effectively in the clinical setting. These skills are often taught in the laboratory setting using a structured teacher directed approach. This study used a ‘post‐test only’experimental design to compare clinical skills acquisition (both cognitive and psychomotor) of students participating in two different teaching‐learning modalities: (i) teacher directed; and (ii) self directed learning. The sample consisted of 59 year 2 nursing students enrolled in the acute care subject. The results demonstrated that, although students acquired a variety of skills by participation in either method of teaching‐learning, those who undertook self directed learning showed a higher level of competency. The reasons for this difference require further investigation.
The triage role in emergency nursing: Development of an educational programme
Authors: McNally Stephen
Published: February 2007

This study explores the professional and educational development of emergency nurses and their beliefs regarding the appropriate content for a triage educational programme. A descriptive survey was conducted of emergency nurses employed by randomly selected teaching and non‐teaching hospitals. Data analysis showed that emergency nurses used various methods to prepare and maintain their triage expertise. The survey found that the best method to prepare the novice emergency nurse for the triage role was to use a combination of a triage educational programme and clinical experience. Respondents indicated great interest in enrolling in an educational programme and, as a result of this survey, a comprehensive triage educational programme has been developed.
Power in partnership
Authors: Yuen Felix , Owens Jan
Published: February 2007

This paper focuses on the meaning and process of collaboration, particularly in the area of research and clinical practice. Much has been written about the existing gaps between research and the practice of nursing; however, action research is one mechanism that allows these elements to be drawn together. Research developed through collaborative participation has the potential to harness the energy, enthusiasm and talents of nurses at different levels and practice into a cohesive group motivated to achieve professional development and quality practice goals. Action research that is built on the philosophy of a quality within the process and significance of the group can lead to effective practice in nursing. Power can be found in partnership.
Group interviewing for the purpose of selection
Authors: Jordan Andrea
Published: February 2007

This paper describes the process of utilizing group interview techniques combined with elements of qualitative methodology to facilitate the selection of newly registered nurses for acceptance into a graduate nurse programme. The paper demonstrates the flexibility and adaptability of group interviewing when interviewing large numbers of candidates for a limited number of positions. It explores the process from a humanistic perspective and identifies the strengths and weaknesses of the instrument, which will enable further refinement and applicability.
The discharge liaison nurse at the interface of hospital and community nursing services
Authors: Armitage Sue K , Kavanagh Kay M
Published: February 2007

The organization of nursing into hospital and community services makes the smooth transition of care between hospital and community difficult to establish. This paper describes the function of discharge liaison nurses as one facet of a study designed to determine how hospital and community nurses perceive their provision of continuing patient care. Semi‐focused interviews were conducted with 12 hospital nurses and 12 community nurses to explore their perceptions of discharge planning related experiences. Hospital and community nurses both relied on discharge liaison nurse to provide a link between hospital and community services. The practice of discharge liaison nurses as facilitators and co‐ordinators of discharge planning are discussed.
Practice patterns of Finnish public health nurses
Authors: Koponen Päivikki , Kalkas Hertta
Published: February 2007

Koponen P, Kalkas H. International Journal of Nursing Practice 1997; 3: 97–104

Practice patterns of Finnish public health nurses

The aim of this study was to: (i) describe the practice patterns of Finnish public health nurses during the development of primary health care based on the ‘population responsibility’ principle; and (ii) to identify the relation of public health nurses’ task division models and types of community (rural/town) to their practice patterns. A detailed recording of public health nurses’ home and clinic visits was developed and used during three annual study periods in 8–9 health centres by 93–118 public health nurses. The total number of recorded visits varied annually from 4842 to 6841. Statistical significance was determined by Chi‐squared. Significant differences were found between the three study periods and also in the practice patterns of public health nurses (PHN) with different task division models and of PHN working in different types of community. However, the short study periods limited the practical importance of these findings.
Liver transplantation: The death/life paradox
Authors: Lumby Judy
Published: February 2007

Lumby J. International Journal of Nursing Practice 1997;3:231–238

Liver transplantation: The death/life paradox

Transplantation of organs has increased dramatically over the last 3 decades. The Australian National Liver Transplant Unit was established in 1985 at Royal Prince Alfred Hospital. Their first 5 years was reported in a paper in 1992 in which survival was defined as ‘going home’. The study reported in this paper followed a 3 year study with one woman who experienced a liver transplant in which survival had many dimensions, of which going home was not one. This post doctoral study of 2 years extended the earlier work with one woman by exploring the experience with eight ‘survivors’. It highlighted the paradox of facing life and death at the same time, which occurs when one has a terminal illness but is on a waiting list for a donor organ which could be life saving. Focus groups were used as the methodology while story telling within the group became the means by which individuals and the group recalled and made meaning of their experiences.
Ropivacaine versus lidocaine for deep‐topical, nerve‐block anaesthesia in cataract surgery: a double‐blind randomized clinical trial
Authors: Ugur Bakiye , Dundar Sema Oruç , Ogurlu Mustafa , Gezer Erdal , Ozcura Fatih , Gursoy Feray
Published: February 2007

Abstract

Purpose:  To evaluate the safety and efficacy of ropivacaine versus lidocaine for deep‐topical, nerve‐block anaesthesia in cataract surgery.

Methods:  This prospective controlled randomized double‐blind study comprised 64 patients undergoing clear corneal phacoemulsification. Patients were equally divided into two group receiving either deep‐topical anaesthesia with 1% ropivacaine‐soaked sponge (Group R, n = 32) or 2% lidocaine‐soaked sponge (Group L, n = 32). The level of intraoperative and postoperative pain was assessed by patients using a verbal analogue scale from 1 to 10. The duration of surgery, the need for supplemental anaesthesia, surgeon satisfaction, and intraoperative and early postoperative complications were recorded. The patients’ heart rate, arterial blood pressure and peripheric oxygen saturation (SpO2) were obtained just before the anaesthesia and during the surgery.

Results:  The demographic data of the patients and duration of surgery were similar in both groups. No significant difference in the mean pain scores of patients were found in the ropivacaine and lidocaine groups. Surgical satisfaction was also statistically insignificant. None of the patients had significant difference in heart rate, blood pressure or SpO2 during the surgical procedure.

Conclusion:  Deep‐topical anaesthesia with ropivacaine and lidocaine in cataract surgery is safe and the two anaesthetic agents do not present differences in the degree of analgesia achieved. Deep‐topical anaesthesia with ropivacaine or lidocaine was equally effective in providing anaesthesia with sufficient quality for cataract surgery.
Teaching of ophthalmology in undergraduate curricula: a survey of Australasian and Asian medical schools
Authors: Fan Jennifer C , Sherwin Trevor , McGhee Charles NJ
Published: February 2007

Abstract

Background:  Despite established international guidelines on preferred teaching components for ophthalmology in undergraduate curricula, with increasingly less specialty‐based undergraduate teaching within curricula, teaching of core ophthalmology knowledge and skills may become marginalized. This survey aims to evaluate the current state of undergraduate ophthalmology teaching in Australasia and proximate Asian medical schools.

Methods:  A questionnaire was developed to determine the content and extent of ophthalmology teaching in the undergraduate medical curriculum. The questionnaire was sent to 25 medical schools throughout Australasia and Asia.

Results:  Nineteen of the 25 questionnaires were returned (76% response rate). Ophthalmology teaching programmes ranged from 2 to 20 days: five (26%) medical schools having one ophthalmology attachment; six schools (32%) two attachments; and the remainder three or more. Only seven of the schools taught all 13 ophthalmology topics recommended in current curriculum guidelines. Ocular examination (100%), lens and cataract (95%) and ocular manifestations of systemic disease (95%) were the most commonly taught topics, with intraocular tumours only covered by 10 schools (53%). Students in 14 schools (74%) attended ophthalmology operating theatre, but only two schools (11%) offered attendance at optometry clinics. Ten schools (53%) required a pass in ophthalmology to complete the academic year.

Conclusion:  Ophthalmology may increasingly be a small, or even absent, component of undergraduate medical curricula. Despite established international ophthalmology curriculum guidelines, this survey highlights significant lack of uniformity in their implementation.
COMPOSITION OF VOLATILE ORGANIC COMPOUNDS IN DIATHERMY PLUME AS DETECTED BY SELECTED ION FLOW TUBE MASS SPECTROMETRY
Authors: Moot Andrew R. , Ledingham Katherine M. , Wilson Paul F. , Senthilmohan Senti T. , Lewis David R. , Roake Justin , Allardyce Randall
Published: February 2007

Background:  There is some evidence that surgical plume may pose a risk to health professionals, but the risks posed by volatile organic compounds have not been thoroughly investigated.

Methods:  The composition of volatile organic compounds in diathermy plume produced during surgery was analysed by selected ion flow tube mass spectrometry.

Results:  Hydrogen cyanide (3–51 parts per million), acetylene (2–8 parts per million), and 1,3‐butadiene (0.15–0.69 parts per million) were identified in the plume.

Conclusion:  Although there is no evidence of adverse health effects from the volatile organic compound in diathermy plume, the evidence that it is safe to breathe this plume is lacking. Therefore, we would recommend the use of smoke evacuators where practical.
OUTCOMES AFTER OESOPHAGOGASTRECTOMY FOR CARCINOMA OF THE OESOPHAGUS
Authors: Omundsen Mark , Babor Richard , Johnston Peter
Published: February 2007

Background:  Carcinoma of the oesophagus is a rare but a highly lethal malignancy. The incidence of adenocarcinoma in particular is increasing in the Western world. Despite improvements in staging, perioperative care and the use of adjuvant/neoadjuvant regimen the prognosis remains poor.

Methods:  All patients who had biopsy‐proven oesophageal carcinoma between the years 1992 and 2004 in the Wellington region, New Zealand, were retrospectively reviewed. The personal and tumour characteristics, operation details, complications and the details of hospital stay of patients who had had a resection were recorded in a database . Survival data were recovered from the notes, hospital database or general practitioner records and were available for all patients who had surgery. Survival analyses were calculated using Kaplan–Meier estimates.

Results:  One hundred and ninety‐one patients were diagnosed with oesophageal carcinoma during the study period (59% adenocarcinoma, 32% squamous cell carcinoma). Only 35% (n = 67) had a resection (81% adenocarcinoma, 13% squamous cell carcinoma). Fifty‐one (77%) had an Ivor Lewis procedure, 9 (14%) had only a laparotomy and 6 (9%) had a laparotomy, right thoracotomy and cervical incision. Forty‐six (70%) tumours were in the distal third of the oesophagus and 13 (20%) were at the oesophagogastric junction. Perioperative mortality was 10% (n = 7) and anastomotic leak rate 9% (n = 6). Five‐year survival was 23%.

Conclusion:  Results from our institution for the resection of oesophageal cancer compare favourably with those in the published work. Staging with computed tomography and laparoscopy has resulted in acceptable resection and survival rates. Survival for this disease is still largely stage dependent and earlier diagnosis probably holds the key to improved prognosis.
Comparison of isoflurane and halothane on recovery from neuromuscular blockade using atracurium in infants with hepatic dysfunction undergoing major abdominal surgery
Authors: GREEN D.W.
Published: February 2007

The effects of either isoflurane or halothane on recovery from neuromuscular blockade with atracurium in infants with hepatic dysfunction undergoing major abdominal surgery were studied. Neuromuscular blockade was assessed visually at minute intervals by ‘train‐of‐four’ using supra‐maximal stimuli. The times to first and second increment and total requirement of atracurium in two groups of infants randomly allocated to receive either isoflurane or halothane for induction and supplementation were recorded. Fourteen patients completed the study, seven with isoflurane and seven with halothane. No evidence was found that recovery from neuromuscular blockade with atracurium was prolonged by isoflurane as compared to halothane.
Neuroblastoma and anaesthesia
Authors: CREAGH‐BARRY P. , SUMNER E.
Published: February 2007

The haemodynamic problems associated with anaesthesia and neuroblastoma were reviewed in 52 children who underwent 138 operations at The Hospital for Sick Children, London, UK. At diagnosis 42 patients (81%) had elevated urinary catecholamine metabolites; nine (17%) were hypertensive, of whom eight were treated with adrenergic blockade. The incidence of intra‐operative hypertension due to excess catecholamine release was 9% (13/138), and was confined to the group undergoing tumour excision (29%; 13/45). Hypertension was observed more frequently in patients who had not received chemotherapy. It was effectively controlled by labetalol. Patients symptomatic of catecholamine secretion before surgery should be managed in a similar manner for those with a phaeochromocytoma. Surgical manipulation of the tumour predisposes to paroxysmal hypertension. Careful monitoring is advised.
Negative pressure ventilation for infants with respiratory failure after cardiac surgery
Authors: JARDINE D. S. , COSTARINO A.
Published: February 2007

We report our experience using negative pressure ventilation (NPV) to support 40 infants who required prolonged positive pressure ventilation after cardiac surgery (average duration of post‐operative positive pressure ventilation was 9.2 days). NPV was used for an average of 2.4 days, during which 20 patients were weaned to spontaneous unsupported ventilation, and 20 patients required reintubation. Progressive tachypnoea during NPV was a reliable sign of respiratory insufficiency and preceded failure of NPV.

Patients who failed one trial of NPV were likely to fail later trials (11 of 13 failed repeated attempts at NPV). Complications following this therapy were minor.

NPV may be successfully used as an alternative form of respiratory support for some infants who require prolonged positive pressure ventilation after cardiac surgery.
Decreased protein binding of alfentanil in plasma from children with kidney or liver failure
Authors: DAVIS P.J. , STILLER R.L. , McGOWAN F.X. , CHAKRAVORTI S. , COOK D.R.
Published: February 2007

Disease states, including end‐stage kidney or liver failure, can alter the protein binding of various drugs in children. The plasma protein binding of alfentanil was evaluated in blood samples from 15 children about to undergo kidney transplantation, 21 children undergoing liver transplantation, and 28 otherwise healthy children undergoing elective surgery. Compared with the healthy children, patients with kidney disease had a significant decrease in protein binding (89.2%± 5.4 v. 93.1%± 3.2), an increase in α1‐acid glycoprotein concentration (108.8 mg·dl−1± 44.3 v. 71.8 mg·dl−1± 30.7), and no change in albumin concentration (3910 mg·dl−1± 754 v. 4555 mg·dl−1± 524); whereas patients with liver disease had a significant decrease in protein binding (85.9%± 6.2 v. 93.1%± 3.2), no change in α1‐acid glycoprotein concentration (65.8 mg·dl−1± 31.8 v. 71.8 mg·dl ± 30.7), and a decrease in albumin concentration (3045 mg·dl−1± 1255 v. 4555 mg·dl−1± 524). Because alfentanil is highly protein bound, even small changes in the drug's free fraction could have marked pharmacodynamic effects in patients with kidney or liver failure.
Fetal anaesthesia for intrauterine treatment
Authors: TASHIRO C. , INAMORI N. , TANIGAMI H. , NISHIMURA M. , FUKUMITSU K. , SHIMIZU I.
Published: February 2007

Fetal anaesthesia was performed 5 times in 1 patient to treat pleural effusions, obtain fetal blood sampling, provide albumin infusion, and establish and replace a pleuro‐amniotic indwelling shunt catheter under ultrasound guidance. A maternal epidural catheter was placed and used for epidural anaesthesia for the first 4 anaesthetics. Fetal administration of pancuronium 0.15 mg·kg−1 via the umbilical vein or 0.25 mg·kg−1 intramuscularly was enough to produce immobilization without maternal effect. However, maternal pretreatment with intravenous diazepam and fentanyl was required for fetal sedation and analgesia, which was necessary for accurate and safe injection, and for suppression of fetal stress.
A comparison of caudal morphine given pre‐ or postsurgery for postoperative analgesia in children
Authors: IRVING G.A. , BUTT A.D. , VAN DER VEEN B.
Published: February 2007

Twenty‐eight children (mean age 4.4 years) undergoing elective major upper‐abdominal or thoracic surgery were randomly selected to receive caudal morphine 0.07 mg·kg−1 in saline either before (Group One) or immediately after surgery (Group Two). Caudal morphine injection given prior to surgery significantly prolonged postoperative analgesia when compared to caudal morphine given immediately post‐surgery. Ten out of 14 children in Group One required no further analgesia over the next 24 h compared to 3 out of 14 in Group Two. There was no detectable difference in ventilatory frequency or oxygen saturation and no clinically significant respiratory depression was recorded in either group. There was no nausea, vomiting or pruritus postoperatively, which was ascribed to the use of trimeprazine and droperidol premedication, however, 30% of patients required catheterization for urinary retention.