bluuebunny/crossref_metadata_2025 huggingface dataset:
Beyond beliefs: Challenging obsessive thoughts and compulsive behaviours within a collaborative counselling relationship
Authors: Baines Kathy , Wills Frank
Published: September 2005

Three clients with obsessive‐compulsive disorder were studied using a multiple case study approach. Clients' experiences of cognitive‐behavioural therapy, in particular the impact of having their beliefs challenged, and their responses to self‐monitoring tasks and behavioural experiments were investigated. Data included case notes made during therapy, pre‐ and post‐therapy questionnaires, and post‐therapy semi‐structured interviews. Qualitative analysis of the data identified clients' obsessive beliefs, general negative beliefs and meta‐cognitive beliefs, and explored any post‐therapy changes in these beliefs. The results demonstrated similarities between cases in obsessive beliefs (e.g. inflated responsibility for harm), general negative beliefs (e.g. feelings of failure), meta‐cognitive beliefs (e.g. the need to control thoughts) and affect (e.g. guilt). Questionnaire data from all three clients suggested no clinically significant post‐therapy changes in general negative beliefs and meta‐cognitive beliefs. However, idiosyncratic changes in obsessive beliefs were reported during therapy and at post‐therapy interview, and clients reported improved functioning and decreased levels of distress during therapy and at interview. Responses to challenge were uniformly positive, but reactions to self‐monitoring and behavioural experiments varied across cases. The implications of these findings for the treatment of obsessive‐compulsive disorder using cognitive behavioural techniques are discussed.
An investigation into the client at the heart of therapy
Authors: Rodgers Brian
Published: September 2005

This paper reports on an exploration of the experience of the client at the heart of therapy. A grounded theory analysis of clients' experiences of therapy provided through a voluntary sector counselling service was undertaken, and generated four main categories: permission, engagement, transparency and restructuring. The results of the study are presented in a way that hopefully retains much of the richness of what people have reported about their experience of counselling. The findings of the study are discussed in terms of the idea that counselling can provide a setting where people can have common therapeutic requirements met.
Photography as a therapeutic tool for substance abuse clients who have a history of sexual abuse
Authors: Graf Noreen M
Published: September 2005

Symptoms of sexual abuse among persons in substance abuse treatment facilities may be difficult to recognise since presenting symptoms frequently mirror those associated with substance abuse. Additionally, treatment may be difficult due to a lack of previous verbal processing and shared negative defence mechanisms that are resistant to traditional talking therapy. The use of photography is presented here as a method of treatment initiation and exploration for substance abuse clients who have a history of sexual abuse. The paper reviews rationale, advantages, current applications and practitioner concerns associated with the use of photography as a therapeutic tool.
Women, alcohol, self‐concept and self‐esteem: A qualitative study of the experience of person‐centred counselling
Authors: Lillie Noreen
Published: September 2005

This study explores the self‐concept and self‐esteem of women with alcohol problems from a client perspective, and relates the findings to person‐centred theory and practice. Eight women with severe and long‐standing alcohol problems, who had received person‐centred counselling, were interviewed in relation to their sense of self over time. The data were analysed using grounded theory methodology, resulting in the emergence of five key categories. Examples from the interviews are used to illustrate the complex relationships between life experience, self‐concept, self‐esteem and drinking. The possible significance of the findings for counsellors working with this client group is discussed.
Evidence based practice: A guide for counsellors and psychotherapists
Authors: Goss Stephen , Rose Suzanna
Published: September 2005

There has been an increasing tendency for healthcare policy makers and managers to require that all forms of therapy are supported by rigorous research evidence. This paper, which has also been distributed as an Information Sheet to all members of the British Association for Counselling and Psychotherapy (BACP), provides a practitioner‐oriented introduction to evidence‐based practice, with suggestions for further reading on this topic.
Oppression within the counselling room
Authors: Reeve Donna
Published: September 2005

This paper suggests that the oppression experienced by disabled people in society is sometimes replayed in the counselling room by counsellors who are unaware of their own disablist attitudes and prejudices. Whilst the provision of Disability Equality Training (DET) within counselling courses would ameliorate the problem, I believe that disabled people would be most empowered by a counselling approach which recognises the potential for oppression within the counsellor‐client relationship. One solution may be the creation of a new counselling approach (disability counselling) which includes the social model of disability as one of the foundations. An alternative solution may be found within the emerging counselling approaches that treat counselling as a social and political process and place emphasis on developing comprehensive anti‐discriminatory practice.
Unlocking the secrets of ‘good supervision’: A phenomenological exploration of experienced counsellors' perceptions of good supervision
Authors: Weaks Dot
Published: September 2005

This paper reflects the findings of a qualitative study carried out to identify the elements of good supervision. Nine experienced counsellors were invited to participate in semi‐structured interviews in which they were asked to share their views and experiences of what good supervision meant for them. Following a grounded theory analysis of interview transcripts, the supervisory relationship emerged as the central component of good supervision. Three key constituents were identified as ‘core conditions' which were necessary for an effective supervision relationship to become established: equality, safety and challenge. It is suggested that supervisees seek different things from supervision. Four different types of ‘seeking’ activity were recognised and categorised in this study.
The inner critic on the move: Analysis of the change process in a case of short‐term client‐centred/experiential therapy
Authors: Stinckens Nele , Lietaer Germain , Leijssen Mia
Published: September 2005

The term ‘inner critic’ describes the strong inner normative voice with which some people block themselves. In client‐centred/experiential psychotherapy this voice is considered as a process disturbance that interferes with the organismic experiencing of the client. Although various attempts have been made to characterise the way the inner critic appears in therapy, these are mostly based on clinical impressions rather than systematic research. This paper introduces a new model of the phenomenon of the ‘inner critic’ in psychotherapy, structured around five main process clusters:

1.A past history of rejection, restriction and neglect

2.Negative self-schemes

3.Information processing deficits

4.Self-protective behaviours

5.Interpersonal problems.

The operation of these factors is illustrated through analysis of a single case which draws on a combination of qualitative and quantitative research methods to explore aspects of the inner critic within a good outcome case of client‐centred/experiential psychotherapy. The aim of this analysis is to chart the various manifestations of the inner critic and to examine how they gradually evolve during the course of therapy. In a first stage we give a narrative account of each session, including some excerpts from the transcript, along with an analysis of the key themes within each session. The second stage of the analysis offers a summary of the quantitative data that we collected, analysed in terms of longitudinal trends across the case as a whole. Finally, we discuss the limitations of our study, explore the implications for practice and make some suggestions for future research.
The persons‐in‐relation perspective: Towards a philosophy for counselling in society
Authors: Kirkwood Colin
Published: September 2005

This paper is the first in a planned series, which aims to articulate and synthesise the persons‐in‐relation perspective in counselling and psychotherapy, drawing together the contributions of the philosopher John Macmurray, the psychotherapist Ian Suttie and the psychoanalyst Ronald Fairbairn. The paper introduces the persons‐in‐relation perspective, derived from Macmurray's work. It outlines the historical and cultural context leading to the emergence of modernism, and the response of personalism. It summarises John Macmurray's life and philosophy, focusing on his account of knowledge, its relation to the senses and the emotions, and his view of persons, society and religion. The paper goes on to develop a hypothesis about the rise of counselling in Britain, linking it to the decline of religion, the conflict between individualism and collectivism, and the re‐emergence of the persons‐in‐relation perspective. It concludes by posing challenges for the person‐centred and psychodynamic orientations, and for counselling as a whole.
Five women talk about work‐related brief therapy and therapeutic writing
Authors: Wright Jeannie
Published: September 2005

Therapeutic writing can play a valuable role in brief, workplace counselling. The present study explores the experiences of five women who used therapeutic writing in this context. Ethical and methodological dilemmas in carrying out this research are highlighted. The study also demonstrates the use of ‘fictionalist’ accounts as a way of overcoming some of the difficulties associated with the dual role of practitioner/researcher, especially confidentiality.
Experiencing gay affirmative therapy: An exploration of clients' views of what is helpful
Authors: Pixton Susan
Published: September 2005

Gay affirmative therapy is a counselling approach that emphasises an affirming, non‐pathologising approach to therapeutic work with lesbian, gay and bisexual clients. In this study, lesbian and gay clients who had experienced counselling that they defined as affirming identified what they perceived to have been helpful. Questionnaires and interviews were used to collect the views of a sample of lesbian, gay and bisexual informants. The material gathered was analysed using a grounded theory approach, which generated six main categories: communicating a non‐pathologising perspective on homosexuality; the counselling relationship; the counselling space; what the counsellor brought to the relationship; humanity; and the counsellor adopting a holistic approach. Some of these identified affirming elements are unique to gay affirmative therapy and cannot be attributed to other factors. The possible significance of the findings for practitioners is discussed.
Therapist responses to requests for disclosure of therapeutic records: An introductory study
Authors: Jenkins Peter
Published: September 2005

This paper describes a questionnaire survey of therapists in the UK who have been subject to requests for disclosure of client records as part of a legal process. Therapist responses are outlined in terms of the perceived effect of such disclosure on the client, therapist and the therapeutic relationship. Negative effects included the experience of exposure of sensitive client material in an adversarial legal system, of powerful emotional responses by therapists, and a sense of feeling professionally de‐skilled in an unfamiliar and often challenging legal environment. Positive effects for the client included the achievement of valued outcomes such as compensation, and, for the therapist, the facilitation of support for the client in this process. These findings are discussed in terms of a contrast between therapist perceptions of consensual and contested disclosure. In the former, therapist and client are in agreement about the restorative value and outcome of disclosure. In contested disclosure, the process is experienced as disrupting therapeutic privacy, undermining professional self‐confidence and introducing an unwelcome element of critical re‐evaluation of client motives for undertaking therapy.
Cultural landscapes in counselling and psychotherapy: Introduction to the Theme Section
Authors: West William , McLeod John
Published: September 2005

The concept of ‘culture’ is gaining in significance within the discourse of counselling and psychotherapy, as a means of making sense of the ways in which shared identities and behaviours are constructed and maintained. The selection of papers included within this Theme Section explore different aspects of the use of the idea of culture within counselling and psychotherapy. In this introductory piece, we seek to place this work in a social and professional context.
Cultural diversity: Mapping the experiences of students on an international counsellor training programme
Authors: Pattison Sue
Published: September 2005

This research study explores one part of a diverse counselling training landscape in the shape of an international postgraduate education and training programme for counsellors. The research sample includes participants from Tanzania, the Gambia, Ghana, Nigeria, Indonesia, China, Taiwan, Iceland, Japan, Greece, Portugal, Lebanon and Saudi Arabia. Cultural diversity is examined in relation to the learning and development of international counselling students. Qualitative analysis of interview data is used to identify issues related to student expectations, the process of becoming a counsellor and student learning outcomes. Some issues in counsellor training appear to be shared across all international students, while other issues arise from specific cultural backgrounds of students. The implications of these findings are discussed.
Research priorities in the psychological therapies: View from the British Association for Counselling and Psychotherapy
Authors: Goss Stephen
Published: September 2005

This paper seeks to summarise recent discussions within the British Association for Counselling and Psychotherapy (BACP) about the strategic direction and priorities for the organisation, the profession as a whole and, ultimately, the service users. The standing research policy commitment to a pluralist approach to research is affirmed and a number of competing approaches are briefly considered. The direction of general policy and specific aims are noted. The paper does not seek to define a BACP position, as such, and is intended to stimulate further debate and discussion which will feed directly into the development of the BACP research policies and activities during this crucial development period.
Masculinity and madness
Authors: Garde Jane
Published: September 2005

This paper explores the way madness is culturally represented in the West, and the impact of these ideas on the mental health system. The paper offers an alternative liberationist approach to gender, madness and psychotherapeutics. Strange, unexpected or apparently inexplicable behaviour and/or thoughts are usually considered to be abnormal. Invariably such behaviour and/or thoughts are labelled as madness ‐ psychological conditions deemed to be problematic. Common images associated with madness include emotional display, wildness, irrationality, sexuality, and passivity. In Western cultures these traits representing madness seem to be equated with aspects of femininity, thus inducing unsympathetic, condemnatory reactions within societies. Such responses tend to serve the social function of enforcing conformity within oppressive systems. Western cultures broadly polarise masculinity and femininity: masculinity tends to represent sanity. Yet this apparently positive status of masculinity leaves men with innumerable difficulties. The social conception of masculinity does not encompass many capacities that distinguish humanity, such as cognitive and behavioural flexibility, emotional awareness, empathy, compassion, co‐operation, exuberance, creativity, imaginativeness and sensitivity. Indeed, this cultural conception of madness impacts adversely on the operation of social institutions and is oppressive in different ways in the lives of both men and women.
Men's experience of considering counselling: ‘Entering the unknown’
Authors: Millar Anthea
Published: September 2005

Agency statistics in the UK and North America reveal that fewer men than women attend counselling, at a ratio of about 1:2. This study investigated men's experience of considering counselling, with the aim of gaining further understanding of factors that might contribute to the existing gender discrepancy in utilisation of counselling. Following responses by 47 men to written questionnaires, 10 men who had considered and ultimately attended counselling were interviewed, and a grounded theory method of analysis was used to generate and analyse the participants' experiences. Three interconnected categories emerged: societal perceptions of counselling and gender roles; change of experience over time; and knowledge — ‘knowing’ and ‘not knowing’ the protocols of counselling. The implications of these findings are discussed. It is recommended that prospective male clients should be provided with information about the counselling process, and that there needs to be increased awareness by counsellors and referring agents of male gender issues.
Gay men's experiences of therapy
Authors: Mair David
Published: September 2005

Fourteen gay men were interviewed using a structured interview schedule to explore their experiences of being in therapy. Particular importance was given to their perceptions of how their sexual orientation impinged on the counselling process and how their assumptions about counsellor sexual orientation affected the therapeutic relationship. The limitations of using structured interviews in qualitative research are acknowledged. Some significant findings were made, which were not well documented in the literature, such as the impact on the therapeutic relationship of internalised homophobia within gay men themselves. These findings hold the potential to inform counselling practice with gay male clients. Recommendations are made in relation to both practice and further research.
Acculturation and ethnic identity in marginal immigrant South Asian men in Britain: A psychotherapeutic perspective
Authors: Dhillon Kamaldeep , Ubhi Manjit
Published: September 2005

The incidence of mental health problems, and their treatment, for immigrant South Asians in Britain appear to be similar to that of the White population. However, there are some significant differences in relation to problems of substance misuse, treatment for depression and suicide. Difficulties in acculturation and in developing an integrated ethnic identity may contribute to some of these differences. Drawing from narratives of marginal immigrant South Asian men, a range of themes is identified. The implications of these issues for therapists are discussed.
Exploration of the attitudes of employees towards the provision of counselling within a profit‐making organisation
Authors: Walton Lesley
Published: September 2005

The provision of workplace counselling has risen significantly over the last 20 years in response to the increase in stress‐related illness amongst employees in UK profit‐making organisations. Despite this expansion there is very little exploration of employee attitudes towards this provision. This paper describes a case study of employee attitudes towards counselling in a UK profit‐making organisation utilising an Employee Assistant Programme (EAP) for staff counselling. The method used for the research was a quantitative approach administered using a short questionnaire distributed to employees by e‐mail. The responses to the questionnaire illustrated that most employees were highly aware of the service and believed stress to be the highest presenting issue to the EAP counsellors. However, stress was actually the lowest presenting issue. The results from this study also suggested that managers had a more negative attitude towards counselling than non‐managers. Men and women were found to have the same highly positive attitude towards counselling. Respondents felt that wider, constant and regular positive promotion of counselling, by the employer as well as the EAP, was needed to increase utilisation of the EAP counselling service. Concerns over confidentiality for those using, or contemplating using, the service were also found — as in other studies — but this study found concerns particularly in relation to managers finding out that an employee had attended counselling. The implications of these findings are discussed.
Who's counting? Access to UK counsellor training: A demographic profile of trainees on four courses
Authors: Coldridge Liz , Mickelborough Peter
Published: September 2005

This paper examines the profiles of students entering four British Association for Counselling and Psychotherapy (BACP) recognised counsellor training courses in the North of England. Data were collected by means of self‐completed questionnaires. The majority of students were white women; a significant percentage were registered disabled and on low incomes. Contrasts between entrants to HE and FE training institutions were found. The implications of these findings are discussed.
Black identity and workplace oppression
Authors: Alleyne Aileen
Published: September 2005

This paper is primarily aimed at counselling and psychotherapy practitioners who meet issues of workplace conflict in their practice and the resulting stress and trauma faced by their clients. I define workplace conflict as complex and enduring situations arising from diverse forms of harassment. These include bullying, scapegoating and other discriminatory and oppressive practices that affect health, esteem and work performance. This paper reports the findings from my doctoral research project which investigated and sought to understand the specific experience and nature of workplace conflict for black workers in three institutional settings: the National Health Service (NHS), education and social services. The inspiration for this research came from psychotherapy practice, where it was repeatedly observed that black workers appeared to be suffering significantly more negative and damaging effects of workplace stress and trauma than white workers. I describe these experiences as workplace oppression and differentiate them from other workplace conflicts.
The Ryanodine Receptors Ca2 + Release Channels: Cellular Redox Sensors?
Authors: Hidalgo Cecilia , Donoso Paulina , Carrasco M Angélica
Published: September 2005

The release of Ca2 + from intracellular stores mediated by ryanodine receptors (RyR) Ca2 + release channels is essential for striated muscle contraction and contributes to diverse neuronal functions including synaptic plasticity. Through Ca2 + ‐induced Ca2 + ‐release, RyR can amplify and propagate Ca2 + signals initially generated by Ca2 + entry into cardiac muscle cells or neurons. In contrast, RyR activation in skeletal muscle is under membrane potential control and does not require Ca2 + entry. Non‐physiological or endogenous redox molecules can change RyR function via modification of a few RyR cysteine residues. This critical review will address the functional effects of RyR redox modification on Ca2 + release in skeletal muscle and cardiac muscle as well as in the activation of signaling cascades and transcriptional regulators required for synaptic plasticity in neurons. Specifically, the effects of endogenous redox‐active agents, which induce S‐nitrosylation or S‐glutathionylation of particular channel cysteine residues, on the properties of muscle RyRs will be discussed. The effects of endogenous redox RyR modifications on cardiac preconditioning will be analyzed as well. In the hippocampus, sequential activation of ERKs and CREB is a requisite for Ca2 + ‐dependent gene expression associated with long lasting synaptic plasticity. Results showing that reactive oxygen/nitrogen species modify RyR channels from neurons and the RyR‐mediated sequential activation of neuronal ERKs and CREB produced by hydrogen peroxide and other stimuli will be also discussed.
IUBMB Life, 57: 315‐322, 2005
Data Integrity Protocol for Sensor Networks
Authors: Durresi Arjan , Paruchuri Vamsi , Kannan Rajgopal , Iyengar S.S.
Published: September 2005

In this paper, we present a novel lightweight protocol for data integrity in wireless sensor networks. Our protocol is based on a leapfrog strategy in which each cluster head verifies if its previous node has preserved the integrity of the packet using the secret key it shares with two hop uptree nodes. The proposed protocol is simple. The analysis and simulation results show that the protocol needs very few header bits, as low as three bits, thus resulting in negligible bandwidth overhead; the protocol poses very low computational overhead, it needs to compute just a hash as compared to multiple complex operations required by any cryptographic implementation for verifying authenticity.
Self-Organization of Activity in Wireless Sensor Networks
Authors: Davis P. , Hasegawa A. , Kadowaki N. , Obana S.
Published: September 2005

We propose a method for managing the spontaneous organization of sensor activity in ad hoc wireless sensor systems. The wireless sensors exchange messages to coordinate responses to requests for sensing data, and to control the fraction of sensors which are active. This method can be used to manage a variety of sensor activities. In particular, it can be used for reducing the power consumption by battery operated devices when only low resolution sensing is required, thus increasing their operation lifetimes.
Is the highest fat oxidation rate coincident with the anaerobic threshold in obese women and men?
Authors: Bircher Stefan , Knechtle Beat , Müller Gabi , Knecht Hans
Published: September 2005

In this study we determined the exercise intensity that elicits the highest fat oxidation rate in 15 obese women and 13 obese men. Furthermore the relationship between this intensity with the lactate (LT) and ventilatory thresholds (VT) was investigated in order to give training recommendation for maximal fat utilization during endurance exercise. After an incremental exercise test until exhaustion on a cycle ergometer, subjects performed six 20‐min exercise bouts of 25, 35, 45, 55, 65 and 75% VO2peak. The 20 min stages were randomly assigned and spread over two separate occasions (three bouts per occasion). Substrate oxidation was measured with indirect calorimetry and was calculated using stochiometric equations. In both, women and men the highest fat oxidation rate occurred at 65% VO2peak and this did not coincide with either the VT or LT. A significant correlation between VT and LT could not be found in women (r=0.33) nor men (r=0.277). In obese women and men training recommendation for maximal fat utilization should not only be given by the intensity at which AnT occurs.
The divergent DSL ligand Dll3 does not activate Notch signaling but cell autonomously attenuates signaling induced by other DSL ligands
Authors: Ladi Ena , Nichols James T. , Ge Weihong , Miyamoto Alison , Yao Christine , Yang Liang-Tung , Boulter Jim , Sun Yi E. , Kintner Chris , Weinmaster Gerry
Published: September 2005

Mutations in the DSL (Delta, Serrate, Lag2) Notch (N) ligand Delta-like (Dll) 3 cause skeletal abnormalities in spondylocostal dysostosis, which is consistent with a critical role for N signaling during somitogenesis. Understanding how Dll3 functions is complicated by reports that DSL ligands both activate and inhibit N signaling. In contrast to other DSL ligands, we show that Dll3 does not activate N signaling in multiple assays. Consistent with these findings, Dll3 does not bind to cells expressing any of the four N receptors, and N1 does not bind Dll3-expressing cells. However, in a cell-autonomous manner, Dll3 suppressed N signaling, as was found for other DSL ligands. Therefore, Dll3 functions not as an activator as previously reported but rather as a dedicated inhibitor of N signaling. As an N antagonist, Dll3 promoted Xenopus laevis neurogenesis and inhibited glial differentiation of mouse neural progenitors. Finally, together with the modulator lunatic fringe, Dll3 altered N signaling levels that were induced by other DSL ligands.
Unexpected prolonged presentation of influenza antigens promotes CD4 T cell memory generation
Authors: Jelley-Gibbs Dawn M. , Brown Deborah M. , Dibble John P. , Haynes Laura , Eaton Sheri M. , Swain Susan L.
Published: September 2005

The kinetics of presentation of influenza virus–derived antigens (Ags), resulting in CD4 T cell effector and memory generation, remains undefined. Naive influenza-specific CD4 T cells were transferred into mice at various times after influenza infection to determine the duration and impact of virus-derived Ag presentation. Ag-specific T cell responses were generated even when the donor T cells were transferred 3–4 wk after viral clearance. Transfer of naive CD4 T cells during early phases of infection resulted in a robust expansion of highly differentiated effectors, which then contracted to a small number of memory T cells. Importantly, T cell transfer during later phases of infection resulted in a modest expansion of effectors with intermediate phenotypes, which were capable of persisting as memory with high efficiency. Thus, distinct stages of pathogen-derived Ag presentation may provide a mechanism by which T cell heterogeneity is generated and diverse memory subsets are maintained.
MT1-matrix metalloproteinase directs arterial wall invasion and neointima formation by vascular smooth muscle cells
Authors: Filippov Sergey , Koenig Gerald C. , Chun Tae-Hwa , Hotary Kevin B. , Ota Ichiro , Bugge Thomas H. , Roberts Joseph D. , Fay William P. , Birkedal-Hansen Henning , Holmbeck Kenn , Sabeh Farideh , Allen Edward D. , Weiss Stephen J.
Published: September 2005

During pathologic vessel remodeling, vascular smooth muscle cells (VSMCs) embedded within the collagen-rich matrix of the artery wall mobilize uncharacterized proteolytic systems to infiltrate the subendothelial space and generate neointimal lesions. Although the VSMC-derived serine proteinases, plasminogen activator and plasminogen, the cysteine proteinases, cathepsins L, S, and K, and the matrix metalloproteinases MMP-2 and MMP-9 have each been linked to pathologic matrix-remodeling states in vitro and in vivo, the role that these or other proteinases play in allowing VSMCs to negotiate the three-dimensional (3-D) cross-linked extracellular matrix of the arterial wall remains undefined. Herein, we demonstrate that VSMCs proteolytically remodel and invade collagenous barriers independently of plasmin, cathepsins L, S, or K, MMP-2, or MMP-9. Instead, we identify the membrane-anchored matrix metalloproteinase, MT1-MMP, as the key pericellular collagenolysin that controls the ability of VSMCs to degrade and infiltrate 3-D barriers of interstitial collagen, including the arterial wall. Furthermore, genetic deletion of the proteinase affords mice with a protected status against neointimal hyperplasia and lumen narrowing in vivo. These studies suggest that therapeutic interventions designed to target MT1-MMP could prove beneficial in a range of human vascular disease states associated with the destructive remodeling of the vessel wall extracellular matrix.
Broadly targeted human cytomegalovirus-specific CD4+ and CD8+ T cells dominate the memory compartments of exposed subjects
Authors: Sylwester Andrew W. , Mitchell Bridget L. , Edgar John B. , Taormina Cara , Pelte Christian , Ruchti Franziska , Sleath Paul R. , Grabstein Kenneth H. , Hosken Nancy A. , Kern Florian , Nelson Jay A. , Picker Louis J.
Published: September 2005

Human cytomegalovirus (HCMV) infections of immunocompetent hosts are characterized by a dynamic, life-long interaction in which host immune responses, particularly of T cells, restrain viral replication and prevent disease but do not eliminate the virus or preclude transmission. Because HCMV is among the largest and most complex of known viruses, the T cell resources committed to maintaining this balance have never been characterized completely. Here, using cytokine flow cytometry and 13,687 overlapping 15mer peptides comprising 213 HCMV open reading frames (ORFs), we found that 151 HCMV ORFs were immunogenic for CD4+ and/or CD8+ T cells, and that ORF immunogenicity was influenced only modestly by ORF expression kinetics and function. We further documented that total HCMV-specific T cell responses in seropositive subjects were enormous, comprising on average ∼10% of both the CD4+ and CD8+ memory compartments in blood, whereas cross-reactive recognition of HCMV proteins in seronegative individuals was limited to CD8+ T cells and was rare. These data provide the first glimpse of the total human T cell response to a complex infectious agent and will provide insight into the rules governing immunodominance and cross-reactivity in complex viral infections of humans.
Adhesive mechanisms governing interferon-producing cell recruitment into lymph nodes
Authors: Diacovo Thomas G. , Blasius Amanda L. , Mak Tak W. , Cella Marina , Colonna Marco
Published: September 2005

Natural interferon-producing cells (IPCs) are found in peripheral lymph nodes (PLNs), where they support NK cell, T cell, and B cell responses to pathogens. However, their route of entry and the adhesive mechanisms used to gain access to PLNs remain poorly defined. We report that IPCs can enter PLNs via a hematogenous route, which involves a multistep adhesive process, and that transmigration is enhanced by inflammation. Results indicate that L-selectin on IPCs is required for efficient attachment and rolling on high endothelial venules in vivo in both nonstimulated and inflamed PLNs. IPCs, however, also possess functional ligands for E-selectin that contribute to this process only in the latter case. In conjunction with selectin-mediated adhesion, both β1- and β2-integrins participate in IPC attachment to the inflamed vessel wall, whereas chemotaxis relies in part on the chemokine receptor CCR5. Identification of the adhesive machinery required for IPC trafficking into PLNs may provide opportunities to regulate immune responses reliant on the activity of these cells.
Optimal word sizes for dissimilarity measures and estimation of the degree of dissimilarity between DNA sequences
Authors: Wu Tiee-Jian , Huang Ying-Hsueh , Li Lung-An
Published: September 2005

Motivation: Several measures of DNA sequence dissimilarity have been developed. The purpose of this paper is 3-fold. Firstly, we compare the performance of several word-based or alignment-based methods. Secondly, we give a general guideline for choosing the window size and determining the optimal word sizes for several word-based measures at different window sizes. Thirdly, we use a large-scale simulation method to simulate data from the distribution of SK–LD (symmetric Kullback–Leibler discrepancy). These simulated data can be used to estimate the degree of dissimilarity β between any pair of DNA sequences.

Results: Our study shows (1) for whole sequence similiarity/dissimilarity identification the window size taken should be as large as possible, but probably not >3000, as restricted by CPU time in practice, (2) for each measure the optimal word size increases with window size, (3) when the optimal word size is used, SK–LD performance is superior in both simulation and real data analysis, (4) the estimate β^ of β based on SK–LD can be used to filter out quickly a large number of dissimilar sequences and speed alignment-based database search for similar sequences and (5) β^ is also applicable in local similarity comparison situations. For example, it can help in selecting oligo probes with high specificity and, therefore, has potential in probe design for microarrays.

Availability: The algorithm SK–LD, estimate β^ and simulation software are implemented in MATLAB code, and are available at

Contact:  tjwu@stat.ncku.edu.tw

Supplementary information: Tables A1–A3, and Remarks 1–11 at
Health‐Related Behavior and Adolescent Mothers
Authors: Chen Mei‐Yen , James Kathy , Hsu Li‐Ling , Chang Shu‐Wen , Huang Lian‐Hua , Wang Edward K.
Published: September 2005

Abstract 
Objective
: To explore health‐related behaviors among adolescent mothers living in the rural area of Taoyuan, Taiwan. Design: A cross‐sectional descriptive design and nonrandom survey method were used. Sample: The sample consisted of 37 adolescent mothers, identified by public health nurses. Measurements: Standardized interview and Adolescent Health Promotion (AHP) questionnaire. Results: Findings revealed a pattern of economic disadvantage. Nearly half of the participants still lived with their biological parents. Two‐thirds needed economic support from their parents (generally coming from their biological mother). Thirty‐five percent of participants reported never using contraceptives, two‐thirds had never had a Pap smear, and 44% did not breast‐feed their infants. Nearly 60% of the children were cared for by the biological mothers of the participants. Adolescent mothers with high school education, and who were employed, married, and received parental economic support had better health‐related behaviors than adolescent mothers without these characteristics. Conclusions: Although the study sample has geographic limitations, future international studies with similar populations of adolescent mothers in rural settings will help public health nurses understand adolescent mothers’ stressors and needs which in turn affect their health‐related behaviors. Intervention strategies are needed to encourage behaviors to keep this population healthy.
Applying the Transtheoretical Model to Physical Activity in Family Caregivers in Taiwan
Authors: Tung Wei‐Chen , Gillett Patricia A. , Pattillo Robin E.
Published: September 2005

Abstract 
Objective
: The objective of this study was to examine whether specific constructs from the Transtheoretical Model (TTM)(i.e., stages of change, self‐efficacy, and perceived benefits and barriers) relative to regular physical activity are applicable to Taiwanese family caregivers. Design: A descriptive and cross‐sectional design was used. Sample: A convenience sample included 108 primary family caregivers of mentally ill patients receiving home care from a psychiatric hospital in southern Taiwan. Measurements: After obtaining institutional review board approval and subject's consent, subjects’ demographics, stages of change for regular physical activity, self‐efficacy, and perceptions of the benefits of and barriers to regular physical activity were assessed through the questionnaire. Results: Subjects in the later stages of the TTM (action or maintenance) had significantly higher levels of self‐efficacy than those in earlier stages (precontemplation or contemplation)(p < 0.05). No significant difference was found in the level of perceived benefits and barriers across different TTM stages. This study provides partial support for the hypothesized relationships between constructs derived from the TTM. Conclusions: Since this is the first TTM study in Taiwan, continued TTM testing is needed to adequately determine the applicability of the TTM and to identify the most effective theory‐based physical activity interventions.
Informing Parents About Newborn Screening
Authors: Kemper Alex R. , Fant Kathryn E. , Clark Sarah J.
Published: September 2005

Abstract 
Objective
: To evaluate current rules and regulations for educating parents about newborn screening. Design: Cross‐sectional survey. Sample: Newborn screening program coordinators in all 50 states and the District of Columbia. Measurements: Answers to a standardized semi‐structured telephone survey in January 2004. Results: Fifty programs provide standardized information about screening, and 32 of these have information available in multiple languages. Most programs (n = 36) believe that parents should be informed about newborn screening as a part of prenatal care; however, none has rules or regulations requiring this. Five require documented informed consent; only one provides the consent form in a language other than English. Hospitals and birthing centers are required by many programs to educate families, including providing information (n = 12), obtaining informed consent (n = 5), informing parents of the right to refuse screening (n = 13), and documenting refusal on institutionally developed forms (n = 9). We found considerable variation in policy language across the newborn screening programs. Conclusions: The complexity of current newborn screening programs and the likelihood of expansion in the number of conditions on newborn screening panels present a unique opportunity and challenge for public health nurses to ensure that these programs are effective and that care is integrated.
Data Collection in a Multisite Project: Teleform™
Authors: Hardin J. Michael , Woodby Lesa L. , Crawford Myra A. , Windsor Richard A. , Miller Thomas M.
Published: September 2005

Abstract  Data collection, entry, validation, and management are salient time‐ and resource‐consuming dimensions of all research projects. This is especially true for multisite studies, which pose unique, additional challenges because of their research design requirements. To save time and reduce the number of manual data entry errors, automated processing systems are becoming more widely used. Our research team chose Teleform™ for data entry and collection for the Smoking Cessation or Reduction in Pregnancy Trial study. This article presents our experience with this new technology.
The Intervention of Outreach: Best Practices
Authors: Tembreull Cindy L. , Schaffer Marjorie A.
Published: September 2005

Abstract  Public health nurses (PHNs) use the intervention of outreach to improve health status by locating “at‐risk” or “of interest” populations, providing information about health concerns and linking the population to resources to address the health concerns. The purpose of this study was to analyze PHNs' use of the intervention of outreach. Knowledge about best practices can contribute to the ability to successfully implement outreach activities. The descriptive qualitative study involved interviewing 10 Minnesota PHNs. Findings suggest strategies to increase outreach effectiveness. Recommendations include providing education on population‐based concepts, such as community assessment and at‐risk populations, and using interventions from the Public Health Intervention Wheel in conjunction with outreach.
Eva M. Reese,  Excerpts from an Oral History
Authors: Abrams Sarah E.
Published: September 2005

Abstract  Eva Miller Reese is a former director of the Visiting Nurse Services of New York (1964–1976) and a past secretary of the Public Health Nursing section of the American Public Health Association. She is also the 1974 recipient of the Haven Emerson Award, the highest honor awarded by the Public Health Association of New York City. A nationally renowned leader in public health nursing, Reese influenced the course of home care nursing during a turbulent time of social unrest and Great Society initiatives in health care. Throughout her career, Reese continually advocated for coordinated, cost‐effective services. Self‐effacing and soft‐spoken during a 1998 interview, Reese conjured an image of her younger self, and remembered some of the realities of reaching adulthood during the Great Depression. Her reflections on home health care, nursing, and the role of public health agencies are rooted in core values of social justice and multidisciplinary action.
The impact of age and gender on biology, clinical features and treatment outcome of non‐Hodgkin lymphoma in childhood and adolescence
Authors: Burkhardt Birgit , Zimmermann Martin , Oschlies Ilske , Niggli Felix , Mann Georg , Parwaresch Reza , Riehm Hansjoerg , Schrappe Martin , Reiter Alfred ,   for the BFM Group
Published: September 2005

We analysed the impact of age and gender on biology and outcome of 2084 patients diagnosed with non‐Hodgkin lymphoma (NHL) between October 1986 and December 2002 and treated according to the Berlin‐Frankfurt‐Münster (BFM) multicentre protocols NHL‐BFM‐86, ‐90 and ‐95. Median age at diagnosis was 8·0 years for 97 precursor B‐lymphoblastic lymphoma (pB‐LBL) patients, 8·8 years for 335 T‐lymphoblastic lymphoma (T‐LBL) patients, 8·4 years for 1004 Burkitt's lymphoma/leukaemia (BL/B‐AL) patients, 11·4 years for 173 diffuse large B‐cell lymphoma (centroblastic subtype) (DLBCL‐CB) patients, 13·2 years for 40 primary mediastinal large B‐cell lymphoma (PMLBL) patients and 10·8 years for 215 anaplastic large‐cell lymphoma (ALCL) patients (P < 0·00001). The male:female ratio was 0·9:1 for pB‐LBL and PMLBL, 1·7:1 for DLBCL‐CB, 1·8:1 for ALCL, 2·5:1 for T‐LBL and 4·5:1 for BL/B‐AL (P < 0·00001). The probability of event‐free survival at 5 years (5‐year pEFS) was 85 ± 1% for all 2084 patients [median follow‐up 5·7 (0·1–15·9) years], and was significantly superior for male T‐LBL and DLBCL‐CB patients. Comparing age‐groups 0–4, 5–9, 10–14 and 15–18 years, pEFS was inferior for the youngest patients only in the pB‐LBL‐ and ALCL‐groups. T‐LBL and DLBCL‐CB adolescent females had worse outcome than younger girls while age had no impact on pEFS for boys. We conclude that the distribution of age and gender differed between NHL‐subtypes. The impact of gender on outcome differed between NHL subgroups. The prognostic impact of age differed not only by NHL‐subtype but also according to gender in some subtypes.
Locus Coeruleus Norepinephrine Regulates the Surge of Prolactin During Oestrus
Authors: Szawka R. E. , Helena C. V. V. , Rodovalho G. V. , Monteiro P. M. , Franci C. R. , Anselmo‐Franci J. A.
Published: September 2005

A secondary surge of prolactin has been recently characterised on the afternoon of oestrus. Because the noradrenergic nucleus locus coeruleus participates in the genesis of the pro‐oestrous and steroid‐induced surges of prolactin, the aim of the present study was to investigate the importance of locus coeruleus norepinephrine in the generation of the prolactin surge of oestrus. For this purpose, we initially re‐evaluated the profile of prolactin secretion during the oestrous cycle to verify whether this surge of prolactin was physiological and specific to the day of oestrus. Thereafter, the following were evaluated: (i) the effect of locus coeruleus lesion on the secondary surge of prolactin and on norepinephrine concentration in the medial preoptic area (MPOA), medial basal hypothalamus (MBH) and paraventricular nucleus (PVN) during the day of oestrus and (ii) locus coeruleus neurones activity during the same day by Fos immunoreactivity. Locus coeruleus lesion completely blocked the prolactin surge of oestrus in all rats studied and also significantly reduced norepinephrine concentration in the MPOA, MBH and PVN during the day of oestrus. The number of double‐labelled tyrosine hydroxylase/Fos immunoreactive neurones in locus coeruleus was significantly higher at 14.00 h of oestrus, suggesting an increase in its activity preceding the prolactin surge that generally occurs at 15.00 h. Therefore, the increase in locus coeruleus activity on the afternoon of oestrus supports the data obtained with bilateral lesion of this nucleus, suggesting a stimulatory role of locus coeruleus norepinephrine in the genesis of the secondary surge of prolactin.