bluuebunny/crossref_metadata_2025 huggingface dataset:
Salinisation: A major threat to water resources in the arid and semi‐arid regions of the world
Authors: Williams W. D.
Published: March 2003

Semi‐arid and arid regions (i.e. drylands with annual mean rainfall between 25 and 500 mm) cover approximately one‐third of the world’s land area and are inhabited by almost 400 million people. Because they are a resource in short supply, waters in drylands are under increasing human pressures, and many are threatened by rising salinities (salinisation) in particular. Rising salinities result from several causes. The salinities of many large natural salt lakes in drylands are rising as water is diverted from their inflows for irrigation and other uses. The excessive clearance of natural, deep‐rooted vegetation from catchments and the discharge of saline agricultural wastewater causes the salinity of many freshwater lakes, wetlands and rivers to rise. The salinisation of some fresh waters is caused by rising saline groundwaters. And in some regions, increasing climatic aridity may be a cause of salinisation. Whatever the cause, salinisation has significant economic, social and environmental impacts. They are usually deleterious and often irreparable. Decreased biodiversity, changes in the natural character of aquatic ecosystems, and lower productivity are frequent ecological effects. In some dryland countries, salinisation is viewed as the single most important threat to water resources. However, the extent and importance of salinisation as a global threat has been greatly underestimated. Recognition of this is the first step in any attempt to manage it effectively. The aims of the present paper, therefore, are three‐fold. First, it aims to define the problem and indicate its extent; second, it aims to outline the causes and effects of salinisation; third, it aims to highlight the social, economic and environmental costs and comment on management responses. An overarching aim is to draw attention to the importance of salinisation as a phenomenon of global significance to waters in drylands.
Numerical simulation of domestic wastewater sewer performance
Authors: Dabrowski Wojciech , Piaseczny Grzegorz
Published: March 2003

The hydraulics of municipal sewers were considered with respect to flow rate fluctuations that sometimes cause accumulation and sometimes cause scouring of the sediments. The minimal slopes that would ensure self‐cleaning conditions once a day and the required capacity for the yearly maximum peak flows were calculated. The range of fluctuations in shear stresses along the sewer walls and in the wastewater table were observed and compared for sewers of different diameters. From these computations a simple design rule for predicting minimal slopes was developed.
Forms of particulate phosphorus in suspension and in bottom sediment in the Danube Delta
Authors: Bostan V. , Dominik J. , Bostina M. , Pardos M.
Published: March 2003

In the summer of 1995, samples of suspended solids and bottom sediments were collected from the lower course of the Danube, downstream from potential pollution sources such as tributaries draining industrialised and densely populated watersheds (the Jiu, Olt, Arges and Ialomita rivers) or big cities on the border of the river (Tulcea, Galati, Braila), and from the Danube Delta. Chemical and toxicological analyses were carried out on these samples. In the present paper, the results of the measurements of the forms of particulate phosphorus are discussed. Phosphorus occurring in the bottom sediments and the suspended solids has various origins and chemical forms. These forms may be operationally defined as: organic phosphorus (OP), apatite inorganic phosphorus (AP) and non‐apatite inorganic phosphorus (NAIP). The AP shows low variability, ranging from 350 to 400 p.p.m. for suspended solids and from 425 to 500 p.p.m. for bottom sediments. This is essentially due to the detrital origin of this form. These values are typical for freshwater sediments in European rivers. The NAIP, which originates both from natural sources and from human pollution, shows a high variability. This indicates that the nutrient pollution is derived from both point and non‐point sources in the watershed. The NAIP concentrations of 800 p.p.m. (Vadul Oii) and 850 p.p.m. (Oltenita) are very high (fourfold the average for European rivers), indicating that strong anthropogenic sources of phosphorus are present in the lower Danube watershed. As the NAIP is potentially bioavailable, its high concentration may contribute to eutrophication in the lower Danube and the Danube Delta.
Using bald eagles to indicate the health of the Great Lakes' environment
Authors: Bowerman William W. , Roe Amy S. , Gilbertson Michael J. , Best David A. , Sikarskie James G. , Mitchell Rachel S. , Summer Cheryl L.
Published: March 2003

The bald eagle (Haliaeetus leucocephalus) is one of the most studied birds of North America, and a great amount of natural life‐history information, including the response of various stressors on the eagles' ability to reproduce, are well known. In Michigan, the eagle has been chosen to track the trends of bioaccumulative compounds of concern across watersheds in the state. The state has been divided into major watersheds, and 20% of these are surveyed each year. A control area in northern Minnesota, Voyageurs National Park, is also sampled annually. We report here on the methods used, the preliminary results of the 1999 field season, and how differences in mercury concentrations varied over a 10‐year period. Mercury in feathers of nestling eagles declined over time only in Lakes Michigan and Huron, but have not decreased among other subpopulations in Michigan. Concentrations of polychlorinated biphenyls (PCBs) and 4,4′‐DDE in blood plasma from nestling eagles have declined over time for most subpopulations; however, they remain greater for breeding areas associated with the Great Lakes' food web. Sea eagles of the genus Haliaeetus are a good sentinel species to track trends in bioaccumulative compounds in aquatic systems.
Present status of submerged macrophyte growth in Lake Biwa: Recent recovery following a summer decline in the water level
Authors: Hamabata E. , Kobayashi Y.
Published: March 2003

Whole‐lake areal distribution of submerged macrophyte growth in Lake Biwa was surveyed using aerial photographs in 1994 and 2000, when unusual declines in the water level of approximately 1 m occurred in the dry summers. The estimated total areas of the submerged macrophyte communities were 1441 ha for 1994 and 2825 ha for 2000. In the shallow and eutrophic southern basin, the bottom area covered by vegetation gradually increased year by year after 1994, and the ratio of this area to the total surface area of the basin in 2000 amounted to 52%. The dominant species were two natives,Hydrilla verticillataandMyriophyllum spicatum, and one exotic,Egeria densa. Changes in physical conditions and water quality associated with the decline in the water level, as well as the reactions of submerged plants to aquatic environments and ecosystem dynamics, are discussed.
Neuropathological discrepancy between Japanese Pick’s disease without Pick bodies and frontal lobe degeneration type of frontotemporal dementia proposed by Lund and Manchester Group
Authors: Ikeda Kenji
Published: March 2003

The concept of frontotemporal dementia (FTD) proposed by the Lund and Manchester group is useful because it distinguishes dementia with frontal and anterior temporal involvement from Alzheimer‐type dementia. The classification and definition of FTD and related disorders, however, are controversial. One point of controversy is the neuropathology of the frontal lobe degeneration (FLD) type of FTD. The FLD type is described as having mild frontal and anterior temporal atrophy and no accompanying tau or ubiquitin pathology. We investigated cases of Japanese Pick’s disease without Pick bodies (PB), the majority of which are thought to correspond to FLD type, in order to clarify whether the nature of the degeneration in these cases could be distinguishable from that in Japanese Pick’s disease with PB, which corresponds approximately to the Pick type of the Lund and Manchester group. Except for the presence of tau‐pathology, no obvious differences were noted between Pick’s disease without PB (FLD type) and Pick’s disease with PB (Pick type) either on neuropathological examination of own cases or a questionnaire survey of Japanese neuropathologists. The reason for this discrepancy may be based on the role of heredity, namely, most Japanese cases of Pick’s disease are solitary, while the FTD cases of the Lund and Manchester group were reportedly accompanied by extensive familial history. There is a possibility that Japanese, British, and Swedish neuropathologists deal with heterogeneous groups of dementia characterized as FTD without tau or ubiquitin pathology.
Clinical picture of intracranial non‐traumatic dissecting aneurysm
Authors: Yamaura Akira , Ono Junichi , Hirai Shinji
Published: March 2003

Non‐traumatic intracranial arterial dissection has been accepted as a unique entity of ‘cerebral infarction in otherwise healthy young adults’, and is particularly prevalent in Western countries. A recent data collection and analysis have revealed additional clinical features. The nationwide study in Japan conducted in 1996 has provided new information on the natural history and current treatment of intracranial dissecting aneurysms in Japan. The incidence of symptomatic dissection was found to be much higher in the vertebrobasilar system than in the carotid system. The mean age of the patients was 51.3 years. Patients with carotid lesions were younger (mean 43.8 years). The male/female ratio was 2 : 1. Fifty‐eight percent of patients presented with subarachnoid hemorrhage. Recurrence was more frequent in patients with subarachnoid hemorrhage (14%) than in patients with no hemorrhage (4.2%). Common radiological findings were dilatation, ‘pearl and string’ sign and narrowing of the affected artery. Surgical treatment involved a variety of procedures including proximal occlusion, entrapment, wrapping and endovascular embolization. Patients with subarachnoid hemorrhage (61%) underwent surgical treatment more frequently than patients with no hemorrhage (17%). Good recovery was achieved in 64% of all patients. Outcome was better in patients with no subarachnoid hemorrhage compared with those with hemorrhage.
Moyamoya disease
Authors: Fukui Masashi , Kono Shinji , Sueishi Katsuo , Ikezaki Kiyonobu
Published: March 2003

Moyamoya disease is a specific chronic cerebrovascular occlusive disease first reported by Japanese surgeons in 1957. The disease is characterized by stenosis or occlusion of the terminal portions of the bilateral internal carotid arteries and abnormal vascular network in the vicinity of the arterial occlusion. It may cause ischemic attacks or cerebral infarction, which is more frequent in children than in adults. In adults, cerebral hemorrhage may occur. The disease is distributed in all age groups, but the highest peak is in childhood at less than 10 years of age. The characteristic histopathologic features of the steno‐occlusive arteries are fibrocellular thickening of the intima containing proliferated smooth muscle cells and prominently tortuous and often duplicated internal elastic lamina. There is usually no atheromatous plaque in the arterial wall. Etiology of the disease is still unknown; however, multifactorial inheritance is considered possible because of a higher incidence of the disease in Japanese and Koreans and approximately 10% of familial occurrence among the Japanese. Recent genetic studies suggest some responsible genetic foci in chromosomes 3, 6 and 17.
Dementia with motor neuron disease
Authors: Mitsuyama Yoshio
Published: March 2003

Dementia with motor neuron disease has been described as a new clinicopathologic entity and more than 100 cases have been reported in Japan since 1964. The clinicopathologic criteria in the diagnosis of dementia with motor neuron disease are: (i) frontotemporal lobe‐type dementia with insidious onset, mostly in the presenile period; (ii) neurogenic muscular wasting during the course of the illness (amyotrophic lateral sclerosis‐ or SPMA‐like symptoms); (iii) duration from the onset of illness to death of 2–5 years (average, 30.6 months); (iv) both extrapyramidal symptoms and definite sensory deficits are present less commonly; (v) no characteristic abnormalities in the cerebrospinal fluid or electroencephalogram on screening; (vi) no known parental consanguinity or familial occurrence; and (vii) non‐specific, mild to slight degenerative changes in the frontotemporal cortex, hypoglossal nuclei and spinal cord, and frequently in the substantia nigra. Dementia with motor neuron disease is characterized by ubiquitin‐immunoreactive intraneuronal inclusions in cortical layer II and hypocampal dentate granule cells.
Encephalomyelitis, brain tumors, neuromuscular diseases and miscellaneous disorders
Authors: Nakazato Yoichi , Nagashima Kazuo
Published: March 2003

Japanese neuropathologists have accomplished and contributed to a considerable number of achievements, and some of these are cited in other articles in this issue. Several of these achievements as well as other miscellaneous discoveries are briefly summarized in the present paper. Specifically these relate to rabies postvaccinal encephalomyelitis, experimental allergic encephalomyelitis, brain tumor research, neuromuscular disorders, schizophrenia, viral infections, glial inclusion body in multiple system atrophy, and the neurobiology of glia.
Molecular biological approaches to neurological disorders including knockout and transgenic mouse models
Authors: Shibata Noriyuki , Oda Hideaki , Hirano Asao , Kato Yoichiro , Kawaguchi Motoko , Dal Canto Mauro C , Uchida Koji , Sawada Tatsuo , Kobayashi Makio
Published: March 2003

Advances of molecular biology have provided a great variety of new approaches to research on human disorders. This article gives an outline of molecular biological approaches to analysis of neurological disorders such as giant cell glioblastoma (GGBM) and amyotrophic lat‐eral sclerosis (ALS), and their respective animal models: p53 knockout mice for GGBM and mutant superoxide dismutase‐1 transgenic mice for ALS. Genomic DNA extracted from fresh‐frozen tissue is examined by Southern blotting for screening mutations in a certain gene. Polymerase chain reaction (PCR) products of a gene in genomic DNA are examined by single‐stranded conformation polymorphism, sequencing and agarose gel electrophoresis for identifying mutations, and for preparing and evaluating DNA probes used in Southern blotting and DNA in situ hybridization (ISH). Total RNA from tissue is examined by northern blotting for quantifying and verifying a certain mRNA. Reverse transcription‐PCR products of a certain mRNA in total RNA are examined by sequencing and agarose gel electrophoresis for preparing and evaluating cDNA probes used in northern blotting and mRNA ISH. Tissue total protein is immunoblotted for quantifying and verifying a certain protein, and for evaluating the specificity of antibodies used in western blotting and immunohistochemistry. Immunoprecipitates are im‐munoblotted for evaluating a profile of protein or other substances. Enzyme‐linked immunosorbent assay is used for measuring tissue concentration of protein or other substances, and for determining titers of specific antibodies. By these procedures, chronological analysis of animal models for human diseases contribute to elucidating pathogenic mechanisms and exploiting new therapies. Noticing both the similarity and difference between human and animal disorders will help understand the nature of disease.
Co‐existence of nemaline and cytoplasmic bodies in muscle of an infant with nemaline myopathy
Authors: Suwa Kiyotaka , Mizuguchi Masashi , Momoi Mariko Y. , Nakamura Minako , Arima Kunimasa , Komaki Hirofumi , Nonaka Ikuya
Published: March 2003

A sporadic case of congenital myopathy had severe muscle weakness of neonatal onset. Nemaline and cytoplasmic bodies were detected in muscle biopsies taken at 4 months of age. These findings were consistent with a diagnosis of nemaline myopathy (severe neonatal form). The simultaneous and abundant presence of these two types of sarcoplasmic inclusion has been found in only a few cases. However, these cases suggest that the sarcoplasmic inclusions may be formed, at least partially, by common mechanisms.
Peritoneal mesothelial cells and the extracellular matrix
Authors: Yung Susan , Chan Tak‐Mao
Published: March 2003

Continuous ambulatory peritoneal dialysis (CAPD) is an important treatment for patients with end‐stage renal failure. Long‐term success is dependent on the functional and structural integrity of the peritoneal membrane. Conventional peritoneal dialysis fluids are non‐physiological. They contain glucose at high concentrations to provide the osmotic drive for ultrafiltration, lactate to correct the metabolic acidosis of renal failure, and a low pH to prevent caramelization of glucose during heat sterilization. These components, in isolation or acting together, exert adverse influences on both the resident cellular and extracellular elements of the peritoneal membrane, as well as phagocytic cells which infiltrate the peritoneum during inflammation, culminating in detrimental structural and functional effects, compromising the viability of the peritoneum during dialysis. Peritoneal biopsy studies of patients on long‐term CAPD have demonstrated an intercellular space between adjacent mesothelial cells which allows the penetration of peritoneal dialysis fluid into the underlying submesothelium. This, together with episodes of peritonitis, can initiate a chronic inflammatory reaction within the peritoneum characterized by increased synthesis of matrix proteins. Perturbation of the regulatory mechanisms which govern the balance of synthesis and degradation of extracellular matrix can lead to progressive fibrosis. Human peritoneal mesothelial cells (HPMC) have been shown to synthesize fibronectin, laminin, collagens, proteoglycans and hyaluronan in vitro, and thus play a role in the pathogenesis of peritoneal fibrosis. This review will give an overview of extracellular matrix (ECM) synthesis by HPMC, how changes in the synthesis are affected by CAPD and postulate how these changes can compromise the dialytic properties of the peritoneum.
End‐stage renal failure in New Zealand Maori: an analysis of circulating transforming growth factor‐β1
Authors: ANDERSON Duane , AUSTIN Paul , PILMORE Helen L
Published: March 2003

SUMMARY: There is a high incidence of end‐stage renal disease in New Zealand Maori. Reasons for this have not been established. Transforming growth factor‐β, (TGF‐β1) is a profibrogenic cytokine, which stimulates the secretion of extracellular matrix components, and has been implicated in the pathogenesis of kidney failure. the aim of this study was to examine TGF‐β1 in the serum of haemodialysis patients at our institution, in order to determine whether there was an upregulation of TGF‐β1 in Maori. A TGF‐Prspecific sandwich enzyme‐linked immunosorbant assay was used to measure active TGF‐β from the sera of 74 haemodialysis patients, and 19 healthy Maori without renal disease, diabetes or hypertension. In addition, clinical and laboratory markers were examined in the haemodialysis patients studied. There was no association between TGF‐β1 and ethnicity in the groups studied. Transforming growth factor‐β1 protein appeared to be inversely related to age. but was not associated with parameters of survival on dialysis such as serum albumin or measures of dialysis adequacy. Although there was a significantly higher incidence of type II diabetes mellitus in the Maori (P < 0.001) in comparison to European patients, the glycaemic control was comparable between the groups, as were all other laboratory and clinical parameters studied. This is the first study to examine the fibrogenic growth factor TGF‐β1 in New Zealand Maori. Thus, an endogenous increase in TGF‐β1 in Maori does not appear to be implicated in the increased incidence of end‐stage renal disease in this population.
Problems and advantages of continuous renal replacement therapy*
Authors: THOMAS Merlin C , HARRIS David CH
Published: March 2003

SUMMARY: The continuous replacement of renal function must facilitate fluid and solute homeostasis, nutrition and vital organ function, and, where possible, hasten the recovery of renal function. Difficulties with anticoagulation, biocompatibility, mobility and cost remain obstacles to be overcome. the use of continuous renal replacement therapy (CRRT) to remove systemic inflammatory mediators is yet to be confirmed. Although survival benefits of CRRT over intermittent dialysis remain controversial, the slow continuous removal of fluid, acid and solute has a number of advantages, especially where patients are haemodynamically unstable.
Renal effects of cyclo‐oxygenase‐2 inhibition
Authors: THOMAS Merlin C , HARRIS David CH
Published: March 2003

SUMMARY: The renal cyclo‐oxygenase (COX)‐2 isoenzyme has an important role in the maintenance of renal homeostasis, particularly in the setting of reduced renal perfusion. Selective inhibition of COX‐2 in the kidney has significant effects on renal physiology, most marked when COX‐2 expression is induced. the clinical risk of renal impairment, salt and water retention, and electrolyte disturbance should be considered carefully when prescribing a COX‐2 inhibitor in this setting.
Peritoneal fibrosis and its prevention
Authors: HUNG Kuan‐Yu , TSAI Tun‐Jun , CHEN Wan‐Yu
Published: March 2003

SUMMARY: Peritoneal fibrosing syndrome (PFS) is composed of a wide spectrum of peritoneal alterations observed in patients under peritoneal dialysis (PD). Long‐term peritoneal exposure to unphysiological PD solutions and recurrent bacterial peritonitis had been claimed as the most common causes predisposing to the development of PFS in a PD population. With the advances in molecular research, physicians and pathologists recognized that peritoneal injury and the accompanied accumulation of extracellular matrix (ECM) within the peritoneum are key events leading to PFS. Bioincompatible solution and it's related products, inflammatory mediators, growth factors as well as cytokines in the peritoneal cavity are contributing factors. Therapeutic strategies antagonizing these mediators and/or their downstream intracellular signalling pathways with either drug molecules or gene transfer may have potential for the prevention or treatment of PFS.
Inhibition of geranylgeranylation suppresses the proliferation of rat cultured mesangial cells
Authors: HE Jin‐Song , HORIKOSHI Satoshi , FUNABIKI Kazuhiko , MAEDA Atsuko , KOBAYASHI Michimasa , SHIRATO Isao , TOMINO Yasuhiko
Published: March 2003

SUMMARY: Mesangial hypercellularity is a critical early histopathological finding observed in human and experimental glomerular diseases. the regulation of mesangial cell proliferation may be crucial in the treatment of glomerular injury. Ras proteins are guanosine triphosphatases that regulate proliferation and differentiation by transducing biological information from extracellular signals to the nucleus. the blocking of Ras function by inhibitors of prenyltransferase has been shown to suppress the proliferation in several kinds of cell types. the objective of the present study was to examine the effects of selective inhibitors of farnesylation (FTI‐277) and geranylgeranylation (GGTI‐286) on proliferation of cultured rat mesangial cells. the incubation of mesangial cells with FTI‐277 and GGTI‐286 with stimulation by either 10% fetal calf cell (FCS) or platelet‐derived growth factor (PDGF) was performed, and bromo‐deoxyuridine (BrdU) incorporation was measured. Ras processing and mitogen‐active protein (MAP) kinase activation, after the incubation with 10% FCS, were also examined. Geranylgeranylation caused a dose‐dependent reduction of FCS or PDGF‐stimulated BrdU incorporation. Geranylgeranylation also inhibited the activation of MAP kinase, but not Ras processing, stimulated by 10% FCS. However, FTI‐277 had little effect on DNA synthesis and MAP kinase activation induced by FCS or PDGF, despite the inhibition of Ras processing. the present study showed that GGTI‐286 inhibited the proliferation of rat cultured mesangial cells. It appears that the antiproliferative effect of the geranylgeranyl transferase I inhibitor may be useful in preventing mesangial cell proliferation.
Exploring the discursive construction of menopause for Thai women
Authors: Punyahotra Suwipa , Street Annettee
Published: March 2003

The terms ‘menopause’ and ‘mid‐life women’ have become the subjects of both the medical gaze and a billion‐dollar industry built by pharmaceutical companies to manage the ‘problems’ of menopause. Menopause is a discursive construction, a label that has become endowed with a large number of taken‐for‐granted assumptions about physical and psychological symptoms, self‐image and health status. These assumptions are based on the medical interests, social preoccupations, research and subsequent drug‐marketing strategies conducted in western societies. Thai society is structured around a different philosophy, which has created different meanings for the mid‐life woman. This paper explores the Western discourses of menopause and the colonizing effect when the assumptions underpinning these are imposed on Thai women.
Troubling distinctions: a semiotics of the nursing/technology relationship
Authors: Sandelowski Margarete
Published: March 2003

I consider the discursive practices that have served conceptually and ontologically to trouble the boundaries between nursing and technology: between nurse/human/subject and machine/non‐human/object. Nursing and technology have been semiotically related largely by two processes: (a) by the metaphor that depicts nursing as technology and (b) by opposition, or as not like and even in conflict with technology. Less frequently but no less significantly, nursing and technology have been semiotically linked (c) by the metaphor that depicts technology as nursing and (d) by metonymy, or by word or picture juxtapositions of nursing with technology. The troubling distinctions between nursing and technology suggest yet another reason why the construction of difference continues to elude nursing.
Psychiatric personnel, risk management and the new institutionalism
Authors: Hazelton Mike
Published: March 2003

This article reports the findings of a series of ethnographic research interviews conducted with psychiatric personnel in one region of Tasmania between 1995 and 1997. These interviews formed part of a more wide‐ranging project examining changes in the regulatory practices of psychiatric personnel in the light of the professional, media and policy discourses that inform them, especially in relation to the impact of social justice reforms spelt out in recent Australian mental health policy. In discussing the nature of psychiatric work the personnel interviewed returned repeatedly to the themes of safety and risk management. The study presents an analysis of discourses deployed around these themes and argues that concerns over safety and risk are central to the emergence of a new institutionalism in acute in‐patient psychiatric services.
Possibilities for critical social theory and Foucault’s work: a toolbox approach
Authors: Manias Elizabeth , Street Annette
Published: March 2003

Possibilities for critical social theory and Foucault’s work: a toolbox approach

The benefits and constraints of philosophical frameworks using the work of Michel Foucault and critical social theorists, such as Fay, Giroux and McLaren, are examined in the light of their traditions. The reasons nurse researchers adopt these frameworks are explored, as are the tensions between the respective theories. A complementary ‘toolbox’ approach to the research process addresses some of the theoretical and methodological challenges presented by each framework. Such an approach provides distinctive insights into nursing practice that the other has ignored or missed. It is argued that by converging the two frameworks into a toolbox approach, it is possible to examine or deconstruct existing practices, whilst also providing an avenue for nurses to reconstruct or change such practices.
Listening for the sounds of silence: a nursing consideration of caring for the politically tortured
Authors: Racine‐Welch Twilla , Welch Mark
Published: March 2003

Listening for the sounds of silence: a nursing consideration of caring for the politically tortured

In 1997 Amnesty International reported that 115 out of 251 countries surveyed practised torture on their citizens. Many of these victims have been forced to flee their country of origin and become refugees in the West, in countries such as Australia, Canada, the UK and the United States. However, torture itself remains an unspoken and covert problem. In addition to the obvious traumatic effects, it may induce shame and dread on the part of the victim. It may be too terrifying and too painful to talk about, and yet may affect every aspect of a person’s life (Forrest 1996). All too commonly a victim of torture may pass unnoticed or unrecognised because health care providers do not know how, or may be unwilling to engage with the issue. This paper will examine the implications for nurses of caring for the tortured. It will explore the nature of torture itself, who might be the perpetrators and who might be the victims (always acknowledging that nurses and other health care staff are often both), how victims of torture may present for health care, and the possible subjective perceptions of a torture victim when faced with a Western health care process and understanding. Finally, it will argue for an increase in awareness and sensitivity on the part of all nurses in all health care settings to the needs and sensibilities of victims of torture, and suggest that caring for them is the distillation of everything good nursing practice should be.
Working in and around the ‘chain of command’: power relations among nursing staff in an urban nursing home
Authors: Jervis Lori L.
Published: March 2003

Working in and around the ‘chain of command’: power relations among nursing staff in an urban nursing home

By most accounts, the discipline of nursing enjoys considerable hegemony in US nursing homes. Not surprisingly, the ethos of this setting is influenced, in large part, by nursing’s value system. This ethos powerfully impacts both the residents who live in nursing homes and the staff who work there. Using ethnographic methods, this project explored power relations among nursing assistants and nurses in an urban nursing home in the United States. Factors contributing to tensions among nursing staff were the stigma attached to nursing homes and those who work in them, as well as the long history of class conflict and power struggles within the discipline of nursing. The latter struggles, in turn, reflected nursing’s quest for professional status in the face of medicine’s hegemony over health‐care. Ultimately, these factors coalesced to produce a local work environment characterized by conflict — and by aides’ resistance to nurses’ domination.
Meanings of living at home on a ventilator
Authors: Lindahl Berit , Sandman Per‐Olof , Rasmussen Birgit H.
Published: March 2003

Meanings of living at home on a ventilator

Nine adults were interviewed in order to illuminate the meanings of being dependent on a ventilator and living at home. The data were analysed using a phenomenological‐hermeneutic method inspired by the philosophy of Ricoeur. Five main themes emerged through the analysis: experiencing home as a safe and comfortable space from which to reach out, experiencing the body as being frail, brave and resilient, striving to live in the present, surrendering oneself to and trusting others, and experiencing technology as a burden and a relief to the lived body. Meanings of being home on a ventilator were interpreted as maintaining autonomy and persistence in interaction with the ventilator and other human beings and being able to rise above yourself and your personal boundaries in order to live a good life. These meanings indicate that aesthetic and ethical values impact on the lived body. They are bound up with experiencing a vital force and interdependency, bringing safety and courage into daily life.
Study on victimization of crime: The trauma of crime victims in Japan
Authors: KONISHI
Published: March 2003

During 6 years (1992–1997), 583 clients received a total of more than 2000 counseling sessions at the Counseling Service for Crime Victim Assistance (CSVA). Clients who receive individual counseling are diverse in features, ranging from those who are in the acute stage a few days after the traumatic event to those who sustained posttraumatic responses decades ago. It is not uncommon that clients are diagnosed as having severe acute stress disorder or posttraumatic stress disorder (PTSD). From the perspective of psychiatric treatment, the CSVA clients can be divided into: (i) people requiring treatment of acute symptoms (primarily dissociation), (ii) chronic PTSD cases, and (iii) complex PTSD cases. Examples of the first two types are presented briefly. The author thinks that the physical and mental responses to trauma may vary to some extent among peoples from different cultural backgrounds. It is necessary to point out that the society and culture related to victimization differ greatly between Japan and the United States. Before arguing about cultural differences of PTSD as a mental disorder, cultural differences of the cases as victims in society must be discussed.
Screening of vascular cognitive impairment on a Hungarian cohort
Authors: Szatmári Szabolcs , Fekete István , Csiba László , Kollár József , Sikula Judit , Bereczki Dániel
Published: March 2003

Cerebrovascular disease is a major public health problem in Eastern European countries. A Hungarian post‐stroke population was examined to estimate the rate of dementia, the risk factors for cognitive impairment, and the applicability of a recently established Canadian diagnostic checklist in this cohort. Chronic cerebrovascular outpatients were screened for cognitive impairment with a combined checklist: the Diagnostic Checklist for Vascular Dementia established by the Consortium of Canadian Centres for Clinical Cognitive Research using the Mini Mental State Examination instead of the detailed neuropsychological part of the Checklist. Of the 247 consecutive patients at a cerebrovascular outpatient unit, 176 had cerebrovascular disorder diagnosed either by computed tomography (CT; n = 126) or by the clinical signs. Of these, 15% were cognitively impaired and 5% fulfilled the criteria of dementia. The mean age of the patients with cognitive impairment was significantly higher than that of patients with normal cognition (68.2 ± 10.2 and 60.5 ± 10.5 years, P < 0.001). The Barthel index was significantly lower in the cognitively affected group than in non‐affected patients (92.4 ± 16.0 and 97.1 ± 8.7, P = 0.027). Diabetes and more than two subcortical infarcts on CT or magnetic resonance imaging were more frequent in patients with cognitive loss (P = 0.043 and P = 0.013, respectively). Cognitive performance was also influenced by the level of education. Higher age, diabetes, motor deficits, and multiple subcortical infarcts are risk factors for cognitive impairment after stroke. The combined checklist appears to be a practical screening test for cognitive impairment in patients with chronic cerebrovascular diseases.
Panic attacks in patients with chronic schizophrenia: A complication of long‐term neuroleptic treatment
Authors: Higuchi Hisashi , Kamata Mitsuhiro , Yoshimoto Masaki , Shimisu Tetsuo , Hishikawa Yasuo
Published: March 2003

Panic attacks meeting the diagnostic criteria for panic disorder (DSM‐III‐R) were found in nine (20%) of 45 patients suffering chronic schizophrenia for more than 5 years. The scores of the Hamilton Depression Rating Scale and the Simpson Angus Scale were significantly higher in the group of patients with panic attacks. They also tended to be taking neuroleptics in larger doses than in the other group. The present report suggests that long‐term treatment with neuroleptics is closely related to the manifestation of panic attacks in chronic schizophrenia. It also suggests that when panic attacks are seen frequently in patients taking high doses of neuroleptics, dose reduction of neuroleptics should be considered.
Frequent breathing‐related electroencephalogram arousals in four patients with mild obstructive sleep apneas
Authors: Mikami Akira , Watanabe Takuya , Motonishi Masamichi , Honda Hideharu , Kyotani Kyoko , Uruha Shigehiko , Terashima Kiyoji , Teshima Yoshio , Sugita Yoshiro , Takeda Masatoshi
Published: March 2003

We report cases of four patients with mild obstructive sleep apnea syndrome (OSAS) with frequent breathing‐related electroencephalogram (EEG) arousals which led to excessive daytime sleepiness. In spite of a relatively low apnea hypopnea index (AHI), sleep was disrupted by frequent EEG arousals associated with respiratory effort as observed in upper airway resistance syndrome. The effects of sleep stage and sleep position on EEG arousals were also investigated. We consider that AHI alone is not a sufficient index to assess severity of OSAS, and it is very important to examine microarousals by the alteration of esophageal pressure in addition to the effect of sleep position.
Nurses’ workload associated with 16‐h night shifts on the 2‐shift system. I: Comparison with the 3‐shift system
Authors: Fukuda Hideki , Takahashi Masaya , Airto Heihachiro
Published: March 2003

To assess nurses’ workload with 16‐h night shifts on a 2‐shift system, we investigated the differences between workloads with each shift on the 2‐ and 3‐shift systems with questionnaires on subjective symptoms and measuring heart rate and physical activity. It was found that the 2‐shift nurses during the 16‐h night shifts complained of fatigue less frequently and showed general decreases in heart rate and physical activity compared with the 3‐shift nurses during 8‐h evening and night shifts. The results suggest that a 2‐h nap, an increase of staff, and a day off may reduce the nurses’ workload when they have 16‐h night shifts.
Grief reactions treated in a psychiatric out‐patient clinic
Authors: Nakamura Yujiro
Published: March 2003

Grief reactions to the death of a close relative are not commonly treated in psychiatric out‐patient clinics in Japan. However, recently our clinic has had a chance to see such cases. I analyzed 11 cases of grief reactions (7 females, 4 males). The first part of this paper focuses on the distinction between normal and abnormal grief reactions, and an attempt was made to classify grief reactions in the nosology. Following this, three factors were specified as enhancing vulnerability to bereavement: (1) sex (female), (2) age (middle‐aged), and (3) cause of death (sudden death). The second part focuses on the dependency seen in the subjects, which was their most marked personality traits. Finally, vertical splitting as defined by Kohut and Kasahara was discussed as a defense mechanism in the crisis of bereavement. The bereaved person preserves a positive image of the deceased and his or herself by vertical splitting, thereby eliminating negative experiences and feelings (denial). This manifested itself in a strong feeling of solidarity with the deceased (identification).

The treatment of the subjects followed a fairly good course, but five patients required more than 1 year. Four patients visited the clinic after the termination of their treatment because of a relapse of their depression.
A case of seizures 1 week after the cessation of interferon‐α therapy
Authors: Seno Haruo , Inagaki Takuji , Itoga Motoi , Miyaoka Tsuyoshi , Ishino Hiroshi
Published: March 2003

We report on a 60‐year‐old woman with a history of bipolar mood disorder who had seizures and developed a delirious state 1 week after the cessation of interferon‐α (IFN‐α) for chronic hepatitis C. The IFN‐α was administered to the patient for 7 weeks (266 million IU). One week after the cessation of IFN‐α therapy, the patient had four generalized tonic–clonic seizures over a 2‐day period and developed a delirious state for 2 months. We consider these seizures and delirious state to be related to IFN‐α.
Possible association of human leucocyte antigen DR1 with delayed sleep phase syndrome
Authors: Hohjoh Hirohiko , Takahashi Yasuro , Hatta Yoko , Tanaka Hidenori , Akaza Tatsuya , Tokunaga Katsushi , Honda Yutaka , Juji Takeo
Published: March 2003

The study investigated the human leucocyte antigen (HLA), types A, B and DR, of 42 patients with delayed sleep phase syndrome (DSPS) and compared the frequencies of the antigens with those in 117 healthy controls. The comparison revealed that the gene frequencies and positivities of HLA‐A, ‐B and ‐DR, except for DR1, had no significant differences between the patients and controls. The frequency of HLA‐DR1 was increased in the DSPS patients as compared with that in the healthy controls (P = 0.0069 in positivity). Although the corrected P‐value (0.069) for multiple comparisons almost reached the significance level, the results indicated a possible association of the HLA‐DR1 antigen with DSPS. This study suggests that there are genetic predispositions to DSPS.
Seizure recurrence after reduction of an antiepileptic drug in patients with unprovoked seizures and severe neurological abnormalities
Authors: Kimura Masahiko , Yoshino Kunio , Suzuki Norido
Published: March 2003

A prospective study of antiepileptic drug (AED) reduction in patients with unprovoked seizures and severe neurological abnormalities after a seizure‐free period of more than 5 years was performed. From a hospital for severely handicapped children (150 patients) and an institution for mentally handicapped people (89 persons), 13 patients were enrolled to this study after informed consent was obtained. All patients had experienced a seizure‐free period of more than 7 years (median, 10 years). The patients had IQs of less than 50 and were almost dependent in their life. Five patients had additional motor deficits. The patients had been taking one to three AED (mean, 1.9) before reduction and only one AED was withdrawn. During the following 2 years, four of the 13 patients (31%) showed a recurrence of seizures. The age at the time of the last seizure was lower in the seizure‐free patients. As to the 10 patients with onset ages of 10 or less, a significant factor as to seizure recurrence was whether or not seizures were controlled before the age of 11 years (P < 0.05, Fisher’s exact probability test). It is suggested that a patient with severe neurological abnormalities, in whom epilepsy or unprovoked seizures are controlled before the age of 11 years (i.e. before adolescence) could be a candidate for the reduction of AED.
Distribution of amyloid β protein precursor in the Alzheimer’s disease brain
Authors: Shoji Mikio , Kawarabayashi Takeshi , Matsubara Etsuro , Ikeda Masaki , Ishiguro Koji , Harigaya Yasuo , Okamoto Koichi
Published: March 2003

In order to clarify the distribution and pathological changes of the amyloid β protein precursor (βAPP), 10 Alzheimer’s disease (AD) brains and seven normal control brains were examined by immunocytochemistry and in situ hybridization histochemistry. All βAPP isoforms were distributed evenly in neuronal cell bodies and their axons and dendrites. The βAPP‐positive neuronal processes showed mesh‐like networks. In AD brains, βAPP‐positive neurons and mesh‐like networks were generally decreased in spite of some intensely labeled neurons. All βAPP isoforms accumulated in neuronal processes, dystrophic neurites and senile plaques. In situ hybridization histochemistry confirmed that all isoforms of βAPP were expressed in neurons in control brains. In AD brains, the βAPP mRNA signal was generally decreased besides some intense signal neurons corresponding to immunostaining findings. Few astrocytes expressed βAPP. Thus, uniform expression and distribution of βAPP were disturbed in AD brains showing uneven decreases or increases of neuronal βAPP expression in individual neurons and βAPP accumulation in neurons, neuronal processes and abnormal structures including dystrophic neurites, senile plaques and neurofibrillary tangles.
Parental bonding and personality in relation to a lifetime history of depression
Authors: Sato Tetsuya , Uehara Toru , Narita Tomohiro , Sakado Kaoru , Fujii Yoichiro
Published: March 2003

This study explores whether personality is mediating the effects of adverse parenting on having had a lifetime history of major depressive disorder and whether personality dimensions, related to the development of lifetime depression, are disposed by adverse parenting in cross‐sectional data derived from an epidemiological sample of volunteer workers. Of 447 individuals who were asked to complete the Munich Personality Test (MPT), the Parental Bonding Instrument (PBI) and the Inventory to Diagnose Depression Lifetime version (IDDL), 322 subjects were included in the analyses (150 male and 172 female; and 38 were diagnosed as having had a history of depression). Comparisons in fit between logistic regression models revealed that a combination of frustration tolerance and rigidity among personality dimensions, as measured by the MPT, and maternal care among the PBI scales were most primary in predicting a lifetime history of depression. Maternal care was, however, not significantly predictive of dimensional scores on the personality dimensions. Neither frustration tolerance nor rigidity was predicted by any PBI scale. When entering the variables sequentially, maternal care and the personality variables were additive and independent risk factors in predicting a lifetime history of depression. The results of this preliminary study raised an objection to a hypothesis that adverse parenting experienced in childhood disposes one to a dysfunctional personality, which then predisposes one to the development of depression in adulthood.
Watershed infarction associated with dementia and cerebral atrophy
Authors: Hashiguchi Shuji , Mine Hideki , Ide Makoto , Kawachi Yasunori
Published: March 2003

A 63‐year‐old man was admitted with progressive left hemiparesis and left homonymous hemianopsia of 1 month’s duration. During the 2 months before admission, he had suffered from slowly progressive dementia. The diagnosis of right‐sided watershed (WS) infarction was made. He exhibited slow progression of dementia and cerebral atrophy during the period of observation after discharge. There was a positive relationship between cerebral atrophy and the degree of dementia. In the present case, WS infarction caused by right internal carotid artery occlusion might be related to dementia and cerebral atrophy.
Relationship between hypersomnia and respiratory disorder during sleep in Prader–Willi syndrome
Authors: Hiroe Yu , Inoue Yuichi , Higami Shigeru , Suto Yuji , Kawahara Ryuzo
Published: March 2003

Abstract To assess whether hypersomnia in Prader–Willi syndrome (PWS) patients is related to the respiratory disorder during sleep (RDDS), we made a systematic evaluation regarding the relationship between the two disorders in three patients. All patients showed hypersomnia manifested as the long duration of night sleep and shortened sleep latencies of multiple sleep latency test. Although magnetic resonance imaging and laboratory studies revealed obstruction of the upper airway and mild increase of esophageal pressure during sleep, the number of other apneic episodes or awakenings was not as frequent. From the above results, we speculate that the mechanism of excessive daytime sleepiness in PWS is not caused by RDDS and quite resembles that of essential hypersomnia.