bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular evolution of the major outer-membrane protein gene (oprF) of Pseudomonas
Authors: Bodilis Josselin , Barray Sylvie
Published: March 2006

The major outer-membrane protein ofPseudomonas, OprF, is multifunctional. It is a non-specific porin that plays a role in maintenance of cell shape, in growth in a low-osmolarity environment, and in adhesion to various supports or molecules. OprF has been studied extensively for its utility as a vaccine component, its role in antimicrobial drug resistance, and its porin function. The authors have previously shown important differences between the OprF and 16S rDNA phylogenies:Pseudomonas fluorescensisolates split into two quite separate clusters, probably according to their ecological niche. In this study, the evolutionary history of theoprFgene was investigated further. The study of G+C content at the third codon position, synonymous codon usage (codon adaptation index, CAI) and genomic context showed no evidence of horizontal transfer or gene duplication. Similarly, a robust likelihood test of incongruence showed no significant incongruence between theoprFphylogeny and the species phylogeny. In addition, the ratio of nonsynonymous mutations to synonymous mutations (Ka/Ks) is high between the different clusters, especially between the two clusters containingP. fluorescensisolates, highlighting important modifications in evolutionary constraints during the history of theoprFgene. Since OprF is known as a pleiotropic protein, modifications in evolutionary constraints could have resulted from variations in cryptic functions, correlated with the ecological fingerprint. Finally, relaxed constraints and/or episodic positive evolution, especially for someP. fluorescensstrains, could have led to a phylogeny reconstruction artifact.
Lon protease of the α-proteobacterium Agrobacterium tumefaciens is required for normal growth, cellular morphology and full virulence
Authors: Su Shengchang , Stephens Bonnie B. , Alexandre Gladys , Farrand Stephen K.
Published: March 2006

The ATP-dependent Lon (La) protease is ubiquitous in nature and regulates a diverse set of physiological responses in bacteria. In this paper alonmutant of theα-proteobacteriumAgrobacterium tumefaciensC58 has been characterized. Unlikelonmutants ofEscherichia coli, thelonmutant ofA. tumefaciensgrows very slowly, is not filamentous and exhibits normal resistance to UV irradiation. The mutant retains motility and chemotaxis, produces apparently normal amounts of exopolysacchride, but displays severe defects in cell morphology, with 80 % of the mutant cells appearing Y-shaped. Lon protease ofA. tumefaciensshares high homology with its counterparts inE. coliand inSinorhizobium meliloti, and functionally complements anE. coli lonmutant for defects in morphology and RcsA-mediated regulation of capsular polysaccharide production. Mutations at sites of LonAtcorresponding to the ATP-binding site and the active site serine of theE. coliLon protease abolish complementation of phenotypes of theA. tumefaciensandE. coli lonmutants. The nucleotide sequence upstream ofA. tumefaciens loncontains an element similar to the consensusσ32heat-shock promoter ofE. coli. Northern and Western blot analyses indicated that expression oflonis induced by elevated temperature, albeit to a much lower level than that ofgroEL. Thelonmutant is highly attenuated for virulence, suggesting that Lon may be required for the proper expression, assembly or function of the VirB/D4-mediated T-DNA transfer system.
The surface (S)-layer gene cspB of Corynebacterium glutamicum is transcriptionally activated by a LuxR-type regulator and located on a 6 kb genomic island absent from the type strain ATCC 13032
Authors: Hansmeier Nicole , Albersmeier Andreas , Tauch Andreas , Damberg Thomas , Ros Robert , Anselmetti Dario , Pühler Alfred , Kalinowski Jörn
Published: March 2006

The surface (S)-layer gene region of the Gram-positive bacterium Corynebacterium glutamicum ATCC 14067 was identified on fosmid clones, sequenced and compared with the genome sequence of C. glutamicum ATCC 13032, whose cell surface is devoid of an ordered S-layer lattice. A 5·97 kb DNA region that is absent from the C. glutamicum ATCC 13032 chromosome was identified. This region includes cspB, the structural gene encoding the S-layer protomer PS2, and six additional coding sequences. PCR experiments demonstrated that the respective DNA region is conserved in different C. glutamicum wild-type strains capable of S-layer formation. The DNA region is flanked by a 7 bp direct repeat, suggesting that illegitimate recombination might be responsible for gene loss in C. glutamicum ATCC 13032. Transfer of the cloned cspB gene restored the PS2− phenotype of C. glutamicum ATCC 13032, as confirmed by visualization of the PS2 proteins by SDS-PAGE and imaging of ordered hexagonal S-layer lattices on living C. glutamicum cells by atomic force microscopy. Furthermore, the promoter of the cspB gene was mapped by 5′ rapid amplification of cDNA ends PCR and the corresponding DNA fragment was used in DNA affinity purification assays. A 30 kDa protein specifically binding to the promoter region of the cspB gene was purified. Matrix-assisted laser desorption ionization time-of-flight mass spectrometry and peptide mass fingerprinting of the purified protein led to the identification of the putative transcriptional regulator Cg2831, belonging to the LuxR regulatory protein family. Disruption of the cg2831 gene in C. glutamicum resulted in an almost complete loss of PS2 synthesis. These results suggested that Cg2831 is a transcriptional activator of cspB gene expression in C. glutamicum.
Transcriptional profiling of Mycoplasma hyopneumoniae during iron depletion using microarrays
Authors: Madsen Melissa L. , Nettleton Dan , Thacker Eileen L. , Minion F. Chris
Published: March 2006

Mycoplasma hyopneumoniae, the causative agent of swine enzootic pneumonia and a major component of the porcine respiratory disease complex, continues to confound swine producers despite control programmes worldwide. The disease is chronic and self-limiting, but the host is subject to immunopathological changes that potentiate respiratory disease associated with other pathogens. The response ofM. hyopneumoniaeto environmental stress is of interest because of its relevance to virulence mechanisms in other bacterial pathogens. One of these stressors, iron deprivation, is a prominent feature of the host innate immune response, and most certainly impacts growth of mycoplasmasin vivo. To study this, microarray technology was applied to the transcriptome analysis ofM. hyopneumoniaeduring iron deprivation. An array consisting of 632 of the 698 ORFs in the genome was used to compare the mRNA isolated from organisms grown under normal laboratory conditions with that from organisms subjected to iron deprivation with the chelator 2,2′-dipyridyl. This analysis identified 27 genes that were either up- or down-regulated in response to low-iron growth conditions (P<0·01), with an estimated false discovery rate below 10 %. These included genes encoding transport proteins, enzymes involved in energy metabolism, and components of the translation process. Ten of the 27 identified genes had no assigned function. These studies indicate thatM. hyopneumoniaecan respond to changes in environmental conditions, but the mechanism employed remains unknown.
The N-terminal region of the Saccharomyces cerevisiae RasGEF Cdc25 is required for nutrient-dependent cell-size regulation
Authors: Belotti Fiorella , Tisi Renata , Martegani Enzo
Published: March 2006

In the yeastSaccharomyces cerevisiae, the Cdc25/Ras/cAMP/protein kinase A (PKA) pathway plays a major role in the control of metabolism, stress resistance and proliferation, in relation to the available nutrients and conditions. The budding yeast RasGEF Cdc25 was the first RasGEF to be identified in any organism, but very little is known about its activity regulation. Recently, it was suggested that the dispensable N-terminal domain of Cdc25 could negatively control the catalytic activity of the protein. In order to investigate the role of this domain, strains were constructed that produced two different versions of the C-terminal domain of Cdc25 (aa 907–1589 and 1147–1589). The carbon-source-dependent cell size control mechanism present in the wild type was found in the first of these mutants, but was lost in the second mutant, for which the cell size, determined as protein content, was the same during exponential growth in both ethanol- and glucose-containing media. A biparametric analysis demonstrated that this effect was essentially due to the inability of the mutant producing the shorter sequence to modify its protein content at budding. A similar phenotype was observed in strains that lackedCDC25, but which possessed a mammalian GEF catalytic domain. Taken together, these results suggest that Cdc25 is involved in the regulation of cell size in the presence of different carbon sources. Moreover, production of the aa 876–1100 fragment increased heat-stress resistance in the wild-type strain, and rescued heat-shock sensitivity in theira1Δ background. Further work will aim to clarify the role of this region in Cdc25 activity and Ras/cAMP pathway regulation.
Trophic interaction of the aerotolerant anaerobe Clostridium intestinale and the acetogen Sporomusa rhizae sp. nov. isolated from roots of the black needlerush Juncus roemerianus
Authors: Gößner Anita S. , Küsel Kirsten , Schulz Daria , Trenz Sonja , Acker George , Lovell Charles R. , Drake Harold L.
Published: March 2006

Acetogens were enumerated from root homogenates of the black needlerushJuncus roemerianusobtained from a nearly pristine salt marsh. An isolated colony, ST1, yielded acetogenic activity and was initially thought to be a pure culture; however, ST1 was subsequently found to be composed of an aerotolerant fermentative anaerobe (RC) and an acetogen (RST) (Tindicates type strain). The two spore-forming mesophiles were separated by selective cultivation under conditions favouring the growth of either RC or RST. The 16S rRNA gene sequence of RC was 99 % similar to that ofClostridium intestinale, indicating that RC was a new isolate of this clostridial species. The rRNA gene sequence most similar to that of RSTwas only 96 % similar to that of RSTand was from a species of the acetogenic genusSporomusa, indicating that RSTwas a new sporomusal species; the nameSporomusa rhizaesp. nov. is proposed. RC grew at the expense of saccharides. H2-forming butyrate fermentation was the primary catabolism utilized by RC under anoxic conditions, while homolactate fermentation was the primary catabolism under oxic conditions. RC consumed O2and tolerated 20 % O2in the headspace of shaken broth cultures. In contrast, RSTwas acetogenic, utilized H2, lactate and formate, did not utilize saccharides, and could not tolerate high concentrations of O2. RSTgrew by trophic interaction with RC on saccharides via the uptake of H2, and, to a lesser extent, lactate and formate produced by RC. Co-cultures of the two organisms yielded high amounts of acetate. These results indicate that (i) previously uncharacterized species ofSporomusaare associated withJuncusroots and (ii) trophic links to O2-consuming aerotolerant anaerobes might contribute to thein situactivities and survival strategies of acetogens in salt marsh rhizospheres, a habitat subject to gradients of plant-derived O2.
Models of Quality‐Adjusted Life Years when Health Varies Over Time: Survey and Analysis
Authors: Schultz Hansen Kristian , Peter Østerdal Lars
Published: March 2006

Abstract.  Quality‐adjusted life year (QALY) models are widely used for economic evaluation in the health care sector. In the first part of the paper, we establish an overview of QALY models where health varies over time and provide a theoretical analysis of model identification and parameter estimation from time trade‐off (TTO) and standard gamble (SG) scores. We investigate deterministic and probabilistic models and consider five different families of discounting functions in all. The second part of the paper discusses four issues recurrently debated in the literature. This discussion includes questioning the SG method as the gold standard for estimation of the health state index, re‐examining the role of the constant‐proportional trade‐off condition, revisiting the problem of double discounting of QALYs, and suggesting that it is not a matter of choosing between TTO and SG procedures as the combination of these two can be used to disentangle risk aversion from discounting. We find that caution must be taken when drawing conclusions from models with chronic health states to situations where health varies over time. One notable difference is that in the former case, risk aversion may be indistinguishable from discounting.
Identification of an erythroid ATP‐dependent aminophospholipid transporter
Authors: Soupene Eric , Kuypers Frans A.
Published: March 2006

The asymmetric distribution of amino‐containing phospholipids in plasma membranes is essential for the function and survival of mammalian cells. Phosphatidylserine (PS) is restricted to the inner leaflet of plasma membranes by an ATP‐dependent transport process. Exposure of PS on the surface of cells serves as a binding site for haemostatic factors, triggers cell–cell interaction and recognition by macrophages and phospholipases. Exposure of PS on the red cell surface plays a significant role in sickle cell pathology. We report the identification of two different isoforms of the aminophospholipid translocase, Atp8a1, or flippase, in the murine red blood cell membrane.
Homozygous C2362F von Willebrand factor induces intracellular retention of mutant von Willebrand factor resulting in autosomal recessive severe von Willebrand disease
Authors: Tjernberg P. , Castaman G. , Vos H. L. , Bertina R. M. , Eikenboom J. C. J.
Published: March 2006

The missense mutation of cysteine 2362 to a phenylalanine in von Willebrand factor (VWF) has been detected in several Italian families with autosomal recessive, severe von Willebrand disease. We investigated how this amino acid change in VWF may lead to a predominantly quantitative defect. This mutation was studied in vitro by transient expression of the full‐length mutant VWF‐C2362F protein and in vivo by analysis of plasma VWF after infusion of 1‐deamino‐8‐d‐arginine vasopressin (DDAVP) in a patient homozygous for this mutation. Single transfections of pSVHVWF‐C2362F and cotransfections of mutant and wild‐type constructs resulted in 8% and 50% VWF antigen, respectively, in conditioned medium. These reduced levels are in accordance with observations in homozygous and heterozygous carriers of the mutation. In addition, VWF‐C2362F was retained intracellularly. Similar results were obtained for C2362F and C2362A. After infusion of DDAVP in a homozygous patient, a twofold decrease in half‐life of plasma VWF‐C2362F was observed. This was not explained by increased susceptibility of recombinant VWF‐C2362F to ADAMTS13. It was concluded that VWF‐C2362F causes reduced VWF plasma levels due to impaired secretion and intracellular retention. Furthermore, it is the loss of cysteine 2362 rather than the introduction of the bulky amino acid side chain that causes these effects.
Mutagenicity of non‐homologous end joining DNA repair in a resistant subset of human chronic lymphocytic leukaemia B cells
Authors: Deriano Ludovic , Merle‐Béral Hélène , Guipaud Olivier , Sabatier Laure , Delic Jozo
Published: March 2006

Non‐homologous end joining (NHEJ) is an important determinant of genomic stability in mammalian cells. This DNA repair pathway is upregulated in a subset of B‐cell chronic lymphocytic leukaemia (B‐CLL) cells resistant to DNA damage‐induced apoptosis. Using an in vitro assay for double‐strand breaks (DSB) end ligation, we studied the fidelity of DSB repair in B‐CLL cells which were resistant or sensitive to in vitro DSB‐induced apoptosis with concomitant patients’ resistance or sensitivity to chemotherapy, respectively. The fidelity of DNA repair was determined by DNA sequencing of polymerase chain reaction products cloned in pGEM‐T vector. Sequence analysis of DNA end junctions showed that the frequency of accurate ligation was higher in sensitive B‐CLL cells and control cell lines, than in resistant cells where end joining was associated with extended deletions. Upregulated and error‐prone NHEJ in resistant cells could be a quite possible mechanism underlying both genomic instability and poor clinical outcome.
Peripartum maternal and foetal ghrelin, growth hormones, IGFs and insulin interrelations
Authors: Fuglsang Jens , Sandager Puk , Møller Niels , Fisker Sanne , Frystyk Jan , Ovesen Per
Published: March 2006

Objective  Ghrelin may influence GH secretion and is associated with insulin sensitivity. In pregnancy, placental growth hormone (PGH) replaces GH. The aim of this study was to investigate the relationship between PGH and ghrelin and their relationship to insulin sensitivity in pregnancy.

Design  Prospective, descriptive study.

Patients  Thirty‐seven singleton pregnant and six twin pregnant women

Measurements  Maternal blood samples were drawn before and 2 days after elective caesarian section (CS). Serum total ghrelin, PGH, GH, GH‐binding protein, insulin and IGF‐I and IGF‐II, and plasma glucose were determined. Insulin sensitivity indices (ISIs) were calculated. Cord blood samples were drawn at delivery for ghrelin determination.

Results  Serum ghrelin only displayed a minimal, although statistically significant, decrease after CS. Prior to delivery serum PGH increased by 25% during fasting, and was undetectable the day after CS. Serum levels of GH were low until 48 h after CS. No significant correlations were detected between PGH or ghrelin and ISIs, although a trend was observed for ghrelin. Twin pregnancies had higher PGH levels than singletons; however, levels of IGFs were similar. In cord blood, ghrelin levels were higher in arterial than venous samples.

Conclusions  Maternal ghrelin levels were only minimally affected by parturition, suggesting that maternal ghrelin is not involved in the transition from PGH to GH secretion. The increased arterial ghrelin levels in the foetus suggest foetal ghrelin production. Serum PGH appears to be influenced by fasting. Finally, elevated PGH levels in twin pregnancies do not appear to affect maternal IGF levels.
The effect of abdominal obesity on insulin sensitivity and serum lipid and cytokine concentrations in African women
Authors: Crowther N. J. , Ferris W. F. , Ojwang P. J. , Rheeder P.
Published: March 2006

Objectives  Studies have shown clear associations of abdominal obesity with lipid and glucose metabolism and cytokine levels in a number of different population groups. However, no such studies have been performed in an African population in which visceral adipose tissue levels have been shown to be lower than in European subjects.

Design and patients  Cross‐sectional analysis in 124 African women.

Measurements  Fasting serum samples were taken from all subjects and anthropometric measurements obtained. Blood levels of glucose, insulin, total cholesterol, high‐density lipoprotein (HDL) and low‐density lipoprotein (LDL) cholesterol, triglyceride, interleukin (IL)‐6, IL‐8 and IL‐18 were measured. Subjects were separated into normal and abnormal glucose tolerant groups and into tertiles according to waist circumference (WC). Insulin resistance was assessed using the homeostasis model assessment (HOMA).

Results  Abnormal glucose‐tolerant subjects had higher WC, glucose and HOMA levels than the normal glucose‐tolerant group. Increased WC was associated with higher triglyceride, insulin and HOMA levels and lower HDL levels. Multiple regression analyses showed that WC associated positively with HOMA and serum triglyceride levels and negatively with HDL levels. IL18 was a positive but weak determinant of the HOMA level and BMI correlated positively with serum IL‐6 concentrations.

Conclusions  Although previous studies have shown that African subjects have a lower visceral adipose depot size than European subjects, abdominal obesity is still associated with insulin resistance and dyslipidaemia. The association between abdominal obesity and metabolic dysfunction within this population is not dependent upon IL‐6, IL‐8 or IL‐18.
Molecular characterization of immunoglobulin D in mammals: immunoglobulin heavy constant delta genes in dogs, chimpanzees and four old world monkey species
Authors: Rogers Kenneth A. , Richardson Jennifer P. , Scinicariello Franco , Attanasio Roberta
Published: March 2006

Antibodies are adaptor molecules that neutralize pathogens and link humoral and cellular defence mechanisms. Immunoglobulin D (IgD), one of the five antibody classes present in mammals, is expressed as an antigen receptor on naïve B cells. The functional role that IgD plays in the immune response is still poorly understood, but the recent characterization of immunoglobulin heavy constant delta genes (IGHD) in a variety of species challenges the view that IgD is of minor importance and is not present in many animals. On the basis of serological studies, IgD appears to be expressed in the majority of mammalian species examined. To confirm, at the molecular level, that IgD is present in different species, we cloned and sequenced IGHD cDNA from dogs and five non‐human primate species (chimpanzee, rhesus macaque, cynomolgus macaque, baboon and sooty mangabey). Our results show that in all six species, IgD heavy chains possess three immunoglobulin domains and a long hinge region encoded by two exons. Only the hinge region of non‐human primates is similar to the human hinge region, with conservation of O‐glycosylation sites and multiple charged residues at opposing ends. The preservation of IgD in primates, dogs and previously characterized species suggests an important functional role for IgD, possibly involving binding to a receptor. The high degree of similarity existing between the structural features of human and non‐human primate IgD suggests that non‐human primates are suitable for in vivo studies designed to define the role that IgD plays in the immune response.
NKT cells play critical roles in the induction of oral tolerance by inducing regulatory T cells producing IL‐10 and transforming growth factor β, and by clonally deleting antigen‐specific T cells
Authors: Kim Hyun Jung , Hwang Su Jin , Kim Byoung Kwon , Jung Kyeong Cheon , Chung Doo Hyun
Published: March 2006

Oral tolerance is the systemic unresponsiveness induced by orally administered proteins. To explore the roles of natural killer T (NKT) cells in oral tolerance, we induced oral tolerance to ovalbumin (OVA) in NKT cell‐deficient mice. In CD1d–/– mice, the induction of tolerance to orally administered high‐ or low‐dose OVA was impaired. Dendritic cells (DCs) in the Peyer's patches (PPs) of CD1d–/– mice fed OVA showed high expression of major histocompatibility complex (MHC) class II and B7 molecules, whereas DCs of control mice fed OVA expressed low levels of these molecules. The adoptive transfer of NKT cells restored oral tolerance and induction of tolerogenic DCs in the PPs and spleens of CD1d–/– mice. Moreover, interleukin (IL)‐10 and transforming growth factor (TGF)‐β1 production in vitro were reduced in cells from the spleen and PPs of CD1d–/– mice compared with those of control mice fed OVA. The numbers of OVA‐specific CD4+ KJ1‐26+ T cells were significantly reduced in the PPs and spleens of DO11·10 mice fed OVA. In contrast, OVA‐specific CD4+ KJ1‐26+ T cells were not deleted in the PPs or spleens of DO11·10 CD1d–/– mice. In conclusion, NKT cells were found to play an indispensable role in oral tolerance by inducing regulatory T cells, and clonally deleting antigen‐specific CD4+ T cells.
Regulatory T cells in human disease and their potential for therapeutic manipulation
Authors: Taams Leonie S. , Palmer Donald B. , Akbar Arne N. , Robinson Douglas S. , Brown Zarin , Hawrylowicz Catherine M.
Published: March 2006

Regulatory T cells are proposed to play a central role in the maintenance of immunological tolerance in the periphery, and studies in many animal models demonstrate their capacity to inhibit inflammatory pathologies in vivo. At a recent meeting [Clinical Application of Regulatory T Cells, 7–8 April 2005, Horsham, UK, organized by the authors of this review, in collaboration with the British Society for Immunology and Novartis] evidence was discussed that certain human autoimmune, infectious and allergic diseases are associated with impaired regulatory T‐cell function. In contrast, evidence from several human cancer studies and some infections indicates that regulatory T cells may impair the development of protective immunity. Importantly, certain therapies, both those that act non‐specifically to reduce inflammation and antigen‐specific immunotherapies, may induce or enhance regulatory T‐cell function. The purpose of this review was to summarize current knowledge on regulatory T‐cell function in human disease, and to assess critically how this can be tailored to suit the therapeutic manipulation of immunity.
Evolutionary conservation of neuropeptide expression in the thymus of different species
Authors: Silva Alberto B. , Aw Danielle , Palmer Donald B.
Published: March 2006

Evidence suggests that the immune and neuroendocrine systems cross talk by sharing ligands and receptors. Hormones and neuropeptides produced by the neuroendocrine system often modulate the function of lymphoid organs and immune cells. We have previously reported the intrathymic expression of somatostatin (SOM) in the mouse and that several neuropeptides, most notably calcitonin‐gene‐related peptide (CGRP), neuropeptide Y (NPY), SOM and substance P (SP), can modulate thymocyte development. However, little is known about the intrathymic expression of these neuropeptides either in the mouse or in other species. Moreover, a comparative analysis of the expression of these molecules would highlight the evolutionary importance of intrathymic neuroendocrine interactions in T‐cell development. We have studied the expression of different neuropeptides in the thymus of zebrafish, Xenopus, avians, rodent, porcine, equine and human by immunohistochemistry and reverse transcription–polymerase chain reaction. We found that CGRP, NPY, SOM, SP and vasointestinal polypeptide (VIP) are expressed in the thymus of all species investigated. The thymic location of many of these neuropeptides was conserved and appears to be within the stromal compartments. Interestingly, in the avian thymus the expression of CGRP, SOM and SP appears to change depending on the age of the tissue. These findings suggest that neuropeptides may play an important role in T‐cell development and provide further evidence of cross talk between the immune and neuroendocrine systems.
Nurses’ perceptions of severe acute respiratory syndrome: relationship between commitment and intention to leave nursing
Authors: Chang Chao‐Sung , Du Pey‐Lan , Huang Ing‐Chung
Published: March 2006

Aims.  This paper reports a study which aimed to: (1) investigate the relationship between nurses’ commitment to the nursing profession and organization and their intention to leave; (2) investigate nurses’ perceptions of the possibility of acquiring severe acute respiratory syndrome infection and its moderation of their commitment to the nursing profession and the organization and their consequent intentions to leave the profession and the organization following the severe acute respiratory syndrome outbreak.

Background.  The outbreak of severe acute respiratory syndrome in 2003 resulted in a fatality rate of approximately 11%. Nurses in hospitals caring for patients with severe acute respiratory syndrome maintained close contact with the infected patients. The high risk of infection and death associated with caring for patients with severe acute respiratory syndrome had a great impact on nurse retention in hospitals. Nurse turnover in many countries where these outbreaks occurred has been high since the first outbreak occurred in March 2003.

Methods.  Three hundred and thirty nurses working at a Taiwan hospital during the time of the severe acute respiratory syndrome outbreak completed the Meyer, Allen & Smith Organizational and Occupational Commitment Scales, Intention to Leave and Perceived Stress of Infection Scales between July and August 2003.

Results.  All three components of occupational and organizational commitments were negatively associated with nurses’ intentions to leave the nursing profession and the organization. Nurses’ perceptions of the possibility of acquiring severe acute respiratory syndrome infection through caring for these patients had a moderating effect on the relationship between commitment and the intention to leave.

Conclusions.  Perceived risk to life from infection has a possible influence on the commitment/intention‐to‐leave model in hospital nurses caring for patients with severe acute respiratory syndrome, and this information can inform hospital and nursing managers about nurse retention following a severe acute respiratory syndrome outbreak and the management of commitment in the context of nursing human resources management.
Introduction of assistive devices: home nurses’ practices and beliefs
Authors: Roelands Marc , Van Oost Paulette , Depoorter Anne Marie , Buysse Ann , Stevens Veerle
Published: March 2006

Aims.  This paper reports a study describing home nurses’ intention and current practices regarding introducing assistive devices, and investigating whether their practice is related to social cognitive factors (attitudes, subjective norms and self‐efficacy).

Background.  Home nurses not only care for patients in particular medical domains, but also educate and guide them towards more independence. Patients with age‐related disabilities in mobility and self‐care might benefit from the use of assistive devices. A home nurse might be the first and only person to discuss the disability and use of an assistive device. Therefore, home nurses’ beliefs about the introduction of assistive devices could affect their daily practices.

Methods.  A cross‐sectional study was conducted with a convenience sample of 64 home nurses chosen from a random sample of home nursing departments. The home nurses completed a self‐administered questionnaire. The Theory of Planned Behaviour framework was used to develop the social cognitive measures regarding each of the six steps distinguished in the introduction of assistive devices.

Results.  Home nurses had positive attitudes and high levels of intention, subjective norm and self‐efficacy towards most steps of the decision process to introduce assistive devices. In a multiple linear regression analysis, attitude and self‐efficacy predicted intention to introduce assistive devices to older clients with disabilities. Intention was correlated to home nurses’ current practices.

Conclusions.  The findings suggest that conditions are present to involve home nurses more explicitly in the introduction of assistive devices to their patients. Social cognitive factors should be taken into account when developing interventions that aim to support home nurses to do this.
Patients’ existential situation prior to colorectal surgery
Authors: Moene Monica , Bergbom Ingegerd , Skott Carola
Published: March 2006

Aim.  The aim of this paper is to present a hermeneutic phenomenological study illuminating patients’ existential situation prior to colorectal surgery. The intention was also to explore the value of the encounter between patient and nurse.

Background.  Patients waiting for major surgery experience multifarious reactions. Emotions of anxiety, fears of the unknown, anaesthesia, cancer diagnosis and death can arise. Several earlier studies have reported the importance of information, coping strategies and the need to reduce anxiety and stress in relation to surgery. However, there is a lack of studies focusing on patients’ existential situation in the preoperative phase.

Methods.  Conversational interviews were conducted with 28 patients 1 week before their surgery during autumn 2002. Analysis of the data was influenced by van Manen's existential themes: lived space/spatiality, lived body/corporeality, lived time/temporality and lived relation/relationality.

Findings.  Participants expressed either hope of increased spatiality or fear of restricted spatiality, according to whether they had a benign or malign diagnosis. Statements about lived time were also related to the diagnosis. Patients waiting for surgery for a benign diagnosis could use the time to relax and gather energy, while malignancy gave them high levels of anxiety and stress. Lived body experiences showed the ambivalence felt in entrusting one's body to professionals. Statements about lived relations drew attention to the need for considerate caregivers to enhance feelings of security and continuity.

Conclusion.  The existential situation of patients in a preoperative context was shown to be a state of uncertainty with regard to lived space, body, time and relation. The significance of meeting and talking to the nurse did not appear in the statements. The nurse was invisible. If nurses were to employ the existential themes proposed by van Manen in preoperative encounter with patients, their need for care might be more clearly identified and affirmed.
Management of childhood fever by parents: literature review
Authors: Walsh Anne , Edwards Helen
Published: March 2006

Aim.  This paper reports a review which draws together findings from studies targeting parents’ temperature‐taking, antipyretic administration, attitudes, practices and information‐seeking behaviours.

Background.  Parents’ concerns about the harmful effects of fever have been reported for more than two decades. These concerns remain despite successful educational interventions.

Method.  Medline, CINAHL, PsycINFO, PsycARTICLES and Web of Science databases were searched from 1980 to 2004 during November 2004. The search terms were fever, child, parent, education, knowledge, belief, concern, temperature, antipyretic and information, and combinations of these.

Findings.  In the 1980s, studies were mainly descriptive of small single site samples of parents with a febrile child seeking assistance from healthcare professionals. From 1990, sample sizes increased and multi‐site studies were reported. Educational interventions were designed to increase knowledge and reduce unnecessary use of health services. One 2003 study targeted knowledge and attitudes. Parental knowledge about normal body temperature and the temperature that indicates fever is poor. Mild fever is misclassified by many as high, and they actively reduce mild fever with incorrect doses of antipyretics. Although some parents acknowledge the benefits of mild fever, concerns about brain damage, febrile convulsions and death from mild to moderate fever persist irrespective of parental education or socio‐economic status. Many base their fever management practices on inaccurate temperature readings. Increased use of antipyretics to reduce fever and waking sleeping febrile children for antipyretics or sponging reflects heightened concern about harmful effects of fever. Educational interventions have reduced unnecessary use of healthcare services, improved knowledge about fever and when to implement management strategies, and reduced incorrect parental accuracy of antipyretic dosing. Information‐seeking behaviours in fever management differ according to country of origin.

Conclusion.  Despite successful educational interventions, little has changed in parents’ fever management knowledge, attitudes and practices. There is a need for interventions based on behaviour change theories to target the precursors of behaviour, namely knowledge, attitudes, normative influences and parents’ perceptions of control.
Supporting parents who have a child referred for genetic investigation: the contribution of health visitors
Authors: Barr Owen G. , McConkey Roy
Published: March 2006

Aim.  This paper reports a study of the views of health visitors in relation to their role in supporting parents of children referred for genetic investigations.

Background.  An increasing number of children are likely to be referred for genetic investigations as our understanding of genetic inheritance develops and a wider range of tests becomes available. Internationally, there are growing expectations that nurses will be able to discuss the referral and testing processes with parents, as well as facilitate informed decision‐making. However, previous studies have highlighted the limited support received from staff in primary care services by parents of children referred for genetic investigation.

Methods.  A questionnaire survey of 345 health visitors was undertaken in 11 community health and social services trusts in Northern Ireland. Questionnaires were distributed at health visitor team meetings and returned in prepaid envelopes. Data collection occurred in 2003.

Findings.  Completed questionnaires were returned by 194 health visitors (56·2% response rate). Many were unsure of the location of their Regional Clinical Genetics Service and reported limited contact with these services. The majority of health visitors were not informed that children on their caseload had a forthcoming appointment, or that they had attended an appointment with a geneticist. Health visitors did not routinely visit parents of children referred for genetic investigation to discuss the appointment, and they reported limited confidence in supporting parents in relation to genetic investigations.

Conclusion.  Improved communication links are needed with Regional Clinical Genetics Services and to ensure that health visitors are informed when children on their caseload have been referred for genetic investigation. In addition, steps need to be taken to increase the coordination of support to parents provided by health visitors and staff within regional genetic services.
Retracted: Osteoporosis prevention education programme for women
Authors: Chan Moon Fai , Ko C.Y.
Published: March 2006

Aim.  This paper reports an evaluation of a nurse‐initiated education programme on four specific osteoporosis prevention behaviours which led to their adoption or to positive attitude changes.

Background.  In the past, osteoporosis was a serious health concern that most commonly affected women in Northern Europe and the United States of America, but was less commonly seen in Asian women. However, in Hong Kong, osteoporosis is currently among the top five conditions causing disability and prolonged hospital stay for older people. From an economic perspective, the most cost‐effective approach is to focus on primary prevention via education, and nurses often have the responsibility of providing such educational programmes.

Method.  A randomized controlled study was conducted from July 2004 to March 2005 with 76 women (38 cases and 38 controls) recruited in two private beauty clinics in Hong Kong. Pre‐, post‐ and follow‐up education data were compared regarding attitudes and adoption frequency before and after the education programme.

Results.  The results showed statistically significant increases for each behaviour: consumption of soy foods (P < 0·001), milk (P < 0·001), more exercise (P = 0·01) and vitamin D/exposure to sunlight (P < 0·001) for the case group compared with the control group. Most participants either disagreed (n = 15, 39·0%) or strongly disagreed (n = 23, 61·0%) that there was not enough information provided in the education programme to motivate them to change. They rated the nurse's performance as either satisfactory or very satisfactory on presentation, ability to answer their questions and ability to describe each behaviour clearly.

Conclusion.  Although positive results with a nurse‐initiated education programme were demonstrated, future research examining the effects of education and occupation on these four adoption behaviours should focus on more diverse populations with respect to age, income or ethnicity. The findings suggest the value of creative approaches in future health education for the prevention of osteoporosis, and the need for a critical appraisal of current strategies and a re‐evaluation of services and funding.
Genetics education in the nursing profession: literature review
Authors: Burke Sarah , Kirk Maggie
Published: March 2006

Aim.  This paper reports a literature review exploring genetics education for nursing professionals. The aim was to contribute to the debate about the future direction of such education.

Background.  Advances in genetics science and technology have profound implications for health care and the growing importance and relevance of genetics for everyday nursing practice is increasingly recognized.

Method.  A search was conducted in February 2005 using the CINAHL and Google Scholar databases and the keywords nurse, midwife, health visitor, education and genetics. Papers were included if they were published in English between 1994 and 2005 and included empirical data about genetics education in nursing. In addition, attempts were made to access the grey literature, with requests for information on research, for example, to members of the Association of Genetic Nurses and Counsellors and searches of relevant websites.

Findings.  Agreement on the relevance of genetics for nursing practice is extensive. Empirical evidence of the learning needs of practitioners highlights widespread deficits in knowledge and skills, and low confidence levels. Provision of nursing education in genetics is patchy and insubstantial across a number of countries, further hampered by lack of strategic development. Significant progress has been made in the identification of learning outcomes for nurses. Research on the delivery of genetics education is limited, but the role of skills‐based training, use of clinical scenarios, and importance of assessment have all been identified as factors that can promote learning.

Conclusion.  Whilst areas of good performance were revealed, many studies identified gaps in professional competence and/or education. New initiatives are underway to support genetics education and its integration into professional practice, but further research is needed on the most effective forms of educational delivery, and an international collaborative approach to this should be considered.
Clinical experiences of students with dyslexia
Authors: Morris David , Turnbull Patricia
Published: March 2006

Aim.  This paper reports a study exploring the clinical experiences of student nurses with dyslexia and its potential influence on their practice.

Background.  Widened access to university education has meant an increase in the number of students with dyslexia. A limited number of studies have explored the academic experiences of dyslexic student nurses. However, nursing students in the United Kingdom spend 50% of their programme in practice settings, and there are no studies detailing their clinical experiences.

Method.  This qualitative exploratory study involved tape‐recorded interviews with a convenience sample of 18 nursing students with a formal dyslexia diagnosis. Data were collected in 2003–2004 and were analysed using thematic analysis.

Findings.  Participants described a number of personalized approaches to managing their difficulties in practice. Whilst many of these may be useful to non‐dyslexic students, descriptions of, for example, avoiding answering the telephone, were inappropriate. Some participants contended with discrimination and ridicule, often choosing not to disclose their disability. Less acute clinical environments appeared to provide more satisfying working experience, and this factor may be influential in shaping future career options. Participants valued more time and an undisturbed place to complete clinical documentation. Heightened self‐awareness promoted patient safety as the major concern for study participants. Positive aspects of dyslexia were never raised or acknowledged by participants.

Conclusion.  The clinical setting provides a challenging environment for nursing students with dyslexia, who find personalized ways to manage their disability. A dyslexia diagnosis continues to carry a stigma that may result in non‐disclosure, with implications for the level of support available. Greater awareness of the practice‐specific needs of such students is required to ensure appropriate support and public safety.
Research utilization and clinical nurse educators: a systematic review
Authors: Milner Margaret , Estabrooks Carole A. , Myrick Florence
Published: March 2006

Background  Clinical nurse educators and other linking agents such as clinical nurse specialists, advanced nurse practitioners, and nurses working in research leadership positions are an important link in the facilitation of evidence‐based practice in health care organizations.

Aim  The purpose of this paper is to report the findings of a systematic review of the literature regarding clinical nurse educators and research utilization, using the Promoting Action on Research Implementation in Health Services framework as a backdrop for the analysis.

Findings  There is a positive relationship between research utilization and attitude toward research, higher levels of education, and reading professional nursing journals among clinical nurse educators. The authors suggest that not all clinical nurse educators have the necessary critical appraisal skills and research knowledge to use research effectively in practice.

Conclusions  Few studies have examined clinical nurse educators and the determinants of their research utilization behaviour in clinical practice. Future research on clinical nurse educators needs to focus on the outcomes of research utilization, including the effectiveness of their role as facilitators and the contexts in which they practice.
New roles in rehabilitation – the implications for nurses and other professionals
Authors: Stanmore Emma , Ormrod Susan , Waterman Heather
Published: March 2006

Rationale, aims and objectives  The development of rehabilitation and intermediate care services, and roles therein, is part of current UK health policy to meet the demands of the ever‐growing older population. One new role is the rehabilitation assistant (RA). This is a generic support worker trained at a basic level in nursing, physiotherapy, occupational therapy and social work who works under the supervision of the referring professionals, to deliver integrated rehabilitation programmes. RAs were introduced in one region in the north‐west of England to increase the rehabilitation activity for patients. An empirical qualitative study was recently undertaken to evaluate the impact of the RAs from the perspectives of patients and associated nurses, therapists, managers and the RAs.

Methods  Fifty‐five semi‐structured interviews were used to collect data, which was then inductively analysed into categories and then themes. The categories included variations in role, benefits of role, acceptance and integration of role, difficulties with role, training and retention. This paper focuses on the benefits and difficulties of the role.

Results  It was found that patients, professionals and the RAs expressed great satisfaction with the new role. However, barriers to effective rehabilitation were reported owing to ward routines and organizational systems that interrupted and caused inconsistencies with the rehabilitation care programmes for patients.

Conclusions  If it is agreed that the majority of patients (unless end stage terminally ill, unwilling or unable) could benefit from some degree of rehabilitation, then there is an issue around how such skills could be widely implemented. This paper discusses the barriers to effective rehabilitation, the benefits and drawbacks of looking at new ways of working and the need for a unified approach by all care workers in rehabilitative care.