bluuebunny/crossref_metadata_2025 huggingface dataset:
Selective cholinergic denervation of the cingulate cortex impairs the acquisition and performance of a conditional visual discrimination in rats
Authors: Winters Boyer D. , Robbins Trevor W. , Everitt Barry J.
Published: January 2004

Results from excitotoxic lesion studies have implicated the cingulate cortex and its basal forebrain afferents in the acquisition and performance of conditional discrimination tasks. In the present work, we sought to clarify the role of specifically cholinergic projections from the vertical limb nucleus of the diagonal band (VDB) to the cingulate cortex in conditional visual discrimination (CVD) learning and performance in rats. We injected the cholinergic immunotoxin 192 IgG‐saporin into the cingulate cortex to produce selective retrograde lesions of the cholinergic neurons projecting from the VDB to the cingulate cortex with the aim of sparing afferents of non‐cingulate regions that can be disrupted by excitotoxic or immunotoxic VDB injections and non‐cholinergic VDB projections that can also be damaged by excitotoxic lesions. Rats sustaining selective cholinergic denervation in this manner were significantly impaired relative to sham‐operated animals in the acquisition and performance of a CVD rule of the type ‘If lights are flashing FAST, press the left lever; if SLOW, press right’. Asymptotic performance of the lesion group was substantially lower than for control rats, indicating an enduring performance deficit. This impairment was associated with a selective disruption on trials with the FAST flashing stimulus. The results confirm the involvement of cholinergic innervation of the cingulate cortex in CVD performance; however, the nature of the deficit suggests a role for cholinergic modulation in task‐relevant stimulus processing rather than stimulus‐response learning per se.
Neonatal 5HT activity antagonizes the masculinizing effect of testosterone on the luteinizing hormone release response to gonadal steroids and on brain structures in rats
Authors: Murray J. F. , Dakin C. L. , Siddiqui A. , Pellatt L. J. , Ahmed S. , Ormerod L. J. A. , Swan A. V. , Davies D. C. , Wilson C. A.
Published: January 2004

Hypothalamic 5HT concentrations are transiently lower in male compared to female Wistar rats in the second week post partum (pp) and our previous findings have shown that pharmacologically potentiating 5HT activity over this period feminizes certain aspects of sexually differentiated behaviours in adult males and androgenized females. In order to investigate whether neonatal testosterone and 5HT interact to influence physiological and morphological brain sexual differences, females, androgenized females and males were treated with the 5HT2 agonist (−) [2,5 dimethoxy‐4‐iodophenyl]‐2‐amino propane HCl [(−) DOI], over days 8–16 pp. In androgenized females (250 µg testosterone proprionate, day 2 pp) (−) DOI prevented the delay in vaginal opening, but did not prevent the androgen‐induced constant oestrus in females treated with 100 µg TP, day 2 pp. (−) DOI overcame the neonatal androgen effect in suppressing the positive feedback of ovarian steroids in a few males and androgenized females. (−) DOI had a feminizing effect on the volume of the anteroventral periventricular nucleus (normally smaller in males), by significantly increasing its volume in male and androgenized females. It also had a significant antagonistic effect on the testosterone‐induced increase in the volume of the sexually dimorphic nucleus of the preoptic area in males and androgenized females. These findings support the view that raised 5HT activity in the second week of life antagonizes the masculinizing effect of neonatal testosterone.
CAST2: identification and characterization of a protein structurally related to the presynaptic cytomatrix protein CAST
Authors: Deguchi‐Tawarada Maki , Inoue Eiji , Takao‐Rikitsu Etsuko , Inoue Marie , Ohtsuka Toshihisa , Takai Yoshimi
Published: January 2004

The cytomatrix at the active zone (CAZ) is thought to define the site of Ca2+‐dependent exocytosis of neurotransmitters. We have recently identified a novel CAZ protein from rat brain which we have named CAST (CAZ‐associated structural protein). CAST forms a large molecular complex with other CAZ proteins such as Bassoon, RIM1 and Munc13‐1, at least through direct binding to RIM1. Here, we have identified a rat protein that is structurally related to CAST and named it CAST2. Subcellular fractionation analysis of rat brain shows that CAST2 is also tightly associated with the postsynaptic density fraction. Like CAST, CAST2 directly binds RIM1 and forms a hetero‐oligomer with CAST. In primary cultured rat hippocampal neurones, CAST2 co‐localizes with Bassoon at synapses. Furthermore, immunoelectron microscopy reveals that CAST2 localizes to the vicinity of the presynaptic membrane of synapses in mouse brain. Sequence analysis reveals that CAST2 is a rat orthologue of the human protein ELKS. ELKS has also recently been identified as Rab6IP2 and ERC1. Accordingly, the original CAST is tentatively re‐named CAST1. These results indicate that CAST2 is a new component of the CAZ and, together with CAST1, may be involved in the formation of the CAZ structure.
A PLCδ1‐binding protein, p122/RhoGAP, is localized in caveolin‐enriched membrane domains and regulates caveolin internalization
Authors: Yamaga Masaki , Sekimata Masayuki , Fujii Makoto , Kawai Katsuhisa , Kamata Hideaki , Hirata Hajime , Homma Yoshimi , Yagisawa Hitoshi
Published: January 2004

A GTPase activating protein (GAP), p122, has previously been cloned as a phospholipase C (PLC)δ1‐interacting protein. p122 shows a specific GAP activity for Rho and enhances the enzyme activity of PLCδ1. In this study, we examined the localization and functions of p122/RhoGAP, using enhanced green fluorescent protein (EGFP)‐tagged proteins. EGFP‐p122 was observed as punctate structures at the plasma membrane of BHK (fibroblastic) cells and MDCK (epithelial) cells. This patchy distribution depended on membrane cholesterol levels and the C‐terminal region of p122 containing the GAP domain was responsible for it. Sucrose density gradient centrifugation and immunostaining of caveolin‐1 revealed that p122 was localized in caveolin‐enriched membrane domains mainly via its GAP domain. We demonstrated that transient expression of EGFP‐p122 caused internalization of caveolin‐1. Moreover, when the EGFP‐tagged GAP domain was introduced in another fibroblastic cell line, NRK cells, punctate fluorescent structures were co‐localized with caveolin‐1. In this case, caveolin‐1‐positive structures were found in patches of F‐actin, unlike those of untransfected cells that formed linear arrays along with actin stress fibres. These results suggest that p122 is localized in caveolae and plays an important role in caveolin distribution through reorganization of the actin cytoskeleton.
Pmr1, a P‐type ATPase, and Pdt1, an Nramp homologue, cooperatively regulate cell morphogenesis in fission yeast: The importance of Mn2+ homeostasis
Authors: Maeda Takuya , Sugiura Reiko , Kita Ayako , Saito Mariko , Deng Lu , He Yi , Yabin Lu , Fujita Yasuko , Takegawa Kaoru , Shuntoh Hisato , Kuno Takayoshi
Published: January 2004

Schizosaccharomyces pombe pmr1
+ gene is homologous to Saccharomyces cerevisiae PMR1 gene, which encodes the P‐type Ca2+/Mn2+‐ATPase. Addition of Mn2+, as well as Ca2+, to the medium induced pmr1+ gene expression in a calcineurin‐dependent manner. The pmr1 knockout (Δpmr1) cells exhibited hypersensitivity to EGTA. A screen for high gene dosage‐suppressors of the EGTA‐hypersensitive phenotype of Δpmr1 led to the identification of pdt1+ gene, which encodes an Nramp‐related metal transporter. The Δpmr1 cells showed round cell morphology. Although Δpdt1 cells appeared normal in the regular medium, it showed round cell morphology similar to that of the Δpmr1 cells when Mn2+ was removed from the medium. The removal of Mn2+ also exacerbated the round morphology of the Δpmr1 cells. The Δpmr1Δpdt1 double mutants grew very slowly and showed extremely aberrant cell morphology with round, enlarged and depolarized shape. The addition of Mn2+, but not Ca2+, to the medium completely suppressed the morphological defects, while both Mn2+ and Ca2+ markedly improved the slow growth of the double mutants. These results suggest that Pmr1 and Pdt1 cooperatively regulate cell morphogenesis through the control of Mn2+ homeostasis, and that calcineurin functions as a Mn2+ sensor as well as a Mn2+ homeostasis regulator.
Mechanisms for the control of body size by a G‐kinase and a downstream TGFβ signal pathway in Caenorhabditis elegans
Authors: Nagamatsu Yasuko , Ohshima Yasumi
Published: January 2004

We recently showed that egl‐4 mutants in Caenorhabditis elegans have a much larger body size and that the egl‐4 gene encodes cyclic GMP‐dependent protein kinases (G‐kinases). Cell sizes, but not cell numbers, in the major organs are increased in the mutants. Genetic interaction studies suggest that EGL‐4 represses the DBL‐1/TGFβ pathway that is known to control body size. To understand the mechanisms of body size control in C. elegans, we analysed sma‐2, sma‐4 and sma‐6 small mutants in the DBL‐1 pathway. The volumes of major organs were precisely determined with the method developed by us. They are significantly decreased as compared to those of the wild‐type while cell numbers are not, indicating that cell size is decreased. DNA contents in the nuclei of major organs are not significantly changed in the small mutants and in an egl‐4 large mutant. Total protein contents are much decreased in the small mutants and slightly increased in the egl‐4 mutant. Based on these results, we propose that decreased cell and body size of the small mutants in the DBL‐1/TGFβ pathway is mainly due to decreased levels of protein expression, and that increase in fluid content is a major reason for the increase in cell and body size in egl‐4 mutants.
The G12 family of heterotrimeric G proteins and Rho GTPase mediate Sonic hedgehog signalling
Authors: Kasai Kenji , Takahashi Masanori , Osumi Noriko , Sinnarajah Srikumar , Takeo Tomohiro , Ikeda Hiroshi , Kehrl John H. , Itoh Gen , Arnheiter Heinz
Published: January 2004

Sonic hedgehog (Shh) is a secreted morphogen crucial for cell fate decision, cellular proliferation, and patterning during vertebrate development. The intracellular Shh signalling is transduced by Smoothened (Smo), a seven‐transmembrane spanning protein that belongs to the G‐protein coupled receptor family. Among four families of Gα subunits, Gαi has been thought to be responsible for transducing Shh signalling, while several lines of evidence indicated that other signalling pathways may be involved. We found that the G12 family of heterotrimeric G proteins and the small GTPase RhoA are involved in Shh/Smo‐mediated cellular responses, including stimulation of target gene promoter and inhibition of neurite outgrowth of neuroblastoma cells. We also found that the G12/RhoA pathway is responsible for Smo‐induced nuclear import of GLI3 which is thought to transduce Shh signals to nucleus. Furthermore, misexpression of a G12‐specific GTPase‐activating protein in rat neural tubes leads to pertubation of motor neurone and interneurone development, mimicking the effects of decreased Shh signalling. These results show that Shh signalling is mediated in part by activating G12 family coupled signalling pathways. The participation of RhoA, a pivotal molecular switch in many signal transduction pathways, may help explain how Shh can trigger a variety of cellular responses.
TNFα‐induced ATF3 expression is bidirectionally regulated by the JNK and ERK pathways in vascular endothelial cells
Authors: Inoue Koichi , Zama Takeru , Kamimoto Takahiro , Aoki Ryoko , Ikeda Yasuo , Kimura Hiroshi , Hagiwara Masatoshi
Published: January 2004

ATF3 (Activating transcription factor 3), a member of the CREB/ATF family, can be induced by stress and growth factors in mammalian cells, and is thought to play an important role in the cardiovascular system. However, little is currently known about how the induction of ATF3 is regulated, except that the JNK pathway is involved. Here, we investigated the differential roles of the MAPK pathways involved in TNFα (tumour necrosis factor α)‐induced ATF3 expression in vascular endothelial cells. In human umbilical vein endothelial cells, the expression of constitutively active MKK7 (MAPK kinase 7) increased the number of ATF3‐positive cells, and dominant negative MKK7 suppressed the TNFα‐induced expression of ATF3, indicating a requirement for the JNK pathway. In contrast, the expression of constitutively active or dominant negative MEK1/2 (MAPK/ERK kinase 1/2) suppressed or enhanced TNFα‐mediated induction of ATF3, respectively. In support of this, the MEK1/2 specific inhibitor U0126 enhanced the expression of ATF3 induced by TNFα. Furthermore, the ERK pathway inhibits the TNFα‐mediated induction of ATF3 mRNA, but not its stability, suggesting the involvement of ERK activity in the transcriptional regulation of the ATF3 gene. Our results suggest that TNFα‐induced ATF3 gene expression is bidirectionally regulated by the JNK and ERK pathways in vascular endothelial cells.
The significance of chicory to the diet of common duiker at Grants valley, Eastern Cape Province, South Africa
Authors: Kigozi Fred
Published: January 2004

South Africa is considered one of the top four chicory (Chichorium intybus) producing countries of the world and commercial growing of the plant in the country is restricted to a small area in three districts of the Eastern Cape Province. Faecal analysis technique was used to study the diet of common duiker (Sylvicapra grimmia Linnaeus, 1758) in a chicory growing region at Grants valley. One of the principal items in the diet of these antelopes was chicory and the crop provided more than one third (35.6%) of the winter diet and a substantial proportion (14.4%) of the spring diet of common duiker. These findings confirmed earlier reports of common duiker feeding on cultivated crops and may have profound implications for the South African chicory industry. The study also confirmed earlier findings that common duiker are selective feeders and predominantly browsers, consuming only a very small proportion of monocotyledonous plants.
Seasonal occurrence and local movements of the grey‐headed (brown‐necked) parrot Poicephalus fuscicollis suahelicus in southern Africa
Authors: Symes Craig T. , Perrin Michael R.
Published: January 2004

Seasonal movements of grey‐headed (brown‐necked) parrots were recorded in parts of its range and are likely a response to breeding and availability of specific food sources. Breeding occurred in the northern Kruger National Park and lowveld near the Mutale–Luvhuvhu river confluence from April to August. Aggregations and movements of birds occurred during the post‐breeding season (August–December) in response to seasonally abundant food sources. In north‐eastern South Africa, grey‐headed parrots occurred at Levubu, following the breeding season and their arrival in the area was correlated with the availability of unripe Mabola Plum, Parinari curatellifolia fruit. Similar regional movements occurred in Zimbabwe, the Caprivi of northern Namibia and Zambia. During these movements, flocks of up to 50 individuals were observed, whilst during breeding months singletons and pairs were more frequently seen. This increased abundance in time and space suggests that seasonal migratory movements occur.
Phenology of figs in Budongo Forest Uganda and its importance for the chimpanzee diet
Authors: Tweheyo Mnason , Lye Kåre A.
Published: January 2004

This paper reports on the phenological patterns of figs in Budongo Forest, Uganda, and how it relates to chimpanzee food availability in different seasons. In addition, we analysed the dung of chimpanzees to understand the composition of fruits in their diet. The aim of our study was to assess Ficus phenology and how it affects chimpanzee diet. Fifteen species of figs were monitored for fruit (syconium) and leaf phenology between June 2000 and 2001. Ficus fruit production varied significantly between and within species, and also with tree trunk and crown diameters. Fig fruit production was asynchronous and individual fig trees produced crops from one to five times in a year. In addition to fruits, chimpanzees fed on young leaves of some Ficus species. Shedding of old Ficus leaves coincided with the dry season, followed by appearance of young leaves. The dry season in Budongo is a period of general fruit scarcity. The combination of fig fruits and young leaves make up the most important food in the diet of chimpanzees. From the chimpanzee dung, more than 78% of seeds comprised fig ‘seeds’ (nutlets) and the rest of the diaspores were from other tree species. Our findings suggest that chimpanzees disperse large number of diaspores in their dung, thereby serving as important agents of natural forest regeneration.
Population dynamics of small mammals at Mlawula, Swaziland
Authors: Mahlaba T. A. M. , Perrin M. R.
Published: January 2004

Population density, biomass and composition of a small mammal community in an Acacia nigrescens savanna were studied over 12 months from August 2000. The community consisted of Mus minutoides (A. Smith 1834), Mastomys natalensis (A. Smith 1834), Lemniscomys rosalia (Thomas 1904), Crocidura hirta (Peters 1952), Steatomys pratensis (Peters 1846); and on one occasion, Graphiurus murinus (Desmarest 1822) was caught. M. minutoides was the dominant species in the site. Species richness was found to vary significantly with the time of the year. The density of M. minutoides was significantly high in winter and low in the other seasons, the ratio of males to females was found to be equal, and pregnant females were caught from November to May. The biomass of small mammals in the area (also density and numbers) was generally low (mean biomass 212 g ha−1). The occurrence of new individuals in catches remained high throughout the study, suggesting a high mortality or emigration rate or a combination of the two.
Growth responses of a woody species to clipping and goat saliva
Authors: Rooke Tuulikki
Published: January 2004

Studies on the role of mammalian herbivore saliva in plant–animal interactions have mostly focused on graminoid species and bovine saliva. A trial was performed in Botswana with clipping treatments to simulate browsing of shoots and the application of goat saliva on the woody species Combretum apiculatum Sonder (Combretaceae). Treatments were performed during early growing season while shoot growth was rapid, and responses of trees were recorded later in the same season. Clipped shoots with saliva had significantly enhanced shoot growth (tripled in length) and leaf production (2.7 times more leaves) compared to clipped shoots without saliva. However, unclipped shoots still grew more than clipped shoots, with or without saliva treatment.
Use of indigenous ecological knowledge of the Maasai pastoralists for assessing rangeland biodiversity in Tanzania
Authors: Mapinduzi Arnold L. , Oba Gufu , Weladji Robert B. , Colman Jonathan E.
Published: January 2004

This paper incorporates the indigenous ecological knowledge (IEK) of the Maasai pastoralists and ecological methods to assess effects of grazing and cropping on rangeland biodiversity at macro‐ and micro‐landscape scales in northern Tanzania. The joint surveys with pastoralists identified indicator plant species and their associations with micro‐landscapes and livestock grazing suitability (i.e. for cattle and small ruminant grazing), while traditional calf‐pasture reserves (alalili pl. alalilia) were evaluated for preservation of rangeland biodiversity. The macro‐landscapes comprising the cool high plateau (osupuko pl. isipuki) and montane forest highland (endim) were included in the survey. At micro‐landscape scales, the osupuko was classified into uplands (orkung'u), slopes (andamata) and dry valley bottomlands (ayarata). The micro‐landscapes were assessed in terms of herbaceous plant species and woody species richness and risks of soil erosion. Biodiversity varied at both the macro‐ and micro‐landscape scales and in accordance with the land‐use types. Greater plant species diversity and less erosion risks were found in the pastoral landscapes than in the agro‐pastoral landscapes. The calf‐grazing pastures had greater herbaceous species richness than the non‐calf pastures, which in turn had more woody species. The study concludes that the indigenous systems of landscape classification provides a valuable basis for assessing rangeland biodiversity, which ecologists should incorporate into ecological surveys of the rangelands in East Africa in the future.
On the use of Timed Species Counts to estimate avian abundance indices in species‐rich communities
Authors: Freeman Stephen N. , Pomeroy Derek E. , Tushabe Herbert
Published: January 2004

Timed Species Counts (TSCs) have been found to provide useful data for assessing the relative abundances of birds in conservation studies, particularly in species‐rich areas, such as many tropical habitats. An index is conventionally based upon the mean TSC from a number of counts. In this paper, we develop a new statistic, λ, which is based upon the assumption that the number of encounters with a species in unit time has a Poisson distribution. Using the same assumptions on detectability that underlie earlier analyses of TSC data, values of λ, unlike the simple mean TSC, are directly proportional to abundance. However, TSC data are affected by detectability, so that comparisons of relative abundance for the same species between similar sites have greater validity than those between different species. Explicit formulae for calculating an estimate of λ and its SE from sample data are described. Although λ can be estimated from either TSC data or the simple proportion of counts in which the species was encountered, for the commonest species a simulation study shows that only data in full TSC form provide accurate estimates. The difference becomes negligible for scarcer species. The use of λ in preference to mean TSC scores is recommended where it is important to compare values of relative abundance.
Watson and Crick 50 years on. From double helix to pharmacogenomics
Authors: Sweeney B. P.
Published: January 2004

The second half of the 20th century has seen quantum leaps in our understanding of molecular biology. The technological advances, which facilitated the recent successful completion of the Human Genome Project, have provided the tools for deciphering the complexity of the human condition. At present, the function of only 50% of genes is known. However, as understanding of the human genome improves, a plethora of gene targets for treating disease will be uncovered – leading to therapies which will be considered revolutionary. Genome related science has begun to impact almost every facet of medicine including anaesthesia and intensive care. Better understanding of interindividual differences will enable better prediction of illness susceptibility as well as response to treatment. These insights will permit therapies to be tailored to individuals or racial groups. At present, there is only rudimentary knowledge of factors controlling gene regulation, but in the future, better understanding of gene‐environment interactions and gene expression will enable pharmaceutical companies to develop new therapies and permit clinicians to optimise their effects, without recourse to current laborious testing regimens. As genomic science progresses, new ethical, legal, social and philosophical dilemmas will also continue to emerge.
Continuous haemodynamic monitoring using transoesophageal Doppler during acute normovolaemic haemodilution in patients with coronary artery disease
Authors: Licker M. , Sierra J. , Tassaux D. , Diaper J.
Published: January 2004

Transoesophageal Doppler monitoring allows non‐invasive assessment of stroke volume. We studied haemodynamic changes during acute normovolemic haemodilution (ANH) in anaesthetised patients with coronary artery disease. Twenty patients were randomly assigned to either ANH or a control group. During ANH, a mean (SD) blood volume of 15.3 (3.4) ml.kg−1 was withdrawn decreasing systemic oxygen delivery from 12.7 (3.3) to 9.3 (1.8) ml.kg−1.min−1 (p < 0.001). In the control group, haemodynamic data remained unchanged, whereas in the ANH group, stroke volume and central venous pressure increased significantly (mean = +21 ml [95% CI: 18–25 ml.min−1]; mean = +2.5 mmHg [95% CI: 2.2–2.8 mmHg], respectively) and heart rate decreased (mean = −6 beat.min−1[95% CI: 6–8 beat.min−1], p < 0.05). According to the Frank–Starling relationship, individual changes in stroke volume compared with central venous pressure fitted a quadratic regression model (R2 > 0.91). A reduced viscosity associated with ANH resulted in improved venous return, higher cardiac preload and increased cardiac output. In summary, this study demonstrated that ANH to a haemoglobin value of 8.6 g.dl−1 was well tolerated in patients with coronary artery disease.
Acupuncture compared to placebo‐acupuncture for postoperative nausea and vomiting prophylaxis: A randomised placebo‐controlled patient and observer blind trial
Authors: Streitberger K. , Diefenbacher M. , Bauer A. , Conradi R. , Bardenheuer H. , Martin E. , Schneider A. , Unnebrink K.
Published: January 2004

This randomised, placebo‐controlled, patient and observer blinded trial was conducted to determine whether acupuncture at the acupuncture point P6 is effective in preventing postoperative nausea and vomiting (PONV) compared to placebo acupuncture. Female patients (n = 220) scheduled for gynaecological or breast surgery were randomly assigned to two groups receiving either acupuncture (n = 109) or placebo acupuncture (n = 111). Each group was stratified for type of surgery and included two subgroups receiving intervention either before or after induction of anaesthesia. The incidence of PONV and/or antiemetic rescue medication within 24 h after surgery was the main outcome measure which showed no statistically significant difference between groups (43.7% acupuncture, 50.9% placebo, p = 0.27). The differences were more pronounced for patients having gynaecological surgery (48.9% acupuncture, 67.6% placebo, p = 0.07) than for those having breast surgery (38.7% acupuncture, 40.3% placebo, p = 0.86). The secondary outcome, vomiting, was significantly reduced by acupuncture from 39.6% to 24.8% (p = 0.03). Subgroup analysis showed no difference between applications of acupuncture before compared to after induction of anaesthesia.
Latex‐free reservoir bags: exchanging one potential hazard for another*
Authors: Blanshard H. J. , Milne M. R.
Published: January 2004

The reservoir bag on the anaesthetic breathing circuit is a safety feature that can protect the patient. It is highly distensible, pressures within the breathing circuit rarely exceeding 3.9 kPa (40 cmH2O) even when the adjustable pressure‐limiting valve is inadvertently left closed. In providing a safe latex‐free environment in our anaesthetic rooms, the traditional latex rubber reservoir bag is substituted by a latex‐free one. To investigate the safety features of several latex‐free reservoir bags already in use in our hospital, we assessed the in‐circuit pressures obtained at stepped fresh gas flows using a lung simulator. Four out of five of the latex‐free bags exceeded pressures of 4.4 kPa (45 cmH2O), raising the possibility that, in trying to avoid an occupational hazard, we might be compromising patient safety. We found that, of the five latex‐free systems we tested, only the Intersurgical complete respiratory system provided an adequate safety mechanism for the patient and thus did not potentially compromise patient safety.
Patient maintained sedation for colonoscopy using a target controlled infusion of propofol*
Authors: Campbell L. , Imrie G. , Doherty P. , Porteous C. , Millar K. , Kenny G. N. C. , Fletcher G.
Published: January 2004

In this study, we evaluated safety and recovery using a patient maintained, target controlled infusion of propofol for sedation in 20 patients undergoing colonoscopy. Using a handset with a two‐minute lockout interval, patients could make 0.2 µg.ml−1 increments to an initial target plasma concentration of 1 µg.ml−1 up to a maximum 4.5 µg.ml−1. Four patients became oversedated but required no airway or circulatory interventions. Subjects had a significant reduction in mean (SD) heart rate: 78.7 (15) vs. 69.8 (13.5) (p < 0.001) and in systolic blood pressure 121.1 (13.2) mmHg vs. 96.5 (8.6) mmHg (p < 0.001). Choice reaction time testing 15 min after colonoscopy showed a significant median (IQR [range]) rise of 162 (− 16, 383.3 [‐199–859]) ms (p < 0.05). Six patients had faster reaction times postcolonoscopy. All patients denied unpleasant recall and were satisfied with the system. Although oversedation was a problem in this model, we conclude that patient maintained propofol sedation could be possible for colonoscopy.
Comparison of patient‐controlled epidural bolus administration of 0.1% ropivacaine and 0.1% levobupivacaine, both with 0.0002% fentanyl, for analgesia during labour
Authors: Purdie N. L. , McGrady E. M.
Published: January 2004

The aim of the study was to compare the relative potencies and clinical characteristics of epidural ropivacaine and levobupivacaine in labour using patient‐controlled epidural analgesia (PCEA). In a randomised double‐blinded study, 60 ASA I or II primigravidae requesting epidural analgesia in early labour were allocated to receive either 0.1% ropivacaine with fentanyl 0.0002% or 0.1% levobupivacaine with 0.0002% fentanyl via a patient‐controlled analgesia pump. Analgesia was established with 15 ml of study solution and maintained using 5‐ml boluses of study solution with a 5‐min lockout interval. There were no significant differences in onset time, duration and quality of analgesia, motor and sensory blockade, local anaesthetic consumption, mode of delivery, neonatal outcome or maternal satisfaction between the groups. We conclude that 0.1% ropivacaine with 0.0002% fentanyl and 0.1% levobupivacaine with 0.0002% fentanyl are clinically indistinguishable for labour analgesia and appear pharmacologically equipotent when using PCEA.
The effect of pre‐operative administration of midazolam on the development of intra‐operative hypothermia
Authors: Toyota K. , Sakura S. , Saito Y. , Ozasa H. , Uchida H.
Published: January 2004

Midazolam is often used for premedication; it is known to promote vasodilation and may therefore affect redistribution of heat during surgery. We examined the effect of pre‐operative administration of midazolam on the development of intra‐operative hypothermia. Forty‐five patients were randomly allocated to one of three groups to receive no premedication (Group C), IM midazolam 0.04 mg.kg−1 (Group M1) or 0.08 mg.kg−1 (Group M2) 30 min prior to anaesthesia. Sedation levels were assessed, and then general anaesthesia was induced and maintained using propofol and fentanyl. During surgery, core temperature, which was similar for the three groups prior to induction of anaesthesia, decreased significantly less in the midazolam groups M1 and M2 compared to the control group C. Patients who were more heavily sedated prior to induction of anaesthesia, had significantly lower core temperatures peri‐operatively than those who were less sedated, and core temperatures in unpremedicated patients fell to significantly lower levels during surgery than those who were drowsy. We conclude that pre‐operative administration of midazolam produces an effect on the development of peri‐operative hypothermia. We found that moderate pre‐operative sedation reduces the peri‐operative heat loss, possibly by affecting core‐to‐peripheral heat distribution.
The multidisciplinary approach to mental health crisis management: an Australian example
Authors: WEBSTER S. , HARRISON L.
Published: January 2004

Changes within the Australian health care system have led many people with mental health disorders to use emergency departments as the point of access to mental health services. Staff in emergency departments are not necessarily equipped to assess the needs of such clients. This paper briefly describes the development of a multidisciplinary mental health liaison team, within the emergency department of one hospital in Sydney, which was designed to assist both staff and clients. Available evidence suggests the implementation of the team has been a success, however, more research is required to confirm the effectiveness of this approach. Questions are raised about appropriate referral and follow‐up for some clients. The study also found deficiencies in the method of routine data collection (Emergency Department Identification System), which makes formal auditing of the team and the services it provides a difficult task.
‘Caught in the middle’? Mental nurse training in England 1919–51
Authors: CHATTERTON C.
Published: January 2004

The early history of mental health nurse training is one that has only been partially researched. While some writers have discussed the content and impact of training on the development of mental health nursing, little has been written on the professional and institutional factors that influenced this development. The medical profession, psychiatry, was to play an important role in the development of training and regulation of nursing staff in the large Victorian asylums and was an important influence on the knowledge base of mental health nursing. Their professional organization, the Medico‐Psychological Association (the Royal Medico‐Psychological Association after 1926 when they acquired a royal prefix) produced the first textbook for asylum nurses in 1885 and established a national training scheme for them 4 years later. However, in 1919 the Nurses Registration Act established the General Nursing Council for England and Wales and this body was given statutory responsibility for the training and registration of nurses, including ‘mental’ nurses. They were soon to be in conflict with the Medico‐Psychological Association. The two organizations continued to run their own rival training schemes for mental health nurses for over 30 years, the Royal Medico‐Psychological Association finally relinquishing their role in 1951. The Royal Medico‐Psychological Association scheme proved far more popular than the General Nursing Councils, with significantly more nurses participating in it. This paper discusses these organizational influences on the development of ‘mental nurse’ training and discusses the possible impact that they have had on the knowledge base of mental health nursing.
The perception of aggression by nurses: psychometric scale testing and derivation of a short instrument
Authors: NEEDHAM I. , ABDERHALDEN C. , DASSEN T. , HAUG H. J. , FISCHER J. E.
Published: January 2004

Patient aggression is a serious problem in psychiatric nursing. Nurses’ attitudes towards aggression have been identified as mediating the choice of nursing interventions. To date, investigations are lacking which elucidate the stability of one of the few scales for measuring the attitude of aggression. This study aimed to investigate the test–retest stability of the Perception of Aggression Scale and to derive a shortened version. In order to test the reliability of the Perception of Aggression Scale items, three groups of psychiatric nurses were requested to fill in the Perception of Aggression Scale twice (30 student nurses after 4 days, 32 qualified nurses after 14 days and 36 qualified nurses after 70 days). We derived the shortened version from an independent data set obtained from 729 psychiatry nurses using principal component analysis, aiming to maximize parsimony and Cronbach's alpha. Amongst competing short versions, we selected those with the highest reliability at 70 or 14 day retest. A scale using 12 of the original 32 items was derived yielding alphas of r = 0.69 and r = 0.67 for the two POAS factors with retest reliabilities of r = 0.76 and r = 0.77. The shortened scale offers a practical and viable alternative to the longer version.
Stress, sources of stress and ways of coping among psychiatric nursing students
Authors: TULLY A.
Published: January 2004

This study measured levels of distress, sources of stress and ways of coping of a convenience sample of psychiatric nursing students (n = 35). Instruments used were the 30‐item General Health Questionnaire, the Jones and Johnson (1997) Student Nurse Stress Index, Parkes (1985) Ways of Coping Questionnaire and a demographic questionnaire. Findings revealed that all students were significantly distressed, exceeding a conventional cut‐off score of 5 on the 30‐item General Health Questionnaire. Students were found to have limited coping skills. Preparing to become a nurse in this setting was found to be significantly emotionally stressful and a possible risk to the well‐being of students. This study provides a baseline from which to address the problem of stress among diplomate psychiatric nursing students.
Defining dual diagnosis of mental illness and substance misuse: some methodological issues
Authors: TODD J. , GREEN G. , HARRISON M. , IKUESAN B. A. , SELF C. , BALDACCHINO A. , SHERWOOD S.
Published: January 2004

This paper discusses methodological issues arising in the initial stages of a larger epidemiological case–control study. Practitioners from both Generic Mental Health and Substance Misuse Services (n = 170) were asked to identify which of their clients, from a time‐limited caseload (n = 2341), had comorbid mental health and substance misuse problems. Although practitioners were provided with a definition of ‘singly diagnosed’ and ‘dually diagnosed’, it became apparent that these definitions were applied pragmatically, depending on the nature of the client's primary problem and the agency they were presenting to. Issues raised include the time period in which a client was considered to have a concurrent mental health problem and substance misuse, how a ‘mental health problem’ was defined and whether a personality disorder should be categorized as a ‘mental health problem’. There was also some disagreement about whether clients who were being treated primarily by Substance Misuse Services, but were also taking prescribed antidepressants, implicitly had a ‘mental health problem’. We raise these methodological issues, as they have implications for determining the prevalence of ‘dual diagnosis’ and the subsequent provision of services.
Rejection – a neglected phenomenon in psychiatric nursing
Authors: HEM M. H. , HEGGEN K.
Published: January 2004

The basically asymmetric character of the ‘psychotic patient–psychiatric nurse’ relationship constitutes an ethical challenge for the nurse. One aspect of this relationship is that nurses must constantly self‐consciously control their behaviour towards the patient. There is some evidence that the patient sometimes feels offended because of his perception that the nurse rejects him. The purpose of this article is to examine the role rejection plays in the ‘psychotic patient–psychiatric nurse’ relationship and ethical implications this might have for the field of psychiatric nursing. This study is conducted using an ethnographic research design that includes participant observation and narrative interviews of nurses working on an acute ward of a psychiatric hospital. One case is analysed and discussed in depth through the philosophical insights (particularly ‘the ethical demand’) of the Danish moral philosopher K.E. Løgstrup. The psychotic patient, being vulnerable, dependent, and trusting, confronts the psychiatric nurse with a constant ‘ethical demand’ to take care of him. The patient's trust, and his fight to maintain his dignity, creates a risk of being rejected. The nurse, by resorting to the tactic of ‘impersonal professional routine’, which does not define the relationship as a personal encounter, creates boundaries between herself and the patient. The nurse's withdrawal from the patient's perception of reality is experienced by the patient as rejection and hence an offence of his dignity. The nurse's rejection of the patient has two causes: external factors – for example inadequate staffing – cause the nurse to be unable to live up to the professional ideal of ‘welcoming’ the patient; internal factors – for example the profession's understanding of itself – create an unclear understanding of the nurse's role and responsibilities. It is necessary to work with both the external and internal factors to improve psychiatric nursing.
Family Intervention in routine practice: it is possible!
Authors: KELLY M. , NEWSTEAD L.
Published: January 2004

Family Intervention for individuals with schizophrenia has a wealth of evidence to attest its efficacy. However, there is little literature available about actual family work services, what they consist of and how they operate. With the publication of the National Institute for Clinical Excellence guidelines for schizophrenia in 2002, there is increased pressure on mental health services to deliver evidence‐based Family Interventions to individuals with schizophrenia and their families. This article will outline how a specialist mental health Trust have been able to successfully establish and implement a designated Family Intervention service into routine practice.
Nurse staffing levels and budgeted expenditure in acute mental health wards: a benchmarking study
Authors: RYAN T. , HILLS B. , WEBB L.
Published: January 2004

This paper describes benchmarking research undertaken within one former National Health Service Executive region examining acute ward funded and actual staffing establishments and funded expenditure for mental health nursing staff. Staffing establishment data were obtained for all 73 acute wards within the region. Of the established posts for trained mental health nurses across these wards, it was identified that there were 12% vacancies (117.99 whole time equivalent) at the time of the study. While some of the shortfall was dealt with by recruiting untrained nursing staff above funded establishments, there remained an overall shortfall in the total nursing workforce across the system of acute wards in the region. Although most of the provider trusts in the region were in development or experiencing major organizational change at the time of the study, considerable variation existed within and between trusts. Variations were identified in funded and actual nursing establishments and cost per bed, raising significant issues for trusts and their local mental health economies. Variations based on mixed‐ and single‐sex wards were also noted. Findings are discussed in respect of the issues raised for the development of wards, provider trusts and their local systems. The utility of the methodology developed in this work is also discussed.
The effects of a transitional discharge model for psychiatric patients
Authors: REYNOLDS W. , LAUDER W. , SHARKEY S. , MACIVER S. , VEITCH T. , CAMERON D.
Published: January 2004

This pilot randomized control trial was motivated by the discovery that many individuals with mental health problems are re‐hospitalized within a year, with many being unable to fully adjust to community living. A solution was proposed in the form of an intervention called transitional discharge. The transitional discharge model included: (1) peer support, which is assistance from former patients who provide friendship, understanding and encouragement; and (2) overlap of inpatient and community staff in which the inpatient staff continue to work with the discharged patient until a working relationship is established with a community care provider. The overall aim of this study was to test the discharge model designed to assist patients discharged from acute admission wards to adjust to community living. This aim was tested through a number of related hypotheses, which suggest that, 5 months following discharge from an acute admission ward of a psychiatric hospital, individuals participating in a transitional discharge model: (1) report fewer symptoms; (2) report better levels of functioning; (3) have better quality of life; (4) are less likely to have been re‐admitted to hospital. The study used a randomized experimental design with two conditions: experimental and usual treatment. In general, both the control and the experimental group demonstrated significant improvements in symptom severity and functional ability after 5 months. Usual treatment subjects in the control group were more than twice as likely to be re‐admitted to hospital. This study needs to be replicated in Scotland with a larger sample and with a modified variation of the intervention called the Transitional Care Intervention.
Pedagogy, power and service user involvement
Authors: FELTON A. , STICKLEY T.
Published: January 2004

This paper explores mental health nurse educators’ perceptions of the involvement of service users in preregistration nurse education. The idea for the study was developed from a local group of people including service users, lecturers and students committed to finding ways to develop service user involvement in education. This qualitative study uses semi‐structured interviews to explore participants’ perceptions in depth. Five lecturers who teach on the diploma programme based at a large teaching hospital were interviewed. The results suggest that the current situation of involving service users at the research site was ineffective. The concepts of ‘role’ and power relationships were used to explore the reasons for this. The development of service user involvement in education is complex and requires further research.
Unreliable evidence
Authors: SHORT N. P. , KITCHINER N. J. , CURRAN J.
Published: January 2004

As the need for effective evidence‐based practice comes under close scrutiny we investigate the effectiveness of three interventions; thought suppression, reassurance and relaxation, that are routinely offered to clients. These strategies have very little evidence to support their continued use. The article continues by discussing and describing situations where more helpful evidence‐based interventions are better suited.