bluuebunny/crossref_metadata_2025 huggingface dataset:
Experiences with component‐oriented technologies in nuclear power plant simulators
Authors: Díaz Manuel , Garrido Daniel , Romero Sergio , Rubio Bartolomé , Soler Enrique , Troya José M.
Published: June 2006

This paper proposes the application of modern component‐oriented technologies to the development of nuclear power plant simulators. On the one hand, as a significant improvement on previous simulators, the new kernel is based on the Common Component Architecture (CCA). The use of such a high‐performance computing oriented component technology, together with a novel algorithm to automatically resolve simulation data dependencies, allows the efficient execution of both parallel and sequential simulation models. On the other hand, RT‐CORBA is employed in the development of the rest of the applications that comprise the simulator. This real‐time communication middleware not only makes the management of communications easier, but also provides the applications with real‐time capabilities. Software components used in these two ways, simulation models integrating the kernel and distributed applications from which the simulator is comprised, improve the evolution and maintenance of the entire system, as well as promoting code reusability in other projects. Copyright © 2006 John Wiley & Sons, Ltd.
Heuristics for fault diagnosis when testing from finite state machines
Authors: Guo Qiang , Hierons Robert M. , Harman Mark , Derderian Karnig
Published: June 2006

When testing from finite state machines, a failure observed in the implementation under test (IUT) is called a symptom. A symptom could have been caused by an earlier state transfer failure. Transitions that may be used to explain the observed symptoms are called diagnosing candidates. Finding strategies to generate an optimal set of diagnosing candidates that could effectively identify faults in the IUT is of great value in reducing the cost of system development and testing. This paper investigates fault diagnosis when testing from finite state machines and proposes heuristics for fault isolation and identification. The proposed heuristics attempt to lead to a symptom being observed in some shorter test sequences, which helps to reduce the cost of fault isolation and identification. The complexity of the proposed method is analysed. A case study is presented, which shows how the proposed approach assists in fault diagnosis. Copyright © 2006 John Wiley & Sons, Ltd.
2′‐deoxy′4′‐C‐ethynyl‐2‐fluoroadenosine, a nucleoside reverse transcriptase inhibitor, is highly potent against all human immunodeficiency viruses type 1 and has low toxicity
Authors: Ohrui Hiroshi
Published: June 2006

An idea to use 4′‐C‐substituted‐2′‐deoxynucleoside derivatives was proposed based on a working hypothesis to solve the problems of existing acquired immune deficiency syndrome chemotherapy (highly active antiretroviral therapy). Subsequent studies have successfully proved the validity of the idea and resulted in the development of 2′‐deoxy‐4′‐C‐ethynyl‐2‐fluoroadenosine, a nucleoside reverse transcriptase inhibitor, which is highly potent to all human immunodeficiency viruses type 1 (HIV‐1s) including multidrug‐resistant HIV‐1 and has a low toxicity. © 2006 The Japan Chemical Journal Forum and Wiley Periodicals, Inc. Chem Rec 6: 133–143; 2006: Published online in Wiley InterScience (www.interscience.wiley.com) DOI 10.1002/tcr.20078
The Landmark Surgical Trials of the National Surgical Adjuvant Breast and Bowel Project
Authors: Wickerham D. Lawrence , Costantino Joseph P. , Mamounas Eleftherios P. , Julian Thomas B.
Published: June 2006

In this paper we provide a summary of several of the completed and ongoing surgical trials of the National Surgical Adjuvant Breast and Bowel Project, one of the cancer cooperative trials groups supported by the US National Cancer Institute.
Reoperative Surgery for Chronic Pancreatitis: Is It Safe?
Authors: Schnelldorfer Thomas , Lewin David N. , Adams David B.
Published: June 2006

Introduction

Eleven percent to fifty‐six percent of patients do not achieve adequate pain relief with initial operative treatment for chronic pancreatitis, and reoperations for recurrent or persistent pain are common. This study evaluates the influence of prior pancreatic procedures on operative morbidity for chronic pancreatitis.

Methods

The records of 336 consecutive patients who underwent pancreaticoduodenectomy (PD, n = 78), lateral pancreaticojejunostomy (LPJ, n = 152), distal pancreatectomy (DP, n = 83), transduodenal sphincteroplasty (SP, n = 20), and total pancreatectomy (TP, n = 3) for chronic pancreatitis were retrospectively reviewed and analyzed.

Results

Seventy‐four patients underwent reoperation after failed prior pancreatic surgery. Patients with de novo pancreatic operations had a similar complication rate as those with reoperation (PD: 48% versus 65%, P > 0.05; LPJ: 23% versus 23%, P > 0.05; DP: 26% versus 28%, P > 0.05; SP: 21% versus 100%, P > 0.05). Major complications such as pancreatic leak or abdominal abscess were similar in the two groups. Minor complications such as delayed gastric emptying or wound infections were more common in the reoperation group. There was no difference in postoperative hospital length of stay.

Conclusions

Patients who undergo reoperative surgery for chronic pancreatitis have an increased risk for minor perioperative complications. The overall complication rate and the incidence of major complications are similar compared to de novo procedure. Reoperative surgery therefore appears feasible and safe in experienced hands.
Assessment of the Preserved Function of the Remnant Stomach in Pylorus‐preserving Gastrectomy by Gastric Emptying Scintigraphy
Authors: Michiura Taku , Nakane Yasushi , Kanbara Tatsuya , Nakai Koji , Inoue Kentaro , Yamamichi Keigo , Kamiyama Yasuo
Published: June 2006

Background

This study evaluated the preserved function of the remnant stomach by gastric emptying scintigraphy in patients who underwent pylorus‐preserving gastrectomy (PPG), and it investigated whether this examination method is a useful tool for evaluation.

Materials and Methods

The residual stomach function was evaluated by gastric emptying scintigraphy in 45 patients with early gastric cancer who had undergone PPG. Function was classified as rapid, intermediate, and delayed emptying types according to gastric emptying curves. Then, the relationships were examined between the gastric emptying types and postprandial symptoms, food intake status, body weight changes, and endoscopic findings.

Results

Seventy‐three percent of the PPG patients were classified as belonging to the intermediate emptying type, and the remainder to the delayed emptying type. The frequencies of complaints such as epigastric fullness, nausea, and vomiting were high in the delayed emptying‐type patients. The intermediate emptying‐type patients consumed larger amounts of food and gained more weight than the delayed emptying‐type patients. It was difficult to estimate gastric emptying function from endoscopic findings.

Conclusions

Gastric function was evaluated by gastric emptying scintigraphy in PPG patients. This method might be useful not only for evaluating the motor function of the remnant stomach, but also for predicting postoperative status.
Quality of Life Assessment in Surgical Oncology Trials
Authors: Avery Kerry , Blazeby Jane M.
Published: June 2006

Integrating health‐related quality of life (HRQOL) as an endpoint for randomized surgical trials provides valuable insight into the patients’ perspective on treatment outcome. Health related quality of life data also play a role in ensuring fully informed consent, determining treatment options and informing treatment decision making. However, few randomized surgical trials have been conducted that meet the minimum requirements for rigorous HRQL assessment and, despite increasing efforts to improve the reporting of randomized trials, many are still not adequately performed. Such methodologic limitations may influence trial findings for HRQL outcomes and undermine the ability of the data collected to inform clinical practice. This review describes key methodological aspects of HRQL assessment that are required in randomized trials to ensure that data are robust. This includes choice of HRQL instrument, the method and timing of assessments and data analysis and presentation. The review also makes recommendations for future research in this area.
Research Reservations: Response and Responsibility in an American Indian Community
Authors: Gone Joseph P.
Published: June 2006

Community action research among the Assiniboine and Gros Ventre tribes of the Fort Belknap Indian reservation in Montana was undertaken to identify the cultural grounds for innovative mental health service delivery. As an enrolled tribal member investigating these matters in my “home” community, however, I encountered a series of challenges and limitations emerging from respondent reservations about sharing personal experiences of difficulty and distress, and the perceived means for redressing these. Focusing upon a difficult interview with a knowledgeable tribal elder, I enlist sociolinguistic analysis—the study of communicative norms governing who talks with whom about what (and under which conditions)—as one crucial means to making sense of this complex research encounter. Similar analyses would seem necessary to ensuring the cultural validity of research conclusions in cross‐cultural action research more generally.
Interaction of FliS flagellar chaperone with flagellin
Authors: Muskotál Adél , Király Réka , Sebestyén Anett , Gugolya Zoltán , Végh Barbara M. , Vonderviszt Ferenc
Published: June 2006

Premature polymerization of flagellin (FliC), the main component of flagellar filaments, is prevented by the FliS chaperone in the cytosol. Interaction of FliS with flagellin was characterized by isothermal titration calorimetry producing an association constant of 1.9 × 107
M−1 and a binding stoichiometry of 1:1. Experiments with truncated FliC fragments demonstrated that the C‐terminal disordered region of flagellin is essential for FliS binding. As revealed by thermal unfolding experiments, FliS does not function as an antifolding factor keeping flagellin in a secretion‐competent conformation. Instead, FliS binding facilitates the formation of α‐helical secondary structure in the chaperone binding region of flagellin.
Fundamental research is the basis for understanding and treatment of many human diseases
Authors: Vance Dennis E.
Published: June 2006

There are numerous examples of how fundamental research has been required to understand and treat human disease. This article focuses on three human diseases of lipid metabolism in which advancements in understanding and treatment would not have been possible without basic research. Fabry disease is an inherited metabolic disorder caused by the lack of a specific enzyme in glycosphingolipid catabolism. Cardiovascular disease is a complex and multifactorial disease but as many as half of the cases can be attributed to abnormal levels of plasma cholesterol. The incidence of liver disease is increasing due to the current epidemic of obesity. It is only recently that curiosity‐driven research has yielded valuable insight into the mechanism by which liver disease evolves.
Mechanisms of ammonium transport, accumulation, and retention in ooyctes and yeast cells expressing Arabidopsis AtAMT1;1
Authors: Wood Craig C. , Porée Fabien , Dreyer Ingo , Koehler Gabriele J. , Udvardi Michael K.
Published: June 2006

Ammonium is a primary source of N for plants, so knowing how it is transported, stored, and assimilated in plant cells is important for rational approaches to optimise N‐use in agriculture. Electrophysiological studies of Arabidopsis AtAMT1;1 expressed in oocytes revealed passive, Δψ‐driven transport of through this protein. Expression of AtAMT1;1 in a novel yeast mutant defective in endogenous ammonium transport and vacuolar acidification supported the above mechanism for AtAMT1;1 and revealed a central role for acid vacuoles in storage and retention of ammonia in cells. These results highlight the mechanistic differences between plant AMT proteins and related transporters in bacteria and animal cells, and suggest novel strategies to enhance nitrogen use efficiency in agriculture.
GRP78‐binding protein regulates cAMP‐induced glial fibrillary acidic protein expression in rat C6 glioblastoma cells
Authors: Oh-hashi Kentaro , Hirata Yoko , Koga Hisashi , Kiuchi Kazutoshi
Published: June 2006

We previously reported that a novel GRP78‐binding protein (GBP) is predominantly expressed in rat brain and its expression declines through the aging process. To characterize its biological function, we established C6 glioblastoma cells that stably overexpressed GBP. Stable overexpression of GBP attenuated cAMP‐induced expression of the glial fibrillary acidic protein (GFAP) gene, which was accompanied by a decrease in cAMP‐induced signal transducer and activators of transcription 3 (STAT3) phosphorylation. Other distinct cAMP‐induced events, including a transient reduction in extracellular signal‐regulated protein kinase phosphorylation and a slowdown in cell proliferation, were hardly affected by GBP overexpression. Most importantly, treatment with siRNA against endogenous GBP markedly downregulated GBP expression in C6 glioblastoma cells, and dramatically augmented cAMP‐induced GFAP mRNA expression in parallel with hyper‐phosphorylation of STAT3. These results suggest a novel function of GBP in regulating GFAP gene expression via STAT3 phosphorylation.
Proteasome response to interferon‐γ is altered in senescent human fibroblasts
Authors: Stratford Fiona L.L. , Chondrogianni Niki , Trougakos Ioannis P. , Gonos Efstathios S. , Rivett A. Jennifer
Published: June 2006

We have investigated immunoproteasomes in human fibroblasts during replicative senescence. Unlike levels of constitutive proteasome catalytic subunits and 26S proteasome regulatory subunits, levels of immunosubunits did not decrease dramatically in senescent cells. However, the induction of immunosubunits by interferon‐γ (IFN‐γ) was lost in senescent cells. In contrast, levels of the 11S proteasome regulator, PA28, were increased by IFN‐γ even in senescent cells, and both immunosubunits and PA28 increased with the reversible growth arrest in confluent cell cultures. The results highlight differences in the mechanisms of regulation of immunoproteasomes compared to constitutive proteasomes and in the irreversible growth arrest of senescent cells compared to reversible contact‐induced growth arrest.
Differential motivational responses to food and pleasurable cues in anorexia and bulimia nervosa: a startle reflex paradigm
Authors: FRIEDERICH HANS-CHRISTOPH , KUMARI VEENA , UHER RUDOLF , RIGA MARIANTHY , SCHMIDT ULRIKE , CAMPBELL IAIN C. , HERZOG WOLFGANG , TREASURE JANET
Published: June 2006

Background. Abnormal perceptions of food and shape underpin the cognitive behavioural model of eating disorders (EDs). The aim of this study was to investigate motivational processing of disorder-specific and standard emotional cues in anorexia (AN) and bulimia nervosa (BN) using startle eyeblink modulation (SEM). SEM was used because it is sensitive to motivational states of approach (appetitive response) and withdrawal (aversive response), which are independent of conscious intentional control.

Method. Acoustically elicited SEM and subjective anxiety ratings were measured in 30 female patients with an ED (n=15 AN, n=15 BN) and 30 female control subjects while they viewed ED-relevant stimuli (food, female bodies) and standardized emotional pictures.

Results. BN subjects showed an appetitive response (startle inhibition) to food relative to neutral cues that differed significantly from AN subjects. By contrast, self-reports indicated significantly increased anxiety related to food cues across both ED groups. To female body picture (relative to neutral) cues, no significant between-group differences were found for SEM. ED subjects unexpectedly showed an aversive response (startle potentiation) to positive cues, in contrast to controls, who showed the established startle attenuation.

Conclusions. These preliminary results suggest that BN patients demonstrated an exaggerated appetitive response to food but not to standardized positive cues, whereas SEM in AN patients points to a generalized failure to activate the appetitive motivational system. Differences in motivational salience to food cues are in line with distinctions between AN and BN in eating behaviour and food consumption and support differential treatment requirements.
Forest property rights under nationalized forest management in Bhutan
Authors: DORJI LAM , WEBB EDWARD L. , SHIVAKOTI GANESH P.
Published: June 2006

Forest nationalization policies in Asia have often resulted in decreased local property rights over forests and users' short-term exploitative behaviour, leading to degradation of forests. Bhutan's centralized forest management structure was initiated with the Forest Act of 1969. This paper evaluates how nationalization of forests in Bhutan changed forest property rights and associated incentives and disincentives and management outcomes for leaf-litter forests (sokshing) and non-sokshing forests. Using the International Forestry Resources and Institutions (IRFI) research protocols, 12 sites across Bhutan's broadleaf zones were surveyed. Changes in forest property rights were analysed using Ostrom and Schlager's ‘bundles of rights’ framework. The forest nationalization policy changed the array of de jure rights that local people had over both traditionally community-used forests (the majority of forests) and small blocks of sokshings that were usually owned by a household and managed to produce valuable leaf litter for their agriculture livelihoods. There was more compliance with regulations in sokshing than in non-sokshing forests. Non-compliance of local people with forest conservation occurred in areas where the chance of being caught for rule breaking was perceived to be low or the costs of compliance were high. This was almost exclusively the case in non-sokshing forest in the form of widespread but low-intensity illegal tree cutting. The continuing significance of sokshing for agricultural livelihoods serves as a strong incentive for conservation of sokshings by rural people, even though the sokshings are under ultimate state control. The successful management of forests requires minimal difference between de jure policies and de facto practices for which rules that allocate property rights and the way those rules are enforced are important elements. Conservation and management rights of non-sokshing for communities would not only promote local stewardship, but also put the limited capacity of the Department of Forest to best use. Increased deforestation around villages may result, because modern development alternatives may make leaf litter insignificant for agriculture.
Factors influencing the sustainability of customary dugong hunting by a remote indigenous community
Authors: KWAN DONNA , MARSH HELENE , DELEAN STEVEN
Published: June 2006

The sustainability of indigenous customary hunting and fishing in remote areas can be influenced by human factors operating at global as well as regional and local scales because of the hybrid nature and sectoral interactions of the local economic environment. The internationally significant population of dugongs (Dugong dugon or seacow) in Torres Strait between Australia and Papua New Guinea supports an important indigenous fishery. The economic, socio-cultural and environmental factors that influenced hunting activity in 1998 and 1999 by the members of the community of Mabuiag Island were investigated to inform the sustainable management of the fishery. The landed catch during the eight months March to October of 145 dugongs in 1998 and 170 dugongs in 1999 potentially provided the community with an average of 290 g of dugong meat per person per day. Fifty-seven per cent of adult males on the island participated in dugong hunting, but more than half the catch in each year was caught by only two hunters. The probability of at least one person from the community going dugong hunting in 1998 and 1999 was 0.59 ± 0.02 per day. This probability was influenced by local environmental factors, including the abundance of dugongs in the traditional hunting grounds (affected by wind speed, year, season and lunar day) and the size of the commercial crayfish catch (which is influenced by the global market price, as well as local conditions). Although dugong hunting remains a very important part of the islanders’ contemporary culture and customary economy, the capacity to hunt dugongs is facilitated by the ease with which some hunters move between the state, commercial and customary sectors of their local economy. The complexities of the economic, social and cultural environments need to be considered in planning for the sustainable harvesting of threatened species by remote indigenous communities.
The control of speech production by bilingual speakers: Introductory remarks
Authors: COSTA ALBERT , SANTESTEBAN MIKEL
Published: June 2006

How much would Bill Murray have liked to be able to speak Japanese! Bill Murray's character in the movie Lost in Translation exemplifies the way we feel when trying to communicate with someone that does not speak the same language. Often, in such cases, the exchange of information is disrupted and even translation does not seem to capture the communicative intention of the interlocutors. Thus, to be able to speak two languages at will is obviously a worthy skill to have. However, there is also a potential drawback, namely, bilingual speakers need to control their production in such a way that the two languages do not end up mixed in an inappropriate manner during the discourse. For example, if Bill Murray would have been an English–Japanese bilingual, he would have had to be careful not to use English words when speaking to the director of the commercial. This poses interesting problems to researchers in cognitive psychology: How does a bilingual speaker control her two languages during speech production? How do bilingual speakers manage to avoid massive interference from the language they are not using? What is the role of the language-not-in-use during lexical retrieval and phonological encoding? The articles included in this issue aim at discussing the answers that have been put forward to some of these questions.
Lexical access in bilingual speakers: What's the (hard) problem?
Authors: FINKBEINER MATTHEW , GOLLAN TAMAR H. , CARAMAZZA ALFONSO
Published: June 2006

Models of bilingual speech production generally assume that translation equivalent lexical nodes share a common semantic representation. Though this type of architecture is highly desirable on both theoretical and empirical grounds, it could create difficulty at the point of lexical selection. If two translation equivalent lexical nodes are activated to roughly equal levels every time that their shared semantic representation becomes activated, the lexical selection mechanism should find it difficult to “decide” between the two (the “hard problem”) – yet in some cases bilinguals benefit from the presence of a translation equivalent “competitor”. In this article, we review three models that have been proposed as solutions to the hard problem. Each of these models has difficulty accounting for the full range of findings in the literature but we suggest that these shortcomings stem from their acceptance of the assumption that lexical selection is competitive. We argue that without this assumption each proposal is able to provide a full account of the empirical findings. We conclude by suggesting that the simplest of these proposals should be rejected before more complicated models are considered.
Modeling the control of phonological encoding in bilingual speakers
Authors: ROELOFS ARDI , VERHOEF KIM
Published: June 2006

Phonological encoding is the process by which speakers retrieve phonemic segments for morphemes from memory and use the segments to assemble phonological representations of words to be spoken. When conversing in one language, bilingual speakers have to resist the temptation of encoding word forms using the phonological rules and representations of the other language. We argue that the activation of phonological representations is not restricted to the target language and that the phonological representations of languages are not separate. We advance a view of bilingual control in which condition-action rules determine what is done with the activated phonological information depending on the target language. This view is computationally implemented in the WEAVER++ model. We present WEAVER++ simulations of the cognate facilitation effect (Costa, Caramazza and Sebastián-Gallés, 2000) and the between-language phonological facilitation effect of spoken distractor words in object naming (Hermans, Bongaerts, de Bot and Schreuder, 1998).
Executive function is necessary to enhance lexical processing in a less proficient L2: Evidence from fMRI during picture naming
Authors: HERNANDEZ ARTURO E. , MESCHYAN GAYANE
Published: June 2006

Recent work in the bilingual literature suggests that naming pictures in a second language (L2) differs from naming pictures in the first language (L1) because of effortful lexical retrieval. This finding has received some support in the neuroimaging literature (De Blesser et al., 2003). In the current study, twelve Spanish-English bilinguals, who had learned English later in early adulthood, were asked to name pictures covertly in either Spanish or English while being scanned with functional Magnetic Resonance Imaging (fMRI). Picture naming in the second language (L2) relative to the native language (L1) revealed increased activity in the right insula, anterior cingulate gyrus and dorsolateral prefrontal cortex (DLPFC) and the left fusiform gyrus. These results are consistent with the view that picture naming in a less proficient L2 requires increased effort to establish links between motor codes and visual forms.
Monitoring skills: diabetes
Authors: Metcalfe L.
Published: June 2006

Summary

The extended independent and supplementary nurse prescribing programme implemented in 2003 is anticipated to have the potential to improve patient care by enabling faster access to medicine for people with chronic conditions such as Diabetes. Diabetes mellitus is a progressive, life–long, chronic condition which affects an estimated 1.4 million people in the UK and inevitably requires medication to control symptoms and prevent complications associated with the disease.

The supplementary prescribing option of nurse prescribing is an opportunity for Diabetes Specialist Nurses (DSN) to provide timely and appropriate clinical management for patients with diabetes within an agreed management plan. The clinical management plan (CMP) is a patient specific document and can only be implemented to enable supplementary nurse prescribing upon agreement by the individual patient, the independent prescriber (doctor or dentist and supplementary prescriber (nurse or pharmacist). The CMP allows the DSN to manage the treatment of the patient by modifying diabetes therapies tailored to the needs of the individual to achieve treatment goals. The use of a patient specific CMP compliments the National service Framework for diabetes requirement that all patients have a care plan. Involving the patient by seeking agreement to implement the CMP may improve concordance and compliance with therapies and treatment decisions.

Monitoring diabetes control is essential from diagnosis as the information received provides valuable feedback as to the effectiveness of therapies. Comprehensive diabetes education should be tailored to empower the patient with knowledge and skills to manage this chronic condition regardless of treatment regimes.

Consideration should always be given to the type of diabetes, the potential effects on lifestyle and treatment options available today.
The Consultation
Authors: Baird Anne
Published: June 2006

Summary Some of the best-known consultation models derived from general practice are briefly described and discussed in terms of their relevance for nurse and pharmacist prescribers. The communication skills needed by the nurse prescriber are also considered, along with an introduction to the concept of the patient's health belief system. Some of the literature that compares nurse and GP consultations is also looked at, as is the concept of diagnosis by nurses. Concordance with medication and consultations with pharmacists are also mentioned.
Oropharyngeal Candidiasis: A review of Current Intervention Strategies
Authors: Emery Caroline
Published: June 2006

Summary This article sets out to review recent research studies pertaining to the drug treatment of oropharyngeal candidiasis in infants. The main aims of treatment programmes are to resolve signs and symptoms of the infection; and minimise drug induced resistance, with minimal adverse side effects. A search for clinical evidence using Medline, Nursing Index and Embase between 1995 and 2003, produces no systemic reviews, no placebo controlled trials only three random control trials for the treatment of oropharyngeal candidiasis in infants. Three independent randomised control trials with samples of infants with oropharyngeal candidiasis (who were not immuno-compromised), compare the three main drug treatments of choice for infants, i.e. miconazole gel, clotrimazole (nystatin) suspension, and fluconazole suspension. The randomised trial of these infants found that miconazole gel had a significantly higher cure rate compared with nystatin suspension. At day 12 of the trial there was a 99% cure rate with the use of miconazole gel (25 mg QDS) compared to only a cure rate of 54% with nystatin suspension (100 000 IU QDS) (P> < 0.0001). The evidence from these studies suggest that miconazole gel (25 mg QDS) is the drug of choice for health visitors treating infants with oropharangeal candidiasis, as it is a safe and effective and cost effective treatment regime from birth.
Nurse Prescribing in Mental Health Care: What can the USA teach us?
Authors: Hemingway S. , McAllister M. , Bailey K. , Coates K. , Mitchell S. , Fenwick M.
Published: June 2006

Summary

Nurse Prescribing in mental health care is now a reality. As part of a long-term plan to introduce the prescribing role for mental health nurses in the local area, Doncaster and South Humber Health Care Trust and the School of Nursing and Midwifery at the University of Sheffield conducted a study tour of centres well established in the clinical practice and educational preparation for prescriptive authority for nurses. The findings from the visit are explored, for example: a) how is a competence in prescribing achieved by nurse, b) what is the educational delivery needed to prepare the potential prescriber? Insights are offered based on the provision of care by nurse prescribers in the states of Massachusetts and Connecticut that we visited. These are then discussed in the context of the future development of this role, which is now being introduced as an innovation aimed at meeting the mental health care needs of patients in the UK.
Prescribing: the ethical dimension
Authors: Adams John
Published: June 2006

Summary

Prescribers face a range of ethical dilemmas in their everyday practice. In this article, the principles-based approach to biomedical ethics developed by Beauchamp and Childress is outlined, with a particular focus on ‘respect for autonomy’. It is argued that the purpose of ethical reflection is to deepen and enrich more general reflection about clinical practice, rather than to provide definitive answers to dilemmas in prescribing.
Nurse prescribing and the enhancement of mental health services
Authors: Nolan Peter , Bradley Eleanor , Carr Neil
Published: June 2006

Abstract

Mental health nurses are relative latecomers to nurse prescribing. This is primarily because nurse prescribing has been seen as more appropriate for general nurses, particularly those working in the community or primary care. Pharmacists and psychiatrists were concerned about the complexity of prescribing for clients with mental health problems and felt that the training of mental health nurses and their clinical experience did not fit them to take on a prescribing role. These, and other impressions, may have influenced which groups of nurses were first selected to become nurse prescribers. However, recent studies have indicated that mental health nurses add considerably to the effectiveness of assessments and care plans, and that they are in an ideal position to integrate drug treatments with a wide range of non-pharmacological therapies knowledgeably, safely, effectively and in a manner that is acceptable to the patient. They have also been found to have an important role to play in monitoring the side effects of drugs and in providing education about medication, and in maintaining a therapeutic alliance with clients on long-term drug treatment. Whatever the limitations, mental health nurses as prescribers may still be deemed to have by some professional groups, and even by themselves, at this stage in the evolution of nurse prescribing, it is now inevitable that they will play a significant part in the overall improvement of mental health services during this decade. They are likely to challenge the existing prescribing practices and help in identifying the conditions under which medication is most therapeutic.
Pharmaceutical influences – Nurse prescribers: eyes wide open
Authors: Davies Jill , Hemingway Steve
Published: June 2006

Summary

The role of the Pharmaceutical Industry within healthcare has been a debate amongst our medical colleagues for the past decade. However, with the growing number of nurses who are now qualified to prescribe, this controversial aspect of professional practice is becoming an area of interest to nurses. This article reviews some of the literature on prescribing and the pharmaceutical Industry, in an attempt to raise nurses awareness. Nurses have skills that are central to their education of assessment and evaluation. It argues that nurses are well placed to utilise these skills to identify the influences of the Pharmaceutical Industry. The role of the Pharmaceutical Industry in professional development is debated, suggesting that nurses have the skills to analyse the potential impact of this form of education. Concepts of Ethics are discussed in relation to prescribing, patient care and professional education and practice.
The potential for prebiotic chemistry in the possible cryovolcanic dome Ganesa Macula on Titan
Authors: Neish C.D. , Lorenz R.D. , O'Brien D.P.
Published: June 2006

New observations of Titan by the Cassini spacecraft suggest the presence of cryovolcanism on the surface. Cryovolcanism has important astrobiological implications, as it provides a means of exposing Titan's organics to liquid water, transforming hydrocarbons and nitriles into more evolved and oxidized prebiotic species. One possible cryovolcano – the 180 km structure Ganesa Macula – resembles the pancake domes seen on Venus by the Magellan spacecraft. To assess the potential of Ganesa Macula for prebiotic chemistry, we estimate its height using radarclinometry and other methods, and calculate the freezing timescale assuming an initially completely liquid dome. Given height constraints of ~200 m to 4 km, we find that liquid water or water–ammonia environments could be sustained in Ganesa Macula for timescales of the order of 102–105 years. These timescales open a window for prebiotic chemistry far wider than can be explored in terrestrial laboratory experiments.
New Police Responses to Domestic Violence: The Go-Order in Germany
Authors: Löbmann Rebecca
Published: June 2006

In recent years, several policy reforms have been instituted encouraging tougher criminal justice system responses to domestic violence. In Germany, go-orders were implemented: Police can insist on the abuser leaving the home for a couple of days. The present study discusses the rate of go-orders, influence factors on police decisions and problems with this intervention. Data sources were a police database of 7098 incidents of domestic violence and a questionnaire survey of 374 patrol officers in Lower Saxony. Findings revealed that the rate of go-orders (36%) was within the range of other German federal states. Factors indicating danger of repeated violence, e.g., intoxication of perpetrator, exerted an influence on police decisions for go-orders. Moreover, the presence of children and the offender’s gender had an influence. The paper concludes that prevention can still be improved with respect to danger prognosis and control of go-orders.
Family Variables Associated with Peer Victimization: Does Family Violence Enhance the Probability of Being Victimized by Peers?
Authors: Mohr Andrea
Published: June 2006

This study was designed to examine the effects of family experiences (family violence, family conflict, parental affection and support) on peer victimization and to explore whether linkages between family variables and peer victimization are mediated by the development of internalizing problems and inappropriate reactions to peer aggression. Self-report data were collected from 446 boys and 287 girls attending the 5th to 10th grade (mean age = 13.3 years). Results show that non-victimized aggressors, aggressive and non-aggressive victims report more negative family experiences and more internalizing problem behavior than matched controls. Results of structural equation modeling show that the effects of the family variables differ from each other and only family violence seems to increase the probability of being victimized by peers.
Evaluation of Aggression-Reducing Effects of the “Viennese Social Competence Training”
Authors: Gollwitzer Mario , Eisenbach Katrin , Atria Moira , Strohmeier Dagmar , Banse Rainer
Published: June 2006

The “Viennese Social Competence Training” (ViSC), a primary violence prevention program for school classes, is summatively and formatively evaluated. The summative evaluation focused on the effectiveness of ViSC concerning the reduction of aggressive behavior; the formative evaluation focused on program implementation and accomplishment of training principles. Four school classes (N = 109) participated in the program, three school-classes (N = 75) served as controls. Qualitative and quantitative data were collected before, during, shortly after and 4 months after the training. Qualitative data indicate high quality of program implementation and accomplishment of training principles. Quantitative data show a decrease in aggressive behavior responses among trained classes. Findings are discussed with regard to their usefulness for future evaluation studies.
Aggression, Self-Understanding, and Social Competence in Swiss Elementary-School Children
Authors: Malti Tina
Published: June 2006

This study examined the relation between aggression, self-understanding, and social competence in a sample of 93 Swiss elementary-school children. Aggression was rated by the parents using the aggression subscale of the Child Behavior Checklist (CBCL/4-18). Self-understanding was assessed with a short version of Damon and Hart’s (1988) self-understanding interview. The social competence of the children was observed in a quasi-experimental, cooperative play situation. The results revealed that aggression was related to domain-specific content aspects of self-understanding. Aggression was, however, negatively associated with social competence. Moreover, nonaggressive children with high levels of self-understanding showed more social competence than aggressive children with both high and low levels of self-understanding.
Preventing Elderly Suicide Through Primary Care by Community-Based Screening for Depression in Rural Japan
Authors: Oyama Hirofumi , Goto Masahiro , Fujita Motoi , Shibuya Hiroshi , Sakashita Tomoe
Published: June 2006

Depression is a major cause of suicide among the elderly. Few previous community-based interventions against depression have reduced the suicide rate. This study aims to evaluate outcomes of a community-based program to prevent suicide among the elderly using a quasi-experimental design with a neighboring reference group. The program, including depression screening with follow-up and health education through primary care and public health nursing, was implemented for 10 years in Matsudai town, a rural area of Japan (population 6,015; suicide rate per 105[≥65-year-olds] for males 290.6, and for females 361.3). Changes in the suicide risk were estimated by the incidence rate ratio (IRR). The female risk of completing suicide in the intervention area was reduced by 70% (age-adjusted IRR: 0.30; 95% CI: 0.14-0.67), while there was no change in the risk for males in the intervention area nor for males or females in the reference area (Kawanishi town: population 9,425; elderly suicide rate for males 212.2, females 151.9). A ratio of the female IRR in the intervention area to that in its prefecture was also estimated at 0.45 (95% CI: 0.19-0.97), showing that the reduction of suicide risk in the intervention area was greater than the historical trend. A community intervention against suicide using management of depression with nonpsychiatric, primary health care would be effective for elderly females, but not males.
Number and Type of Substances in Alcohol and Drug-Related Completed Suicides in an Australian Sample
Authors: Oei Tian P.S. , Foong Teresa , Casey Leanne M.
Published: June 2006

Background: The association between substance use and suicide is well-established, but evidence is scant regarding the relationship between the number, type, and level of substances and other risk factors in completed suicide across the lifespan. Aims: To examine the relationship between social/demographic characteristics and the number, type, and level of drugs present in an unrestricted age sample of completed suicides in Australia. Method: An analysis was undertaken of 893 substance-related suicides using data from the Government Statistician's Office for the years 1989-1992. Results: The number and type of substances present in suicide victims was related to the individuals' gender, age, marital status, employment status, and method of suicide. Blood alcohol level was significantly different between the methods of suicide, but was unrelated to demographic characteristics of the individual. The level of antidepressants and minor tranquilizers in the individuals was also unrelated to demographic characteristics. Conclusion: Examination of the type and number of substances present in completed suicides is an important component in creating profiles of potential suicide victims.
High Rates of Suicide and Attempted Suicide Using Pesticides in Nickerie, Suriname, South America
Authors: Graafsma T. , Kerkhof A. , Gibson D. , Badloe R. , van de Beek L.M.
Published: June 2006

Suicide and attempted suicide are identified as a serious mental health problem in Suriname, especially in the district of Nickerie. An epidemiological study in the Nickerie catchment area revealed high rates of suicide (48 per 100,000) and attempted suicide (207 per 100,000) on average in the years 2000-2004. Particularly remarkable is the high number of attempted suicides among males (49%), and the use of pesticides in both fatal (55%) and nonfatal suicidal behavior (44%). Probably this high incidence of suicidal behavior reflects the very poor economic situation of the district, poverty of most of the population, high levels of alcohol misuse, domestic violence, the rigidity of Hindustani culture regarding family traditions, the accessibility of pesticides, and the lack of future perspectives. Health care alone will not be sufficient to tackle this problem. One of the most urgent measures to prevent suicides is to stow away pesticides in locked cabinets with the key held by the proprietor.
Exploring the Relationship Between Area Characteristics and Self-Harm
Authors: Johnston Amy , Cooper Jayne , Kapur Navneet
Published: June 2006

Self-harm is strongly associated with later suicide and it is a major public health problem in its own right in many countries. There is a lack of evidence for effective individual level interventions following self-harm. Ecological studies examining the relationship between area characteristics and self-harm have yielded some interesting descriptive data but have had a number of limitations. Methodological and statistical developments in other fields of research may assist in building on findings to date. For example: The concept of social capital potentially provides a structure for examining sociocultural aspects of area; the use of more specific measures of locality will assist in studying area influences more fully; multilevel modelling may help to resolve the ecological fallacy through specifying variance attributable to factors at multiple levels simultaneously; areas in transition may provide natural conditions in which to investigate the impact of changing social environment. The potential utility of these new approaches is discussed with examples. Further investigation of the relationship between self-harm and area characteristics in a wide variety of settings may help to develop area-based interventions. Such interventions may have the potential to effect significant reductions in suicidal behavior.
Suicidal Intent in Single-Car Accident Drivers
Authors: Pompili Maurizio , Girardi Paolo , Tatarelli Giulia , Tatarelli Roberto
Published: June 2006

This study addressed the issue of a possible link between single-car accident drivers and suicidal intent. In the international literature this topic has generated both positive and negative results. Some authors have stressed unconscious suicidal motivations in various single accidents. Nevertheless, refutation of such theory was demonstrated through experimental studies. We selected 30 single-car accident drivers who had been admitted to emergency departments and then hospitalized for an average period of 10 days. We administered the Reason for Living Inventory (RFL) and investigated their attitudes toward suicide. We also matched these patients with a control group of drivers who had never had a car accident. Results showed that single-car accident drivers were not exposed to a higher overall suicidal risk, though they reported a higher risk on the RFL Survival and Coping Beliefs subscale and often expressed tiredness of being alive. These patients had experienced more life events than controls. We conclude that, although suicide risk was low in our patients, they were engaged in looking for a solution to their problems in which the accident played a role in such a process. This behavior has some characteristics of the logic of suicidal individuals.
Role of flares and shocks in determining solar energetic particle abundances
Authors: Cane H. V. , Mewaldt R. A. , Cohen C. M. S. , von Rosenvinge T. T.
Published: June 2006

We examine solar energetic particle (SEP) event‐averaged abundances of Fe relative to O and intensity versus time profiles at energies above 25 MeV/nucleon using the SIS instrument on ACE. These data are compared with solar wind conditions during each event and with estimates of the strength of the associated shock based on average travel times to 1 AU. We find that the majority of events with an Fe to O abundance ratio greater than two times the average 5–12 MeV/nuc value for large SEP events (0.134) occur in the western hemisphere. Furthermore, in most of these Fe‐rich events the profiles peak within 12 hours of the associated flare, suggesting that some of the observed interplanetary particles are accelerated in these flares. The vast majority of events with Fe/O below 0.134 are influenced by interplanetary shock acceleration. We suggest that variations in elemental composition in SEP events mainly arise from the combination of flare particles and shock acceleration of these particles and/or the ambient medium.