bluuebunny/crossref_metadata_2025 huggingface dataset:
Dinucleotide deletion in –α3.7 allele causes a severe form of α+ thalassaemia
Authors: Viprakasit Vip , Ayyub Helena , May Alison
Published: July 2003

Abstract: We describe a family of Italian origin in which the father and his two children had hypochromia and microcytosis with normal iron status. All individuals underwent an uneventful clinical course and required no treatment. To investigate the molecular basis of this phenotype, which is a prerequisite for further genetic counselling, we revealed that all affected family members are carriers of a common form of α+ thalassaemia resulting from the deletion of 3.7 kb of the α‐globin cluster (αα/−α3.7). However, this genotype alone could not account for the phenotype presenting in this family. Further characterization of the α‐globin genes demonstrated an additional AC deletion in the vicinity of the initiation codon of the −α3.7 allele. This secondary mutation causes an additional impaired translation of the affected allele producing increased globin chain imbalance. This leads to a more severe phenotype, as heterozygotes for such mutation (αα/−αT) have hypochromic microcytosis and abnormal globin chain synthesis that mimic α0 thalassaemia trait (−−/αα). Accurate genotyping of α globin determinant is absolutely required as there is a possibility that an interaction of this unusual double mutation with other common α0 thalassaemias (−−/−αT) can give rise to a very severe, probably fatal, α thalassaemia.
Morphological ontogeny of the gonad of three plectropomid species through sex differentiation and transition
Authors: Adams S.
Published: July 2003

The gonadal ontogeny through sex differentiation and transition of three protogynous coral trout species, Plectropomus leopardus, P. maculatus and P. laevis was described, based on anatomical and germinal differences along the length of the reproductive tract. Gonads of immature and mature females, sex changing individuals (transitionals) and males were examined. Specific anatomical features that were compared between sexual phases included the presence and structure of sperm sinuses, gonadal musculature and germinal cell types. All three coral trout species first differentiated as an immature female. The sexual pattern of P. leopardus and P. maculatus was concluded to be diandric protogynous hermaphroditism (males were derived from the juvenile phase as well as through sex change of mature females). Plectropomus laevis was found to be monandric as males were only derived through sex change in mature females. Structural changes did not occur concomitantly with the germinal changes associated with sex change in these Plectropomus species, which is atypical for protogynous species described to date. Precursory sperm sinuses in the dorso‐medial region of the gonad were present, although non‐functional, in a proportion of immature and mature females of all three species. These proportions, however, varied between species depending on the sexual pattern. The structural and germinal changes observed were hypothesized as anatomical adaptations that aid in minimizing time spent in the (non‐reproductive) sexual transition phase and maximizing flexibility in male development in the diandric species.
Histological investigation on the ovarian cycle of the bluefin tuna in the western and central Mediterranean
Authors: Corriero A. , Desantis S. , Deflorio M. , Acone F. , Bridges C. R. , De la Serna J. M. , Megalofonou P. , De Metrio G.
Published: July 2003

The histological analysis of eastern Atlantic bluefin tuna Thunnus thynnus ovaries caught from February to September 1999–2000, made it possible to distinguish the presence of seven oocyte developmental stages and allowed the characterization of six time‐dependent ovary maturity stages. The ovaries of mature (fork length, LF ≥ 110 cm) bluefin tuna were non‐active from August (spent period) to March (quiescent period) when they contained only perinucleolar‐stage oocytes. Ovary development started in April to early May (recrudescent period) with the appearance of oocytes at the lipid stage. Vitellogenesis appeared in mid‐May (ripening period) and post‐vitellogenesis occurred in late May to mid‐June (pre‐spawning period). In late June to early July, hydrated oocytes, a sign of imminent spawning, were found only in specimens caught in Balearic waters. Females ranging between 100 and 110 cm LF, captured during the recrudescent and ripening periods, had the largest oocytes at the lipid stage, most of which were degenerating. An extensive vitellogenic atresia was observed in the ovaries of five females caught during the spawning period in non‐spawning areas.
Sexual dimorphism and gonadal development of the Australian longfinned river eel
Authors: Walsh C. T. , Pease B. C. , Booth D. J.
Published: July 2003

The sex and stage of gonadal development of longfinned river eels Anguilla reinhardtii, captured from nine river catchments in New South Wales, Australia, between 1999 and 2001, were determined macroscopically. Sex was verified by histology. Histology was also necessary, however, to accurately define stages of gonadal development, particularly in individuals <600 mm in total body length. Anguilla reinhardtii displayed asynchronous gamete development. The most advanced cells present in migrating male and female A. reinhardtii were spermatocytes and pre‐vitellogenic oocytes, respectively. Gonadal development stages were positively correlated with body size in both sexes. Females, however, were significantly larger than males and their gonads matured over a broader size range. Size at sexual differentiation (42–60 cm for males and 50–76 cm for females) was much larger than for most other anguillids that have been studied, with the exception of the New Zealand longfinned eel Anguilla dieffenbachii. Corresponding with its large range in size at sexual differentiation was a relatively large range in size at migration for both males (44–62 cm) and females (74–142 cm).
Indications for a recent Holarctic expansion of pike based on a preliminary study of mtDNA variation
Authors: Maes G. E. , Van Houdt J. K. J. , De Charleroy D. , Volckaert F. A. M.
Published: July 2003

An extremely limited haplotypic diversity within populations and a strikingly low divergence between European and Canadian haplotypes were found in pike Esox lucius. Certain haplotypes were associated with a particular geographical region in Europe: a widespread European and a restricted Hungarian–Norwegian type. The low haplotypic intraspecific divergence suggests a late Pleistocene expansion from an ancestral population.
Long lasting stickleback sperm; is ovarian fluid a key to success in fresh water?
Authors: Elofsson H. , Mcallister B. G. , Kime D. E. , Mayer I. , Borg B.
Published: July 2003

Although the sperm of externally fertilizing fishes usually has a brief life span of up to a few minutes, this study showed that the sperm of the three‐spined sticklebackGasterosteus aculeatusmoved for several hours in brackish water and up to at least 10 h in the presence of ovarian fluid. Three‐spined sticklebacks were able to spawn in waters ranging from full‐strength sea water to fresh water, an ability unusual among fishes. The influence of salinity on sperm motility was examined, using three‐spined sticklebacks from sea (salinity 30), brackish (5·5) and freshwater (0) populations. All three populations were found to have sperm with long motility periods in brackish water, lasting 165–270 min. Seawater three‐spined sticklebacks had sperm motile for up to 65 min in sea water, whereas sperm from fresh‐ and brackish‐water fish were quiescent in this medium. In fresh water, sperm from all three populations showed a very brief motility period, lasting <60 s. The presence of ovarian fluid, however, prolonged the motility period of sperm from both fresh‐ and brackish‐water three‐spined sticklebacks, for up to 7 and 10 h in fresh and brackish water, respectively, with some sperm found to be motile for up to 24 h. The results indicated that ovarian fluid created a favourable environment for the sperm and might have facilitated the three‐spined sticklebacks' successful penetration of fresh water.
The war between the malaria parasite and the immune system: immunity, immunoregulation and immunopathology
Authors: ARTAVANIS-TSAKONAS K , TONGREN J E , RILEY E M
Published: July 2003

Throughout history malaria has proved to be a significant threat to human health. Between 300 and 500 million clinical cases occur each year worldwide, approximately 2 million of which are fatal, primarily in children. The vast majority of malaria-related deaths are due to infection with Plasmodium falciparum; P. vivax causes severe febrile illness but is rarely fatal. Following repeated exposure to infection, people living in malaria endemic areas gradually acquire mechanisms to limit the inflammatory response to the parasite that causes the acute febrile symptoms (clinical immunity) as well as mechanisms to kill parasites or inhibit parasite replication (antiparasite immunity). Children, who have yet to develop protective immune mechanisms are thus at greater risk of clinical malaria, severe disease and death than adults. However, two epidemiological observations indicate that this is, perhaps, an oversimplified model. Firstly, cerebral malaria – a common manifestation of severe malaria – typically occurs in children who have already acquired a significant degree of antimalarial immunity, as evidenced by lower mean parasite densities and resistance to severe anaemia. One potential explanation is that cerebral malaria is, in part, an immune-mediated disease in which immunological priming occurs during first infection, eventually leading to immunopathology on re-infection. Secondly, among travelers from nonendemic areas, severe malaria is more common – and death rates are higher – in adults than in children. If severe malaria is an immune-mediated disease, what might be priming the immune system of adults from nonendemic areas to cause immunopathology during their first malaria infection, and how do adults from endemic areas avoid severe immunopathology? In this review we consider the role of innate and adaptive immune responses in terms of (i) protection from clinical malaria (ii) their potential role in immunopathology and (iii) the subsequent development of clinical immunity. We conclude by proposing a model of antimalarial immunity which integrates both the immunological and epidemiological data collected to date.
Prospective audit of adverse reactions occurring in 459 primary antibody-deficient patients receiving intravenous immunoglobulin
Authors: BRENNAN V M , SALOMÉ-BENTLEY N J , CHAPEL H M ,   Immunology Nurses Study, Abbey Jane , Askew Tracey , Cochrane Sheila , Fletcher Claire , Bennett Claire , Freud Cilla , Ryan Annie , Haines Mary , Powell Pauline , Saunderson Delene , Short Jan , Toolan John , Hendry Doreen , Wilkes Ann
Published: July 2003

Intravenous immunoglobulin (IVIG) is used as the standard replacement therapy for patients with primary antibody deficiencies. A previous study of adverse reactions in patients self-infusing at home over 1 year showed an overall reaction rate of 0·7%. A larger prospective study is reported here, involving a greater number of immunology centres and including children and adults who received infusions from medical or nursing staff as well as those self-infusing. Four hundred and fifty-nine patients were entered into this study and 13 508 infusions were given. The study showed that no severe reactions occurred and the reaction rate was low at 0·8%. This figure could have been lower, 0·5%, if predisposing factors responsible for some reactions had been considered before infusion. In conclusion, the study shows the importance of ongoing training for patients and staff to recognize the predisposing factors to prevent avoidable reactions. Because none of these reactions were graded as severe, the present guidance to prescribe self-injectable adrenaline for patients infusing outside hospital should be reviewed.
Immune complex–FcγR interaction modulates monocyte/macrophage molecules involved in inflammation and immune response
Authors: BARRIONUEVO P , BEIGIER-BOMPADRE M , FERNANDEZ G C , GOMEZ S , ALVES-ROSA M F , PALERMO M S , ISTURIZ M A
Published: July 2003

The interaction between receptors for the Fc portion of IgG (FcγRs) from monocytes/macrophages and immune complexes (IC) triggers regulatory and effector functions. Recently, we have demonstrated that IC exert a drastic inhibition of basal and IFN-γ-induced expression of MHC class II on human monocytes. Taking into account that the regulation of MHC class II molecules is a crucial event in the immune response, in this report we extend our previous studies analysing the effect of STAT-1 phosphorylation in the down-regulatory process, the fate of the intracellular pool of MHC class II molecules and the effect of complement on MHC class II down-regulation induced by IC. We also studied the effect of IC on the expression of MHC class II (I-Ad) in macrophages using a mouse model of chronic inflammation. We demonstrate that IC induce a depletion not only on surface expressed but also on intracellular MHC class II content and that IC-induced down-regulation of MHC class II is not mediated by the inhibition of STAT-1 phosphorylation. On the other hand, the effect of IC is not specific for the down-regulation of MHC class II, for it could be restricted to other molecules involved in inflammatory processes. Our experiments also show that the activation of the complement system could be a crucial step on the regulation of the effect of IC on MHC class II expression. In agreement with our in vitro experiments using human monocytes, IC treatment reduces the expression of MHC class II in a mouse model of chronic inflammation.
Monocytes and neutrophils from tuberculosis patients are insensitive to anti-inflammatory effects triggered by the prototypic formyl peptide N-formyl-methionyl-leucyl-phenylalanine (FMLP)
Authors: BEIGIER-BOMPADRE M , ALEMÁN M , BARRIONUEVO P , FRANCO M C , RUBEL C J , SASIAIN M DEL C , PALERMO M S , ABBATE E , ISTURIZ M A
Published: July 2003

Tuberculosis is a chronic infectious disease caused by Mycobacterium tuberculosis where formyl peptides, which are cleavage products of bacterial and mitochondrial proteins, are present. In this study, we demonstrated that interferon gamma (IFN)-γ and interleukin (IL)-10 induced the overexpression of the receptor for the Fc portion of IgG I (FcγRI) in monocytes from tuberculosis (TB) patients, showing that these cells respond to IFN-γ and IL-10 signals. We also demonstrated that lower doses of IL-10 render monocytes from TB patients less responsive to higher doses of the cytokine. Although the prototypic formyl peptide N-formyl-methionyl-leucyl-phenylalanine (FMLP) is a well-known proinflammatory agonist, we have demonstrated previously that preincubation of monocytes with FMLP inhibited the up-regulation of FcγRI induced by IFN-γ or IL-10. This effect was not observed in monocytes from TB patientes. FMLP also induced the down-regulation of the expression of FcγRI in monocytes that had been activated already with IFN-γ. However, this effect of FMLP was not observed in monocytes from TB patients and supernatants from monocytes obtained from these patients were incapable of inducing the down-regulation of FcγRI. In contrast to normal donors, supernatants from FMLP-treated neutrophils from TB patients did not modify the basal level of expression of FcγRI in monocytes from normal donors. In conclusion, in this study we demonstrated the existence of two novel mechanisms that may contribute to the pathological effects generated by M. tuberculosis: the enhancement of FcγRI in response to IFN-γ and IL-10, and the unresponsiveness to the anti-inflammatory effects induced by formyl peptides.
Pre-neutralization of C5a-mediated effects by the monoclonal antibody 137-26 reacting with the C5a moiety of native C5 without preventing C5 cleavage
Authors: FUNG M , LU M , FURE H , SUN W , SUN C , SHI N Y , DOU Y , SU J , SWANSON X , MOLLNES T E
Published: July 2003

Complement C5a is aetiologically linked to inflammatory tissue damage in conditions like septicaemia, immune complex diseases and ischaemia-reperfusion injury. We here describe a monoclonal antibody (mAb), 137–26, that binds to the C5a moiety of human C5 and neutralizes the effects of C5a without interfering with C5 cleavage and the subsequent formation of lytic C5b-9 complex. Mouse anti-human C5 mAbs were generated and the reactivity with C5 and C5a was detected by ELISA and surface plasmon resonance. The inhibition of C5a binding to C5a receptor was studied using a radioligand binding assay. The effects of the antibody on C5a functions were examined using isolated neutrophils and a novel human whole blood model of inflammation. Haemolytic assays were used to study the effect on complement-mediated lysis. mAb 137–26 reacted with both solid- and solution-phase C5 and C5a in a dose-dependent manner with high affinity. The antibody competed C5a binding to C5a receptor and inhibited C5a-mediated chemotaxis of neutrophils. Furthermore, the antibody effectively abrogated complement-dependent E. coli-induced CD11b up-regulation and oxidative burst in neutrophils of human whole blood. mAb 137–26 was more potent than a C5a receptor antagonist and a previously described anti-C5a antibody. mAb 137–26 did not inhibit complement-mediated lysis, nor did it activate complement itself. Together, mAb 137–26 binds both the C5a moiety of native C5 and free C5a, thereby effectively neutralizing the biological effects of C5a. The antibody may have therapeutic potential in inflammatory diseases where C5a inhibition combined with an operative lytic pathway of C5b-9 is particularly desired.
Combined cyclosporin-A /prednisone therapy of patients with active uveitis suppresses IFN-γ production and the function of dendritic cells
Authors: FRASSANITO M A , DAMMACCO R , FUSARO T , CUSMAI A , GUERRIERO S , SBORGIA C
Published: July 2003

In this study, we assessed the Th1/Th2 polarization of the immune response and the involvement of dendritic cells (DC) and Th1 lymphocytes in the pathogenesis of uveitis. Thirty-seven patients with chronic idiopathic uveitis were enrolled: 21 of them had active uveitis and the remaining 16 were in complete remission. Patients with active uveitis were characterized as follows: 5 had intermediate uveitis, 5 panuveitis and the remaining 11 posterior uveitis. Thirteen healthy subjects were also studied as controls. Patients with active uveitis were treated with cyclosporin-A (CsA) associated to low doses of prednisone (PDS) and studied at baseline and after 6 months of therapy. Analysis of cytokine-producing CD3+ lymphocytes revealed a strong Th1 polarization of the immune response in patients with active uveitis. Th1 lymphocytes paralleled serum IL-12 levels and the response to therapy, which greatly reduced both IFN-γ +/CD3+ lymphocytes and serum IL-12 levels, associated with a general clinical improvement. In vitro studies demonstrated that DC from untreated patients with active uveitis were mature and functionally active. In fact, they showed a higher ability to stimulate cell proliferation of allogeneic T cells in primary mixed lymphocyte reaction (MLR) and produced larger amounts of IL-12 than DC from CsA/PDS-treated patients and those in remission. These results demonstrate that CsA/PDS therapy impairs the capacity of mature DC to secrete IL-12 and inhibits their MLR activity.
Hierarchical recognition of CpG motifs expressed by immunostimulatory oligodeoxynucleotides
Authors: KLINMAN D M , CURRIE D
Published: July 2003

Synthetic oligodeoxynucleotides (ODN) containing unmethylated CpG motifs trigger human PBMC to proliferate and secrete Ig, cytokines and chemokines. CpG ODN have entered clinical trials, and show promise as vaccine adjuvants, antiallergens, and for the treatment of infectious diseases and cancer. ODNs under consideration for human use vary in the sequence, number and location of the CpG motifs they contain. Yet little is known of the magnitude of the immune response elicited by these diverse ODNs, or the rules governing their interaction with immune cells. This work compares the proliferative, IgM, IL-6 and IP-10 response of PBMC from normal donors to a diverse panel of CpG ODNs. Results indicate that ODNs expressing 3–4 different CpG motifs are strongly stimulatory. The location of these motifs is important, with those at the 5′ end exerting the greatest influence on ODN activity. These findings provide a basis for the rational design of ODNs optimized for clinical use.
Rescue of the autoimmune scurfy mouse by partial bone marrow transplantation or by injection with T-enriched splenocytes
Authors: SMYK-PEARSON S K , BAKKE A C , HELD P K , WILDIN R S
Published: July 2003

The scurfy mutant mouse is the genetic and phenotypic equivalent of the single-gene human autoimmune disease immunodysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX). The scurfy mutation disrupts the Foxp3 gene, a putative master switch for T regulatory cell development. Bone marrow transplant without conditioning was previously reported to be ineffective in scurfy mice, yet clinical remission occurs in transplanted human IPEX patients despite limited donor engraftment. In view of this contradiction, we sought to validate scurfy as a model for studying the pathogenesis and treatment of human IPEX, in particular the phenomenon of dominant immune regulation. One half of scurfy mice given bone marrow transplants after sublethal irradiation recovered and survived long-term with donor chimerism ranging from 1·7% to 50%. Early transfer of 2 × 107 normal T cell-enriched splenocytes also prevented or limited disease and permitted long-term survival. Donor T cells in rescued mice made up 3–5% of lymphocytes and became highly enriched for CD25+ T cells over time. Transfer of 106 CD4+ CD25+ sorted T cells showed some beneficial effect, while CD4+ CD25- cells did not. Thus, both partial bone marrow transplant and T-enriched splenocyte transfer are effective treatments for scurfy. These results indicate that scurfy results from a lack of cells with dominant immune regulatory capacity, possibly T regulatory cells. The potency of small numbers of normal cells indicates that IPEX may be a feasible target for gene therapy.
A novel inflammatory eye disease induced by lymphocytes from knockout mice sensitized against the deleted ocular antigen
Authors: GELDERMAN M P , CHARUKAMNOETKANOK P , BRADY J P , HUNG L , ZIGLER J S , WAWROUSEK E F , VISTICA B P , FORTIN E , CHAN C-C , GERY I
Published: July 2003

Lens-associated uveitis (LAU), a severe inflammatory eye disease, is thought to be mediated by autoimmunity against lens crystallins. Previously described animal models for this disease are antibody-mediated, since no cellular response to self crystallins could be induced in experimental animals. Here, we describe a new model for LAU, in which lymphocytes from knockout mice deficient in αB-crystallin are sensitized against the deleted protein and induce severe ocular inflammation when adoptively transferred into wild type recipients. Similar to LAU, the experimental disease developed only following rupture of the lens capsule, produced in this study by capsulotomy; no disease was detected in recipient eyes with no capsulotomy, or in those treated with cautery, or in eyes affected by systemic treatment with sodium iodate, lipopolysaccharide or X-irradiation. The ocular changes in affected eyes included heavy cellular infiltration and proteinaceous exudate in both the anterior and posterior segments of the eye, that reached their peak on day 4 following cell transfer and subsided quite rapidly thereafter.
Semi‐quantitative analysis of soft‐tissue reactions in fine needle aspirates from tissue cysticercosis
Authors: Kapila K. , Sahai K. , Verma K.
Published: July 2003

Fine needle aspiration cytology (FNA) has a well‐documented role in the diagnosis of cysticercosis. However, little is discussed about the associated inflammatory response in the host tissues. Aspirates from 182 cases of subcutaneous cysticercosis were semiquantitated for the type and degree of inflammatory response, and the amount and preservation of the parasite. Tissue sections were reviewed where available. In the FNA where no parasite was observed but a confirmatory tissue diagnosis was available, it was found that eosinophils (52%), epithelioid cell granulomas (30%), palisading histiocytes (33%) and giant cells (28%) were seen less frequently than in those where larval fragments were identified in the aspirated material in varying quantities, the response being 88–92% eosinophils, 50–70% palisading histiocytes, 68–80% epithelioid cell granulomas and 46–74% giant cells. Repair cells were maximally seen when readily identifiable larval fragments were seen in the aspirate. Bizarre cells were equally distributed in these aspirates. The tissue response in FNA from subcutaneous cysticercosis can be varied and eosinophils are found to increase with the presence of the degenerating parasite. In soft‐tissue aspirates, palisading histiocytes with epithelioid cell granulomas with or without giant cells and an inflammatory exudate with predominantly eosinophils alerts one to search diligently for a parasite.
A challenge to the rhetoric of emancipation: recreating a professional culture
Authors: Clare Judith
Published: July 2003

This paper explores the notion that nursing education is a political process which reproduces traditional practices There is evidence to suggest that dominant ideologies, embedded in the social processes of education and health care, shape the consciousness of nurse teachers and students towards conformity and compliance with established practices in hegemonic institutions Traditional practices or ‘common sense’ reinforces the structural arrangements which contribute to the contradictions that students experience between knowledge they are ‘given’ in the classroom and knowledge they derive from their clinical learning experiences It is clinical placements which bring students face to face with their position in the established hierarchy of knowledge, professional relationships and routinized practices In this sense students may experience their classroom education as a denial of their lived experience in clinical settings They may learn to negotiate among the different meanings and explanations they encounter and learn to act in ways that are personally and professionally ‘safe', thereby reproducing traditional nursing culture Project 2000 in Great Britain and the calls for a ‘curriculum revolution’ from North America promise transformation of traditional practice But it is the political processes of teaching and learning and their practical effects which must be revealed for critique and transformation if professional ideals of reflective practice, emancipatory knowledge and professional autonomy are to play an integral part in transforming professional nursing practice within hegemonic institutions
The place of research and development in nurse education
Authors: Millar Margaret A
Published: July 2003

The National Health Service (NHS) document Research for Health, a research and development strategy for the NHS, provides a starting point to explore the place of research and development in nurse education The thesis focuses on whether research and development in nurse education is the concern of education or nursing Some parallels are drawn between nursing and teaching A way forward for the realization of a place for research and development in nurse education is suggested
Factors affecting student nurses’ learning in community placements: a phenomenological study
Authors: Baillie Lesley
Published: July 2003

The study aimed to explore the question, what factors affect student nurse learning in a community setting? A phenomenological approach was taken by carrying out in‐depth interviews with eight Project 2000 students who had just completed 8 weeks of community placements The factors which emerged centred around three themes the students themselves, the mentors and the placements Students recognized that their own approach to the placement was important They found that the role they fulfilled in the placements affected their learning, preferring a participative role to observation only The role of the mentor was found to be crucial for learning Important factors were the mentors’ knowledge and attitude towards the Project 2000 course and their professionalism (particularly communication skills), as perceived by the students Also significant were the mentors’ skills at facilitating learning in the placements, by encouraging questions and reflection, and organizing a variety of experiences Factors relating to the placements concerned their relevance to the course (as perceived by the students) and the breadth of experience available Whilst this was a small sample, from which no generalizations can be made, the study gives insight into students, teachers and community staff of the experience of learning in the community setting
New paradigm research in practice: the trials and tribulations of action research
Authors: Meyer Julienne E
Published: July 2003

This methodological paper reflects on the way in which nursing research has developed along similar lines to research in education It focuses on the emergence of action research as an example of collaborative research within the practice discipline of nursing Action research is placed in the framework of new paradigm research and questions concerning its scientific merit are addressed along with its idealistic value to nursing Drawing on issues raised during the collection of data for a PhD study which examined a changing ward culture, I hope to share some methodological concerns about the use of action research as a means of changing practice
Resolving epistemological pluralism: a personal account of the research process
Authors: Taylor Julie S
Published: July 2003

In this paper, the author seeks to address issues of personal and professional development that may occur during the research process Whilst research reports now abound in the nursing literature, this personal aspect is often neglected As we seek to encourage research awareness within the profession, many student and qualified nurses now produce a small research project, and this often concentrates on measurable outcomes By examining her own perceived learning in resolving epistemological pluralism whilst undertaking such a project as a tutor student, the author has attempted to resolve the problem of ignoring the personal Indeed, she believes that increased self‐awareness can only enhance nursing professionalism
Conducting research interviews with elderly people by telephone
Authors: Worth Allison , Tierney Alison J
Published: July 2003

Telephone interviews were employed by nurse researchers as a means of collecting data from elderly people following their discharge from hospital The paper reviews the literature concerning interviews with elderly patients by telephone and recounts first‐hand experience of the method on the basis of over 500 telephone interviews Although some difficulties were encountered in conducting interviews with the hearing‐impaired and the unwell, the method was found to be a cost‐effective and useful means of obtaining follow‐up data for research purposes The prime factor in ensuring successful use of the method was the recruitment of subjects via personal interview prior to telephone contact
The content of nurses’ oral shift reports in homes for elderly people
Authors: Liukkonen Arja
Published: July 2003

The paper deals with the content of nurses’ oral shift reports in homes for elderly people Material for the study was gathered from two homes by recording nurses’ morning, afternoon and evening reports on audio tape over 4 weeks It was analysed by classifying the content of the reports Emphasis in the reports was on matters associated with physical needs and medical treatment of the aged person. There were considerably fewer statements in the report about opinions and state of mind of elderly people Nurses did not often discuss how to support independence of elderly people The reports provided situationally dependent and random information for the nurses’ decision‐making process In comparison, they contained relatively little information or discussion about care as a whole
Insights from latent partition analysis into categories inherent in wellness‐illness
Authors: Jensen Louise , Allen Marion
Published: July 2003

How health–disease is perceived or conceptualized is important for nursing research There is increasing evidence that individual representations are important in constructing the experience of health–disease What is the personal saliency of health–disease for the individual? To explore the patterns of meaning inherent in health–disease, a card sort was undertaken among 15 healthy individuals and 15 individuals with chronic renal disease Both groups were given 28 cards to sort twice once for when they felt ‘well’ and again for when they felt ‘ill’ The theoretical basis underlying the items of the card sort was a model of wellness‐illness being developed Latent partition analysis was used to cluster the concepts from each data set followed by multi‐dimensional scaling to analyse the structure of the intercategory probability estimates A possible unidimensional pattern of meaning (harmony) emerged for the ‘well’ data and a two‐dimensional pattern (disharmony and optimism) for the ‘ill’ data This represents a preliminary step in the development of a theoretical model that would permit assessment of the meaning of health–disease for the individual
Information and anxiety: a critical reappraisal
Authors: Teasdale Kevin
Published: July 2003

A series of British and North American research studies into information‐giving and the relief of patient anxiety is reviewed The research results are inconsistent and the theory that information relieves anxiety in hospitalized patients appears to be an oversimplification It is argued that ‘information’ is conventionally viewed as a neutral and objective entity which can be transmitted to patients in semantic form through language However, recent advances in the philosophy of language suggest that human communication depends less on the decoding of semantic information than upon the inferences which recipients draw from context Communication, therefore, becomes a problem‐solving process in which communicators selectively present what they know in order to induce recipients to infer the intended meanings This inferential model of communication provides a theoretical basis from which research studies can be reappraised Viewed from an inferential perspective, the results suggest that patient anxiety can be relieved more reliably by the use of re‐framing and empowering interventions than by the presentation of information in a neutral way with no direct attempt to influence the inferences which patients may make
The comprehensive Breast Cancer Knowledge Test: validity and reliability
Authors: Stager Jennifer Lou
Published: July 2003

Two subscales for a breast cancer knowledge test were developed and tested to be used (a) in determining a woman's general knowledge of breast cancer (i e risk factors and epidemiology) and her knowledge of breast cancer curability, and (b) in exploring the relationship between knowledge of breast cancer and utilization of screening practices These subscales were designed to be used in conjunction with the Breast Cancer Knowledge Test (BCKT), which assesses screening and detection knowledge The instrument was submitted to four experts in the field of oncology to establish content validity Reliability testing was conducted on a random sample of 182 women Internal consistency reliability for the post‐tested general knowledge subscale was 0 60, and for the curability subscale was 0 62 The overall alpha coefficient was 0 71 In combination with the BCKT, these subscales can be used to describe a woman's knowledge of breast cancer
The ethical use of fetal tissue for transplantation and research
Authors: Verklan M Terese
Published: July 2003

The exercise of organ and tissue transplantation is a common occurrence in our society Expectations of future advances in this arena are raising many ethical, moral and public‐policy questions The scientific data base supporting the usefulness of fetal tissue to repair or reverse disease is modest, and uses are speculative Should fetal tissue transplantation research proceed and, if so, under what conditions? This paper examines the issues related to the use and procurement of fetal tissue for research and transplantation
Reflection: a review of the literature
Authors: Atkins Sue , Murphy Kathy
Published: July 2003

This paper is a review of the literature on reflection The purpose was to unravel and make sense of the complex literature, and to identify the skills required to engage in reflection An analysis of the literature revealed that differences between authors’ accounts of reflective processes are largely those of terminology, detail and the extent to which these processes are arranged in a hierarchy Key stages of reflection are identified and represented by a model Skills required to engage in reflection were found to be implicit in the literature and these are identified Methodological issues related to empirical literature are discussed It is suggested that reflection is an important learning tool in professional education and that the skills required for reflection need to be developed in professional courses
Mentorship: a feminist critique of current research
Authors: DeMarco Rosanna
Published: July 2003

Reciprocal professional nurse relationships called mentorships have been researched over the last decade from the perspective of coming to know what they are, why they work and what they bring to each of the participants ‘Knowing’ always has its limitations, since we, the inquirers, are only able to come to understand through the ways we have been shown to ask questions or where to ask them If the personal is political, then nurses who explore mentorship/protégé relationships or any other area in nursing practice or education, must become aware of the unconscious biases which affect our choices in research From a feminist perspective, each of us must decide, at least, to explore alternate ways of ‘knowing’ through the use of methodologies which engage women's lived experiences in a context which allows for stories to be shared and not reported This paper is an opportunity to explore historical concepts, current needs for mutual support and the environmental and contextual experiences which may be fertile sod for new ways to understand how we can authentically bring meaning to each other wherever we work or study
The complexities of using a structure, process and outcome framework: the case of an evaluation of discharge planning for elderly patients
Authors: Closs S José , Tierney Alison J
Published: July 2003

Effective planning for discharge from hospital of elderly patients is becoming increasingly important as the elderly population rises Donabedian's structure‐process‐outcome framework was used for an evaluation of discharge planning at a large teaching hospital. This paper discusses first the difficulties of defining the boundaries between each of the three Donabedian categories, and then makes some suggestions as to what factors require inclusion when considering the structures, processes and outcomes of discharge planning for elderly patients
Whose responsibility is it anyway? Hospital admission and discharge of older people in an inner‐London District Health Authority
Authors: Victor Christina R , Young Elizabeth , Hudson Meryl , Wallace Paul
Published: July 2003

The division of responsibilities that exists between primary and secondary health care services and health and social care services may create problems in the provision of care to patients whose needs mean that a number of different agencies are involved in their care The objective of all the agencies involved is the smooth transfer of clients between different sectors of care provision One client group thought to be particularly vulnerable to dislocations in the continuous pattern of care provision is older people Problems over the division of responsibility between professional groups are particularly evident on admission to and discharge from hospital It is the latter rather than the former aspect that has been the focus of research An extensive multi‐methods study of the admission and discharge of older people from hospital in an inter‐city District Health Authority was undertaken This paper examines the transfer of older people between different elements of the health and social care systems Our study illustrates that on neither admission nor on discharge was there a clearly defined mechanism for affecting liaison between hospital and community Clearly, the responsibility for this task must be delegated to a specific group However, such responsibility must be given within a properly resourced and managed system, otherwise the current position of blurred responsibilities will remain It is unclear as to how the reform of the National Health Service and the introduction of the internal market and the purchaser/provider division will aid the improved co‐ordination which this study has identified as being required
Nurse teacher stress in Northern Ireland
Authors: Hunter Pauline , Houghton David M
Published: July 2003

Occupational stress among a 60% sample of all nurse tutors in Northern Ireland was investigated by means of the General Health Questionnaire (GHQ), Maslach Burnout Inventory and a stress questionnaire Seventy per cent of tutors judged themselves to be worse or much worse than usual on 45% of GHQ items Significant levels of moderate and high burnout were discovered on the sub‐scales of emotional exhaustion and depersonalization, with an almost unanimous (95%) report of high burnout arising out of feelings of lack of personal accomplishment Male nurse tutors reported more frequent and more intense signs of burnout than their female counterparts at a statistically significant level of difference in emotional exhaustion (P= 0 028 and P= 0 003 respectively) and in depersonalization (P < 0 003 and P= 0 007 respectively) The work stressor most commonly identified by tutors (72%) was that of experiencing too little time to perform their duties to their satisfaction The most common request for help to alleviate workplace stress (61%) was for more support and appreciation from their seniors
Assertiveness among professional nurses
Authors: Kilkus Stephen P
Published: July 2003

Assertiveness is considered healthy behaviour for all people that, when present, mitigates against personal powerlessness and results in personal empowerment Nursing has determined that assertive behaviour among its practitioners is an invaluable component for successful professional practice The purpose of this descriptive study was to determine assertiveness levels of a population of professional nurses and to determine if assertiveness levels are related to selected demographic factors including age, gender, years of nursing experience, basic nursing education, clinical nursing speciality, type of employer, highest educational level and prior assertiveness training The sample was composed of 500 registered nurses (64% response rate), chosen randomly from the list of active licensees registered with the Minnesota (USA) State Board of Nursing, who completed and returned an assertiveness questionnaire The questionnaire consisted of the Rathus Assertiveness Schedule (RAS) and a personal/ professional data form Data analysis included descriptive as well as inferential statistics The results revealed that this group of nurses was more assertive than any other group of nurses or non‐nurses reported in the literature using the RAS The oldest group of nurses (60–76 years) was significantly less assertive than any of the younger groups of nurses Nurses practising with a diploma as the highest level of education were significantly less assertive than nurses having a baccalaureate or above And there was a significant difference in assertiveness between groups of nurses practising in different clinical specialties based on the ANOVA It appears that the majority of nurses in this study are assertive They believe in themselves and their abilities It is hoped that the self‐assertion generated by this belief will eventually lead to further personal and professional empowerment
Case Report. Successful treatment of cutaneous Paecilomyces lilacinus infection with oral itraconazole in an immune competent host
Authors: Gottlieb T. , Atkins B. L.
Published: July 2003

Summary.  A 59‐year‐old woman presented to us with an eight‐month history of Paecilomyces lilacinus soft tissue infection. She was treated with a six‐month course of oral itraconazole. The lesion resolved fully without the need for adjunctive surgery. Susceptibility testing confirmed susceptibility to itraconazole. This is the second case of confirmed P. lilacinus soft tissue infection in an immunocompetent host treated with oral itraconazole alone.
Case Report. Fungaemia due to Penicillium piceum, a member of the Penicillium marneffei complex
Authors: Horré R. , Gilges S. , Breig P. , Kupfer B. , De Hoog G. S. , Hoekstra E. , Poonwan N. , Schaal K. P.
Published: July 2003

Summary.  Due to the inability of most Penicillium species to grow at 37 °C, systemic non‐marneffei infections are very rare in the human host. We describe a case of fungemia due to Penicillium piceum in a female patient, who died a few days after repeated isolation of this fungus from blood cultures. The species is a member of the section Biverticillata of Penicillium, as was confirmed by rDNA Internal Transcribed Spacer (ITS) sequence data, and hence may share virulence factors with P. marneffei.
The influences on and experiences of becoming nurse entrepreneurs: A Delphi study
Authors: Wilson Anne , Averis Andrea , Walsh Ken
Published: July 2003

There is little known about private practice nursing as an area of advanced practice. As more nurses take the option to develop private practice, the experiences of and influences on nurses currently in private practice might be a useful guide to the pitfalls and difficulties which might be encountered. In addition, an understanding of the experiences of and influences might assist nursing organizations and health services to provide support to nurses who play an integral part in health care delivery in the community. A research study was undertaken utilizing a two‐round Delphi Technique to elicit and assess consensus on the reasons for nurses going into business and the experiences they encountered in becoming and being a nurse entrepreneur. The study instrument in round one comprised a questionnaire with statement headings inviting opinions on the influences and experiences of nurses in business. In the second round, levels of agreement were elicited from responders on collated opinions from round one, including statements formed from comments written in round one. The initial questionnaire also included closed questions to obtain a profile of nurses in private practice. Responders were 59 nurses in private practice in round one and 54 nurses in round two. The themes raised could be grouped under headings of influences, advantages/disadvantages, education/experience, skills/knowledge, characteristics and barriers. The level of agreement on the themes was reasonably high. Dissent occurred on issues of increased income, professional image and support structures. This Delphi study has identified key areas of consensus on the experiences of nurses in private practice who have extended their career into the business arena. It has also identified areas in which further work needs to be carried out to understand this work of nurse entrepreneurs.