bluuebunny/crossref_metadata_2025 huggingface dataset:
MicroRNA-140 plays dual roles in both cartilage development and homeostasis
Authors: Miyaki Shigeru , Sato Tempei , Inoue Atsushi , Otsuki Shuhei , Ito Yoshiaki , Yokoyama Shigetoshi , Kato Yoshio , Takemoto Fuko , Nakasa Tomoyuki , Yamashita Satoshi , Takada Shuji , Lotz Martin K. , Ueno-Kudo Hiroe , Asahara Hiroshi
Published: May 2010

Osteoarthritis (OA), the most prevalent aging-related joint disease, is characterized by insufficient extracellular matrix synthesis and articular cartilage degradation, mediated by several proteinases, including Adamts-5. miR-140 is one of a very limited number of noncoding microRNAs (miRNAs) specifically expressed in cartilage; however, its role in development and/or tissue maintenance is largely uncharacterized. To examine miR-140 function in tissue development and homeostasis, we generated a mouse line through a targeted deletion of miR-140. miR-140−/− mice manifested a mild skeletal phenotype with a short stature, although the structure of the articular joint cartilage appeared grossly normal in 1-mo-old miR-140−/− mice. Interestingly, miR-140−/− mice showed age-related OA-like changes characterized by proteoglycan loss and fibrillation of articular cartilage. Conversely, transgenic (TG) mice overexpressing miR-140 in cartilage were resistant to antigen-induced arthritis. OA-like changes in miR-140-deficient mice can be attributed, in part, to elevated Adamts-5 expression, regulated directly by miR-140. We show that miR-140 regulates cartilage development and homeostasis, and its loss contributes to the development of age-related OA-like changes.
The Arabidopsis Paf1c Complex Component CDC73 Participates in the Modification ofFLOWERING LOCUS CChromatin
Authors: Yu Xuhong , Michaels Scott D.
Published: May 2010

FLOWERING LOCUS C (FLC) is a key repressor of flowering in Arabidopsis (Arabidopsis thaliana) and is regulated, both positively and negatively, by posttranslational histone modifications. For example, vernalization (the promotion of flowering by cold temperatures) epigenetically silences FLC expression through repressive histone modifications such as histone H3 lysine-9 dimethylation (H3K9me2) and H3K27me3. In contrast, an RNA polymerase II-associated complex (Paf1c) activates FLC expression through increased H3K4 and H3K36 methylation. As a result of this regulation, FLC has become a useful model for the study of chromatin structure in Arabidopsis. Here we show that At3g22590 is the Arabidopsis homolog of the yeast (Saccharomyces cerevisiae) Paf1c component CDC73 and is enriched at FLC chromatin. In contrast to other Paf1c component mutants that exhibit pleiotropic developmental phenotypes, the effects of cdc73 mutations are primarily limited to flowering time, suggesting that CDC73 may only be required for Paf1c function at a subset of target genes. In rapid-cycling strains, cdc73 mutants showed reduced FLC mRNA levels and decreased H3K4me3 at the FLC locus. Interestingly, in late-flowering autonomous-pathway mutants, which contain higher levels of FLC, cdc73 mutations only suppressed FLC in a subset of mutants. H3K4me3 was uniformly reduced in all autonomous-pathway cdc73 double mutants tested; however, those showing reduced FLC expression also showed an increase in H3K27me3. Thus, CDC73 is required for high levels of FLC expression in a subset of autonomous-pathway-mutant backgrounds and functions both to promote activating histone modifications (H3K4me3) as well as preventing repressive ones (e.g. H3K27me3).
Structural characterization of tartrate dehydrogenase: a versatile enzyme catalyzing multiple reactions
Authors: Malik Radhika , Viola Ronald E.
Published: May 2010

The first structure of an NAD-dependent tartrate dehydrogenase (TDH) has been solved to 2 Å resolution by single anomalous diffraction (SAD) phasing as a complex with the intermediate analog oxalate, Mg2+and NADH. This TDH structure fromPseudomonas putidahas a similar overall fold and domain organization to other structurally characterized members of the hydroxy-acid dehydrogenase family. However, there are considerable differences between TDH and these functionally related enzymes in the regions connecting the core secondary structure and in the relative positioning of important loops and helices. The active site in these complexes is highly ordered, allowing the identification of the substrate-binding and cofactor-binding groups and the ligands to the metal ions. Residues from the adjacent subunit are involved in both the substrate and divalent metal ion binding sites, establishing a dimer as the functional unit and providing structural support for an alternating-site reaction mechanism. The divalent metal ion plays a prominent role in substrate binding and orientation, together with several active-site arginines. Functional groups from both subunits form the cofactor-binding site and the ammonium ion aids in the orientation of the nicotinamide ring of the cofactor. A lysyl amino group (Lys192) is the base responsible for the water-mediated proton abstraction from the C2 hydroxyl group of the substrate that begins the catalytic reaction, followed by hydride transfer to NAD. A tyrosyl hydroxyl group (Tyr141) functions as a general acid to protonate the enolate intermediate. Each substrate undergoes the initial hydride transfer, but differences in substrate orientation are proposed to account for the different reactions catalyzed by TDH.
A randomized trial of the effects of two novel nicotine replacement therapies on tobacco withdrawal symptoms and user satisfaction
Authors: McRobbie Hayden , Thornley Simon , Bullen Chris , Lin Ruey‐Bin , Senior Hugh , Laugesen Murray , Whittaker Robyn , Hajek Peter
Published: May 2010

Aims  To determine effects on craving, user satisfaction, and consumption patterns of two new nicotine replacement therapies (NRT) used for eight hours after overnight tobacco abstinence.

Design  In a within‐subject, cross‐over trial participants were randomly assigned Zonnic® nicotine mouth spray (1 mg/spray), Zonnic® nicotine lozenge (2.5 mg), Nicorette® gum (4 mg) and placebo lozenge on each of four study days.

Setting  University research unit.

Participants  Forty‐seven dependent adult smokers.

Measurements  Participants rated their urges to smoke, irritability, concentration and restlessness before and during the first hour of product use on a 100‐point scale. A subsample of 11 participants provided blood samples for nicotine analysis.

Findings  All active products reduced craving significantly more than placebo (mean reductions of 28.6, 25.8, 24.7 and 8.9 points for mouth spray, gum, lozenge and placebo). Mouth spray relieved craving faster than placebo and gum with significant reductions within five minutes of use (mean differences of −14.5 (95% CI: −23.0 to −6.0) and −10.6 (95% CI: −19.1 to −2.1) with placebo and gum respectively. Mouth spray produced a faster time to maximum plasma nicotine concentration (14.5 minutes, 95% CI: 8.0 to 21.0) compared to the lozenge (30.3 minutes, 95% CI: 21.1 to 39.5) and gum (45.8 minutes, 95% CI: 36.2 to 55.4). Maximum concentrations of blood nicotine were higher with mouth spray (10.0 ng/ml) and lozenge (10.8 ng/ml) compared to gum (7.8 ng/ml). Both lozenge and mouth spray were well tolerated.

Conclusions  The mouth spray and lozenge are at least as effective as 4 mg nicotine gum in relieving craving suggesting that they are likely to be effective in aiding smoking cessation. The mouth spray may be particularly useful for acute craving relief.
Addiction Research Centres and the Nurturing of Creativity. Substance abuse research in a modern health care centre: the case of the Centre for Addiction and Mental Health
Authors: Rehm Jürgen , Giesbrecht Norman , Gliksman Louis , Graham Kathryn , Le Anh D. , Mann Robert E. , Room Robin , Rush Brian , Tyndale Rachel F. , Wells Samantha
Published: May 2010

The Centre for Addiction and Mental Health is one of the premier centres for research related to substance use and addiction. This research began more than 50 years ago with the Addiction Research Foundation (ARF), an organization that contributed significantly to knowledge about the aetiology, treatment and prevention of substance use, addiction and related harm. After the merger of the ARF with three other institutions in 1998, research on substance use continued, with an additional focus on comorbid substance use and other mental health disorders. In the present paper, we describe the structure of funding and organization and selected current foci of research. We argue for the continuation of this successful model of integrating basic, epidemiological, clinical, health service and prevention research under the roof of a health centre.
A claims‐based Markov model for Crohn’s disease
Authors: Malone D. C. , Waters H. C. , Van Den Bos J. , Popp J. , Draaghtel K. , Rahman M. I.
Published: May 2010

Aliment Pharmacol Ther 2010; 32: 448–458

Background  Crohn’s disease is a chronic condition that often presents in early adulthood.

Aim  To evaluate health care costs and costs per quality‐adjusted life year (QALY) for Crohn’s disease.

Methods  A Markov model was developed using administrative claims data for patients aged ≥ 18 years with ≥ 3 years of continuous enrolment from 2000 to 2008 and ≥2 Crohn’s disease claims. Disease states (remission, mild–moderate, moderate–severe, and severe–fulminant) were defined using the American College of Gastroenterology treatment guidelines criteria. Transition probabilities were calculated from consecutive 6‐month periods. Costs were determined from paid claims and QALY utilities were obtained from the literature. The model assumed a 30‐year‐old patient at the time of entry into the model.

Results  There were 40 063 patients identified, with a total of 420 773 cycles [remission (197 111; 46.8%), mild–moderate (44 024; 10.5%), moderate–severe (132 695; 31.5%), severe‐fulminant (46 925; 11.2%)]. The costs/QALY for remission, mild–moderate, moderate–severe, and severe–fulminant disease states respectively were $2896, $8428, $11 518 and $69 277 for males and $2896, $8426, $22 633 and $69 412 for females.

Conclusions  Overall, health care costs for patients with Crohn’s disease increased with disease severity. Although the probabilities of transitioning from other health states to the severe–fulminant disease state were low, the cost/QALY was high.
Control specimens for immunocytochemistry in liquid‐based cytology
Authors: Hansen T. , Pedersen H. , Brauner V. , Hariri J.
Published: May 2010

T. Hansen, H. Pedersen, V. Brauner and J. Hariri

Control specimens for immunocytochemistry in liquid‐based cytology

Objective  Immunostaining necessitates the use of positive as well as negative controls, which is usually an easy procedure in immunohistochemistry (IHC). To find suitable control specimens for immunocytochemistry (ICC) is, on the other hand, a challenging task and to the best of our knowledge is not sufficiently dealt with in the English literature. The aim of this trial was to develop an applicable method to select, collect, process and store control specimens for ICC using liquid‐based cytology (LBC).

Methods  The study included 21 different antibodies, which were known to react with at least one of the cellular components from tonsils, serous fluids and bronchial washings. The LBC specimens from the tonsils were collected as SurePath™ specimens (BD, Bencton, Dickinson and Company) by brushing the cut‐surface of a fresh tonsil and then immersing the brush head into the SurePath™ vial. The serous fluids and bronchial washings were fixed in CytoRich Red™ (BD). Some of the cellular suspensions from the tonsils and equal amounts of the serous fluid and the bronchial washings were also mixed as a cocktail. Unstained SurePath slides were then prepared on the PrepStain™ (BD) Non‐GYN Program, and the unstained and dry slides were then stored at 5 °C to test the effect of storage on the preservation of the antigenicity. ICC was then performed on BenchMark‐XT™.

Results  Cellular components in unstained SurePath™ slides reacted positively with relevant antibodies. Slides that were stored for up to 40 days did not loose staining intensity.

Conclusion  Specimens from body fluids and cell‐suspensions that are collected by brushing the cut‐surface from different types of fresh tissues or organs can be used as control specimens either separately or as mixtures. Dry and unstained slides can then be prepared and stored in a refrigerator for at least 40 days without loosing staining intensity.
The balance between extracellular cathepsins and cystatin C is of importance for ovarian cancer
Authors: Kolwijck Eva , Kos Janko , Obermajer Natasja , Span Paul N. , Thomas Chris M.G. , Massuger Leon F.A.G. , Sweep Fred C.G.J.
Published: May 2010

Eur J Clin Invest 2010; 40 (7): 591–599

Background  A major step in cancer formation involves the degradation of the extracellular matrix, mediated by multiple degradative actions of (lysosomal) proteases. Extracellular release of lysosomal proteases (cathepsins) and their inhibitors has been associated with the development and progression of several types of cancer. We investigated whether cathepsins in ovarian cyst fluid (oCF) were associated with disease outcome in patients with epithelial ovarian cancer (EOC).

Materials and methods  The levels of cathepsin B (CatB), H (CatH), L (CatL) and X (CatX) and their most abundant extracellular inhibitor cystatin C (CysC) were determined in oCF of 50 EOC patients by quantitative ELISAs. The cathepsin levels and ratios between cathepsins and CysC were related to clinicopathological parameters (Mann–Whitney U and Kruskal–Wallis tests) and survival (Cox Regression analysis).

Results  Median (25th–75th percentile) levels of cathepsin B, H, L, X and CysC in oCF were 97 (42–203), 18 (12–32), 61 (37–108), 20 (13–47) and 657 (501–805) ng mL−1 respectively. Ratio of CysC/CatB was significantly lower for patients with metastatic compared with localised EOC (P = 0·025). Ratios of CysC/CatH and CysC/CatX differed significantly between histological subtypes (P = 0·012 and P = 0·035 respectively) and were significantly higher for high‐grade tumours compared with low‐grade tumours (P = 0·031 and P = 0·039 respectively). Neither cathepsins nor their ratios were significant predictors of survival for EOC patients.

Conclusions  Ratios between CysC and cathepsins in oCF differed significantly between important clinicopathological subgroups. We believe that a complex cascade of proteolytic events, in which cathepsins play different roles, might be responsible for progression and metastasis in EOC.
Context‐specific influence of water temperature on brook trout growth rates in the field
Authors: XU CAILIN , LETCHER BENJAMIN H. , NISLOW KEITH H.
Published: May 2010

1. Modelling the effects of climate change on freshwater fishes requires robust field‐based estimates accounting for interactions among multiple factors.

2. We used data from an 8‐year individual‐based study of a wild brook trout (Salvelinus fontinalis) population to test the influence of water temperature on season‐specific growth in the context of variation in other environmental (i.e. season, stream flow) or biotic factors (local brook trout biomass density and fish age and size) in West Brook, a third‐order stream in western Massachusetts, U.S.A.

3. Changes in ambient temperature influenced individual growth rates. In general, higher temperatures were associated with higher growth rates in winter and spring and lower growth rates in summer and autumn. However, the effect of temperature on growth was strongly context‐dependent, differing in both magnitude and direction as a function of season, stream flow and fish biomass density.

4. We found that stream flow and temperature had strong and complex interactive effects on trout growth. At the coldest temperatures (in winter), high stream flows were associated with reduced trout growth rates. During spring and autumn and in typical summers (when water temperatures were close to growth optima), higher flows were associated with increased growth rates. In addition, the effect of flow at a given temperature (the flow‐temperature interaction) differed among seasons.

5. Trout density negatively affected growth rate and had strong interactions with temperature in two of four seasons (i.e. spring and summer) with greater negative effects at high temperatures.

6. Our study provided robust, integrative field‐based estimates of the effects of temperature on growth rates for a species which serves as a model organism for cold‐water adapted ectotherms facing the consequences of environmental change. Results of the study strongly suggest that failure to derive season‐specific estimates, or to explicitly consider interactions with flow regime and fish density, will seriously compromise our ability to predict the effects of climate change on stream fish growth rates. Further, the concordance we found between empirical observations and likely energetic mechanisms suggests that our general results should be relevant at broader spatial and temporal scales.
Facilitators and barriers to intervening for problem alcohol use
Authors: Tsai Yun‐Fang , Tsai Mei‐Chu , Lin Yea‐Pyng , Weng Chih‐Erh , Chen Ching‐Yen , Chen Min‐Chi
Published: May 2010

tsai y.‐f., tsai m.‐c., lin y.‐p., weng c.‐e., chen c.‐y. & chen m.‐c. (2010) Facilitators and barriers to intervening for problem alcohol use. Journal of Advanced Nursing 66(7), 1459–1468.

Title.  Perceived support from healthcare practitioners among adults with type 2 diabetes.

Aim.  This article is a report of a study exploring nurses’ perceived facilitators and barriers to conducting brief interventions for problem alcohol use.

Background.  Excessive alcohol use has been associated with health, social and legal problems. Healthcare providers worldwide need help to detect and intervene with hazardous/harmful drinkers.

Methods.  For this cross‐sectional study, ten hospitals were randomly selected throughout Taiwan during 2007. Nurses (N = 741) were selected from the emergency department, and psychiatric and gastrointestinal medical‐surgical units where most patients with alcohol problems are seen. Data collected using facilitator and barrier scales and a demographic information form were analysed by descriptive statistics and stepwise, multiple linear regression analysis.

Results.  Nurses identified the top facilitator to intervening for problem alcohol use as ‘patients’ drinking problems are related to their illness’. Top barriers were ‘patients lack motivation to change’ and ‘patients express no interest in receiving intervention’. Perceived facilitators were associated with nurses’ work unit, intention to intervene for problem alcohol use, and age. Perceived barriers were associated with work unit, experience in intervening for problem alcohol use, and having attended a training course.

Conclusion.  Source of perceived barriers reflected cultural influences. Taiwanese nurse education needs to be strengthened in terms of brief interventions for problem alcohol use. Emergency department nurses need to become more aware of their important role in alcohol intervention. Alcohol‐related education is needed for the general population and hospital policymakers to enhance facilitators and reduce barriers to intervening for problem alcohol use.
Sleep quality and quality of life in female shift‐working nurses
Authors: Shao Ming‐Fen , Chou Yu‐Ching , Yeh Mei‐Yu , Tzeng Wen‐Chii
Published: May 2010

shao m.‐f., chou y.‐c., yeh m.‐y. & tzeng w.‐c.(2010) Sleep quality and quality of life in female shift‐working nurses.Journal of Advanced Nursing 66(7), 1565–1572.

Title. Sleep quality and quality of life in female shift‐working nurses.

Aim. This paper is a report of a study of the factors that influence sleep quality and quality of life among shift‐working nurses and the relationship between their sleep quality and quality of life.

Background. Although shift‐working nurses strive to adapt their life schedules to shift rotations, they tend to suffer from severe sleep disturbances and increased rates of cancer, cardiovascular diseases, digestive disease and irregular menstrual cycles. Poor sleep is also associated with medical errors and occupational injuries.

Methods. A cross‐sectional study was conducted in 2008 with a convenience sample of 435 female nurses from five regional hospitals in Taiwan. Data were collected on sleep quality and quality of life using the Pittsburgh Sleep Quality Index and World Health Organization Quality of Life Instrument‐BREF Taiwan version respectively. Data were analysed using descriptive statistics, independentt‐tests, analysis of variance and Pearson correlations.

Findings. The majority of female shift workers (57%) had global sleep‐quality scores ≥5, indicating poor sleep and all mean scores in four domains of the quality‐of‐life measure were statistically significantly lower than those of females in Taiwan’s general population. Scores for poor sleep quality and quality of life were related to premenstrual dysphoria, occupational injury, illness and medication use. In addition, the associations between scores on the sleep‐quality and quality‐of‐life scales were statistically significantly inversely correlated.

Conclusion. Advice should be included in both undergraduate programmes and continuing education to help nurses to recognize and improve their own sleep quality and life quality managers should create a supportive environment to encourage shift‐working nurses to engage in healthy behaviours.
Factors influencing arrival of patients with acute myocardial infarction at emergency departments: implications for community nursing interventions
Authors: Xanthos Theodoros , Pantazopoulos Ioannis , Vlachos Ioannis , Stroumpoulis Konstantinos , Barouxis Dimitrios , Kitsou Vassiliki , Marathias Katerina , Karabinis Andreas , Papadimitriou Lila
Published: May 2010

xanthos t., pantazopoulos i., vlachos i., stroumpoulis k., barouxis d., kitsou v., marathias k., karabinis a. & papadimitriou l. (2010) Factors influencing arrival of patients with acute myocardial infarction at emergency departments: implications for community nursing interventions. Journal of Advanced Nursing 66(7), 1469–1477.

Title.  Factors influencing arrival of patients with acute myocardial infarction at emergency departments: implications for community nursing interventions.

Aim.  This paper identifies the characteristics of Greek patients with acute myocardinal infraction who have long prehospital delays and identifies the factors that are specifically associated with these delays.

Background.  The time between the first appearance of symptoms until the hospitalization of the patient with myocardial infarction correlates statistically significantly with in‐hospital and long‐term mortality.

Methods.  The study took place in two Greek coronary care units from 1 June 2007 to 31 July 2008. From 232 consecutive patients with myocardial infarction, 160 were enrolled. Data were collected by a trained hospital staff nurse, who interviewed all patients within 48 hours of hospital admission.

Results.  Smokers arrived statistically significantly sooner at the hospital than non‐smokers [smokers’ prehospital time delay: 78·9 (sd = 3·2) minutes vs. non‐smokers’ prehospital time delay: 98·2 (sd = 4·1) minutes, Mann–Whitney U‐test, Z = −2·5, P < 0·05]. Patients with hyperlipidaemia arrived with a mean delay of 13 minutes less than normolipidaemic patients. Those with inferior ST segment elevation myocardial infarction exhibited statistically significantly shorter delay times than those with anterior or lateral (inferior vs. anterior, P = 0·003, inferior vs. lateral, P = 0·024, anova with Bonferroni‐Holm post hoc test, F = 7·5, P = 0·001).

Conclusion.  Community nurses should educate all patients about myocardial infarction, not only those at high risk but also those without known risk factors for ischaemic heart disease.
Effect of acute and chronic job demands on effective individual teamwork behaviour in medical emergencies
Authors: Gevers Josette , Van Erven Pierre , De Jonge Jan , Maas Maaike , De Jong Jos
Published: May 2010

gevers j., van erven p., de jonge j., maas m. & de jong j. (2010) Effect of acute and chronic job demands on effective individual teamwork behaviour in medical emergencies. Journal of Advanced Nursing 66(7), 1573–1583.

Title.  Effect of acute and chronic job demands on effective individual teamwork behaviour in medical emergencies.

Aim.  This paper is a report of a study conducted to determine the combined effect of acute and chronic job demands on acute job strains experienced during medical emergencies, and its consequences for individual teamwork behaviour.

Background.  Medical emergency personnel have to cope with high job demands, which may cause considerable work stress (i.e. job strains), particularly when both acute and chronic job demands are experienced to be high. This may interfere with effective individual teamwork behaviour.

Methods.  A cross‐sectional survey study was conducted in 2008, involving 48 members (doctors and nurses) of medical emergency teams working in the emergency department of a Dutch general hospital. Data were analyzed by means of hierarchical regression analyses.

Results.  High acute job demands impeded effective teamwork behaviour, but only when they resulted in acute job strain. Acute emotional demands were more likely to result in acute job strain when chronic emotional job demands were also experienced as high. Although acute cognitive and physical strains were also detrimental, effective teamwork behaviour was particularly impeded by acute emotional strain.

Conclusion.  Acute job strains impair effective individual teamwork behaviour during medical emergencies, and there is urgent need to prevent or reduce a build‐up of job strain from high acute and chronic demands, particularly of the emotional kind.
Job stress, achievement motivation and occupational burnout among male nurses
Authors: Hsu Hsiu‐Yueh , Chen Sheng‐Hwang , Yu Hsing‐Yi , Lou Jiunn‐Horng
Published: May 2010

hsu h.‐y., chen s.‐h., yu h.‐y. & lou j.‐h. (2010) Job stress, achievement motivation and occupational burnout among male nurses. Journal of Advanced Nursing 66(7), 1592–1601.

Title.  Job stress, achievement motivation and occupational burnout among male nurses.

Aim.  This paper is a report of an exploration of job stress, achievement motivation and occupational burnout in male nurses and to identify predictors of occupational burnout.

Background.  Since the Nightingale era, the nursing profession has been recognized as ‘women’s work’. The data indicate that there are more female nurses than male nurses in Taiwan. However, the turnover rate for male nurses is twice that of female nurses. Understanding the factors that affect occupational burnout of male nurses may help researchers find ways to reduce the likelihood that they will quit.

Method.  A survey was conducted in Taiwan in 2008 using a cross‐sectional design. A total of 121 male nurses participated in the study. Mailed questionnaires were used to collect data, which were analysed using descriptive statistics and stepwise multiple regression.

Results.  The job stress of male nurses was strongly correlated with occupational burnout (r = 0·64, P < 0·001). Stepwise multiple regression analyses indicated that job stress was the only factor to have a statistically significant direct influence on occupational burnout, accounting for 45·8% of the variance in this. Job stress was comprised of three dimensions, of which role conflict accounted for 40·8% of the variance in occupational burnout.

Conclusion.  The contribution of job stress to occupational burnout of male nurses was confirmed. As occupational burnout may influence the quality of care by these nurses, nurse managers should strive to decrease male nurses’ job stress as this should lead to a reduction of negative outcomes of occupational burnout.
Breaking bad news in inpatient clinical settings: role of the nurse
Authors: Warnock Clare , Tod Angela , Foster Julie , Soreny Cathy
Published: May 2010

warnock c., tod a., foster j. & soreny c. (2010) Breaking bad news in inpatient clinical settings: role of the nurse. Journal of Advanced Nursing 66(7), 1543–1555.

Title.  Breaking bad news in inpatient clinical settings: role of the nurse.

Aim.  This paper is a report of an exploration of the role of the nurse in the process of breaking bad news in the inpatient clinical setting and the provision of education and support for nurses carrying out this role.

Background.  The term ‘breaking bad news’ is mostly associated with the moment when negative medical information is shared with a patient or relative. However, it can also be seen as a process of interactions that take place before, during and after bad news is broken. Little research has been conducted exploring the role of the nurse in the process of breaking bad news in the inpatient clinical setting.

Methods.  A questionnaire was developed using Likert scales and open text questions. Data collection took place in 2007. Fifty‐nine inpatient areas took part in the study; 335 questionnaires were distributed in total and 236 were completed (response rate 70%).

Results.  Nurses engaged in diverse breaking bad news activities at many points in care pathways. Relationships with patients and relatives and uncontrolled and unplanned events shaped the context in which they provided this care. Little formal education or support for this work had been received.

Conclusion.  Guidance for breaking bad news should encompass the whole process of doing this and acknowledge the challenges nurses face in the inpatient clinical area. Developments in education and support are required that reflect the challenges that nurses encounter in the inpatient care setting.
Healthcare professionals’ perceptions of existential distress in patients with advanced cancer
Authors: Mok Esther , Lau Ka‐po , Lam Wai‐man , Chan Lai‐ngor , Ng Jeffrey S.C. , Chan Kin‐sang
Published: May 2010

mok e., lau k‐p., lam w‐m., chan l‐n., ng j.s.c. & chan k‐s. (2010) Healthcare professionals’ perceptions of existential distress in patients with advanced cancer. Journal of Advanced Nursing 66(7), 1510–1522.

Title.  Healthcare professionals' perceptions of existential distress in patients with advanced cancer.

Aim.  This paper is a report of an exploration of the phenomenon of existential distress in patients with advanced cancer from the perspectives of healthcare professionals.

Background.  Existential distress is an important concern in patients with advanced cancer; it affects their well‐being and needs to be addressed in the provision of holistic care.

Method.  Focus groups were conducted from November 2008 to February 2009 with physicians, nurses, social workers, occupational therapists, physiotherapists, and chaplains working in a palliative care unit that served patients with advanced cancer in Hong Kong. Data collection and analysis were guided by the grounded theory approach. All categories were saturated when five focus groups had been held with a total number of 23 participants.

Findings.  We found three causal conditions of existential distress: anticipation of a negative future, failure to engage in meaningful activities and relationships, and having regrets. Three basic (caring, relating and knowing) and six specific (positive feedback, religious support, new experiences, task setting, exploring alternatives and relationship reconciliation) intervening strategies were identified. Whether the intervening strategies would be effective would depend on patients’ openness and readiness; healthcare professionals’ self‐awareness, hopefulness, and interest in knowing the patients; and a trusting relationship between patients and healthcare professionals. A sense of peace in patients was considered a consequence of successful interventions.

Conclusion.  This paper acknowledges the lack of an accepted conceptual framework of existential distress in patients with advanced cancer. It is based on healthcare professionals’ views, and further studies from the perspectives of patients and their families are needed.
Placement, relocation and end of life issues in aging adults with and without Down's syndrome: a retrospective study
Authors: Patti P. , Amble K. , Flory M.
Published: May 2010

Background  Aging adults with Down's syndrome (DS) experience more relocations and other life events than adults with intellectual disabilities aged 50 and older without DS. Age‐related functional decline and the higher incidence of dementia were implicated as the contributing factors that led to relocation and nursing home placement.

Method  A retrospective study of adults with intellectual disabilities who were born prior to the year 1946 was conducted to analyse the number of relocations experienced over a 5‐ and 10‐year period. The cohort consisted of 140 individuals (61 with DS between ages 50–71 years, and 79 without DS between ages 57–89 years) who had been referred to a diagnostic and research clinic.

Results  Analyses revealed the number of relocations over a 5‐ and 10‐year period were significantly greater in the DS group. Placement in a nursing home for end of life care was significantly higher in the DS group whereas the majority (90%) in the non‐DS group remained in a group home setting. Mortality was significantly earlier in the DS group with the mean age at death to be 61.4 years compared with 73.2 years in the non‐DS group.

Conclusions  The present results suggest that aging adults with DS encounter more relocations, and are more likely to have their final placement for end of life care in a nursing home. In contrast, the adults without DS were subjected to less relocation and remained in the same group home setting.
Loss of response to melatonin treatment is associated with slow melatonin metabolism
Authors: Braam W. , Van Geijlswijk I. , Keijzer Henry , Smits Marcel G. , Didden Robert , Curfs Leopold M. G.
Published: May 2010

Background  In some of our patients with intellectual disability (ID) and sleep problems, the initial good response to melatonin disappeared within a few weeks after starting treatment, while the good response returned only after considerable dose reduction. The cause for this loss of response to melatonin is yet unknown. We hypothesise that this loss of response is associated with slow melatonin metabolism.

Method  In this study, we determined melatonin clearance in two female (aged 61 and 6 years) and one male (aged 3 years) patients who had chronic insomnia, late melatonin onset and mild ID, and whose sleep quality worsened a few weeks after initial good response to melatonin treatment, suggesting melatonin tolerance. After a 3‐week washout period, patients received melatonin 1.0, 0.5 or 0.1 mg, respectively. Salivary melatonin level was measured just before melatonin administration, and 2 and 4 h thereafter. After this melatonin clearance test, melatonin treatment was resumed with a considerably lower dose.

Results  In all patients melatonin concentrations remained >50 pg/mL at 2 and 4 h after melatonin administration. After resuming melatonin treatment sleep problems disappeared. The same procedure was followed in three patients who did not show loss of response to melatonin after 6 months of treatment. In all patients in the control group melatonin concentrations decreased between 2 and 4 h after melatonin administration with a mean of 83%.

Conclusion  We hypothesise that loss of response to melatonin treatment can be caused by slow metabolisation of exogenous melatonin. As melatonin is metabolised in the liver almost exclusively by cytochrome P450 enzyme CYP1A2, this slow melatonin metabolism is probably due to decreased activity/inducibility of CYP1A2. In patients with loss of response to melatonin, a melatonin clearance test should be considered and a considerably dose reduction is advised.
A parent training model for toilet training children with autism
Authors: Kroeger K. , Sorensen R.
Published: May 2010

Background  Azrin & Foxx pioneered an intensive toilet training protocol for individuals with intellectual disability living in a residential setting. Since the development of the Rapid Toilet Training (RTT) protocol, many have replicated the efficacy, most notably in educational and outpatient treatment settings, but often training over longer periods of time. This study presents data from a parent training model that replicates Azrin and Foxx's results and training time.

Method  This multiple baseline across subjects design study employs an ABA design where two boys diagnosed with autism were toilet trained using a modified Azrin & Foxx intensive teaching protocol. The first subject, a 4‐year‐old boy, did not have a history of attempted toilet training. The second subject, a 6‐year‐old boy, demonstrated a history of failed toilet training attempts in both the home and school settings. The trainings were conducted in the home setting where a novel parent‐training approach was implemented.

Results  Participant 1 was continent at the end of the second day of training, and completely toilet trained (including initiation and communication) by day 10 of the intervention. Participant 2 was continent after day 1 and completely toilet trained by day 5 of the intervention.

Conclusions  Long‐term follow‐up demonstrates maintenance of skills 3 years post training. Social validity via parent satisfaction was assessed. Limitations to the current study and recommendations for future research were discussed.
Stereology of isolated objects with the invariator
Authors: CRUZ‐ORIVE L.M. , RAMOS‐HERRERA M.L. , ARTACHO‐PÉRULA E.
Published: May 2010

The invariator is a new stereological design to generate motion invariant test lines in three dimensions on an isotropic plane through a fixed point. The theory has been published recently. The purpose of this paper is to illustrate the application of the invariator on a group of rat brains to estimate brain volume and external surface area. Each brain was first split into its two hemispheres and then embedded into a ball filled with agar following a configuration named the antithetic isector, with the idea of reducing the error variance. After rolling the ball at random it was scanned by magnetic resonance imaging into a stack of parallel systematic sections: this is the isotropic Cavalieri design which, combined with the antithetic isector idea, proves to be very accurate. The invariator used only an equatorial section of the ball, and in the present case the coefficient of error of the volume and surface area estimators of an individual brain was about 30%. As it is design unbiased, the invariator may prove its strength mainly to estimate population means.
Oestradiol‐17β Stimulates the Release of Luteinizing Hormone and Follicle‐Stimulating Hormone from Bovine Anterior Pituitary Cell cultures
Authors: Braun U. , Schams D. , Leidl W.
Published: May 2010

The influence of oestradiol‐17β on LH and FSH release from bovine anterior pituitary cell cultures was examined. A 24 hour preincubation period of anterior pituitary cell cultures with 10−7 M oestradiol‐17β increased the sensitivity of the LH and FSH‐producing cells to GnRH significantly more LH and FSH being released.

The cell cultures were preincubated for 24 hours with oestradiol‐17β doses increasing from 10−11 to 10−7 M and thereafter incubated for 6 hours with and without 10−8 M GnRH respectively. An influence of oestradiol‐17β on the basal LH and FSH secretion could be seen only with the dose of 10−7 oestradiol‐17β. The GnRH‐stimulated LH secretion was, however, increased dose‐dependently by oestradiol‐17β doses ranging from 10−9 to 10−7 M. FSH‐secretion was increased by 10−11 to 10−9 M oestradiol‐17β.

Preincubation of the anterior pituitary cell cultures for 12, 24 and 36 hours, respectively, revealed that the GnRH‐stimulated LH secretion was increased by longer preincubation periods with oestradiol‐17β. The present investigations using cell cultures support the findings in vivo and it is concluded that oestradiol‐17β increases the sensitivity of the bovine anterior pituitary gland to GnRH.

Der Einfluß von Oestradiol‐17β auf die LH‐ und FSH‐Freisetzung in Hypophysenvorderlappenzellkulturen des Rindes

Es wurde der Einfluß von Oestradiol‐17β auf die LH‐ und FSH‐Freisetzung boviner Hypophysenvorderlappenzellkulturen untersucht. Eine 24stündige Vorinkubation der Hypophysenvorderlappenzellkulturen mit 10−7 M Oestradiol‐17β erhöhte die Sensibilität der LH‐ und FSH‐produzierenden Zellen gegenüber GnRH, d. h. es wurde signifikant mehr LH und FSH freigesetzt.

Die Zellkulturen wurden während 24 Stunden mit 10−11 bis 10−7 M ansteigenden Dosen Oestradiol‐17β vorinkubiert und anschließend weitere 6 Stunden mit oder ohne 10−8 M GnRH stimuliert. Die basale LH‐ und FSH‐Sekretion wurde nur durch die Dosis 10−7 M Oestradiol‐17β beeinflußt. Die GnRH‐stimulierte LH‐Sekretion wurde jedoch mit von 10−9 bis 10−7 M ansteigenden Dosen Oestradiol‐17β dosisabhängig erhöht. Die GnRH‐stimulierte FSH‐Sekretion wurde durch von 10−11 bis 10−9 M ansteigende Oestradioldosen erhöht.

Eine Vorinkubation der Zellkulturen mit Oestradiol‐17β während 12, 24 oder 36 Stunden zeigte, daß die GnRH‐stimulierte LH‐Sekretion um so größer war, je länger die Vorinkubation dauerte.

Die vorliegenden Untersuchungen unterstützen die in vivo gewonnenen Erkenntnisse und lassen den Schluß zu, daß Oestradiol‐17β die Empfindlichkeit boviner Hypophysen‐vorderlappenzellen auf GnRH steigert.
Dissimilar Ruminal Epithelial Response to Short‐Term and Continuous Intraruminal Infusion of Sodium n‐Butyrate
Authors: Gálfi P. , Neogrády S. , Kutas F.
Published: May 2010

Two ewes were given 2 g/kg body weight/day of sodium n‐butyrate through a rumen fistula in two different ways for 9 days.

Continuous infusion of butyrate caused a decrease in ruminal epithelial cell proliferation. Histologically, a thickening of the stratum corneum was observed.

Daily short‐term infusions produced stimulation of ruminal epithelial cell proliferation. Histological examination revealed parakeratotic changes in the stratum corneum.

Unterschiedliche Reaktionen des Pansenepithels nach kurzfristiger und kontinuierlicher intraruminaler Infusion von Natrium‐n‐Butyrat

Zwei Schafe erhielten während 9 Tagen über eine Pansenfistel je 2 g Natrium‐n‐Butyrat/kg KGW/Tag auf unterschiedliche Art verabreicht. Die kontinuierliche Infusion von Butyrat führte zu einer Reduktion der Zellproliferation im Pansenepithel. Histologisch konnte eine Verdickung des Stratum corneum beobachtet werden. Tägliche kurzfristige Infusionen stimulierten die Zellproliferation im Pansenepithel. Die histologische Untersuchung ergab parakeratotische Veränderungen im Stratum corneum.

Réactions différentes de l'épithélium de la panse après une infusion brève et continue dans le Rumen de sodium‐n‐butyrate

Deux moutons ont reçu pendant 9 jours 2 g de sodium‐n‐butyrate/kg de poids par une fistule de la panse. L'infusion continue de butyrate a provoqué une diminution de la prolifération cellulaire dans l'épithélium de la panse. Un épaississement de Stratum corneum a été observé à l'histologie. Des infusions brèves journalières stimulèrent la prolifération cellulaire dans l'épithélium de la panse. L'examen histologique a montré des lésions de parakératose dans Stratum corneum.

Respuestas disímiles del epitelio ruminal a la infusión intrarruminal a corto plazo y a la continua de butirato‐n sódico

Cada una de dos ovejas recibieron durante 9 días, a través de una fístula, 2g de butirato‐n sódico/kg peso en vivo/día administrados de forma diferente. La infusión continua de butirato conducía a la reducción de la proliferación celular en el epitelio de la panza. Histológicamente se pudo observar el espesamiento del estrato córneo. Las infusiones diarias a corto plazo producían estimulación de la proliferación celular en el epitelio ruminal. El examen histológico reveló cambios paraqueratóticos en el estrato córneo.
Modifizierte Operationstechnik für die isoliert perfundierte Hühnerleber
Authors: Mechler Ursula , Hilbig V.
Published: May 2010

Es wird eine Operationsmethode am Huhn vorgestellt, die es ermöglicht, Perfusioner an der isolierten Hühnerleber vorzunehmen. Sie basiert auf der von Bickerstaffe und Mitarbeitern 1970 und von Barratt und Mitarbeitern 1974 publizierten Operationstechnik. Eigene Erfahrungen führten dazu, den von den genannten Autoren beschriebener Operationsablauf in einigen Passagen zu verändern, um dadurch den Operationsablauf zu vereinfachen, zeitlich zu verkürzen und somit einen rascheren Anschluß der Leber an die Perfusionsapparatur zu erreichen.

Modified operative technique for perfusion of the isolated chicken liver

A method of operating on the chicken is described which makes it possible to perfuse the isolated liver. It is based on the techniques described by Bickerstaffe et al. 1970 and Barratt et al. (1974). The authors' experiences have resulted in modifications of the technique in some respects which result in simplifying the operative procedure, carrying it out more rapidly, and obtaining more rapid attachment to the perfusion apparatus.

Technique opératoire modifiée pour le foie de volaille isolé en perfusion

Une méthode opératoire sur la poule est présentée qui rend possible des perfusions sur le foie de volaille isolé. Cette méthode est basée sur la technique opératoire publiée par Bickerstaffe et al. 1970 et Barratt et al. 1974. Des expériences ont conduit à certaines modifications des opérations décrites à une simplification du déroulement de l'opération avec une durée abrégé et à un raccord plus rapide du foie aux appareils de perfusion.

Técnica operatoria modificada para el hígado aislado, perfundido de gallina

Se presenta una técnica operatoria, la cual permite llevar a cabo perfusiones en el higado aislado de gallina. La misma se basa en la técnica operatoria publicada por Bickerstaffe y colbs. en 1970 y por Barratt y colbs. en 1974. Las experiencias propias condujeron a modificar el curso de la operación descrito por los autores mencionados en algunos pasajes, simplificando así el transcurso de la operación, acortando el tiempo y alcanzando, por lo tanto, una comunicación más rápida del hígado al conjunto de aparatos de perfusión.