bluuebunny/crossref_metadata_2025 huggingface dataset:
Sublingual immunotherapy in youngsters: adherence in a randomized clinical trial
Authors: Röder E. , Berger M. Y. , De Groot H. , Gerth van Wijk R.
Published: July 2008

Background
Adherence is essential for effective treatment. Although several trials on the efficacy of sublingual immunotherapy (SLIT) in youngsters have been published, few contain data on medication intake.

Objective
We aimed to quantify adherence both to study protocol and medication intake as well as to identify factors that may influence adherence to SLIT in youngsters with rhinoconjunctivitis.

Methods
Two hundred and four youngsters (6–18 years) with hayfever participated in a randomized controlled trial and used grass pollen extract or placebo for 2 years. The primary outcome of the trial was the mean daily total rhinoconjunctivitis symptom score in the second grass pollen season. Participants having completed the follow‐up were considered adherent to the study protocol. Adherence to medication intake was assessed by weighing the study medication. Participants who completed the follow‐up and used 80% of the prescribed medication were considered adherent to medication intake. Patient‐, disease‐ and treatment‐related factors were analysed.

Results
One hundred and fifty‐four youngsters completed the study. The main reason for discontinuation was the inability to take medication according to schedule. Drop‐outs were older, had more difficulty following the medication instructions and their overall evaluation of the treatment effect was lower. The number and reasons for drop‐out did not differ between treatment groups. In total, 77% of the participants was adherent to medication intake. Self‐reported adherence was 99%. Non‐adherent participants experienced more severe symptoms before the trial. Symptom scores did not differ between adherent and non‐adherent participants. In adherent as well as non‐adherent participants, no difference was found between verum and placebo group with respect to symptom scores.

Conclusion
Adherence to both study protocol and medication intake was good. Drop‐out was affected by age, evaluation of the treatment effect and medication instructions. Non‐adherence to medication intake was influenced by the severity of the disease before the trial. The ineffectiveness of SLIT could not be explained by non‐adherence.
Immunochemical characterization of Glycine max L. Merr. var Raiden, as a possible hypoallergenic substitute for cow's milk‐allergic patients
Authors: Curciarello R. , Lareu J. F. , Fossati C. A. , Docena G. H. , Petruccelli S.
Published: July 2008

Background
Cows' milk allergy (CMA) is the most common cause of food allergy in infancy. The only proven treatment is the complete elimination of cows' milk proteins (CMPs) from the diet by means of hypoallergenic formulas. Soybean‐based formulae are widely used although intolerance to soy has been reported to occur in 15–40% of infants with CMA.

Objective
The aim of this work was to analyse the in vitro reactivity of the soybean cultivar Raiden, which naturally lacks glycinin A4A5B3, to evaluate whether this genotype could be a safe CMP substitute for CMA patients.

Methods
The reactivity of conventional soybean (CS) and Raiden soybean (RS) genotypes and also recombinant glycinin A4A5B3 and αβ‐conglycinin with casein‐specific monoclonal antibodies and CMP‐specific polyclonal serum was evaluated by immunoblotting and ELISA. A sequential competitive ELISA with the polyclonal antiserum and different soluble inhibitors was performed. In addition, an indirect ELISA with sera of atopic children with CMA was carried out to analyse the IgE‐binding capacity of the different soybean components.

Results
We have shown that CS contains four components that cross‐react with CMP, while RS has only one. The remaining cross‐reactive component in RS was identified as α‐subunit β‐conglycinin. By means of inhibitory ELISA, we demonstrated that CS, RS and the α‐subunit β‐conglycinin extracts inhibited the binding of CMP‐specific antibodies to the CMP‐coated solid phase. Finally, we showed that CS, RS and the recombinant proteins were recognized by human CMP‐specific IgE antibodies.

Conclusion
This work shows that although Raiden has fewer cross‐reactive components than conventional soybean, it still has a residual cross‐reactive component: the α‐subunit β‐conglycinin. This reactivity might make this genotype unsuitable to treat CMA and also explains adverse reactions to soybean in CMA infants.
Role of CD10 immunochemistry in differentiating hepatocellular carcinoma from metastatic carcinoma of the liver
Authors: Ahuja A. , Gupta N. , Kalra N. , Srinivasan R. , Chawla Y. , Rajwanshi A.
Published: July 2008

Background:  Differentiation of hepatocellular carcinoma (HCC) from metastatic carcinoma in liver may be difficult on fine needle aspiration cytology (FNAC), especially when both appear as moderate to poorly differentiated tumours. A panel of immunocytochemical stains is frequently used in case of diagnostic difficulty. Recently, CD10 immunostain with a canalicular staining pattern has been shown to be a specific marker for hepatocytic differentiation.

Objective:  The present study was designed to assess the value of CD10 immunostain in distinguishing HCC from metastatic carcinoma in material obtained by FNAC of liver masses.

Materials and methods:  Formalin‐fixed, paraffin‐embedded cell blocks of 22 cases (7 cases of HCC and 15 cases of metastatic carcinoma), direct acetone‐fixed smears and destained smears of 28 cases (18 cases of HCC and 10 cases of metastatic carcinoma) prepared from FNAC of the liver were immunostained using monoclonal antibody against CD10.

Results:  Seventeen (68%) of twenty‐five cases of HCC were positive for CD10 with a canalicular staining pattern. Among them 7 (70%) of 10 cases were well‐differentiated HCC and 10 (66%) of 15 cases were moderate to poorly differentiated HCC. Of 25 cases of metastatic carcinoma, four (16%) were positive for CD10 with a cytoplasmic (three cases) and membranous staining (one case) pattern.

Conclusion:  CD10 immunostaining is useful in discriminating HCC and metastatic carcinoma of the liver and is easily applied on cell blocks as well as FNAC smears.
Diagnostic accuracy of fine‐needle aspiration cytology in histological grade 1 breast carcinomas: are we good enough?
Authors: Karimzadeh M. , Sauer T.
Published: July 2008

Background:  Fine‐needle aspiration cytology (FNAC) of both palpable and non‐palpable breast carcinomas has a high accuracy and sensitivity in dedicated centres. It is generally thought that low‐grade carcinomas have a distinctly lower sensitivity due to discrete cellular atypia that may be difficult to appreciate. Grade 1 carcinomas make up about 45% of screening‐detected breast carcinomas and about 20% of symptomatic breast cancers. The aim of this study was to evaluate the diagnostic sensitivity of grade 1 carcinomas and identify the critical features in the cytological diagnostic work‐up of these tumours.

Methods:  There were FNAC smears from 494 histologically confirmed grade 1 carcinomas diagnosed during 1996–2004. The cytological diagnoses were compared with the histology.

Results:  A definitive malignant diagnosis (absolute sensitivity) was given in 382 cases (77.3%). Equivocal or suspicious diagnoses were given in 75 (15.2%), benign or probably benign (false negative) in 24 (4.8%). Thirteen cases (2.6%) were unsatisfactory. Complete sensitivity was 92.7%. Invasive ductal carcinomas comprised 81.3% of all cases; absolute sensitivity for these was 80.9%. Invasive lobular and tubular carcinomas comprised 7.3% and 5.9% of cases, respectively; absolute sensitivity for these diagnosis was 50.0% and 57.1%, respectively, significantly lower than for other subtypes (P ≤ 0.0001) whereas the difference for complete sensitivity was less but still significant (P = 0.017). Absolute and complete sensitivities were lower for tumours less than 1 cm size compared with more than 1 cm (P ≤ 0.00001).

Conclusion:  Preoperative FNAC diagnosis of grade 1 breast carcinoma has a high sensitivity, especially in ductal carcinomas. Invasive lobular and tubular carcinomas were less likely to receive a definite preoperative diagnosis. The main reason for not reaching a definitive malignant diagnosis was sampling error due to small tumours less than 1 cm in diameter, irrespective of tumour subtype.
Prospective study of urine cytology screening for BK polyoma virus replication in renal transplant recipients
Authors: Koukoulaki M. , O’Donovan M. , Pursglove S. , Alexopoulou D. , Hadjiconstantinou V. , Drakopoulos S.
Published: July 2008

Objective:  BK virus (BKV) may be associated with interstitial nephritis in renal transplant recipients and this can lead to irreversible chronic allograft dysfunction. Early diagnosis of BKV nephropathy determines its progress because no specific antiviral therapy exists. Urine cytology, detection of viral DNA in urine or blood and renal biopsy are the main diagnostic tools. The purpose of this study was to evaluate the use of urine cytology for diagnosis of BKV replication in renal graft recipients.

Patients and methods:  We studied 32 de novo renal transplant recipients prospectively with sequential urine samples for a period of 1 year. Thin‐Prep methodology was used to prepare the slides. Cytology results were correlated with polymerase chain reaction (PCR) in urine and blood.

Results:  Decoy cells indicative of BKV infection were detected in 14 (7.3%) of the 190 urine samples derived from 11 recipients. In three cases with positive decoy cells, BK viraemia and viruria were simultaneously identified. In a further three cases, BKV active replication was confirmed in urine by both cytology and PCR.

Conclusions:  Urine cytology is an easy and rapid method of detecting decoy cells in cases where renal biopsy is not possible. However, the low incidence of detection of decoy cells in the present study, together with poor correlation with PCR results, questions its sensitivity and specificity in diagnosing BKV reactivation.
Diagnostic value of clot examination for malignant cells in serous effusions
Authors: Jalal R. , Aftab K. , Hasan S. H. , Pervez S.
Published: July 2008

Objective:  To assess the diagnostic value of clot examination for satisfactory processing and confirmation of malignancy in serous effusions in routine cytological evaluation and compare the results with those of conventional smear and cell block preparations.

Methodology:  Body cavity fluids (n = 600) received in our laboratory were processed according to a pre‐designed protocol for the study as follows: Day1: on receipt of the specimen, smears were made and a cell block was prepared from the sediment. Day2: after overnight sample storage of the remaining specimen at 2–8 °C all fluids were examined for the presence of a clot at the bottom of the container. Fluids in which clot had formed were fixed in formalin. The clot was then placed on a lens paper, wrapped and processed routinely. Diagnostic yields were compared.

Results:  In this study, we included 600 cases of serous fluids from pleural, pericardial and peritoneal effusions. In 73% (n = 437) of samples, clot formation was seen, while in 27%, (n = 163) no clot had formed. Routine smear and cell block preparations showed malignant cells in 9.6% (n = 42). However, with the addition of the clot preparation, the number of cases in which atypical/malignant cells were seen increased from 42 to 85 (19.4%), with a P < 0.001. Special stains and immunohistochemistry (IHC) were also performed on clot preparations in 10 difficult cases.

Conclusion:  Clot preparation from body cavity fluids on the second day can be used as an adjunct to smear and routine cell block preparation to improve the accuracy and yield of the cytological diagnosis and may also be of great help for special studies such as IHC staining.
Emergence of larval yellow perch, Perca flavescens, in South Dakota lakes: potential implications for recruitment
Authors: ISERMANN D. A. , WILLIS D. W.
Published: July 2008

Abstract  Temporal patterns in length frequency distributions and hatch dates were described for larval yellow perch, Perca flavescens (Mitchill), captured in surface ichthyoplankton trawls from late April to mid‐June 2000 to 2002 in six South Dakota, USA lakes. Fewer than 15 larval yellow perch were collected in four of six lakes during 2002, suggesting that in some cases factors prior to, during or immediately after hatching likely play a critical role in the perch recruitment process. When larval yellow perch were encountered in larger numbers, temporal trends in total length (TL) frequencies indicated that only a single cohort was produced annually in each lake. Most yellow perch in these lakes hatched between 29 April and 17 May, and most hatching occurred during 5–11 days each year. Larval TL was not related to hatch date. The apparent prevalence of relatively short hatch periods in these yellow perch populations probably increases the risk of catastrophic losses resulting from periods of poor environmental conditions.
Assessing biotic integrity in a Mediterranean watershed: development and evaluation of a fish‐based index
Authors: MAGALHÃES M. F. , RAMALHO C. E. , COLLARES‐PEREIRA M. J.
Published: July 2008

Abstract  Biological indicators for Mediterranean rivers are poorly developed. This study evaluates the effectiveness of the Index of Biotic Integrity approach (IBI) with fish assemblages in the Guadiana catchment, a typical Mediterranean watershed in Southern Portugal. Reference sites were selected from a set of 95 sites, using a multivariate approach. Fifty‐five candidate metrics were screened for range, responsiveness, precision and redundancy. Final metrics included: proportion of native fish, number of intolerant and intermediate species, number of invertivore native fish, number of phyto‐lithophilic and polyphilic species, and catches of exotics. The IBI scores correlated with composite gradients of human impact and differed significantly between reference and non‐reference sites. Application of the IBI to an independent validation set with 123 sites produced results congruent with the development set and repeatable assessments at 22 sites showed concordance in IBI scoring. This application highlights the effectiveness of the IBI approach even with fish assemblages of limited diversity and ecological specialisation as in Mediterranean streams.
Influence of terminal rig configuration on the anatomical hooking location of line‐caught yellowfin bream, Acanthopagrus australis
Authors: BUTCHER P. A. , BROADHURST M. K. , REYNOLDS D. , CAIRNS S. C.
Published: July 2008

Abstract  Experiments were carried out to test the dependence of anatomical hooking location on terminal rig configuration, and identify strategies by which hook ingestion can be minimised to reduce post‐release mortality of angled yellowfin bream, Acanthopagrus australis (Günther). Eighty‐five anglers targeted yellowfin bream using different designs and sizes of circle and J hooks and recorded technical, environmental and biological data for each landed fish. Considerably fewer fish (16.6 and 8.5%, respectively) ingested hooks than those hooked in the mouth (82.1 and 88.6%), and a greater percentage of J hooks were ingested than circle hooks or a J hook modified with a 15‐mm horizontal bar. Irrespective of hook type, the rate of ingestion also declined with increasing hook weight and decreasing fish size. In cage experiments, significantly more hooks baited with natural soft baits (e.g. intestines and cephalopods) were ingested than those baited with artificial baits, crustaceans or teleosts, while in the field fewer hooks were ingested using artificial bait (e.g. bread and pellets) than terrestrial animals, teleosts, crustaceans, teleost or terrestrial animal intestines, cephalopods or polychaetes. Similarly, rigs with floats, short traces or a sinker only on the hook, along with angling in environments with at least some current reduced ingestion. Based on this study, anglers targeting yellowfin bream should be encouraged to use circle or modified J hooks and, regardless of the hook design, the largest hook size possible attached to short traces or a sinker only and hard baits.
Assessing the long‐term genetic impact of historical stocking events on contemporary populations of Atlantic salmon, Salmo salar
Authors: FINNEGAN A. K. , STEVENS J. R.
Published: July 2008

Abstract  Supplementation of wild fish with non‐native or domesticated fish is common practice. However, these stocked and native fish differ both ecologically and genetically and, in the wild, they interact in a multitude of ways, often with negative repercussions for the native population. This study assessed the long‐term genetic impact of historical stocking activities on a contemporary population of Atlantic salmon, Salmo salar L. During the 1960s salmon from hatcheries in Scotland and Iceland were transplanted to the River Dart, England. Microsatellite loci were used to assess the current level of population admixture between samples taken from the source location of the stocked fish during the 1960s and contemporary Dart populations. After allowances were made for natural genetic relationships between donor and recipient populations, the long‐term impact of the historical stocking events on a catchment scale appears minimal. However, one tributary consistently reflected closer genetic relationships with the donor populations, indicating a possible long‐term impact on a localised scale.
Temporal dynamics of dissolved oxygen in a floating–leaved macrophyte bed
Authors: GOODWIN KARA , CARACO NINA , COLE JONATHAN
Published: July 2008

1. Oxygen concentrations in shallow vegetated areas of aquatic systems can be extremely dynamic. In these waters, characterizing the average oxygen content or frequency of low oxygen events (hypoxia) may require high frequency measurements that span seasons and even years. In this study, moored sondes were used to collect 15‐min interval dissolved oxygen (DO) readings in an embayment of the tidal Hudson River with dense coverage by an invasive floating leaved plant (Trapa natans) and in adjacent open waters. Measurements were made from late spring to summer over a 2‐year period (2005, 2006).

2. Oxygen concentrations were far more dynamic in the vegetated embayment than in the adjacent open waters and while hypoxic conditions never occurred in the open waters, they occurred frequently in the vegetated site. Overall the vegetated site was hypoxic (DO < 2.5 mg L−1) 30% of the time and had an average oxygen concentration of 5.1 mg L−1. Oxygen concentration was significantly (P < 0.0001, anova) related to season, year and tide. Low tide periods during summer of 2006 had the lowest average oxygen concentration and the highest frequency of hypoxia.

3. The greater hypoxia in summer than spring is related to changes in plant morphology. In the spring and early summer when plants are submersed hypoxia occurs at lower frequency and duration than in the summer when dense floating vegetation covers the water. The tidal pattern in oxygen is related to hydrologic exchange with the non‐vegetated open waters. Year‐to‐year variation may be related to relatively small changes in plant biomass between years.

4. Oxygen concentrations in aquatic systems can be critical to habitat quality and can have cascading impacts on redox sensitive nutrient and metal cycling. For some systems with dynamic oxygen patterns neither weekly spot sampling nor short‐duration, high‐frequency measurements may be sufficient to characterize oxygen conditions of the system.
Biocompatibility of various root canal filling materials ex vivo
Authors: Scotti R. , Tiozzo R. , Parisi C. , Croce M. A. , Baldissara P.
Published: July 2008

Aim  To evaluate the biocompatibility of a resin‐based endodontic filler (RealSeal) using the indirect cytotoxicity test.

Methodology  Human gingival fibroblasts were cultured ex vivo. Pellets of the materials to be tested were incubated for 24, 48, and 72 h at 37 °C under sterile conditions to obtain their eluates. The fibroblasts were exposed to either diluted (50%) or undiluted eluates for 24 h. A culture medium with foetal calf serum was added to the control wells. Cell viability was estimated by 3‐[4,5‐dimethylthiazol‐2‐yl]‐2,5‐diphenyltetrazolium bromide method. The data concerning cell viability were statistically analyzed using one‐way anova test and Bonferroni multiple comparisons test.

Results  Eluates obtained after 24 h of incubation with the resin filler did not reduce cellular viability. An increase in cellular viability, as compared with control cells, was observed in the gutta‐percha group. The undiluted eluate from the polyether material was cytotoxic, causing an 82 ± 4% decrease in cellular viability. Eluates obtained after 48 h of incubation with the resin filler increased cellular viability, whereas the polyether significantly reduced viability. Gutta‐percha did not cause any detectable change. After 72 h of incubation the eluate of the resin filler caused an increase in cellular viability, as did gutta‐percha, whereas polyether caused a significant decrease.

Conclusions  RealSeal resin filler was nontoxic in this laboratory model. Further investigations are necessary to verify its usefulness in clinical applications.
Research‐related activities in community‐based child health services
Authors: Comino Elizabeth J. , Kemp Lynn
Published: July 2008

Title.  Research‐related activities in community‐based child health services.

Aim.  This paper is a report of a study to describe current research‐related activities within community‐based child health services in a large urban health service.

Background.  In recent years, increased participation in research‐related activities has accompanied implementation of evidence‐based practice in hospital‐based services. Little is known about participation in these activities in community‐based health services.

Methods.  We undertook a descriptive study of current research‐related activities by staff working in community‐based child health services in an urban setting in Australia in 2006–2007. Research‐related activities were defined as reflective practice, quality improvement, evaluation and research.

Results.  Staff reported that research‐related activities usually comprised reflective practice or quality improvement. These activities worked best when there were sufficient staff within teams and a stable environment. Evaluation was confined to activities closely related to quality improvement. Participation in research was limited. Our consultation revealed a need for sustained investment to build organizational and workforce capacity, and resource support and infrastructure to encourage participation in research‐related activities.

Conclusion.  Increased focus on evidence‐based practice has created expectations that community‐based child health service staff will utilize and contribute to research evidence. Whilst there is interest among community‐based child health service staff in participating in research‐related activities, investment in leadership, skill development, infrastructure, resource and novel ways to enhance research output within these services are needed to increase participation in research‐related activities, and the evidence base for community‐based child health services.
Effect of PETTLEP imagery training on performance of nursing skills: pilot study
Authors: Wright Caroline , Hogard Elaine , Ellis Roger , Smith Dave , Kelly Conleth
Published: July 2008

Title.  Effect of PETTLEP imagery training on performance of nursing skills: pilot study.

Aim.  This article is a report of a study to evaluate the effect of PETTLEP‐based imagery training on nursing skill performance.

Background.  Imagery structuring has been demonstrated to facilitate the development of psychomotor skills in sporting performance. A form of imagery structuring known as PETTLEP was employed in this study. PETTLEP (an acronym for its procedures) involves preparation through focussing on physical characteristics, the environment, the task itself, timing, learning, emotion and perspective.

Methods.  A pilot study was conducted, using experimental design, and the data were collected in 2005. Participants in the experiment were 56 pre‐registration students from one university in the United Kingdom. Half of the students received training for two basic nursing skills using PETTLEP procedures, and scores were compared for two objective structured clinical examinations.

Results.  Students who received PETTLEP training for blood pressure measurement performed statistically significantly better than those who did not (F = 4·62 P = <0·05). The training did not have a statistically significant effect for aseptic techniques. We suggest that the psychomotor element in aseptic techniques was not as important as that involved in blood pressure measurement.

Conclusion.  PETTLEP imagery should be explored further as a method to help nursing students acquire skills that have a psychomotor component.
Swedish language Person‐centred Climate Questionnaire – patient version: construction and psychometric evaluation
Authors: Edvardsson David , Sandman Per‐Olof , Rasmussen Birgit
Published: July 2008

Title. Swedish language Person‐centred Climate Questionnaire – patient version: construction and psychometric evaluation

Aim. This paper is a report of a study to construct and evaluate psychometric properties of the Swedish language patient version Person‐centred Climate Questionnaire.

Background. Person‐centred care is widely described as a preferred model of care as it uses the individual person’s perspective as point of departure. However, the concept is elusive and lacks definition and a means of measurement.

Method. A preliminary item pool generated from qualitative studies was distributed to a sample of hospital patients (n = 544) and subjected to item analysis and reduction using exploratory and confirmatory factor analysis. The psychometrical properties of the final questionnaire were evaluated using statistical estimates of validity and reliability.

Results. The final 17‐item questionnaire consists of three factors explaining 65·1% of the total variance in data, and shows satisfactory goodness‐of‐fit in confirmative factor analyses. The factors were labelled safety, everydayness and hospitality. Content and construct validity was estimated as satisfactory by Delphi assessment, factor and item analysis. Cronbach’s alpha was satisfactory for the total scale (0·93), and also for the three subscales: safety 0·94, everydayness 0·82 and generosity 0·64.

Conclusion. The Person‐centred Climate Questionnaire is a valid and reliable contribution for assessing to what extent the climate of hospital environments is person‐centred. The instrument enables descriptions and comparisons of environments, exploration of correlates between person‐centredness and patient outcomes and/or measure results of various interventions.
Perceptions of filial piety among Taiwanese university students
Authors: Tsai Hsiu‐Hsin , Chen Mei‐Hui , Tsai Yun‐Fang
Published: July 2008

Title.  Perceptions of filial piety among Taiwanese university students.

Aim.  This paper is a report of a study to explore the perceptions of filial piety among university students in Taiwan.

Background.  Young Asians have been more influenced than their parents by recent social and economic developments, creating an intergenerational gap in attitudes towards filial piety. This gap directly influences expectations about ways of caring for ageing parents and intergenerational well‐being. Resolving these differences depends on intergenerational communication.

Methods.  Data were collected in four audiotaped focus group interviews with 40 students (37 females, three males, average age = 21·3 years) at two universities in northern Taiwan during 2006. Transcripts were analysed by thematic analysis.

Findings.  Taiwanese university students are likely to practise filial duty differently from their parents, but this does not mean they are less filial. Five major themes indicated that participants viewed filial piety as following cultural traditions, reciprocating parents’ love and care, loving parents from the heart, achieving intergenerational well‐being, but practising filial piety would depend on future circumstances.

Conclusion.  The findings reflect a shift from their parents’ views, particularly the filial practice of living with one’s older parents. These young adults loved and respected their parents, but would consider alternative living situations for them, depending on future circumstances. As considering an alternative to culturally traditional filial practice may have an impact on intergenerational well‐being, we suggest that nurses could act as a bridge to facilitate communication between the two generations.
Patient safety culture in nursing: a dimensional concept analysis
Authors: Feng Xianqiong , Bobay Kathleen , Weiss Marianne
Published: July 2008

Title.  Patient safety culture in nursing: a dimensional concept analysis.

Aim.  This paper is a report of a dimensional concept analysis of patient safety culture in nursing.

Background.  Patient safety is an important issue in healthcare organizations. As the release of Institute of Medicine reports in the United States of America, substantial interest has arisen in studying patient safety culture; however, the concept remains poorly defined.

Data sources.  Multiple databases, including CINAHL, MEDLINE, PsycINFO and Anthropological Index Online, were searched from 1970 to 2006. A keyword search method was employed followed by a combined key word search.

Review methods.  A concept analysis based on Caron and Bowers’ method was carried out using 45 papers, three books and three theses after examination of the abstracts to identify definitions, dimensions, perspectives and consequences needed for content and dimensional analyses.

Findings.  Nurses’ shared values, beliefs and behavioural norms towards patient safety were identified as the overarching dimensions of the patient safety culture. The four sub‐dimensions of patient safety culture were synthesized as system, personal, task‐associated and interaction. Two main philosophical perspectives, functional and interpretative, were added to the analysis and further clarification was provided.

Conclusion.  It is expected that understanding the nature, as well as the key elements of the concept, would assist with analysing the existing safety culture and help to determine the strategies to build or shape the safety culture.
Repositories and communities at cross‐purposes: issues in sharing and reuse of digital learning resources
Authors: Margaryan A. , Littlejohn A.
Published: July 2008

Abstract  Globally, institutions are setting up digital repositories to support the sharing of resources for teaching and learning. The educational rationale is that a single set of resources can be restructured to support different pedagogical approaches and to achieve economies of scale. A key problem is that these learning object repositories (LORs), like many other learning technology innovations, are often designed to exploit the capabilities of technology rather than to meet learners' needs. The premise of this study is that the nature and organization of a community is likely to impact the way an LOR is used. Key dimensions of repositories and communities are discussed. Three repository systems are analysed to identify how communities use repositories. Guided by Activity Theory, the LORs and user communities are analysed as activity systems. These activity systems are compared and contradictions between them are identified. From the analysis, barriers and enablers for the use of LORs to support learning are discussed and a framework for addressing the key issues in the repository development stage is proposed.
Using the interactive whiteboard to resource continuity and support multimodal teaching in a primary science classroom
Authors: Gillen J. , Littleton K. , Twiner A. , Staarman J.K. , Mercer N.
Published: July 2008

Abstract  All communication is inherently multimodal, and understandings of science need to be multidimensional. The interactive whiteboard offers a range of potential benefits to the primary science classroom in terms of relative ease of integration of a number of presentational and ICT functions, which, taken together, offers new opportunities for fostering multifaceted pedagogic strategies. In this case study, we examine in detail how a teacher pursues two themes across four science lessons. We examine how the teacher creates continuity in her students’ learning experiences through taking up some of the affordances of the IWB in order to represent scientific phenomena and engage children in activities to consolidate their understandings. Support is offered for the notion that while pedagogic goals and strategies must determine the selection of tools, rather than the ‘tail wagging the dog’ as in technology‐focussed hyperbole, planned use of the interactive whiteboard, conceptualized as a ‘heterogeneous mediational tool kit’ (Wertsch 1991), can be effectively integrated into teaching practice.
Patients bringing information to primary care consultations: a cross‐sectional (questionnaire) study of doctors' and nurses' views of its impact
Authors: Dilliway Greg , Maudsley Gillian
Published: July 2008

Objectives  To explore the perceived frequency and impact of patients bringing health information from the Internet to primary care consultations.

Method  A questionnaire was sent to all general practitioners (GPs) and practice nurses (nurses) in a primary care trust in the North‐west of England.

Results  The response was 52.3%, more nurses responding than GPs (61.2% vs 46.8%). A substantial majority (93.9% and 78.0%) had experienced patients bringing such information in the last 6 months, which often lengthened the consultations. Significantly more nurses than GPs felt that the information helped the consultation (87.1% vs 37.7%), but also reported that patients bringing such information was off‐putting (21.9% vs 6.3%).

Conclusions  Both GPs and nurses experienced patients bringing health information to consultations and significantly differed in their views about whether it helped or hindered. Primary care staff should anticipate patients' use of the Internet for health information and should actively manage patients introducing it into the consultation.
Critical appraisal of the literature on economic evaluations of substitution of skills between professionals: a systematic literature review
Authors: Dierick‐van Daele Angelique T. M. , Spreeuwenberg Cor , Derckx Emmy W. C. C. , Metsemakers Job F. M. , Vrijhoef Bert J. M.
Published: July 2008

Objective  Substitution of skills has been introduced to increase health service efficiency, but little evidence is available about its cost‐effectiveness. This systematic review aims to identify economic evaluations of substitution between professionals, to assess the quality of the study methods applied and to value the results for decision making.

Methods  Publications between January 1996 and November 2006 were searched in Medline, Cochrane, Cinahl, database of Health Technology Assessments, EPOC and Embase. Randomized controlled trials (RCTs), cost–benefit analysis, interrupted time series design and systematic reviews were selected. The methodological quality of the papers was reviewed, using the critical appraisal of Drummond and the EPOC list.

Results  Eleven studies were finally included of 7605 studies: three cost‐effectiveness studies, three cost‐minimization studies and five studies related to partial economic evaluations. Small numbers of participating professionals and several limitations in the cost valuation and the measurement of costs were identified.

Conclusions  Several potential limitations influence the validity and generalizability. Full economic evaluations per se are of limited value for making decisions about substitution of skills. The tenuous relationship between structural, process and outcome variables is not sufficient investigated. For meaningfully placing the costs and consequences of substitution of skills in the context of health care and generating relevant data for decision making, it is strongly recommended to combine an economic evaluation (RCT) with an observational longitudinal study.
Assessment of individual vaccine status in a vaccinology experts' group
Authors: Duclos Antoine , Bouhour Damien , Baptiste Charles , Launay Odile , Guiso Nicole ,   the Avancées Vaccinales Experts' Group
Published: July 2008

Rationale  Worldwide, experts in vaccinology have promoted the broad annual coverage of health care workers with the influenza vaccine. Furthermore, pertussis vaccination is now recommended for young adults and health care workers working with newborns.

Aim  To analyse the compliance with these guidelines among experts responsible for the development or dissemination of national immunization schedules.

Method  A cross‐sectional survey was conducted in a vaccinology workshop group of French experts, using a self‐administered questionnaire.

Results  Among 44 experts, the average rate of influenza vaccination was 69.5% (95% confidence interval, 61.6% to 77.3%) between the 2003/04 and 2005/06 flu seasons, whereas the rate of pertussis vaccination during this period was only 30%. The main reasons that the experts gave for not being vaccinated were a lack of time or simply not remembering to do so.

Conclusion  Experts had low coverage rates for influenza and pertussis vaccination. To improve these rates, a multifaceted intervention combining audit and feedback strategy with a vaccine day is planned.
Infection of the heart of the common bream, Abramis brama (L.), with Myxobolus s.l. dogieli (Myxozoa, Myxobolidae)
Authors: Molnár K , Cech G , Székely C
Published: July 2008

Myxobolus dogieli
Bykhovskaya‐Pavlovskaya & Bykhovski, 1940 is regarded as a site specific myxosporean, infecting the heart of cyprinid fish. During a survey of the myxosporean fauna of Lake Balaton fish, heart myxobolosis was found in the common bream, Abramis brama, with heavy infection of the ventricle and the bulbus arteriosus in some infected bream. Developing and mature plasmodia were mostly in the connective tissue of the subepicardium and subendocardium. Plasmodia developing in the subendocardium protruded into the lumen of the heart, while plasmodia developing in the subepicardium protruded over the epicardium forming large sausage‐like outgrowths. Plasmodia with mature spores were found in the summer. The shape and size of the spores corresponded to those of the original description. Phylogenetic analysis based on the 18S rDNA sequence of M. dogieli showed that this species fit well in the genus Myxobolus. As no molecular data are available on spores from the type host, common carp, the species studied by us is temporarily designated as Myxobolus s.l. dogieli.
Pathology and mass mortality of Pacific oysters, Crassostrea gigas (Thunberg), in 2005 at the East Frisian coast, Germany
Authors: Watermann B T , Herlyn M , Daehne B , Bergmann S , Meemken M , Kolodzey H
Published: July 2008

In 2005, Pacific oysters, Crassostrea gigas, were collected from May to September along the East Frisian coast and processed for histology. Because of mass mortalities in September, additional samples of moribund oysters and apparently healthy blue mussels, Mytilus edulis, were subjected to virological and ultrastructural investigation. The oysters displayed a variety of pathological conditions including viral gametocytic hypertrophy which is reported here for the first time from the German coast. Haemocyte aggregations in the digestive tract, in the intestinal mucosa and submucosa, in the mid‐gut gland and in the ventricle of the heart were commonly observed at some stations. In association with mass mortalities, severe gill necrosis occurred which may have contributed to the high mortality rates. Total mortality rates of up to approximately 60% were seen. All size classes and thus age classes of oysters were affected, with highest mortality rates within the youngest age classes which had just reached sexual maturity (shell lengths <40 mm). The smallest dead oysters had shell lengths of 10 mm. The phenomenon was mainly restricted to C. gigas stocks in harbours, probably because of favourable conditions for infection, i.e. limited water exchange, less food availability, reduced oxygen content and higher pollution levels.
Diet and physical activity in patients with colorectal adenomas: directions for intervention programmes
Authors: Caswell S. , Anderson A. S. , Steele R. J. C.
Published: July 2008

Background  Screening programmes provide an opportunity to combine early detection programmes with prevention strategies for chronic disease risk reduction. The aim of the current exploratory research was to identify diet and activity habits in adults diagnosed with colorectal adenomas on screening colonoscopy in order to inform the development of an intervention study in this patient group.

Methods  Participants were recruited from colonoscopy clinics and completed a 7‐day food diary and physical activity record.

Results  Valid food diaries were completed by 32 participants. Mean daily intake of nonstarch polysaccharide was estimated at 14.2  (SD 4.2) g per day and fruit and vegetable intake (FVI) at 3.6 (SD 1.9) portions. The highest quartile of FVI consumers reported greater consumption of fruit (on any occasion) and vegetables (at evening meal) compared with low FVI consumers. Physical activity records (n = 36) indicated that walking was the most common method of activity with few indications of leisure time sport. Overall, 37% of participants failed to meet minimum recommend activity levels.

Conclusion  The magnitudes of change in activity and diet required to conform with current guidelines were estimated. Food habits that were pertinent to the population were identified and help to provide goal‐based guidance for intervention design.
Food and nutrient intakes of primary school children: a comparison of school meals and packed lunches
Authors: Rees G. A. , Richards C. J. , Gregory J.
Published: July 2008

Background  New school meal standards are currently being phased in by the government in an attempt to improve the nutritional composition of school food. However, no standards are applied to packed lunches. The present study aimed to compare the food and nutrient intakes of primary school children eating a school meal with those taking a packed lunch.

Methods  A sample of 120 children, aged 6–11 years, was observed once at a lunch time and all items consumed were recorded. Nutrient analysis was performed, and differences in nutrient intake between those children consuming packed lunches and school meals were determined.

Results  Mean energy and protein intakes were similar. The amount of energy provided by starchy carbohydrate was also similar but, compared with school meals, packed lunches provided twice as much energy from sugar (P < 0.001). School meals on average provided more energy from fat (P < 0.001), but intakes of saturated fat were lower in the school meals group (P = 0.021). Packed lunches provided more sodium (P < 0.001), calcium (P < 0.001) and iron (P = 0.016) than the school meals. Very few packed lunches contained vegetables, and fruit intake was particularly low for those having a school meal.

Conclusions  Children taking a packed lunch to school were consuming approximately double the amount of sugar and 50% more sodium and saturated fat in their midday meal compared with those having a school lunch. However packed lunches were providing children with more calcium, iron and fruit.
Skeletal components of class III malocclusions and compensation mechanisms
Authors: SPALJ S. , MESTROVIC S. , LAPTER VARGA M. , SLAJ M.
Published: July 2008

Summary  The aim of this retrospective study was to assess the skeletal characteristics of sagittal maxillary and mandibular discrepancies resulting in class III malocclusions and compensation mechanisms in one Caucasian European population (Croatian). The study sample included 107 patients (63 females and 44 males), aged between 11 and 18 years of age (mean age 14·6 ± 2·2), with a class III malocclusion. Forty‐three angular and linear measurements were assessed from the pre‐treatment lateral cephalographs of each subject. anova, Tukey post hoc and t‐test were used for statistical analysis. The most common differential skeletal type was mandibular prognathism with a normal maxilla (43%), followed by maxillary retrognathism with a normal mandibular position (19·6%), while the combination of maxillary retrognathism and mandibular prognathism was found to be rare (<5%). Subjects with maxillary retrognathia, appeared to also have a vertical facial pattern, suggesting a tendency towards vertical growth as a possible compensation mechanism. Those with mandibular prognathia tended to exhibit a horizontal facial growth pattern and typically included more pronounced dento‐alveolar compensation, that is, proclination of maxillary and retroclination of mandibular incisors. There were no differences observed in gender, overjet or soft tissue profiles between different sagittal skeletal types. Dominant protrusive mandible in Croatians can be related to European Caucasian ancestry, where this entity is historically described as ‘Habsburg jaw’.
Ambulatory polysomnography for the assessment of sleep bruxism
Authors: DOERING S. , BOECKMANN J. A. , HUGGER S. , YOUNG P.
Published: July 2008

Summary  Ambulatory polysomnography (PSG) is introduced as a new method for assessing sleep bruxism. Nocturnal recordings of masseter electromyography (EMG), electro‐encephalography, electro‐oculography, electrocardiography, thoracic effort and body position allow for the detection of typical nocturnal masseter activity as well as the determination of sleep stages. Twelve patients with a clinical diagnosis of bruxism were assessed with the ambulatory PSG, all of them fulfilled diagnostic PSG criteria according to Kato et al. (Dent Clin North Am. 2001; 45: 657–684). Per hour of sleep patients showed 34·2 (±10·6) EMG bursts and 5·6 (±1·3) sleep bruxism episodes. Because of the ability to determine sleep stages and the application in the home environment the ambulatory PSG represents a cost‐saving alternative to sleep laboratory investigations that might be especially useful in field studies and clinical application.
Pharmacokinetics and bioavailability of cefquinome in healthy piglets
Authors: LI X. B. , WU W. X. , SU D. , WANG Z. J. , JIANG H. Y. , SHEN J. Z.
Published: July 2008

A study on bioavailability and pharmacokinetics of cefquinome in piglets was conducted after intravenous (i.v.) and intramuscular (i.m.) administrations of 2.0 mg/kg of body weight, respectively. Plasma concentrations were measured by high‐performance liquid chromatography assay with UV detector at 268‐nm wavelength. Plasma concentration–time data after i.v. administration were best fit by a two‐compartment model. The pharmacokinetic values were distribution half‐life 0.27 ± 0.21 h, elimination half‐life 1.85 ± 1.11 h, total body clearance 0.26 ± 0.08 L/kg·h, area under curve 8.07 ± 1.91 μg·h/mL and volume of distribution at steady state 0.46 ± 0.10 L/kg. Plasma concentration–time data after i.m. administration were also best fit by a two‐compartment model. The pharmacokinetic parameters were distribution half‐life 0.88 ± 0.42 h, elimination half‐life 4.36 ± 2.35 h, peak concentration 4.01 ± 0.57 μg/mL and bioavailability 95.13 ± 9.93%.