bluuebunny/crossref_metadata_2025 huggingface dataset:
Bioactive Constituents of Brazilian Red Propolis
Authors: Trusheva Boryana , Popova Milena , Bankova Vassya , Simova Svetlana , Marcucci Maria Cristina , Miorin Patricia Laguna , Pasin Flavia da Rocha , Tsvetkova Iva
Published: May 2006

In a new propolis type, red Brazilian propolis, 14 compounds were identified (six of them new for propolis), among them simple phenolics, triterepenoids, isoflavonoids, prenylated benzophenones and a naphthoquinone epoxide (isolated for the first time from a natural source). Three of the major components demonstrated significant antimicrobial activity, and two (obtained as inseparable mixture) possessed radical scavenging activity against 1,1‐diphenyl‐2‐picrylhydrazyl (DPPH).
Alcohol use in families: a 15‐year prospective follow‐up study
Authors: Seljamo Sami , Aromaa Minna , Koivusilta Leena , Rautava Päivi , Sourander Andre , Helenius Hans , Sillanpää Matti
Published: May 2006

Aims  To study the prevalence of adolescents’ problematic alcohol use and its parental predictors: drinking habits and socio‐demographic factors.

Design, setting, participants and measurements  Questionnaires were sent regularly to the same Finnish families (n = 1132) from the onset of pregnancy (in 1986–87) to the child’s age of 15 years (in 2001–02) (n = 1028). There was a total of three follow‐up points.

Findings  At 15 years of age, 83% of girls and 79% of boys had used alcohol; 18% of boys and 14% of girls had been drunk more than once a month. The child’s permanent separation from at least one biological parent was the strongest socio‐demographic predictor of adolescents drinking. Fathers’ present heavy drinking and parental early drinking were the best predictors of their children’s problematic alcohol use at the age of 15.

Conclusions  Knowledge of fathers’ alcohol use and its time of onset may be used to determine children who are at added risk of problematic alcohol use later in life. Special guidance, support and treatment can be targeted to these families.
Tobacco use after experiencing a major natural disaster: analysis of a longitudinal study of 2063 young adults
Authors: Parslow Ruth A. , Jorm Anthony F.
Published: May 2006

Aim  To identify the extent to which tobacco use is affected by experience of a natural disaster and resulting symptoms of post‐traumatic stress disorder (PTSD).

Design  Longitudinal community survey.

Setting  Canberra, the national capital of Australia.

Participation  A random selection of 2063 young adults participating in this project lived in a region affected by a major bushfire in 2003. They were first interviewed in 1999–2000 and re‐interviewed in 2003–4 after the bushfire had occurred.

Measurements  Changes in participants’ level of consumption of tobacco over a 4‐year period were calculated. When interviewed after the disaster, participants answered questions concerning their experience of traumatic events, their immediate emotional response during the disaster and their fire‐related PTSD symptoms of re‐experiencing and hyperarousal.

Findings  Experience of traumatic events experienced during the disaster was associated with an increase in consumption of tobacco (OR: 1.12, 95% CI: 1.03–1.21). PTSD symptoms did not contribute independently to increased tobacco use after controlling for trauma experiences.

Conclusions  These findings indicate that trauma experiences can trigger increased tobacco use in young adults regardless of whether such experiences result in PTSD symptoms. Public health information provided to communities and health‐care providers should note that increases in this preventable health risk may occur as a result of individuals experiencing trauma.
Paths to child social adjustment: parenting quality and children’s processing of social information
Authors: Haskett M. E. , Willoughby M.
Published: May 2006

Background  The purpose of this research was to examine the manner in which multiple influences on child social adjustment operated together to predict differential outcomes for young children. Specifically, this study was designed to (i) examine the role of social cognitive and emotional factors in parents’ observed and self‐reported behaviour towards their children, and (ii) investigate the impact of parenting and children’s social information processing (SIP) patterns on children’s subsequent social adjustment in the school setting.

Methods  A model of children’s peer social adjustment was evaluated using a group of 166 children, over‐sampled for history of physical child abuse. Assessment of constructs was multi‐method, including parent and child self‐reports as well as teacher reports of child adjustment and observations of parent–child and child–peer interactions.

Results  Using structural equation modelling, support was found for our theoretical model. Specifically, parents’ negative child‐related beliefs and clinical elevations in emotional distress were predictors of harsh, insensitive parenting, which in turn predicted children’s SIP operations and social maladjustment 6 months later. However, children’s SIP did not significantly predict their social adjustment above and beyond the impact of parenting.

Conclusions  Results indicated that the quality of parenting that children received was more central to subsequent adjustment in peer interactions than were children’s SIP operations. Furthermore, the quality of parenting children experienced was closely linked to parents’ beliefs about their children and parents’ mental health status. Directions for future research and potential implications for clinical practice are discussed.
The extent of parental compliance with timing of administration of their children's antibiotics
Authors: Dawson Anne , Newell Robert
Published: May 2006

Antibiotics are widely prescribed to children, and the responsibility for ensuring adequate administration typically rests with parents However, compliance with antibiotic medication is generally low, and previous studies often fail to specify the criteria for compliance adequately In particular, little attention has been paid to accuracy of timing of antibiotic administration outside hospital, even though timing is important in maintaining therapeutic drug levels The current study examined the self‐reports of 75 mothers of their behaviours in administration of antibiotics to their children, with particular attention being paid to the frequency and timing of administration The study found that, when timing of doses was considered, only seven parents could be considered as fully compliant with dosage instructions, a much lower proportion than indicated in previous studies which applied a more lenient definition of compliance The implications of this finding are discussed, with particular reference to the role of the nurse and to the comparative usefulness of different definitions of compliance
Stress and coping strategies in community psychiatric nurses: a Q‐methodological study
Authors: Leary John , Gallagher Tim , Carson Jerome , Fagin Lenny , Bartlett Heather , Brown Daniel
Published: May 2006

With the development of the concept of community care there has been a significant expansion of the community psychiatric nurse (CPN) profession The present study attempts to examine which aspects of their work CPNs currently find stressful The study also examines the various strategies which CPNs feel to be useful in attempting to cope with such occupational stress Forty‐four CPNs in four health districts participated in this Q‐methodological study which provided the opportunity for CPNs to construct their own concepts of stressors and coping strategies The results obtained indicated that CPNs identified nine distinct areas of stress within their work, along with 12 distinct coping strategies which they considered useful in attempting to deal with such stress The implications of these findings are discussed
Mental health nursing skills in an acute admission environment: perceptions of mental health nurses and other mental health professionals
Authors: Gijbels Marry
Published: May 2006

Some of the findings of a descriptive study into the perceived therapeutic skills of mental health nurses are presented The study was set in an acute psychiatric admission unit of a district general hospital Data were collected through semistructured interviews with nurses, psychiatrists, psychologists, occupational therapists and social workers The data were analysed through thematic content analysis The findings suggest that nurses in this environment valued and possessed a range of therapeutic skills and qualities, but were unable to draw on these, leaving them to employ mainly coordinating, administrative and managerial skills A number of influencing factors were identified, which prevented nurses from using their therapeutic potential The author argues that the vision of mental health nursing in this setting may have to be altered
International comparison of baccalaureate nursing degrees: collaboration in qualitative analysis
Authors: French Peter , Anderson Judith , Burnard Philip , Holmes Colin , Mashaba Grace , Wong Thomas , Bing‐hua Zhao
Published: May 2006

This paper describes a study which investigated the perceived similarities and differences of a selection of baccalaureate nursing degrees from different continents An international research team was formed, and by using a modified version of the Delphi process and nominal group techniques the group undertook a qualitative analysis of curriculum documents The major areas of analysis were aims, content, methods and assessment Under these headings the group produced a list of key issues supported by a number of indicative statements by collating the independent analyses undertaken by each of the team members Examples of findings are that critical thinking and personal development are most obvious in aims but that the progression of curricula may not achieve this there are differences in ‘westren’ and ‘asian’ orientations to the concept of personal autonomy Sciences are valued more than arts or humanities. The lecture method as well as practice placement dominate the teaching methods. Transcultural nursing is not significant except where there are two therapeutic ideologies in existence Assessment methods are largely summative. The findings have application in the development of credit transfer and international exchange schemes. The conclusions highlight areas of special consideration when designing such schemes.
Critical aspects of nursing in aged and extended care
Authors: Pincombe Jan , O'Brien Bart , Cheek Julianne , Ballantyne Alison
Published: May 2006

An ageing Australian population and improving medical retrieval technology have led to an increasing need for nurses to manage complex and acute health issues of ageing and chronic disability In a study of aged and extended care involving nurses, residents, allied health professionals and family members, investigators used semi‐structured interviews to identify critical aspects of nursing The aim of the study was to begin to identify and illustrate a theoretical framework of ‘critical’ nursing activities for aged and extended care Two important themes to emerge were the structure of the health care setting and the characteristic behaviours of people associated with it These themes reinforce the importance of treating people as individuals and of describing caring criteria in ways which reinforce holism
Agency and research team co‐operation: an exploration of human territoriality
Authors: Ervin Naomi E , Dawkins Cecilia E
Published: May 2006

The purpose of this paper is to alert researchers and agency staff to potential conflicts that may arise during research projects conducted in busy community‐based agencies Within a framework of human territoriality, key factors in avoiding such conflicts are explored Territoriality is the defence against intruders of an area of land which is considered to be owned For humans, something owned includes space, objects, ideas, privileges or rights Key territoriality concepts explored in the paper are the private domain, encompassing a privacy retreat and personal space, and the public arena which includes psychological space and action territory Examples of violation of the types of territory are examined and suggestions for prevention of conflicts are provided
Parent participation: a concept analysis
Authors: Coyne Imelda T
Published: May 2006

Parent participation has become a central tenet of paediatric nursing in the United Kingdom The purpose of this paper is to explore the meaning of parent participation, to clarify the concept to benefit children and then‐ families, and to increase understanding among practitioners The concept analysis utilized was directed by Rodgers ‘evolutionary approach’ that views concept development as an ongoing dynamic process A review of British literature and research studies indicated that parent participation is a complex and multi‐dimensional concept In the evolution of parent participation, the terminology changed from ‘parental involvement’ to ‘partnership in care’, to ‘care‐by‐parent’ and finally to ‘family‐centred care’ The analysis reveals a lack of coherence in the descriptions, with the terminology changing but the underlying theme remaining parent participation Parent participation can be conceptualized as a composite of attributes that relate to the family, the nurse and then‐relationships Those attributes include negotiation, control, willingness, competence and autonomy The concept of family‐centred care is gradually assuming importance in the literature This acknowledgement of the family is long overdue However the concept remains poorly defined and urgent clarification is needed in this area To adopt a family‐centred care approach, a radical paradigm shift is required
Is there a relationship between job satisfaction and absenteeism?
Authors: Matrunola Paula
Published: May 2006

This study attempted to address the problem of stress and burnout in hospital nurses by exploring factors which affect job satisfaction and the relationship between these and absence rates Fifty nurses working in the elderly care unit of a district general hospital were asked to complete a job satisfaction questionnaire, specifically developed to include factors appropriate to the study, together with Maslach's burnout inventory and Beck's hopelessness scale The hypothesis that job satisfaction is related to absenteeism was not supported However, significant correlations between some variables were isolated These correlations were tested using Spearmans risk correlation co‐efficient It is hoped that the job satisfaction questionnaire will become a useful instrument in screening those at risk of burnout, and a diagnostic aid to help consider the factors which affect job satisfaction The implications of the study point to the need for the prevention of stress from environmental factors by the adoption of organizational strategies to promote positive working conditions, and the development of coping strategies in the form of stress awareness seminars, regular staff support groups and counselling services
The experience of reassurance: patients’ perspectives
Authors: Fareed Asraf
Published: May 2006

This study sets out to examine reassurance from the perspective of patients from a medical and a surgical setting in a local general hospital unit The rationale for studying reassurance is discussed and it is indicated that the phenomenon of reassurance as a caring construct is under‐researched The aims of the study are listed and phenomenology is used as the research method to answer the research question posed The participants were asked to describe their experiences of being reassured by the nurses Unstructured interviews were the main method of data collection and the sample consisted of eight patients of mixed gender Data were analysed using Colaizzi's procedural steps and these are described The process of research is described and ethical considerations discussed The results are described using raw data from the subjects The emerging themes include perception of the environment, ‘being with’, receiving information and knowledge of facts, interpersonal skills, ‘being there’, communication skills, trusting relationship, being cared for, assertion of optimism, and humanistic traits of the nurses In the conclusion, the limitations of the study are briefly mentioned The relevance of the findings to nursing practice are addressed and tentative recommendations for further research are made
Clinical evaluation — difficulties experienced by sessional clinical teachers of nursing: a qualitative study
Authors: Duke Maxine
Published: May 2006

Evaluation of nursing students in the clinical field requires the clinical teacher to make judgements regarding student progress in a number of areas In this study concepts of role theory, oppressed group behaviour and the ethics of caring emerged and were used as conceptual frameworks to interpret the data relating to the evaluation of undergraduate students The number of experienced faculty available for clinical teaching and evaluation has become inadequate and a large number of casual or sessional clinical teachers are employed to teach students in the clinical field Despite the well documented problems associated with clinical teaching and the use of inexperienced clinical teachers, sessional clinical teachers are nevertheless expected to evaluate student success in meeting the clinical requirements of the nursing course, often resulting in disparate decisions for students A phenomenological study was carried out using unstructured interviews and written clinical scenarios, to explore the evaluation process from the perspective of the sessional clinical teachers Research findings indicate that although the sessional clinical teachers were skilled at identifying student problems, they were reluctant to make difficult evaluation decisions, due to low self‐esteem, role conflict and their ethic of caring It seems that gender socialization, patriarchal dominance and apprenticeship training had effected their confidence in their own decision making The implications of such findings are of concern for the ongoing credibility and integrity of nursing courses, as clinical teachers have an influence on the nursing profession through the preparation of its practitioners
Sex and virulence in Escherichia coli: an evolutionary perspective
Authors: Wirth Thierry , Falush Daniel , Lan Ruiting , Colles Frances , Mensa Patience , Wieler Lothar H. , Karch Helge , Reeves Peter R. , Maiden Martin C. J. , Ochman Howard , Achtman Mark
Published: May 2006

Pathogenic Escherichia coli cause over 160 million cases of dysentery and one million deaths per year, whereas non‐pathogenic E. coli constitute part of the normal intestinal flora of healthy mammals and birds. The evolutionary pathways underlying this dichotomy in bacterial lifestyle were investigated by multilocus sequence typing of a global collection of isolates. Specific pathogen types [enterohaemorrhagic E. coli, enteropathogenic E. coli, enteroinvasive E. coli, K1 and Shigella] have arisen independently and repeatedly in several lineages, whereas other lineages contain only few pathogens. Rates of evolution have accelerated in pathogenic lineages, culminating in highly virulent organisms whose genomic contents are altered frequently by increased rates of homologous recombination; thus, the evolution of virulence is linked to bacterial sex. This long‐term pattern of evolution was observed in genes distributed throughout the genome, and thereby is the likely result of episodic selection for strains that can escape the host immune response.
Tapping the nucleotide pool of the host: novel nucleotide carrier proteins of Protochlamydia amoebophila
Authors: Haferkamp Ilka , Schmitz‐Esser Stephan , Wagner Michael , Neigel Nadjeschka , Horn Matthias , Neuhaus H. Ekkehard
Published: May 2006

Protochlamydia amoebophila UWE25 is related to the Chlamydiaceae comprising major pathogens of humans, but thrives as obligate intracellular symbiont in the protozoan host Acanthamoeba sp. The genome of P. amoebophila encodes five paralogous carrier proteins belonging to the nucleotide transporter (NTT) family. Here we report on three P. amoebophila NTT isoforms, PamNTT2, PamNTT3 and PamNTT5, which possess several conserved amino acid residues known to be critical for nucleotide transport. We demonstrated that these carrier proteins are able to transport nucleotides, although substrate specificities and mode of transport differ in an unexpected manner and are unique among known NTTs. PamNTT2 is a counter exchange transporter exhibiting submillimolar apparent affinities for all four RNA nucleotides, PamNTT3 catalyses an unidirectional proton‐coupled transport confined to UTP, whereas PamNTT5 mediates a proton‐energized GTP and ATP import. All NTT genes of P. amoebophila are transcribed during intracellular multiplication in acanthamoebae. The biochemical characterization of all five NTT proteins from P. amoebophila in this and previous studies uncovered that these metabolically impaired bacteria are intimately connected with their host cell’s metabolism in a surprisingly complex manner.
Syn‐extension leucogranite deformation during convergence in the Eastern Central Alps: example of the Novate intrusion
Authors: Ciancaleoni Laurent , Marquer Didier
Published: May 2006

The Novate intrusion is a Late Alpine leucogranite that intruded the structures related to dextral back‐thrusting along the Periadriatic Fault System in the Eastern Central Alps. The Novate granite was heterogeneously deformed from amphibolite to greenschist facies conditions during cooling of the intrusion. The deformation inside the granite is characterized by strongly localized and anastomosed ductile shear zones surrounding lenses of weakly deformed granite and by late faults formed at the brittle–ductile transition. The fault kinematic analysis of conjugated shear zones suggests that the Novate leucogranite was emplaced at 25 Ma in an extensional regime along the southern tip of the Forcola Fault. A model of extensional jog opening by vertical shearing along the Forcola Fault provided the space for magma accommodation. The Novate granite is the first evidence for orogen‐parallel syn‐extensional leucogranite emplacement during the Oligocene collision in the Alps.
The PTPN22 1858T variant is not associated with primary biliary cirrhosis
Authors: Milkiewicz P. , Pache I. , Buwaneswaran H. , Liu X. , Coltescu C. , Heathcote E. J. , Siminovitch K. A.
Published: May 2006

The minor allele of a single nucleotide polymorphism (SNP) in the PTPN22 gene (1858T) encoding the Lyp‐tyrosine phosphatase has been recently associated with multiple autoimmune disorders, raising the possibility that this variant may also represent a risk allele for primary biliary cirrhosis (PBC). We therefore investigated the possible association of the PTPN22(1858T) variant with PBC in a Canadian population. We studied 160 Caucasian patients with biopsy and antimitochondrial antibodies (AMA)‐proven PBC who were genotyped for the PTPN22(C1858T) SNP using a single‐base primer extension assay and mass spectrometry. The frequency of the PTPN22(1858T) allele was then compared between the patients and 290 healthy controls. No association was detected between the PTPN22(1858T) allele and PBC, the frequency of this variant being similar in patients with PBC (7.5%) and controls (8.4%). Restricting the analysis to patients with PBC with any second autoimmune condition or specifically with sicca syndrome or autoimmune thyroid disease also revealed no association with this variant. Thus the PTPN22(1858T) variant is not associated with PBC or with the combination of PBC and a second autoimmune disease. These data suggest that this variant does not confer risk for PBC and does not account for the frequent presence of other autoimmune diseases in patients with PBC.
Selection on protein‐coding genes of natural cyanobacterial populations
Authors: Mes Ted H. M. , Doeleman Marije , Lodders Nicole , Nübel Ulrich , Stal Lucas J.
Published: May 2006

We examined the distribution of synonymous and non‐synonymous changes in 12 protein‐coding genes of natural populations of cyanobacteria to infer changes in gene functionality. By comparing mutation distributions within and across species using the McDonald–Kreitman test, we found data sets to contain evidence for purifying selection (hetRofTrichodesmium,nifHofCylindrospermopsis raceborskiiandrpoC1ofAnabaena lemmermannii) and positive selection (kaiCofMicrocoleus chthonoplastesandrbcXofAnabaenaandAphanizomenonsp.). Other genes from the same set of clonal isolates (petBandrbcLinM. chthonoplastesandAnabaena/Aphanizomenon, respectively) did not harbour evidence for either form of selection. The results of branch models of codon evolution agreed fully with the results of the McDonald–Kreitman test in terms of significance and absolute value of the dN/dS estimates. The high frequency of gene‐specific mutation patterns and their association with branches that separate closely related cyanobacterial genera suggest that evolutionary tests are suited to uncover gene‐specific selective differentiation in cyanobacterial genomes. At the same time, given the lack of information about the history of cyanobacteria, analysis of larger numbers of protein‐coding genes of clonal cyanobacterial isolates will produce more detailed pictures of the effects of natural selection.
NOT EVERY CELL IS SACRED: A REPLY TO CHARO
Authors: DISILVESTRO RUSSELL
Published: May 2006

Massimo Reichlin, in an earlier article in this journal, defended a version of the ‘argument from potential’ (AFP), which concludes that the human embryo should be protected from the moment of conception. But R. Alta Charo, in her essay entitled ‘Every Cell is Sacred: Logical Consequences of the Argument from Potential in the Age of Cloning’, claims that versions of the AFP like Reichlin’s are vulnerable to a rather embarrassing problem: with the advent of human cloning, such versions of the AFP entail that every somatic cell in the human body ought to be protected. Since this entailment is clearly absurd, Charo argues, these versions of the AFP should be rejected. I argue that the reasons Charo cites for believing in this entailment are inconclusive. For example, the four reasons she gives for doubting any differences between the nature of skin cells and zygotes are ultimately unconvincing. Against Charo, I maintain that there is a relevant distinction between the sort of potential possessed by the somatic cell and the sort of potential possessed by the early human embryo. Since only the latter sort of potential falls within the scope of the AFP, the alleged absurd entailment Charo invites us to consider is no entailment at all. Hence the AFP cannot be rejected on the grounds Charo advances. Even in an age of cloning, the claim that some cells are ‘sacred’ because of their potential does not entail the claim that every cell is sacred.
COLLINGWOOD, BRADLEY, AND HISTORICAL KNOWLEDGE
Authors: BURNS ROBERT M.
Published: May 2006

The central feature of the narrative structure of Collingwood's The Idea of History (IH) is the pivotal role accorded to Bradley, evident in the table of contents and in the two discussions of him. Few readers have noticed that, confusingly, the book's first discussion of Bradley (on pages 134‐141) is a revision of the (1935) Inaugural Lecture “The Historical Imagination,” which constitutes the book's second discussion of Bradley (on pages 231‐249). The differences between these two presentations of Bradley are significant. The 1935 account (presented in IH on pages 231‐249) seeks to portray the Bradley of the Presuppositions of Critical History as a Copernican revolutionary in historical thought, even though the neo‐Kantian transcendentalism promoted in the Lecture had been the core of Collingwood's approach to philosophy of history from the mid‐1920s, many years before he encountered Bradley's essay. By 1935 this transcendentalism was in the process of self‐destructing because of inner contradictions. By 1936, once Collingwood's narrative and his criticisms of Bradley left the 1935 claims unsustainable, Collingwood shifted attention to Bradley's later works, in an unsuccessful attempt to sustain the notion of his originality (presented in IH on pages 134‐141).

Hitherto neglected Collingwood manuscripts held in the Bodleian prove that by 1940 Collingwood recognized this, so that the prominence Knox gave to Bradley in his editing of the IH is demonstrably not in accord with Collingwood's views and plans for The Idea of History. Knox's much‐disputed claim that there was a radical shift to historicism in the later Collingwood is, however, confirmed, clear proof being adduced that in the later 1930s the attempt transcendentally to deduce universal and necessary presuppositions of historical knowledge is abandoned for a radically historicist account, paralleled by a demotion of “critical history” as the final form of “history proper” in favor of “scientific history.”
CIVILIZATION: THE CAREER OF A CONTROVERSIAL CONCEPT
Authors: Goudsblom Johan
Published: May 2006

Civilization and Its Contents. By Bruce Mazlish
Comparison of the Dissemination and Implementation of Standardized Public Health Nursing Competencies in Academic and Practice Settings
Authors: Oppewal Sonda , Lamanna Beth F. , Lee Glenn Loyd
Published: May 2006

ABSTRACT
Objectives: To assess the use of the “Core Competencies for Public Health Professionals” standards in practice and academic work settings by public health nurses (PHNs), and to determine differences between practitioners and faculty.

Design: Nonexperimental, descriptive study using a cross‐sectional survey.

Sample: Three public health nursing (PHN) organizations sent invitations to all members. A total of 334 (18.7%) from an estimated 1,786 members completed the survey.

Measurements: The investigators developed a 17‐item web‐based survey with open‐ and closed‐ended responses, using Rogers' diffusion of innovations as a theoretical framework.

Results: Respondents are equally familiar with the competencies for public health professionals disseminated by the Council on Linkages and for PHNs by the Quad Council of Public Health Nursing Organizations (Quad Council). Two thirds of PHNs are aware of the competencies after only 2 years, primarily from professional PHN organizations. Faculty are adopting and using the competencies at a significantly faster rate than practitioners.

Conclusions: Faculty and practitioners who use the competencies value them, and rarely discontinued their use after adoption. Efforts to promote diffusion among faculty and especially practitioners need to continue. Professional organizations can actively provide and share examples of useable formats and best practices associated with the competencies.
Utility of Qualitative Research Findings in Evidence‐Based Public Health Practice
Authors: Jack Susan M.
Published: May 2006

ABSTRACT
Epidemiological data, derived from quantitative studies, provide important information about the causes, prevalence, risk correlates, treatment and prevention of diseases, and health issues at a population level. However, public health issues are complex in nature and quantitative research findings are insufficient to support practitioners and administrators in making evidence‐informed decisions. Upshur's Synthetic Model of Evidence (2001) situates qualitative research findings as a credible source of evidence for public health practice. This article answers the following questions: (1) where does qualitative research fit within the paradigm of evidence‐based practice and (2) how can qualitative research be used by public health professionals? Strategies for using qualitative research findings instrumentally, conceptually, and symbolically are identified by applying Estabrooks' (1999) conceptual structure of research utilization. Different research utilization strategies are illustrated through the use of research examples from the field of work on intimate partner violence against women. Recommendations for qualitative researchers disseminating findings and for public health practitioners/policy makers considering the use of qualitative findings as evidence to inform decisions are provided.
Instrument Development of the Confidence in Home Care Services Questionnaire for Use With Elders and Caregivers of Mexican Descent
Authors: Crist Janice D. , Velazquez Humberto , Durnan Ian , Figueroa Diana Ramirez
Published: May 2006

ABSTRACT
Mexican American elders use home care services less than non‐Hispanic white elders, and a larger study is testing whether lack of confidence in home care services, measured by the Community Service Attitude Inventory, is a factor. In order to further develop the questionnaire for use with Mexican American elders and caregivers, qualitative interviews were conducted with Mexican American elders (n=5), Mexican American caregivers (n=5), and home care providers (n=5). Content analysis of interviews supported 2 dimensions: confidence and fear/worry. The research team developed 29 items from the dimensions. Testing of the items (n=15) suggested content validity and two additional items. The revised questionnaire was translated and tested for language equivalence in Spanish and English, assisted by a local community advisory council (n=9). Through collaboration, bicultural/bilingual teams and community partners refined 1 instrument that can be used to measure one of many barriers to equity in health care services with vulnerable populations. Thematic findings may be incorporated into nurses' interventions as they offer home care services to families.
Predictors of Mortality in the Old‐Old in Israel: The Cross‐Sectional and Longitudinal Aging Study
Authors: Ben‐Ezra Menachem , Shmotkin Dov
Published: May 2006

OBJECTIVES:To examine whether well‐known predictors of mortality change their predictive power over time, being reduced or even reversed in the old‐old.

DESIGN:A multidimensional survey of the Cross‐Sectional and Longitudinal Aging Study conducted from 1989 to 1992 with follow‐up of mortality after 6, 8, 10, and 12 years since 1989.

SETTING:Israel.

PARTICIPANTS:Participants (N=1,369) were drawn from a national sample of the Jewish Israeli population aged 75 to 94.

MEASUREMENTS:Data included sociodemographic factors and measures of health, physical condition, cognitive performance, and depression.

RESULTS:The results showed that age, sex, disability, self‐rated health, and marital status predicted mortality and that their predictive power changed over 9 years.

CONCLUSION:In the old‐old, predictors of mortality changed over time, and their predictive effect eventually diminished. The predictors found to be most significant (age, sex, disability, and self‐rated health) support the common cause theory.
Healthcare Utilization of Elderly Persons Hospitalized After a Noninjurious Fall in a Swiss Academic Medical Center
Authors: Seematter‐Bagnoud Laurence , Wietlisbach Vincent , Yersin Bertrand , Büla Christophe J.
Published: May 2006

OBJECTIVES: To determine the risk of hospital readmission, nursing home admission, and death, as well as health services utilization over a 6‐month follow‐up, in community‐dwelling elderly persons hospitalized after a noninjurious fall.

DESIGN: Prospective cohort study with 6‐month follow‐up.

SETTING: Swiss academic medical center.

PARTICIPANTS: Six hundred ninety persons aged 75 and older hospitalized through the emergency department.

MEASUREMENTS: Data on demographics and medical, physical, social, and mental status were collected upon admission. Follow‐up data were collected from the state centralized billing system (hospital and nursing home admission) and proxies (death).

RESULTS: Seventy patients (10%) were hospitalized after a noninjurious fall. Fallers had shorter hospital stays (median 4 vs 8 days, P<.001) and were more frequently discharged to rehabilitation or respite care than nonfallers. During follow‐up, fallers were more likely to be institutionalized (adjusted hazard ratio=1.82, 95% confidence interval=1.03–3.19, P=.04) independent of comorbidity and functional and mental status. Overall institutional costs (averaged per day of follow‐up) were similar for both groups ($138.5 vs $148.7, P=.66), but fallers had lower hospital costs and significantly higher rehabilitation and long‐term care costs ($55.5 vs $24.1, P<.001), even after adjustment for comorbidity, living situation, and functional and cognitive status.

CONCLUSION: Elderly patients hospitalized after a noninjurious fall were twice as likely to be institutionalized as those admitted for other medical conditions and had higher intermediate and long‐term care services utilization during follow‐up, independent of functional and health status. These results provide direction for interventions needed to delay or prevent institutionalization and reduce subsequent costs.
The Role of Information and Influence in Social Networks
Authors: Davern Michael , Hachen David S.
Published: May 2006

Abstract.  This article examines two mechanisms through which social networks are related to job mobility: (1) access to diverse sources of information about job openings and (2) nonredundant sources of influence. Using data on job changing and social networks among television station managers, we assess the extent to which job information and influence variables mediate the relationship between social network structure and getting a better job. Results indicate that there is an association between job mobility and having nonredundant contacts, but our measures of the information and influence mechanisms are not significant mediators. We conclude by reexamining the network‐resource model that forms the basis for much of the research on the relationship between social networks and job mobility.
Current usage of intravenous immune globulin and the rationale behind it: the Massachusetts General Hospital data and a review of the literature
Authors: Darabi Kamran , Abdel‐Wahab Omar , Dzik Walter H.
Published: May 2006

BACKGROUND:  Intravenous immune globulin (IVIG) has been approved by the Food and Drug Administration (FDA) for use in 6 conditions: immune thrombocytopenic purpura (ITP), primary immunodeficiency, secondary immunodeficiency, pediatric HIV infection, Kawasaki disease, prevention of graft versus host disease (GVHD) and infection in bone marrow transplant recipients. However, most usage is for off‐label indications, and for some of these comprehensive guidelines have been published.

STUDY DESIGN AND METHODS:  We retrospectively reviewed all approved IVIG transfusions at Massachusetts General Hospital in 2004 to identify the current usage pattern and completed a literature review.

RESULTS:  IVIG was most commonly used in the treatment of chronic neuropathy, which included chronic inflammatory demyelinating polyneuropathy (CIDP) and multifocal motor neuropathy. For such patients, the annual cost of IVIG can exceed $50,000 per patient. Other common indications were the treatment of hypogammaglobulinemia, ITP, renal transplant rejection, myasthenia gravis, Guillain‐Barre syndrome, necrotizing fasciitis, autoimmune hemolytic anemia, and Kawasaki disease. IVIG was administered in a variety of other indications each representing <3% of the total treated patients.

CONCLUSION:  Only a few indications account for most of the usage for IVIG. Reports concerning IVIG continue to grow at a tremendous pace but few high‐quality randomized controlled trials have been reported. Randomized trials are especially needed for conditions such as CIDP, which consume large quantities of product.
Amelogenins regulate expression of genes associated with cementoblasts in vitro
Authors: Swanson Erica C. , Fong Hanson K. , Foster Brian L. , Paine Michael L. , Gibson Carolyn W. , Snead Malcolm L. , Somerman Martha J.
Published: May 2006

Amelogenins are major proteins expressed by ameloblasts during development of the crown (enamel and dentin). These matrix proteins guide crystal habits of the mineral phase of developing enamel and are possible regulators of other genes/proteins during development and maturation of crown and root (dentin and cementum). This study focused on defining the effect that a specific proteolytic cleavage product of amelogenin, tyrosine‐rich amelogenin peptide (TRAP), has on cementoblast behavior. Immortalized cementoblasts (OCCM‐30) were exposed to TRAP in vitro. Cells treated with TRAP were evaluated for cell proliferation, gene expression for osteocalcin (OCN), osteopontin (OPN), and bone sialoprotein (BSP), and induction of mineral nodule formation. No significant difference in cell proliferation was found between vehicle‐treated cells and those treated with TRAP for up to 9 d after treatment. Gene expression of OCN, OPN, and BSP in TRAP‐treated cementoblasts showed down‐regulation, up‐regulation, and no significant change, respectively, relative to vehicle control. A marked decrease in mineral nodule formation was found in cells treated with TRAP compared with the vehicle control, in a dose‐dependent manner. These data, along with our previous results demonstrating similar activity with full‐length amelogenin and leucine‐rich amelogenin peptide (LRAP), suggest that amelogenin‐like molecules regulate mesenchymal cell behavior.
Amelogenin and ameloblastin show growth‐factor like activity in periodontal ligament cells
Authors: Zeichner‐David Maggie , Chen Li‐Sha , Hsu Zhengyan , Reyna Julia , Caton Javier , Bringas Pablo
Published: May 2006

Enamel proteins, particularly amelogenin, have been associated with other functions in addition to regulating enamel biomineralization. Extracts of enamel proteins are currently being used to regenerate periodontal tissues, and new studies suggest that enamel proteins might have chondrogenic and osteogenic properties. In this study, we wanted to determine the effect, if any, of purified recombinant amelogenin and ameloblastin on the adhesion, proliferation, and differentiation of periodontal ligament cells in vitro. Immortomouse‐derived periodontal ligament (PDL) cells were grown under permissive and differentiation conditions in the presence of different concentrations of mouse recombinant amelogenin, recombinant ameloblastin, or both. Cells were collected after 4 h to determine attachment, after 24 h to determine proliferation, and after 7, 14, 21 and 28 d to determine differentiation using reverse transcription–polymerase chain reaction (RT–PCR). Both amelogenin and ameloblastin had a small, but statistically significant, effect on increasing the cell attachment and proliferation of PDL cells. Both amelogenin and ameloblastin modulated bone morphogenetic protein (BMP) expression, down‐regulated the expression of collagen type I, and induced the de novo expression of osteocalcin. Amelogenin also induced the expression of bone sialoprotein. These results suggest that amelogenin, as well as ameloblastin, might have some ‘growth factor’ activity during periodontium development and regeneration.
Transvascular dissemination of Porphyromonas gingivalis from a sequestered site is dependent upon activation of the kallikrein/kinin pathway
Authors: Hu S.‐W. , Huang C.‐H. , Huang H.‐C. , Lai Y.‐Y. , Lin Y.‐Y.
Published: May 2006

Background and Objective:  Epidemiological evidence implicates a connection between human periodontitis and systemic diseases. One possible mechanism involves the direct dissemination of periodontopathogens to the target organs through the circulation. The aim of this work was to define the mechanism used by Porphyromonas gingivalis for dissemination from a sequestered infection site.

Material and Methods:  BALB/c mice were subcutaneously infected with P. gingivalis via use of a mouse chamber model. Tissue fluids from various sites were collected and cultured to determine the presence of P. gingivalis. Evans Blue dye was used to measure the dissemination ability of P. gingivalis. Kinin‐associated molecules were introduced into mice, and their effects on bacterial dissemination and mouse pathology were monitored.

Results:  P. gingivalis strain A7436 caused remote lesions and septicemia with severe cachexia, resulting in animal death. Intrachamber challenge with A7436 resulted in vascular permeability enhancement (VPE), as measured by the systemic infiltration of Evans Blue dye into chamber fluids. VPE was blocked by kininase and kinin receptor antagonist and enhanced by exogenous bradykinin and kininase inhibitor. Live bacteria were recovered from the subcutaneous perichamber and abdominal spaces (spreading), and from the blood (disseminating) of infected mice. Both kininase and kinin receptor antagonist reduced animal mortality as a result of infection with strain A7436 and decreased the number of bacteria recoverable from the blood, but they were not associated with bacterial spreading.

Conclusions:  The results suggest that activation of the kinin system is involved in the breach of the vascular barrier that permits dissemination of P. gingivalis.
1141150242 IgA is required for protection against Chlamydia infection in the male genital tract
Authors: Beagley KW , Cunningham KA , Carey AJ , Hickey DK , Bao S
Published: May 2006

Aim:  To determine if IgA is required for protection against Chlamydia infection in the male reproductive tract (MRT).

Materials and Methods:  Male polyimmunoglobulin receptor knockout mice (PIgR‐/‐) and wild‐type C57BL/6 (WT) mice were immunised intranasally with chlamydial major outer membrane protein (MOMP) and cholera toxin (CT). MOMP‐specific IgG and IgA in serum and prostatic fluids were measured by ELISA. Serum and PF were also assayed for inhibition of in vitro chlamydial infection. Immunized WT and PIgR‐/‐ mice were challenged by direct inoculation of C. muridarum into the meatus urethra. Four weeks post challenge Chlamydia levels in the penile urethra, epididymis and testis were determined by PCR.

Results:  Equivalent levels of IgG were found in the serum of both WT and PIgR‐/‐ mice however IgA in serum of PIgR‐/‐ mice was 19‐ to 20‐fold higher than in WT animals consistent with the lack of the PIgR IgA transport molecule. IgA levels were significantly lower in PIgR‐/‐ PF compared to WT PF after both immunization and infection. Only PF from WT but not PIgR‐/‐ animals was able to inhibit in vitro chlamydial infection. Following challenge significantly higher levels of Chlamydia were recovered from the MRT of PIgR‐/‐ mice compared to WT animals.

Conclusions:  Male mice lacking a functional PIgR were unable to clear a genital tract Chlamydia infection despite high levels of serum IgA. These data show that mucosal IgA plays a major role in preventing chlamydial infection of the male genital tract and suggest that immunization strategies to protect males should target a strong mucosal IgA response.