bluuebunny/crossref_metadata_2025 huggingface dataset:
In Vitro Maturation and Fertilization of Buffalo Oocytes: Effects of Storage of Ovaries, IVM Temperatures, Storage of Processed Sperm and Fertilization Media
Authors: Ravindranatha BM , Nandi S , Raghu HM , Reddy SM
Published: March 2003

Contents

Studies were conducted to examine the possibility of preserving slaughterhouse‐derived buffalo ovaries at 4°C for 0 (control), 12 and 24 h to maintain the developmental competence of the oocytes (experiment 1), to assess the effect of incubation temperature during oocyte maturation on rates of in vitro maturation (IVM) and in vitro fertilization (IVF) of buffalo oocytes and embryo development (experiment 2), and to examine the effect of storage at 25°C for 0 (control), 4 and 8 h of frozen–thawed buffalo sperm and BO and H‐TALP as sperm processing and fertilization media on cleavage and embryo development in vitro of buffalo oocytes (experiment 3) in order to optimize the IVF technology in buffalo. Results suggested that storage of ovaries at 4°C for 12 or 24 h significantly (p < 0.05) reduced the developmental potential of oocytes. Incubation temperatures during the IVM influenced the fertilization rate but had no significant effect on maturation and subsequent embryo development. The incubation temperature of 38.5°C during IVM was found to be optimum for embryo production in vitro. Storage of frozen–thawed sperm at 25°C for 8 h significantly (p < 0.05) decreased its ability to cleave the oocytes. Sperm processed in BO medium had significantly (p < 0.05) higher ability to cleave the oocytes than the H‐TALP medium.
Family involvement: The key to opening locked wards and closed minds
Authors: Jubb Maureen , Shanley Eamon
Published: March 2003

ABSTRACT:

Treatment under the traditional medical model has largely ignored the family’s knowledge, expertise and potential therapeutic effects on hospitalized mentally ill people. This paper reviews the family’s role as caregiver. It reports on an evaluation of services by caregivers. Its findings reflect views stated in other surveys in identifying the need for improvement in education and social support for families, greater family involvement in the patient’s care and improvement in staff attitudes towards families. The study concludes by describing the development of a family support project in a Nursing Practice Development Unit in a secure ward and offers a blueprint for mental health nurses in facilitating the more active involvement of families in the recovery of their family members.
Experience, knowledge and attitudes of mental health staff regarding clients with a borderline personality disorder
Authors: Cleary Michelle , Siegfried Nandi , Walter Garry
Published: March 2003

ABSTRACT:

A survey of mental health staff experience, knowledge and attitudes regarding the management of clients with a diagnosis of borderline personality disorder (BPD) aimed to obtain baseline data to provide direction for developing planned education and determining staff willingness to participate in such training. A 23‐item questionnaire was developed and posted to mental health staff in a public Area Mental Health Service in New South Wales (n = 516). A total of 229 staff completed the questionnaire. Most staff (85%) reported having contact with clients who have a diagnosis of BPD at least once a month or more frequently, with 32% of respondents reporting daily contact. Eighty per cent of respondents found dealing with clients who have a BPD to be moderate to very difficult; 84% of staff felt that dealing with this client group was more difficult than dealing with other client groups. Most staff (82%) believed that, as mental health professionals, they had a role in the assessment, management and referral of clients with BPD, as well as in educating and providing information. Staff readily identified resources which would be helpful to them when working with such clients. It was encouraging to see that the majority of staff (95%) indicated their willingness to gain further education and training in the management of these clients. Although many staff believed they were knowledgeable about and confident in managing these clients, most staff also indicated difficulties posed by these clients and perceived a need for further education and training in this area.
Attitudes of postgraduate nursing students towards consumer participation in mental health services and the role of the consumer academic
Authors: Happell Brenda , Pinikahana Jaya , Roper Cath
Published: March 2003

ABSTRACT:

Consumer participation in health care is increasingly becoming an expectation of health services. While important progress has been made in the mental health area, the attitudes of mental health professionals towards consumers poses a severe limitation. Greater consumer involvement in the education of mental health professionals has been presented as a strategy to encourage the development of a greater acceptance of consumer involvement by health professionals. A consumer academic position has been introduced into the Centre for Psychiatric Nursing Research and Practice. An important aspect of this role concerns the education of postgraduate psychiatric/mental health nursing students, in order to provide a consumer perspective and encourage greater consumer participation. In order to determine the impact of this project a questionnaire was developed by the authors to measure attitudes to consumer participation and the role of the consumer academic. This paper presents the first stage of this study. The questionnaire was administered to students (n = 25) on the first day of the course. The findings suggest that most students favour a high level of consumer participation but that this is limited to specific areas of treatment planning and delivery. Furthermore, the students’ demonstrate some level of ambivalence regarding the value and necessity of the consumer academic role.
Dual role of Ras and Rho proteins: At the cutting edge of life and death
Authors: Gómez Javier , Martínez‐A Carlos , González Ana , Rebollo Angelita
Published: March 2003

Small GTP‐binding proteins of the Ras superfamily are master controllers of the cell physiology. The range of processes in which these proteins are involved include cell cycle progression, cell division, regulation of cell morphology and motility and intracellular trafficking of molecules and organelles. The study of apoptosis, the physiological form of cell suicide, is progressively linking the functions of small G proteins to the control of the mechanisms that trigger the genetic programmes of cell death. To date, isoforms of the Ras and Rho groups have been related to both promotion and suppression of apoptosis. Further, signalling pathways driven by these proteins have been associated with the function and/or expression of molecules that regulate apoptotic responses. Thus, all available evidence points to a critical role for Ras and Rho proteins as major gatekeepers of the decision between cellular life and death.
Early pregnancy factor: An extracellular chaperonin 10 homologue
Authors: Morton Halle
Published: March 2003

Early pregnancy factor (EPF) has been identified as a homologue of chaperonin 10 (cpn10) with immunosuppressive and growth factor properties. As a homologue of cpn10, it belongs to the heat shock family of proteins (hsp) but, unlike other members of this family, EPF is detected extracellularly. Early pregnancy factor was first discovered in pregnancy serum by the rosette inhibition test, and the novelty of its discovery was that its presence could diagnose pregnancy within 6–24 h of a fertile mating. As well as being a monitor of the presence of a viable embryo, it is necessary for embryonic survival. In this capacity it acts as both an immunosuppressant and growth factor. Early pregnancy factor is also a product of proliferating primary and neoplastic cells and functions as an autocrine growth factor both in vivo and in vitro. It has a modifying effect on the outcome of experimental autoimmune encephalomyelitis, an animal model of multiple sclerosis. Early pregnancy factor is considered to be one of the major factors involved in the modification of multiple sclerosis observed during pregnancy.
Molecular mechanisms of ionizing radiation‐induced apoptosis
Authors: Watters Dianne
Published: March 2003

Ionizing radiation activates not only signalling pathways in the nucleus as a result of DNA damage, but also signalling pathways initiated at the level of the plasma membrane. Proteins involved in DNA damage recognition include poly(ADP ribose) polymerase (PARP), DNA‐dependent protein kinase, p53 and ataxia‐ telangiectasia mutated (ATM). Many of these proteins are inactivated by caspases during the execution phase of apoptosis. Signalling pathways outside the nucleus involve tyrosine kinases such as stress‐activated protein kinase (SAPK)/c‐Jun N‐terminal kinase (JNK), protein kinase C, ceramide and reactive oxygen species. Recent evidence shows that tumour cells resistant to ionizing radiation‐induced apoptosis have defective ceramide signalling. How these signalling pathways converge to activate the caspases is presently unknown, although in some cell types a role for calpain has been suggested.
Regulation of caspase activation and apoptosis by cellular zinc fluxes and zinc deprivation: A review
Authors: Chai Fugui , Truong‐Tran Ai Q , Ho Lien H , Zalewski Peter D
Published: March 2003

Non‐toxic agents that target intracellular signalling pathways in apoptosis may have potential therapeutic use in many diseases. One such agent is the transition metal Zn, a dietary cytoprotectant and anti‐oxidant, which stimulates cell proliferation and suppresses apoptosis. Zn is maintained in discrete subcellular pools that are critical for the functional and structural integrity of cells. The present review initially describes the current state of knowledge on the cellular biology of Zn, especially the critical free or loosely bound (labile) pools of Zn, which are thought to regulate apoptosis. We then review the evidence relating Zn to apoptosis, including studies from our laboratory showing potent synergy between intracellular Zn deficiency and the short chain fatty acid butyrate in induction of caspase activation and the downstream events of apoptosis. Our studies have also reported the suppressive effects of micromolar concentrations of Zn on caspase‐3 activation in cell‐free models. Other key issues that will be discussed include the identification of the putative molecular targets of Zn and the evidence that systemic changes in labile Zn levels are sufficient to alter susceptibility to apoptosis and lead to physiopathological changes in the human body. Finally, we propose that labile Zn may serve as a coordinate regulator of mitosis and apoptosis to regulate tissue growth.
New tuberculosis vaccines based on attenuated strains of the Mycobacterium tuberculosis complex
Authors: Collins Desmond M
Published: March 2003

The world urgently needs a better tuberculosis vaccine. Bacille Calmette–Guerin (BCG), an attenuated strain of Mycobacterium bovis, has been very widely used as a vaccine for many years but has had no major effect on reducing the incidence of tuberculosis. A number of alternative living and non‐living vaccines are being investigated. Live vaccine candidates include genetically modified forms of BCG, genetically attenuated strains of the Mycobacterium tuberculosis complex and genetically engineered vaccinia virus and Salmonella strains. Non‐living vaccine candidates include killed mycobacterial species, protein subunits and DNA vaccines. One requirement for acceptance of any new vaccine will be a favourable comparison of the protection it induces relative to BCG in a range of animal models, some of which may need further development. Molecular genetic techniques are now available that enable production of live attenuated strains of the M. tuberculosis complex with vaccine potential. In the first of two broadly different approaches that are being used, large numbers of mutants are produced by transposon mutagenesis or illegitimate recombination and are screened for properties that correlate with attenuation. In the second approach, putative genes that may be required for virulence are identified and subsequently inactivated by allelic exchange. In both approaches, mutants that are attenuated need to be identified and subsequently tested for their vaccine efficacy in animal models. Many mutants of the M. tuberculosis complex have now been produced and the vaccine properties of a substantial number will be assessed in the next 3 years.
One year in Antarctica: Mucosal immunity at three Australian stations
Authors: Gleeson M , Francis JL , Lugg DJ , Clancy RL , Ayton JM , Reynolds JA , McConnell CA
Published: March 2003

The effect of a year's isolation in Antarctica on the human mucosal immune system was assessed during the winter of 1992 at three Australian Antarctic stations: Casey, Davis and Mawson. Saliva samples were collected from each expeditioner prior to their departure from Australia and during each month in Antarctica. The concentrations of salivary immunoglobulins IgA and IgG were significantly different between the three stations, but there were no differences for salivary IgM and albumin. The mean concentrations of IgA were higher at Mawson (P < 0.008), and the mean concentrations of IgG were lower at Davis (P < 0.001) compared with the other stations. Ranges of values observed at the stations over the 12–13 months were similar. The variability of values within individuals showed station differences for salivary IgM and IgG only. The study revealed significant changes in salivary immunoglobulin values over the period in Antarctica, with similar patterns at the three Australian stations. The salivary IgA and IgM levels were lower in the first 4 months in Antarctica (January–April) and increased to maximum values in July–August, before returning to mean levels when isolation was broken in October–November. The patterns of salivary IgA and IgM suggest that stressors due to isolation may play a role in alterations of mucosal immunity in expeditioners in Antarctica.
Helicobacter pylori vaccines and mechanisms of effective immunity: Is mucus the key?
Authors: Sutton Philip
Published: March 2003

In this theoretical article, the hypothesis is proposed that immunization against gastric helicobacter infection is mediated by CD4+ T‐cell induced changes in mucus production. Vaccine development for the gastric pathogen Helicobacter pylori has encountered several problems. Resolving these problems is impeded by our lack of understanding of the mechanisms by which the immune response influences bacterial colonization. Protective immunity requires CD4+ T cells, but the majority of helicobacters are located in the mucus of the gastric lumen, away from the epithelial surface. Evidence suggests that this mechanism functions independently of antibodies, so how this is achieved is unknown. Clues to this mechanism may be provided by immune clearance of nematode infection. Similar to H. pylori, expulsion of the intestinal nematode, Nippostrongylus brasiliensis, in rodents is mediated by CD4+ T‐cell changes in the numbers of goblet cells and the type of mucins secreted into the gut. Immune‐mediated changes in secretion of gastric mucins could similarly be responsible for the reductions in helicobacter colonization seen in immunized animals. Helicobacter pylori are highly motile bacteria that have evolved to inhabit their specialized niche. Alterations in their mucus environment could influence their motility, such that the bacteria cannot remain efficiently within the mucus and are flushed away.
Central nervous system in cerebral malaria: ‘Innocent bystander’ or active participant in the induction of immunopathology?
Authors: Medana Isabelle M , Chaudhri Geeta , Chan‐Ling Tailoi , Hunt Nicholas H
Published: March 2003

Cerebral malaria (CM) is a major life‐threatening complication of Plasmodium falciparum infection in humans, responsible for up to 2 million deaths annually. The mechanisms underlying the fatal cerebral complications are still not fully understood. Many theories exist on the aetiology of human CM. The sequestration hypo‐thesis suggests that adherence of parasitized erythrocytes to the cerebral vasculature leads to obstruction of the microcirculation, anoxia or metabolic disturbances affecting brain function, resulting in coma. This mechanism alone seems insufficient to explain all the known features of CM. In this review we focus on another major school of thought, that CM is the result of an over‐vigorous immune response originally evolved for the protection of the host. Evidence in support of this second hypothesis comes from studies in murine malaria models in which T cells, monocytes, adhesion molecules and cytokines, have been implicated in the development of the cerebral complications. Recent studies of human CM also indicate a role for the immune system in the neurological complications. However, it is likely that multiple mechanisms are involved in the induction of cerebral complications and both the presence of parasitized erythrocytes in the central nervous system (CNS) and immunopathological processes contribute to the pathogenesis of CM. Most studies examining immunopathological responses in CM have focused on reactions occurring primarily in the systemic circulation. However, these also do not fully account for the develop‐ment of cerebral complications in CM. In this review we summarize results from human and mouse studies that demonstrate morphological and functional changes in the resident glial cells of the CNS. The degree of immune activation and degeneration of glial cells was shown to reflect the extent of neurological complications in murine cerebral malaria. From these results we highlight the need to consider the potentially important contribution within the CNS of glia and their secreted products, such as cytokines, in the development of human CM.
Hypothalamic–pituitary–adrenal axis regulation of inflammation in rheumatoid arthritis
Authors: Morand Eric F , Leech Michelle
Published: March 2003

The profound anti‐inflammatory effects of glucocorticoids in drug therapy are reflected in the effects in vivo of endogenous glucocorticoids produced by the adrenals. The production of adrenal glucocorticoids is driven by the hypothalamus and pituitary, which in turn are responsive to circulating products of the inflammatory response, especially cytokines. That inflammation can drive the production of anti‐inflammatory glucocorticoids denotes the hypothalamic–pituitary–adrenal (HPA)‐immune axis as a classic negative feedback control loop. Defects in HPA axis function are implicated in susceptibility to, and severity of, animal models of rheumatoid arthritis (RA), and are hypothesized to contribute to the human disease. In this paper, data supporting the concept of the HPA axis as a regulator of the inflammatory response in animal models of arthritis are reviewed, along with data from studies in humans. Taken together, these data support the hypothesis that the HPA axis provides one of the key mechanisms for inhibitory regulation of the inflammatory response. Manipulation of HPA axis‐driven endogenous anti‐inflammatory responses may provide new methods for the therapeutic control of inflammatory diseases.
DNA vaccines: Future strategies and relevance to intracellular pathogens
Authors: Sharma AK , Khuller GK
Published: March 2003

Increasing awareness of microbial threat has rekindled interest in the great potential of vaccines for controlling infectious diseases. The fact that diseases caused by intracellular pathogens cannot be overcome by chemotherapy alone has increased our interest in the generation of highly efficacious novel vaccines. Vaccines have proven their efficacy, as the immunoprotection they induce appears to be mediated by long‐lived humoral immune responses. However, there are no consistently effective vaccines available against diseases such as tuberculosis and HIV, and other infections caused by intracellular pathogens, which are predominantly controlled by T lymphocytes. This review describes the T‐cell populations and the type of immunity that should be activated by successful DNA vaccines against intracellular pathogens. It further discusses the parameters that need to be fulfilled by protective T‐cell Ag. We then discuss future approaches for DNA vaccination against diseases in which cell‐mediated immune responses are essential for providing protection.
Does recycling in germinal centres exist?
Authors: Meyer‐Hermann Michael
Published: March 2003

A general criterion is formulated to decide if the recycling of B cells exists in germinal centre (GC) reactions. The criterion is independent of the selection and affinity maturation process and based solely on total centroblast population arguments. An experimental test is proposed to verify whether the criterion is fulfilled.
Experimental autoimmune encephalomyelitis induction in naive mice by dendritic cells presenting a self‐peptide
Authors: Weir Catherine R , Nicolson Kirsty , Bäckström B Thomas
Published: March 2003

Self‐reactive T cells escape deletion in the thymus and are found in the peripheral repertoire. Because bone‐marrow‐derived dendritic cells (BM‐DC) are potent activators of antigen‐specific T cells, these cells could theoretically activate self‐reactive T cells leading to autoimmunity. We investigated whether BM‐DC could induce the autoimmune disease experimental autoimmune encephalomyelitis (EAE). Our results show that transfer of BM‐DC presenting a self‐peptide from the myelin oligodendrocyte glycoprotein (MOG35–55) into naive mice induced EAE 7–14 days later. MOG35–55‐specific T cells of the Th1 phenotype were present in the lymph nodes and spleens of mice that received live peptide‐pulsed BM‐DC. Heat‐killed or formaldehyde‐fixed BM‐DC presenting MOG35–55 could induce neither clinical signs of EAE nor a measurable T‐cell response in vitro. These data show that live BM‐DC presenting a self‐antigen can induce the organ‐specific autoimmune disorder EAE in a non‐transgenic system. Therefore, this new EAE model could be used as a more clinically relevant model for the human disease multiple sclerosis. These findings could also have implications for the use of DC immunotherapy in a clinical setting.
Immature, but not inactive: the tolerogenic function of immature dendritic cells
Authors: Mahnke Karsten , Schmitt Edgar , Bonifaz Laura , Enk Alexander H , Jonuleit Helmut
Published: March 2003

The induction of antigen‐specific T cell tolerance and its maintenance in the periphery is critical for the prevention of autoimmunity. Recent evidence shows that dendritic cells (DC) not only initiate T cell responses, but are also involved in silencing of T cell immune responses. The functional activities of DC are mainly dependent on their state of activation and differentiation, that is, terminally differentiated mature DC can efficiently induce the development of T effector cells, whereas immature DC are involved in maintenance of peripheral tolerance. The means by which immature DC maintain peripheral tolerance are not entirely clear, however, their functions include the induction of anergic T cells, T cells with regulatory properties as well as the generation of T cells that secrete immunomodulatory cytokines. This review summarizes the current knowledge about the immunoregulatory role of immature DC that might act as guardians for the induction and maintenance of T cell tolerance in the periphery.
Inhibition of LPS‐induced nitric oxide and TNF‐α production by α‐lipoic acid in rat Kupffer cells and in RAW 264.7 murine macrophages
Authors: Kiemer Alexandra K , Müller Christian , Vollmar Angelika M
Published: March 2003

The activation of Kupffer cells represents a central mechanism of inflammatory liver injury involving the production of two important inflammatory mediators, nitric oxide and TNF‐α. The aim of this study was to investigate the effect of the hepatoprotective compound α‐lipoic acid (thioctic acid) on the production of nitric oxide and TNF‐α in isolated rat Kupffer cells and RAW 264.7 macrophages. Isolated rat Kupffer cells or RAW 264.7 were either untreated, treated with α‐lipoic acid (500 µg/mL), or activated with 1 µg/mL of lipopolysaccharide in the presence or absence of α‐lipoic acid (0.2−500 µg/mL). After 20 h the accumulation of nitrite was measured by the Griess assay. Tumour necrosis factor‐α secretion was quantified after 4 h by L929 bioassay. Cell viability was determined by mitochondrial reduction of 3‐(4,5‐dimethylthiazol‐2‐yl)‐2,5‐diphenyl tetrazolium bromide (MTT) test, nuclear factor‐κB (NF‐κB) and activator protein‐1 (AP‐1) DNA binding activity by gelshift assays. Treatment of Kupffer cells and RAW 264.7 with α‐lipoic acid alone had no effect on basal nitric oxide production. However, α‐lipoic acid significantly inhibited lipopolysaccharide‐induced nitrite accumulation. α‐Lipoic acid did not alter basal TNF‐α secretion in Kupffer cells, whereas it significantly inhibited lipopolysaccharide‐induced TNF‐α production. α‐Lipoic acid attenuated the activation of nuclear factor‐κB and AP‐1, two transcription factors pivotal in induction of inducible nitric oxide synthase and TNF‐α. α‐Lipoic acid significantly inhibits lipopolysaccharide‐induced macrophage production of nitric oxide and TNF‐α via an attenuated activation of NF‐κB and activator protein‐1. The reduced production of nitric oxide and TNF‐α in Kupffer cells may be involved in the hepatoprotective action conveyed by α‐lipoic acid.
Family issues in home‐based care
Authors: Wellard Sally Jane , Street Annette Fay
Published: March 2003

In Australia, home‐based care for the chronically ill is increasing. Technological advances and increased economic constraints are often cited as the reasons for the increase in home‐based treatments. Exploring the development of home‐based care, in particular home‐based dialysis, using a case‐study approach provided an opportunity to identify the issues of families involved in home care. Issues that emerged included: (i) the development of the home‐based clinic; (ii) the role of women; (iii) social isolation; (iv) and the lack of effective support from general practitioners and health services.
Measuring outcomes from the patients’ perspective
Authors: Middleton Sandy , Lumby Judy
Published: March 2003

This descriptive study examines the outcomes of care from the perspective of patients following a recent orthopaedic admission at a teaching hospital in Sydney. Results were extracted and analysed from transcripts of audio‐taped focus groups. Participants identified five nursing activities that made a positive difference to patient outcomes. These activities were: (i) patient‐controlled analgesia; (ii) water‐filled gloves placed under patients’ heels; (iii) cream rubbed into patients’ heels; (iv) an explanation, at pre‐admission clinic, of the impending operation; and (v) being informed about the details of their treatment while in hospital. Three activities that participants felt made a negative difference to their outcome were also identified, as were seven activities not performed by nursing staff that participants felt would have made a positive difference to their outcome. The results from this study reinforce the importance of basic nursing care, and the value of measuring outcomes, not only from the professional perspective, but also from the patients’ viewpoint.
‘Feedback. I listened, reflected and utilized’: Third year nursing students' perceptions and use of feedback in the clinical setting
Authors: Rn Pauline A Glover
Published: March 2003

The aim of this case study was to identify third year nursing students' perceptions and use of feedback in the clinical area. Questionnaires, clinical logs and interviews were used to collect the data. The final sample group was five third‐year nursing students undertaking clinical placement in a major metropolitan hospital in Adelaide in semester one of the 1998 academic year. Findings from the study suggest that the registered nurse provides significant feedback mostly in the patient's bay or at the bedside. Positive feedback and the ‘feedback sandwich’ are suggested to be most useful to the student's learning. Further, feedback has the ability to enhance the student's performance and make them feel confident and competent in their role, especially when the feedback is immediate. It allows for reflection in practice and offers the student the opportunity to meet the Australian Nursing Council Inc. competency of reflective practice.
The context of care: Issues of power and control between patients and community mental health nurses
Authors: Muir‐Cochrane Eimear
Published: March 2003

Issues of power and control are inevitably linked to the nurse–patient relationship within mental health settings. This paper discusses power relations between nurses and patients within the context of the home visit as an important component of the provision of care to patients living with enduring mental illness. An interpretive ethnographic account was adopted to explore how nurses and patients negotiated issues of power and control with respect to the specific responsibilities associated with community mental health nursing practice. The home visit involved a shifting of power in favour of the patient; patients behaved as ‘hosts’ and nurses as ‘guests’. However, within this framework, nurses still exerted power in relation to certain aspects of patients' daily living which are deemed to be within the domain of nursing, and so legitimise the nurse's interventions. This study explicates the daily exigencies of community mental health practice and provides insights into difficult aspects of nurses' work, which have received little attention in the nursing literature to date.
Comparison of the FemoStop device and manual pressure in reducing groin puncture site complications following coronary angioplasty and coronary stent placement
Authors: Walker Sandra Beverley , Cleary Sonja , Higgins Monica
Published: March 2003

This study compared two techniques, the FemoStop device (RADI Medical Systems, Uppsala, Sweden) and manual pressure, currently used by nurses to achieve haemostasis at the groin puncture site following removal of femoral arterial sheaths in patients following coronary angioplasty and coronary stent placement. Participants were randomly allocated the FemoStop device or manual pressure. Participants’ groins were observed for evidence of complications including haemorrhage, haematoma formation and pseudoaneurysm following removal of the femoral arterial sheath and the following day. Of the 274 participants recruited into the study, 5.5% (n = 15) were unable to be included as a result of the absence of data on the Angioplasty Record of Care Form (n = 5) or excessive bleeding at the groin puncture site (n = 10). This left 259 eligible participants. Of these, 18.1% (n = 47) did not have their groin puncture site inspected by a post‐procedural observer, thereby reducing the number of participants eligible to complete all stages of the study to 212. The results showed that the presence of a haematoma on removal of the femoral arterial sheath had a significant relationship with the type of treatment used, with those participants in the FemoStop device group showing a greater incidence of haematoma development at the time of sheath removal than those in the manual pressure group. No significant difference was detected in haematoma formation or bleeding between the two groups as a result of the risk factors identified in the literature, including participant anxiety, weight or anticoagulant therapy. There was not any significant difference between the two groups in reported pain during removal of the femoral arterial sheath; however, there was a significant distinction in the amount of time taken to achieve haemostasis. The results showed that haemostasis was achieved more quickly in those participants in the manual pressure group than those in the FemoStop group.

The results of this research study indicate that although manual pressure achieved haemostasis more quickly than the FemoStop device, both methods are as effective in reducing groin complications in patients following removal of the femoral arterial sheath following coronary angioplasty and stent placement.
Adolescent coping with grief after the death of a loved one
Authors: Rask Katja , Kaunonen Marja , Paunonen‐Ilmonen Marita
Published: March 2003

The purpose of this article was to describe adolescent coping after the death of a loved one. Data were obtained by two self‐report questionnaires filled in by 14–16‐year‐old pupils in two secondary schools in Finland. The sample consisted of 89 adolescents (70% girls) who had each experienced the death of a loved one. The instrument used in the study was developed by Hogan and DeSantis. The article reports the responses to two open‐ended questions. The data were analyzed using content analysis. The most important factors that helped adolescents cope with grief were self‐help and support from parents, relatives and friends. However, the official social support system was not experienced as very helpful. No one reported help, for example, from school health services. According to the adolescents, fear of death, a sense of loneliness and intrusive thoughts were factors that hindered coping with grief. Some respondents felt that parents or friends were an additional burden on them. The results are discussed in terms of identifying the different impact of social support, the importance of self‐help and professional help. Knowledge of factors that have an effect on adolescent coping with bereavement is important for families, effective nursing practice, school health services and parents.
Medication study supports registered nurses’ competence for single checking
Authors: Jarman Heather , Jacobs Elly , Zielinski Valerie
Published: March 2003

In 1999, a review of medication policies and practices for The Geelong Hospital, a Victorian regional acute care hospital, was conducted under the leadership and direction of the Executive Nursing Director. The findings of the review suggested that a study be conducted to examine the safety of single‐person (registered nurse division 1) checking of a designated group of medications that had previously been double‐checked. The present study was conducted as a descriptive study in adult inpatient units and speciality and midwifery services of The Geelong Hospital, and included the monitoring of medication errors for the designated group of medications under a single‐person checking protocol for a 7‐month period. A similar number of medication errors were reported when compared with a similar time‐frame in which double‐person checking was standard practice. At the completion of the study, a convenience sample of 129 nurses from the participating units and services completed questionnaires. The majority of the nurses appreciated the increased autonomy the change to single‐person checking of medications provided. They also identified benefits for patients, including that they were able to be more responsive to patient needs.
Focus group study of endometriosis: Struggle, loss and the medical merry‐go‐round
Authors: Cox Helen , Henderson Lorraine , Andersen Natalie , Cagliarini Glenda , Ski Chantal
Published: March 2003

Women with endometriosis experience a range of problems for which they may or may not be adequately supported. This paper reports on one aspect of a study conducted at the Epworth Hospital, Melbourne, to identify the information needs of women facing laparoscopy for endometriosis. A number of focus groups were conducted that provided women with a forum for communicating their experiences of endometriosis and laparoscopy. The findings include the experiences of 61 women who described the lack of support, the struggles and the losses involved in living with endometriosis. By far the worst experience that these women described was the encounter with health professionals and the ways in which their symptoms were trivialised and dismissed. There is a great deal for nurses to learn about the experience of living with endometriosis if they are to support women with this chronic illness in their search for well‐being.
Cordilleran‐type orogeny and episodic growth of continents: Insights from the circum‐Pacific continental margins
Authors: Tagami Takahiro , Hasebe Noriko
Published: March 2003

A new material migration hypothesis for the plate subduction zone orogeny, so‐called ‘the cordilleran‐type orogeny’, is proposed on the basis of geological constraints as well as mechanics of accretionary wedges. The major tectonic processes of the hypothesis comprise: (i) episodic, extensive magmatism along the margin of an overriding plate; (ii) supply of voluminous igneous and eroded materials through forearc to trench, with an increase in the net sediment influx into trench; (iii) accelerated accretion of sediments beneath an overriding older accretionary wedge; and (iv) upward material migration within the wedge and resultant exhumation of high‐P/T metamorphic rocks near the inland margin of the wedge. This hypothesis was validated by the test using available geo‐ and thermo‐chronological data from two classical types of subduction‐related orogens in Southwest Japan and California. The hypothesis, coupled with the thermochronologic point of view, requires the reconsideration of coevality of paired metamorphism. The temporal pairing is to be observed between the beginning of the regional high‐T/P metamorphism and that of the uplift and exhumation of high‐P/T metamorphism, with some time lag needed for material migration. Where the temporal pairing is examined therefore, the formation age of igneous rocks and related high‐T/P metamorphic rocks should be compared to the exhumation age of high‐P/T metamorphic rocks. The episodic, extensive magmatism that triggers the cordilleran‐type orogeny shows a temporal correlation in the mid‐Cretaceous for most circum‐Pacific continental margins. The resultant widespread formation of accretionary complexes is also observed in the western part of the circum‐Pacific margins. The deduced mid‐Cretaceous circum‐Pacific orogeny accompanied a gross increase in the continental crust production rate, and was approximately coeval with the Pangea breakup and the Central Pacific superplume episode, implying the orogeny as a part of the mid‐Cretaceous pulsation of the Earth.
Opening geometry of the Kurile Basin (Okhotsk Sea) as inferred from structural data
Authors: Baranov Boris , Wong How Kin , Dozorova Karina , Karp Boris , Lüdmann Thomas , Karnaukh Viktor
Published: March 2003

Abstract  The Kurile Basin in the Okhotsk Sea, northwestern Pacific, is a back‐arc basin located behind the Kurile Island Arc. It is underlain by oceanic crust and its origin has been attributed to back‐arc spreading. Two models for the opening of the Kurile Basin exist, for which the spreading axis is oriented northeast–southwest and northwest–southeast, respectively. New data are presented here on the morphostructure of the slope of the northern Kurile Basin and of the central Kurile Basin which support a strike of the spreading axis in the latter direction. Bathymetric as well as single‐channel and multichannel seismic reflection data demonstrate the existence of dominant northwest‐striking normal faults on the northern slope of the Kurile Basin. In the central Kurile Basin a basement rise striking north‐northwest–south‐southeast (here named the Sakura Rise) was mapped. The rise morphology has the distinct imprint of a rift structure with symmetrical volcanic edifices on the rise axis and faulted blocks that tilt in opposite directions on the flanks. These data suggest that the Kurile Basin opened in a northeast–southwest direction. In the generally accepted plate tectonic reconstructions, northwest–southeast spreading associated with dextral strike–slip along the north–south‐striking shear zone of Sakhalin and Hokkaido islands has been assumed. In the present model, spreading in the Kurile Basin was presumably connected with dextral displacement along a northeast‐striking shear zone on the southern segment of the Okhotsk Sea.
CASE REPORT: A rare association of primary biliary cirrhosis and systemic lupus erythematosus and review of the literature
Authors: Islam Shamsul , Riordan John , Mcdonald Jennifer
Published: March 2003

We report a rare occurrence of systemic lupus erythematosus in a patient known to have had well‐documented primary biliary cirrhosis for 10 years. The presentation was dramatic with pericardial tamponade, but responded well to high dose corticosteroid. There are only five such definite associations reported in the literature. In the present case, other possible causes were considered, such as drug‐induced cholestasis, drug‐induced lupus, autoimmune chronic active hepatitis and the overlap syndrome.
Hepatitis E infection in children: Study of an outbreak
Authors: Arora Narender , Panda Subrat , Nanda Santosh , Ansari Israrul , Joshi Seema , Dixit Rajesh , Bathla Rajni
Published: March 2003

Background
: Hepatitis E virus (HEV) is responsible for most of the hepatitis epidemics in the developing world and it frequently affects young adults. Therefore, common perception is that it does not affect children.

Methods
: A group of 20 school children (13 years old) were possibly exposed to hepatitis E virus infection during a 2 day trekking trip. Epidemiological and clinical information was correlated to the presence of the hepatitis E virus genome and antibodies to HEV structural and non‐structural proteins found in the blood of the children, using polymerase chain reaction and line immunoassay techniques.

Results
: Ten children developed icteric hepatitis, seven prodrome‐like illness without jaundice while three remained asymptomatic. Immunoglobulin M (IgM) antibodies to open reading frame (ORF)2 protein (pORF2) were detected in all 19 children tested, whereas 11 and 10 of the children were positive for IgM antibodies against ORF1 (pORF1) and ORF3 (pORF3) proteins, respectively. The rate of HEV infection was found to be 85%. Viraemia was observed in 11 children and was present in four of the seven anicteric patients (55%) compared with six of the nine (66%) icteric patients. One child without any symptom also had viraemia.

Conclusions
: The data obtained indicate a high susceptibility of children for HEV infection and a frequently prolonged viraemia in those infected.

© 1999 Blackwell Science Asia Pty Ltd
Prediction of oesophagogastric varices in patients with liver cirrhosis
Authors: Ng Fook‐Hong , Wong Siu‐Yin , Loo Ching‐Kong , Lam Kwong‐Ming , Lai Chi‐Wing , Cheng Chi‐Sing
Published: March 2003

Background
: All patients with liver cirrhosis are recommended for evaluation of oesophagogastric varices (EGV) regularly. This prospective study was designed to develop a predictive model for EGV in cirrhotic patients.

Methods
: Ninety‐two patients were recruited. From all patients studied, the size of palpable spleen, liver chemistry value, platelet count, prothrombin time, diameter of main portal vein and splenic length as assessed by ultrasonography were determined. Upper endoscopy was performed. Oesophageal varices (EV) and gastric varices (GV) were graded (EV, grade 1–4; GV, grade 1–3). In the predictive model, the EGV was classified into two grades (low, grade 1–2 EV or grade 1 GV; high, grade 3–4 EV or grade 2–3 GV).

Results
: There were 53 patients with EGV and 39 patients without EGV as determined by endoscopy. Patients with EGV had a significantly higher degree of ascites and hepatic encephalopathy, lower platelet count and longer splenic length than those without EGV. Low platelet count and presence of ascites were the significant independent predictors for high‐grade EGV (concordance rate 0.83). The optimal critical value for the platelet count was 150 × 10
9/L. Of patients without thrombocytopenia and ascites, 37% had low‐grade EGV but none had high‐grade EGV, whereas 38 and 35% of patients with thrombocytopenia or ascites had low and high‐grade EGV, respectively. Therefore, this predictive model for high‐grade varices had a positive and negative predictive value of 35 and 100%, respectively.

Conclusion
: Endoscopic screening for EGV was not necessary until thrombocytopenia or ascites occurred.
C ASE R	EPORT: Occurrence of hepatocellular carcinoma 4.5 years after successful treatment with virus clearance for chronic hepatitis C
Authors: Miyano Shintaro , Togashi Hitoshi , Shinzawa Haruhide , Sugahara Kazuhiko , Matsuo Taku , Takeda Yoshio , Saito Koji , Saito Takafumi , Ishiyama Shuichi , Kaneko Masayuki , Takahashi Tsuneo
Published: March 2003

A 67‐year‐old man with hepatitis C virus infection and histological features of chronic active hepatitis was treated with human recombinant interferon alpha‐2b. He responded successfully to interferon with normalization of serum alanine aminotransferase and continuous eradication of hepatitis C virus. However, 4.5 years after the end of interferon therapy, hepatocellular carcinoma, 20 mm in diameter, was detected by routine ultrasonographic screening. The patient underwent surgical treatment for resection of the hepatocellular carcinoma. The non‐cancerous liver tissue was histologically normal. This suggests that patients who have shown a complete response to interferon therapy for chronic hepatitis C should be followed up closely.
No evidence of increased risk of colorectal cancer in individuals heterozygous for the Cys282Tyr haemochromatosis mutation
Authors: Macdonald Graeme A , Tarish Jabsar , Whitehall Vicki Jl , M Sally J , Mellick George D , Buttenshaw Ron L , Johnson Anthony G , Young Joanne , Leggett Barbara A
Published: March 2003

Background and Aims
: Previous studies have suggested that increased body iron stores and heterozygosity for haemochromatosis are associated with an increased risk of colorectal carcinoma. The aim of this study is to determine if there is an association between (i) colorectal carcinoma and heterozygosity for the Cys282Tyr mutation of the haemochromatosis gene (HFE) and (ii) this mutation and tumour site or stage.

Methods
: Two hundred and twenty‐nine unselected patients (127 males, 102 females, mean age 68.0 years) with sporadic colorectal carcinoma and 228 controls (145 males, 83 females, mean age 69.7 years) were studied. DNA was tested for the presence of the Cys282Tyr mutation by digestion with Rsa1 and fragments separated by electrophoresis.

Results
: Twenty‐one patients with colorectal cancer and 23 control subjects were heterozygous for the Cys282Tyr mutation of HFE (relative risk 0.90). There was no association between heterozygosity of the Cys282Tyr mutation and tumour site or stage.

Conclusions
: Heterozygosity for the Cys282Tyr mutation of HFE does not appear to be a risk factor for colorectal carcinoma.

© 1999 Blackwell Science Asia Pty Ltd