bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of a new pressure ulcer preventive dressing containing ceramide 2 with low frictional outer layer
Authors: Nakagami Gojiro , Sanada Hiromi , Konya Chizuko , Kitagawa Atsuko , Tadaka Etsuko , Matsuyama Yutaka
Published: August 2007

Title.  Evaluation of a new pressure ulcer preventive dressing containing ceramide 2 with low frictional outer layer

Aim.  This paper is a report of an evaluation of the effectiveness of a newly developed dressing for preventing persistent erythema and pressure ulcer development and improving the water‐holding capacity without increasing the skin pH in bedridden older patients.

Background.  Shear forces and skin dryness play important roles in persistent erythema and pressure ulcer development. To eliminate these risks, we developed a dressing to reduce shear forces and improve the water‐holding capacity. However, the effects of this dressing in clinical settings remain unknown.

Method.  An experimental bilateral comparison study was conducted at a hospital in Japan in 2004 with 37 bedridden older patients at risk of pressure ulcer development. The dressing was randomly applied to the right or left greater trochanter for 3 weeks. No dressing was applied to the opposite side as a control. The skin was monitored weekly during the 3‐week application for persistent erythema and pressure ulcer development. Skin hydration and pH were also assessed during the intervention and for 1 week after dressing removal.

Findings.  The incidence of persistent erythema was significantly lower in the intervention area than the control area [P = 0·007, RR 0·18 (95% CI: 0·05–0·73) and NNT 4·11 (2·50–11·63) ]. No pressure ulcers occurred in either the intervention or control area. Skin hydration increased significantly during dressing application and remained high after removal (P < 0·001) relative to the control area. Skin pH decreased significantly during the application (P < 0·001) but returned to control levels after removal (P = 0·38).

Conclusion.  This safe and effective dressing can be used for patients with highly prominent bones and dry skin to prevent pressure ulcers.
Effects of Butafosfan on salivary cortisol and behavioral response to social stress in piglets1
Authors: VAN DER STAAY F. J. , DE GROOT J. , VAN REENEN C. G. , HOVING‐BOLINK A. H. , SCHUURMAN T. , SCHMIDT B. H.
Published: August 2007

We assessed the efficacy of Butafosfan, a component of Catosal®, in the metaphylactic treatment of stress in pigs. Four 6‐week‐old female littermates were taken from 12 litters. They were confronted with a pig from a different litter for 2 h. There were 24 pairs, each consisting of confronting two unfamiliar pigs in a new pen. This housing of unfamiliar pigs provides a good, but simple, model of the psychosocial stress that pigs experience when housed in large groups on pig farms. Immediately before being housed with an unfamiliar pig, 12 pairs of pigs were injected subcutaneously with Catosal® at a dose equivalent to 20 mg Butafosfan per kg body weight; the other 12 pairs received the control solution containing all ingredients of Catosal® except Butafosfan. The frequency and duration of aggressive behavior and the salivary cortisol response were measured during the first 2 h of the encounter. No adverse effects associated with Catosal® were observed. Subcutaneous injection of Catosal® reduced the stress‐induced salivary cortisol response and the frequency of aggressive behavior evoked by the social stress of housing two unfamiliar pigs together.
Evolutionary trend of phylogenetic diversity of nitrogen fixation genes in the gut community of wood‐feeding termites
Authors: YAMADA A. , INOUE T. , NODA S. , HONGOH Y. , OHKUMA M.
Published: August 2007

Nitrogen fixation by gut microorganisms is one of the crucial aspects of symbiosis in wood‐feeding termites since these termites thrive on a nitrogen‐poor diet. In order to understand the evolution of this symbiosis, we analysed the nitrogenase structural gene nifH in the gut microbial communities. In conjunction with the published sequences, we compared approximately 320 putatively functional NifH protein sequences obtained from a total of 19 termite samples that represent all the major branches of their currently proposed phylogeny, and from one species of the cockroach Cryptocercus that shares a common ancestor with termites. Using multivariate techniques for clustering and ordination, a phylogeny of NifH protein sequences was created and plotted variously with host termite families, genera, and species. Close concordance was observed between NifH communities and the host termites at genus level, but family level relationships were not always congruent with accepted termite clade structure. Host groups examined included basal families (Mastotermitidae, Termopsidae, Kalotermitidae, as well as Cryptocercus), the most derived lower termite family Rhinotermitidae, and subfamilies representing the advanced and highly diverse apical family Termitidae (Macrotermitinae, Termitinae, and Nasutitermitinae). This selection encompassed the major nesting and feeding styles recognized in termites, and it was evident that NifH phylogenetic divergence, as well as the occurrence of alternative nitrogenase‐type NifH, was to some extent dependent on host lifestyle as well as phylogenetic position.
A spatial analysis method (SAM) to detect candidate loci for selection: towards a landscape genomics approach to adaptation
Authors: JOOST S. , BONIN A. , BRUFORD M. W. , DESPRÉS L. , CONORD C. , ERHARDT G. , TABERLET P.
Published: August 2007

The detection of adaptive loci in the genome is essential as it gives the possibility of understanding what proportion of a genome or which genes are being shaped by natural selection. Several statistical methods have been developed which make use of molecular data to reveal genomic regions under selection. In this paper, we propose an approach to address this issue from the environmental angle, in order to complement results obtained by population genetics. We introduce a new method to detect signatures of natural selection based on the application of spatial analysis, with the contribution of geographical information systems (GIS), environmental variables and molecular data. Multiple univariate logistic regressions were carried out to test for association between allelic frequencies at marker loci and environmental variables. This spatial analysis method (SAM) is similar to current population genomics approaches since it is designed to scan hundreds of markers to assess a putative association with hundreds of environmental variables. Here, by application to studies of pine weevils and breeds of sheep we demonstrate a strong correspondence between SAM results and those obtained using population genetics approaches. Statistical signals were found that associate loci with environmental parameters, and these loci behave atypically in comparison with the theoretical distribution for neutral loci. The contribution of this new tool is not only to permit the identification of loci under selection but also to establish hypotheses about ecological factors that could exert the selection pressure responsible. In the future, such an approach may accelerate the process of hunting for functional genes at the population level.
Long distance pollen‐mediated gene flow at a landscape level: the weed beet as a case study
Authors: FÉNART STÉPHANE , AUSTERLITZ FRÉDÉRIC , CUGUEN JOËL , ARNAUD JEAN‐FRANÇOIS
Published: August 2007

Gene flow is a crucial parameter that can affect the organization of genetic diversity in plant species. It has important implications in terms of conservation of genetic resources and of gene exchanges between crop to wild relatives and within crop species complex. In the Beta vulgaris complex, hybridization between crop and wild beets in seed production areas is well documented and the role of the ensuing hybrids, weed beets, as bridges towards wild forms in sugar beet production areas have been shown. Indeed, in contrast to cultivated beets that are bi‐annual, weed beets can bolt, flower and reproduce in the same crop season. Nonetheless, the extent of pollen gene dispersal through weedy lineages remains unknown. In this study, the focus is directed towards weed‐to‐weed gene flow, and we report the results of a pollen‐dispersal analysis within an agricultural landscape composed of five sugar beet fields with different levels of infestation by weed beets. Our results, based on paternity analysis of 3240 progenies from 135 maternal plants using 10 microsatellite loci, clearly demonstrate that even if weedy plants are mostly pollinated by individuals from the same field, some mating events occur between weed beets situated several kilometres apart (up to 9.6 km), with rates of interfield‐detected paternities ranging from 11.3% to 17.5%. Moreover, we show that pollen flow appears to be more restricted when individuals are aggregated as most mating events occurred only for short‐distance classes. The best‐fit dispersal curves were fat‐tailed geometric functions for populations exhibiting low densities of weed beets and thin‐tailed Weibull function for fields with weed beet high densities. Thus, weed beet populations characterized by low density with geographically isolated individuals may be difficult to detect but are likely to act as pollen traps for pollen emitted by close and remote fields. Hence, it appears evident that interfield pollen‐mediated gene flow between weed beets is almost unavoidable and could contribute to the diffusion of (trans)genes in the agricultural landscape.
Molecular characterization and experimental host range of Euphorbia mosaic virus‐Yucatan Peninsula, a begomovirus species in the Squash leaf curl virus clade
Authors: Hernández‐Zepeda C. , Idris A. M. , Carnevali G. , Brown J. K. , Moreno‐Valenzuela O. A.
Published: August 2007

Euphorbia mosaic virus (EuMV), a tentative species within the genus Begomovirus, was isolated from Euphorbia heterophylla plants growing in the Yucatan Peninsula, Mexico. The complete bipartite genome was cloned from total DNA extracts and the nucleotide (nt) sequence was determined. The DNA‐A sequence of the EuMV‐Yucatan Peninsula (EuMV‐YP) isolate shared 95% nt identity with the partially characterized type EuMV isolate from Puerto Rico. The EuMV‐YP genome organization was like that of other New World, bipartite begomoviruses. The DNA‐A component was 2613 nt in size, while the DNA‐B component was 2602 nt long. The 165‐nt common region (CR) sequence for the DNA‐A and DNA‐B components shared a lower than expected nt identity of 86%. The organization and iterons of the putative AC1 binding site of EuMV‐YP were similar to those of begomoviruses in the Squash leaf curl virus (SLCV) clade. Characteristic disease symptoms were reproduced in E. heterophylla plants inoculated at the seedling stage using the cloned viral DNA‐A and DNA‐B components, confirming disease aetiology. Results of an experimental host‐range study for EuMV‐YP indicated that it infected at least five species in three plant families, including the Euphorbiaceae (E. heterophylla), Solanaceae (Datura stramonium, pepper, tomato) and Fabaceae (bean). Phylogenetic analysis of the DNA‐A and DNA‐B components indicated that EuMV‐YP is a New World begomovirus and that it is a new member of the SLCV clade.
Immunoassay determination of rapamycin: reliability of the method with respect to liquid chromatography mass spectrometric quantification
Authors: Pieri Maria , Capone Domenico , Gentile Antonio , Miraglia Nadia , Leo Emilo , Federico Stefano , Basile Vincenzo , Acampora Antonio
Published: August 2007

Abstract:  Immunochemical assays represent a promising tool for quantification of immunosuppressants in organ transplanted patients, because they require small sample volumes and minimum sample pre‐treatment; nevertheless considerations about method specificity, sensitivity and reproducibility cannot be overlooked. The present paper investigates the reliability of using the immunoparticle enzyme immunoassay (MEIA) for the quantification of blood rapamycin (RAPA) levels in therapeutic drug monitoring of renal transplanted patients with respect to a validated liquid chromatography tandem mass spectrometric (LC/ESI‐MSMS) method, used as reference. Linearity of MEIA was tested over the range 0.0–30.0 ng/mL, with accuracy and precision within acceptable limits. Fifty‐two blood samples were collected from 42 renal transplanted patients and analyzed simultaneously by both methods. The Pearson’s regression analysis gave the following parameters: correlation equation [RAPA]MEIA = 1.330 + 0.776 [RAPA]LC/ESI‐MSMS, r = 0.8526, SD = 1.778, p < 0.0001. The obtained average rapamycin concentration was 8.8 ± 3.4 ng/mL using MEIA and 9.6 ± 3.7 ng/mL for LC/ESI‐MSMS, with an overall underestimation of about 6% of the immunoenzymatic test. Accuracy of MEIA ranged from −33% to 36% with respect to the reference mass spectrometric method. Although immunoenzymatic test represents a fast and sufficiently accurate method for its use in clinical practice, specificity of the assay is still not sufficiently investigated and reference methods and/or Proficiency Testing Scheme should be used as external control.
Immunomodulatory constituents of human milk change in response to infant bronchiolitis
Authors: Bryan Dani‐Louise , Hart Prue H. , Forsyth Kevin D. , Gibson Robert A.
Published: August 2007

Although epidemiological evidence is generally supportive of a causal association between respiratory syncytial virus (RSV) bronchiolitis during infancy and the development of persistent wheeze/asthma, if not allergy, the mechanism by which this occurs and an explanation for why all children do not succumb remains to be elucidated. Breast feeding has been found to confer a protective effect against respiratory infections such as RSV bronchiolitis and allergy; however, again there is little direct evidence and no clear mechanism. In this study, we examined whether human milk immunomodulatory factors (cells, cytokines) change in response to clinically diagnosed, severe bronchiolitis in the recipient breast‐fed infant. We examined milk from 36 breast feeding mothers of infants hospitalized with bronchiolitis and compared them with milk from 63 mothers of postpartum age‐matched healthy controls. Milks from mothers of infants hospitalized with bronchiolitis had significantly greater numbers of viable cells when compared with the milks obtained from mothers of healthy infants (1.3 ± 0.4 vs. 0.3 ± 0.03 × 106 cells/ml, mean ± s.e.m.; p ≤ 0.001). Further, the cells obtained from the mothers of infants hospitalized with bronchiolitis were found to produce a skewed cytokine profile ex vivo in response to stimulation by live RSV but not when cultured with a non‐specific mitogen (concanavalin A). This study provides preliminary evidence for an immunological link between mothers and their breast‐fed infants during severe respiratory infections as well as a possible contributing factor to the development of persistent wheeze in these infants.
Chronic treatment of rats with sodium valproate downregulates frontal cortex NF‐κB DNA binding activity and COX‐2 mRNA1
Authors: Rao Jagadeesh S , Bazinet Richard P , Rapoport Stanley I , Lee Ho‐Joo
Published: August 2007

Objectives:  Valproic acid (VPA) is used to treat bipolar disorder, but its mechanism of action is not clear. VPA shares many cellular and molecular targets with lithium, including reducing arachidonic acid turnover in rat brain phospholipids and cyclooxygenase‐2 (COX‐2) protein level and activity in rat brain.

Methods:  We examined the effect of chronic VPA administration (200 mg/kg body weight for 30 days) to produce therapeutically relevant plasma concentrations, on transcription factors (NF‐κB, AP‐1, AP‐2, C/EBP, CREB, and ETS) that are known to regulate the COX‐2 gene.

Results:  Chronic VPA significantly increased AP‐1 DNA binding activity and decreased NF‐κB DNA binding activity, p50 subunit protein and mRNA expression of COX‐2 in frontal cortex compared with untreated control rats. It did not alter AP‐2, C/EBP, ETS or CREB DNA binding activity.

Conclusions:  VPA downregulates NF‐κB DNA binding activity, likely by decreasing the p50 protein levels. This effect may explain its downregulation of COX‐2 mRNA. The decrease in NF‐κB activity by chronic VPA may affect other NF‐κB‐regulated genes and may be related to VPA's action in bipolar disorder. Chronic VPA may decrease the reported increased brain NF‐κB components in bipolar patients.
Orbitofrontal dysfunction in a monozygotic twin discordant for postpartum affective psychosis: a functional magnetic resonance imaging study
Authors: Fahim Cherine , Stip Emmanuel , Mancini‐Marïe Adham , Potvin Stéphane , Malaspina Dolores
Published: August 2007

Background:  Incomplete concordance for psychosis in monozygotic (MZ) twins has been interpreted as indicative of non‐genetic cofactors in transmission of the illness. In this case study, we consider childbirth a landmark in the onset of psychotic symptoms, leading to the diagnosis of puerperal psychosis and then to bipolar/schizoaffective disorder. At the end of the third trimester, there is a sudden drop in estrogen, which exerts prominent effects on the serotonergic system in the orbitofrontal cortex (OFC).

Objectives:  The purpose of the present study was to investigate OFC activation during emotional processing in MZ twins discordant for affective psychosis.

Methods:  Blood‐oxygen‐level‐dependent activation using functional magnetic resonance imaging was measured during the passive viewing of emotional film excerpts.

Results:  Consistent with our hypothesis, a significant locus of activation was found in the left OFC in the normal MZ twin, but not in the psychosis MZ twin.

Conclusions:  The personality changes noted in the psychosis MZ twin (postpartum psychosis) may be related to dysfunctional OFC. Ms J's childbirth may have triggered the onset of psychotic symptoms, leading to the diagnosis of bipolar or schizoaffective disorder.
Risk of suicide attempt and suicide death in patients treated for bipolar disorder1
Authors: Simon Gregory E , Hunkeler Enid , Fireman Bruce , Lee Janelle Y , Savarino James
Published: August 2007

Objectives:  To evaluate demographic and clinical predictors of suicide attempt and suicide death in a population‐based sample of people treated for bipolar disorder (BD).

Methods:  Computerized records were used to identify 32,360 individuals treated for BD at two large prepaid health plans. Suicide attempts were identified using computerized records of outpatient visit diagnoses and hospital discharge diagnoses. Suicide deaths were identified using state death certificate data.

Results:  Overall event rates were 1.06 per 1,000 person‐years for suicide death, 5.6 per 1,000 person‐years for suicide attempt leading to hospitalization, and 13.9 per 1,000 person‐years for suicide attempt not leading to hospitalization. Men had a significantly lower rate of suicide attempt [hazard ratio (HR) 0.68, 95% confidence interval (CI) 0.56–0.83] but a higher rate of suicide death (HR 2.70, 95% CI 1.69–4.31). Suicide attempts were significantly more frequent among younger patients, but suicide deaths did not vary significantly by age. Substance use comorbidity was significantly related to risk of suicide attempt (HR 2.53, 95% CI 2.07–3.09) but not to risk of suicide death (HR 1.02, 95% CI 0.54–1.93). Comorbid anxiety disorder was associated with significantly higher risk of both suicide attempt (HR 1.40, 95% CI 1.14–1.72) and suicide death (HR 1.81, 95% CI 1.09–2.99).

Conclusions:  Among people treated for BD, risk of suicide death is significantly related to male sex and comorbid anxiety disorder. The predictors of suicide death differ markedly from predictors of suicide attempt.
Telling a story, writing a narrative: terminology in health care
Authors: Wiltshire John
Published: August 2007

Telling a story, writing a narrative: terminology in health care

This paper examines the current use of the terms ‘story’, ‘narrative’ and ‘voice’ within health care. It argues that the focus on narrative forms is related to nursing's professional development of an alternative epistemology to science, and to nursing theorists' mistrust of ‘Enlightenment’ modes. However, in order for this project to be productively developed it is necessary to distinguish story from narrative: the former is an informal activity, the latter is meditative and theoretical. Both have dierapeutic dimensions.
The art of stained glass: metaphor for the art of nursing
Authors: Hess Joanne D
Published: August 2007

The art of stained glass: metaphor for the art of nursing

The aesthetic is a way of knowing the meaning of and the meaning in the art of nursing. The art of creating stained glass offers a personal metaphor for nursing's essence; the art of caring. Both arts aim to fulfil the potential of their subjects to achieve a harmony that goes beyond their individual components. Stained glass artistry and caring in nursing require technical expertise, yet technical skill and knowledge are not the substance of either art. Both transcend space and time, and the art of stained glass and the art of nursing are influenced by the artist's/nurse's personal, social and cultural history. Just as die artisan transforms the glass and lead and is transformed in the creative moment, so does the caring transaction transform both patient and nurse. This personal reflection explores the nature of caring in nursing as mirrored by the author's work with stained glass.
Art, science and social science in nursing: occupational origins and disciplinary identity
Authors: Rafferty Anne Marie
Published: August 2007

Art, science and social science in nursing: occupational origins and disciplinary identity

This paper forms part of a wider study examining the history and sociology of nursing education in England between 1860 and 1948. It argues that the question of whether nursing was an art, science and/or social science has been at the ‘heart’ of a wider debate on the occupational status and disciplinary identity of nursing. The view that nursing was essentially an art and a ‘calling’, was championed by Florence Nightingale. Ethel Bedford Fenwick and her allies insisted that nursing, like other professions, was a ‘scientific’ and technical enterprise. Social scientists later came to challenge nursing's claim to professionalism by analysing nursing work first within the context of industrial psychology. But they also advocated a rapprochement between nursing, health services and social science research, a challenge which we are in nursing, still striving to meet This paper argues for a strong coalition of nursing with its former nineteenth century ally, social science, in the continuing struggle for change within nursing and health care policy. Rather than searching for some rarified and purified essence of nursing knowledge, it argues that nurses need to join forces with sociologists and economists in striving to shape the agenda for health services research and provide the evidential basis for health policy transformation more generally.
Nursing research and the philosophy of hermeneutics
Authors: Draper Peter
Published: August 2007

This paper explores some of the implications of hermeneutic philosophy for nursing research. Using illustrative material from recent research into the quality of life of older people in nursing homes, the paper shows that hermeneutics provides a perspective from which to examine the literature, and which guides both the collection and interpretation of data. The paper may be of interest to all scholars interested in the relationship between hermeneutics and the methods of social and nursing research.
Vietnam memories: Australian Army Nurses, the Vietnam War, and oral history
Authors: Hemmings Lynn
Published: August 2007

This paper is about women nurse veterans from the Royal Australian Army Nursing Corps (RAANC) who served in Vietnam. I aim to develop an understanding about these nurses that might place their experiences into a wider context. My conclusions provide starting points for future studies on myth, remembering and oral history.
The nurse researcher: an added dimension to qualitative research methodology
Authors: Gardner Glenn
Published: August 2007

Nurse researchers are increasingly adopting qualitative methodologies for research practice and theory development. These approaches to research are, in many cases, more appropriate for die field of nursing inquiry than the previously dominant techno‐rational methods. However, there remains the issue of adapting methodologies developed in other academic disciplines to the nursing research context. This paper draws upon my own experience with interpretive research to raise questions about the issue of nursing research within a social science research framework. The paper argues that by integrating the characteristics of nursing practice with the characteristics of research practice, the researcher can develop a ‘nursing lens’, an approach to qualitative research that brings an added dimension to social science methodologies in the nursing research context. Attention is drawn to the unique nature of the nurse‐patient relationship, and the ways in which this aspect of nursing practice can enhance nursing research. Examples are given from interview transcripts to support this position.
Manuscript reviewing: too long a concealed form of scholarship?
Authors: Emden Carolyn
Published: August 2007

Reviewing manuscripts prior to publication is an increasingly time consuming activity for many professionals. This paper proposes that reviewing is a significant form of scholarship that deserves more overt attention, and an increased level of sharing among reviewers on their unique approach to the task. A review of relevant literature reveals a range of reviewing procedures and practices among journals, some of which are relatively novel within nursing. Research is reportedly scant on the topic, and the research that has been undertaken shows that the best reviewers are not necessarily the most senior; indeed the more senior and busy the reviewer, the more likely the review shall be superficial and hasty. Within this paper I include a personal approach to reviewing that draws upon the thinking of Richard Bernstein and promotes a ‘conversational’—as apposed to an ‘adversarial’—style.
Reviewing Foucault: possibilities and problems for nursing and health care
Authors: Cheek Julianne , Porter Sam
Published: August 2007

This paper addresses Foucauldian theory and its usefulness to nursing research. It is written in the form of a discussion between the authors on the merits and liabilities of Foucauldian theory as applied to analyses of nursing. As such, it focuses upon some of the more pertinent critiques of both Foucauldian and postmodern theory. By addressing Foucault from two different positions, the discussion seeks to demonstrate the complexity of Foucauldian theory and warns against oversimplification in its application to nursing research. The authors also argue for an awareness of the strengths and weaknesses of any given theoretical stance.
Multicultural health care: reconciling universalism and particularism
Authors: Fuller Jeff
Published: August 2007

Multicultural health care: reconciling universalism and particularism

One of the issues of concern in multicultural health care is the degree to which one universal (or mainstream) service can meet the needs of all groups and the extent to which specialist (or ethno‐specific) services are required to meet the needs of particular groups. In order to advance debate on this issue, multiculturalism is examined against concepts of identity, equality, bureaucracy and participation. While the appeal of universal healthcare services is that they appear to deliver equal healdi care to all, they in fact systematically advantage diose whose values most closely fit widi die dominant social norms. Altiiough ethnic‐specific services may overcome diis problem, in that they enable ‘tailor‐made’ care, it is unlikely that diey would be able to meet all of the healdi needs of all people from edinic minorities, especially in locations where numbers are low. Ethnic minority participation in the processes of the healdi system is proposed as a way for die universal health system to reconcile die need to treat people equally (universalism), but in accordance witii dieir unique and different needs (particularism).
Transcultural nursing and a care management partnership project
Authors: Lazure Ginette , Vissandjée Bilkis , Pepin Jacinthe , Kérouac Suzanne
Published: August 2007

Transcultural nursing and a care management partnership project

This paper aims to illustrate how Leininger's Theory of Culture Care Diversity and Universality has influenced the research process of a study that emerged from a care management partnership between Canadian nursing teachers and Tunisian nurses. The purpose of the study was to investigate the meanings of care as viewed by university hospital‐based Tunisian nurses. The qualitative analysis of data gathered through observation‐participation and interviews highlights recurrent patterns and reveals three major professional care themes. For Tunisian nurses care means to secure the patient's cooperation towards the medical regimen within established rules in die hospital; to contribute to curing the patient by using current technology as well as by maintaining their technical skills and improving their medical knowledge; to take charge of the patient to assist the physician in treating disease. This study showed that Tunisian nurses emphasize curing rather than widely shared community values such as interdependence, intercommunication, understanding, presence and responsibility for odiers. Discussion of die study's findings draws upon the perspective provided by Freire's Oppressed Group Theory. In order to promote cultural congruence within the Care Management Partnership Project in Tunisia, the tfiree predicted modes of care within Leininger's theory guide die decisions and actions for future nursing research and partnership activities.
Gestures of resistance: the nurse's body in contested space
Authors: Savage Jan
Published: August 2007

Gestures of resistance: the nurse's body in contested space

This paper is based on a one‐year ethnographic study that focused on nurse‐patient relationships on a ward where therapeutic nursing and professional autonomy were explicit nursing goals. Through participant observation and semi‐structured interviews, it was found that nurses, as a team, adopted a highly relaxed form of posture. Their informal and open stance served to emphasize their ‘closeness’ with patients, supporting nurses' claim of a special role in the healthcare team, and making flesh some of the differences between nursing and medical roles. The interpretation of nurses' bodily practice rested in part on the meanings given to the ward space: patients felt the ward to be a private domain in which nurses' informality endorsed their sense of being cared for as if by family, while for medical staff the ward remained a public space in which female nurses tacitly challenged their authority as men through the adoption of a masculine bodily praxis. The paper thus looks at links between the gendered body, the gendered professions of medicine and nursing, and the gendered nature of space. It argues that work on occupational closure has previously privileged the discursive, and suggests that understanding how nurses arbitrate professional boundaries in everyday practice will benefit from consideration of the nurse's body as a point of political resistance.
Definitions of oppression
Authors: G. LeBlanc Raeann
Published: August 2007

Definitions of oppression

How we begin to serve others as healthcare professionals and how it is we define underserved and oppressed peoples is important in understanding issues in the organization and allocation of health care. This exploration, based on feminist post‐structuralist theory, explores how nurses formulate definitions of 'underserved' and 'vulnerable'. This study goes beyond prescribed definitions to locate meanings used to identify oppression. I present, through an analysis of a literature search, the context and construction of the terms 'vulnerable population' and 'medically underserved'. Professional nursing journals are the source of relevant text. The implications of working with particular understandings of the terms 'vulnerable' and 'underserved' is based on my assumption that healthcare providers need to critically focus on the personal and political meanings they attribute to the labels used to define the clients and communities with whom they work. The presentation of this material supports that the way we define 'vulnerable' and 'underserved' is related to how our work fighting racism, ageism, AIDS, poverty, homophobia, addiction, domestic violence, sexism and colonization is realized.
CONFERENCE REVIEWS
Authors: Omeri Akram
Published: August 2007

Transcultural Nursing: Global Unifier of Care, Facing Diversity with Unity
Sairey Gamp: generating fact from fiction
Authors: Summers Annette
Published: August 2007

Australian midwives today are generally employed by maternity hospitals as obstetric or maternity nurses and specialize in only one area of the childbirthing process, under die umbrella of medicine. This is quite different to the provision of midwifery care in die nineteendi and early twentiedi centuries in Australia, when childbirthing took place widiin a home setting, widi a community midwife in attendance under die umbrella of die household. Australian midwives are now attempting to regain some of die autonomy diat diey believe was possessed by midwives of die past by being professionally accredited to operate as independent midwives. The de‐institutionalization of childbirthing cannot simply come about by giving midwives accreditation to operate as autonomous practitioners, as the forces diat led society to institutionalize child‐birdiing practices, as well as die avenues for change, are complex. This paper examines one of the forces behind diat change: the denigration of the image of the community midwife by the medical and nursing professions, through the character of Sairey Gamp created by Charles Dickens. By examining die historical terrain and the historical influences that led to the demise of the community midwife, we can provide answers for debate on the present status of the midwife.
Postmodern feminist emancipatory research: is it an oxymoron?
Authors: Fahy Kathleen
Published: August 2007

Many nurse‐researchers who use feminist methods believe that postmodernism undermines die scientific and emancipatory aspirations of our discipline and diey are dierefore wary of postmodern dieories. One of die main direats of postmodernism is die critique of humanism because humanism forms the ediical foundation for both nursing and feminism. These critiques expose die dark underside of humanistic ideals and show how, paradoxically, humanism has functioned to oppress people. The arguments presented here help emancipatory researchers to defend dieir practices, bodi in relation to research participants and in die ways in which die subject is dieorized. The conclusion is diat postmodernism can be compatible widi politically motivated, humanistically‐based inquiry.
Heideggerian phenomenology: an approach to understanding family caring for an older relative
Authors: Kellett Ursula Marie
Published: August 2007

Recent research has found diat family caregivers do not discuss their caregiving in terms of tasks but instead describe their care as shaped by concerns, commitments and goals. The purpose of this paper is to challenge the ways in which nurses approach die family caregiving process and to explore possibilities for evolving nursing knowledge by questioning existing practice in die light of developing insight into die ways in which being a family caregiver is meaningful. A critique of die philosophical orientations of rationalism and empiricism provides a platform to discuss the merits of a Heideggerian phe‐nomenological approach in assisting nurses to better understand family caring experience. Such critique serves to support the notion of displacing die traditional scientific view as die prime means of disclosing trudi, acknowledging alternative ways of knowing.
Clinical outcome of surgical management for patients with renal cell carcinoma involving the inferior vena cava
Authors: Terakawa Tomoaki , Miyake Hideaki , Takenaka Atsushi , Hara Isao , Fujisawa Masato
Published: August 2007

Background:  The objective of this study was to evaluate the clinical outcome after surgical management of renal cell carcinoma (RCC) extending to the inferior vena cava (IVC).

Methods:  This study included a total of 55 patients (41 men and 14 women; mean age, 59.3 years) with RCC (39 right‐ and 16 left‐sided tumors) involving the IVC, who underwent radical nephrectomy and tumor thrombectomy between 1983 and 2005 at a single institution in Japan. The level of thrombus was classified as follows: level I, infrahepatic; level II, intrahepatic; level III, suprahepatic; and level IV, extending to the atrium. Clinicopathological data from these patients were retrospectively reviewed to identify factors associated with survival.

Results:  There were 11 and 18 patients who were diagnosed as having lymph node and distant metastases, respectively. Twenty‐two patients had tumor thrombus in level I, 20 in level II, 10 in level III, and 3 in level IV. Pathological examinations demonstrated that 34 and 21 patients had clear cell carcinoma and non‐clear cell carcinoma, respectively, 42, 9 and 4 were pT3b, pT3c and pT4, respectively, and 6, 35 and 14 were Grades 1, 2 and 3, respectively. Cancer‐specific 1‐, 3‐ and 5‐year survival rates of these 55 patients were 74.5%, 51.4% and 30.3%, respectively. Among several factors examined, clinical stage (P = 0.047), lymph node metastasis (P = 0.016), histological subtype (P = 0.034) and tumor grade (P < 0.001) were significantly associated with cancer‐specific survival by univariate analysis. Furthermore, multivariate analysis demonstrated clinical stage (P = 0.037) and tumor grade (P < 0.001) as independent predictors of cancer‐specific survival irrespective of other significant factors identified by univariate analysis.

Conclusions:  In patients with RCC involving the IVC, biological aggressiveness characterized by tumor grade rather than tumor extension would have more potential prognostic importance; therefore, more intensive multimodal therapy should be considered in patients with high grade RCC with tumor thrombus extending into the IVC.
Intravenous extended liposarcoma arising from renal sinus
Authors: Matsushita Mabumi , Ito Akihiro , Ishidoya Shigeto , Endoh Mareyuki , Moriya Takuya , Arai Yoichi
Published: August 2007

Abstract:  Liposarcoma arising from the renal sinus is rare and there have been no reports of intravenous extended liposarcoma of the renal sinus thus far. We report a case of liposarcoma of the renal sinus that extended into the renal venous lumen. A 58‐year‐old woman was referred to our hospital for an intravascular fatty tumor of the right renal vein incidentally discovered by an abdominal screening ultrasonogram. Computer tomography revealed a fatty tumor extending from the right kidney to the right renal vein with no evidence of metastatic lesions. Total right nephrectomy and extirpation of the intravascular tumor of the right renal vein were carried out. Pathological findings showed well‐differentiated liposarcoma of the renal sinus. The tumor invaded to the right renal vein and the renal parenchyma.
Cortistatin promotes and negatively correlates with slow‐wave sleep
Authors: Bourgin Patrice , Fabre Véronique , Huitrón‐Reséndiz Salvador , Henriksen Steven J. , Prospero‐Garcia Oscar , Criado José R. , De Lecea Luis
Published: August 2007

Sleep need is characterized by the level of slow‐wave activity (SWA) and increases with time spent awake. The molecular nature of this sleep homeostatic process is practically unknown. Here, we show that intracerebroventricular administration of the neuropeptide, cortistatin (CST‐14), enhances EEG synchronization by selectively promoting deep slow‐wave sleep (SWS) during both the light and dark period in rats. CST‐14 also increases the level of slow‐wave activity (SWA) within deep SWS during the first two hours following CST‐14 administration. Steady‐state levels of preprocortistatin mRNA oscillate during the light : dark cycle and are four‐fold higher upon total 24‐h sleep deprivation, returning progressively to normal levels after eight hours of sleep recovery. Preprocortistatin mRNA is expressed upon sleep deprivation in a particular subset of cortical interneurons that colocalize with c‐fos. In contrast, the number of CST‐positive cells coexpressing pERK1/2 decreases under sleep deprivation. The capacity of CST‐14 to increase SWA, together with preprocortistatin's inverse correlation with time spent in SWS, suggests a potential role in sleep homeostatic processes.
Aldolase C‐positive cerebellar Purkinje cells are resistant to delayed death after cerebral trauma and AMPA‐mediated excitotoxicity
Authors: Slemmer Jennifer E. , Haasdijk Elize D. , Engel Doortje C. , Plesnila Nikolaus , Weber John T.
Published: August 2007

The cerebellum has been shown to be vulnerable to global ischemic damage in tightly controlled zones of Purkinje cells (PCs) that lack aldolase C, an enzyme critical for glycolysis. Here, we investigated whether aldolase C‐negative PCs were more likely to die after cerebral trauma in vivo, and whether this death was mediated by excitotoxic [α‐amino‐3‐hydroxy‐5‐methylisoxazole‐4‐propionic acid (AMPA)‐mediated] means in vitro. Mice were subjected to controlled cortical impact, or remained uninjured, and were killed at 6 h, 24 h or 7 days after injury. Cerebellar sections (both ipsilateral and contralateral to the site of cerebral injury) were stained against aldolase C and calbindin (a marker of PCs). The number of viable, calbindin‐positive PCs decreased significantly at 24 h and 7 days after injury, and the percentage of surviving, aldolase C‐positive PCs significantly increased at those time‐points. In addition, we subjected murine cerebellar cultures to AMPA (30 µm, 20 min), which killed a significant number of PCs at 24 h post‐treatment. A similar number of PCs was lost after transfection with aldolase C siRNA, and this effect was exacerbated in transfected cultures treated with AMPA. The results from the present study indicate that aldolase C provides marked neuroprotection to PCs after trauma and excitotoxicity.
D1‐ and D2‐like dopamine receptors regulate signaling properties of group I metabotropic glutamate receptors in the rat globus pallidus
Authors: Poisik Olga V. , Smith Yoland , Conn P. Jeffrey
Published: August 2007

Dopamine is essential to the proper functioning of basal ganglia (BG) because loss of dopaminergic input profoundly alters the activity of these nuclei. Experimental evidence suggests that multiple aspects of glutamatergic neurotransmission in the BG are altered with the loss of dopaminergic input. Using whole‐cell patch‐clamp recording in rat brain slices, we examined whether activity of dopamine receptors is necessary to maintain signaling properties of group I metabotropic glutamate receptor subtypes, mGluR1 and 5, in the rat globus pallidus (GP), one of the nuclei in the BG circuit. Dopaminergic depletion due to systemic treatment with reserpine caused a change in the signaling properties of group I mGluRs, where mGluR1 lost the ability to depolarize GP neurons, while mGluR5 gained such ability. Bath‐application of dopamine or D1‐ and D2‐like dopamine receptor agonists to slices from reserpinized rats partly reversed these effects and caused mGluR1 to gain back its ability to depolarize GP neurons. On the other hand, stimulation of either D1‐like or D2‐like dopamine receptors was sufficient to abolish the activating properties of mGluR5 acquired following reserpine treatment. Interestingly, inhibition of protein kinase A activity alone was sufficient to largely reverse plasticity in function of group I mGluRs that was induced by reserpine treatment. Our data reveal that specific roles of group I mGluRs in the GP depend on the activity of D1‐like and D2‐like dopamine receptors, further corroborating the importance of dopamine in maintaining proper glutamatergic neurotransmission in the BG.
Results of a nationwide prospective audit of stoma complications within 3 weeks of surgery
Authors: Cottam J. , Richards K. , Hasted A. , Blackman A.
Published: August 2007

Objective  Actuarial analysis of stoma complications (problematic stomas) is lacking. The objectives of this audit were: to identify the incidence of stoma complications within the UK; to highlight any dissimilarity of incidence from centre to centre; to ascertain if the height of the stoma (distance of stoma lumen from the skin) at the time of fashioning is a predisposing factor to problems; and finally to initiate much needed research.

Method  Commencing 1st January 2005, stoma care services nationwide (256) were invited to audit prospectively their next 50 enteric stomas or for a period of 1  year which ever came first. The definition of a problematic stoma being one, which needed one or more accessories to keep the patient clean and dry for a minimum period of 24 h. The incident is to have happened within 3 weeks of surgery. Factors taken into account were: type of stoma, height of stoma within 48 h of surgery; emergency or elective procedure, problem identified, BMI, gender and underlying diagnosis of the patient. The identities of the participating centres are confidential.

Results  Of the 256 hospital‐based stoma care services within the UK, 93 (36%) participated. A total of 3970 stomas were recorded, of which 1329 (34%) were identified as problematic. Sixty‐two centres reported 45–50 stomas with a range of complications 6–96%. The loop ileostomy was found to be the stoma which causes most problems. A stoma of <10 mm is a predisposing factor to complications and problems are more likely to occur following an emergency procedure. More men than women have stomas formed, but have significantly fewer problems and there is no significant difference between underlying diagnoses.

Conclusion  The stoma height, stoma type and gender of the patient are significant risk factors identified in this audit. The BMI of patient did not affect the outcome. Patients undergoing an emergency procedure are more likely to have a problematic stoma. The significant variation of complications from centre to centre indicates surgical technique as being the key factor in stoma formation and subsequent quality of life for the patient.