bluuebunny/crossref_metadata_2025_split huggingface dataset:
Online discussions develop students’ clinical reasoning skills during fieldwork
Authors: Scanlan Justin Newton , Hancock Nicola 
Published: August 2010

Aim:  Pilot study to examine if the addition of a structured framework improved the quality of clinical reasoning demonstrated within clinically based online discussions by occupational therapy students undertaking fieldwork.Methods:  Cognitive elements of the clinical reasoning process present within students’ discussions were compared before (2005 cohort) and after (2007 cohort) the introduction of a structured framework to guide discussions. Students’ self reports (2007 cohort) of clinical reasoning skills were also analysed before and after two consecutive fieldwork placements.Results:  The structured framework increased the proportion of postings containing the advanced ‘evaluate’ element of clinical reasoning and decreased the proportion of postings containing only the basic ‘understand’ elements. Self‐reported clinical reasoning skills improved following the first fieldwork placement and this improvement was sustained following the second placement.Conclusions:  The structured framework appears useful in enhancing students’ depth of clinical reasoning during fieldwork, although further investigation is required.
Recombinant human factor VIIa‐induced alterations in tissue factor and thrombomodulin in patients with advanced liver cirrhosis
Authors: VAN THIEL DAVID H , FARR DEBORAH E , MINDIKOGLU AYSE L , TODO AKIRA , GEORGE MAGDALENE M 
Published: August 2010

AbstractBackground:  Recombinant human factor VIIa (rhFVIIa) is used to treat hemophilia and occasionally individuals with liver disease. The aim of the present study was to investigate the consequences of rhFVIIa in individuals with advanced liver disease in an attempt to understand the mechanism of action of rhFVIIa in this unique population.Methods:  Levels of plasma tissue factor, plasminogen activator inhibitor‐1, tissue factor pathway inhibitor, fibrin split products, d‐dimers and free thrombomodulin were measured following the administration of rhFVIIa in 17 subjects. The results were compared to normal controls.Results:  The prothrombin time declined from 20.2 ± 2.8 s to 14.3 ± 3.9 s (P < 0.01). No change in the activated partial thromboplastin time occurred. A 15.6% reduction in thrombomodulin was observed (P < 0.05). A mean 75.2% reduction in plasma tissue factor occurred (P < 0.01). Tissue factor pathway inhibitor levels declined to less than the control value (P < 0.05). No changes in plasminogen activator inhibitor‐1, fibrin split products or d‐dimer levels occurred.Conclusions:  These data demonstrate that rhFVIIa administration to individuals with liver disease results in (i) a transient improvement in the prothrombin time; (ii) no change in the activated partial thromboplastin time; and (iii) a marked reduction in the levels of thrombomodulin and tissue factor. These data suggest that rhFVIIa binds tissue factor and enhances tissue factor and thrombomodulin clearance from the circulation.
Possible contribution of prior hepatitis B virus infection to the development of hepatocellular carcinoma
Authors: TANAKA HIRONORI , IWASAKI YOSHIAKI , NOUSO KAZUHIRO , KOBAYASHI YOSHIYUKI , NAKAMURA SHIN‐ICHIRO , MATSUMOTO EIJI , TOSHIKUNI NOBUYUKI , KANEYOSHI TOSHIHIKO , OHSAWA TOSHIYA , TAKAGUCHI KOUICHI , FUJIO KOZO , SENOH TOMONORI , OHNISHI TOHRU , SAKAGUCHI KOHSAKU , SHIRATORI YASUSHI 
Published: August 2010

AbstractBackground:  The prevalence of prior hepatitis B virus (HBV) infection in hepatocellular carcinoma (HCC) patients and its role in hepatocarcinogenesis are not clear. The aim of the present study is to clarify the importance of prior HBV infection in development of HCC.Methods:  Of 1288 consecutive HCC patients between January 1999 and October 2002, 1008 patients were enrolled. To determine the influence of prior HBV infection in hepatitis B surface antigen (HBsAg)‐negative HCC, the prevalence of antibody to hepatitis B core antigen (anti‐HBc) was examined according to age, and the clinical features were compared between the anti‐HBc positive and the negative groups.Results:  The proportion of HBsAg‐negative HCC patients, HCC patients with antibody to hepatitis C virus (anti‐HCV; C‐HCC) and HCC patients negative for both HBsAg and anti‐HCV (nBnC‐HCC), increased with age. The anti‐HBc‐positive rates in C‐HCC patients also increased with age. Those rates in nBnC‐HCC patients were >50% in all age groups. Furthermore, it was found that the anti‐HBc‐positive rates of these patients were higher than those of corresponding control patients. Tumor size and a positive rate for vessel involvement both in C‐HCC and nBnC‐HCC patients were larger and higher, respectively, in anti‐HBc‐positive patients compared with anti‐HBc‐negative patients, although the difference in nBnC‐HCC did not reach statistical significance because of the small numbers. These tumor characteristics were similar to those of B‐HCC patients.Conclusion:  A possible contribution of prior HBV infection to the development of HCC is indicated.
Camostat, an oral trypsin inhibitor, reduces pancreatic fibrosis induced by repeated administration of a superoxide dismutase inhibitor in rats
Authors: EMORI YASUYUKI , MIZUSHIMA TAKAAKI , MATSUMURA NAOKI , OCHI KOJI , TANIOKA HIROAKI , SHIRAHIGE AKINORI , ICHIMURA MITSUKO , SHINJI TOSHIYUKI , KOIDE NORIO , TANIMOTO MITSUNE 
Published: August 2010

AbstractBackground and Aim:  An oral trypsin inhibitor, camostat (CM), has a beneficial effect on chronic pancreatitis, but its mechanism is not yet fully understood. Recently, pancreatic stellate cells (PSC) have been reported to play an essential role in pancreatic fibrosis. An experimental model of pancreatic fibrosis induced by a superoxide dismutase (SOD) inhibitor (diethyldithiocarbamate [DDC]) was developed in rats. Thus, the effect of an oral trypsin inhibitor on pancreatic fibrosis and PSC was investigated.Methods:  Pancreatic fibrosis was induced in rats using DDC (DDC rats). DDC + CM rats were administered DDC, and subsequently were fed a diet containing CM. Immunohistochemistry of the pancreas was performed with monoclonal anti‐α‐smooth muscle actin (α‐SMA) antibody and anti‐desmin antibody.Results:  The DDC rats showed a significant increase in α‐SMA‐positive cells or desmin‐positive cells compared with control rats. These significant increases in the fibrotic area improved after treatment with CM. The level of prolyl hydroxylase in the pancreas, which significantly increased as a result of DDC, decreased after treatment with CM.Conclusion:  Camostat has a beneficial effect on pancreatic fibrosis induced by the administration of a SOD inhibitor, which inhibits the proliferation and activation of PSC.
Gastrobiliary motility is not coordinated in patients with non‐ulcer dyspepsia of normal gastric emptying time: Simultaneous sonographic study
Authors: MIZUSHIMA TAKAAKI , SAWA KIMINARI , OCHI KOJI , TANIOKA HIROAKI , WAKUTA AKIKO , MATSUSHITA KOKI , SHIRAHIGE AKINORI , KIURA KATSUYUKI , TANIMOTO MITSUNE , KOIDE NORIO , HARADA HIDEO 
Published: August 2010

AbstractBackground:  Disorders of the motor function of the upper gastrointestinal tract have been implicated in the pathogenesis of non‐ulcer dyspepsia. Approximately 50% of patients with abdominal symptoms (without ulcer) have normal gastric emptying. Apart from gastric emptying, other mechanisms are very important in the etiology of non‐ulcer dyspepsia.Methods:  Gastric emptying and gallbladder motility were simultaneously investigated in 16 patients with non‐ulcer dyspepsia and in 15 healthy controls. Fasting blood samples were taken, and pepsinogen levels were assayed.Results:  Gastric emptying time, fasting antral diameter, and post‐prandial antral diameter were not significantly different between the patients with non‐ulcer dyspepsia and the controls. Fasting gallbladder volume, the time required to reach minimal gallbladder residual volume, minimal gallbladder residual volume, and the serum levels of pepsinogen were not significantly different. Simple linear regression was used to summarize the relationship between gastric emptying time and time required to reach minimal gallbladder residual volume. In the controls, the gastric emptying time and time required to reach minimal gallbladder residual volume were linearly related. However, in the patients with non‐ulcer dyspepsia, they were not related.Conclusions:  These observations suggest that disturbance of coordination between gastric emptying and gallbladder emptying is a cause of the symptoms of non‐ulcer dyspepsia.
Pilot study using transcutaneous electrical stimulation (interferential current) to treat chronic treatment‐resistant constipation and soiling in children
Authors: CHASE JANET , ROBERTSON VAL J , SOUTHWELL BRIDGET , HUTSON JOHN , GIBB SUSIE 
Published: August 2010

AbstractBackground:  Chronic constipation in children may have organic or behavioral causes. The purpose of the present study was to investigate the effect of treatment with transcutaneous electrical stimulation (using interferential current) in children with chronic treatment‐resistant constipation with proven organic disorders.Methods:  Eight children (7–16 years) with at least 4 years of chronic treatment‐resistant constipation and soiling, who had failed diet, laxative treatment and behavioral therapy were given 1 month of transcutaneous electrical stimulation. The three most severe cases had appendicostomies with antegrade washouts every 2–3 days to prevent impaction and reduce their soiling. Children and carers kept a daily diary of bowel habits, recording number of spontaneous defecations, episodes of soiling, use of bowel washouts and medications. Transcutaneous stimulation using interferential current was applied three times per week for 3–4 weeks using four surface electrodes, two to the paraspinal area of T9–10 to L2 and one to either side of the anterior abdominal wall beneath the costal margin. Diaries were recorded for 1 month before, during, and after stimulation and for 2 weeks 3 months later.Results:  Transcutaneous electrical stimulation using interferential current stopped soiling in 7/8 children and increased the frequency of spontaneous defecations in 5/8. Defecations remained high and soiling low for 3 months in 3/6 children (with data).Conclusions:  These results suggest that transcutaneous electrical stimulation using interferential current has a beneficial effect for children with chronic treatment‐resistant constipation. Further trials using larger series of patients are needed to confirm this benefit, to determine the ideal stimulation parameters and to investigate why electrical stimulation might be effective.© 2005 Blackwell Publishing Asia Pty Ltd
The importance of metabolic factors for the increasing prevalence of fatty liver in Shanghai factory workers
Authors: Fan Jian‐Gao , Li Feng , Cai Xiao‐Bo , Peng Yong‐De , Ao Qing‐Hong , Gao Yan 
Published: August 2010

AbstractBackground and Aim:  To evaluate changes in the prevalence rates of ultrasonographic fatty liver (FL) in a specific population.Methods:  An analysis of the medical records of BaoSteel Group (Shanghai, China) employees was done to evaluate the prevalence of FL in this population, in which health examinations were performed biennially between 1995 and 2002.Results:  The study reviewed a database of 59 131 employees, of which 27.1% received medical check‐ups four times within the study period, 26.6% three times, and 24.0% twice. The prevalence rates of obesity and metabolic disorders were high at baseline and increased significantly with time. The prevalence of ultrasonographic FL increased from 3.87% to 14.04% in the overall population, while there was an increase from 4.44% to 14.64% in men and 1.56% to 11.37% in women over the 6‐year study period. Increased rates of FL were also noted, from 25.88% to 51.39%, among patients with elevated serum alanine aminotransferase (ALT) levels (>40 U/L). The highest overall prevalence rates of FL were found in individuals aged 50–60 years, with all age‐associated prevalence significantly higher in males than females.Conclusion:  The prevalence of FL increased rapidly over the study period with increased rates of obesity and metabolic disorders; FL is becoming a major cause of abnormal ALT levels in the specific population.
Dignity in health‐care: a critical exploration using feminism and theories of recognition
Authors: Aranda Kay , Jones Andrea 
Published: August 2010

ARANDA K and JONES A.Nursing Inquiry2010;17: 248–256 Dignity in health‐care: a critical exploration using feminism and theories of recognitionGrowing concerns over undignified health‐care has meant the concept of dignity is currently much discussed in the British National Health Service. This has led to a number of policies attempting to reinstate dignity as a core ethical value governing nursing practice and health‐care provision. Yet these initiatives continue to draw upon a concept of dignity which remains reliant upon a depoliticised, ahistorical and decontexualised subject. In this paper, we argue the need to revise the dignity debate through the lens of feminism and theories of recognition. Postmodern feminist theories provide major challenges to what remain dominant liberal approaches as they pay attention to the contingent, reflexive, and affective aspects of care work. Theories of recognition provide a further critical resource for understanding how moral obligations and responsibilities towards others and our public and private responses to difference arise. This re‐situates dignity as a highly contested and politicised concept involving complex moral deliberations and diverse political claims of recognition. The dignity debate is thus moved beyond simplistic rational injunctions to care, or to care more, and towards critical discussions of complex politicised, moral practices infused with power that involve the recognition of difference in health‐care.
From ‘part of ’ to ‘partnership’: the changing relationship between nurse education and the National Health Service
Authors: Gillett Karen 
Published: August 2010

GILLETT K . Nursing Inquiry 2010; 17: 197–207 From ‘part of ’ to ‘partnership’: the changing relationship between nurse education and the National Health ServiceWorldwide, many countries have moved towards incorporating nurse education into the higher education sector and this inevitably has implications for the relationship between nurse education providers and local health service providers. This study explores the changes to the relationship in the UK between nurse education providers and the UK National Health Service over the past 20 years and demonstrates how two political ideologies have been central to those changes. The two ideologies of interest are the introduction of internal markets to the National Health Service by the Conservative government at the end of the 1980s and the New Labour response to the fragmentation of public services caused by Conservative neoliberal policy, which was to introduce the notion of ‘partnership working’. This study reviews the wider debate around partnership policy and applies that debate to evaluate the way that nurse education providers and the National Health Service are working in partnership to provide clinical practice placements for nursing students.
INTEGRATION OF PROSPECTIVE QUALITY OF LIFE AND NUTRITIONAL ASSESSMENT AS ROUTINE COMPONENTS OF MULTIDISCIPLINARY CARE OF PATIENTS WITH HEAD AND NECK CANCER
Authors: Oates Justine , Clark Jonathan R. , Read Jane , Reeves Nicole , Gao Kan , O’Brien Christopher J. 
Published: August 2010

Background:  Quality of life (QOL) and nutritional assessment of patients with head and neck cancer can provide additional information about the effects of treatment beyond the standard measures of disease control and survival. Integrating a prospective evaluation program into a multidisciplinary service may ensure that a more holistic model of care is developed.Methods:  Prospective evaluation of QOL and nutrition before and after treatment for head and neck cancer was implemented in 2001. All patients enrolled in the program were treated with curative intent. Patients completed the European Organisation for Research and Treatment of Cancer Core QOL Questionnaire and Head and Neck Specific Module before treatment and at 3, 6 and 12 months after completion of therapy. In conjunction, patients underwent nutritional assessment by body mass index, biochemical parameters and the patient‐generated subjective global assessment tool.Results:  Among 288 patients who consented to participate in this study, 134 patients completed the QOL assessment criteria and were eligible for evaluation. Examples of QOL and nutritional data for patients with cancers of the oral cavity, oropharynx, nasopharynx, larynx, hypopharynx, parotid gland and paranasal sinus, and also unknown primary cancers are given. Implementation of this prospective assessment program required appropriate resources and was hampered by time constraints, logistics with blood tests and patient compliance.Conclusions:  Despite difficulties with implementation, the information concerning QOL and nutritional status obtained in this study provided an appreciation of the long‐term functional effects of treatment for head and neck cancer. Prospective QOL assessment and nutritional evaluation should become integral components of the care of patients with cancers of the head and neck.
Achieving quality in colonoscopy: bowel preparation timing and colon cleanliness
Authors: Athreya Prasad J. , Owen Gareth N. , Wong Shing W. , Douglas Philip R. , Newstead Graham L. 
Published: August 2010

AbstractBackground:  Colonoscopy is considered the gold standard for investigation of large bowel pathology. Numerous factors influence the efficacy of bowel preparation for colonoscopy. Inadequate bowel preparation can lead to missed pathology. Timing of fasting and bowel preparation, timing of procedure and possibly patient bowel habit and presence of diverticula may have an influence on the quality of the preparation. The aim of this study was to investigate the quality of cleansing of sodium picosulfate (Picoprep‐3™, Pharmatel Fresenius Kabi Pty Ltd, Pymble, NSW, Australia) with different administration schedules and to evaluate whether patient's bowel patterns influence the quality of cleansing.Methods:  Three hundred twenty‐five patients (175 morning and 150 afternoon procedures) were interviewed prior to colonoscopy to evaluate bowel habit and timing of preparation administration. Quality of cleansing was then assessed during colonoscopy using a 5‐point scale. Further factors analysed included the patient's prior bowel habit and the presence of diverticula at colonoscopy. Procedural end points evaluated included procedure total time, caecal intubation time and withdrawal times.Results:  The quality of cleansing for individual bowel segments was worse for afternoon procedures (P < 0.05 for some segments) and for patients with prior constipation (P < 0.05 for descending colon segments). Caecal intubation times were shorter for patients with diarrhoea and longer for female patients, who also had shorter withdrawal times. No correlation was found between the procedural end points (total duration, caecal intubation time and withdrawal times) and the timing of fasting.Conclusions:  Quality of cleansing is significantly improved when bowel preparation is taken entirely the day prior to colonoscopy. Patients with prior constipation demonstrated poorer cleansing.
Polymorphism and recombination for rDNA in the putatively asexual microsporidian Nosema ceranae, a pathogen of honeybees
Authors: Sagastume Soledad , del Águila Carmen , Martín‐Hernández Raquel , Higes Mariano , Henriques‐Gil Nuno 
Published: August 2010

Summary Nosema ceranae is currently one of the major pathogens of honeybees, related to the worldwide colony losses phenomenon. The genotyping of strains based on ribosomal DNA (rDNA) can be misleading if the repeated units are not identical. The analysis of cloned rDNA fragments containing the intergenic spacer (IGS) and part of the rDNA small‐subunit (SSU) gene, from N. ceranae isolates from different European and Central Asia populations, revealed a high diversity of sequences. The variability involved single‐nucleotide polymorphisms and insertion/deletions, resulting in 79 different haplotypes. Two sequences from the same isolate could be as different as any pair of sequences from different samples; in contrast, identical haplotypes were also found in very different geographical origins. Consequently, haplotypes cannot be organized in a consistent phylogenetic tree, clearly indicating that rDNA is not a reliable marker for the differentiation of N. ceranae strains. The results indicate that recombination between different sequences may produce new variants, which is quite surprising in microsporidia, usually considered to have an asexual mode of reproduction. The diversity of sequences and their geographical distribution indicate that haplotypes of different lineages may occasionally be present in a same cell and undergo homologue recombination, therefore suggesting a sexual haplo‐diploid cycle.
Red but not dead? Membranes of stressed Saccharomyces cerevisiae are permeable to propidium iodide
Authors: Davey H. M. , Hexley P. 
Published: August 2010

SummaryFlow cytometric monitoring of propidium iodide (PI) uptake is a well‐established and rapid method for monitoring cell death and is used on the basis that the intact membrane of viable cells excludes the propidium ion and that loss of this permeability barrier represents irreparable damage and thus cell death. These assumptions are typically based on analysis of live and killed cells. Here we have identified stress levels that lead to a loss of viability of a proportion of Saccharomyces cerevisiae cells and under these conditions we show that there is a subpopulation of cells that can take up PI during and immediately following exposure to stress but that a short incubation allows repair of the membrane damage such that subsequent exposure to PI does not result in staining. Irrespective of the stress applied, approximately 7% of cells exhibited the ability to repair. These results indicate that the level of damage that the yeast cell membrane can sustain and yet retain the ability to repair is greater than previously recognized and care must therefore be taken in using the terms ‘PI‐positive’ and ‘dead’ synonymously. We discuss these findings in the context of the potential for such environmental stress‐induced, transient membrane permeability to have evolutionary implications via the facilitation of horizontal gene transfer.