bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurses’ perception of the use of computerised information systems in practice: questionnaire development
Authors: Oroviogoicoechea Cristina , Watson Roger , Beortegui Elena , Remirez Silvia 
Published: December 2009

Aim. To develop and validate a questionnaire to explore the perceptions of nurses about the implementation of a computerised information system in clinical practice.Background. A growing interest in understanding nurses’ experience of developing and implementing clinically relevant Information Technology systems and the lack of measurement tools in this area, justifies further research into the development of instruments to provide an insight into nurses’ experience.Design. Survey and questionnaire development.Method. An initial draft of the questionnaire was developed based on the literature and expert opinion. The questionnaire was piloted by ten nurses to check face validity, reliability and test‐retest reliability. A revised version of the questionnaire was distributed to nurses working in the in‐patient area of a university hospital in Spain (n = 227). Principal components analysis with oblique rotation was carried out to test theoretically developed underlying dimensions and to test construct validity. Cronbach’s alpha coefficient was used to determine internal consistency.Results. Cronbach’s alpha for all the items included in the different scales was 0·88 in the pilot questionnaire and test‐retest reliability was adequate. Principal components analysis of items related to mechanisms produced a three‐component structure (‘IT support’, ‘usability’ and ‘information characteristics’). The three factors explained 48·6% of the total variance and Cronbach’s alpha ranged from 0·66–0·79. Principal components analysis of items related to outcomes produced a three factor solution (‘impact on patient care’, ‘impact on communication’ and ‘image profile’). The factors explained 65·9% of the total variance and Cronbach’s alpha ranged from 0·64–0·85.Conclusion. The study provides a detailed description and justification of an instrument development process. The instrument is valid and reliable for the setting where it has been used.Relevance to clinical practice. The instrument could provide insight into nurses’ experience of IT implementation that will guide further development of systems to enhance clinical practice.
A systematic review of nursing rehabilitation of stroke patients with aphasia
Authors: Poslawsky Irina E , Schuurmans Marieke J , Lindeman Eline , Hafsteinsdóttir Thóra B 
Published: December 2009

Aim and objectives.  To explore the evidence on rehabilitation of stroke patients with aphasia in relation to nursing care, focusing on the following themes: (1) the identification of aphasia, (2) the effectiveness of speech‐language interventions.Background.  Patients with poststroke aphasia have higher mortality rates and worse functional outcome than patients without aphasia. Nurses are well aware of aphasia and the associated problems for patients with stroke because they have daily contact with them. The challenge is to provide evidence‐based care directed at the aphasia. Although rehabilitation stroke guidelines are available, they do not address the caregiving of nurses to patients with aphasia.Design.  Systematic review.Method.  Published studies were reviewed, focusing on identification and treatment of aphasic patients after stroke in terms of the consequences for nursing care. Also, data concerning effective speech‐language interventions were extrapolated into nursing practice with respect to the classification of nursing interventions.Results.  Intensive speech‐language therapy, which was initiated in the acute stage post stroke, showed the best rehabilitation outcomes. Trained persons other than speech‐language therapists provided effective speech‐language interventions. Speech‐language therapy included several types of intervention that met nursing intervention classifications.Conclusion.  The contribution of nursing to the rehabilitation of patients with aphasia is relevant. The use of screening instruments by nurses can increase early detection of aphasia, a precondition for initiating timely speech‐language therapy. Collaboration between speech‐language therapists and nurses is of the utmost importance for increasing the intensity and functionality of speech‐language exercises, which may enhance the quality of treatment.Relevance to clinical practice.  The findings of this study can be used to develop nursing rehabilitation guidelines for stroke patients with aphasia. Further research is necessary to explore the feasibility of using such guidelines in clinical nursing practice and to examine the experiences of patients with nursing interventions directed at aphasia.
‘To Swim or Not To Swim’: the impact of jellyfish stings causing Irukandji Syndrome in Tropical Queensland
Authors: Sando Jennifer J , Usher Kim , Buettner Petra 
Published: December 2009

Aim.  This manuscript presents both demographic and descriptive data related to a distressing clinical condition known as Irukandji syndrome. Chart audit and observation data were collected to explore trends in patient characteristics and to review the current practices surrounding the management of the syndrome by advanced practice ED nurses.Background.  Irukandji syndrome, a known health emergency in northern Australia, causes severe symptoms such as muscle pains, nausea and vomiting, headache and chest pain causing clinical challenges for emergency nurses. Little is written about this condition from a nursing perspective.Design.  A mixed methods case study approach.Methods.  Data were collected by observation and chart audit from 186 patients diagnosed with Irukandji syndrome between 2001–2007.Results.  Of the 186 patients, 44·1% were local residents and 58·6% were men. Median age of the patients was 27 years (range 16–77). There was a time trend with a greater number of stings occurring out at the Great Barrier Reef than at mainland beaches (p < 0·001). Important results were found regarding waiting times for pain management and intuitive rather than documented assessment practices of advanced practice nursing staff.Conclusion.  Irukandji syndrome causes severe emotional distress and acute pain, however, people continue to swim in marine sting environments and fail to make use of available protective clothing such as body suits. Local residents continue to be stung regardless of the educational information available suggesting a review of the current public education campaign is required.Relevance to clinical practice.  Nurses failed to document assessment processes limiting adequately the ability to assess trends in the patient’s condition effectively and treat symptoms efficiently. It is, therefore, timely to review the critical role that assessment plays in clinical care.
Factors that influence health quotient in Chinese college undergraduates
Authors: Guo Jia , Whittemore Robin , He Guo‐Ping 
Published: December 2009

Aim and objectives.  The purpose of this study was to describe the health quotient of Chinese undergraduates, to discern whether socio‐demographic characteristics, academic achievements and perceived health status significantly affect the health quotient of Chinese college students and to identify the predictable factors of health quotient in undergraduates.Background.  Rapidly increasing enrollment in higher education in China in recent years has brought growing concern about undergraduate health and lifestyle. The Health Quotient profile questionnaire, which assesses self‐reported holistic health, provides opportunity to study the health of Chinese undergraduates.Design.  A descriptive cross‐sectional study.Methods.  The study was conducted with 1874 Chinese undergraduates aged 15–28  from eight colleges in Changsha. Students were recruited by a multistage cluster stratified random sampling method.Results.  The mean score of the Health Quotient questionnaire indicated a positive health quotient; however, 32·1% of the sample scored below the criterion score for a positive health quotient. Undergraduates scored low on knowledge of health. Gender, residence before university, father’s educational background, self‐rated health, college category, achievement in study and status as student chief significantly predicted health quotient scores.Conclusions.  Holistic health of college students is important and implies positive health behaviours and a focus on health promotion. The overall holistic health of the subjects was good, and students appear capable of managing their own health. Poor health knowledge may be an important factor in college students’ future health status. Risk factors associated with health quotient of undergraduates should be considered in college health care.Relevance to clinical practice.  The health quotient is one instrument that can be used to assess college students’ holistic health and target health promotion interventions. Health knowledge dissemination could be a core task for Chinese college nurses. Further, international research that examines the relationship of student characteristics, college location, culture, health behaviours, health status and holistic health is indicated.
Pain assessment and management practices in children following surgery of the lower limb
Authors: Shrestha‐Ranjit Jaga Maya , Manias Elizabeth 
Published: December 2009

Aims.  To examine paediatric nurses’ pain assessment and management practices in relation to postoperative care for children following surgery of a fractured lower limb and to compare these practices with evidence‐based guidelines.Background.  Managing pain is one of the most challenging issues in current paediatric practice. The incidence of lower limb fractures is high in children, which often leads to pain and related complications in the postoperative period.Design.  A retrospective clinical audit study.Methods.  A retrospective audit of all medical records (n = 106) was undertaken over two years of children aged 5–15 years who were admitted for surgical procedure for a fractured lower limb. An audit tool was developed to collect data related to children’s postoperative pain assessment and management on the day of operation to the third postoperative day. The study was undertaken in a tertiary paediatric hospital in Australia.Results.  The retrospective audit revealed that assessment and management of children’s postoperative pain was inadequate. On average, 75% of children experienced some degree of pain; 50% had moderate to severe pain. Nurses assessed pain less frequently compared to the number of times they were expected to assess pain postoperatively. Most analgesics were prescribed on an ‘as needed’ basis and patients received significantly lower amounts of analgesics than prescribed amounts.Conclusion.  The clinical audit revealed that addressing children’s postoperative analgesic needs was not consistent with evidence‐based guidelines.Relevance to clinical practice.  While this study was undertaken in only one hospital, the results are likely to be applicable to other children’s hospital settings. Nurses need to be proactive in promoting effective assessment and management of pain in children. The results of this study provide a useful guide for planning and implementing future strategies to improve postoperative pain management in children.
New Production of Eosinophils and the Corresponding Th1/Th2 Balance in the Lungs after Allergen Exposure in BALB/c and C57BL/6 Mice
Authors: Lu Y. , Sjöstrand M. , Malmhäll C. , Rådinger M. , Jeurink P. , Lötvall J. , Bossios A. 
Published: December 2009

AbstractAllergic asthma is associated with eosinophilic inflammation in the airways. Animal models commonly used to elucidate allergic inflammation mechanisms include BALB/c and C57BL/6 mice. Our aim was to evaluate lung eosinophilia and the corresponding Th1/Th2 balance in the two strains after allergen exposure. BALB/c and C57BL/6 mice were subjected to ovalbumin‐induced allergic airway inflammation using BrdU to label newly produced cells. The numbers of new eosinophils were evaluated by differential cell count and immunocytochemistry (MBP+BrdU+). Proliferation rate of lung eosinophils was measured by analysis of CD45+CCR3+BrdU+ cells by FACS. Distribution of newly produced eosinophils in the lung and the Th1/Th2 (CD4+T‐bet+/CD4+GATA‐3+) balance was evaluated by immunohistochemistry. Allergen challenge with ovalbumin induced comparable eosinophilia in bone marrow (BM), blood and lung tissue in both strains of mice compared to phosphate‐buffered saline controls, which was confirmed by immunocytochemistry. There was a small increase in the number of lung MBP+BrdU− eosinophils in C57BL/6 mice compared to BALB/c mice, which suggests a basal increase in this strain following sensitization. While there was no difference in eosinophilic proliferation in the lung, the distribution of the newly produced eosinophils differs between the two strains. BALB/c mice showed staining primarily around vessels and airways, whereas C57BL/6 mice showed a more even distribution in the lung tissue. No difference in the Th1/Th2 balance was observed between two strains. This study shows that there is a difference in the distribution of eosinophils in the lung between the C57BL/6 and BALB/c mice, but no difference in eosinophil production or Th1/Th2 balance.
Cell‐Mediated Immune Response and Th1/Th2 Cytokine Profile of B‐T Constructs of F1 and V Antigen of Yersinia pestis
Authors: Gupta G. , Khan A. A. , Rao D. N. 
Published: December 2009

Abstract Yersinia pestis, a Gram‐negative bacterium, is the etiological agent of pneumonic and bubonic plague and still active in various regions of the world. Because plague is highly infectious and can readily spread by aerosolization, it poses a bioterrorism threat. The effective induction of mucosal as well as systemic immunity is an important attribute of an improved vaccine for plague. An alternative approach described here is the use of protective epitopes derived from immunodominant antigens (F1 and V) of Yersinia pestis. As T‐cell immunity is also a major contributor of protection, microencapsulated B‐T constructs of F1 and V antigen were used to immunize outbred and inbred mice through intranasal route, and lympho‐proliferative response and cytokine profile of both Th1 and Th2 arms were measured in spleen, lamina propria and Peyer’s patches. Three B‐T constructs of F1 antigen and seven of V antigen showed significantly high T‐cell response in terms of inducing systemic as well as mucosal response when compared to constituent peptides. These ten conjugates showed Th1 cytokine profile whereas rest of the conjugates showed mixed Th1/Th2 response. Four conjugates of V antigen showed high level of IL‐10 production. In present study, microencapsulated B‐T constructs after intranasal immunization generated systemic as well as mucosal immune response in all three sites, which offers an alternative approach for plague vaccine.
Immunohistochemistry of Pancreatic Development in Cattle and Pig
Authors: Carlsson G. L. , Scott Heller R. , Serup P. , Hyttel P. 
Published: December 2009

SummaryWith 8 figures and 2 tablesThe aim of this study was to characterize bovine and porcine pancreatic development by immunohistochemistry. In the pig, staining for both glucagon and insulin was noted at day 19. In cattle, glucagon staining was observed at day 25 and insulin staining from day 26. In both species, glucagon‐stained cells were abundant initially, but later insulin‐stained cells became most abundant. A few cells displayed co‐localization of glucagon and insulin staining during initial development in both species. Initially, most of the cells of the pancreatic primordia and the duodenal epithelium displayed Pdx‐1‐staining. All insulin‐stained cells displayed Pdx‐1‐stained nuclei, whereas no glucagon‐stained cells did so. Many Pdx‐1‐stained cells lacked insulin staining, but with development, the relative number of these cells diminished. Nkx6.1‐staining was initially seen in a pattern similar to that for Pdx‐1, but was lacking duodenal staining. Subsequently, the number of Nkx6.1‐stained cells diminished, but increased again to a level where practically all insulin‐stained cells also presented Nkx6.1‐staining. Glucagon‐stained cells, on the other hand, never had Nkx6.1 staining. In conclusion, the localization of the two transcription factors, Pdx‐1 and Nkx6.1, demonstrated that pancreas development appears to be controlled by mechanisms comparable with those operating in humans.
Short‐term morbidity associated with sentinel lymph node biopsy in cutaneous malignant melanoma
Authors: Ling Adrian , Dawkins Rosie , Bailey Michael , Leung Michael , Cleland Heather , Serpell Jonathan , Kelly John 
Published: December 2009

ABSTRACTGuidelines for the surgical treatment of cutaneous primary malignant melanoma are well established; however, the approach to the treatment of the regional lymph nodes remains more controversial. In many centres, sentinel lymph node biopsy has been adopted as routine in the treatment of malignant melanoma for prognostic purposes, as it is not of proven therapeutic benefit. The Multicentre Selective Lymphadenectomy Trial II aims to determine the comparative benefits of subsequent completion lymphadenectomy versus observation in those found to have a positive sentinel node biopsy. Until results are available, the risks of the procedure must be weighed against the value of prognostic information gained from performing a sentinel node biopsy. In this retrospective analysis of sentinel lymph node biopsies at our institution, we show that in general, short‐term morbidity associated with this procedure is low, but that morbidity is higher in a subgroup of people with higher weight or body mass index, and in those whose biopsy is located in the groin.
Managing patients with cutaneous squamous cell carcinoma metastatic to the axilla or groin lymph nodes
Authors: Goh Amy , Howle Julie , Hughes Michael , Veness Michael J. 
Published: December 2009

ABSTRACTCutaneous squamous cell carcinoma accounts for 20% of all non‐melanoma skin cancer with a minority arising on the trunk and extremities. A small proportion will develop metastases to regional nodes of the axilla or groin. We performed a retrospective review of patients with metastatic cutaneous squamous cell carcinoma to the axilla and groin treated at Westmead Hospital, Sydney. The purpose of this study was to document the treatment and outcome of these patients. We identified 18 men and 8 women with a median age of 73 years. Median follow‐up was 18.5 months. Median lesion size was 27 mm (range 3–130 mm) and median thickness was 7 mm (range 3–32 mm). Nine patients developed metastases to the groin, 14 to the axilla, 1 in the epitrochlear, and 2 to both the epitrochlear and axillary lymph nodes. All patients were treated with surgery +/− radiotherapy. Recurrence developed in seven patients (27%) with most developing distant metastases. Most (6/7) patients with recurrence died. Predicting patients that may develop nodal metastatic non‐head and neck cutaneous squamous cell carcinoma is difficult. Following diagnosis, surgery remains the primary treatment and select patients with unfavourable features, such as extranodal spread, may benefit from the addition of adjuvant radiotherapy.
Comprehensive genetic analysis of overlapping syndromes of RAS/RAF/MEK/ERK pathway
Authors: Tumurkhuu Munkhtuya , Saitoh Makiko , Sato Atsushi , Takahashi Kan , Mimaki Masakazu , Takita Junko , Takeshita Kazuhide , Hama Takehiro , Oka Akira , Mizuguchi Masashi 
Published: December 2009

AbstractBackground:  Germline mutations in several members of RAS/RAF/MEK/ERK pathway cause clinically similar genetic disorders, including Noonan syndrome (NS), Costello syndrome (CS) and cardio‐facio‐cutaneous syndrome (CFC). Each of these syndromes has a wide spectrum of molecular etiology. The aim of the present study was to conduct a comprehensive genetic analysis of RAS/RAF/MEK/ERK pathway in these syndromes.Methods:  Three patients with NS and two patients with CS/CFC were examined. Peripheral blood samples were collected from all patients as well as from 100 healthy Japanese volunteers. The protein phosphatase, non‐receptor type II (PTPN11), KRAS, HRAS, NRAS, BRAF, RAF1, Son of Sevenless (SOS1) and MEK1genes were analyzed.Results:  In a patient with a severe Noonan phenotype, a rare PTPN11 mutation was detected: A to G transition at position 172, causing an N58D substitution within the N‐SH2 domain. In a CS/CFC patient no HRAS mutations were found, but a novel SOS1 missense mutation was found: A to G transition at position 473, causing a T158A substitution within domain of histone‐like fold (HF).Conclusions:  A case mimicking CS with SOS1 T158A substitution, which has not been reported previously in CS, revealed the complex relationship between the genotype and phenotype of overlapping syndromes of the RAS/RAF/MEK/ERK pathway.
DO DEPOSITORS RESPOND RATIONALLY TO BANK RISKS? EVIDENCE FROM JAPANESE BANKS DURING CRISES
Authors: Hori Masahiro , Ito Yasuaki , Murata Keiko 
Published: December 2009

AbstractThis paper empirically examines depositors' ability to distinguish healthy banks from problematic banks, a necessary condition for depositors to impose discipline on banking institutions. We analyzed a large panel of 784 deposit‐taking institutions in Japan during the period from the 1992 financial year to the 2002 financial year. Our estimates indicate that depositors rightly appreciated the difference between healthy banks and risky banks, and that depositors of larger institutions are more sensitive to the bank risks than those of smaller institutions. We further argue that the estimated risk sensitivities of depositors are large enough to discipline the deposit‐taking institutions.
GENERAL EQUILIBRIUM ANALYSIS OF OVERLAPPING GENERATIONS WITH HETEROGENEOUS TIME PREFERENCES
Authors: Ohta Hiroshi , Li Ke , Kawano Hidetaka 
Published: December 2009

AbstractThe overlapping generations model presented herein requires incorporation of exactly three periods in which one lives, but makes intertemporal decision‐making twice, neither once nor three times. Single decision‐making at the outset, none thereafter, ignores the fact that one makes decisions every day anew as long as tomorrow exists. Incorporating such observations most simply requires decisions to be made at the first period and the second, but not at the third or last period. Our model reveals how the Mabiki (infanticides) and the Narayama (elderlycides) can occur simultaneously. We also find conditions under which child‐indulgence and parental overprotection called sunekajiri might be reckoned a virtue.
COMPETITIVE POSITION OF PRIMARY AIRPORTS IN THE ASIA‐PACIFIC RIM
Authors: De Wit Jaap , Veldhuis Jan , Burghouwt Guillaume , Matsumoto Hidenobu 
Published: December 2009

AbstractThis paper measures and compares the network performance and hub competitive position of primary airports in the Asia‐Pacific rim, taking into account the quantity and quality of both direct and indirect connections. The results reveal that Tokyo has the best network performance and hub competitive position. The most striking growth of network development is found at Chinese airports, while network performance deteriorates at Oceanian airports. Finally, the results show that the position of Oneworld and Star Alliance is stronger in this region, whereas SkyTeam has an innegligible position especially at Japanese airports, owing to the fifth and sixth freedom rights.