bluuebunny/crossref_metadata_2025_split huggingface dataset:
In Lynch syndrome adenomas, loss of mismatch repair proteins is related to an enhanced lymphocytic response
Authors: Meijer Tineke W H , Hoogerbrugge Nicoline , Nagengast Fokko M , Ligtenberg Marjolein J L , Van Krieken J Han J M 
Published: October 2009

Aims:  Lynch syndrome‐associated tumours are characterized by the presence of an increased number of tumour‐infiltrating lymphocytes. This enhanced lymphocytic response may be elicited by genetically altered proteins that may arise as a result of a defective DNA mismatch repair system. The aim was to investigate this hypothesis by correlating loss of mismatch repair proteins and infiltration of lymphocytes in Lynch syndrome‐associated adenomas and hyperplastic polyps.Methods and results:  Mismatch repair protein expression and the number of tumour‐infiltrating lymphocytes were assessed in Lynch syndrome (41 adenomas and nine hyperplastic polyps) and in familial colorectal cancer (nine adenomas and one hyperplastic polyp). Nineteen sporadic adenomas were included as a control group. Twenty of 32 (63%) adenomas with loss of mismatch repair protein expression showed an increase in tumour‐infiltrating lymphocytes. Eight adenomas (8/32; 25%) displayed many tumour‐infiltrating lymphocytes, whereas most adenomas (12/32; 38%) showed a minor increase. In adenomas with mismatch repair protein expression, both sporadic and Lynch syndrome associated, not one showed an increased number of tumour‐infiltrating lymphocytes. Hyperplastic polyps in Lynch syndrome patients showed neither loss of mismatch repair expression nor an increase in tumour‐infiltrating lymphocytes.Conclusions:  There is a correlation between the loss of mismatch repair proteins and the infiltration of lymphocytes in Lynch syndrome‐associated adenomas.
Differential expression of the semaphorin 3A pathway in prostatic cancer
Authors: Yacoub Mokrane , Coulon Alix , Celhay Olivier , Irani Jacques , Cussenot Olivier , Fromont Gaelle 
Published: October 2009

Aims:  To analyse the expression pattern of the semaphorin 3A (Sema3A) pathway, including the receptor neuropilin 1 (NRP1) and its ligands the ‘antitumoral’ Sema3A and the ‘protumoral’ vascular endothelial growth factor (VEGF)in prostatic cancer.Methods and results:  tissues were obtained from 120 patients treated by prostatectomy for clinically localized prostatic cancer, and 31 hormone‐refractory prostatic cancer (HRPC) samples. Immunohistochemistry was performed on tissue microarrays using antibodies directed against Sema3A, NRP1 and VEGF. Moreover, real‐time reverse transcriptase‐polymerase chain reaction was performed on frozen prostatic tissue, including normal prostate, clinically localized tumours and HPRC. Sema3A immunoreactivity of the membrane of cancer cells was closely associated with NRP1 expression in clinically localized prostatic cancer, but not in HRPC. In clinically localized cancer, Sema3A expression correlated with lower preoperative prostate‐specific antigen (PSA) and pathological stage; NRP1 reactivity was associated with lower PSA and Gleason score, and VEGF reactivity with higher PSA and Gleason score. HRPC displayed higher expression of NRP1 compared with clinically localized cancer, and lower Sema3A immunoreactivity.Conclusions:  These results support the hypothesis that dysregulation of the Sema3A pathway plays a key role in prostatic cancer progression, and suggest a loss of the inhibitory Sema3A autocrine loop in HRPC.
Translation and validation of a Chinese language version of the Early Childhood Oral Health Impact Scale (ECOHIS)
Authors: LEE GILLIAN H. M. , MCGRATH COLMAN , YIU CYNTHIA K. Y. , KING NIGEL M. 
Published: October 2009

Objective.  This study aimed to adapt the Early Childhood Oral Health Impact Scale (ECOHIS) for pre‐school children in a Chinese speaking community and to investigate its psychometric properties (validity and reliability).Methods.  A Chinese language version of the ECOHIS was derived through a forward–backward translation and tested for face and content validity among a focus group. A convenient sample of pre‐school children (n = 111) was recruited (including a sub‐sample with early childhood caries and caries‐free children). Parents of the children self‐completed the derived Chinese‐ECOHIS measure. Validity of the measure was assessed by investigating the relationship between dental caries status and Chinese‐ECOHIS scores (construct and criterion validity). A sub‐sample of the parents repeated the ratings of the measure to enable reliability assessments. Both internal and test–retest reliability were determined.Results.  A Chinese version of ECOHIS was derived with minor modification to the original version. Chinese‐ECOHIS scores were associated with children’s caries experience (dmft) (r = 0.66, P < 0.05) supporting convergent validity. In addition, variations in ECOHIS scores were apparent with respect to caries and caries‐free groups (P < 0.001), supporting the ability to distinguish between patient groups. Cronbach’s alpha values (internal reliability) for total ECOHIS score were 0.91 and intraclass correlation coefficient value (test–retest reliability) was 0.64.Conclusions.  A Chinese version of the ECOHIS was developed and demonstrated acceptable validity and reliability. These findings can enable assessments of pre‐school child oral health‐related quality of life in Chinese speaking communities.
Review: the legal duty of care for nurses and other health professionals
Authors: Young Andy 
Published: October 2009

Aims and objectives.  To explore the nature and extent of the legal duty of care in relation to contemporary healthcare practice.Background.  The paper seeks to re‐frame and update the legal duty of care for clinical nursing practice in the 21st century, taking into account collaborative and partnership working in healthcare practice.Design.  Doctrinal legal ‘approach’.Method.  ‘Black letter’ legal research methodology used for data collection and analysis. Literature search using Westlaw and LexisNexis database(s) to identify recent common law decisions.Results.  There has been a perceptible doctrinal shift away from paternalism and toward patient empowerment and autonomy in the last decade. This has implications for nurses and other healthcare professionals in terms of consenting patients and acting reasonably to ensure quality patient care.Conclusions.  A number of experienced nurses are currently assuming extended roles and some are completing medical tasks, traditionally allocated to doctors. These specialist practitioners must remember that additional responsibility invariably means increased professional risk and accountability. Therefore, it is essential that those engaging in advanced nursing practice, fully understand the nature and reach of their professional duty of care and the significance of statutory and common law developments.Relevance to clinical practice.  Nurses and other healthcare professionals must update their clinical skills and practice within a legal framework and to certain standards. The cases cited and discussed are relevant to all branches of nursing and indeed to all health professions.
Effectiveness of two rehabilitation strategies provided by nurses for stroke patients in Mexico
Authors: Torres‐Arreola Laura del Pilar , Doubova (Dubova) Svetlana Vladislavovna , Hernandez Sergio F , Torres‐Valdez Laura E , Constantino‐Casas Norma P , Garcia‐Contreras Fernando , Torres‐Castro Sara 
Published: October 2009

Objective.  Rehabilitation strategies have been developed to improve functional state in stroke patients. The main objective of this study was to evaluate the effectiveness of the early rehabilitation at hospital and its continuity at home provided by nurses, on the functional recovery of basic and social activities in stroke patients compared with conventional care.Design.  A randomised clinical trial was carried out in three general hospitals of the Mexican Institute of Social Security (IMSS) in Mexico City between April 2003–May 2004.Participants.  Stroke patients.Methods.  Two rehabilitation strategies provided by nurses for stroke patients were compared: physiotherapy plus caregiver education in rehabilitation (strategy 1, S1) vs. education alone (strategy 2, S2). The main outcome variables were the basic (Barthel index) and social (Frenchay activities index) activities of daily living, of each patient. Age, sex, morbidity, stroke symptoms, complications, neurological damage (Canadian Scale), cognitive state (mini‐mental state examination questionnaire) and duration of hospitalisation were defined as the control variables. Patients were evaluated at baseline and months one, three and six thereafter.Results.  One hundred and ten patients with ischaemic stroke were enrolled and randomised; 59 were assigned to S1 and 51 to S2. Comparison of the outcome variables showed that patients improved significantly over time, but no differences were observed between groups. We observed no significant difference in strategy performance with regard to the basic and instrumental activities of daily living.Relevance to clinical practice.  Participants who received physiotherapy with additional caregiver education benefit no more than those whose caregivers received education alone. Those countries that do not have integral rehabilitation programmes for stroke patients should understand their importance and budget resources for them. Meanwhile, both caregiver education and nurses trained in specific care and physiotherapy are alternatives that benefit these patients.
The relationship between intravenous infusate colonisation and fluid container hang time
Authors: Rickard Claire M , Vannapraseuth Boun , McGrail Matthew R , Keene Lorraine J , Rambaldo Sam , Smith Chloe A , Ray‐Barruel Gillian 
Published: October 2009

Aims.  To examine the level of microbial colonisation in intravenous fluids after 24 hours of use in an acute care setting to determine the necessity of changing infusate bags on a time‐related basis.Background.  Catheter‐related bloodstream infections are a serious and life‐threatening complication of intravascular devices. Colonised intravenous fluids are one potential source of infection; however, there is little published literature on incidence rates and few recent studies. Routine intravenous fluid replacement has been advocated as an infection control method, but the effectiveness of this is unknown and the optimal duration for infusate use remains uncertain.Design.  Cross‐sectional study over 18 months in a 257‐bed teaching hospital.Methods.  Infusate specimens (n = 264) were obtained from crystalloid fluids that had been used for 24 hours or more. Microbiological culture and sensitivity testing was performed and infusate‐related bloodstream infection (IRBSI) rates were recorded. Sample testing of previously unopened intravenous solutions acted as a control.Results.  The infusate colonisation rate was 0·4%, or 0·09 per 1000 infusion hours. The only isolated organism was coagulase‐negative Staphylococcus. Infusions had been in use for 24–185 hours (1–8 days). There was no difference in median duration of use for colonised (35·0 hours) and sterile (34·0 hours) specimens (Mann–Whitney test, p = 0·99). There were no cases of IRBSI.Conclusion.  The incidence of intravenous fluid colonisation and the risk of related bloodstream infection are low even after several days of infusate use. Current practice appears to successfully maintain the sterility of intravenous fluids.Relevance to clinical practice.  Routine replacement of intravenous fluids continues in many settings, often 24 hourly, in the belief that this prevents infection. We found no relationship between duration of use and colonisation and routine replacement may be unnecessary. Further research is needed to investigate the effectiveness of routinely replacing intravenous fluids at set time points to prevent colonisation and infection.
Seeking connection: family care experiences following long‐term dementia care placement
Authors: Bramble Marguerite , Moyle Wendy , McAllister Margaret 
Published: October 2009

Aim.  To outline the experiences of family caregivers in Brisbane, Australia who have placed a relative with dementia into long‐term care.Background.  Whilst the aged care literature in Australia highlights the rising numbers of people with dementia admitted to long‐term care, empirical research exploring family and staff relationships and their influence on quality of care remains limited. International research demonstrates that the transition to long‐term care is stressful for families and the person with dementia, often resulting in ongoing family and staff conflict.Design.  The study utilised a descriptive qualitative design.Methods.  A purposive sample of 10 participants from a large study that tested an education intervention took part in the qualitative phase of this mixed method, sequential design study. Semi‐structured interviews and confirmatory thematic analysis were used to identify family caregiver experiences following placement of their relative in long‐term care.Results.  The findings emphasise the increasing isolation and burden of care felt by families prior to admission, which often is perpetuated during long‐term care placement and may present as dissatisfaction with care.Conclusions.  Improving staff–family relationships has the potential to reduce conflict and to improve the long‐term care environment, relieve the pressure of work overload, decrease staff frustration and reduce negative reactions to family caregivers.Relevance to clinical practice.  The findings highlight the crucial need for long‐term care facilities to support families, as well as the person with dementia, through the transition to the care environment. The resulting improved family relationships with staff, based on negotiation and increasing knowledge of dementia care, can then provide potential to develop more specialised evidence‐based dementia care and service delivery.
Implementation and evaluation of a nursing process support system for long‐term care: a Taiwanese study
Authors: Yeh Shu‐Hui , Jeng Bingchiang , Lin Li‐Wei , Ho Tien‐Hui , Hsiao Chiu‐Yueh , Lee Li‐Na , Chen Shu‐Li 
Published: October 2009

Aims.  To (1) develop and implement a Nursing Process Support System in Chinese (NPSSC) enabling computerised documentation for nursing home residents, (2) evaluate the efficiency of NPSSC, (3) assess obstacles to the use of the NPSSC and (4) assess nurse users’ satisfaction with the NPSSC.Background.  Long‐term care facilities in Taiwan have been slow to computerise resident’s medical records. The development and implementation of a computerised documentation system provides a way to enhance nursing documentation in long‐term care settings and can prevent hazards that result from documentation errors.Design.  Quasi‐experimental.Methods.  This study used one group pre/post‐test. Five nursing homes in Taiwan were included in the study. Twenty‐seven nurses used the NPSSC to computerise 396 residents’ medical records. Using the NPSSC allowed nurses to enter health assessment data into the computer system, which automatically triggered appropriate nursing diagnoses. The NPSSC included geriatric nursing interventions and the use of alternative Chinese therapies.Results.  Obstacles that hindered nurses' use of the NPSSC were identified and possible solutions to overcome these hindering factors were discussed. The use of the NPSSC significantly improved nursing documentation in that resident’s records were organised and consistent and nurses were able to complete a comprehensive care plan within 48 hours. Nurses reported a higher satisfaction in nursing documentation after the implementation of the NPSSC than previously.Conclusions.  This study suggested a pathway to develop and implement a computer‐based, user‐friendly nursing documentation system for nursing homes. This study may be used as a template for implementing computerised documentation worldwide.Relevance to clinical practice.  Nursing home providers may consider implementing the NPSSC to replace the traditional hand‐written documentation system. An effective use of in‐service programs within the workplace helped ease the transition from hand‐written documentation to the computer‐based NPSSC.
Rhodopsin population genetics and local adaptation: variable dim‐light vision in sand gobies is illuminated
Authors: EBERT DANIEL , ANDREW ROSE L. 
Published: October 2009

The visual pigments of fish are thought to be adapted to the variable spectral qualities of aquatic light environments. Most research on the role of natural selection on the evolution of rhodopsins and dim‐light vision in fish has focused on variation among species and higher taxa. In this issue, Larmuseau et al. reveal substantial intraspecific sequence variation in RH1 (the rhodopsin gene) in sand gobies (Pomatoschistus minutus). Using population genetics and molecular evolution approaches, they detect positive selection on RH1 and find evidence for adaptation to local light conditions.
No evidence of over‐reporting of SARS in mainland China
Authors: Liu Wei , Han Xiao‐Na , Tang Fang , Borsboom Gerard J. J. M. , Yang Hong , Cao Wu‐Chun , De Vlas Sake J. 
Published: October 2009

SummaryObjective  To find out whether there was over‐reporting of SARS patients in mainland China in view of the relatively low case fatality ratio in mainland China, in comparison with other affected countries and areas.Methods  We searched PubMed for all SARS antibody detection papers (in English or Chinese language) using the keywords ‘SARS’ and ‘antibody’. Then the resulting articles were further read through to select the SARS detection results using ELISA methods of serum samples collected at least 1 month after disease onset. A multi‐level logistic regression was applied to test for possible differences in the proportions positive between locations of the study.Results  A total of 48 studies were identified, including 39 from mainland China and nine from elsewhere (Hong Kong, Taiwan, Canada and Vietnam). For mainland China, there was no difference between Guangdong, Beijing and other provinces in the proportions testing positive (83.0%, 85.8% and 85.4% respectively). The grand average of 84.2% seropositive was lower than the 95.1% for the countries and areas outside of mainland China combined. However, this difference was far from significant after correcting for dependency of individual tests within the same study.Conclusions  Our study showed no evidence of over‐reporting of SARS in mainland China, nor in Guangdong, where the SARS epidemic started. Even if the lower seroprevalence in mainland China, relative to other affected areas, does represent actual over‐reporting, then this factor can only explain a modest 10% of the lower case fatality in mainland China.
The SARS outbreak in a general hospital in Tianjin, China: clinical aspects and risk factors for disease outcome
Authors: Wei Mao‐Ti , De Vlas Sake J. , Yang Zhen , Borsboom Gerard J. J. M. , Wang Lihong , Li Haiying , Li Yuming , Zhang Zhilun , Richardus Jan Hendrik , Wang Shi‐Xin 
Published: October 2009

SummaryObjectives  To describe clinical characteristics of severe acute respiratory syndrome (SARS) patients in a hospital in Tianjin, China, thereby comparing probable and suspected cases; to study risk factors associated with the death of cases; to describe the implementation of preventive interventions during the hospital outbreak.Methods  Physical and haematological information was obtained from clinical records. White blood cell counts, and percentages of neutrophilic granulocytes and neutrophilic lymphocytes were measured. The service department of the hospital provided information about daily use of protective materials. Differences in clinical symptoms between probable and suspected SARS cases were tested by Fisher’s exact test. Non‐linear mixed modelling was used to test for differences between the haematological patterns for probable and suspected cases. Risk factors for dying among probable SARS cases were tested by logistic regression.Results  The SARS outbreak started with a patient from Beijing on 15 April 2003, and spread quickly among the healthcare workers and in‐patients in the hospital. In total 90 probable and 21 suspected cases were reported, with 17 deaths among them (case fatality rate 15%). Haematological patterns were significantly different between probable and suspected cases, whereas the percentages with certain clinical symptoms showed no apparent difference. Death of probable SARS cases was only significantly associated with high age and use of a respiratory machine (mainly for the most severe cases), whereas e.g. co‐morbidity and steroid treatment showed no impact in multivariate analysis. Stringent control measures, including distribution of huge numbers of protective materials, started on 20 April, which soon lead to a strong decrease in the incidence of new cases. After the last SARS case left the hospital on 6 June, protective materials were dispensed at substantially lower rates, but not to zero, as was the case during the first days of the outbreak.Conclusion  The working definition of probable SARS used during the epidemic appeared to have been fairly accurate. Many valuable lessons were learned regarding prevention of hospital spread of infection, especially the need to have sufficient protective supplies available and to implement these rigidly and at an early stage of an (threatening) epidemic.
The impact of public health control measures during the SARS epidemic in mainland China
Authors: De Vlas Sake J. , Feng Dan , Cooper Ben S. , Fang Li‐Qun , Cao Wu‐Chun , Richardus Jan Hendrik 
Published: October 2009

SummaryWe tracked the effective reproductive number (Rt) over time to assess the impact of important public health control measures in the five most SARS‐affected geographic areas in mainland China. As soon as the Chinese authorities gained full control of all activities to combat SARS, Rt decreased dramatically and consistently below one. Many control measures that seriously affected public life were implemented afterwards, i.e., when the epidemic was already dying down.
Nurse‐led telephone triage in an Australian rural mental health service
Authors: Barnett Tony , Henderson Susan , Henry Darrin , Gumpold Anne , Foote Peter , Gallop Steve 
Published: October 2009

This paper reports on changes in referral patterns of a rural mental health telephone triage service based in Gippsland, Victoria, Australia. A retrospective audit of service data over the period 1999–2005 was undertaken as part of a quality improvement exercise. Data collected included service utilization statistics and critical reflection on the role of the mental health triage clinician within the service.There was an average of 2771 referrals each year and a trend for increased use by general practitioners and hospital emergency departments. Triage nurses reported concerns about: professional isolation, lack of formal education, difficulties in making decisions based on limited data as well as poor understanding of the role by users (patients and referrers). Further research is needed to evaluate the impact of this form of patient assessment on psychiatric nursing practice and clinical outcomes.