bluuebunny/crossref_metadata_2025_split huggingface dataset:
Struggling with an unfamiliar and unreliable body: the experience of irritable bowel syndrome
Authors: Håkanson Cecilia , Sahlberg‐Blom Eva , Nyhlin Henry , Ternestedt Britt‐Marie 
Published: February 2009

Aim.  To describe the phenomenon living with irritable bowel syndrome from a life‐world perspective.Background.  Ten to twenty per cent of the adult population in the world is known to live with irritable bowel syndrome. The life‐world experience of people with irritable bowel syndrome has been paid little attention. A deeper understanding about the phenomenon living with irritable bowel syndrome is of interest for the future development of care.Design and methods.  The study was performed using a phenomenological method. Data was collected by in‐depth, open interviews performed in 2006, with nine persons between 25–55 years, diagnosed with irritable bowel syndrome. The interviews were analysed according to the method of Giorgi.Results.  Six interrelated key constituents have been identified: Having an altered self‐image, feeling ashamed, distrusting the body, feeling tired, blaming oneself, and finding solutions. A structure has been formulated, describing that living with irritable bowel syndrome means struggling with an unfamiliar and unreliable body. Tiredness, distrust, and feelings of shame towards the body bring about limitations in everyday life. At the same time, living with irritable bowel syndrome means having a strong will to exceed the limitations and become familiar with one self.Conclusion.  This study suggests that living with irritable bowel syndrome means to struggle with an unfamiliar and unreliable body that brings about changes of self‐image and limitations in every day life. Feelings of distrust, shame and embarrassment towards troublesome symptoms, are important contributions to the limitations experienced.Relevance to clinical practice.  Nurses have a major role to play in the care for people with irritable bowel syndrome. A caring perspective, in which the life‐world is central, is an important approach to care for these persons. Using the dialogue as a forum where patients can share their unique life‐world experiences lets nurses gather knowledge that is essential in helping patients identify and acknowledge new and positive understandings of the lived body.
Determining patient activity levels in chronic kidney disease
Authors: Bonner Ann , Wellard Sally , Caltabiano Marie 
Published: February 2009

Aim. This study used the human activity profile to investigate the levels of activity in people with chronic kidney disease in far North Queensland, Australia.Background. People with chronic kidney disease experience reduced levels of fitness and a reduced capacity to engage in regular activity because of a number of illness related factors. Consequently there is an impact on the ability to perform routine activities of daily life. Increasingly the promotion of activity is viewed as an integral component of rehabilitation programs in renal units.Design and methods. A descriptive cross sectional design was used to assess differences in current levels of activity for groups of persons with chronic kidney disease who differed in their renal history and type of renal therapy. Both descriptive data (such as activity levels and breathlessness) as measured by a researcher‐administered questionnaire and biochemistry data were collected on 112 people with chronic kidney disease. The study was conducted in 2006.Results. Participants in this study were less active than the general population with women, older or indigenous patients significantly less active. Participants with diabetic nephropathy were significantly the least active. A significant difference between mean activity scores was found for type of renal replacement therapy, with participants receiving haemodialysis being the least active. Additionally, lower levels of albumin were significantly correlated with fewer activities.Conclusion. The human activity profile is a useful indicator of the broad range of physical activities undertaken by people with chronic kidney disease, and that there is a reduced ability to undertake ordinary everyday activities. The broad scope of the human activity profile may make it a valuable assessment tool.Relevance to clinical practice. It is particularly important for nurses to understand the impact of chronic illness on the ability to undertake basic activities of daily life, and the necessity to introduce routine assessment of everyday activities for all renal patients is warranted.
The meaning of living with chronic obstructive pulmonary disease
Authors: Clancy Karen , Hallet Christine , Caress Ann 
Published: February 2009

Aim.  To explore the existential experiences of 10 patients with chronic obstructive pulmonary disease (COPD) who had been prescribed long‐term oxygen therapy (LTOT) and their carers.Background.  Chronic obstructive pulmonary disease is a progressive and debilitating condition, with an insidious onset often diagnosed in the middle to later years of life, after a history of worsening breathlessness (Herbert & Gregor 1997). It is a life limiting condition that is on the increase worldwide. Evidence suggests that for some people with COPD oxygen therapy can improve longevity and quality of life (MRC 1981, NOTT 1980). Understanding of the existential meaning of COPD for people is required.Method.  This longitudinal Heideggerian study was carried out between 2005–2006. Participants were interviewed separately, in their own homes, at the start of LTOT, second 3 months later and finally at 9 months.Results.  Themes of living with COPD emerged from the data; struggling, fear, experience of ill health, blame, fatalism and hidden disability.Conclusion.  The participants all shared very negative experiences regarding the changes that living with COPD had placed on their lifestyle and quality of life. The introduction of oxygen appeared, for all but one couple, to increase the negative impact of living with poor health.Relevance to clinical practice.  The participants’ experiences in this study highlight the need for health professionals to explore with people what it is like living with a long‐term condition. This sharing of experiences may help individuals to make informed choices about treatment and readdress their perception of ‘just existing’ with ‘no quality to their lives’ thereby enabling people and carers to adjust to living with a life‐limiting condition like COPD and the introduction of life long‐term therapeutic interventions.
The triumph of hope over experience: using peoples’ experiences to inform leg ulcer care through participatory action research
Authors: Petersson Pia , Springett Jane , Blomqvist Kerstin 
Published: February 2009

Aim.  To explore how people experienced leg ulcer care so as to inform practitioners about the patients’ view as a vehicle for a changed leg ulcer care practice.Background.  Great numbers of people suffer from chronic leg ulcers and many have to live with their illness for a long time. Even when the illness is controlled by medical treatment, the person with leg ulcers has to deal with physical, emotional, cognitive and social problems and long‐term encounters with practitioners.Method.  A Participatory Action Research approach was used. Nine older persons with chronic leg ulcers, treated in primary care, were asked about their experiences of the care. Content analysis and reflective dialogues with practitioners and persons with chronic leg ulcers was performed. The study was undertaken from autumn 2004 to spring 2005.Result.  Although the persons with chronic leg ulcers experienced their encounters with practitioners as satisfying, findings illuminated low participation in their own care and low practitioner involvement in issues about their daily living with chronic illness. In addition, the participatory action research project did not proceed from problem identification towards development and change.Conclusion.  Participation is about negotiation and transferring power and authority from practitioners towards patients and from researchers towards practitioners and patients. Undertaking a participatory action research project that brings sustainable change requires substantial work to involve practitioners in initiating and planning the research.Relevance to clinical practice.  Participation requires true partnership. To reach participation between researchers, practitioners and patients would need a significant change in attitude of all parties as well as a change in the care culture. Changing attitudes is not enough as long as practitioners and patients are stuck in a hierarchical structure with predetermined and taken for granted roles and relations in the medical culture.
Evaluation of a multidisciplinary patient education program for people with systemic lupus erythematosus
Authors: Miljeteig Kari , Graue Marit 
Published: February 2009

Aim.  To evaluate an educational program for people with systemic lupus erythematosus using an action research approach.Background.  People with systemic lupus erythematosus can benefit from attending patient education programs that address their psychosocial needs. Although patient education has always been a feature of practice, educational programs have not always included patients’ input into the design. Involving patients in all stages of a project is a challenge for both professionals and patients.Methods.  One participatory action research cycle was used to explore peoples’ learning needs and views on form and content of the program and to explore teaching and learning competence in the multidisciplinary team. The decision on how to develop the educational program was based on focus group interviews and field notes. The educational program was implemented in 2001 with two groups of patients (n = 13) and outcomes of action evaluated at an individual level using quality of life, pain, fatigue and physical well‐being instruments pre and post implementation.Results.  The adoption of new roles was a challenge for both patients and members of the multidisciplinary team. Training to combine counselling with interactive teaching and learning methods was wanted by professionals. Patients said safe environments which facilitate learning experiences and communication with professionals are essential.Conclusion.  Clinical competence combined with patient knowledge and experiences were used to develop a patient centred educational program and to plan further action. Collaboration in the multidisciplinary team and with patients should be considered in both the planning and implementation of patient education programs.Relevance to clinical practice.  The potential for patients to collaborate in designing programs for improved self‐care management is tremendous. The information gained from this study can be used to inform educational program planning for systemic lupus erythematosus patients and future collaboration in the multidisciplinary team.
A 750 bp sensory integration region directs global control of the Escherichia coli GadE acid resistance regulator
Authors: Sayed Atef K. , Foster John W. 
Published: February 2009

Summary Escherichia coli survives pH 2 environments through an acid resistance (AR) system regulated by the transcriptional activator GadE. Numerous proteins control gadE at an upstream, conserved, 798 bp intergenic region. We show this region produces three transcripts starting at −124 (T1), −324/−317 (T2) and −566 (T3) bp from the gadE start codon. Transcriptional lacZ fusions to gadE promoter regions revealed P1 and P3 were active while P2 alone was not. However, pairing P3 with P2 activated P2 and increased expression 20‐fold above P3 alone. The fusions were transferred to Salmonella, which lacks this AR system, and plasmid‐borne E. coli‐specific regulators EvgA, YdeO, GadE and GadX were introduced. Data revealed that YdeO and GadX activate P3, P2 and P3P2, while GadE autoactivates P1 and represses P3 and P3P2. The developing model indicates that different signals activate YdeO, GadX, or an MnmE‐dependent regulator, which stimulate gadE transcription from the P3 and P2 promoters. Once made, GadE activates P1 and represses P3 and P2. The P1 region also enables efficient downstream transcription and translation of the P3 or P2 transcripts. Evidence indicates the entire 750 bp sensory integration locus is necessary for a versatile response.
Cross‐talk between two global regulators in Streptomyces: PhoP and AfsR interact in the control of afsS, pstS and phoRP transcription
Authors: Santos‐Beneit Fernando , Rodríguez‐García Antonio , Sola‐Landa Alberto , Martín Juan F. 
Published: February 2009

SummaryThe regulatory proteins AfsR and PhoP control expression of the biosynthesis of actinorhodin and undecylprodigiosin in Streptomyces coelicolor. Electrophoretic mobility shift assays showed that PhoPDBD does not bind directly to the actII‐ORF4, redD and atrA promoters, but it binds to the afsS promoter, in a region overlapping with the AfsR operator. DNase I footprinting studies revealed a PhoP protected region of 26 nt (PHO box; two direct repeats of 11 nt) that overlaps with the AfsR binding sequence. Binding experiments indicated a competition between AfsR and PhoP; increasing concentrations of PhoPDBD resulted in the disappearance of the AfsR–DNA complex. Expression studies using the reporter luxAB gene coupled to afsS promoter showed that PhoP downregulates afsS expression probably by a competition with the AfsR activator. Interestingly, AfsR binds to other PhoP‐regulated promoters including those of pstS (a component of the phosphate transport system) and phoRP (encoding the two component system itself). Analysis of the AfsR‐protected sequences in each of these promoters allowed us to distinguish the AfsR binding sequence from the overlapping PHO box. The reciprocal regulation of the phoRP promoter by AfsR and of afsS by PhoP suggests a fine interplay of these regulators on the control of secondary metabolism.
Micro‐arrayed wheat seed and grass pollen allergens for component‐resolved diagnosis
Authors: Constantin C. , Quirce S. , Poorafshar M. , Touraev A. , Niggemann B. , Mari A. , Ebner C. , Akerström H. , Heberle‐Bors E. , Nystrand M. , Valenta R. 
Published: February 2009

Background:  Wheat is a potent allergen source and can cause baker’s asthma, food and pollen allergy. The aim of the study was to develop an allergen micro‐array for differential diagnosis of baker’s asthma, wheat‐induced food allergy and grass pollen allergy.Methods:  We analysed the immunoglobulin‐E reactivity profiles of patients suffering from baker’s asthma, wheat‐induced food allergy and grass pollen allergy to micro‐arrayed recombinant wheat flour allergens and grass pollen allergens and compared these results with clinical results and diagnostic tests based on crude wheat flour, wheat pollen and grass pollen allergen extracts.Results:  We identified recombinant wheat flour allergens, which are specifically recognized by patients suffering from baker’s asthma, but not from patients with food allergy to wheat or pollen allergy. rPhl p 1 and rPhl p 5 were identified as marker allergens specific for grass pollen allergy. They can be used to replace grass pollen extracts for allergy diagnosis and to identify grass pollen allergic patients among patients suffering from baker’s asthma and wheat‐induced food allergy. Profilin was identified as a cross‐reactive allergen recognized by patients suffering from baker’s asthma, food and pollen allergy.Conclusions:  Our results indicate that it will be possible to design serological tests based on micro‐arrayed recombinant wheat seed and grass pollen allergens for the discrimination of baker’s asthma, wheat‐induced food allergy and grass pollen allergy.
A multicentre study assessing the prevalence of sensitizations in patients with asthma and/or rhinitis in China
Authors: Li J. , Sun B. , Huang Y. , Lin X. , Zhao D. , Tan G. , Wu J. , Zhao H. , Cao L. , Zhong N. ,   China Alliance of Research on Respiratory Allergic Disease (CARRAD)
Published: February 2009

Background:  The prevalence of sensitization in patients with asthma and rhinitis in mainland China remains unclear.Objective:  Our aim was to estimate the prevalence of allergy in patients with respiratory allergic diseases such as asthma and/or rhinitis attending respiratory clinics within mainland China. The study also investigated regional and annual differences in the prevalence and pattern of sensitization among the patients in China.Method:  A cross‐sectional survey was performed in 6304 patients suffering from asthma and/or rhinitis in 17 cities from 4 regions of China. Patients completed a standardized questionnaire asking for the presence of respiratory and allergic symptoms. They also underwent skin prick tests with 13 common aeroallergens.Results:  Among the 6304 patients, 4545 (72.1%) had at least one positive skin prick reaction. The overall prevalence of positive skin prick responses was 59.0% for Dermatophagoides farinae, 57.6% for Dermatophagoides pteronyssinus, 40.7% for Blomia tropicalis, 16.1% for American cockroach, 14.0% for dog, 11.5% for Blatella germanica, 11.3% for Artemisia vulgaris, 10.3% for cat, 6.5% for Ambrosia artemisifolia, 6.3% for mixed mould I, 4.4% for mixed mould IV, 3.5% for mixed grass pollen and 2.2% for mixed tree pollen. Sensitizations to common allergens varied widely between geographical areas and demonstrated unique pattern in patients by stratification with age groups, with asthma and/or rhinitis. Severity of rhinitis and asthma was significantly correlated with skin index of reactivity to Artemisia vulgaris, Ambrosia artemisifolia and to D. pteronyssinus, D. farinae and Blomia tropicalis respectively (P < 0.001). Positive reactivity to the tested allergens and concomitant reactivity to multiple allergens including to house dust mites and Blomia tropicalis was markedly increased in patients with both asthma and rhinitis.Conclusion:  House dust mites were the most prevalent allergens in patients with asthma and/or rhinitis in China. There were significant differences in patterns of sensitizations in patients from different geographical areas, age groups as well as asthma and/or rhinitis.
Diversity in the bronchial epithelial cell response to infection with different rhinovirus strains
Authors: WARK Peter A.B. , GRISSELL Terry , DAVIES Bronwyn , SEE Hayley , GIBSON Peter G. 
Published: February 2009

ABSTRACTBackground and objective:  Infection with rhinovirus (RV) is the most common trigger for acute asthma and COPD. The aim of this study was to characterize the variability in the response of primary bronchial epithelial cells to infection with several strains of RV.Methods:  RV strains, RV‐43, RV‐48 (major group RV), RV‐47 (minor) and EV‐68 (enterovirus), were cultured from subjects with acute asthma and compared with the laboratory RV strains, RV‐16, RV‐14 (major) and RV‐1B (minor). Primary bronchial epithelial cells were obtained from healthy control and asthmatic subjects by endobronchial brushing. Response to infection was assessed by the release of IL‐6, interferon (IFN)‐γ induced protein (IP)‐10 and IFN‐β, as measured by ELISA. Viral replication was assessed by serial titration assays and cell viability by flow cytometry.Results:  Major group RV strains and EV‐68 all efficiently infected and replicated in epithelial cells causing little cell death. The clinical major group RV strains caused greater release of IL‐6 and IP‐10 compared with laboratory major group RV strains. Infection with minor group RV resulted in greater release of IP‐10, IL‐6 and IFN‐β that was associated with induction of apoptosis and less efficient viral replication. Asthmatic bronchial epithelial cells were less able to respond by releasing IFN‐β following infection with RV‐1B.Conclusions:  Considerable diversity exists in the response to RV strains, especially between minor and major group RV. The impaired IFN‐β response in asthmatic bronchial epithelial cells may make them particularly susceptible to minor group RV.
Using the posterior pelvic pain provocation test in pregnant Japanese women
Authors: Ando Fukiko , Ohashi Kazutomo 
Published: February 2009

AbstractThis study investigated the usefulness of the posterior pelvic pain provocation (PPPP) test for differentiating between pelvic pain and low back pain because of the different prognoses and treatment strategies. We recruited 263 Japanese women who were > 36 weeks' gestation and 213 were included. The PPPP test was applied to 154 women with self‐reported lumbopelvic pain. The participants were divided into three groups: the PPPP test positive (PPPP+, n = 60) subgroup, PPPP test negative (PPPP−, n = 94) subgroup, and no pain group (n = 59). The disability scores of the PPPP+ subgroup were significantly higher than the scores of the PPPP− subgroup and no pain group. In the PPPP+ subgroup, the intensity of pelvic pain was significantly correlated with the disability scores, but that of low back pain was not. The PPPP test could be carried out by a midwife without side‐effects and could detect pregnant women with impaired ability in daily life due to lumbopelvic pain.
Review of work‐related stress in mainland Chinese nurses
Authors: Zeng Yingchun 
Published: February 2009

AbstractThe aim of this review was to identify the specific work‐related stressors of mainland Chinese nurses and to present the current state of stress research in order to discuss directions for further research. A literature search from January 2000 to June 2007 was conducted among three electronic databases. The specific stressors among Chinese nurses were effort–reward imbalance, the poor image of nursing in the community, and managerial issues. The studies were limited to either descriptive or correlation designs, a variety of stress scales were used to investigate the nurses' work‐related stressors, and there were no published studies reporting stress management interventions for Chinese nurses. This review highlights that further stress research targeted to Chinese nurses needs more prospective and longitudinal studies and has to develop a consistent instrument to measure stressors. The priority issue is the initiation of stress management interventions to improve nurses' coping skills, while the long‐term goal is to reduce the level of stress or eliminate the stressors through individual, organizational, and societal interventions.
Wealth Index association with gender issues and the reproductive health of Egyptian women
Authors: Afifi Mustafa 
Published: February 2009

AbstractThis study investigated the association of the Wealth Index of married women in Egypt with a number of gender and reproductive health issues found in the 2005 Egypt Demographic Health Survey. The data from a subsample of 5249 currently married women from a total of 19 474 was examined using logistic regression analysis. The women's lowest wealth quintile predicted the intention to continue female genital cutting for their daughters, exposure to physical and sexual marital violence, not being empowered in household decisions, having a higher number of children, having an unintended last child, mothers' maltreatment of their children, the perception of a lack of health‐care providers or drugs as an obstacle to receiving care, and not being covered by health insurance. The association of poverty with the aforementioned adverse health outcomes are discussed. Physicians should understand the effect of poverty on health and endeavour to influence policy‐makers to reduce the poverty burden on health.