bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the nutritional status among residents in a Danish nursing home – health effects of a formulated food and meal policy
Authors: Kuosma Kirsi , Hjerrild Joan , Pedersen Preben Ulrich , Hundrup Yrsa Andersen 
Published: May 2008

Aims and objectives.  To gain information about the effects of implementation of a written food and meal policy and to evaluate to what extent systematic nutritional assessment and intervention would result in weight stability among the residents.Background.  Studies have shown that aged residents living in institutions suffer from malnutrition or are at risk of malnutrition. Health policies have pointed out that more attention should be given to individualised nutritional care. Several techniques are available to identify malnourished nursing home residents, but very few studies have reported findings of studies based on systematic nutritional assessment.Design and methods.  A quasi‐experimental study based on a time series design used the residents as their own controls. The study included all 20 residents who resided at the nursing home at baseline in September 2004. Five residents died during the study period (mean age 84·4 years, range 62–91 years). Altogether 15 residents (75%) were assessed all five times during the study period.Results.  The proportion of weight‐stable residents increased significantly over the study from 52·6% (CI 99%: 23·1–80·2) at baseline to 87·7% (p < 0·01) at the end of the study. The proportion of weight losers significantly decreased from 42% (CI 99%: 23·1–80·8) to 13·3% (p < 0·01). The weight ranges indicate substantial weight changes, but over time the weight ranges became narrower, indicating a tendency towards weight stability.Conclusions.  Although the nursing home had a formulated food and meal policy, this study shows the importance of a regular nutritional assessment combined with an individualised care planning.Relevance to clinical practice.  Regular weighing combined with individualised care planning results in weight stability in nursing home residents. Individualised approach for nutritional care led by a qualified nurse is just as important in nursing homes as it is in hospitals.
A review of developments in medical termination of pregnancy
Authors: Lipp Allyson 
Published: May 2008

Aim.  This literature review aims to supplement guidelines by providing an overview of recent evidence relevant to medical termination of pregnancy.Background.  Termination of pregnancy is available to women in the UK within legal parameters. Although guidelines form a strong body of evidence on which nurses and midwives can base their practice, there is a need to supplement them with up‐to‐date robust research findings.Method.  A systematic search of the literature with high sensitivity and low specificity was undertaken on five databases using medical subject headings (MeSH) terms including (medical) induced abortion, therapeutic abortion and termination of pregnancy.Results.  The literature search revealed articles under the following headings: The importance of choice for the women involved the need for the optimal medication type, dose, route and interval between stages one and two, and the optimum place for medical termination to take place.Conclusion.  It was found that women attach a great deal of importance to the opportunity to choose their method of termination. The first stage of mifepristone is now a standard practice and an optimum dose has been determined. Several studies examined misoprostol used in the second stage of medical termination. There was some evidence for repeated doses of misoprostol, particularly in later gestation, with conflicting evidence on the optimal route. There were some grounds for reducing the interval between stages. Consideration should be given to home medical termination based on individual circumstances and choice. Gestation and previous obstetric history is an important factor to take into account when determining optimal regimen.Relevance to clinical practice.  The number of medical termination of pregnancies performed has risen in recent years together with the nurses’ involvement. As new research is published, it is imperative that nurses adapt to base their involvement on the best available evidence.
Predictors of life situation among significant others of depressed or aphasic stroke patients
Authors: Franzén‐Dahlin Åsa , Laska Ann‐Charlotte , Larson Jenny , Wredling Regina , Billing Ewa , Murray Veronica 
Published: May 2008

Aim.  The aim of this study was to examine predictors of the life situation of the significant other of depressed or aphasic stroke patients.Background.  Depression and aphasia are common consequences of stroke, and both may put pressure on the significant other who have to deal not only with a possible physical handicap but also with communication and/or serious psychiatric difficulties.Design.  Descriptive, cross‐sectional study.Methods.  The participants were significant others of 71 depressed and 77 aphasic stroke patients. Depression was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorder, and degree of aphasia was diagnosed with the Amsterdam Nijmegen Everyday Language Test. Assessments of the life situation, state of depression and aggression, personality change and need of assistance were made through questionnaires issued to the significant others.Results.  Perceived need of assistance was the only common predictor of life situation of the significant other in both groups (p < 0·001). With respect to the aphasic patients, perceived personality change (p < 0·001) and living with the patient (p = 0·004) were factors that had a negative effect on the life situation of the significant other.Conclusions.  This study highlights that the perception of the patient’s need of assistance is an important factor in predicting the life situation among spouses of depressed as well as aphasic stroke patients. A comparison of the two groups to explain the life situation of the significant others revealed greater explanatory power for the aphasic group.Relevance to clinical practice.  Assessments of the spouses’ perception as well as of the patients’ factual situation may identify those significant others at risk. With this new approach, necessary steps may be taken to alleviate pressure on the significant other.
District nurses’ involvement in pain care: a theoretical model
Authors: Blomberg Anne‐Marie , Hylander Ingrid , Törnkvist Lena 
Published: May 2008

Aim.  To explore district nurses care of chronic pain sufferers and to create a theoretical model that can explain the variation in district nurses experiences when caring for these patients.Background.  Many people suffer from chronic pain, which greatly affects their wellbeing and causes physical suffering and psychosocial limitations. District nurses frequently meet patients who suffer from chronic pain and consequent problems. District nurses often feel powerless and ill‐equipped, and they experience difficulties during interactions with these patients.Method.  This is a qualitative study with a theory‐generating approach. Data were collected from interviews with 20 district nurses in five focus groups. Interviews were taped, transcribed and then analysed as per the grounded theory method.Results.  The result is a theoretical model of district nurses’ involvement in pain care. The model: (1) illustrates three main conditions in the care situation that influence district nurses’ involvement in pain care and (2) explains the connection between how district nurses actively or passively detect and actively or passively respond to patients with pain problems.Conclusions.  The model explains why district nurses sometimes feel powerless or ill‐equipped in dealing with chronic pain problems. Insufficient conditions make it difficult for district nurses to become involved with pain problems and thus result in passive detection of and passive response to pain problems. Supporting patients to communicate their pain, collaboration with and involvement from other professionals regarding pain care, the organisation’s guidelines and support for pain care and training in pain care are interventions that will contribute to district nurses’ involvement in pain care.Relevance to clinical practice.  Through the model, chronic pain care can be better explained and understood; consequently chronic pain care can be improved. The model can be used in each, unique, case‐study analysis. Nursing staff and students can also use the model as a basis for discussions about chronic pain sufferers.
Assessment of body image in obesity using a digital morphing technique
Authors: Johnstone A. M. , Stewart A. D. , Benson P. J. , Kalafati M. , Rectenwald L. , Horgan G. 
Published: May 2008

AbstractBackground  Historically, body image research has relied on generic, whole body outlines, which may not be suited to obese individuals. The development of computer generated, individualized digital images to represent body image may be more effective.Methods  Sixty volunteers participated, with three categories of subject: lean, obese and lean regular exercisers. Body image was assessed using a digital morphing technique in comparison to two standard paper questionnaires.Results  Using the novel digital morphing tool, obese subjects displayed poorer body awareness (perception) than their lean counterparts (P = 0.03), significantly over‐estimating their actual body size. Both genders overestimated body size to a similar degree. For body satisfaction, females wished to be smaller and males to be larger, identifying gender‐specific body regions (P < 0.001). Obese subjects showed greatest dissatisfaction (P < 0.001) with body image. There was significant correlation for body image dissatisfaction (P < 0.05) between the digital technique and the questionnaires, which was highest for the figural stimuli questionnaire (r = 0.80, P < 0.001).Conclusions  This method represents a novel and alternative approach to rating body image perception (IP) and satisfaction in obese subjects, particularly providing data on specific regional areas. Body image dissatisfaction appears to be both due to poor body IP compounded with the desire to be smaller.
Body fat distribution, serum glucose, lipid and insulin response to meals in Alström syndrome
Authors: Paisey R. B. , Hodge D. , Williams K. 
Published: May 2008

AbstractBackground  Alström syndrome is an autosomal recessive condition characterized by obesity, insulin resistance and hypertriglyceridaemia. Responses to fat and carbohydrate ingestion are important in planning dietetic advice and may help to explain the mechanism of metabolic disorder in the syndrome.Methods  After a 12‐h fast, five Alström subjects received a 3.1 MJ (742 kcal), 75.8% fat breakfast on day 1, and a 3.3 MJ (794 kcal), 77.5% carbohydrate breakfast on day 2. Serum glucose, triglyceride and insulin levels were measured at baseline, and 2 and 3.5 h post‐meal. Abdominal computerized tomography in three subjects and magnetic resonance imaging in one demonstrated distribution of abdominal fat.Results  Body fat was distributed subcutaneously, as well as viscerally. There were no changes in serum glucose, insulin or triglycerides after the high fat meal. Triglycerides remained stable after the high carbohydrate meal but glucose and log insulin levels increased [8.4 ± 4.1 to 13.4 ± 6.9 mmol L−1 (P < 0.05) and 2.6 ± 0.27 to 3.15 ± 0.42 pmol L−1 (P < 0.05), respectively].Conclusions  Dietetic advice in Alström syndrome must include calorie restriction to reduce obesity, which is predominantly subcutaneous. This study has shown that low carbohydrate advice may prove more effective than fat restriction in control of hyperglycaemia and hyperinsulinism. A single high energy meal does not exacerbate hypertriglyceridaemia.
A study of the attitudes and perceived barriers to undertaking clinical governance activities of dietitians in a Welsh National Health Service trust
Authors: Shakeshaft A. M. 
Published: May 2008

AbstractBackground  Previous studies of National Health Service (NHS) employees have identified barriers to undertaking clinical governance activities. Little of this research has investigated dietitians; however, where dietitians were included, generally positive attitudes towards research and evidence‐based practice were reported alongside the identified barriers.Methods  A quantitative, whole population census was undertaken via a questionnaire distributed to 54 dietitians employed by Gwent Healthcare NHS Trust.Results  Dietitians reported positive attitudes towards clinical governance; however, barriers to undertaking clinical governance activities were identified. The main barriers included lack of time, inadequate funding, the view that direct patient care should always be prioritised over clinical governance activities and inadequate research and critical evaluation skills.Conclusions  Findings were similar to those reported in previous studies of NHS staff. Where comparison was possible, all of the barriers identified were reported at lower levels than in previous studies. As the study was purely quantitative in nature, no understanding was gained regarding the nature of identified barriers or what factors influenced the dietitians’ attitudes and perceptions. For further in‐depth analysis of these factors, a qualitative study is recommended. As the study comprised a whole population census, the findings cannot be generalized to the dietetic profession as a whole, or to other staff groups within or outside of the study Trust.
Gastrointestinal inflammation: lessons from metabolic modulators
Authors: Arulampalam V. 
Published: May 2008

Abstract.The link between inflammation and metabolism was apparent already early last century, but has recently been revitalized following molecular studies of artherosclerosis, obesity and insulin resistance. A growing list of nuclear receptors, pivotal players in lipid, xenobiotic and energy metabolism has been identified as having immunomodulatory functions. These receptors might hold the key to some of the questions pertinent to chronic inflammation, and can lend themselves to be manipulated as therapeutic agents. This review will attempt to appraise the importance of such mediators in the pathophysiology of chronic inflammation in the colon.
SOME DYNAMIC ASPECTS OF BRAIN METABOLISM IN RATS GIVEN A PORTOCAVAL ANASTOMOSIS
Authors: CREMER JILL E. , HEATH D. F. , TEAL HAZEL M. , WOODS MARGARET S. , CAVANAGH J. B. 
Published: May 2008

Some dynamic aspects of brain metabolism in rats given a portocaval anastomosisThree weeks after portocaval shunt, when the only ultrastructural change in the CNS is watery swelling of astrocytes, the chronic hyperammonaemia so induced is associated with an increase of brain glutamine (330%), and a decrease of glutamate (90%) and glucose (63%). The metabolic fate of [2–14C] glucose was followed over a time course of 40 min after an intravenous injection. Details are given of a compartmental analysis of metabolic kinetic relationships, particularly of brain glutamate and glutamine. When applied to [2–14C]glucose data there was no evidence of an increased rate of glutamine synthesis in the operated rats. The increased labelling of glutamine could be accounted for by a larger pool size with a slower fractional turnover coefficient. In control rats [l‐14C]butyrate conferred label very rapidly on a small fraction of brain glutamine. Analysis showed there was little or no overlap between pools of amino acids labelled by [1–14C]butyrate and those labelled by [2–14C]glu‐cose. In operated animals there was a marked decrease in the total amount of labelled [l‐14C]butyrate entering the brain. Analysis showed some overlap between labelling of amino acids by [14C]butyrate and [14C]glucose, as well as several other changes. The biochemical differences found are likely to be causally related to the ultrastructural changes in astrocytes and lend support to previous concepts of morphological assignments to metabolic compartments.
OBSERVATIONS ON THE PATHOGENESIS OF SPINA BIFIDA IN CHICK EMBRYOS: FORKING OF THE NEURAL TUBE
Authors: ROKOS J. 
Published: May 2008

Observations on the pathogenesis of spina bifida in chick embryos: forking of the neural tubeForking is an early malformation in which the neural tube is split into 2–6 tubules, walled off by neuroepithelium. Occasionally the undivided tube proximal to forking of the neural tube (FNT) or some of the secondary tubules, may show marked cystic dilatation. FNT may occur at any level of the cord and hence its development is not related to the caudal cell mass (‘tail node’). It is important that FNT may be covered by intact ectoderm or may occur simultaneously with myeloschisis. Spina bifida (SB) probably develops in those cases of FNT in which marked increase in volume of the malformed tube, due either to cystic dilatation or to presence of multiple tubules, prevents the mesoderm from growing between the ectoderm and the neural tissue. FNT seems to result from primary damage to the neural tissue around the posterior neuropore, followed by formation of supernumerary tubules from fragmented neuroepithelium. This process does not interfere with normal growth of the ectoderm. The likely consequences of FNT are deduced tentatively from a comparison with cases of fully developed spontaneous human SB associated with diastematomyelia (DM). FNT is related to variable degree of myelodysplasia, diplomyelia, myelocystocele and meningocele. The hypothesis (Rokos, 1975) that meningocele is a manifestation of anteroposterior FNT (anteroposterior DM) is supported by the present findings.
NEUROFIBILARY DEGENERATION INDUCED IN THE RABBIT BY ALUMINUM CHLORIDE: ALUMINIUM NEUROFIBRILLARY TANGLES
Authors: YATES CELIA. M. , GORDON A. , WILSON HELEN 
Published: May 2008

Neurofibrillary degeneration induced in the rabbit by aluminium chloride aluminium neurofibrillary tanglesNeurofibrillary tangles were produced in the brain and spinal cord of rabbits by the intraventricular administration of aluminium chloride. The development of the tangles and of the accompanying behavioural effects was followed. The presence of tangles consistently preceded the onset of behavioural effects which comprised impairment of motor activity, terminal convulsions and opisthotonos. Limited electroencephalographic studies suggested that the convulsions were not of cortical origin. The lesion consisted of massed intraneuronal argyrophilic tangles which appeared as cytoplasmic clearings in sections stained with haematoxylin and eosin. The size of the tangle and the number of affected neurons increased with time and the tangles themselves were rather larger and differed in their distribution from those found in senile dementia and Alzheimer's disease. Of note was the sparing of the vagal nuclei and contrasting sensitivity of the hypoglossal nuclei to aluminium. It is suggested that aluminium‐induced tangles in the rabbit could serve as a model for the study of tangle formation.
EOSINOPHILIC ROD‐LIKE STRUCTURES IN MYELINATED FIBERS OF HAMSTER SPINAL ROOTS
Authors: HIRANO A. , DEMBITZER H. M. 
Published: May 2008

Eosinophilic rod‐like structures in myelinated fibers of hamster spinal rootsThe spinal roots of homozygous mutant hamsters carrying the recessive gene for hind leg paralysis as well as normal controls were studied at both the light and electron microscopic levels. Eosinophilic rod‐like inclusions essentially identical to those seen in human brains were observed in the inner loops of Schwann cells of myelinated fibers of the spinal roots. The electron microscope revealed inclusions with the characteristic ‘lattice‐like’ structure as well as other purely filamentous bodies. Both mutant and normal hamsters displayed these changes but they were more frequent in mutant animals.
APPLICATION OF AN IMMUNOPEROXIDASE METHOD TO A STUDY OF THE CENTRAL NERVOUS SYSTEM: PRELIMINARY FINDINGS IN A STUDY OF HUMAN FORMALIN‐FIXED MATERIAL
Authors: ESIRI M. M. , TAYLOR C. R. , MASON D. Y. 
Published: May 2008

Application of an immunoperoxidase method to a study of the central nervous system: preliminary findings in a study of human formalin‐fixed materialCentral nervous system matcrial from 40 patients has been studied using the immunoperoxidase technique on formalin‐fixed paraffin‐embedded tissues, to examine the distribution of immunoglobulins, transferrin, and lysozyme. In various pathological conditions there was evidence of deposition of immunoglobulins and other serum proteins on or in myelin sheaths, and neurons. In patients dying without evidence of neurological disease there was similar faint staining which was limited to perivascular zones and was probably due to postmortem diffusion of serum proteins out of vessels. Where present, reactive astrocytes stained for the presence of a number of serum proteins, including immunoglobulin and transferrin. In various inflammatory conditions immunoglobulin was demonstrated in mononuclear inflammatory cells in the perivascular spaces and in the neuropil of the brain. In recent plaques of multiple sclerosis there was positive specific staining of mononuclear inflammatory cells and myelin sheaths for immunoglobulin. The significance of these observations is briefly discussed.
QUANTITATIVE STUDIES OF MUSCLES TRANSPLANTED BETWEEN NORMAL AND DYSTROPHIC MICE
Authors: NEERUNJUN J. S. , DUBOWITZ V. 
Published: May 2008

Quantitative studies of muscles transplanted between normal and dystrophic miceAuto‐ and heterotransplants of minced tibialis anterior muscle in normal and dystrophic mice, with and without polydimethyl silicone‐capped (PDS) nerve, were examined at 150 days and the following morphological features quantitated: weights of transplants, total number of fibres, frequency and diameter of Type 1 and 2 fibres, number of fibres with internal nuclei, frequency of fibres undergoing splitting, degeneration and regeneration, and the amount of connective tissue. Similar studies were made on intact 150 day old normal and dystrophic muscles. In the intact animals there was no significant difference between male and female muscles, but dystrophic muscles were smaller and contained more connective tissue and fibres showing internal nuclei, splitting, degeneration and regeneration. The diameter of fibres was larger in male muscle of normal and female muscle of dystrophic mice. All 150 day old transplants in normal mice with PDS‐capped nerve and dystrophic mice consisted entirely of connective tissue. Only transplants in normal mice with intact nerve were viable. Both normal and dystropic transplants were smaller than unoperated normal muscle but their fibres differentiated normally and showed less variation in size than those of intact dystrophic muscle. They also contained some fibres with internal nuclei and fibres undergoing splitting. The data indicate that under the influence of the normal nerve dystrophic transplants fare just as well and are quantitatively similar to normal transplants. It is suggested that the motor nervous system plays an important role in the pathogenesis of murine dystrophy.