bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical supervision and burnout: the influence of clinical supervision for community mental health nurses
Authors: Edwards Deborah , Burnard Philip , Hannigan Ben , Cooper Linda , Adams John , Juggessur Tara , Fothergil Anne , Coyle Dave 
Published: June 2006

Aims.  The aim of this study was to establish the degree to which clinical supervision might influence levels of reported burnout in community mental health nurses in Wales, UK.Methods.  The research instruments used were the Maslach Burnout Inventory and the Manchester Clinical Supervision Scale. At the time of the survey 817 community mental health nurses were reported to work within Wales. Two hundred and sixty (32%) community mental heath nurses working in 11 NHS Trusts responded to the survey.Results.  One hundred and eighty‐nine (73%) community mental heath nurses had experience of clinical supervision in their present posts and 105 (40%) in their previous posts. The findings from the Maslach Burnout Inventory indicated high levels of emotional exhaustion for 36%, high levels of depersonalization for 12% and low levels of personal accomplishment for 10% of the community mental heath nurses surveyed. Univariate analysis showed that those community mental heath nurses who were younger, male and who had not experienced six or more sessions of clinical supervision were more likely to report cold negative attitudes towards their clients as indicated by higher scores on the depersonalization subscale of the Maslach Burnout Inventory. One hundred and sixty‐six community mental heath nurses had experienced six or more sessions of clinical supervision and had completed the Maslach Burnout Inventory. Higher scores on the Manchester Clinical Supervision Scale were also associated with lower levels of measured burnout, with significant negative correlations between the total Manchester Clinical Supervision Scale score and the emotional exhaustion subscale (r = −0·148, P = 0·050) and the depersonalization subscale (r = −0·220, P = 0·003) of the Maslach Burnout Inventory. These findings suggest that if clinical supervision is effective then community mental heath nurses are likely to report lower levels of emotional exhaustion and depersonalization.Conclusions.  The findings from this study suggest that if clinical supervision is effective then community mental heath nurses report lower levels of burnout. Further research is required to determine the long‐term benefits of implementing clinical supervision and to determine which other factors have an influence on levels of burnout for this group of nurses.Relevance to clinical practice.  Health service organizations have a responsibility for ensuring that all individual practitioners have access to effective clinical supervision and the Nursing and Midwifery Council could extend the registered nurses personal accountability to include – to seek clinical supervision as and when necessary.
Modelling emergency decisions: recognition‐primed decision making. The literature in relation to an ophthalmic critical incident
Authors: Bond Susan , Cooper Simon 
Published: June 2006

Aims.  To review and reflect on the literature on recognition‐primed decision (RPD) making and influences on emergency decisions with particular reference to an ophthalmic critical incident involving the sub‐arachnoid spread of local anaesthesia following the peribulbar injection.Background.  This paper critics the literature on recognition‐primed decision making, with particular reference to emergency situations. It illustrates the findings by focussing on an ophthalmic critical incident.Design.  Systematic literature review with critical incident reflection.Methods.  Medline, CINAHL and PsychINFO databases were searched for papers on recognition‐primed decision making (1996–2004) followed by the ‘snowball method’. Studies were selected in accordance with preset criteria.Results.  A total of 12 papers were included identifying the recognition‐primed decision making as a good theoretical description of acute emergency decisions. In addition, cognitive resources, situational awareness, stress, team support and task complexity were identified as influences on the decision process.Conclusions.  Recognition‐primed decision‐making theory describes the decision processes of experts in time‐bound emergency situations and is the foundation for a model of emergency decision making (Fig. 2). Influences and processes of RPD making.imageRelevance to clinical practice.  Decision theory and models, in this case related to emergency situations, inform practice and enhance clinical effectiveness. The critical incident described highlights the need for nurses to have a comprehensive and in‐depth understanding of anaesthetic techniques as well as an ability to manage and resuscitate patients autonomously. In addition, it illustrates how the critical incidents should influence the audit cycle with improvements in patient safety.
Nurse discharge planning in the emergency department: a Toowoomba, Australia, study
Authors: Hegney Desley , Buikstra Elizabeth , Chamberlain Chris , March Judy , McKay Michelle , Cope Gail , Fallon Tony 
Published: June 2006

Aim.  This study aimed to ascertain whether a model of risk screening carried out by an experienced community nurse was effective in decreasing re‐presentations and readmissions and the length of stay of older people presenting to an Australian emergency department.Objectives.  The objectives of the study were to (i) identify all older people who presented to the emergency department of an Australian regional hospital; (ii) identify the proportion of re‐presentations and readmissions within this cohort of patients; and (iii) risk‐screen all older patients and provide referrals when necessary to community services.Design.  The study involved the application of a risk screening tool to 2139 men and women over 70 years of age from October 2002 to June 2003. Of these, 1102 (51·5%) were admitted and 246 (11·5%) were re‐presentations with the same illness. Patients presenting from Monday to Friday from 08:00 to 16:00 hours were risk‐screened face to face in the emergency department. Outside of these hours, but within 72 hours of presentation, risk screening was carried out by telephone if the patient was discharged or within the ward if the patient had been admitted.Results.  There was a 16% decrease in the re‐presentation rate of people over 70 years of age to the emergency department. Additionally during this time there was a 5·5% decrease in the readmission rate (this decrease did not reach significance). There was a decrease in the average length of stay in hospital from 6·17 days per patient in October 2002 to 5·37 days per patient in June 2003. An unexpected finding was the decrease in re‐presentations in people who represented to the emergency department three or more times per month (known as ‘frequent flyers’).Conclusions.  Risk screening of older people in the emergency department by a specialist community nurse resulted in a decrease of re‐presentations to the emergency department. There was some evidence of a decreased length of stay. It is suggested that the decrease in re‐presentations was the result of increased referral and use of community services. It appears that the use of a specialist community nurse to undertake risk screening rather than the triage nurse may impact on service utilization.Relevance to clinical practice.  It is apparent that older people presenting to the emergency department have complex care needs. Undertaking risk screening using an experienced community nurse to ascertain the correct level of community assistance required and ensuring speedy referral to appropriate community services has positive outcomes for both the hospital and the patient.
Increased Levels of IgE and Autoreactive, Polyreactive IgG in Wild Rodents: Implications for the Hygiene Hypothesis
Authors: Devalapalli A. P. , Lesher A. , Shieh K. , Solow J. S. , Everett M. L. , Edala A. S. , Whitt P. , Long R. R. , Newton N. , Parker W. 
Published: June 2006

AbstractTo probe the potential role of Th1 versus Th2 reactivity underlying the hygiene hypothesis, intrinsic levels of Th1‐associated and Th2‐associated antibodies in the serum of wild rodents were compared with that in various strains of laboratory rodents. Studies using rat lung antigens as a target indicated that wild rats have substantially greater levels of autoreactive, polyreactive immunoglobulin G (IgG), but not autoreactive, polyreactive IgM than do laboratory rats, both on a quantitative and qualitative basis. Increased levels of serum IgG and IgE were observed in both wild rats and wild mice relative to their laboratory‐raised counterparts, with the effect being most pronounced for IgE levels. Further, wild rats had greater intrinsic levels of both Th1‐ and Th2‐associated IgG subclasses than did lab rats. The habitat (wild versus laboratory raised) had a more substantial impact on immunoglobulin concentration than did age, strain or gender in the animals studied. The presence in wild rodents of increased intrinsic, presumably protective, non‐pathogenic responses similar to both autoimmune (autoreactive IgG, Th1‐associated) and allergic (IgE, Th2‐associated) reactions as well as increased levels of Th1‐associated and Th2‐associated IgG subclasses points toward a generally increased stimulation of the immune system in these animals rather than a shift in the nature of the immunoreactivity. It is concluded that, at least to the extent that feedback inhibition is a controlling element of immunoreactivity, an overly hygienic environment may affect the threshold of both types of immune responses more so than the balance between the different responses.
Prevalence of intraspecific relationships between range size and abundance in Danish birds
Authors: Borregaard Michael Krabbe , Rahbek Carsten 
Published: June 2006

ABSTRACTIn this study, we investigate patterns in the prevalence of dynamic range–abundance relationships of the Danish avifauna, using breeding bird atlases from 1971 to 1974 and from 1993 to 1996. We focus on differences between common and rare species by dividing the assemblage into range‐size quartiles. The trend in total population size was determined using an index. Range was determined as grid cell occupancy and standardized to facilitate comparisons between common and rare species. While narrow‐ranging species showed strong and consistent range–abundance relationships, the relationships for widespread species were weak and exhibited considerable variation. This may be due to differences in patterns of resource use, since widespread species generally have wider niches, and so may be less affected by resource‐based factors linking range and abundance. Since a tight and dynamic relationship is upheld for rare species, monitoring strategies based on range size surveys seem viable.
Ipsilateral corticocortical projections to the primary and middle temporal visual areas of the primate cerebral cortex: area‐specific variations in the morphology of connectionally identified pyramidal cells
Authors: Elston Guy N. , Rosa Marcello G. P. 
Published: June 2006

AbstractWe quantified the morphology of over 350 pyramidal neurons with identified ipsilateral corticocortical projections to the primary (V1) and middle temporal (MT) visual areas of the marmoset monkey, following intracellular injection of Lucifer Yellow into retrogradely labelled cells. Paralleling the results of studies in which randomly sampled pyramidal cells were injected, we found that the size of the basal dendritic tree of connectionally identified cells differed between cortical areas, as did the branching complexity and spine density. We found no systematic relationship between dendritic tree structure and axon target or length. Instead, the size of the basal dendritic tree increased roughly in relation to increasing distance from the occipital pole, irrespective of the length of the connection or the cortical layer in which the neurons were located. For example, cells in the second visual area had some of the smallest and least complex dendritic trees irrespective of whether they projected to V1 or MT, while those in the dorsolateral area (DL) were among the largest and most complex. We also observed that systematic differences in spine number were more marked among V1‐projecting cells than MT‐projecting cells. These data demonstrate that the previously documented systematic differences in pyramidal cell morphology between areas cannot simply be attributed to variable proportions of neurons projecting to different targets, in the various areas. Moreover, they suggest that mechanisms intrinsic to the area in which neurons are located are strong determinants of basal dendritic field structure.
Horizontal cell receptive fields are reduced in connexin57‐deficient mice
Authors: Shelley Jennifer , Dedek Karin , Schubert Timm , Feigenspan Andreas , Schultz Konrad , Hombach Sonja , Willecke Klaus , Weiler Reto 
Published: June 2006

AbstractHorizontal cells are coupled by gap junctions; the extensive coupling of the horizontal cells is reflected in their large receptive fields, which extend far beyond the dendritic arbor of the individual cell. In the mouse retina, horizontal cells express connexin57 (Cx57). Tracer coupling of horizontal cells is impaired in Cx57‐deficient mice, which suggests that the receptive fields of Cx57‐deficient horizontal cells might be similarly reduced. To test this hypothesis we measured the receptive fields of horizontal cells from wildtype and Cx57‐deficient mice. First, we examined the synaptic connections between horizontal cells and photoreceptors: no major morphological alterations were found. Moreover, horizontal cell spacing and dendritic field size were unaffected by Cx57 deletion. We used intracellular recordings to characterize horizontal cell receptive fields. Length constants were computed for each cell using the cell's responses to concentric light spots of increasing diameter. The length constant was dependent on the intensity of the stimulus: increasing stimulus intensity reduced the length constant. Deletion of Cx57 significantly reduced horizontal cell receptive field size. Dark resting potentials were strongly depolarized and response amplitudes reduced in Cx57‐deficient horizontal cells compared to the wildtype, suggesting an altered input resistance. This was confirmed by patch‐clamp recordings from dissociated horizontal cells; mean input resistance of Cx57‐deficient horizontal cells was 27% lower than that of wildtype cells. These data thus provide the first quantification of mouse horizontal cell receptive field size and confirm the unique role of Cx57 in horizontal cell coupling and physiology.
Cold‐seeking behavior as a thermoregulatory strategy in systemic inflammation
Authors: Almeida Maria C. , Steiner Alexandre A. , Branco Luiz G. S. , Romanovsky Andrej A. 
Published: June 2006

AbstractSystemic inflammation (SI) is a leading cause of hospital death. Although fever and hypothermia are listed as symptoms in every definition of SI, how SI affects thermoregulatory behavior is unclear. SI is often modeled by systemic administration of bacterial lipopolysaccharide (LPS) to rats. When rats are not allowed to regulate their body temperature (Tb) behaviorally, LPS causes either fever or hypothermia, and the direction of the response is determined by LPS dose and ambient temperature (Ta). However, in many studies in which rats were allowed to regulate Tb behaviorally (by selecting their preferred Ta in a thermogradient apparatus), they consistently expressed warmth‐seeking behavior and developed fever. We hypothesized that SI can cause not only warmth‐seeking behavior but also cold‐seeking behavior; we then tested this hypothesis by studying LPS‐induced thermoregulatory behavior in adult Wistar rats. A multichannel thermogradient apparatus, implantable data loggers and infrared thermography were used; multiple control experiments were conducted; and the ability of the apparatus to reliably register the changes in rats' preferred Ta induced by thermal (external cooling or heating) or chemical (TRPV1 or TRPM8 agonist) stimuli was confirmed. The rats responded to a low dose of LPS (10 µg/kg i.v.) with warmth‐seeking behavior and a polyphasic fever, but to a high dose (5 mg/kg i.v.) with marked cold‐seeking behavior and hypothermia followed by warmth‐seeking behavior and fever. This is the first well‐controlled study to report SI‐associated cold‐seeking behavior in rats. Cold‐seeking behavior is likely to be an important defense response in severe SI.
GABAA receptor activation suppresses Period 1 mRNA and Period 2 mRNA in the suprachiasmatic nucleus during the mid‐subjective day
Authors: Ehlen J. Christopher , Novak Colleen M. , Karom Mary C. , Gamble Karen L. , Paul Ketema N. , Albers H. Elliott 
Published: June 2006

AbstractThe mammalian circadian clock can be entrained by photic and nonphotic environmental time cues. γ‐aminobutyric acid (GABA) is a nonphotic stimulus that induces phase advances in the circadian clock during the middle of the subjective day. Several nonphotic stimuli suppress Period 1‐ and Period 2 mRNA expression in the suprachiasmatic nucleus (SCN); however, the effect of GABA on Period mRNA is unknown. In the present study we demonstrate that microinjection of the GABAA receptor agonist muscimol into the SCN region suppresses the expression of Period 1 mRNA in the hamster. A significant suppression of Period 2 mRNA following microinjection of muscimol was not observed in free‐running conditions. However, Period 2 mRNA was significantly reduced following muscimol treatment when animals were maintained under a light cycle and transferred to constant darkness 42 h prior to treatment. An additional study investigated the maximum behavioural phase advance inducible by GABAA receptor activation.Together, these data indicate that, like other nonphotic stimuli, GABA suppresses Period 1‐ and Period 2 mRNA in the SCN.
Altered geographic and temporal variability in phenology in response to climate change
Authors: Menzel A. , Sparks T. H. , Estrella N. , Roy D. B. 
Published: June 2006

ABSTRACTAim  In response to recent climate warming, numerous studies have reported an earlier onset of spring and, to a lesser degree, a later onset of autumn, both determined from phenological observations. Here, we examine whether these reported changes have affected the synchronization of events on a regional level by examining temporal and spatial variability in phenology. In particular, we study whether years with earlier springs are associated with an altered spatial variability in phenology.Location  Germany and the United Kingdom.Methods  Plant phenological observations of 35 different phases (events such as flowering and leafing) collected by the German Weather Service (1951–2002) and butterfly phenological records of 29 species collected by the UK Butterfly Monitoring Scheme (1976–2003) are used. In these long‐term records, we examine the temporal (year‐to‐year) variability and the spatial (geographic or between site) variability with particular emphasis on how they vary with time of the year and with earliness or lateness of the phase.Results  Early phenological events (i.e. spring) are more variable than later events, both in time and in space, although the pattern is clearer for plants than for butterflies. Confirming previous results, we find a clear relationship between the mean date of spring and summer phases and the degree to which they have become earlier. The spatial variability of spring events is greater in warmer years that have faster plant development. However, late spring and summer events do not show a consistent relationship. Autumn events are somewhat more spatially variable in years characterized by later seasons.Main conclusions  This is the first examination of spatial variability of plant and animal phenological events at a multinational scale. Earlier spring events are likely to be associated with increased spatial variability in plants, although this is unlikely to also be true for summer events. If species experience differential changes in geographic variation this may disrupt interactions among them, e.g. in food webs. On the other hand, these may offer advantages for mobile species. Further research on linked species is recommended.
Molecular Variability of the 16p13.3 Region in Amerindians and its Anthropological Significance
Authors: Battilana J. , Cardoso‐Silva L. , Barrantes R. , Hill K. , Hurtado A. M. , Salzano F. M. , Bonatto S. L. 
Published: June 2006

SummaryA total of 1558 base pairs in the 16p13.3 region were investigated in 98 individuals of Mongolian, Northern Arctic and Amerindian affiliation, and the results compared with those obtained in a previous worldwide study of the same genomic region. Fifty‐five polymorphic sites could be classified into thirty‐five haplotypes from the total data. A median joining network based on the haplotypes revealed two distinct clusters: one with low diversity, with haplotypes found in all five geographic‐ethnic categories; while the other, with the most divergent haplotypes, was composed mainly of Africans and a few Amerindians. Almost all neutrality parameters yielded significantly negative values. Demographic simulations with the exclusively Amerindian dataset rejected all scenarios, including a bottleneck beginning more than 12,000 years ago. The demographic scenarios tested considering population growth were similar among the Amerindian and worldwide or Eurasian data sets. The results suggest that Amerindians are a representative sample of Eurasian populations, preserving the signal of demographic growth from the out of Africa exodus and, together with data from uniparental markers, support a scenario of a bottleneck of moderate intensity during the peopling of the New World.
The regulation of acetylcholinesterase by cis‐elements within intron I in cultured contracting myotubes
Authors: Cohen Tatiana V. , Randall William R. 
Published: June 2006

AbstractThe onset of spontaneous contraction in rat primary muscle cultures coincides with an increase in acetylcholinesterase (AChE) activity. In order to establish whether contractile activity modulates the rate of AChE transcript synthesis, and what elements of the gene are determinant, we examined the promoter and intron I in contracting muscle cultures. Ache genomic fragments attached to a luciferase reporter were transfected into muscle cultures that were either electrically stimulated or paralyzed with tetrodotoxin to enhance or inhibit contractions, respectively. Cultures transfected with intron I‐containing constructs showed a 2‐fold increase in luciferase activity following electrical stimulation, compared to tetrodotoxin treatment, suggesting that this region contains elements responding to contractile activity. Deleting a 780 bp distal region within intron I, containing an N‐box element at +890 bp, or introducing a 2‐bp mutation within its core sequence, eliminated the contraction‐induced response. In contrast, mutating an N‐box element at +822 bp had no effect on the response. Furthermore, co‐transfecting a dominant negative GA‐binding protein (GABP), a transcription factor known to selectively bind N‐box elements, reduced the stimulation‐mediated increase. Our results suggest that the N‐box within intron I at +890 bp is a regulatory element important in the transcriptional response of Ache to contractile activity in muscle.