bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social capital, age and religiosity in people who are lonely
Authors: Lauder William , Mummery Kerry , Sharkey Siobhan 
Published: February 2006

Aims and objectives.  The aims of the study were to (i) investigate age and loneliness, (ii) investigate the association between religiosity and loneliness, and (iii) and explore the relationship between social capital and loneliness.Background.  Loneliness is the subjective experience of social isolation and is a risk factor for a wide range of health problems including heart disease and depression. Poor self‐rated health, domestic violence and poor economic conditions are associated with greater loneliness.Design.  The study was a cross‐sectional survey of a random sample of adults aged 18 years and over.Methods.  A random sample of 1289 subjects was interviewed by computer‐assisted telephone interviewing. This interview included the Loneliness Scale and items from the Social Capital Module of the General Household Survey.Findings.  Loneliness is more common in men and people without strong religious beliefs. An income‐loneliness gradient is evident. Little support was found for the association between social capital and loneliness.Conclusion.  The prevalence of loneliness is relatively stable in this population. Loneliness is linked to income and unemployment and as such pathways between socio‐economic factors, loneliness and health need to guide interventions and future research.Relevance to clinical practice.  Loneliness is linked to a range of social and economic factors. Current Health Visiting practice recognizes the importance of tackling the effects of poverty and social deprivation and places community building at the core of much Health Visiting practice. This broad community level approach can usefully transfer into all community nursing and health promotion activity.
Nurse consultants: organizational influences on role achievement
Authors: Woodward Valerie A , Webb Christine , Prowse Morag 
Published: February 2006

Aims.  This paper reports on organizational influences on nurse consultant post holders. The influence of individual characteristics has been the subject of another paper.Background.  Nurse consultant posts were set up in the United Kingdom from the late 1990s onwards and, therefore, there has been little opportunity to report on evaluations of these innovative initiatives.Design.  A cross‐sectional design, using a convenience sample, was adopted.Methods.  Ten nurse consultants working in a variety of settings and specialties participated in in‐depth, tape‐recorded interviews. The data were analysed using the Framework approach.Findings.  Support systems were important influences on nurse consultants’ role achievement levels. These took the form of internal trust networks, nurse consultant forums and links with higher education institutions. Post holders both gave and received support and acted to empower other nurses. Thus, relationships were vital to successful role integration. The culture and structures of the National Health System were also a powerful influence in terms of local and national modernization policies, and participants had to be careful in their choice of strategies to deal with the traditional medically dominated culture.Conclusions.  The new nurse consultant role is challenging and innovative, but a major area of contention is how much post holders are expected to take on work previously done by doctors rather than developing their nursing role. Organizational support and commitment are needed if nurse consultants are to maximize the benefits of this innovation.Relevance to clinical practice.  The findings show that new nursing roles are not always easily accepted in multidisciplinary settings and that holders of such post need to have the appropriate previous knowledge, skills and personal characteristics, as well as the ability to negotiate their way through organizational influences.
The power of hope: patients’ experiences of hope a year after acute spinal cord injury
Authors: Lohne Vibeke , Severinsson Elisabeth 
Published: February 2006

Aims and objectives.  The aim of this present study was to explore patients’ experiences of the meaning they attribute to hope and hoping a year after acute spinal cord injury.Background.  Nursing literature is pointing towards the importance of having hope for a healthful living. However, the concept of hope has preliminarily been defined in an abstract and general way and is therefore difficult to grasp.Design and methods.  This qualitative study has a longitudinal and descriptive–explorative design. Data were collected by personal interviews (n = 10) one year after acute spinal cord injury. A phenomenological–hermeneutic approach, based on the philosophy of Ricoeur, was used to extract the essences of the patients’ experiences.Results.  The findings resulted in one main interpretation: ‘The Power of Hope’, and two sub‐themes: ‘Will, Faith and Hope’ and ‘Hoping, Struggling and Growing’. The power of hope was interpreted as the individual having experienced the meaning a year after the injury, mainly expressed through will power.Conclusions.  This study shows that experiences of hope were important to all participants, providing energy and power to the process of struggling because hope is necessary for further progress and personal development.Relevance to clinical practice.  Nursing interventions should be mainly directed towards emotional and motivational strategies to promote the will power and personal growth through learning experiences.
Registered Nurses working together with family members of older people
Authors: Weman Karin , Fagerberg Ingegerd 
Published: February 2006

Aim.  The aim of the study was to reach a more profound understanding, through looking at nurses’ working situation, of those factors that influence how nurses are able to work together with family members of older people living in nursing homes or similar facilities.Background.  Working with the care of older people as a Registered Nurse provides a varied job with many challenges. Nurses have to co‐operate with family members of those in community health care. Co‐operation is important and necessary for all involved.Design.  Nurses working in elder care in a geographically defined area received a questionnaire with three open‐ended questions, on the difficulties and/or problems involved with working together with family members, and the positive or negative aspects of this co‐operation.Methods.  Analysis was carried out using the latent content analysis method.Results.  Three themes, problems within the system, interaction with families and caring in nursing work, are presented with categories and their subcategories. The nurses wanted their superior to be a nurse so that their working situation would be better understood. Appreciation from their superior and family members was also a very important part of their work as nurses in community health care. The frequent changes and the lack of time in the work of elder care often put nurses under considerable psychological pressure. For the most part family members are a resource for the elder, but sometimes they will avoid contact, which will make co‐operating difficult.Conclusion.  Registered Nurses and family members are dependent on each other in their care of the elder.Relevance to clinical practice.  More attention should be paid to the working situation of Registered Nurses in community health care, and their ability to work together with family members of older people.
Understanding and overcoming the barriers of implementing patient decision aids in clinical practice*
Authors: O'Donnell Siobhan , Cranney Ann , Jacobsen Mary J. , Graham Ian D. , O'Connor Annette M. , Tugwell Peter 
Published: February 2006

AbstractPatient decision aids (ptDAs) have been developed to assist patients with difficult health‐related decisions. Despite their proven effects on decision quality in numerous efficacy trials, we lack an evidence‐based approach for implementing them as part of the process of care. Pragmatic trials of ptDAs have uncovered a myriad of implementation challenges; therefore we need a better understanding of the barriers and strategies to overcome them to facilitate their widespread uptake. The following paper provides an overview of the barriers related to the uptake of ptDAs within the process of care and the strategies, opportunities and research priorities to overcome them. This report is based on our interpretation of the literature and our collective experience in implementing ptDAs within trials and other contexts.
Acute Activation of Hippocampal Glucocorticoid Receptors Results in Different Waves of Gene Expression Throughout Time
Authors: Morsink M. C. , Steenbergen P. J. , Vos J. B. , Karst H. , Joëls M. , De Kloet E. R. , Datson N. A. 
Published: February 2006

AbstractSeveral aspects of hippocampal cell function are influenced by adrenal‐secreted glucocorticoids in a delayed, genomic fashion. Previously, we used Serial Analysis of Gene Expression to identify glucocorticoid receptor (GR)‐induced transcriptional changes in the hippocampus at a fixed time point. However, because changes in mRNA levels are transient and most likely precede the effects on hippocampal cell function, the aim of the current study was to assess the transcriptional changes in a broader time window by generating a time curve of GR‐mediated gene expression changes. Therefore, we used rat hippocampal slices obtained from adrenalectomised rats, substituted in vivo with low corticosterone pellets, predominantly occupying the hippocampal mineralocorticoid receptors. To activate GR, slices were treated in vitro with a high (100 nM) dose of corticosterone and gene expression was profiled 1, 3 and 5 h after GR‐activation. Using Affymetrix GeneChips, a striking pattern with different waves of gene expression was observed, shifting from exclusively down‐regulated genes 1 h after GR‐activation to both up and down regulated genes 3 h after GR‐activation. After 5 h, the response was almost back to baseline. Additionally, real‐time quantitative polymerase chain reaction was used for validation of a selection of responsive genes including genes involved in neurotransmission and synaptic plasticity such as the corticotropin releasing hormone receptor 1, monoamine oxidase A, LIMK1 and calmodulin 2. This permitted confirmation of GR‐responsiveness of 15 out of 18 selected genes. In conclusion, direct activation of GR in hippocampal slices results in transient changes in gene expression. The pattern in which gene expression was modulated suggests that the fast genomic effects of glucocorticoids may be realised via transrepression, preceding a later wave of transactivation. Furthermore, we identified a number of interesting candidate genes which may underlie the glucocorticoid‐mediated effects on hippocampal cell function.
Regulation by Orexin of Feeding Behaviour and Locomotor Activity in the Goldfish
Authors: Nakamachi T. , Matsuda K. , Maruyama K. , Miura T. , Uchiyama M. , Funahashi H. , Sakurai T. , Shioda S. 
Published: February 2006

AbstractOrexin is a hypothalamic neuropeptide that is implicated in the regulation of feeding behaviour and the sleep‐wakefulness cycle in mammals. However, in spite of a growing body of knowledge concerning orexin in mammals, the orexin system and its function have not been well studied in lower vertebrates. In the present study, we first examined the effect of feeding status on the orexin‐like immunoreactivity (orexin‐LI) and the expression of orexin mRNA in the goldfish brain. The number of cells showing orexin‐LI in the hypothalamus of goldfish brain showed a significant increase in fasted fish and a significant decrease in glucose‐injected fish. The expression level of orexin mRNA in the brains of fasted fish increased compared to that of fed fish. We also examined the effect of an i.c.v. injection of orexin or an anti‐orexin serum on food intake and locomotor activity in the goldfish. Administration of orexin by i.c.v. injection induced a significant increase of food intake and locomotor activity, whereas i.p. injection of glucose or i.c.v. injection of anti‐orexin serum decreased food consumption. These results indicate that the orexin functions as an orexigenic factor in the goldfish brain.
Purinergic Receptor Ligands Stimulate Pro‐Opiomelanocortin Gene Expression in AtT‐20 Pituitary Corticotroph Cells
Authors: Zhao L.‐F. , Iwasaki Y. , Oki Y. , Tsugita M. , Taguchi T. , Nishiyama M. , Takao T. , Kambayashi M. , Hashimoto K. 
Published: February 2006

AbstractAlthough recent studies have suggested that purinergic receptors are expressed in the anterior pituitary gland, their involvement in the regulation of pituitary hormone gene expression is not completely understood. In the present study, we examined the expression of purinergic receptors and the effects of purinergic receptor ligands on pro‐opiomelanocortin (POMC) gene expression, in AtT20 mouse corticotroph cells. We identified the expression of most of the purinergic receptor subtypes (A1, A2, P2X1, 3‐7, P2Y1, 2, 4) mRNAs, analysed by the reverse transcriptase‐polymerase chain reaction. We also found that adenosine and ATP, two representative and endogenous agonists of A1‐3 and P2X/P2Y receptors, respectively, stimulated the 5′‐promoter activity of the POMC gene in a dose‐ and time‐related manner. When these ligands were simultaneously used with corticotrophin‐releasing hormone (CRH), effects that were more than additive were observed, suggesting an enhancing role of these compounds in CRH‐mediated adrenocorticotrophic hormone (ACTH) synthesis. These ligands also stimulated the expression of transcription factors involved in the regulation of the POMC gene, but did not enhance ACTH secretion. Finally, the positive effect of adenosine as well as CRH was completely inhibited by the protein kinase A inhibitor H89, whereas that of ATP was not influenced, indicating that different intracellular signalling pathways mediate these effects. Altogether, our results suggest a stimulatory role for these purinergic receptor ligands in the regulation of POMC gene expression in corticotroph cells. Because adenosine and ATP are known to be produced within the pituitary gland, it is possible they may be acting in an autocrine/paracrine fashion.
Ethnic differences in total and cause‐specific infant mortality in the Netherlands
Authors: Troe Ernst‐Jan W. M. , Bos Vivian , Deerenberg Ingeborg M. , Mackenbach Johan P. , Joung Inez M. A. 
Published: February 2006

SummaryWe examined ethnic differences in infant mortality and the contribution of several explanatory variables. Data of Statistics Netherlands from 1995 to 2000 were studied (1 178 949 live borns). Proportional hazard analysis was used to show ethnic dif­ferences in total and cause‐specific infant mortality. Obstetric, demographic and ­geographical variables, and socio‐economic status were considered as possible determinants. The four major ethnic minority groups showed an elevated risk of infant mortality, ranging from 1.28 in Turkish infants to 1.50 in Antillean/Aruban infants. In the early neonatal period, risks were elevated for Surinamese (hazard ratio [HR] 1.48, 95% confidence intervals [CI] 1.23, 1.78) and Antilleans/Arubans (HR 1.43, 95% CI 1.06, 1.92). In the post‐neonatal period, risks were only elevated for Turkish (HR 2.20, 95% CI 1.80, 2.69) and Moroccan infants (HR 2.06, 95% CI 1.67, 2.55). Surinamese and Antillean/Aruban infants had an elevated risk of dying from perinatal causes (HR 1.62, 95% CI 1.33, 1.98 and 1.69, 95% CI 1.24, 2.29 respectively), Turkish and Moroccan infants had an elevated risk of dying from congenital anomalies (HR 1.42, 95% CI 1.16, 1.73 and 1.46, 95% CI 1.20, 1.79 respectively).Inequalities  as  a  result  of  socio‐economic  position  and  demographic  factors,  such as marital status and maternal age, partially explain the ethnic differences in infant mortality. We conclude that ethnic minority groups in the Netherlands have a higher infant mortality than the native population, which in part seems preventable by reducing inequalities in socio‐economic status. Marital status and age of the mother are important other risk factors of infant mortality.
Parental marijuana use and risk of childhood acute myeloid leukaemia: a report from the Children's Cancer Group (United States and Canada)
Authors: Trivers Katrina F. , Mertens Ann C. , Ross Julie A. , Steinbuch Michael , Olshan Andrew F. , Robison Leslie L. 
Published: February 2006

SummaryThe aetiology of childhood acute myeloid leukaemia (AML) is largely unknown. Maternal marijuana use just before, or during pregnancy has been previously associated with childhood AML. This case–control investigation formally tested the hypothesis that parental marijuana use increases the risk of childhood AML in offspring. Incident cases of AML <18 years of age, diagnosed between 1989 and 1993, and registered with the Children's Cancer Group (a paediatric clinical co‐operative group), were eligible for inclusion. Control children were selected via random digit dialling and individually matched 1:1 to cases on age, race and residential location, except for rare morphological subtypes that were matched 1:2. Parental telephone interviews were conducted to determine exposure and covariate information. Conditional logistic regression was used to estimate matched odds ratios (OR) and 95% confidence intervals [CI] adjusted for household income, parental education and parental age. The analysis included 517 cases and 610 matched controls. A series of sensitivity analyses examined the potential for recall bias.Ever lifetime use of marijuana by mothers was not associated with childhood AML [OR = 0.89; 95% CI = 0.66, 1.19]. Maternal marijuana use any time during the 3 months before, or during pregnancy was inversely associated with childhood AML [OR = 0.43; 95% CI = 0.23, 0.80]. Paternal use during the same time period was not associated with risk. Assuming a large degree of differential exposure misclassification was present, the corrected ORs ranged between 0.82 and 1.40. The previously reported positive association between maternal marijuana use before or during pregnancy and childhood AML was not confirmed. The decreased ORs observed in this study may be due to recall bias assuming plausibly low values of sensitivity.
Systematic review of adverse outcomes of external cephalic version and persisting breech presentation at term
Authors: Nassar Natasha , Roberts Christine L. , Barratt Alexandra , Bell Jane C. , Olive Emily C. , Peat Brian 
Published: February 2006

SummaryThe aim of this study was to determine the frequency of adverse maternal and fetal outcomes of both external cephalic version (ECV) and persisting breech presentation at term. We conducted a systematic review of the literature using Medline, Embase and All Evidence Based Medicine (EBM) Reviews databases. Data were extracted from studies that compared women who had an ECV from 36 weeks’ gestation with a similar control group of women enrolled at the same gestational age, eligible for, but who did not have an ECV.Eleven studies with a total of 2503 women were included. Adverse outcomes related to ECV were rarely reported and in most studies there was no evidence that relevant outcomes were ascertained among similar women who did not have an ECV. There was no increased risk of antepartum fetal death associated with ECV, but numbers were small. There were no reported cases of uterine rupture, placental abruption, prelabour rupture of membranes or cord prolapse, but these outcomes were not examined among controls. Onset of labour within 24 h and nuchal cord was non‐significantly higher among women who had an ECV compared with those with a persisting breech. Despite limited reporting and small numbers, the results of our review suggest that adverse maternal and fetal outcomes of both ECV and persisting breech presentation are rare. Only with improved reporting and collection of safety data on ECV and persisting breech presentation can we provide high‐quality information to assist informed decision making by pregnant women with a breech presentation at term.
Risks of repeated miscarriage
Authors: George Lena , Granath Fredrik , Johansson Anna L. V. , Olander Bodil , Cnattingius Sven 
Published: February 2006

SummaryThere is a lack of well‐designed epidemiological studies of possible risk factors for repeated miscarriage. In this Swedish population‐based case–control study, we investigated the association between sociodemographic and anthropometric factors, obstetric history and life‐style factors, with respect to the risks of first‐trimester repeated miscarriage. Information on maternal characteristics was collected through in‐person interviews. Plasma blood samples were analysed for cotinine and folate concentrations. Adjusted odds ratios (OR) with 95% confidence interval [CI] were used to estimate the relative risk of repeated miscarriage.The risks of repeated miscarriage were increased for women aged ≥35 years (adjusted OR 2.9 [95% CI 1.4, 5.8]), as well as for women aged ≤24 years (OR 2.8 [95% CI 1.1, 6.8]). Women with a history of at least one preceding miscarriage prior to the two index pregnancies, women reporting prolonged time to conceive, and women with a history of myoma, faced a more than fourfold increased risk of repeated miscarriage. Smokers were at an increased risk of repeated miscarriage (OR 2.1 [95% CI 1.1, 4.1]). Among non‐smoking women with high caffeine intake, there was an increased risk of repeated miscarriage, whereas there was no such association among smokers. Low plasma folate levels were not associated with increased risks.
Maternal caffeine consumption and fetal death: a case–control study in Uruguay
Authors: Matijasevich Alicia , Barros Fernando C. , Santos Iná S. , Yemini Alejandra 
Published: February 2006

SummaryMatijasevich A, Barros FC, Santos IS, Yemini A. Maternal caffeine consumption and fetal death: a case–control study in Uruguay. Paediatric and Perinatal Epidemiology 2006; 20: 100–109.The objective of this study was to examine the association between caffeine intake during pregnancy and fetal mortality in Montevideo, the capital city of Uruguay, taking into account several potential confounding factors. A population‐based case–control study was conducted between 1 August 2002 and 31 December 2003. A total of 382 cases and 792 controls were recruited. Cases consisted of women hospitalised with a medically confirmed diagnosis of spontaneous antepartum fetal death, in all maternity hospitals during the study period. Antepartum fetal death was defined as a fetal death in which the attending doctor certified that the death occurred prior to the onset of labour. Fetal deaths were included if they were of at least 20 weeks’ gestational age or weighed >350 g. Controls were women who had a live, vigorous and term adequate‐for‐gestational‐age newborn. Multiple gestations and fetuses/newborns with evident congenital malformations were excluded.Only a small proportion of the mothers (8.1% of the cases and 9.5% of the controls) did not consume caffeine during pregnancy. Among consumers, mate drinking was the most frequent source of caffeine in both cases and controls. After controlling for mother's and her partner's education, history of abortions and/or fetal deaths, vomiting/nausea during the first trimester of gestation and attendance for prenatal care, the category of mean caffeine intake of ≥300 mg/day showed a significantly increased risk of fetal death (OR 2.33 [1.23; 4.41]) compared with no caffeine consumption during pregnancy. The study also found that less‐educated women, mothers who did not attend for prenatal care and women with a history of abortions and fetal death were at an increased risk of fetal death. As mate drinking is highly consumed among pregnant women in Uruguay, the association found with fetal death makes it a preventable risk factor.