bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mice overexpressing p40 in lungs have reduced leucocyte influx and slightly impaired resistance during tuberculosis
Authors: Leemans Jaklien C. , Wieland Catharina W. , Florquin Sandrine , van der Poll Tom , Vervoordeldonk Margriet J. B. M. 
Published: January 2006

SummaryInterleukin (IL)‐12 (p70) is a heterodimeric cytokine composed of p40 and p35, that plays a major role in the protective immune response to Mycobacterium tuberculosis. To define the role of p40 in lungs during pulmonary M. tuberculosis infection we generated transgenic (Tg) mice overexpressing p40 under control of the surfactant protein C promoter. Tg mice expressed the transgene in their lungs, yet demonstrated elevated pulmonary p40 protein levels. After infection, Tg mice displayed higher pulmonary p40 and p70 levels than wild type mice. Interferon‐γ concentrations were similar in uninfected and infected Tg and wild type mice, arguing against agonistic effects of p40. Tg mice demonstrated reduced recruitment of macrophages, lymphocytes and neutrophils to the lungs early after infection. This was accompanied by reduced pulmonary tumour necrosis factor‐α, macrophage inflammatory protein (MIP)‐2 and MIP‐1α levels. This suggests that elevated p40 concentrations inhibited the chemotactic effects of p70 on leucocytes. Furthermore, Tg mice displayed slightly higher pulmonary mycobacterial outgrowth late in the infection than wild type mice. Taken together, we demonstrate that constitutive overexpression of p40 in lungs negatively influences IL‐12‐mediated leucocyte migration and protection against lung tuberculosis. This suggests a novel antagonistic role for p40 homodimers in regulating the chemotactic bioactivity of IL‐12 after pulmonary mycobacterial infection.
Immunohistochemical analysis of cytokines and apoptosis in tuberculous lymphadenitis
Authors: Mustafa Tehmina , Mogga Stanley J. , Mfinanga Sayoki G. M. , Mørkve Odd , Sviland Lisbet 
Published: January 2006

SummaryRelatively little is known about the effector mechanisms whereby the human immune system controls Mycobacterium tuberculosis infection. In this study we elaborate on the immune response and mechanisms of persistence of mycobacteria in lesions by analysing, using immunohistochemistry, the expression of cytokines [tumour necrosis factor‐α (TNF‐α), interleukin‐10 (IL‐10), transforming growth factor‐β (TGF‐β) and interferon‐γ (IFN‐γ)], apoptotic cells and apoptosis‐related proteins [Bcl2, Bax, Fas ligand (FasL) and Fas] in the human tuberculous lymphadenitis lesions. The expression of apoptosis‐related proteins has been shown to be exploited by mycobacteria to evade the immune response and persist in the host. Foreign body (FB) granulomas were used as controls. In tuberculosis (TB) granulomas, epithelioid cells and multinucleated giant cells expressed cytokines differently. In epithelioid cells, the numbers of TNF‐α‐, IL‐10‐ and TGF‐β‐stained cells were higher than IFN‐γ‐stained cells (P < 0·01). TGF‐β and FasL were strongly expressed in the necrotic centres as compared with other cytokines. More giant cells expressed IL‐10 and TGF‐β than expressed TNF‐α and IFN‐γ (P < 0·01). Staining of consecutive sections revealed that some giant cells expressed IL‐10 but not TNF‐α. Apoptotic TB giant cells correlated positively with the expression of TNF‐α, IFN‐γ and TGF‐β, but not with the expression of IL‐10. The percentage of giant cells expressing Bax was lower than those expressing Fas, unlike the epithelioid cells, suggesting that TB giant cells are less susceptible to apoptosis. Compared with FB giant cells, there were fewer TB giant cells showing TNF‐α, IFN‐γ, FasL, Fas expression or undergoing apoptosis (P < 0·05). Taken together, these observations show that the cellular microenvironment of TB granulomas down‐regulates microbicidal functions, favouring bacillary survival and persistence. TGF‐β and FasL may be responsible for tissue destruction. The giant cells, being less susceptible to apoptosis, may remain a continuous source of pro‐inflammatory cytokines, causing immune pathology.
Nurses’ perceptions of quality end‐of‐life care on an acute medical ward
Authors: Thompson Genevieve , McClement Susan , Daeninck Paul 
Published: January 2006

Aim.  This paper reports the findings of a study that generated a conceptual model of the nursing behaviours and social processes inherent in the provision of quality end‐of‐life care from the perspective of nurses working in an acute care setting.Background.  The majority of research examining the issue of quality end‐of‐life care has focused on the perspectives of patients, family members and physicians. The perspective of nurses has generally received minimal research attention, with the exception of those working within palliative or critical care. The vast majority of hospitalized patients, however, continue to be cared for and die on medical units. To date, little research has been conducted examining definitions and determinants of quality end‐of‐life care from the perspective of nurses working in acute adult medical settings.Method.  Grounded theory method was used in this study of 10 nurses working on acute medical units at two tertiary university‐affiliated hospitals in central Canada. Data were collected during 2002 by interview and participant observation.Findings.  The basic social problem uncovered in the data was that of nurses striving to provide high quality end‐of‐life care on an acute medical unit while being pulled in all directions. The unifying theme of ‘Creating a haven for safe passage’ integrated the major sub‐processes into the key analytic model in this study. ‘Creating a haven for safe passage’ represents a continuum of behaviours and strategies, and includes the sub‐processes of ‘facilitating and maintain a lane change’; ‘getting what's needed’; ‘being there’; and ‘manipulating the care environment’.Conclusion.  The ability of nurses to provide quality end‐of‐life care on an acute medical unit is a complex process involving many factors related to the patient, family, healthcare providers and the context in which the provision of end‐of‐life care takes place.
Profiles of pain after day surgery: patients’ experiences of three different operation types
Authors: Coll Anne Marie , Ameen Jamal 
Published: January 2006

Aim.  The aim of this paper is to examine the pain profile of three types of day surgery operation and undertake a comparative analysis of the intensity and duration of pain over a consecutive 4‐day period.Background.  Although studies on pain after day surgery have figured prominently, evidence is limited as to what intensity and duration of pain should be regarded as unacceptable, and how it varies for different operation types.Methods.  A prospective postal survey (n = 785) was undertaken during a 12‐month period in 1998/1999 involving three day surgery units in three different areas in England and Wales and based on three commonly performed operation types: hernia repair, varicose vein surgery and laparoscopic sterilization. A visual analogue scale was used to measure the intensity of pain experienced over a 4‐day consecutive time period. Analysis of variance was used to explore statistically significant differences between levels of pain for the operation types.Results.  On the day of surgery and even on the third postoperative day, high levels of severe pain (>50 mm on a Visual Analogue Scale) were experienced. Pain levels differed across different operation types. On the day of surgery, more patients undergoing laparoscopic sterilization experienced severe pain. By the third postoperative day, more of those who had been operated on for hernia repair, followed by varicose vein surgery and laparoscopic sterilization, continued to experience severe pain.Conclusion.  A large number of patients experienced severe levels of pain after day surgery. This could have resulted from a lack of knowledge about the assessment and management of pain, in which nurses play an important role. This study has highlighted that different pain trajectories are associated with different operation types, and this has important implications for the preoperative and postoperative preparation of day surgery patients as well as the role of nurses in the overall success of the day surgery process.
Caring for patients living with AIDS: knowledge, attitude and global level of comfort
Authors: Oyeyemi Adetoyeje , Oyeyemi Bashir , Bello Ibraheem 
Published: January 2006

Aims.  This paper reports a study that aimed to determine Nigerian nurses’ knowledge, attitudes and overall level of comfort in giving nursing care to acquired immune deficiency syndrome patients; determine the relationship between these variables; and identify the sociodemographic variables that influence nurses’ attitudes and how comfortable they are giving nursing care to patients with acquired immune deficiency syndrome.Background.  There is little information on sub‐Saharan African nurses’ knowledge, attitude and feeling of comfort in providing care to patients living with acquired immune deficiency syndrome.Methods.  Two hundred and seventy‐seven nurses in two teaching hospitals and two general hospitals in Nigeria were surveyed in 2003. The survey questionnaire had two parts. Part I elicited demographic information and information on previous encounters with acquired immune deficiency syndrome patients and Part II consisted of three subscales assessing knowledge, attitude and level of comfort administering certain nursing procedures to acquired immune deficiency syndrome patients.Results.  Respondents demonstrated low levels of knowledge and poor attitudes towards people with acquired immune deficiency syndrome. Attitudes appeared to be influenced by the nurse's speciality, rank, prior education and experience with patients with acquired immune deficiency syndrome. The responding nurses showed low levels of comfort in giving care to patients with acquired immune deficiency syndrome.Conclusions.  The findings suggest that Nigerian nurses will hesitate to care for patients with acquired immune deficiency syndrome, and that there is potential for avoidance behaviour towards them. Periodic continuing education and curriculum enhancement to include clinical clerkship, structured experience, guided discussion on ethical scenarios and attitude exploration are suggested in order to achieve and maintain adequate knowledge and a positive attitude. University‐based professional and postprofessional nursing education, which could enhance acquisition of a broad knowledge base, therefore represents the future direction.
Consulting the oracle: ten lessons from using the Delphi technique in nursing research
Authors: Keeney Sinead , Hasson Felicity , McKenna Hugh 
Published: January 2006

Aim.  The aim of this paper was to provide insight into the Delphi technique by outlining our personal experiences during its use over a 10‐year period in a variety of applications.Background.  As a means of achieving consensus on an issue, the Delphi research method has become widely used in healthcare research generally and nursing research in particular. The literature on this technique is expanding, mainly addressing what it is and how it should be used. However, there is still much confusion and uncertainty surrounding it, particularly about issues such as modifications, consensus, anonymity, definition of experts, how ‘experts’ are selected and how non‐respondents are pursued.Discussion.  This issues that arise when planning and carrying out a Delphi study include the definition of consensus; the issue of anonymity vs. quasi‐anonymity for participants; how to estimate the time needed to collect the data, analyse each ‘round’, feed back results to participants, and gain their responses to this feedback; how to define and select the ‘experts’ who will be asked to participate; how to enhance response rates; and how many ‘rounds’ to conduct.Conclusion.  Many challenges and questions are raised when using the Delphi technique, but there is no doubt that it is an important method for achieving consensus on issues where none previously existed. Researchers need to adapt the method to suit their particular study.
Nutrition of the critically ill patient and effects of implementing a nutritional support algorithm in ICU
Authors: Wøien Hilde , Bjørk Ida Torunn 
Published: January 2006

Aim.  To test whether a feeding algorithm could improve the nutritional support of intensive care patients.Background.  Numerous factors may impede delivery of both enteral and parenteral nutrition to patients in the intensive care unit. Often there is a discrepancy between what is prescribed and actual delivery of nutrients. The purpose of this study was to test the effect of a nutritional support algorithm in an intensive care unit mainly by using the enteral route and if necessary by combining enteral and parenteral nutrition.Methods.  In this prospective study, nutritional data were collected from routinely fed critically ill patients (controls, n = 21) during the first three days following admission to the intensive care unit. A nutritional support algorithm was then implemented and nutritional data were collected from critically ill patients who participated in this intervention (intervention group, n = 21). Data collected included the total amount of calories prescribed vs. received, onset of delivery of enteral nutrition, enteral vs. parenteral nutrition, and the use and size of enteral feeding tubes.Results.  Patients in the intervention group were both prescribed and actually received significantly larger amounts of nutrients than patients in the control group. They also received a larger proportion of their nutrients in the form of enteral nutrition. In addition, the nutritional support algorithm led to greater consistency in nursing practices with respect to aspiration of gastric content and rate of increment in enteral feeding.Conclusion.  The study confirms that a nutritional support algorithm improved the delivery of nutrients to critically ill patients. The algorithm was most effective with respect to the delivery of enteral nutrition. The effect was primarily because of early and more rapid increment in the delivery of enteral nutrition administered by nurses based on improved physician orders. The combination of enteral and parenteral nutrition may contribute to meeting adequate nutritional requirements.Relevance to clinical practice.  By using a nutritional algorithm focused on enteral nutrition, but including parenteral nutrition as a supplement, it is possible to improve the delivery of clinical nutrition in the intensive care unit patients.
Chest drain removal pain and its management: a literature review
Authors: Bruce Elizabeth A , Howard Richard F , Franck Linda S 
Published: January 2006

Aims and objectives.  The purpose of this review was to analyse critically the published research on chest drain removal pain and its management. The findings of descriptive and non‐pharmacological intervention studies were summarized and studies of analgesic efficacy were critiqued in depth.Background.  The removal of a chest drain is a painful and frightening experience, particularly for children. However, there is limited research regarding the amount of pain experienced or effectiveness of analgesia for this procedure.Results.  Fourteen studies were reviewed, including five descriptive studies; three studies of non‐pharmacological interventions; and six randomized controlled trials of morphine, local anaesthetics and Entonox. The search revealed only two paediatric studies. Many of the studies had design limitations or were poorly reported. The majority of studies indicated that patients experienced moderate to severe pain during chest drain removal, even when morphine or local anaesthetics were given.Conclusions.  Morphine alone does not provide satisfactory analgesia for chest drain removal pain. Non‐steroidal anti‐inflammatory drugs, local anaesthetics and inhalation agents may have a role to play in providing more effective analgesia for this procedure.Relevance to clinical practice.  Analgesic protocols for the management of painful procedures such as chest drain removal are unsatisfactory and practice in this area should be revised. More research is needed to determine the efficacy of drugs other than morphine, particularly Entonox and to investigate multi‐modal techniques of management further.
Caring in nursing: investigating the meaning of caring from the perspective of cancer patients in Beijing, China1
Authors: Liu Jun‐E , Mok Esther , Wong Thomas 
Published: January 2006

Aims.  The aims of the study were to develop an understanding of caring in nursing from the perspective of cancer patients and attempt to identify the concept of caring in the Chinese cultural context.Background.  Caring as a concept remains elusive, the acceptable definitions of the term care have not been reached. The expressions, processes and patterns of caring vary among cultures, but there is a lack of Chinese culture‐based study about caring in nursing.Methods.  A qualitative research design was used and 20 cancer patients were interviewed using a semi‐structured interview guide. A qualitative content analysis was used to identify themes in the data.Results.  Three themes emerged from the data, which suggested that caring is delivering care in an holistic way: nurses’ caring attitudes and their professional responsibility for providing emotional support, nurses’ professional knowledge and their professional responsibility for providing informational support and nurses’ professional skills and their professional responsibility for providing practical support. The caring behaviour of nurses as perceived by cancer patients involved the provision of emotional, informational, and practical support and help based on patients’ needs. A model of caring in nursing was formulated.Conclusions.  Caring in nursing as perceived by cancer patients involves nurses having qualified professional knowledge, attitudes and skills in oncology and providing the informational, emotional and practical supports and help required by cancer patients.Relevance to clinical practice.  Caring is manifested in nursing actions through nurse–patient communication process. Patients have their inner expectation for nurses’ caring behaviour and attitudes and nurses’ performance of caring or uncaring behaviour has a direct influence on the feelings of patients. It is necessary for all nurses to continue improving their oncology professional knowledge, attitudes and skills as well as their abilities of offering informational, emotional and practical support and help for their cancer patients.
Structured reminiscence: an intervention to decrease depression and increase self‐transcendence in older women
Authors: Stinson Cynthia Kellam , Kirk Edythe 
Published: January 2006

Aims/objectives. The purpose of this study was to assess the effect of group reminiscing on depression and self‐transcendence of older women residing in an assisted living facility in southeast Texas. There were two major objectives for this study. One objective was to determine if depression decreased in older women after structured reminiscence group sessions held twice weekly for a six‐week period. A second objective was to determine if self‐transcendence increased after structured reminiscence group sessions held twice weekly for a six‐week period.Background. Reminiscence has been studied to determine its impact on a variety of conditions including but not limited to depression, self‐esteem, fatigue, isolation, socialization, well‐being, language acquisition and cognitive functioning. This review of research specifically focused on reminiscence, depression, self‐transcendence and older people.Design/methods. Two groups were assessed at baseline, three and six weeks to answer the research questions. A sample of 24 women between the ages of 72 and 96 years were randomly assigned to either a reminiscence (experimental) group or the activity (control) group of the facility. Pearson'srwas used to determine the magnitude of the relationship between subjects’ responses on the Geriatric Depression Scale and the Self‐Transcendence Scale. A mixed design analysis of variance (anova) was used to determine if there was a difference between the experimental and control groups on scores of the Geriatric Depression Scale and the Self‐Transcendence Scale at baseline, three and six weeks.Conclusions. Data revealed a non‐significant decrease in depression and increase in self‐transcendence in the reminiscence group at the completion of six weeks, indicating a trend toward a positive result with reminiscence group sessions. The study also revealed an inverse relationship between depression and self‐transcendence. These findings underscore the importance of screening older people for depression.Relevance to clinical practice. One of the primary modalities used for the treatment of depression in elderly women is medication. Antidepressant medications lead to harmful side effects without alleviating the underlying depression. For these reasons, there is a need to research alternative therapies for treatment of depression in the older female. Reminiscence offers a possible intervention for treatment of depression in older women.
The transition to school: adaptation in young children with and without intellectual disability
Authors: McIntyre L. L. , Blacher J. , Baker B. L. 
Published: January 2006

AbstractBackground  Previous research has highlighted the importance of the transition to school for young children and their families. A child's successful adaptation to school is likely influenced by a number of factors, including academic, social, emotional, behavioural and cognitive competencies. Children with intellectual disability (ID) may be at heightened risk for early school difficulties, in part due to their deficits in cognitive and adaptive behaviours.Methods  Factors associated with the adaptive transition to school in young children with (n = 24) and without (n = 43) ID were examined. Adaptive transitions were defined as having few teacher‐reported problem behaviours and positive student–teacher relationships. Child self‐regulatory skills and both parent‐ and teacher‐reported social skills were evaluated to determine if they predicted positive adaptation in school for 5‐ to 6‐year‐old children. Data were gathered from child assessments, parent reports on standardized measures, direct observations of delay of gratification tasks and teacher reports on standardized measures.Results  Children with ID had significantly more teacher‐reported problem behaviour, poorer overall student–teacher relationships, fewer parent‐ and teacher‐reported social skills and fewer self‐regulation skills than typically developing children. Self‐regulation at child age 36 months (latency to touch a desired toy) was significantly related to adaptation to school, as were parent and teacher reports of social skills. Social skills significantly predicted adaptation to school, even after accounting for the effects of child IQ and adaptive behaviour.Conclusions  Children with ID had less positive early school experiences, as indicated by multiple indices of adaptation to school. Fostering early social skills may be an important target for increasing the positive adaptation to school for young children, especially those with ID.