bluuebunny/crossref_metadata_2025_split huggingface dataset:
Misconceived and maladaptive beliefs about heart disease: a comparison between Taiwan and Britain
Authors: Lin Yu‐Ping , Furze Gill , Spilsbury Karen , Lewin Robert JP 
Published: October 2008

Aims and objectives. To assess and compare misconceived and maladaptive beliefs about coronary heart disease between Taiwanese and British people with heart disease.Background.  Holding misconceived and maladaptive beliefs about heart disease has deleterious effects on a patient’s quality of life. Cultural contexts influence a person’s responses to illness, but little information exists about the ways in which cultural values influence a person’s attributions and coping behaviours regarding their heart disease.Design.  A cross‐sectional survey using a descriptive comparative design was carried out in Taiwan and Britain.Methods.  A structured questionnaire was used to elicit misconceived or potentially maladaptive beliefs about heart disease. People with a confirmed diagnosis of coronary heart disease were recruited from a teaching hospital in Taipei (n = 238) and a tertiary cardiothoracic centre in the North of England (n = 204).Results.  Taiwanese patients held more misconceived and maladaptive beliefs about heart disease than those in Britain. Both British and Taiwanese patients showed high agreement on ‘stress is one of the main causes of heart disease’ and ‘always avoid stress’, but these beliefs were more common in Taiwanese patients (p < 0·001). Misconceptions about avoiding anything that might bring on angina were common in both countries.Conclusions.  While there were some similarities in the cardiac beliefs held by the two groups of patients, Taiwanese patients held significantly more misconceptions. This may be explained by differences between the patients’ cultures, including social norms, health care provision and health information from the media.Relevance to clinical practice.  Interventions should be developed to dispel maladaptive beliefs thereby altering the coping actions of patients. The meaning and purpose of specific behaviours needs to be interpreted within the context of a patient’s culture. Awareness of cultural perspectives may help to develop nursing care plans that are more successful as they are more individually applicable to patients.
Use of non‐conventional nurses’ attire in a paediatric hospital: a quasi‐experimental study
Authors: Festini Filippo , Occhipinti Valentina , Cocco Margherita , Biermann Klaus , Neri Stella , Giannini Chiara , Galici Valeria , De Martino Maurizio , Caprilli Simona 
Published: October 2008

Aims: To test the impact of a multi‐coloured non‐conventional attire on a population of children admitted to a paediatric hospital.Design: Quasi‐experimental before‐after controlled study.Background: It has been suggested that non‐conventional nurses’ uniforms in paediatric settings may contribute to lowering children’s distrust towards healthcare providers and reduce fear. Little formal research has investigated on the impact of nursing attire in a paediatric setting. No study has so far analysed the effects in actual use of a non‐conventional, other than the traditional type of uniform, on a paediatric hospitalised population.Design: A quasi‐experimental study.Methods: We introduced multi‐coloured nurses’ attire in two wards of a paediatric hospital. Using open questions and semantic differential scales (SDS), we evaluated the effects of this non‐conventional attire on a group of hospitalised children, compared to sex‐and‐age‐matched controls interviewed before the introduction. Parents were also interviewed.Results: One hundred and twelve hospitalised children and their parents (n = 112) were studied. The percentage of positive words used by children to define their nurse was higher in children interviewed after the introduction of non‐conventional uniforms (96·2% vs. 81·8%, p = 0·01). Children’s perception of nurses was significantly improved by the use of multi‐coloured attire (‘bad’–‘good’ SDS: p = 0·01; ‘disagreeable’–‘nice’ SDS: p = 0·001). Children’s perceptions regarding hospital environment did not change. Parents’ perception of nurses’ uniform adequacy to the role and capability to reassure resulted improved (p < 0·0001, p = 0·0003).Conclusions: Multi‐coloured non‐conventional attire were preferred by hospitalised children and their parents. Their introduction improved the perception children have of their nurses. Moreover, the coloured uniforms improve the parents perception about the reliability of the nurse.Relevance to clinical practice: The use of non‐conventional nurses’ attire can contribute to improve the child–nurse relation, which has the potential to ease the discomfort experienced by children due to hospitalisation.
Restraint use among nursing home residents: cross‐sectional study and prospective cohort study
Authors: Meyer Gabriele , Köpke Sascha , Haastert Burkhard , Mühlhauser Ingrid 
Published: October 2008

Aims and objectives.  To investigate (1) the prevalence of physical restraints and psychoactive medication, (2) newly administered physical restraints, frequency of application of the devices and frequency of psychoactive medication on demand during 12‐month follow‐up and (3) characteristics associated with restraint use in nursing homes.Background.  High quality data on restraint use in German nursing homes are lacking so far. Such information is the basis for interventions to achieve a restraint‐free care.Design.  Cross‐sectional study and prospective cohort study.Setting and subjects.  Thirty nursing homes with 2367 residents in Hamburg, Germany.Methods.  External investigators obtained prevalence of physical restraints by direct observation on three occasions on one day, psychoactive drugs were extracted from residents’ records and prospective data were documented by nurses.Results.  Residents’ mean age was 86 years, 81% were female. Prevalence of residents with at least one physical restraint was 26·2% [95% confidence interval (CI) 21·3–31·1]. Centre prevalence ranged from 4·4 to 58·9%. Bedrails were most often used (in 24·5% of residents), fixed tables, belts and other restraints were rare. Prevalence of residents with at least one psychoactive drug was 52·4% (95% CI 48·7–56·1). The proportion of residents with at least one physical restraint after the first observation week of 26·3% (21·3–31·3) cumulated to 39·5% (33·3–45·7) at the end of follow‐up (10·4 SD 3·3 months). The relative frequency of observation days with at least one device ranged from 4·9–64·8% between centres. No characteristic was found to explain centre differences.Conclusions.  The frequency of physical restraints and psychoactive drugs in German nursing homes is substantial. Pronounced centre variation suggests that standard care is possible without restraints.Relevance to clinical practice.  Effective restraint minimisation approaches are urgently warranted. An evidence‐based guideline may overcome centre differences towards a restraint‐free nursing home care.
Metasynthesis: withdrawing life‐sustaining treatments: the experience of family decision‐makers
Authors: Meeker Mary Ann , Jezewski Mary Ann 
Published: October 2008

Aim.  The present study was undertaken to synthesise findings from qualitative investigations of family participation in decisions to withdraw and/or withhold life‐sustaining treatment from a seriously ill family member.Background.  As a consequence of increasing effectiveness and sophistication of available medical interventions, death is commonly preceded by a decision to withdraw or withhold potentially life‐sustaining treatments. These decisions take place in a bioethical context characterised by the preeminence of self‐determination, but patients are typically too ill to make their own decisions. Thus, family members are called upon to participate in these morally consequential decisions on the patient’s behalf.Design.  MetasynthesisMethod.  Metasynthesis is a form of inquiry that provides for integration of qualitative studies’ findings to strengthen knowledge for practice and advance theoretical development. This metasynthesis was conducted using the constant comparative methods of grounded theory.Results.  Family members engage in a process of participation in decision‐making that is comprised of three major categories: reframing reality, relating and integrating. Surrogates used both cues and information as they reframed their understanding of the patient’s status. Relationships with providers and with other family members powerfully influenced the decision‐making process. Integrating was characterised by reconciling and going forward. This part of the process has both intrapersonal and interpersonal aspects and describes how family decision‐makers find meaning in their experience and move forward in their lives.Conclusions.  This synthesis provides a more comprehensive and empirically supported understanding of family members’ experiences as they participate in treatment decisions for dying family members.Relevance to clinical practice.  This metasynthesis provides evidence to improve family care during treatment withdrawal/withholding decision‐making and a theoretical model that can be used to guide creation of clinical practice guidelines. Through increased understanding of family members’ experiences, clinicians can more effectively support family decision‐making processes.
Using the caring dimensions inventory as an indicator of person‐centred nursing
Authors: McCance Tanya , Slater Paul , McCormack Brendan 
Published: October 2008

Aims.  This paper reports findings from a large‐scale quasi‐experimental study that used a measure of caring as a means of evaluating person‐centred nursing and aims to illustrate the synergy between the concepts of caring and person‐centredness.Background.  Evidence would suggest that effective person‐centred nursing requires the formation of therapeutic relationships between professionals, patients and others significant to them in their lives and that these relationships are built on mutual trust, understanding and a sharing of collective knowledge. This correlates with the conceptualisation of caring that is underpinned by humanistic nursing theories.Design.  A pretest post‐test design was used in this study to evaluate the effect of person‐centred nursing on a range of outcomes, one of which was nurses’ and patients’ perception of caring.Methods.  The Person‐Centred Nursing Index was the main data collection tool. The Caring Dimension Inventory and Nursing Dimensions Inventory, were component parts of the Person‐Centred Nursing Index and were used to measure nurses’ and patients’ perceptions of caring. The Person‐Centred Nursing Index was administered at five points in time over a two‐year intervention period.Results.  Nurses had a clear idea of what constituted caring in nursing, identifying statements that were reflective of person‐centredness, which was consistent over time. This was in contrast to patients, whose perceptions were more variable, highlighting incongruencies that have important implications for developing person‐centred practice.Conclusion.  The findings confirm the Caring Dimension Inventory/Nursing Dimensions Inventory as an instrument that can be used as an indicator of person‐centred practice. Furthermore, the findings highlight the potential of such instruments to generate data on aspects of nursing practice that are traditionally hard to measure.Relevance to clinical practice.  The findings would suggest that nurses need to be aware of patients’ perceptions of caring and use this to influence changes in practice, where the prime goal is to promote person‐centredness.
Sinorhizobium meliloti, a bacterium lacking the autoinducer‐2 (AI‐2) synthase, responds to AI‐2 supplied by other bacteria
Authors: Pereira Catarina S. , McAuley J. Randall , Taga Michiko E. , Xavier Karina B. , Miller Stephen T. 
Published: October 2008

SummaryMany bacterial species respond to the quorum‐sensing signal autoinducer‐2 (AI‐2) by regulating different niche‐specific genes. Here, we show that Sinorhizobium meliloti, a plant symbiont lacking the gene for the AI‐2 synthase, while not capable of producing AI‐2 can nonetheless respond to AI‐2 produced by other species. We demonstrate that S. meliloti has a periplasmic binding protein that binds AI‐2. The crystal structure of this protein (here named SmlsrB) with its ligand reveals that it binds (2R,4S)‐2‐methyl‐2,3,3,4‐tetrahydroxytetrahydrofuran (R‐THMF), the identical AI‐2 isomer recognized by LsrB of Salmonella typhimurium. The gene encoding SmlsrB is in an operon with orthologues of the lsr genes required for AI‐2 internalization in enteric bacteria. Accordingly, S. meliloti internalizes exogenous AI‐2, and mutants in this operon are defective in AI‐2 internalization. S. meliloti does not gain a metabolic benefit from internalizing AI‐2, suggesting that AI‐2 functions as a signal in S. meliloti. Furthermore, S. meliloti can completely eliminate the AI‐2 secreted by Erwinia carotovora, a plant pathogen shown to use AI‐2 to regulate virulence. Our findings suggest that S. meliloti is capable of ‘eavesdropping’ on the AI‐2 signalling of other species and interfering with AI‐2‐regulated behaviours such as virulence.
Uptake of the antifungal cationic peptide Histatin 5 by Candida albicans Ssa2p requires binding to non‐conventional sites within the ATPase domain
Authors: Sun Jianing N. , Li Wansheng , Jang Woong Sik , Nayyar Namrata , Sutton Mark D. , Edgerton Mira 
Published: October 2008

Summary Candida albicans Hsp70 Ssa1/2 proteins have been identified as cell wall binding partners for the antifungal cationic peptide Histatin 5 (Hst 5) in vivo. C. albicans Ssa2p plays a major role in binding and translocation of Hst 5 into fungal cells, as demonstrated by defective peptide uptake and killing in C. albicans SSA2 null mutants. Candidal Hsp70 proteins are classical chaperone proteins with two discrete functional domains consisting of peptide binding and ATP binding regions. Pull‐down assays with full‐length and truncated Ssa2 proteins found that the ATPase domain was required for Hst 5 binding. Further mapping of Ssa2p by limited digestion and peptide array analyses identified two discrete Hst 5‐binding epitopes within the ATPase region. Expression of Ssa2p in C. albicans cells carrying mutations in the first epitope identified by thermolysin digestion (Ssa2128−132A3) significantly reduced intracellular transport and fungicidal activity of Hst 5, confirming its importance as a binding site for Hst 5 function in vivo. Since this Hst 5 binding site lies within the Ssa2p ATPase domain near the ATP‐binding cleft, it is possible that ATP modulates Hst 5 binding to Ssa2p. Indeed, gel filtration assays demonstrated that although nucleotides are not required for Hst 5 binding, their presence improved binding affinity by 10‐fold. Thus, C. albicans Ssa2p binds Hst 5 at a surface‐localized epitope in a subunit of the ATPase domain; and this region is required for intracellular translocation and killing functions of Hst 5.
Ribosome biogenesis; the KsgA protein throws a methyl‐mediated switch in ribosome assembly
Authors: Mangat Chand S. , Brown Eric D. 
Published: October 2008

SummaryMany trans‐acting factors that aid in ribosome biogenesis have been identified in higher organisms but relatively few such factors are known in prokaryotes. In bacteria, the list of such factors includes ATP‐energized helicases and chaperones as well as an emerging cadre of switch GTPases. The KsgA protein is a universally conserved methyltransferase that dimethylates both A1518 and A1519 of the 16S rRNA of the small ribosomal subunit. Methylation has long been thought to be solely for fine‐tuning of protein translation. In this issue of Molecular Microbiology, Connolly et al. present data suggesting KsgA might function in the assembly of the small subunit of the ribosome. Indeed, the work indicates that KsgA might have a checkpoint role in ribosome biogenesis where methylation by this protein marks the completion of its assembly role. These findings open our thinking to new candidate assembly factors and provide a new direction for understanding ribosome assembly.
Identification of VceA and VceC, two members of the VjbR regulon that are translocated into macrophages by the Brucella type IV secretion system
Authors: De Jong Maarten F. , Sun Yao‐Hui , Den Hartigh Andreas B. , Van Dijl Jan Maarten , Tsolis Renée M. 
Published: October 2008

SummarySurvival and replication inside host cells by Brucella spp. requires a type IV secretion system (T4SS), encoded by the virB locus. However, the identity of the molecules secreted by the T4SS has remained elusive. We hypothesized that proteins translocated by the T4SS would be co‐regulated with the virB operon. The LuxR family regulator VjbR, known to regulate virB, bound a fragment of the virB promoter containing an 18 bp palindromic motif (virB promoter box), showing that VjbR regulated the virB operon directly. To identify virB co‐regulated genes, we searched the Brucella suis 1330 and B. abortus 2308 genomes for genes with an upstream virB promoter box. One hundred and forty‐four promoters in the two genomes contained the virB promoter box, including those of fliC encoding flagellin and cgs encoding cyclic β‐glucan synthetase. Thirteen of these proteins were tested for VirB‐dependent translocation into macrophages using a β‐lactamase reporter assay. This analysis resulted in the identification of the proteins encoded by BAB1_1652 (VceA) and BR1038/BAB1_1058 (VceC) as novel protein substrates of the Brucella T4SS. VceC could also be translocated by the Legionella pneumophila Dot/Icm T4SS into host cells. Our results suggest that VjbR co‐ordinates expression of the T4SS and at least two of its secreted substrates.
Abrogation of ospAB constitutively activates the Rrp2‐RpoN‐RpoS pathway (sigmaN‐sigmaS cascade) in Borrelia burgdorferi
Authors: He Ming , Oman Tara , Xu Haijun , Blevins Jon , Norgard Michael V. , Yang X. Frank 
Published: October 2008

SummaryMolecular mechanisms underlying the reciprocal regulation of the two major surface lipoproteins and virulence factors of Borrelia burgdorferi, OspA and OspC, are not fully understood. Herein, we report that inactivation of the ospAB operon resulted in overproduction of OspC and many other lipoproteins via the constitutive activation of the Rrp2‐RpoN‐RpoS pathway. Complementing the ospAB mutant with a wild‐type copy of ospA, but not an ospA variant that lacks the lipoprotein signal sequence, restored normal regulation of the Rrp2‐RpoN‐RpoS pathway; these results indicate that the phenotype was not caused by spurious mutations. Interestingly, while most of the ospAB mutant clones displayed a constitutive ospC expression phenotype, some ospAB mutant clones showed little or no ospC expression. Further analyses revealed that this OspC‐negative phenotype was independent of abrogation of ospAB. While activation of the Rrp2‐RpoN‐RpoS pathway was recently shown to downregulate ospA, our findings suggest that reduction of OspA can also activate this pathway. We postulate that the activation of the Rrp2‐RpoN‐RpoS pathway and downregulation of OspA form a positive feedback loop that allows spirochaetes to produce and maintain a constant high level of OspC and other lipoproteins during tick feeding, a strategy that is critical for spirochaetal transmission and mammalian infection.
Effect of Nippostrongylus brasiliensis L3 ES on inflammatory mediator gene transcription in lipopolysaccharide lung inflammation
Authors: ZHAO M. , BROWN D. M. , MACCALLUM J. , PROUDFOOT L. 
Published: October 2008

SUMMARY The anti‐inflammatory properties of parasitic helminths have been largely linked to their excretory–secretory (ES) products. Some studies have noted a lack of TNF‐α production and limited recruitment of neutrophils into the lungs after Nippostrongylus brasiliensis infection. We previously reported that instillation of ES from L3 larvae of N. brasiliensis to the lungs could inhibit the recruitment of neutrophils on a background of LPS‐induced inflammation. A similar reduction in neutrophil recruitment was observed in this study. This reduction was associated with the significant inhibition in gene transcription of the adhesion molecule, ICAM‐1, and the chemokine, MIP‐2 in bronchoalveolar lavage (BAL) cells. The LPS‐stimulated gene transcription of the pro‐inflammatory cytokines TNF‐α and IL‐1β was also significantly reduced by L3 ES. Inducible nitric oxide synthase (iNOS) is normally elevated in classically activated macrophages, however, in this case gene transcription of iNOS was inhibited by L3 ES and may suggest a phenotype change to anti‐inflammatory. The general inhibition of pro‐inflammatory mediators observed in this study suggests that infective stage L3 larvae excrete and/or secrete inhibitory products capable of modifying the normally potent LPS inflammatory response.
Comparison of four statistical approaches to score child development: a study of Malawian children
Authors: Cheung Yin‐Bun , Gladstone Melissa , Maleta Ken , Duan Xiaolian , Ashorn Per 
Published: October 2008

SummaryObjective  Assessment of child development often results in a multitude of binary outcome data. There is no agreed way to use them to score the developmental status of children. Conventional methods include age‐standardized Z‐scores and simple sum of number of passes. Recently two approaches based on the Rasch model and the concept of ‘developmental age’ have been proposed. This study aims to compare the performance of the four approaches.Methods  In a longitudinal study, 473 Malawian children were measured for growth status at age 36 months and administered a new test of developmental milestones between age 3 and 6 years. The test consisted of four domains: gross motor (GM), fine motor (FM), social and language development. The four approaches were used to score the developmental level of each child in each domain, and the results compared.Results  In this sample, the approach based on the Rasch model provided development scores that were more normally distributed than the other approaches did. The four sets of scores were highly correlated with each other. They gave similar estimates of the effect of height‐for‐age on GM, social and language development. In FM development, the maximum difference in the effect size estimates was only 0.04 standard deviation despite its statistical significance (P = 0.009).Conclusion  The four approaches were practically equivalent in the context of the estimation of an intervention effect or association. Their relative advantages and disadvantages are discussed. None of them can be universally recommended.