bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nursing Advocacy: an Ethic of Practice
Authors: Gaylord Nan , Grace Pamela 
Published: November 2007

Advocacy is an important concept in nursing practice; it is frequently used to describe th nurse-client relationship. The term advocacy, however, is subject to ambiguity of interpretation. Such ambiguity was evidenced recently in criticisms levelled at the nursing profession by hospital ethicist Ellen Bernal. She reproached nursing for using 'patient rights advocate' as a viable role for nurses. We maintain that, for nursing, patient advocacy may encompass, but is not limited to, patient rights advocacy. Patient advocacy is not merely the defence of infringements of patient rights. Advocacy for nursing stems from a philosophy of nursing in which nursing practice is the support of an individual to promote his or her own well-being, as understood by that individual. It is an ethic of practice. La défense des malades joue un grand rôle dans la pratique des infirmiers/ères. Le terme est souvent utilisé pour définir les rapports entre malades et soignants. Le mot 'defénse' pourtant, peut être mal compris. Une ambiguïté était évidente récemment dans la critique de la profession infirmière faite par la philosophe éthique Ellen Bernal. Elle reproche à la profession d'utiliser le terme 'avocat des droits des malades' pour désigner le rôle primordial des infirmiers/ères. Nous croyons que pour les soignants, la défense des malades peut comprendre le rôle 'd'avocat des droits des malades' mais elle ne s'y borne pas. La défense n'est pas limitée à la défense des infractions des droits des malades. La défense dans la profession infirmière est basée sur une philosophie où la pratique infirmière est le soutien des malades dans leur quête de promouvoir leur propre bien-être. Die Fürsprache spielt eine wichtige Rolle in der Krankenpflege. Sie wird oft als kennzeichnend für die Beziehung zwischen Patient und Pflegepersonal beschrieben. Der Ausdruck 'Fürsprache' kann aber auch mehrdeutig interpretiert werden. Das wurde letzthin in der Kritik der Ethikerin Ellen Bernal an der Krankenpflege sichtbar. Sie machte den Pflegenden den Vorwurf, dass sie sich die Rolle des 'Rechts-Advokat des Patienten' aneignen. Wir sind der Meinung, dass es die Aufgabe des Pflegepersonals ist, auch die Rechte der Patienten zu vertreten, aber dass das nur ein Teil der Fürsprache ist. Sie ist nicht nur Verteidignung von verletzten Patientenrechten. Die Fürsprache in der Krankenpflege stammt von einer Philosophie, deren Ausübung die Unterstützung der Patienten für ihr Wohlergehen zum Ziel hat, so wie die Patienten selbst ihr Wohlergehen verstehen. Sie ist eine Ethik der Tat.
Suicide and Voluntary Active Euthanasia: Why the Difference in Attitude?
Authors: Beech Ian 
Published: November 2007

It appears that the attitudes of health professionals differ towards suicide and voluntary active euthanasia. An acceptance of, if not an agreement with, voluntary active eutha nasia exists, while there is a general consensus that suicide should be prevented. This paper searches for a working definition of suicide, to discover ethical reasons for the negative value that suicide assumes, and also to provide a term of reference when comparing suicide with euthanasia. On arriving at a working definition of suicide, it is compared with voluntary active euthanasia. An analysis of utilitarian and deontological considerations is provided and proves to be inconclusive with respect to the ethical principles informing the attitudes of professionals. Therefore, a search for other influences is attempted; this indicates that psychological influences inform attitudes to a greater degree than ethical principles.
Ethics Education and Nursing Practice
Authors: Scott P. Anne 
Published: November 2007

This paper suggests that a consideration of health care practice is a necessary step in gaining insight into the appropriate composition of an ethics course for students in the health care professional. Health care practice, if it responds to the needs of society, is dynamic in nature. In the current climate of change in the health service, the author sug gests that the nursing profession needs to become more proactive in analysing and attempting to determine the future shape of nursing. To protect patient care the nursing profession needs to have its eyes open to the ethical dimensions of changes in role and practice. The author argues that, in attempting to ensure that the education to which nursing students are exposed is of relevance, it is necessary to introduce an element of the ideal into the ethics component of their professional education. From early on in their profes sional development students should be aware of the scope and standards of practice, and the type of role enactment to which the profession requires them to aspire.
Nursing Ethics: What Lies Ahead? The Case of Bulgaria
Authors: Popova Sashka 
Published: November 2007

In Bulgaria, we are sharing a transition to a civic society and a market economy, which means transferring to new parameters of our culture. Many old customs based on coer cion, obedience and unacceptable interference are gradually dying out, and new princi ples tend to shape the way we live our collective lives. These include the ethics of partnership, which tend to create an assertion of individual rights and an affirmation of free will and autonomy, and within which the individual is protected in the pursuit of personal judgements. It is remarkable, however, that we have so much difficulty in talk ing about and identifying the most beneficial approaches for the achievement of the new design of our society. In this paper, I propose to illustrate the current crisis in nursing ethics with informa tion mainly from Bulgaria. However, I think that the problems and trends in the other Eastern European countries are similar.
Respect for Autonomy: Is It Always Paramount?
Authors: Morgan Diane 
Published: November 2007

Following the argument proposed by Tschudin in 1986 that many nurses do not have the skills for ethical decision-making, this article identifies and discusses one ethical prob lem from practice. The problem concerns an extremely obese patient who refuses to be moved by a hoist. The nurses acquiesce to the patient's wishes and she is moved manually by four mem bers of staff. The issues identified for discussion are: the paramountcy of the principle of respect for the patient's autonomy; the rights and obligations of the nurses; and the jus tification for influencing patient choice. The approach used by the ward nurses is analysed and the value of using an ethical decision-making model is considered.
Finding family for prospective consent in emergency research
Authors: Robertson Claudia S. , McCullough Laurence B. , Brody Baruch 
Published: November 2007

Background Innovative approaches are needed to allow for research in the emergency setting while not compromising either the rights or the interests of the subjects enrolled in such research. The emergency consent exception was developed to meet this need. Purpose The goal was to describe the timing of initial contact with relatives and the timing of obtaining informed consent for a research study in patients with severe traumatic brain injury. Methods The study was designed as a prospective, observational study of 129 patients enrolled in an emergency study of traumatic brain injury conducted under the emergency consent exception. Detailed descriptive information was collected both about the availability of relatives of patients enrolled in a study of traumatic brain injury to give prospective consent within the time period required for entering the study and about the extent to which they did give prospective consent during that time period. Results The number of patients with relatives who could be contacted by research staff increased with time after injury, with 3% (95% CI=0 to 6%), 25% (95% CI=18 to 32%), and 43% (95% CI=35 to 52%) having family at 1, 3, and 6 h, respectively postinjury. An additional 15% were available within the next 6 h. The median time after injury to the initial family contact by the research staff was 2.0 h for patients who had relatives already present at the hospital and 5.7 h for patients whose family had already been contacted by the hospital. The percentage of family members actually giving prospective research consent was much smaller; only 18% actually gave prospective consent within 6 h postinjury. The proportion of critically ill patients with family available to give prospective consent for enrollment in emergency research studies depends primarily on the time period allowed for enrollment in the individual study and the length of the transition from initial contact to completed prospective consent. Limitations The study was performed in a specific patient population and may not be generalizable to other settings. Conclusions Careful attention should be paid by investigators and IRBs as to whether the emergency consent exception is really required for a particular study, or whether the study could proceed using only prospective consent with a longer recruitment period, more research sites, and a higher yield of available family members giving prospective consent. Measures that could shorten the time between initial contact and obtaining informed consent (for example, allowing consent over the phone rather than requiring written consent) might decrease the need for the emergency consent exception. Clinical Trials 2007; 4: 631—637. http://ctj.sagepub.com
Using causal models to show the effect of untestable assumptions on effect estimates in randomized controlled trials
Authors: Allard Robert , Boivin Jean-François 
Published: November 2007

Background The methods by which randomized controlled trials (RCTs) are analyzed rest on several assumptions, most of which are untestable. Purpose To show how estimates of the net effect of treatment on survival can be obtained requiring only the assumption that randomization produced equivalent groups. Methods The assumptions underlying ratio measures of effect, based on disease occurrence times (DOT) obtained from survival curves, are identified and cumulatively removed. Results The four assumptions usually made are that (1) the ratio of disease incidence rates under treatment and under reference exposure is constant over time, (2) the groups being compared are exchangeable (equivalent), (3) a subject's DOT under treatment is independent of what his DOT would have been under the reference exposure, and (4) the treatment effect, if any, is in the same direction in all subjects. Removing Assumption 4 leads to an estimator of effect resembling the etiologic fraction, but able to accommodate both causative and preventive effects. Removing all assumptions but that of exchangeability still permits the estimation, directly from the survival curves, of a range of effect magnitudes, causative or preventive, compatible with the observed DOTs. The exchangeability assumption is the easiest to meet, by randomizing enough subjects. Limitations The statistical uncertainty that affects the estimates of survival probabilities has been ignored. Taking uncertainty into account further widens the range of effects compatible with the observations. Conclusions Retaining only the exchangeability assumption allows for a range of possible treatment effects to be estimated, although it may be wide. Readers of RCT reports should understand that the determination of a point estimate of effect within this range is entirely a function of unverifiable analytic assumptions. Clinical Trials 2007; 4: 611—620. http://ctj.sagepub.com
Identification of DNA-binding proteins using support vector machines and evolutionary profiles
Authors: Kumar Manish , Gromiha Michael M , Raghava Gajendra PS 
Published: November 2007

Abstract

Background
Identification of DNA-binding proteins is one of the major challenges in the field of genome annotation, as these proteins play a crucial role in gene-regulation. In this paper, we developed various SVM modules for predicting DNA-binding domains and proteins. All models were trained and tested on multiple datasets of non-redundant proteins.

Results
SVM models have been developed on DNAaset, which consists of 1153 DNA-binding and equal number of non DNA-binding proteins, and achieved the maximum accuracy of 72.42% and 71.59% using amino acid and dipeptide compositions, respectively. The performance of SVM model improved from 72.42% to 74.22%, when evolutionary information in form of PSSM profiles was used as input instead of amino acid composition. In addition, SVM models have been developed on DNAset, which consists of 146 DNA-binding and 250 non-binding chains/domains, and achieved the maximum accuracy of 79.80% and 86.62% using amino acid composition and PSSM profiles. The SVM models developed in this study perform better than existing methods on a blind dataset.

Conclusion
A highly accurate method has been developed for predicting DNA-binding proteins using SVM and PSSM profiles. This is the first study in which evolutionary information in form of PSSM profiles has been used successfully for predicting DNA-binding proteins. A web-server DNAbinder has been developed for identifying DNA-binding proteins and domains from query amino acid sequences http://www.imtech.res.in/raghava/dnabinder/.
Detection of inflammatory bowel disease by proton magnetic resonance spectroscopy (1H MRS) using an animal model
Authors: Varma Sonal , Bird Ranjana , Eskin Michael , Dolenko Brion , Raju Jayadev , Bezabeh Tedros 
Published: November 2007

Abstract

Background
The aim of this study was to analyze the potential of proton magnetic resonance spectroscopy (1H MRS) in diagnosing early inflammatory bowel disease (IBD).

Methods
Thirty male Sprague Dawley rats were fed 2% carrageenan in their diet for either 1 or 2 weeks. 1H MRS was performed ex-vivo on colonic mucosal samples (n = 123) and the spectra were analyzed by a multivariate method of analysis. The results of the multivariate analysis were correlated with histological analysis performed using H & E stain for the presence of inflammation in the samples from each group.

Results
Multivariate analysis classified the samples in their respective groups with an accuracy of 82%. Our region selection algorithm identified four regions in the spectra as being discriminatory. The metabolites assigned to these regions include creatine, phosphatidylcholine, the -CH
2HC= group in fatty acyl chain, and the glycerol backbone of lipids. The differences in concentration of these metabolites in each group offer insight into the biochemical changes occurring during IBD and confer diagnostic potential to 1H MRS as a tool to study colonic inflammation in conjunction with biopsy.

Conclusion

1H MRS is a sensitive tool to detect early colonic inflammation in an animal model of IBD.
Antibody microarray analysis of cell surface antigens on CD4+ and CD8+ T cells from HIV+ individuals correlates with disease stages
Authors: Wu Jing Qin , Wang Bin , Belov Larissa , Chrisp Jeremy , Learmont Jenny , Dyer Wayne B , Zaunders John , Cunningham Anthony L , Dwyer Dominic E , Saksena Nitin K 
Published: November 2007

AbstractBackgroundExpression levels of cell surface antigens such as CD38 and HLA-DR are related to HIV disease stages. To date, the immunophenotyping of cell surface antigens relies on flow cytometry, allowing estimation of 3–6 markers at a time. The recently described DotScan antibody microarray technology enables the simultaneous analysis of a large number of cell surface antigens. This new technology provides new opportunities to identify novel differential markers expressed or co-expressed on CD4+ and CD8+ T cells, which could aid in defining the stage of evolution of HIV infection and the immune status of the patient.ResultsUsing this new technology, we compared cell surface antigen expression on purified CD4+ and CD8+ T cells between 3 HIV disease groups (long-term non-progressors controlling viremia naturally; HIV+ patients on highly active antiretroviral therapy (HAART) with HIV plasma viral loads <50 copies/ml; and HIV+ patients with viremia during HAART) and uninfected controls. Pairwise comparisons identified 17 statistically differential cell surface antigens including 5 novel ones (CD212b1, CD218a, CD183, CD3 epsilon and CD9), not previously reported. Notably, changes in activation marker expression were more pronounced in CD8+ T cells, whereas changes in the expression of cell membrane receptors for cytokines and chemokines were more pronounced in CD4+ T cells.ConclusionOur study not only confirmed cell surface antigens previously reported to be related to HIV disease stages, but also identified 5 novel ones. Of these five, three markers point to major changes in responsiveness to certain cytokines, which are involved in Th1 responses. For the first time our study shows how density of cell surface antigens could be efficiently exploited in an array manner in relation to HIV disease stages. This new platform of identifying disease markers can be further extended to study other diseases.
Semiquantitative RT-PCR measurement of gene expression in rat tissues including a correction for varying cell size and number
Authors: Romero Maria del Mar , Grasa Maria del Mar , Esteve Montserrat , Fernández-López José Antonio , Alemany Marià 
Published: November 2007

Abstract

Background
Current methodology of gene expression analysis limits the possibilities of comparison between cells/tissues of organs in which cell size and/or number changes as a consequence of the study (e.g. starvation). A method relating the abundance of specific mRNA copies per cell may allow direct comparison or different organs and/or changing physiological conditions.

Methods
With a number of selected genes, we analysed the relationship of the number of bases and the fluorescence recorded at a present level using cDNA standards. A lineal relationship was found between the final number of bases and the length of the transcript. The constants of this equation and those of the relationship between fluorescence and number of bases in cDNA were determined and a general equation linking the length of the transcript and the initial number of copies of mRNA was deduced for a given pre-established fluorescence setting. This allowed the calculation of the concentration of the corresponding mRNAs per g of tissue. The inclusion of tissue RNA and the DNA content per cell, allowed the calculation of the mRNA copies per cell.

Results
The application of this procedure to six genes: Arbp, cyclophilin, ChREBP, T4 deiodinase 2, acetyl-CoA carboxylase 1 and IRS-1, in liver and retroperitoneal adipose tissue of food-restricted rats allowed precise measures of their changes irrespective of the shrinking of the tissue, the loss of cells or changes in cell size, factors that deeply complicate the comparison between changing tissue conditions. The percentage results obtained with the present methods were essentially the same obtained with the delta-delta procedure and with individual cDNA standard curve quantitative RT-PCR estimation.

Conclusion
The method presented allows the comparison (i.e. as copies of mRNA per cell) between different genes and tissues, establishing the degree of abundance of the different molecular species tested.
Evaluating the protein coding potential of exonized transposable element sequences
Authors: Piriyapongsa Jittima , Rutledge Mark T , Patel Sanil , Borodovsky Mark , Jordan I King 
Published: November 2007

AbstractBackgroundTransposable element (TE) sequences, once thought to be merely selfish or parasitic members of the genomic community, have been shown to contribute a wide variety of functional sequences to their host genomes. Analysis of complete genome sequences have turned up numerous cases where TE sequences have been incorporated as exons into mRNAs, and it is widely assumed that such 'exonized' TEs encode protein sequences. However, the extent to which TE-derived sequences actually encode proteins is unknown and a matter of some controversy. We have tried to address this outstanding issue from two perspectives: i-by evaluating ascertainment biases related to the search methods used to uncover TE-derived protein coding sequences (CDS) and ii-through a probabilistic codon-frequency based analysis of the protein coding potential of TE-derived exons.ResultsWe compared the ability of three classes of sequence similarity search methods to detect TE-derived sequences among data sets of experimentally characterized proteins: 1-a profile-based hidden Markov model (HMM) approach, 2-BLAST methods and 3-RepeatMasker. Profile based methods are more sensitive and more selective than the other methods evaluated. However, the application of profile-based search methods to the detection of TE-derived sequences among well-curated experimentally characterized protein data sets did not turn up many more cases than had been previously detected and nowhere near as many cases as recent genome-wide searches have. We observed that the different search methods used were complementary in the sense that they yielded largely non-overlapping sets of hits and differed in their ability to recover known cases of TE-derived CDS. The probabilistic analysis of TE-derived exon sequences indicates that these sequences have low protein coding potential on average. In particular, non-autonomous TEs that do not encode protein sequences, such as Alu elements, are frequently exonized but unlikely to encode protein sequences.ConclusionThe exaptation of the numerous TE sequences found in exons asbona fideprotein coding sequences may prove to be far less common than has been suggested by the analysis of complete genomes. We hypothesize that many exonized TE sequences actually function as post-transcriptional regulators of gene expression, rather than coding sequences, which may act through a variety of double stranded RNA related regulatory pathways. Indeed, their relatively high copy numbers and similarity to sequences dispersed throughout the genome suggests that exonized TE sequences could serve as master regulators with a wide scope of regulatory influence.Reviewers:This article was reviewed by Itai Yanai, Kateryna D. Makova, Melissa Wilson (nominated by Kateryna D. Makova) and Cedric Feschotte (nominated by John M. Logsdon Jr.).
The Concept of a Central – Local Government Partnership: Issues obscured by ideas
Authors: Thrasher Michael 
Published: November 2007

Controversy currently surrounds the relationship between central and local government as policies designed to control and curb public expenditure are viewed by local authorities as yet another attempt to erode their capacity for autonomous action. In recent years the whole issue of central–local relations has been typified by a mood of despondency and frustration as efforts to improve the situation have failed, unable to move beyond the most basic of accusations and recriminations. Perhaps research currently being undertaken will enable the various contestants in this debate to substantiate their often wild assertions but there is a danger that the differences between the two sides have become so great that restoring trust and respect will require a great deal of time.
Discussion between central and local government cannot be aided, we suspect, by the fact that there appears so little agreement about the nature and purpose of local government. This surely has important implications for the way in which central government formulates policies regarding local government since the role of ideas, values and attitudes in public policy-making is crucial. The aim of this article, therefore, is to explore the historical origins and development of some ideas about central–local government relations.