bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pleomorphic adenoma and adenoid cystic carcinoma: in vitro study of the impact of TGFβ1 on the expression of integrins and cytoskeleton markers of cell differentiation
Authors: Lourenço Silvia Vanessa , Lima Dirce Mary C. 
Published: April 2007

SummaryPleomorphic adenoma (PA) and adenoid cystic carcinoma (ACC) are the commonest benign and malignant salivary gland tumours respectively. Interactions between cells and extracellular matrix of PA and ACC, partially mediated by integrins, are important in their biology. The expression of integrins is regulated by numerous factors, amongst them, transforming growth factor β1 (TGFβ1). Our study investigated the effects of TGFβ1 on the expression of integrin β subunits in vitro and on the expression of cytoskeletal proteins of cells derived from PA and ACC. The expression of cytoskeletal differentiation markers and integrins was assessed using immunofluorescence. ELISA assays were employed to quantitate the expression integrins and MTT assays evaluated the mitochondrial activity of cells stimulated with TGFβ1. PA cells showed increased expression of integrins and de novo expression of differentiation markers upon TGFβ1 stimulation. ACC cells were less responsive to such stimulation. This may reflect important differences in the biological behaviour of benign and malignant cells.
Interventions to enhance patient compliance with leg ulcer treatment: a review of the literature
Authors: Hecke Ann Van , Grypdonck Maria , Defloor Tom 
Published: April 2007

Background and aims.  Non‐compliance with compression therapy and with leg exercises and leg elevation is a common problem, often reported in patients with venous leg ulceration. Studies on compliance‐enhancing interventions and the effectiveness of these interventions in patients with venous leg ulceration were reviewed.Methods.  MEDLINE, Cochrane, Embase and CINAHL were explored up to April 2005. Reference lists, wound care journals and conference proceedings were searched. Experts and manufacturers of compression systems were contacted. Studies were eligible if they included patients with venous or mixed leg ulcers and reported patient compliance outcome. Twenty studies were included.Results.  Most studies describe patient compliance as the extent to which the compression system was worn and/or the extent to which treatment regimen was followed. Self‐reporting was the most commonly used method of compliance assessment. There are indications that class III stockings for patients with venous ulcers enhance compliance compared with short stretch compression bandages. No real evidence is found that intermittent pneumatic compression systems improved compliance. There is no well‐documented evidence that healthcare system interventions increase compliance. Educational programmes combining cognitive, behavioural and affective components were shown to have a positive effect on leg elevation, but not on compliance with compression therapy.Conclusion.  The included studies have a lack of consistency in defining the standard and operationalization of compliance. Patient compliance plays an ancillary role in research. No study has been able to offer an acceptable and well‐documented solution to the non‐compliance problem.Relevance to clinical practice.  Research might focus on the development of comprehensive compliance‐enhancing strategies. A stronger commitment of healthcare providers and society is needed to make progress in this area. The scope of nursing must be expanded to also include the problems experienced by patients with leg ulcers and the improvement of patient compliance.
Quality of life for older people living in long‐stay settings in Ireland
Authors: Murphy Kathy , Shea Eamon O , Cooney Adeline 
Published: April 2007

Aim. The aim of this study was to explore the quality of life of older people living in long‐stay care in Ireland from the perspectives of residents and staff.Background. While the literature on quality of life is complex, several areas of agreement are evident. Quality of life is a multi‐dimensional concept, which cannot be explained solely in medical terms and only makes sense if presented in an holistic context. Quality of life contains both subjective and objective elements; therefore, there is a need to take account of both when measuring the concept.Method. A mixed method research design was selected for this study. Three methods were employed; focus groups (n = 7) a quantitative survey of 526 long‐stay facilities and qualitative interviews with 101 residents and 48 staff.Results. The findings revealed four thematic domains of quality of life: care environment and ethos of care, personal identity, connectedness to family and community and activities and therapies.Conclusion. The study found that there were differences in resident experiences across care study sites and important differences in staffing provision, skill mix and physical environment between private and public facilities. Several factors were also found that either enhanced or diminished residents’ potential to retain their connections and relationships with other people. Finally, residents were most likely to participate in activities which were designed to take into account their own particular interests.Relevance to clinical practice. This study articulates domains of quality of life from the perspective of residents and staff and gives support to the claims that management and organizational structures within long‐stay care facilities matter for quality of life. Clear identification of what is important to older people is important as services need to be shaped around quality of life as much as quality of care, notwithstanding the close relationship between the two.
Developing an integrated career and competency framework for diabetes nursing
Authors: Davis Ruth , Turner Eileen , Hicks Deborah , Tipson Margaret 
Published: April 2007

Aims and Objectives.  To describe the development of an integrated career and competency framework for diabetes nursing.Background.  The UK Nursing and Midwifery Council provides a definition of competence, but the terminology used in relation to the subject is often ambiguous and confusing. These concepts are explored in relation to nursing practice and the different approaches to competency framework development are described. To work alongside the Royal College of Nursing (RCN) and Skills for Health competency initiatives, a Diabetes Nursing Strategy Group representing nurses working in diabetes care was formed to oversee the development of an integrated career and competency framework for diabetes nursing.Design.  At the outset, the design was guided by the RCN Practice Development Team and employed qualitative methodology including the modified Delphi and nominal group technique.Methods.  A purposive sample of nurses representing all sectors and grades of staff involved in diabetes care was invited to workshops to undertake a values clarification exercise. Content analysis was performed to identify themes. Further workshops identified areas of specialist practice and competence statements were developed and refined in a series of consultations.Results.  Competence statements for a range of diabetes‐related areas were produced for nurses at the levels of unregistered practitioners, competent nurses, experience/proficient nurses, senior practitioners/expert nurses and consultant nurses.Conclusions.  The description of the process of developing of the integrated career and competency framework should help other groups going through the same process.Relevance to clinical practice.  In addition to helping groups identify a formula for the development of a competency framework, the framework itself is designed to provide a basis for educational programmes, personal career development and a tool for managers managing career progression within diabetes nursing.
Attitudes of nursing staff working with older people towards nutritional nursing care
Authors: Bachrach‐Lindström Margareta , Jensen Sara , Lundin Rickard , Christensson Lennart 
Published: April 2007

Aim.  The aim of this study was to examine attitudes of the nursing staff in geriatric care towards factors of importance for nutritional nursing care.Background.  Studies show that nutritional risk assessment is seldom performed on older patients as routine and very few patients have a nutritional care plan. Patients in long‐term care who are easy to feed are also found to be looked upon more positively than those with high feeding needs.Methods.  A total of 252 registered nurses and nurse aids working at geriatric rehabilitation and medical care clinics and resident homes participated in the study. Attitudes were examined using the Staff Attitudes to Nutritional Nursing Care Geriatric scale. The scale includes 18 items and was designed as a one to five‐point Lickert‐type scale. It gives a total score and five subscales representing the dimensions ‘Norms’, ‘Habits’, ‘Assessment’, ‘Intervention’ and ‘Individualization’. A higher score indicates a more positive attitude.Results.  Of all nursing staff, 53% displayed a positive attitude towards factors of importance for nutritional nursing care and the rest displayed a neutral or negative attitude. The ‘Intervention’ dimension, dealing with nutritional problems and how to manage them, reflected the highest level of positive attitudes, which represents 71% of the nursing staff. The ‘Norms’ dimension had the lowest relative frequency of positive attitudes, 27%. The registered nurses held significantly more positive attitudes than the nurse aids did.Conclusions.  Nutritional issues comprise an important and time‐consuming responsibility in geriatric care; however, nursing staff do not show an unequivocal positive attitude regarding this responsibility. The consequences this entails for the older patient need to be examined further.Relevance to clinical practice.  Nursing staff play an important role in caring for patients who are malnourished or at risk for malnutrition. Positive attitudes might hinder the development of undernourishment or the further worsening of an already undernourished patient's condition.
Influences on parents’ fever management: beliefs, experiences and information sources
Authors: Walsh Anne , Edwards Helen , Fraser Jenny 
Published: April 2007

Aim.  To identify parents’ knowledge, beliefs, management and sources of information about fever management.Background.  Despite numerous studies exploring parents’ management of childhood fever; negative beliefs about fever and overuse of antipyretics and health services for mild fevers and self‐limiting viral illnesses continue to be reported.Design.  Qualitative design using semi‐structured interviews and discussions.Method.  Fifteen metropolitan parents whose children were aged six months to five years, volunteered to participate in individual interviews or group discussions. Recruitment was through Playgroup Queensland's online newsletter and letters from two childcare centres to all parents. Verbatim and audio data were collected by an experienced moderator using a semi‐structured interview guide. Data analysis: Two transcripts were independently analysed by two researchers; categories, sub‐headings and codes were independently developed, crosschecked and found comparable. Remaining transcripts were analysed using developed categories and codes.Results.  Fever, determined through behavioural changes, was perceived as ‘good’, a warning that something was wrong. High fever, reported as 38·0–39·1 °C, was considered harmful; it must be prevented or reduced irrespective of concerns about antipyretics. Positive febrile experiences reduced concern about fever. Negative experiences such as febrile convulsions, media reports of harm, not receiving a definitive diagnosis, inaccessibility to regular doctors and receiving conflicting information about fever management increased the concerns. Parents seek information about fever from multiple sources such as doctors, books and other parents.Conclusions.  Parents’ experiences with and information sources about fever and fever management influenced their knowledge, beliefs and practices. Positive experiences reduce concerns, health service usage and sometimes antipyretic usage. Negative experiences increase concerns, monitoring and antipyretic and health service usage.Relevance to clinical practice.  Health professionals need to update their fever management knowledge ensuring that it is based on the latest scientific knowledge. They must provide parents of young children with consistent, reliable information preferably before their first child's first febrile episode.
Investigating the health profiles of Hong Kong Chinese: results of a cluster analysis
Authors: Chan Moon Fai , Mok Esther , Wong Thomas Kwok Shing , Lee Regina Lai Tong , Fok May Sin Mai 
Published: April 2007

Aim.  The aim of this study was to identify the health profile of a group of Hong Kong Chinese adults.Background.  People were on the alert about their current health status and health has become the most valuable asset to many Hong Kong people.Methods.  A descriptive correlational survey was conducted during the period December 2003 – September 2004 in six districts in Hong Kong; 702 Chinese adults aged 18–64 completed a structured questionnaire.Results.  Cluster analysis revealed two profiles groups on their attitude towards social health, sexual behaviour, mental health, diet/nutrition, smoking/substance use, health knowledge and physical activity.Conclusions.  Health data describing the health status of adults can be structured into a profile reflecting the characteristics of the target population under study. The findings showed that subjects in both clusters face two serious health issues: engage in little physical activity and possess poor knowledge about health. This finding does suggest that nurses can apply our understanding of these health profiles and to develop interventions that improve their health.Relevance to clinical practice.  This finding does suggest that nurses can apply our understanding of these health profiles and to develop interventions that improve their health.
The impact of sarcoptic mangeSarcoptes scabieion the British foxVulpes vulpespopulation
Authors: SOULSBURY CARL D. , IOSSA GRAZIELLA , BAKER PHILIP J. , COLE NIK C. , FUNK STEPHAN M. , HARRIS STEPHEN 
Published: April 2007

ABSTRACTDisease epizootics can significantly influence host population dynamics and the structure and functioning of ecological communities. Sarcoptic mangeSarcoptes scabieihas dramatically reduced red fox populationsVulpes vulpesin several countries, including Britain, although impacts on demographic processes are poorly understood. We review the literature on the impact of mange on red fox populations, assess its current distribution in Britain through a questionnaire survey and present new data on resultant demographic changes in foxes in Bristol, UK.A mange epizootic in Sweden spread across the entire country in < 10 years resulting in a decline in fox density of up to 95%; density remained lowered for 15–20 years. In Spain, mange has been enzootic for > 75 years and is widely distributed; mange presence was negatively correlated with habitat quality.Localized outbreaks have occurred sporadically in Britain during the last 100 years. The most recent large‐scale outbreak arose in the 1990s, although mange has been present in south London and surrounding environs since the 1940s. The questionnaire survey indicated that mange was broadly distributed across Britain, but areas of perceived high prevalence (> 50% affected) were mainly in central and southern England. Habitat type did not significantly affect the presence/absence of mange or perceived prevalence rates. Subjective assessments suggested that populations take 15–20 years to recover.Mange appeared in Bristol's foxes in 1994. During the epizootic phase (1994–95), mange spread through the city at a rate of 0.6–0.9 km/month, with a rise in infection in domestic dogsCanis familiaris c. 1–2 months later. Juvenile and adult fox mortality increased and the proportion of females that reproduced declined but litter size was unaffected. Population density declined by > 95%.In the enzootic phase (1996–present), mange was the most significant mortality factor. Juvenile mortality was significantly higher than in the pre‐mange period, and the number of juveniles classified as dispersers declined. Mange infection reduced the reproductive potential of males and females: females with advanced mange did not breed; severely infected males failed to undergo spermatogenesis. In 2004, Bristol fox population density was only 15% of that in 1994.
Occurrence of specific reactions induced by Pseudomonas syringae pv. syringae on bean pods, lilac and pear plants
Authors: YESSAD‐CARREAU S. , MANCEAU C. , LUISETTI J. 
Published: April 2007

A study on the pathogenicity of 81 strains of Pseudomonas syringae pv. syringae (PSS) isolated from 16 different hosts was conducted on lilac plants, bean pods and pear seedlings, using artificial inoculation.Only 55 among the 81 strains induced a necrotic lesion when inoculated on lilac leaves. On bean pods, all but one of the bean isolates, and only eight strains among the 52 strains isolated from other hosts, induced typical green water‐soaked lesions. On pear leaves, only pear isolates incited a typical progressive necrotic reaction, the isolates from other origins inducing no symptoms or a weak reaction limited to the inoculation point. This study indicates that in addition to the large variability observed in aggressiveness of PSS strains, host specificity occurred on bean and pear.
No association in frequency of KIR receptors in patients with rheumatoid arthritis from Northern Ireland
Authors: Middleton D. , Meenagh A. , Wright G. D. 
Published: April 2007

AbstractThe frequency of inhibiting and activating killer cell immunoglobulin‐like receptors was similar in 331 patients with rheumatoid arthritis and in 354 controls. Patients and controls came from a relatively homogeneous Caucasian population from Northern Ireland, thus limiting population stratification. Furthermore, no differences were found when the patients were sub‐divided according to gender or shared epitope and when the presence of the human leucocyte antigen ligand was taken into account.
Dose effect of sevoflurane and isoflurane anesthetics on cortical blood flow during controlled hypotension in the pig
Authors: Kimme P. , Ledin T. , Sjöberg F. 
Published: April 2007

Background:  The ability of the brain to preserve adequate cerebral blood flow (CBF) during alterations in systemic perfusion pressure is of fundamental importance. At increasing concentrations, isoflurane and sevoflurane have been known to alter CBF, which may be disadvantageous for patients with increased intracranial pressure. The aim was to examine the effects of isoflurane and sevoflurane at increasing minimum alveolar concentrations (MAC) on CBF, during controlled hypotension.Methods:  We studied eight pigs during variations in perfusion pressure induced by caval block (100, 60, 50, and 40 mmHg) under normocapnia. CBF was measured locally in a defined area (4 × 5 measurement points covering 1 cm2) of the motor cortex using laser Doppler perfusion imaging. Physiological variables, assessed by analysis of arterial O2 and CO2, hemoglobin and hematocrit, were controlled. CBF was measured during propofol (10 mg × kg−1× h−1) and fentanyl (0.002 mg × kg−1× h−1) anesthesia, and then during anesthesia with either isoflurane or sevoflurane (given in random order) at increasing MAC (0.3–1.2). After a washout period, the measurements were repeated with the other gas.Results:  CBF was significantly higher in the cortex during normotensive (control) settings, MAP ∼100 mmHg, compared with during hypotension (MAP 40–60 mmHg). Neither different anesthetic nor MAC or local measurement sites were found to influence CBF at any perfusion pressure.Conclusion:  In this experimental model, the effect of hypotension on CBF was not altered by the anesthetics used [isoflurane, sevoflurane (MAC 0.3–1.2) or propofol (10 mg × kg−1× h−1)]. In this aspect (cortical tissue perspective), these volatile agents appear as suitable as propofol for neurosurgical anesthesia for patients at risk.
Beat‐to‐beat change in ‘myocardial performance index’ related to load
Authors: Haney M. F. , A’Roch R. , Johansson G. , Poelaert J. , Biber B. 
Published: April 2007

Background:  This study was designed to assess the relationship of the ‘myocardial performance index’ (MPI) to the beat‐by‐beat change in pre‐load with static or unchanged contractile status.Methods:  Eight anesthetized juvenile pigs were studied using direct measurement of the left ventricular pressure and volume. Transient inflation of a vena cava balloon catheter produced controlled pre‐load alterations. Consecutive beats were analyzed, grouped for first, second, third, etc. during the pre‐load alteration, and evaluated for the change in MPI during the same contractile status with a controlled pre‐load alteration. Two pharmacologic inotropic interventions were also included to generate several myocardial conditions in each animal.Results:  MPI demonstrated a strong linear relationship to the pre‐load and after‐load. MPI increased progressively during decreasing end‐diastolic volume, mostly related to changes in ejection time. MPI was observed at the same level for three different myocardial function conditions (all eight animals), with a different relationship between MPI and pre‐load noted for each observation.Conclusions:  MPI is strongly load dependent, and can vary widely in value for the same contractile status if the load is varied. The use of this index in critically ill patients should be limited in this respect. Further work is needed to establish the relationship of MPI to load and contractile status.
The effect of combining intermittent hemodiafiltration with forced alkaline diuresis on plasma myoglobin in rhabdomyolysis
Authors: Peltonen S. , ÅHlström A. , Kylävainio V. , Honkanen E. , Pettilä V. 
Published: April 2007

Background:  Our aim was to examine the effect of combining intermittent hemodiafiltration (HDF) with forced alkaline diuresis on plasma myoglobin in rhabdomyolysis.Methods:  This was a prospective, randomized, controlled, cross‐over study. Sixteen rhabdomyolysis patients with plasma myoglobin concentrations above 10,000 μg/l were randomized. Forced alkaline diuresis was started immediately after allocation and continued throughout the study. HDF, which lasted for 4 h, was started in group A immediately after allocation and in group B 4 h later. The primary analysis was intention‐to‐treat by repeated measures analysis of variance and Mann–Whitney U‐test.Results:  The percentage elimination of myoglobin from the circulation during HDF differed significantly from that during alkaline diuresis (28.1% vs. 14.2%, respectively; P < 0.01). The mean decrease in plasma myoglobin concentration during HDF [9731 μg/l; 95% confidence interval (CI), 3672–5345 μg/l] and forced alkaline diuresis (3646 μg/l; 95% CI, 1260–6032 μg/l) did not show a statistically significant difference (P= NS). The mean total amount of myoglobin found in the ultrafiltrate was 58.4 mg.Conclusion:  The percentage myoglobin decrease during combined HDF and forced alkaline diuresis was higher than that during forced alkaline diuresis alone. Renal replacement therapy with filtration techniques may be considered for the clearance of myoglobin from plasma when urine alkalinization is not successful.