bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers to use of information and computer technology by Australia’s nurses: a national survey
Authors: Eley Robert , Fallon Tony , Soar Jeffrey , Buikstra Elizabeth , Hegney Desley 
Published: October 2008

Aims and objectives.  To support policy planning for health, the barriers to the use of health information and computer technology (ICT) by nurses in Australia were determined.Background.  Australia, in line with many countries, aims to achieve a better quality of care and health outcomes through effective and innovative use of health information. Nurses form the largest component of the health workforce. Successful adoption of ICT by nurses will be a requirement for success. No national study has been undertaken to determine the barriers to adoption.Design.  A self‐administered postal survey was conducted.Method.  A questionnaire was distributed to 10,000 members of the Australian Nursing Federation. Twenty possible barriers to the use of health ICT uptake were offered and responses were given on a five point Likert scale.Results.  Work demands, access to computers and lack of support were the principal barriers faced by nurses to their adoption of the technology in the workplace. Factors that were considered to present few barriers included age and lack of interest. While age was not considered by the respondents to be a barrier, their age was positively correlated with several barriers, including knowledge and confidence in the use of computers.Conclusions.  Results indicate that to use the information and computer technologies being brought into health care fully, barriers that prevent the principal users from embracing those technologies must be addressed. Factors such as the age of the nurse and their level of job must be considered when developing strategies to overcome barriers.Relevance to clinical practice.  The findings of the present study provide essential information not only for national government and state health departments but also for local administrators and managers to enable clinical nurses to meet present and future job requirements.
‘A pacemaker in my heart’– classification of questions asked by pacemaker patients as a basis for intervention
Authors: Rassin Michal , Zilcha Lia , Gross Dalia 
Published: October 2008

Aims.  The research aimed to identify the information patients find necessary, following pacemaker implantation.Background.  Although pacemaker devices do not have an adverse impact on lifestyle, they evoke anxiety related to the patient’s activities and lifestyle.Design.  Survey.Methods.  A convenience sample of participants was taken from the entire population of patients who attended the cardiology clinic between January–June 2007; 274 individual meetings were held with 123 pacemaker patients in three periods, reflecting different stages of recovery. In the meeting, patients were invoked to ask any question they may have regarding pacemaker implantation. The questions were collected from the patients and categorised chronologically, in accordance with their frequency in three periods, reflecting different stages of recovery.Results.  Eight categories, representing common issues and content were raised: motion and effort, environmental influences, personal hygiene, knowledge concerning the pacemaker operation, medical treatment, eating and drinking, clothing and general questions. Findings show that the common factor for most of the questions was the loss of confidence in the various aspects of life. The largest relative question proportion was in the motion and effort (27%) (e.g. may I swim? how many kg may I lift?) and environmental influences (26%) (e.g. may I use a cellular phone? may I use a shaving machine?).Conclusions.  A coherent, continuous pattern was found, characterising the different points of measurement where, at the first point, questions were characterised as more existential, related to daily routine activities and as time passed and patients were exposed to non‐daily activities and conditions, other questions were raised.Relevance to clinical practice.  Pacemaker implant guidance should be based upon experimental evidence, arranged according to each category’s relative weight and take into account the patient’s point of view.
Caring for people with type 1 diabetes mellitus engaging in disturbed eating or weight control: a qualitative study of practitioners’ attitudes and practices
Authors: Tierney Stephanie , Deaton Christi , Whitehead Julie 
Published: October 2008

Aims and objectives.  To explore the attitudes and practices of hospital‐based healthcare professionals toward people with type 1 diabetes mellitus (T1DM) exhibiting disturbed eating or weight control.Background.  Eating disturbances and insulin manipulation are common among individuals with T1DM, although little is known about how these behaviors are assessed and managed in practice.Design.  Qualitative study.Methods.  Face‐to‐face, semi‐structured interviews were conducted with 20 professionals from four hospitals in England, all of which were taped and transcribed verbatim and analysed using a framework approach.Results.  Four main themes were identified from the data collected, which related to the classification, detection and treatment of eating disturbances among people with T1DM and professionals’ lack of training in this area. For example, interviewees were unclear about what should be considered ‘disordered’ eating among individuals with T1DM. Participants described a paucity of immediately available services to which individuals could be referred, if they were felt to require extra help, and stated that they felt uncertain about managing these patients without outside support because of their limited training in the treatment of eating disorders.Conclusions.  A lack of clarity as to what constitutes a problem among those with T1DM in relation to eating and weight control and an absence of follow‐up services for them contributed to a sense of anxiety expressed by interviewees when faced with such a patient.Relevance to clinical practice.  Effective interventions addressing dangerous eating or weight control in people with diabetes are sorely needed, as is better training of healthcare professionals on this topic.
Factors influencing Macao nurses’ intention to leave current employment
Authors: Chan Moon Fai , Luk Andrew Leung , Leong Sok Man , Yeung Siu Ming , Van Iat Kio 
Published: October 2008

Aims.  To investigate factors associated with nurses’ intention to leave current employment in Macao.Background.  The shortage of nursing staff and nurses voluntarily leaving their jobs has continued to be a problem affecting the delivery of health care all over the world. One way to alleviate this shortfall is via recruitment, but this is not always successful. Another way is to reduce the rate at which nurses voluntarily leave their work places.Design.  A descriptive survey was conducted and data were collected using a self‐reported structured questionnaire. Nurses were recruited in the Health Bureau and one private hospital in Macao. The status of nurses’ intention to leave current employment (yes vs. no) was the dependent variable and nurses’ predisposing characteristics, organisational environments and five components on job satisfaction outcomes were independent variables.Results.  Of 426 nurses, 166 (39·0%) indicated an intention to leave current employment. The results showed that age (p < 0·001), work experience (p < 0·001), workplace (p = 0·015) and job satisfaction: pay and benefits (p < 0·001) were significant risk factors to predict nurses’ intention to leave current employment.Conclusions.  More than one‐third of the nurses in Macao indicated an intention to leave current employment. This figure may be a cause of concern for the hospital management and highlights the need to implement strategies to improve the communication between nurses and the organisation, to enhance nurse job satisfaction and commitment to the organisation.Relevance to clinical practice.  Our findings outline some issues contributing to this problem and provide the nurse manager with information regarding specific influences on nurses’ turnover in Macao. Given the complexity of issues outlined in this analysis, nurse managers should assist their nursing staff to deal with those influences, make efforts to address the nursing shortage that will require additional communications and recognise the needs and values of their staff and empower them to create a better work environment. As a consequence, their commitment to the organisation can be fostered.
The neurobiology and genetics of eating and weight regulation
Authors: Hebebrand J. 
Published: October 2008

Over the past 15 years tremendous advances have been made in the elucidation of pathways relevant to eating behaviour and body weight regulation. It has become evident that these pathways are intricately interwoven with those underlying mood and anxiety regulation, motor activity, cognition, sleep, fertility and libido. In addition, advances have been made in determining genetic variation underlying inter‐individual differences in body weight. To illustrate these novel findings we will focus on: 1) Monogenic and oligogenic obesity: The underlying genes were initially detected in animal models. Based on mutation screens of the human homologues functionally relevant mutations were detected in the genes coding for leptin, its receptors and the melanocortin‐4 receptor (MC4R). The effect of such mutations is large. Leptin gene mutations lead to hyperphagia and subsequently obesity. Hyperphagia, albeit of a substantially reduced magnitude, has also been observed in obese children with mutations in the MC4R. 2) Polygenic obesity: The advent of genome wide association studies has led to the detection of single polygenes, among which FTO features prominently. Typically, a variant predisposing to obesity accounts for a body weight elevated by on average 200 to 1500 grams. Such polygenes act in concert to account for inter‐individual differences in body weight. 3) Leptin has been shown to have profound implications for anorexia nervosa. Serum leptin levels in this eating disorders are annormaly low. The hypoleptinemia entails a down‐regulation of the hypothalamic‐pituitary‐gonadal‐axis, which underlies the amenorrhea characteristic of anorexia nervosa. Furthermore, the hypoleptinemia induces hyperactivity in a rat model of anorexia nervosa. In patients, leptin levels are inversely correlated with activity levels.
The Tom Oppe Lecture: Behavioural phenotypes and child psychiatry
Authors: Steinhausen H.‐C. 
Published: October 2008

The concept of a behavioural phenotype was first introduced by Nyhan (1972) when he described a characteristic behaviour of self‐mutilation in Lesch‐Nyhan‐Syndrome. Later, Flint and Yule (1994) pointed out that a behavioural phenotype is a characteristic pattern of motor, cognitive, linguistic and social abnormalities that is consistently associated with a biological disorder. In some instances the behavioural phenotype may represent a psychiatric disorder, in others there may be behaviours that usually will not be regarded as a psychiatric disorder.Dykens (1995) added that a behavioural phenotype may best be described as the heightened probability that people with a given syndrome will be characterized by certain behavioural sequelae. The implications of this are (i) that there is a certain amount of within‐syndrome variability, (ii) that there is total vs. partial specificity of certain behaviours, (iii) that behavioural phenotypes relate to various behavioural domains, (iv) that behavioural phenotypes have indirect effects on the behaviour of caretakers, and (v) that developmental and contextual factors in addition to genetic factors contribute to behavioural phenotypes (Hodapp & Dykens, 2007). The rather recent interest in the concept of behavioural phenotypes has renewed the interest of Child and Adolescent Psychiatry in intellectual disability issues that had been lost for decades. It also increased interest in the genetic origins of mental disorders and behavioural abnormalities with an interaction of two major recent scientific developments in the field. One of these trends is represented by the rapid progress in molecular biology that has led to a better understanding of the genetic mechanisms contributing to psychopathology. The other trend is based on the development of more and more refined instruments for the dimensional assessment of adaptive and maladaptive behaviours which have supplemented the classical categorical approach of assessment in child psychopathology. With this theoretical underpinning, the study of behavioural phenotypes has become an attractive research domain in child and adolescent psychiatry. In addition, there are also practical implications in terms of improving communication among experts and lay‐person both on assessment and counselling.
Rett Syndrome and long‐term disorder profile
Authors: Smeets E. , Schrander‐Stumpel C. , Curfs L. 
Published: October 2008

Since the identification of mutations in MECP2 in females with clinical Rett syndrome, numerous efforts have been made to understand phenotype‐genotype relationships. Most of these studies were conducted by examining the type and localization of these mutations in the gene in relation to clinical severity. It seemed unsatisfactory, in view of the age range and variable severity, to look only at the type and localization of the mutation in MECP2 in trying to establish a phenotype/genotype relationship. Describing each RTT individual after a long term follow up and grouping females with the same disorder history and same MECP2 mutation is therefore appropriate.Complete clinical and molecular data were obtained on 103 females. The guidelines for reporting manifestations common in Rett syndrome were used in the evaluation of clinical severity. The individuals were grouped according to similar disorder profiles on long‐term follow up. In a cohort of 103 females clinically diagnosed with Rett syndrome, 91 had a detectable MECP2 mutation. 60% still sit and walk. Hand use is preserved or reduced in 44%. Speech has been lost in the majority (87%). Epilepsy was problematic in about 30%. Scoliosis, severe kyphosis or a combination of both was present in 27%, needing surgery in 13%.Description of the profile of the disorder and long‐term clinical history facilitated the grouping of females with the same MECP2 mutation and a similar history. This approach will contribute more to the understanding of the ongoing pathology in Rett syndrome relative to the specific character of the involved MECP2 mutation. Some examples of these disorder profiles will be discussed.
Are patients with chronic fatigue syndrome just ‘tired’ or also ‘sleepy’?
Authors: NEU DANIEL , HOFFMANN GUY , MOUTRIER ROBERT , VERBANCK PAUL , LINKOWSKI PAUL , LE BON OLIVIER 
Published: October 2008

SummaryIt is presently unclear whether chronic fatigue syndrome (CFS) patients exhibit daytime sleepiness in addition to fatigue. Both, fatigue, such as that seen in CFS patients, and excessive daytime sleepiness, such as in sleep apnea–hypopnea syndrome (SAHS), remain poorly understood. Both daytime conditions are generally related to unrefreshing sleep and show affective symptoms. This study’s objective was to contribute to the understanding of the relationship between fatigue and sleepiness in CFS patients not co‐morbid for primary sleep or psychiatric disorders. We compared 16 untreated CFS patients (mean age 32.8, all females) with 13 untreated SAHS (mean age 47.7, all females) patients and 12 healthy controls (mean age 32.2, all females). Objective sleepiness was measured using multiple sleep latency tests (MSLT). Subjective sleepiness and fatigue were assessed with the Epworth Sleepiness Scale and the Fatigue Severity Scale, respectively. Mean Sleep Latency (SL) on the MSLT was significantly shorter in SAHS patients than in CFS patients and CFS patients showed significantly shorter mean SL than matched controls but within normal range. Subjective sleepiness was greatest in SAHS patients and subjective fatigue was highest in CFS patients. Affective symptoms showed highest intensities in CFS patients. While higher than the control group on all measures, compared to SAHS, the CFS group had higher subjective fatigue and lower subjective and objective sleepiness. Despite possible overlap in symptoms and signs of both daytime conditions, our data indirectly support the clinical distinction between fatigue and sleepiness.
24 hours of sleep deprivation in the rat increases sleepiness and decreases vigilance: introduction of the rat‐psychomotor vigilance task
Authors: CHRISTIE MICHAEL A. , MCKENNA JAMES T. , CONNOLLY NINA P. , MCCARLEY ROBERT W. , STRECKER ROBERT E. 
Published: October 2008

SummaryA novel animal‐analog of the human psychomotor vigilance task (PVT) was validated by subjecting rats to 24 h of sleep deprivation (SD) and examining the effect on performance in the rat‐PVT (rPVT), and a rat multiple sleep latency test (rMSLT). During a three‐phase (separate cohorts) crossover design, vigilance performance in the rPVT was compared with 24 h SD‐induced changes in sleepiness assessed by polysomnographic evaluation and the rMSLT. Twenty‐four hours of SD was produced by brief rotation of activity wheels at regular intervals in which the animals resided throughout the experiment. In the rPVT experiment, exercise controls (EC) experienced the same overall amount of locomotor activity as during SD, but allowed long periods of undisturbed sleep. After 24 h SD response latencies slowed, and lapses increased significantly during rPVT performance when compared with baseline and EC conditions. During the first 3 h of the recovery period following 24 h SD, polysomnographic measures indicated sleepiness. Latency to fall asleep after 24 h SD was assessed six times during the first 3 h after SD. Rats fell asleep significantly faster immediately after SD, than after non‐SD baseline sessions. In conclusion, 24 h of SD in rats increased sleepiness, as indicated by polysomnography and the rMSLT, and impaired vigilance as measured by the rPVT. The rPVT closely resembles the human PVT test widely used in human sleep research and will assist investigation of the neurobiologic mechanisms that produce vigilance impairments after sleep disruption.
Medical students’ attitudes to psychiatric illness in primary care
Authors: Dixon Robert P , Roberts Lesley M , Lawrie Stephen , Jones Lisa A , Humphreys Martin S 
Published: October 2008

Context  Previous research has shown that general practitioners (GPs) hold negative attitudes towards patients with schizophrenia, which do not simply reflect the nature or chronic aspects of the illness. This study aimed to describe the attitudes and predicted behaviour of medical students towards patients with mental illness in a primary care setting and to investigate whether these were affected by the students’ level of training.Methods  A sample of 1239 students from the University of Birmingham Medical School were each given one of four case vignettes, all of which were identical except that the patient involved was described as having a previous diagnosis of, respectively, schizophrenia, depression, diabetes or no illness. Students rated their level of agreement with 12 attitudinal statements relating to the vignette.Results  A total of 1081 (88%) students responded to the questionnaire. Students were generally less favourable in their responses to patients with either schizophrenia or depression. They would not be as happy to have them on their list, believed they would consume more time and considered they would be less likely to comply with advice and treatment. They expressed more concern about the risk of violence, the potential welfare of children and the possibility of illegal drug and excessive alcohol use. General clinical and psychiatric training had little effect on these reactions.Conclusions  Patients with mental illness provoke less favourable responses in medical students, which are not altered by furthering education. Undergraduate primary care‐based mental health education should be re‐evaluated to ensure that students develop an empathetic and positive approach to mental health patients and their treatment.
Differential CXC Receptor Expression in Colorectal Carcinomas
Authors: Rubie C. , Kollmar O. , Frick V. O. , Wagner M. , Brittner B. , Gräber S. , Schilling M. K. 
Published: October 2008

AbstractIn this study, we aimed to assess the expression profile of chemokine receptors CXCR1–4 in inflammatory and malignant colorectal diseases and corresponding hepatic metastases of synchronous and metachronous origin to elucidate their role in colorectal cancer (CRC) progression and metastasis. Chemokine receptor expression was assessed by quantitative real‐time PCR, immunohistochemistry (IHC) and Western blot analysis in resection specimens from patients with ulcerative colitis (UC, n = 25), colorectal adenomas (CRA, n = 8), different stages of CRC (n = 48) as well as colorectal liver metastases (CRLM) along with their corresponding primary colorectal tumours (n = 16). While none of the chemokine receptors were significantly upregulated or downregulated in UC or CRA tissues, CXC receptors 1, 2 and 4 demonstrated a significant increase in expression in all tumour stages of CRC specimens with CXCR4 correlating with tumour grading (P < 0.05). On the other hand, CXCR3 showed no significant upregulation in either tumour stage, but significant overexpression in CRLM. While CXCR4 demonstrated significant upregulation in both tumour entities, IHC analysis revealed that the predominate cell type expressing CXCR4 in CRC is represented by tumour cells, whereas in CRLM the majority of positive CXCR4 signals is due to hepatocytes along the tumour invasion front. In conclusion, our findings show a very differential expression pattern of the four receptors in colorectal carcinomas and their corresponding liver metastases with prominent expression profiles that indicate a potential role in the pathogenesis of CRC.
Adjuvants LT‐K63 and CpG Enhance the Activation of Dendritic Cells in Neonatal Mice
Authors: Hannesdottir S. G. , Olafsdottir T. A. , Giudice G. D. , Jonsdottir I. 
Published: October 2008

AbstractDendritic cells (DC) play a major role in the priming of T cells and initiating specific immune responses. We assessed the effects of the adjuvants LT‐K63 and CpG on neonatal DC in vivo and in vitro. Cytokine levels (IL‐10, IL‐12p70 and IL‐12p40/IL‐23p40) were measured and the expression of the activation markers CD86, CD40 and MHCII on CD11c+ DC was analysed by using FACS. The proportion of MHCIIhigh CD11c+ DC was higher in neonatal mice immunized with a pneumococcal conjugate (PncTT) and LT‐K63 or CpG compared with that when PncTT was alone. In vitro stimulation with LT‐K63 enhanced the expression of CD86 more on CD11c+ DC from spleens of mice immunized as neonates than those immunized as adults, whereas in vitro stimulation with CpG enhanced the expression of CD86 and CD40 on CD11c+ DC similarly in both age groups. CpG stimulation in vitro enhanced IL‐10 and IL‐12(p70) production in mice immunized as neonates with PncTT and either adjuvant, but not PncTT alone. The adjuvants LT‐K63 and CpG enhance the activation of CD11c+ DC in mice immunized as neonates and can thereby overcome one of the limiting factors in the initiation of the immune response to conjugate vaccines in early life. The fact that neonatal DC are more susceptible to stimulation with either adjuvant, LT‐K63 or CpG, could imply that neonatal CD11c+ DC are more easily activated than adult CD11c+ DC, and/or be a consequence of the predominance of different DC subsets in neonatal and adult mice.