bluuebunny/crossref_metadata_2025_split huggingface dataset:
British Paediatric Surveillance Unit Study of Biliary Atresia: Outcome at 13 Years
Authors: McKiernan PJ , Baker Alastair J , Lloyd Carla , Mieli‐Vergani Giorgina , Kelly Deirdre A 
Published: January 2009

ABSTRACTBackground:Little information is available on contemporary, prospectively collected data on the long‐term outcome of national cohorts of children with biliary atresia.Objective:This study aimed to describe the current outcome of a national cohort of children with biliary atresia.Patients and Methods:All 93 cases of biliary atresia in the United Kingdom and Ireland diagnosed between March 1993 and February 1995 were followed up prospectively.Results:A total of 91 children underwent Kasai portoenterostomy in 15 individual centres. Only 2 centres treated more than 5 children annually. Median age at last follow‐up was 12 years (range 0.25–14). Fifteen children (16%) have died: 10 after unsuccessful portoenterostomy, 1 of sepsis after successful portoenterostomy, and 4 after liver transplantation. Forty‐two (45%) underwent liver transplantation at a median age of 1 year (range 0.5–9), with 90% survival. All 41 children with failed portoenterostomy (and 2 without portoenterostomy) died or underwent liver transplantation at a median age of 0.8 years (range 0.25–6.5). When the portoenterostomy was successful, 40 of 50 patients (80%) are alive without liver transplantation. The 13‐year actuarial survival without liver transplantation is 43.8% overall and is better in children treated at centres that treat more than 5 cases yearly (54% vs 27.3%, P = 0.005).Conclusions:If the portoenterostomy is successful, then few children with biliary atresia will need transplantation before adolescence. Children with biliary atresia should be treated in experienced centres to maximize the chance of successful surgery.
Self‐assembly of sapovirus recombinant virus‐like particles from polyprotein in mammalian cells
Authors: Oka Tomoichiro , Yamamoto Mami , Miyashita Kana , Ogawa Satoko , Katayama Kazuhiko , Wakita Takaji , Takeda Naokazu 
Published: January 2009

ABSTRACTThe SaV genome is a positive‐sense, non‐segmented single‐strand RNA molecule of approximately 7.5 kb that is polyadenylated at its 3′ terminus. The major capsid (VP1) of SaV is thought to be produced as the ORF1 polyprotein followed by cleavage, or translation from subgenomic RNA (3′‐coterminal with the virus genome), or both. We have recently reported the formation of SaV VLP from subgenomic‐like RNA in mammalian cells. In the present study, we demonstrated that the VP1 cleaved from a part of ORF1 polyprotein self‐assembled into VLP in mammalian cells when a transient expression system using a recombinant vaccinia virus encoding T7 RNA polymerase was used.
Annual growth ofCassiope tetragonaas a proxy for Arctic climate: developing correlative and experimental transfer functions to reconstruct past summer temperature on a millennial time scale
Authors: ROZEMA JELTE , WEIJERS STEF , BROEKMAN ROB , BLOKKER PETER , BUIZER BERT , WERLEMAN CHANTAL , EL YAQINE HASSAN , HOOGEDOORN HANNEKE , FUERTES MIGUEL MAYORAL , COOPER ELISABETH 
Published: January 2009

AbstractAnnual growth of the polar evergreen shrubCassiope tetragonaon Svalbard was evaluated as a proxy for Arctic summer temperatures. Transfer functions were derived from temperature‐growth correlations of shoots and from a temperature‐growth response, obtained from experimental warming using open top chambers (OTC) in high Arctic tundra vegetation at Isdammen approximately 1.5 km southeast of Longyearbyen, Svalbard (78°N, 15 E) and in Longyeardalen, 3 km west of Isdammen from 2004 to 2006. Air temperatures, monitored throughout the summer months, were 1.3 °C higher inside the OTCs than in the control plots. Annual stem growth was measured by tagging stems and leaves, and in the lab with shoots harvested from OTCs and control plots. Annual growth parameters assessed were leaf production, sum of length and weight of individual leaves, and stem length increment derived from leaf scar distances and the distances between wintermarksepta in the stem. Wintermarksepta are formed at the end of the summer growth period when the pith is narrowing and consist of dense and dark tissue (Fig. 1b). The variation of annual growth in a 34‐year site chronology (based onCassiopeshoots from the surroundings of the OTCs and control plots) correlated strongly with the mean summer temperature on Svalbard. The number of leaf pairs, leaf length and stem length also increased in the OTC warmed plots in the second and third year of warming. Transfer functions were derived from the temperature‐annual growth correlations from a single shoot from Longyeardalen, from the cross‐dated Isdammen site chronology and from the growth response to experimental warming. Based on leaf scar distances and distances between wintermarksepta of well‐preserved subfossil shoots in arctic tundra soil, annual stem length increase was assessed for the layers of a soil core collected at the Isdammen site. Based on the derived transfer functions summer temperature of the period relating to the 15 cm deep tundra soil core layer, radiocarbon dated at 4230±40 bp, may have been 3.0 °C lower than the present‐day 6.2 °C value. These results indicate that the transfer functions can be used to reconstruct past temperatures, beyond the time range of instrumental temperature and ice core records of Svalbard. (a) Morphology of shoot ofCassiope tetragonacollected May 26, 2007, Longyeardalen. Removal of the front row of leaves shows four leaf pairs of the 2006 summer, the leaf primordium for the 2007 growing season and the stem length increase summer 2006. (b) Wintermarksepta, darker colored than the pith tissue, indicating the winterperiod in a longitudinal section of an air‐dried shoot collected August 26, 2006, Longyeardalen.image
Past century changes in Araucaria angustifolia (Bertol.) Kuntze water use efficiency and growth in forest and grassland ecosystems of southern Brazil: implications for forest expansion
Authors: SILVA LUCAS C. R. , ANAND MADHUR , OLIVEIRA JULIANO M. , PILLAR VALÉRIO D. 
Published: January 2009

Abstract Araucaria angustifolia (Bertol.) Kuntze is an indigenous conifer tree restricted to the southern region of South America that plays a key role in the dynamics of regional ecosystems where forest expansion over grasslands has been observed. Here, we evaluate the changes in intrinsic water use efficiency (iWUE) and basal area increment (BAI) of this species in response to atmospheric CO2, temperature and precipitation over the last century. Our investigation is based on tree‐rings taken from trees located in forest and grassland sites in southern Brazil. Differences in carbon isotopic composition (δ13C), 13CO2 discrimination (Δ13C) and intracellular carbon concentration (Ci) are also reported. Our results indicate an age effect on Δ13C in forest trees during the first decades of growth. This age effect is not linked to an initial BAI suppression, suggesting the previous existence of nonforested vegetation in the forest sites. After maturity all trees show similar temporal trends in carbon isotope‐derived variables and increasing iWUE, however, absolute values are significantly different between forest and grassland sites. The iWUE is higher in forest trees, indicating greater water competition or nutritional availability, relative to grassland, or both. BAI is also higher in forest trees, but it is not linked with iWUE or atmospheric CO2. Nevertheless, in both forest and grassland sites A. angustifolia has had growth limitations corresponding to low precipitation and high temperatures observed in the 1940s.
The origins and diversification of C4 grasses and savanna‐adapted ungulates
Authors: BOUCHENAK‐KHELLADI YANIS , ANTHONY VERBOOM G. , HODKINSON TREVOR R. , SALAMIN NICOLAS , FRANCOIS OLIVIER , NÍ CHONGHAILE GRAINNE , SAVOLAINEN VINCENT 
Published: January 2009

AbstractC4 grasses constitute the main component of savannas and are pervasive in other dry tropical ecosystems where they serve as the main diet for grazing animals. Among potential factors driving C4 evolution of grasses, the interaction between grasses and grazers has not been investigated. To evaluate if increased grazing pressure may have selected for higher leaf silica production as the grasses diverged, we reconstructed the phylogeny of all 800 genera of the grass family with both molecular (combined multiplastid DNA regions) and morphological characters. Using molecular clocks, we also calculated the age and number of origins of C4 clades and found that shifts from C3 to C4 photosynthesis occurred at least 12 times starting 30.9 million years ago and found evidence that the most severe drop in atmospheric carbon dioxide in the late Oligocene (between 33 and 30 million years ago) matches the first origin of C4 photosynthesis in Chloridoideae. By combining fossil and phylogenetic data for ungulates and implementing a randomization procedure, our results showed that the appearance of C4 grass clades and ungulate adaptations to C4‐dominated habitats match significantly in time. An increase of leaf epidermal density of silica bodies was found to correspond to postulated shifts in diversification rates in the late Miocene [24 significant shifts in diversification (P<0.05) were detected between 23 and 3.7 million years ago]. For aristidoid and chloridoid grasses, increased grazing pressure may have selected for a higher leaf epidermal silica production in the late Miocene.
Soil drying and nitrogen availability modulate carbon and water exchange over a range of annual precipitation totals and grassland vegetation types
Authors: St. CLAIR SAMUEL B. , SUDDERTH ERIKA A. , FISCHER MARC L. , TORN MARGARET S. , STUART STEPHANIE A. , SALVE ROHIT , EGGETT DENNIS L. , ACKERLY DAVID D. 
Published: January 2009

AbstractIncreased intensity in precipitation events and longer periods of water deficit are predicted as a general trend under future climate scenarios with potentially large effects on terrestrial ecosystem function. The primary objective of this study was to understand how variation in the intensity of precipitation inputs followed by intermittent soil drying events influence leaf and ecosystem carbon dioxide (CO2) and water exchange in a California annual grassland mesocosm experiment. We further examined how nitrogen (N) availability, and differences in plant community composition (grass‐forb combinations) affected gas exchange responses to the precipitation treatments. Net ecosystem CO2 exchange (NEE) and evapotranspiration (ET) increased significantly with greater precipitation and were positively correlated with soil moisture. A repeated 10‐day soil drying period, following 11 days of watering, strongly depressed NEE over a range of annual precipitation totals (297, 657 and 987 mm), and plant community types. Ecosystem dark respiration (Re) and leaf level photosynthesis (Amax) showed greater sensitivity to periods of soil drying in the low precipitation plots (297 mm). N additions significantly increased NEE and Re, particularly as water availability was increased. Across the range of precipitation totals and plant community types, intermittent periods of soil moisture deficit and native soil N availability constrained leaf and ecosystem level CO2 exchange, while the influence on water vapor exchange was less pronounced.
The use of technology in cancer care: applying Foucault’s ideas to explore the changing dynamics of power in health care
Authors: Forbat Liz , Maguire Roma , McCann Lisa , Illingworth Nicola , Kearney Nora 
Published: January 2009

AbstractTitle.  The use of technology in cancer care: applying Foucault’s ideas to explore the changing dynamics of power in health care. Aim.  This study is a report to identify the utility of a hand‐held side‐effect monitoring system for people receiving chemotherapy in the home care setting.Background.  Increasingly, health care is being provided in people’s own homes and communities rather than in hospitals. This has driven the development of technologies which support patients in the home environment. The meaning of such technologies can be explored from a Foucauldian perspective to shed light on how they enable new forms of medical surveillance.Method.  An intervention study was performed in 2006 using new technologies for people receiving chemotherapy. Questionnaires were completed by 56 people affected by cancer who used the new technology; 12 of these people were then interviewed. Secondary analysis of the interview data is presented in this paper, drawing on Foucault’s writing about surveillance and power in medical settings.Findings.  The interview transcripts contain numerous examples of people affected by cancer reflecting on issues such as power and surveillance in cancer care. While these terms are ordinarily considered to reflect negative elements of care, they were used by participants in an empowering manner.Conclusion.  Theoretical insights can help nurses to think critically about the advances of technology. In particular, there are implications for how nurses consider the relationship of technology to patients and for power dynamics in healthcare relationships. We suggest that there is a need to problematize and celebrate the growth of technologically‐driven health surveillance.
Occupational exposure to blood and body fluids among Turkish nursing students during clinical practice training: frequency of needlestick/sharp injuries and hepatitis B immunisation
Authors: Talas Melek Serpil 
Published: January 2009

Aim and objective.  To describe the rate of needlestick/sharp injuries in nursing students, to estimate the rate of vaccination administration and to define nursing students’ status using universal precautions for protecting from blood‐borne infections.Background.  Nursing students have a high risk of occupational exposure to bloodborne pathogens because they may have insufficient background knowledge to recognise the level of risk posed by a particular patient and their inexperience with procedural skills and infection control procedures.Design.  This study was designed as a retrospective and descriptive survey.Methods.  The frequency and mechanism of needlestick/sharp injuries and hepatitis B immunisation were determined retrospectively by surveying students in three nursing schools. In November 2004, 473 students were questioned about needlestick/sharp injuries that they had sustained during their clinical practice and hepatitis B immunisations.Results.  Forty‐nine per cent of the students who responded sustained injuries; of these 74% were injured while on wards. The highest number (72·2%) had been injured by hollow‐bore needles; 65·2% who were injured were not wearing gloves at the time of injury; 27% of injuries were associated with recapping the needle; 43·9% reported their injuries to administrators and the rate of those receiving medical assistance after needlestick/sharp injuries was less than not seeking assistance; 67·7% had been vaccinated against hepatitis B.Conclusion.  This study showed that nursing students frequently sustain needlestick/sharp injuries and hepatitis B immunisation rate was low.Relevance to clinical practice.  Findings will help in designing more intensive education programs directed at the students to increase their awareness of and compliance with Universal Precautions and in instituting policies so that they are fully immunised against hepatitis B before beginning clinical practice.
Caregiver self‐efficacy for managing behavioural problems of older people with dementia in Taiwan correlates with care receivers’ behavioural problems
Authors: Huang Huei‐Ling , Shyu Yea‐Ing Lotus , Chen Sien‐Tsong , Hsu Wen‐Chuin 
Published: January 2009

Aims and objective.  To investigate the relationship between family caregivers’ self‐efficacy for managing behavioural problems of older people with dementia and their behavioural problems in Taiwan.Background.  Older people with dementia commonly have at least one behavioural problem, which caregivers complain is difficult to handle. To provide interventions that can help caregivers more effectively manage the behavioural problems of care receivers with dementia, caregivers’ self‐efficacy on managing behavioural problems must be assessed. However, it is not clear yet how these behavioural problems of older people with dementia may influence caregivers’ self‐efficacy for managing behavioural problems.Design.  A prospective, correlational study.Method.  Eighty dyads of older people with dementia and their family caregivers were recruited from neurological clinics of a medical centre in Taiwan. Care receivers were assessed for behavioural problems using the Chinese version of Cohen‐Mansfield Agitation Inventory, community form. Caregivers’ self‐efficacy for managing care receivers’ agitation was measured by the research team‐developed Agitation Management Self‐Efficacy Scale.Results.  Caregiver self‐efficacy for managing behavioural problems was significantly and positively associated with more caregiver education, greater duration of caregiving and with care receivers’ less physically non‐aggressive behaviours. When caregiver characteristics were controlled for in hierarchical regression analysis, physically non‐aggressive behaviours explained 6% of the variance in caregiver self‐efficacy.Conclusions.  Results of this study contradict the general belief that physically aggressive behaviours of elders with dementia are more difficult for family caregivers to handle than other behavioural problems. Clinicians need to address physically non‐aggressive problem behaviours.Relevance to clinical practice.  Nurses could assess older patients with dementia for physically non‐aggressive behaviours and train less educated caregivers to improve their self‐efficacy for managing problem behaviours, thus enhancing the quality of life for both caregivers and care receivers.
What factors affect influenza vaccine uptake among community‐dwelling older Chinese people in Hong Kong general outpatient clinics?
Authors: Kwong Enid Wai‐yung , Lam Ivy Oi‐yi , Chan Tony Moon‐Fai 
Published: January 2009

Aim.  This study aimed to identify the influenza vaccination rate among community‐dwelling older Chinese people in Hong Kong general outpatient clinics and to identify the factors affecting their vaccine uptake.Background.  Community‐dwelling older Chinese people in Hong Kong underuse influenza vaccination. The first step to increase their vaccination rates is to understand the factors affecting their influenza vaccine uptake.Design.  This was a retrospective and descriptive study.Methods.  The sample comprised 197 subjects from five general outpatient clinics in the Kowloon East cluster of Hong Kong. A self‐report questionnaire was used for data collection via individual face‐to‐face interviews.Results.  Out of 197 subjects, 64·47% reported having received the vaccine within the previous 12 months. The regression model revealed that perceived benefits including ‘vaccination prevents me from catching influenza (OR = 12·18, CI = 3·61–41·07, p < 0·001)’, ‘If I get vaccinated, I will decrease the frequency of medical consultation (OR = 8·12, CI = 2·70–24·38, p = 0·001)’ and ‘If I am vaccinated and still get flu, I will not be as sick with it (OR = 0·43, CI = 0·24–0·76, p = 0·004)’, perceived barriers, which are ‘the side‐effects of influenza vaccination interfere with my usual activities (OR = 0·04, CI = 0·01–0·13, p < 0·001)’, ‘influenza vaccination is painful (OR = 2·73, CI = 1·55–4·81, p = 0·001)’ and ‘I am scared of needles (OR = 0·43, CI = 0·23–0·79, p = 0·007)’ and recommendations from doctors (OR = 14·18, CR = 4·09–49·16, p < 0·001) and families (OR = 3·67, CR = 1·24–10·83, p = 0·019) interactively influenced the subjects’ vaccine uptake.Conclusion.  Specific benefits and barriers affecting the influenza uptake of community‐dwelling older Chinese people in general outpatient clinics have been identified. Specifically, recommendation from families plays a significant role in motivating the uptake of this Chinese ageing group.Relevance to clinical practice.  We adopt strategies including personal invitation and reminders of influenza vaccination by doctors and educating doctors, older people and their families on influenza vaccination to increase the uptake of community‐dwelling Chinese older people in general outpatient clinics.
Caring for children with complex emotional and psychological disorders: experiences of nurses in a rural paediatric unit
Authors: Reid‐Searl Kerry , Dwyer Trudy , Happell Brenda , Moxham Lorna , Kahl Julie , Morris Jodie , Wheatland Narelle 
Published: January 2009

Aims.  To explore the experiences of general nurses towards caring for children with mental health issues and to identify strategies to improve management of these children.Background.  There has been an increase of children and adolescents with complex emotional and psychological disorders being admitted to paediatric units of general hospitals due to a lack of specialist child and youth mental health facilities. The study is situated in a 16 bed paediatric unit of a rural public hospital. As the closest inpatient child mental health unit of this kind is more than 600 km away, the paediatric unit admits children and adolescents with a primary psychiatric diagnosis.Design.  A participatory action research approach guided this study.Methods.  Focus groups and individual interviews were conducted with a purposive convenience sample of all nursing staff (n = 20) working in the paediatric unit. Verbatim interview transcripts were analysed to identify the major themes.Results.  Two main themes emerged from data analysis: (1) role preparation and adequacy; (2) lack of support and resources. Participants suggested several strategies to address these concerns including: improving relationships with mental health services, professional development, and developing a greater appreciation for mental health interventions.Conclusions.  There is a clear need for an increased understanding of mental health practices, an improved relationship between general and mental health services and continuing professional development to ensure nurses possess the skills and confidence to provide quality care to children admitted to a paediatric unit with a mental health diagnosis.Relevance to clinical practice.  Few general nurses have mental health training and, through no fault of their own, may be providing less than optimal care to children who are admitted with a mental health diagnosis. Through a desire to improve care, the following participatory action research project was instigated.
Herbal product use in a sample of Turkish patients undergoing haemodialysis
Authors: Kara Belgüzar 
Published: January 2009

Aim.  To examine herbal product use among patients with end‐stage renal disease undergoing haemodialysis.Background.  Herbal therapy is a very popular choice for many patients. However, little information is available about herbal product use in renal patients.Design.  The study was designed as a cross‐sectional survey. The data were obtained from 114 end‐stage renal disease patients in two haemodialysis centres in Ankara, Turkey between June–August 2007.Methods.  Data were collected through face‐to‐face structured interviews. Descriptive statistics and the chi‐square test were conducted.Results.  Approximately one‐third of the patients (28·1%) used a herbal product after the diagnosis of chronic kidney disease. Of these, 13·2% reported currently taking herbal products. A minority of participants (12·5%) informed their physician of herbal product use. Marital status was the only variable significantly associated with herbal product use.Conclusions.  The results of this study showed that many patients used herbal products, but most did not disclose this use to their physician. Herbal product use was more prevalent among the participants who were married.Relevance to clinical practice.  Understanding the patterns and reasons of herbal use is beneficial in efforts to improve the care of patients with end‐stage renal disease. Nurses should be aware of the potential health risks caused by herbal products and should educate the patient and the family.