bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the perceived role of the nurse consultant through the lived experience of healthcare professionals
Authors: McSherry Rob , Mudd Dave , Campbell Steve 
Published: February 2007

Aims and objectives.  This study aimed to evaluate the perceived impact of the nurse consultant through the lived experience of the staff.Background.  Ambiguities exist about the nature, function and value of the nurse consultant role to the individual, nursing and the UK National Health Service.Design.  A descriptive qualitative research design was developed to evaluate the perceived impact of the nurse consultant through the lived experience of staff by the use of a 360‐degree semi‐structured interview framework. Interviews were undertaken with executive, senior managers, medical, nursing and allied healthcare professional colleagues. The study was based on three nurse consultants working at a University Hospital in the North East of England. A collaborative purposive sampling technique was used involving 10 participants to provide detailed, objective and relevant information associated with the nurse consultant role.Findings.  Thirty semi‐structured interviews were undertaken. A thematic analysis using Bowling's approach to deciphering interview data revealed nine primary categories. With the exception of the personal qualities, the nurse consultant brings to the role. A series of generalist themes emerged associated with how the role can be enhanced in the future by involving, informing and engaging staff and by developing a phased approach to implementing and evaluating the role.Conclusions.  The findings indicate that the continued success of the nurse consultant role is associated with developing a more structured approach to implementation and evaluation within the employing organizations.Relevance to clinical practice.  Awareness of the nurse consultant should be raised through communication, clarification of expectations by engaging and supporting the staff in the acceptance of the role. Organizationally there should be a more phased approach to establishing, implementing and evaluating the nurse consultant.
Prognostic factors associated with poor graft outcomes in renal recipients with post‐transplant glomerulonephritis
Authors: Requião‐Moura Lúcio R , Moscoso‐Solorzano Grace T , Franco Marcello F , Ozaki Kikumi S , Pacheco‐Silva Alvaro , Kirsztajn Gianna Mastroianni , Câmara Niels O.S. 
Published: February 2007

Abstract:  Background:  Little data are available concerning post‐transplantation glomerulonephritis (PTx‐GN) and its prognostic factors associated with graft outcomes.Methods:  We retrospectively evaluated patients with de novo and recurrent PTx‐GN to identify the factors associated with their negative impact on graft and patient outcomes. PTx‐GN was diagnosed in 55 patients, wherein 17 (31%) had recurrent glomerulonephritis (GN) and 16 (29%) had de novo.Results:  Our enrolled population consisted of 34 ± 13.7‐yr‐old male patients (72%), on hemodialysis for a median of 18 months (0–204) and mainly grafted from living donors (76%). The median onset time of proteinuria and hematuria was 50 d (10–2160) and 30 d (4–1170), respectively. One‐yr graft survival rates after PTx‐GN diagnosis was 64%. The most frequent de novo GN was membranous GN (26%), while focal segmental glomerulosclerosis was the most frequent recurrent GN (41%), with a very early onset (median of three months). One‐yr graft survival was better in the recurrent disease than in the de novo patients, 76% vs. 55% (p = 0.24). The best predictor factors that correlated with graft survival were: proteinuria <3.5 g [relative risk (RR) = 0.24, p = 0.017], serum creatinine below 2.0 mg/dL (RR = 0.06, p = 0.016) at the time of biopsy and the use of angiotensin‐converting enzyme inhibitors (ACEI) (RR = 0.12, p = 0.005). The use of ACEI markedly improved one‐yr graft survival rates (92% vs. 47%, p < 0.001).Conclusion:  PTx‐GN has a strong negative impact on kidney graft survival. De novo GN appears to have a poorer prognosis than the recurrent type. Patients who used ACEI showed a better survival rate in the follow‐up.
Implementation and Evaluation of a Nursing Home Fall Management Program
Authors: Rask Kimberly , Parmelee Patricia A. , Taylor Jo A. , Green Diane , Brown Holly , Hawley Jonathan , Schild Laura , Strothers Harry S. , Ouslander Joseph G. 
Published: February 2007

OBJECTIVES: To evaluate the feasibility and effectiveness of a falls management program (FMP) for nursing homes (NHs).DESIGN: A quality improvement project with data collection throughout FMP implementation.SETTING: NHs in Georgia owned and operated by a single nonprofit organization.PARTICIPANTS: All residents of participating NHs.INTERVENTION: A convenience sample of 19 NHs implemented the FMP. The FMP is a multifaceted quality improvement and culture change intervention. Key components included organizational leadership buy‐in and support, a designated facility‐based falls coordinator and interdisciplinary team, intensive education and training, and ongoing consultation and oversight by advanced practice nurses with expertise in falls management.MEASUREMENTS: Process‐of‐care documentation using a detailed 24‐item audit tool and fall and physical restraint use rates derived from quality improvement software currently used in all Georgia NHs (MyInnerView).RESULTS: Care process documentation related to the assessment and management of fall risk improved significantly during implementation of the FMP. Restraint use decreased substantially during the project period, from 7.9% to 4.4% in the intervention NHs (a relative reduction of 44%), and decreased in the nonintervention NHs from 7.0% to 4.9% (a relative reduction of 30%). Fall rates remained stable in the intervention NHs (17.3 falls/100 residents per month at start and 16.4 falls/100 residents per month at end), whereas fall rates increased 26% in the NHs not implementing the FMP (from 15.0 falls/100 residents/per month to 18.9 falls/100 residents per month).CONCLUSION: Implementation was associated with significantly improved care process documentation and a stable fall rate during a period of substantial reduction in the use of physical restraints. In contrast, fall rates increased in NHs owned by the same organization that did not implement the FMP. The FMP may be a helpful tool for NHs to manage fall risk while attempting to reduce physical restraint use in response to the Centers for Medicare and Medicaid Services quality initiatives.
Light‐chain removal by plasmapheresis in myeloma‐associated renal failure
Authors: Cserti Christine , Haspel Richard , Stowell Christopher , Dzik Walter 
Published: February 2007

BACKGROUND: Although plasmapheresis has been recommended to reverse nephrotoxic elevations of serum free light chains (sFLCs), there are scant published data on removal of sFLC measured with modern assays.STUDY DESIGN AND METHODS: sFLC levels were recorded in two patients with myeloma‐associated renal failure receiving multiple plasmapheresis procedures.RESULTS: In one patient, presenting with acute renal failure 8 months after diagnosis of κ‐LC myeloma, 16 plasmapheresis procedures neither reduced sFLC levels (percent removal ranging from −70% to +40%) nor improved renal function. In another patient who presented with leukemic immunoglobulin A‐λ myeloma and acute renal failure, sFLC decreased by 30 to 60 percent after each plasmapheresis procedure, but rebounded within 5 to 10 hours. Renal failure occurred despite plasmapheresis, and hemodialysis was required.CONCLUSIONS: In both patients, plasmapheresis failed to effectively lower sFLC levels. The results provide initial biologic data supporting the conclusions of a recent randomized multicenter clinical trial in which plasmapheresis was an ineffective adjunct to chemotherapy for myeloma‐associated acute renal failure.
Generation of kinins during preparation and storage of whole blood–derived platelet concentrates
Authors: Moreau Marie Eve , Thibault Louis , Désormeaux Anik , Chagnon Miguel , Lemieux Réal , Robillard Pierre , Marceau François , Colman Robert W. , Lepage Yves , Rivard Georges‐Étienne , Adam Albert 
Published: February 2007

BACKGROUND: Leukoreduction of platelet (PLT) concentrates (PCs) may be associated with hypotension in recipients, and a role for bradykinin (BK)‐related peptides has been proposed for this side effect.STUDY DESIGN AND METHODS: The concentration of BK and one of its vasoactive metabolites, des‐arginine9‐BK (des‐Arg9‐BK), was measured in a large number of PCs as a function of leukoreduction and storage duration with specific enzyme immunoassays and complementary techniques.RESULTS: On Day 0 of storage, kinins were detected in leukoreduced and unfiltered PCs at a concentration lower than 100 pg per mL. During storage, both kinin levels peaked on Day 5 of storage, with a concentration higher than 1 ng per mL in 22 percent of PCs whether filtered on Day 0 or not. Physicochemical and pharmacologic characterizations of immunoreactive kinins confirm their nature. In vitro activation of the contact system of the corresponding PLT‐poor plasma showed that a high kinin concentration on Day 5 of the storage corresponded with a low kinin‐forming capacity of plasma. On Day 7, BK was no longer elevated presumably due to its degradation and the depletion of kinin‐forming capacity of the plasma in stored PCs. The activities of metallopeptidases that metabolize BK‐related peptides in plasma from PCs were at levels similar to those recorded in the plasma of a normal reference population and were unaffected by storage.CONCLUSION: Storage of PCs contributes to the hydrolysis of high‐molecular‐weight kininogen and generation of pharmacologically relevant BK levels that might pose a hazard in susceptible patients.
Do sensorial manipulations affect subjects differently depending on their postural abilities?
Authors: Paillard Thierry , Bizid Riadh , Dupui Philippe 
Published: February 2007

Objectives:To examine whether sensorial manipulation affects subjects differently according to their postural performance and the strategies used. The literature showed that the level of competition of soccer players influences their postural performance and strategy.Methods:Eight high-level (HL) professional soccer players and nine regional-level (RL) soccer players were tested (1) in a reference condition and (2) in a manipulated sensorial condition (MAN). The MAN condition consisted of perturbing the proprioceptive and exteroceptive information. For each postural condition, balance was assessed by measuring the centre of foot pressure using a force platform during a test of bipedal standing posture.Results:The postural control was less perturbed in the HL than in the RL players in the two postural conditions. Moreover, the group–condition interaction showed that the postural control was less disturbed in the HL than in the RL players when the sensory information was manipulated.Conclusions:The HL soccer players probably possessed a better internal model of verticality than the RL players. Subjects who had a better postural control level were less disturbed by sensorial manipulation than the others in postural regulation.
Global value, full value and societal costs: capturing the true cost of destroying marine ecosystems
Authors: Failler Pierre , Pan Haoran 
Published: February 2007

English World fisheries are characterized by ecological, economic and social costs which are not taken into account by current market mechanisms. However, the sustainability of ecosystems and fishing activities depends on their being taken into account in order to arrive at the most appropriate management decisions. The European research programme ECOST (Ecosystem, Society, Consilience and Precautionary Principle: Development of an Assessment Method of the Societal Cost for Best Fishing Practices and Efficient Public Policies) develops an integrative approach to the various costs generated by fishing activities. In doing so it seeks to develop a decision-making tool which can contribute to the success of the Plan of Implementation proposed at the Johannesburg summit. French Les pêcheries mondiales sont caractérisées par des coûts écologiques, économiques et sociaux qui ne sont pas pris en compte par les mécanismes de marchés actuels. Or la pérennité des écosystèmes et des activités de pêche dépend de leur prise en compte afin de prendre les décisions d'aménagement les plus appropriées. Le programme de recherche européen en coopération ECOST (Ecosystèmes, société, consilience et principe de précaution: développement d'une méthode d'évaluation des coûts sociétaux pour parvenir à des pratiques de pêche et des politiques publiques durables) développe une approche intégrative des différents coûts engendrés par les activités de pêche ainsi que les politiques publiques. Il tend de la sorte à développer un outil d'aide à la décision pouvant contribuer à la réussite du plan d'implémentation du sommet de Johannesbourg.
Impact on respiratory tract infections of heptavalent pneumococcal conjugate vaccine administered at 3, 5 and 11 months of age
Authors: Esposito Susanna , Lizioli Alessandro , Lastrico Annalisa , Begliatti Enrica , Rognoni Alessandro , Tagliabue Claudia , Cesati Laura , Carreri Vittorio , Principi Nicola 
Published: February 2007

Abstract

Background
Medical and public health importance of pneumococcal infections justifies the implementation of measures capable of reducing their incidence and severity, and explains why the recently marketed heptavalent pneumococcal conjugate vaccine (PCV-7) has been widely studied by pediatricians. This study was designed to evaluate the impact of PCV-7 administered at 3, 5 and 11 months of age on respiratory tract infections in very young children.

Methods
A total of 1,571 healthy infants (910 males) aged 75–105 days (median 82 days) were enrolled in this prospective cohort trial to receive a hexavalent vaccine (DTaP/IPV/HBV/Hib) and PCV-7 (n = 819) or the hexavalent vaccine alone (n = 752) at 3, 5 and 11 months of age. Morbidity was recorded for the 24 months following the second dose by monthly telephone interviews conducted by investigators blinded to the study treatment assignment using standardised questionnaires. During these interviews, the caregivers and the children's pediatricians were questioned about illnesses and the use of antibiotics since the previous telephone call. All of the data were analysed using SAS Windows v.12.

Results
Among the 1,555 subjects (98.9%) who completed the study, analysis of the data by the periods of follow-up demonstrated that radiologically confirmed community-acquired pneumonia (CAP) was significantly less frequent in the PCV-7 group during the follow-up as a whole and during the last period of follow-up. Moreover, there were statistically significant between-group differences in the incidence of acute otitis media (AOM) in each half-year period of follow-up except the first, with significantly lower number of episodes in children receiving PCV-7 than in controls. Furthermore, the antibiotic prescription data showed that the probability of receiving an antibiotic course was significantly lower in the PCV-7 group than in the control group.

Conclusion
Our findings show the effectiveness of the simplified PCV-7 schedule (three doses administered at 3, 5 and 11–12 months of age) in the prevention of CAP and AOM, diseases in which Streptococcus pneumoniae plays a major etiological role. A further benefit is that the use of PCV-7 reduces the number of antibiotic prescriptions. All of these advantages may also be important from an economic point of view.
Apical ballooning syndrome complicated by acute severe mitral regurgitation with left ventricular outflow obstruction – Case report
Authors: Chandrasegaram Manju D , Celermajer David S , Wilson Michael K 
Published: February 2007

Abstract

Background
Apical ballooning syndrome (or Takotsubo cardiomyopathy) is a syndrome of transient left ventricular apical ballooning. Although first described in Japanese patients, it is now well reported in the Caucasian population. The syndrome mimicks an acute myocardial infarction but is characterised by the absence of obstructive coronary disease. We describe a serious and poorly understood complication of Takotsubo cardiomyopathy.

Case Presentation
We present the case of a 65 year-old lady referred to us from a rural hospital where she was treated with thrombolytic therapy for a presumed acute anterior myocardial infarction. Four hours after thrombolysis she developed acute pulmonary oedema and a new systolic murmur. It was presumed she had acute mitral regurgitation secondary to a ruptured papillary muscle, ischaemic dysfunction or an acute ventricular septal defect.
Echocardiogram revealed severe mitral regurgitation, left ventricular apical ballooning, and systolic anterior motion of the mitral valve with significant left ventricular outflow tract gradient (60–70 mmHg). Coronary angiography revealed no obstructive coronary lesions.
She had an intra-aortic balloon pump inserted with no improvement in her parlous haemodynamic state. We elected to replace her mitral valve to correct the outflow tract gradient and mitral regurgitation. Intra-operatively the mitral valve was mildly myxomatous but there were no structural abnormalities. She had a mechanical mitral valve replacement with a 29 mm St Jude valve. Post-operatively, her left ventricular outflow obstruction resolved and ventricular function returned to normal over the subsequent 10 days. She recovered well.

Conclusion
This case represents a serious and poorly understood association of Takotsubo cardiomyopathy with acute pulmonary oedema, severe mitral regurgitaton and systolic anterior motion of the mitral valve with significant left ventricular outflow tract obstruction. The sequence of our patient's presentation suggests that the apical ballooning caused geometric alterations in her left ventricle that in turn led to acute and severe mitral regurgitation, systolic anterior motion of the mitral valve and left ventricular outflow tract obstruction. The left ventricular outflow tract obstruction and mitral regurgitation were corrected by mechanical mitral valve replacement. We describe a variant of Takotsubo cardiomyopathy with acute mitral regurgitation, systolic anterior motion of the mitral valve leaflet and left ventricular outflow tract obstruction of a dynamic nature.
Non-invasive MR imaging of inflammation in a patient with both asymptomatic carotid atheroma and an abdominal aortic aneurysm: a case report
Authors: Howarth Simon PS , Tang Tjun Y , Graves Martin J , U-King-Im Jean-Marie , Li Zhi-Yong , Walsh Stewart R , Gaunt Michael E , Gillard Jonathan H 
Published: February 2007

Abstract
Inflammation is a recognized risk factor for the vulnerable atherosclerotic plaque.
USPIO-enhanced MRI imaging is a promising non-invasive method to identify high-risk atheromatous plaque inflammation in vivo in humans, in which areas of focal signal loss on MR images have been shown to correspond to the location of activated macrophages, typically at the shoulder regions of the plaque. This is the first report in humans describing simultaneous USPIO uptake within atheroma in two different arterial territories and again emphasises that atherosclerosis is a truly systemic disease. With further work, USPIO-enhanced MR imaging may be useful in identifying inflamed vulnerable atheromatous plaques in vivo, so refining patient selection for intervention and allowing appropriate early aggressive pharmacotherapy to prevent plaque rupture.
Rapid, accurate, computational discovery of Rho-independent transcription terminators illuminates their relationship to DNA uptake
Authors: Kingsford Carleton L , Ayanbule Kunmi , Salzberg Steven L 
Published: February 2007

Abstract
Background
In many prokaryotes, transcription of DNA to RNA is terminated by a thymine-rich stretch of DNA following a hairpin loop. Detecting such Rho-independent transcription terminators can shed light on the organization of bacterial genomes and can improve genome annotation. Previous computational methods to predict Rho-independent terminators have been slow or limited in the organisms they consider.

Results
We describe TransTermHP, a new computational method to rapidly and accurately detect Rho-independent transcription terminators. We predict the locations of terminators in 343 prokaryotic genomes, representing the largest collection of predictions available. In Bacillus subtilis, we can detect 93% of known terminators with a false positive rate of just 6%, comparable to the best-known methods. Outside the Firmicutes division, we find that Rho-independent termination plays a large role in the Neisseria and Vibrio genera, the Pasteurellaceae (including the Haemophilus genus) and several other species. In Neisseria and Pasteurellaceae, terminator hairpins are frequently formed by closely spaced, complementary instances of exogenous DNA uptake signal sequences. We quantify the propensity for terminators to include these sequences. In the process, we provide the first discussion of potential uptake signals in Haemophilus ducreyi and Mannheimia succiniciproducens, and we discuss the preference for a particular configuration of uptake signal sequences within terminators.

Conclusion
Our new fast and accurate method for detecting transcription terminators has allowed us to identify and analyze terminators in many new genomes and to identify DNA uptake signal sequences in several species where they have not been previously reported. Our software and predictions are freely available.
Contrasting effects of FLIPL overexpression in human T cells on activation-induced cell death and cytokine production
Authors: Charo Jehad , Robbins Paul F 
Published: February 2007

AbstractThere have been disparate findings about the role of FLIP in the survival of mouse T cells and human tumor cell lines. The role of cellular FLIP in human T cell activation and function needs to be clarified further. To study this role, we have overexpressed long transcript FLIP (FLIPL) in primary T cells, including self-antigen-reactive, melanoma-specific T cells. We found that FLIPL overexpression protects human T cells from activation-induced cell death and enhances their prolifertive capacity but suppresses the ability of these cells to produce the proinflammatory cytokines IL-2 and IFN-γ in response to CD3 or antigen-specific stimulation. The multiple effects of FLIPL indicate that this protein may influence T cell responses to antigenic stimulation.