bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Veiling sexualities’: a grounded theory of mental health nurses responses to issues of sexuality
Authors: Higgins Agnes , Barker Phil , Begley Cecily M. 
Published: April 2008

AbstractTitle.  ‘Veiling sexualities’: a grounded theory of mental health nurses responses to issues of sexuality. Aim.  This paper is a report of a study to develop a grounded theory explaining how mental health nurses respond to issues of sexuality in clinical practice.Background.  The history of sexuality and people with mental health problems has largely been a history shrouded in misunderstanding, stigma, myth and negativity. However, individuals with mental health problems may experience sexuality and relationship difficulties related to their life experiences, mental illness, or its treatment.Methods.  Grounded theory was the methodology used for the study. Interviews were conducted in 2005–2006 with 27 mental health nurses working an urban area in the Republic of Ireland. Data were analysed using the concurrent processes of constant comparative analysis, data collection, theoretical sampling and memo writing.Findings.  The core category to emerge from the data was ‘veiling sexualities’. This refers to participants’ accounts of how they responded to the sexuality dimension of clients’ lives. Participants’ main concerns about sexuality were related to feelings of personal and professional vulnerability, due to a lack of competence, comfort and confidence in this area. The theory highlights the manner in which nurses perpetuate practices that marginalize, discriminate and socially exclude clients as ‘sexual citizens’.Conclusion.  The theory of Veiled Sexualities may facilitate acknowledgement of the presence of sexuality in all nurse–client encounters, and promote a discourse on the sexual rights of people experiencing mental distress among mental health nurses and all involved in the delivery of mental health services.
Concept synthesis of the art of nursing
Authors: Finfgeld‐Connett Deborah 
Published: April 2008

AbstractTitle.  Concept synthesis of the art of nursing. Aim.  The aim of this paper is to add clarity to the concept art of nursing.Background.  Nurses have attempted to explicate the art of nursing since the time of Florence Nightingale. Despite these efforts, the concept remains obscure. A clearer conceptualization of nursing art is needed to help guide practice and research.Method.  Fifty‐nine English‐language narratives (e.g. editorials, letters, anecdotes, brief items, etc.) that discuss the art of nursing were located using the Cumulative Index to Nursing & Allied Health Literature (1982–2006). Qualitative analysis and synthesis of these documents was completed using an adaptation of Walker and Avant’s concept synthesis method.Findings.  The art of nursing consists of expert use and adaptation of empirical and metaphysical knowledge and values. It involves sensitively adapting care to meet the needs of individual patients, and in the face of uncertainty, the discretionary use of creativity. The art of nursing provides for enhanced mental and physical well‐being among patients. It also results in professional satisfaction and personal growth among nurses.Conclusion.  Results from this investigation substantiate existing knowledge related to the art of nursing. In addition, the findings extend that knowledge by more clearly identifying the antecedents, attributes and outcomes of nursing art. Specifically, the epistemological and ontological components are more clearly identified. Clarity of this type is important in terms of future development of discipline‐specific practice and research.
Night duty as an opportunity for learning
Authors: Campbell Ann‐Mari , Nilsson Kerstin , Pilhammar Andersson Ewa 
Published: April 2008

AbstractTitle.  Night duty as an opportunity for learning. Aim.  This paper is a report of a study to examine what opportunities night nurses have to learn in terms of being able to distinguish variations in the patients’ conditions.Background.  Night nurses often lack access to the formalized in‐service training offered to day nurses. As every clinical experience can be seen as an opportunity for learning, learning takes place even at night. However, the learning of night nurses has not been studied previously.Method.  This study is based on interviews with a convenience sample of 10 night nurses at a medium‐sized Swedish hospital in 2001. These interviews were reanalysed in 2006 concerning learning situations. The interviews were tape‐recorded, transcribed verbatim, coded and examined using latent content analysis.Findings.  There are certain opportunities for learning during the night shift, and three learning situations come to the fore: (1) the report situation, (2) the personal assessment round, where the nurses form their own picture of the patient, (3) in assessment prior to contact with the doctor on duty. Nurses learn from variations in patients’ conditions and when they have to report their experience verbally. Learning does take place at night and gestalt psychology is a helpful tool for understanding how former knowledge and experience affect night nurses’ learning.Conclusion.  Knowledge developed during the night shift is a neglected field. There is a need for further investigations of what night nurses learn, and this knowledge ought to be integrated in the body of nursing knowledge.
Do mosquitoes filter the access of Plasmodium cytochrome b lineages to an avian host?
Authors: GAGER ANDREA B. , DEL ROSARIO LOAIZA JOSÉ , DEARBORN DONALD C. , BERMINGHAM ELDREDGE 
Published: April 2008

AbstractMany parasites show fidelity to a set of hosts in ecological time but not evolutionary time and the determinants of this pattern are poorly understood. Malarial parasites use vertebrate hosts for the asexual stage of their life cycle but use Dipteran hosts for the sexual stage. Despite the potential evolutionary importance of Dipteran hosts, little is known of their role in determining a parasite's access to vertebrate hosts. Here, we use an avian malarial system in Panama to explore whether mosquitoes act as an access filter that limits the range of vertebrate hosts used by particular parasite lineages. We amplified and sequenced Plasmodium mitochondrial DNA (mtDNA) from Turdus grayi (clay‐coloured robin) and from mosquitoes at the same study site. We trapped and identified to species 123 141 female mosquitoes and completed polymerase chain reaction (PCR) screening for Plasmodium parasites in 435 pools of 20 mosquitoes per pool (8700 individuals total) spanning the 11 most common mosquito species. Our primers amplified nine Plasmodium lineages, whose sequences differed by 1.72%–10.0%. Phylogenetic analyses revealed partial clustering of lineages that co‐occurred in mosquito hosts. However PAN3 and PAN6, the two primary parasite lineages of T. grayi, exhibited sequence divergence of 8.59% and did not cluster in the phylogeny. We detected these two lineages exclusively in mosquitoes from different genera — PAN3 was found only in Culex (Melanoconion) ocossa, and PAN6 was found only in Aedeomyia squamipennis. Furthermore, each of these two parasite lineages co‐occurred in mosquitoes with other Plasmodium lineages that were not found in the vertebrate host T. grayi. Together, this evidence suggests that parasite–mosquito associations do not restrict the access of parasites to birds but instead may actually facilitate the switching of vertebrate hosts that occurs over evolutionary time.
Role of angiotensin‐converting enzyme gene polymorphisms in children with sepsis and septic shock
Authors: Cogulu Ozgur , Onay Huseyin , Uzunkaya Demet , Gunduz Cumhur , Pehlivan Sacide , Vardar Fadil , Atlihan Fusun , Ozkinay Cihangir , Ozkinay Ferda 
Published: April 2008

AbstractBackground: Sepsis is characterized by a systemic inflammatory response. Its development and outcome are associated with host defense, pathogenicity of the microorganism and genetic polymorphisms. Genetic polymorphisms of the immune system genes have been shown to have a close relationship with the clinical outcomes of sepsis. Angiotensin‐converting enzyme (ACE) plays a major role in the host defense against invading pathogens. It is therefore likely that polymorphisms in the ACE gene may have an important effect on determining the development and the outcome of sepsis.Methods: Ninety‐eight children diagnosed as having sepsis and 287 healthy children were included in the study. Insertion/deletion polymorphisms were analyzed using reverse‐hybridization assay.Results: The carriers of I allele (D/I genotype and I/I genotype) were found to have an increased risk of developing sepsis compared to the controls.Conclusion: DD genotype may play a positive role against the development of sepsis in healthy children.
Estimation of measles vaccine coverage needed to prevent transmission in schools
Authors: Mori Nobuo , Ohkusa Yasushi , Ohyama Takaaki , Tanaka‐Taya Keiko , Taniguchi Kiyosu , Kobayashi John M. , Doy Mikio , Okabe Nobuhiko 
Published: April 2008

AbstractBackground:The aim of the present study was to produce the first estimation in Japan of the basic reproduction number (R0) and the minimum level of vaccine coverage needed to prevent measles outbreaks (Pc).Methods:A questionnaire survey was conducted during two measles outbreaks among 12–15‐year‐old middle school students in one prefecture in spring, from the end of February to the beginning of May 2002, and a stochastic mathematical model was constructed to calculate vaccine effectiveness (VE) and the basic reproduction number (R0). Pcwas calculated from R0and VE.Results:In outbreak 1 (school A), 62 (94%) of 66 patients responded to the questionnaire. Of a total of 601 students, 534 (88.9%) responded. Of these, 82.6% (441/534) had previously received measles vaccine. In outbreak 2 (school B), 20 (99%) of 21 patients responded. Of a total of 375 students, 373 (99.5%) responded. Of these, 317 (85.0%) received measles immunization. Mathematical analysis was as follows: in outbreak 1 R0was 7.40 (95% confidence interval [CI]: 7.36–7.44) and VE was 76.55% (95%CI: 53.24–87.54). In outbreak 2, R0was 18.89 (95%CI: 18.88–18.90) and VE was 98.54% (95%CI: 94.89–99.73). Consequently, Pcwas 112.97% (95%CI: 92.29–145.52) in outbreak 1 and 96.11% (95%CI: 93.81–98.53) in outbreak 2.Conclusion:Because of the lower VE in outbreak 1, measles virus transmission could not have been stopped even if all students received a single dose of vaccine. In outbreak 2, with higher VE, the outbreak could have been prevented by increasing the proportion of students who had been vaccinated.
Relationship between SP1 polymorphism and osteoporosis in β‐thalassemia major patients
Authors: Guzeloglu‐Kayisli Ozlem , Cetin Zafer , Keser Ibrahim , Ozturk Zeynep , Tuncer Tiraje , Canatan Duran , Luleci Guven 
Published: April 2008

AbstractBackground: β‐Thalassemia is an autosomal recessive disease characterized by defective β‐globin chain production. Osteoporosis is an important cause of morbidity in patients with β‐thalassemia major. The pathogenesis of reduced bone mineral density (BMD) is multifactorial. A range of genetics factors have been implicated in other populations of patients with osteoporosis. Polymorphism at the Sp1 binding site of the collagen type I A1 (COLIA1) gene is thought to be an important factor in the development of osteoporosis.Methods: Alleles S and s, detected by presence of a G or T nucleotide, respectively in a regulatory site of the COLIA1 gene were investigated in 37 β‐thalassemia major patients with osteoporosis and 92 controls without osteoporosis or osteopenia using polymerase chain reaction–restriction fragment length polymorphism.Results: Fifteen and nine β‐thalassemia major patients displayed SS and Ss genotypes, respectively, whereas 13 were found to have an ss genotype. The mean BMD of the β‐thalassemia major patients with ss genotype was similar to those with the Ss and SS genotypes. In the control group, 77 and 15 subjects had SS and Ss genotypes, respectively, with no ss genotype. Allelic and genotypic distribution in patients were significantly different from controls.Conclusion: Determining base substitutions at the Sp1 binding site on the COLIA1 gene in early years may be important in preventing osteoporosis in children with β‐thalassemia major.
Regulation of hyperactivation of hamster spermatozoa by progesterone
Authors: NOGUCHI TAKAO , FUJINOKI MASAKATSU , KITAZAWA MASAFUMI , INABA NORIYUKI 
Published: April 2008

Aim:  Although it is accepted that progesterone (P) induces acrosome reaction through non‐genomic regulation, it is not well known if P also affects hyperactivation of sperm.Methods:  Hamster spermatozoa were hyperactivated by incubation for 4 h on modified Tyrode's albumin lactate pyruvate medium and recorded on a DVD via a charge‐coupled device camera attached to a microscope with phase‐contrast illumination and a small CO2 incubator. Phosphorylation of proteins was detected by western blotting using antiphosphotyrosine antibodies.Results:  Sperm hyperactivation was significantly increased and accelerated by a non‐genomic signal of P. Although acceleration of motility of hyperactivated sperm occurred with 10, 20 and 40 ng/mL P, the most effective concentration was 20 ng/mL. Progesterone also significantly increased 80‐kDa tyrosine phosphorylation of sperm proteins. Both extracellular Ca2+ and albumin were essential for sperm hyperactivation, and the former was also essential for maintaining sperm flagellar movement. Moreover, phospholipase C (PLC) was associated with the regulation of hyperactivation by P.Conclusion:  It is likely that P regulates sperm hyperactivation by a non‐genomic signal in relation to tyrosine phosphorylation and PLC. (Reprod Med Biol 2008; 7: 63–74)
The validity of the Jessen formula in overnight orthokeratology: a retrospective study
Authors: Chan Ben , Cho Pauline , Mountford John 
Published: April 2008

AbstractPurpose:  To investigate the validity of the Jessen formula, with a compression factor of 0.75, in determining the back optic zone radius (BOZR) of an orthokeratology (ortho‐k) lens for myopic reduction [i.e. BOZR = flattest K− (target reduction + 0.75)].Methods:  One hundred and twenty‐three consecutive ortho‐k patient files from the Optometry Clinic of The Hong Kong Polytechnic University were reviewed. Pertinent data at the preliminary visit and at the morning visit after 2 weeks of lens wear for 63 patients who fulfilled the inclusion criteria were retrieved for analysis. All patients were either fitted with DreimLens (DreimLens Taiwan, Taiwan Macro Vision Group, Taiwan, China) or eLens (E&E Optics Ltd., Hong Kong SAR, China) designs. Only data from the right eye were analysed. The validity of the Jessen formula was evaluated by comparing the equation of the plot of myopic reduction attempted (based on the Jessen formula) and myopic reduction achieved (based on subjective refraction).Results:  The Jessen formula was found to underestimate the intended target of myopic reduction following ortho‐k. The results suggested that the formula should be revised to BOZR = flattest K− (1.23 target reduction + 1.27).Conclusion:  If the intention is to overcorrect the ortho‐k patient by 0.75 D to allow for regression during the daytime, the Jessen formula with a compression factor of 0.75 is not valid to determine the BOZR of the ortho‐k lens designs.
Optimal spherical focus in the peripheral retina
Authors: Charman W. N. , Atchison D. A. 
Published: April 2008

AbstractIt is well known that, in most eyes, astigmatism increases with the field angle. A simple reduced‐eye model is used to demonstrate that, for point imagery in the peripheral retina, the combination of oblique astigmatism with elliptical entrance and exit pupils means that the retinal image with the optimal rotational symmetry is not necessarily at a focus corresponding to a ‘best‐sphere’ correction. Equations are derived for the position of focus at which a circularly symmetric blur patch is obtained and for the dimensions of the patch in this and other image planes. Ray tracing through a wide‐angle schematic eye is used to explore the validity of the simple model. It is shown that although the latter gives good predictions of retinal imagery for very small entrance pupils, it becomes less valid for larger, more realistic pupil diameters, due to the increasing importance of the effects of higher‐order aberrations. Nevertheless, the simple model can still yield useful insights into through‐focus, peripheral optical imagery.
Performance of colour‐deficient people on the Holmes–Wright lantern (type A): consistency of occupational colour vision standards in aviation
Authors: Birch Jennifer 
Published: April 2008

AbstractIntroduction:  The Holmes–Wright lantern type A (H‐W A) is an occupational colour vision test used by the UK Civil Aviation Authority (CAA) and approved by Joint Aviation Requirements (JAR) to select aircrew. Pass, to obtain a CAA Class 1 Aviation medical certificate, can be achieved at three stages of the examination. The Commission Internationale d’Eclairage (CIE) recommends that the Falant pass criteria are used with all approved lanterns. A pass to obtain CIE Colour Vision Standard 2 can be achieved at two stages of the examination. This study examines the consistency of these pass criteria.Methods:  One hundred and twenty‐five men with red–green colour deficiency were examined. All subjects completed three runs of the nine colour pairs shown on the H‐W A at high brightness, in photopic and scotopic viewing.Results:  Ten of 78 deuteranomalous trichromats examined passed to obtain a CAA Class 1 Aviation medical certificate at the first stage of the examination but only two of these subjects were successful at all three stages. Seventeen deuteranomalous trichromats passed to obtain CIE Colour Vision Standard 2 in photopic viewing and 20 subjects (one protanope and 19 deuteranomalous trichromats) passed in scotopic viewing. Only 50% of subjects who passed at the first stage of the examination were also successful at the second stage in either viewing condition. Ten deuteranomalous trichromats passed to obtain CIE Colour Vision Standard 2 in both photopic and scotopic viewing. Forty‐three per cent of subjects made red–green errors and 79% made red–white errors at some stage of the examination.Conclusions:  The staged pass criteria used by the CAA and the CIE lack internal consistency when applied to the H‐W A. Colour‐deficient people who pass to a standard at the first stage of the examination are unlikely to be successful if the examination is continued. The staged pass criteria do not identify individuals with superior colour discrimination ability and it is difficult to justify selection of personnel for high risk occupations in aviation on this basis.
Therapeutic relationships in critical care nursing: a reflection on practice
Authors: O’Connell Elizabeth 
Published: April 2008

AbstractAims:  The aim of this paper is to gain a greater understanding of the emotional intelligence required to form therapeutic nurse‐patient relationships in the context of critical care nursing.Context:  There is currently a demand for patient‐centred nursing in all aspects of health care to improve both quality of care and consumer satisfaction. Central to patient‐centred care is the presence of a therapeutic nurse‐patient relationships, but the development of these relationships present a challenge in the acute and technological world of critical care nursing.Theoretical Framework:  Using Titchen’s Skilled Companionship Model as a guide as well as empirical and theoretical knowledge on nurse‐patient relationships, this paper presents a reflection on a relationship that the author developed with a patient and his family encountered in her practice as a critical care nurse.Reflective Conclusions:  Engaging in therapeutic nurse‐patient relationships can expose nurses to emotional pain in the context of critical care nursing. The process of reflection can facilitate critical care nurses in the development of the emotional intelligence required to develop and maintain these relationships and this enhances the care of critically ill patients and their families.
End‐of‐life care in UK critical care units – a literature review
Authors: Morgan Jane 
Published: April 2008

AbstractAim:  To appraise literature concerning end‐of‐life care (ELC) in adult critical care units in the UK in order to improve clinical practice.Objective:  To understand the interplay between legal and ethical, political, societal aspects of ELC for sustainable quality care.Background:  Significant changes in health care policy for the critically ill patient have occurred since 1999. Simultaneously, the government is committed to improving care for the dying by integrating the palliative care ethos across the National Institutes of Health (NHS) to include non‐cancer sufferers. Death continues to be a feature of critical illness, particularly following the decision to withhold/withdraw life‐prolonging treatments.Search strategy:  A search of MEDLINE, BNI, CINAHL and PSYCinfo using key words revealed very few results; consequently, the search was broadened to include ASSIA, King’s Fund, TRIP, Healthstar, NHS Economic Evaluation Data, Cochrane, professional journals and government documents.Conclusions:  The literature reveals a paradigm shift from critical to palliative care, in other words, from a reductionist approach to a more humanistic approach in the acute setting. When treatment is deemed futile, quality ELC involving the assessment, ongoing assessment and care after death becomes the new goal for the critical care team. To practice ELC competently, nurses require organizational and educational support at local and national levels.Relevance to clinical practice:  Although medico‐legal decision‐making is not part of their professional role, critical care nurses have an extraordinary opportunity to make a difference to the dying patient and their family and their acceptance of death.
The Price of Bouncing Back: One‐Year Mortality and Payments for Acute Stroke Patients with 30‐Day Bounce‐Backs
Authors: Kind Amy J. H. , Smith Maureen A. , Liou Jinn‐Ing , Pandhi Nancy , Frytak Jennifer R. , Finch Michael D. 
Published: April 2008

OBJECTIVES: To examine 1‐year mortality and healthcare payments of stroke patients experiencing zero, one and two or more bounce‐backs within 30 days of discharge.DESIGN: Retrospective analysis of administrative data.SETTING: Four hundred twenty‐two hospitals in the southern and eastern United States.PARTICIPANTS: Eleven thousand seven hundred twenty‐nine Medicare beneficiaries aged 65 and older surviving at least 30 days with acute ischemic stroke in 2000.MEASUREMENTS: One‐year mortality and predicted total healthcare payments were calculated using log‐normal parametric survival analysis and quantile regression, respectively. Models included sociodemographics, prior medical history, stroke severity, length of stay, and discharge site.RESULTS: Crude survival at 1 year for the zero, one and two or more bounce‐back groups was 83%, 67%, and 55%, respectively. The one bounce‐back group had 49% shorter (time ratio (TR)=0.51, 95% confidence interval (CI)=0.46–0.56) and the two or more bounce‐backs group had 68% shorter (TR=0.32, 95% CI=0.27–0.38) adjusted 1‐year survival time than the zero bounce‐back group. For high‐ and low‐cost patients, adjusted predicted payments were greater with each additional bounce‐back experienced.CONCLUSION: Acute stroke patients experiencing bounce‐backs within 30 days have strikingly poorer survival and higher healthcare payments over the subsequent year than their counterparts with no bounce‐backs. Bounce‐backs may serve as a simple predictor for identifying stroke patients at extremely high risk for poor outcomes.