bluuebunny/crossref_metadata_2025_split huggingface dataset:
Poor work environments and nurse inexperience are associated with burnout, job dissatisfaction and quality deficits in Japanese hospitals
Authors: Kanai‐Pak Masako , Aiken Linda H , Sloane Douglas M , Poghosyan Lusine 
Published: November 2008

Aims.  To describe nurse burnout, job dissatisfaction and quality of care in Japanese hospitals and to determine how these outcomes are associated with work environment factors.Background.  Nurse burnout and job dissatisfaction are associated with poor nurse retention and uneven quality of care in other countries but comprehensive data have been lacking on Japan.Design.  Cross‐sectional survey of 5956 staff nurses on 302 units in 19 acute hospitals in Japan.Methods.  Nurses were provided information about years of experience, completed the Maslach Burnout Inventory and reported on resource adequacy and working relations with doctors using the Nursing Work Index‐Revised.Results.  Fifty‐six per cent of nurses scored high on burnout, 60% were dissatisfied with their jobs and 59% ranked quality of care as only fair or poor. About one‐third had fewer than four years of experience and more than two‐thirds had less than 10. Only one in five nurses reported there were enough registered nurses to provide quality care and more than half reported that teamwork between nurses and physicians was lacking. The odds on high burnout, job dissatisfaction and poor–fair quality of care were twice as high in hospitals with 50% inexperienced nurses than with 20% inexperienced nurses and 40% higher in hospitals where nurses had less satisfactory relations with physicians. Nurses in poorly staffed hospitals were 50% more likely to exhibit burnout, twice as likely to be dissatisfied and 75% more likely to report poor or fair quality care than nurses in better staffed hospitals.Conclusions.  Improved nurse staffing and working relationships with physicians may reduce nurse burnout, job dissatisfaction and low nurse‐assessed quality of care.Relevance to clinical practice.  Staff nurses should engage supervisors and medical staff in discussions about retaining more experienced nurses at the bedside, implementing strategies to enhance clinical staffing and identifying ways to improve nurse‐physician working relations.
Challenges in getting workforce research in nursing used for decision‐making in policy and practice: a Canadian perspective
Authors: O’Brien‐Pallas Linda , Hayes Laureen 
Published: November 2008

Aims and objectives.  This paper draws upon empirical research and other published sources to discuss nursing workforce issues, the challenges of using health human resource research in policy decisions and the importance of evidence‐based policies and practices for nursing care and outcomes.Background.  Increasing evidence points to the critical relationship between registered nurse care and improved patient outcomes. The negative impact that insufficient nurse staffing has on patient, nursing and system outcomes has influenced health human resource researchers to further examine nurses’ work environments to determine factors that are amenable to policy change.Design.  Survey of literature was conducted.Methods.  Electronic databases were searched using keywords.Results.  Sustained health human resource planning efforts by policy makers are difficult given changing governments and political agendas. The health human resource conceptual framework provides researchers and planners with a guide to decision‐making that considers current circumstances as well as those factors that need to be accounted for in predicting future requirements. However, effective use of research depends on communication of findings between researchers and policymakers.Conclusions.  Health care managers and other decision‐makers in health care organisations often lack an understanding of the research process and do not always have easy access to current evidence. Also, managerial decisions are often constrained by organisational requirements such as resource availability and policies and procedures.Relevance to clinical practice.  Unless nursing workplace issues are addressed, the physiological and psychological stress in the work environments of nurses will continue. Effective health human resource policy and planning (at the macro level) and management strategies (at the micro level) would stabilise the nursing workforce and reduce job stress. Furthermore, the efficiency and cost‐effectiveness of the health system could be enhanced through improved health outcomes of care providers and health care clients.
A cryptic invasion within an invasion and widespread introgression in the European water frog complex: consequences of uncontrolled commercial trade and weak international legislation
Authors: HOLSBEEK G. , MERGEAY J. , HOTZ H. , PLÖTNER J. , VOLCKAERT F. A. M. , DE MEESTER L. 
Published: November 2008

AbstractIn Western Europe, many pond owners introduce amphibians for ornamental purposes. Although indigenous amphibians are legally protected in most European countries, retailers are circumventing national and international legislation by selling exotic nonprotected sibling species. We investigated to what extent non‐native species of the European water frog complex (genus Pelophylax) have become established in Belgium, using morphological, mitochondrial and nuclear genetic markers. A survey of 87 sampling sites showed the presence of non‐native water frogs at 47 locations, mostly Marsh frogs (Pelophylax ridibundus). Surprisingly, at least 19% of all these locations also harboured individuals with mitochondrial haplotypes characteristic of Anatolian water frogs (Pelophylax cf. bedriagae). Nuclear genotyping indicated widespread hybridization and introgression between P. ridibundus and P. cf. bedriagae. In addition, water frogs of Turkish origin obtained through a licensed retailer, also contained P. ridibundus and P. cf. bedriagae, with identical haplotypes to the wild Belgian populations. Although P. ridibundus might have invaded Belgium by natural range expansion from neighbouring countries, our results suggest that its invasion was at least partly enhanced by commercial trade, with origins as far as the Middle East. Also the invasion and rapid spread of Anatolian lineages, masked by their high morphological similarity to P. ridibundus, is likely the result of unregulated commercial trade. We expect that Anatolian frogs will further invade the exotic as well as the native range of P. ridibundus and other Pelophylax species elsewhere in Western and Central Europe, with risks of large‐scale hybridization and introgression.
Across the southern Andes on fin: glacial refugia, drainage reversals and a secondary contact zone revealed by the phylogeographical signal of Galaxias platei in Patagonia
Authors: ZEMLAK TYLER S. , HABIT EVELYN M. , WALDE SANDRA J. , BATTINI MIGUEL A. , ADAMS EMILY D. M. , RUZZANTE DANIEL E. 
Published: November 2008

AbstractWe employed DNA sequence variation at two mitochondrial (control region, COI) regions from 212 individuals of Galaxias platei (Pisces, Galaxiidae) collected throughout Patagonia (25 lakes/rivers) to examine how Andean orogeny and the climatic cycles throughout the Quaternary affected the genetic diversity and phylogeography of this species. Phylogenetic analyses revealed four deep genealogical lineages which likely represent the initial division of G. platei into eastern and western lineages by Andean uplift, followed by further subdivision of each lineage into separate glacial refugia by repeated Pleistocene glacial cycles. West of the Andes, refugia were likely restricted to the northern region of Patagonia with small relicts in the south, whereas eastern refugia appear to have been much larger and widespread, consisting of separate northern and southern regions that collectively spanned most of Argentinean Patagonia. The retreat of glacial ice following the last glacial maximum allowed re‐colonization of central Chile from nonlocal refugia from the north and east, representing a region of secondary contact between all four glacial lineages. Northwestern glacial relicts likely followed pro‐glacial lakes into central Chilean Patagonia, whereas catastrophic changes in drainage direction (Atlantic → Pacific) for several eastern palaeolakes were the likely avenues for invasions from the east. These mechanisms, combined with evidence for recent, rapid and widespread population growth could explain the extensive contemporary distribution of G. platei throughout Patagonia.
Descriptive epidemiology of congenital heart disease in Northern England
Authors: Dadvand Payam , Rankin Judith , Shirley Mark D. F. , Rushton Stephen , Pless‐Mulloli Tanja 
Published: November 2008

SummaryCongenital heart disease (CHD) is the most prevalent group of congenital anomalies. There is considerable variation in the reported epidemiology of CHD, mainly attributable to methodological differences. Using register‐based data, the current study describes the epidemiology of CHD in a geographically well‐defined population of the North of England during 1985–2003.The total prevalence of CHD was 85.9 per 10 000 births and terminations of pregnancy for fetal anomaly. Livebirth prevalence was 79.7 per 10 000 livebirths. Both total and livebirth prevalence increased during the study period. Ninety‐two per cent of affected pregnancies resulted in a livebirth, 5% were terminated, 2% resulted in a stillbirth, and 1% in a late miscarriage. Almost a quarter (23%) of cases had one or more coincident anomalies of other organs, with chromosomal abnormalities the most frequent group. A total of 89.2% of cases survived to 1 year and the survival improved during the study period. This population‐based study has demonstrated an increasing trend in both prevalence and survival among children with CHD.
Changing roles and responses of health care workers in HIV treatment and care
Authors: Rajaraman Divya , Palmer Natasha 
Published: November 2008

SummaryA key limiting factor in the scale up and sustainability of HIV care and treatment programmes is the global shortage of trained health care workers. This paper discusses why it is important to move beyond conceptualising health care workers simply as ‘inputs’ in the delivery of HIV treatment and care, and to also consider their roles as partners and agents in the process of health care. It suggests a framework for thinking about their roles and responses in HIV care, considers the current evidence base, and concludes by identifying key areas for future research on health care workers’ responses in HIV treatment and care in low and middle income settings.
The safety of sublingual immunotherapy with one or multiple pollen allergens in children
Authors: Agostinis F. , Foglia C. , Landi M. , Cottini M. , Lombardi C. , Canonica G. W. , Passalacqua G. 
Published: November 2008

Background:  Since the majority of allergic patients are polysensitized, it is often necessary to prescribe immunotherapy with multiple allergens. It is crucial to know if the administration of multiple allergens with sublingual immunotherapy (SLIT) increases the risk of side‐effects in children.Methods:  Consecutive children with respiratory allergy because of pollens, receiving SLIT for multiple or single allergens were followed‐up in a postmarketing survey. Inclusion criteria were those for prescribing SLIT according to guidelines. Parents recorded in a diary card the side‐effects (eye symptoms, rhinitis/ear itching, asthma, oral itching/swelling, nausea, vomiting, abdominal pain, diarrhoea, urticaria, angioedema and anaphylaxis). The side‐effects were graded as mild, moderate and severe.Results:  Four hundred and thirty‐three children (285 male, age range 3–18 years) receiving SLIT were surveyed. Of them, 179 received a single extract, and 254 multiple allergens. The total number of doses given was 40 169 (17 143 with single allergen). Overall, 178 episodes were reported. Of them, 76 occurred with the single allergen (42.46% patients, 4.43/1000 doses) and 102 (40.3% patients, 4.42/1000 doses) with multiple allergens (P = NS). 165 episodes (92.5%) were mild and self‐resolving and were equally distributed in the two groups. In 13 cases, the events were judged of moderate severity and medical advice was required. Three patients discontinued SLIT, despite the local side‐effects being mild. No emergency treatment was required at all.Conclusion:  The use of multiple allergens for SLIT does not increase the rate of side‐effects in children.
Human anti‐pig cell‐mediated cytotoxicity in vitro involves non‐T as well as T cell components
Authors: Chan Derek V. , Auchincloss Hugh 
Published: November 2008

Abstract:Human anti‐pig cell‐mediated cytotoxicity was studied in vitro. Unprimed human peripheral blood lymphocytes (PBL) were able to lyse pig targets but not human targets when the assay was performed in human serum (HS). Much less, but still detectable, lysis was obtained using fetal calf serum (FCS). Human PBLs cultured for 6 days in FCS without stimulating cells showed substantial lysis of pig targets. This lysis was increased by the addition of human IL‐2. Unseparated human PBLs stimulated for 6 days with pig cells in serum‐free media lysed pig targets expressing the same or different SLA antigens as the stimulating cells. This lysis could not be significantly inhibited by anti‐CD3 or anti‐CD8 blocking antibodies during the effector phase of the assay. T cell‐enriched human PBLs treated with anti‐CD 16 and anti‐CD56 antibodies plus complement also lysed pig targets. These effector cells were significantly inhibited by anti‐CD3 and anti‐CD8 antibodies but not by anti‐CD4 antibodies. Furthermore, these primed T cell effectors could only lyse pig targets that shared the same MHC class I antigens as the sensitizing stimulators.These results suggest that human anti‐pig cell‐mediated cytotoxicity in vitro has at least three different components in bulk culture: 1) an ADCC component depending on natural antibodies from human serum, 2) an NK and/or a LAK cell component that is enriched by in vitro culture and interleukin‐2 (IL‐2), and (3) an allospecific T cell component, involving CD3+, CD8+, class I‐specific effector cells.
Effect of DSG on xenogeneic immune reactivity with special emphasis on human anti‐pig cellular reactions in vitro
Authors: Borg Anette Johansson , Kumagai‐Braesch Makiko , Möller Erna 
Published: November 2008

Abstract:The effect of the immunosuppressive drug 15‐deoxyspergualin (DSG) on xenogeneic human anti‐porcine cellular reactivity in vitro, including MLR induced proliferation, interleukin‐2 (II‐2) production, generation of cytotoxic cells, and the effect on antibody‐dependent cellular cytotoxicity (ADCC), were compared with the effects of cyclosporin A (CsA) and/or FK506. The cytotoxic response was evaluated for both direct and indirect pathways for antigen presentation. In addition, the effects of DSG and CsA on antibody production to pig peripheral blood lymphocytes (PBL) in mice was studied. The degree of immunosuppression of xenogeneic and allogeneic cellular responses was compared. CsA and FK506 effectively inhibited proliferation and II‐2 production induced by allogeneic human PBL or xenogeneic porcine PBL, whereas DSG did not have any effect on these responses. However, DSG suppressed both the allogeneic and xenogeneic in vitro induced cytotoxic responses, to the same level whether induced via the direct or indirect pathways of immune activation. In contrast, CsA inhibited cytotoxicity induced by xenogeneic cells via the direct but not via the indirect pathway. No effect of FK506 and DSG on ADCC was demonstrated.A 5‐day treatment with DSG or CsA of mice immunized with pig PBL partly suppressed antibody production. In DSG treated mice anti‐pig PBL antibodies were produced, but titers were lower than in nontreated or CsA treated mice. The results indicate that DSG may be more effective than CsA/FK506 in inhibiting cytotoxic responses and antibody production induced by xenogeneic pig cells. A possible explanation could be that cytotoxicity induced via the indirect activation pathway of xenoreactivity is mediated to a high degree by CD3‐CD16+(natural killer) NK‐like cells, and that stimulation of these cells may be more sensitive to DSG than to CsA/FK506.
Extracorporeal (“ex vivo”) connection of pig kidneys to humans. II. The anti‐pig antibody response
Authors: Rydberg Lennart , Björck Staffan , Hallberg Eva , Magnusson Stefan , Sumitran Suchitra , Samuelsson Bo E. , Strokan Valeri , Svalander Christian T. , Breimer Michael E. 
Published: November 2008

Abstract: Pig kidneys were extracorporeally “ex vivo” connected to the circulation of two volunteer male dialysis patients (Breimer et al., this issue). The patients were pretreated by daily plasmapheresis for 3 consecutive days, which reduced the anti‐pig lymphocytotoxic titer from 8 to 2 in the first patient and from 8 to 1 in the second patient. The anti‐pig hemagglutinating titers were reduced from 32 to 4 in the first patient and from 2 to 1 in the second patient. No drugs, except heparin, were given. The perfusion lasted for 65 min in patient 1 and the experiment was terminated due to increased vascular resistance in the pig kidney. Ultrastructural investigation showed a picture similar to a hyperacute vascular rejection. Immunohistochemical studies showed a weak staining of IgM antibodies, but no IgG in the small arteries and glomeruli.The pig kidney of patient 2 was perfused for 15 min and the experiment terminated due to serious side effects of the patient. Light and electron microscopical investigation showed virtually no structural changes of the kidney tissue and immunostaining for human antibodies was negative.In both patients, serum samples collected 2–5 weeks postperfusion showed a strong anti‐pig antibody titer rise (up to 512) which thereafter declined but stabilized on a higher level than before the experiment. The antibody response in the two patients was different. In patient 1, the major anti‐pig antibodies directed to carbohydrate antigens were of IgG (IgG1 and IgG2 subclasses) type, while the IgM response was less prominent and virtually no IgA antibodies were produced. Despite the short duration of the perfusion in patient 2, a humoral immune response was seen that was mainly confined to the IgA immunoglobulin class (IgA1 subclass). Blood group glycospingolipid fractions, prepared from the contralateral kidney of the donor pigs, were used for immunostaining with patient serum samples. In both patients, the antibodies produced after the perfusion, mainly recognized the Galα1–3Gal epitope both as part of the “linear B” pentasaccharide but also on more complex carbohydrate structures.Patient 1 was HLA‐immunized before the experiment due to a kidney allograft and had a panel reactivity of 85% before the perfusion. No change in the panel reactivity of HLA‐antibodies was found after the perfusion experiments. Patient 2 had no HLA antibodies before and remained negative after the perfusion.Patient serum samples collected before and after the perfusion were tested for reactivity against human endothelial cell lines. No antibodies were generated.
Characteristics of direct and indirect activation of human T cells against allogeneic and porcine xenogeneic cells/peptides
Authors: Kumagai‐Braesch Makiko , Borg Anetfe Johansson , Satake Masahiro , Möller Erna 
Published: November 2008

Abstract:The immunological consequences of direct versus indirect activation of T lymphocytes is of considerable interest both in allogeneic and in xenogeneic transplantation. In this paper, the activation of human T cells by allogeneic and xenogeneic porcine antigen‐presenting cells (APC) (direct activation), or by donor‐derived peptides presented on autologous APC (indirect activation) was studied in vitro. The direct activation of purified human T lymphocytes by allogeneic and xenogeneic porcine stimulator cells led to marked proliferative responses, IL‐2 and IFN‐γ production. The ratio of CD4/CD8 of responsive cells upon direct activation was the same for allogeneic and xenogeneic stimulation. Also, the CD25 expression on total and on CD8+ lymphoblasts was similar in allogeneic and xenogeneic responses. The frequency of alloreactive and xenoreactive CTLp following direct activation was 7.7 ± 1.4 / 104and 3.7 ± 1.3 / 104, respectively. Direct activation of proliferation and IL‐2 and IFN‐γ production in both experimental situations was completely blocked by Cyclosporin A (CsA). 15‐deoxyspergualin (DSG), which is thought to prevent antigen processing, had little effect. Thus, when it comes to direct activation of T lymphocytes xeno‐ and allospecific responses were qualitatively and quantitatively comparable.However, some differences between allogeneic and xenogeneic responses were observed when indirect activation was studied using stimulator cells from peripheral blood depleted of both adherent cells and of SLA class II positive cells or when human allogeneic or xenogeneic fibroblasts were used as stimulators. Indirect activation following recognition of alio‐ or xenogeneic peptides in a responder HLA‐restricted fashion resulted in proliferation, IL‐2 and IFN‐y production, albeit lower than in direct combinations. Indirect activation also induced a lower proportion of CD25+ lymphoblasts than direct activation. Furthermore, indirect xenoactivation resulted preferentially in proliferation and CD25 expression in the CD4+ cell population, and in contrast to direct activation, not only CsA but also DSG inhibited activation. Thus, our findings indicate that direct and indirect activation of human responder T cells stimulated by allogeneic and/or xenogeneic porcine cells/peptides results in immune responses with similar characteristics. Only the proliferation of CD8+ cells and their expression of CD25 and of functional IL‐2 receptors was weaker following xeno‐ than alloactivation, reasons for which are discussed. We conclude that indirect activation of T cell reactivity against xenogeneic peptides leads to an efficient immune response, likely to be of clinical importance for rejection of xenogeneic transplants devoid of professional antigen‐presenting cells.
Amplification of Bovine Viral Diarrhoea Virus Introduced into an In Vitro Embryo Production System Via Oocytes from Persistently Infected Cattle
Authors: Marley MSD , Givens MD , Galik PK , Riddell KP , Stringfellow DA 
Published: November 2008

ContentsThe purpose of this study was to determine whether or not embryos derived from in vitro fertilization of oocytes from persistently infected (PI) cattle would contain infectious virus. Three in vitro embryo production treatment groups were assessed: 1) oocytes and uterine tubal cells (UTC) free of bovine viral diarrhoea virus (BVDV) (negative control), 2) oocytes free of BVDV fertilized and cultured in media containing UTC obtained from PI heifers, and 3) oocytes from PI heifers fertilized and cultured in media containing UTC free of BVDV. The developmental media, UTC and embryos (individual or groups of five) were assayed for virus. Virus was not isolated from any samples in treatment group 1. As shown in previous studies, a proportion of embryo samples were positive for BVDV in treatment group 2. In treatment group 3, the virus associated with the oocytes contaminated the developmental media and infected susceptible co‐culture cells used during fertilization and culture. In addition, 65% (11/17) of the degenerated ova from treatment group 3 had infectious virus associated with them. While none of the ova developed into transferable embryos, the study did confirm that use of oocytes from PI cows could lead to amplification of BVDV and cross contamination during in vitro embryo production.