bluuebunny/crossref_metadata_2025_split huggingface dataset:
The experiences of loneliness, depression, and social support of Turkish patients with continuous ambulatory peritoneal dialysis and their caregivers
Authors: Asti Turkinaz , Kara Magfiret , Ipek Gulay , Erci Behice 
Published: March 2006

Aim.  The aim of the study was to examine the relationship between loneliness, depression and social support of Turkish patients with continuous ambulatory peritoneal dialysis and their caregivers.Background.  By altering the lifestyle of the patient and family or caregiver, chronic illness and continuous ambulatory peritoneal dialysis can create loneliness and depression. Perceived social support may facilitate coping with illness.Design.  Descriptive corelational design was used.Methods.  Data were collected by using the UCLA loneliness scale, the Beck's depression scale and the perceived social support from family and friends scales and demographic data form.Results.  A total of 130 subjects including 65 patients with continuous ambulatory peritoneal dialysis and 65 caregivers took part in this study. The mean ages of the patients and caregivers were similar (44·69 ± 17·22 and 43·90 ± 8·52 years respectively). Scores of loneliness and depression were below cut‐off scores in both groups. However, scores of the loneliness of patients were higher than that of the caregivers. Perceived social support from family and friend were above cut‐off scores in both groups and it was different for patients and caregivers.Conclusion.  The results of this study indicate that Turkish patients with continuous ambulatory peritoneal dialysis and their caregivers did not experience loneliness and depression.Relevance to clinical practice.  Results of the study suggest that the nurses need to be aware of patients’ and caregivers’ psychological reactions to continuous ambulatory peritoneal dialysis, which may be expressed in feelings of loneliness and depression, and employ social support resources for patients with peritoneal dialysis and caregivers to cope with their illness and to adapt lifestyle changes.
A study of nurses’ inferences of patients’ physical pain
Authors: Wilson Benita , McSherry Wilfred 
Published: March 2006

Aim.  The aim of this study was to establish if postregistration education and clinical experience influence nurses’ inferences of patients’ physical pain.Background.  Pain is a complex, subjective phenomenon making it an experience that is elusive and difficult to define. Evaluation of an individual's pain is the product of a dynamic, interactive process that frequently results in ineffective pain management. Educating nurses should address the deficit, however the clinical environment is thought to be most influential in the acquisition of knowledge.Design.  A series of vignettes was used to consider nurses’ inferences of physical pain for six hypothetical patients; these were employed within a self‐administered questionnaire that also addressed lifestyle factors of patients in pain, general attitudes and beliefs about pain management and general knowledge of pain control.Method.  One hundred questionnaires were distributed; 86 nurses returned the questionnaire giving a response rate of 86%. Following selection of the sample 72 nurses participated in the study: 35 hospice/oncology nurses (specialist) and 37 district nurses (general). Data analysis was carried out using SPSS and qualitative analysis of the written responses.Results.  The specialist nurses tended to infer lower levels of physical pain than the general nurses when considering the patients in the vignettes.Conclusion.  Education and clinical experience influence nurses’ knowledge, attitudes and beliefs about pain. However, it would appear that the specialist nurses’ working environment and knowledge base engenders a practice theory divide, resulting in desensitization to patients’ physical pain.Relevance to clinical practice.  It is suggested that the specialist nurses use defence mechanisms to protect them from the conflict that arises from working within the clinical environment. These cognitive strategies have the potential to ease cognitive dissonance for the nurse, but may increase patient suffering.
The acquisition and exercise of nephrology nursing expertise: a grounded theory study
Authors: Bonner Ann , Greenwood Jennifer 
Published: March 2006

Aims and objectives.  This purpose of this study was to describe the process of expertise acquisition in nephrology nursing practice.Background.  It has been recognized for a number of decades that experts, compared with other practitioners in a number of professions and occupations, are the most knowledgeable and effective, in terms of both the quantity and quality of output. Studies relating to expertise have been undertaken in a range of nursing contexts and specialties; to date, however, none have been undertaken which focus on nephrology nursing.Design.  This study, using grounded theory methodology, took place in one renal unit in New South Wales, Australia and involved six non‐expert and 11 expert nurses.Methods.  Simultaneous data collection and analysis took place using participant observation, semi‐structured interviews and review of nursing documentation.Findings.  The study revealed a three‐stage skills‐acquisitive process that was identified as non‐expert, experienced non‐expert and expert stages. Each stage was typified by four characteristics, which altered during the acquisitive process; these were knowledge, experience, skill and focus.Conclusion.  This was the first study to explore nephrology nursing expertise and uncovered new aspects of expertise not documented in the literature and it also made explicit other areas, which had only been previously implied.Relevance to clinical practice.  Of significance to nursing, the exercise of expertise is a function of the recognition of expertise by others and it includes the blurring of the normal boundaries of professional practice.
The incidence of pressure ulcers in surgical patients: a sample hospital in Turkey
Authors: Karadag Mevlüde , Gümüskaya Necla 
Published: March 2006

Aim.  This research was conducted for the purpose of determining the incidence of surgery‐related pressure ulcer formation.Background.  Patients undergoing surgery are prone to develop pressure ulcers during surgery. Pressure ulcer incidence in surgery population is reported between 3·5% and 29·5%. Some of these factors that occur during surgery are being under pressure for a long time, remaining wet, and metabolic and circulatory changes related to the surgery and anaesthesia.Design.  The research was conducted as a prospective‐analytic‐descriptive study with 84 patients who agreed to participate in the study and who were 20 years old or older, having elective surgery, having a surgical procedure lasting two or more hours under general anaesthesia, and who had no risk for pressure ulcer development before surgery according to the Braden Pressure Ulcer Risk Assessment Scale. Research data were obtained using a Data Collection Form that has places for pre‐, intra‐ and postoperative factors that may be related to surgery‐related pressure ulcer development; a Body Mass Index Data Form and the Braden Pressure Ulcer Risk Assessment Scale. The Braden Pressure Ulcer Risk Assessment Scale was used to determine that patients had no risk for pressure ulcer development pre‐ and postoperatively and it was used for the purpose of establishing the patients risk status and areas at risk. Patients were monitored for pressure ulcers until the sixth postoperative day and risk status and areas at risk were determined. Data obtained in the research were analysed using percentage, chi‐squared, McNemar and Cohen's Kappa tests for reliability between dependent groups.Results.  At the conclusion of the research, the findings obtained showed that 54·8% of the patients (n = 46) were observed to have Stage 1 pressure ulcers. A total of 41·3% of the patients had pressure ulcers in more than one region and 56·5% of these were of the erythema type. During the six‐day postoperative monitoring, 97·9% of the pressure ulcers were observed in the first three days.Conclusion.  The study made clear that surgery‐related pressure ulcers are an important problem.Relevance to clinical practice.  (i) Determining the incidence of pressure ulcers during surgery in Turkey; (ii) For nurses to be able to prevent surgery‐related pressure ulcers, it is necessary for them to direct their care by knowing factors that have a role in the development of pressure ulcers during surgery therefore this study will be to call Turkish nurse's attention to pressure ulcers during surgery.
Diffusion‐weighted magnetic resonance imaging of white matter in bipolar disorder: a pilot study
Authors: Regenold William T , D'Agostino Christopher A , Ramesh Narayanan , Hasnain Mehrul , Roys Steven , Gullapalli Rao P 
Published: March 2006

Objective:  Diffusion‐weighted magnetic resonance imaging (MRI) has shown increased sensitivity in detecting brain white matter disease compared to traditional T2‐weighted MRI. Diffusion‐weighted imaging (DWI) can quantitatively assess the microstructural integrity of white matter using the average apparent diffusion coefficient (ADCav), a measure of the extent to which water molecules move freely within tissue. On the basis of numerous studies suggesting white matter disease in bipolar patients, particularly patients with more severe illness, this study aimed to test the utility of DWI in assessing the white matter integrity of bipolar patients with severe illness.Methods:  The existing MRI scans of eight bipolar patients and eight age‐matched controls with neurological illness were examined retrospectively. ADCav values for pixels within white matter regions of interest (ROIs) were calculated and used to plot ADCav frequency histograms for each ROI. Mean ADCav values for the two groups were then compared by ANCOVA.Results:  The bipolar mean ADCav (0.855 ± 0.051 × 10−3 mm2/s) for combined white matter ROIs significantly exceeded that of controls (0.799 ± 0.046 × 10−3 mm2/s), while covarying for age (F = 4.47, df = 3, p = 0.025).Conclusions:  This is the first report of an elevated ADCav in the white matter of a group of patients with bipolar disorder. In this group of patients with severe illness, increased white matter ADCav suggests microstructural changes consistent with decreased white matter integrity. DWI may be an additional, useful tool to assess white matter abnormalities in bipolar disorder.
Early onset bipolar disorder: possible linkage to chromosome 9q34
Authors: Faraone Stephen V , Lasky‐Su Jessica , Glatt Stephen J , Eerdewegh Paul Van , Tsuang Ming T 
Published: March 2006

Objectives: Bipolar disorder (BD) is characterized by manic and depressive states that onset at various times in life. Research shows that early onset forms of BD are associated with a stronger genetic loading for the illness. We hypothesized that using age at onset to look at subsets of BD families in a genetic linkage analysis would prove useful in separating etiologically homogeneous BD sub‐groups and subsequently identifying genetic susceptibility regions.Methods: We used the wave‐I National Institute of Mental Health (NIMH) Genetics Initiative BD sample, which includes 540 individuals from 97 families with BD, in an ordered‐subsets linkage analysis with age at onset of mania as the subset‐identifying covariate. This analysis was performed using GENEHUNTER‐PLUS followed by the ordered‐subsets analysis program. This program generates empirical p‐values for the subset with the largest LOD score to determine whether this value was significantly higher than the baseline LOD score using all families.Results: Three chromosomal regions resulted in LOD scores above 2.0: 2.21 (6q25), 3.21 (9q34), and 2.16 (20q11). The largest increase in LOD score was observed on chromosome 9q34 between markers D9S290 and D9S915 in the subset of 58 families that had mania onset before age 20. Families with a minimal mania onset less than 20 years had a significantly greater number of psychiatric comorbidities (p = 0.02) and a marginal increase in depressive symptoms (p = 0.10).Conclusions: Further investigation into chromosomal region 9q34 is necessary to determine whether this region may harbor a gene specific to families with a minimal age at onset of less than 20.
Inositol deficiency diet and lithium effects
Authors: Shaldubina Alona , Stahl Ziva , Furszpan Mariala , Regenold William T , Shapiro Joseph , Belmaker Robert H , Bersudsky Yuly 
Published: March 2006

Objectives:  A major hypothesis explaining the therapeutic effect of lithium (Li) in mania is depletion of inositol via inhibition of inositol monophosphatase. However, inositol is also present in the diet. Restriction of dietary inositol could theoretically enhance the effects of Li.Methods:  We used dietary inositol restriction in animal studies and also devised a palatable diet for humans that is 90% free of inositol.Results:  Dietary inositol restriction significantly augmented the inositol‐reducing effect of Li in rat frontal cortex. Li reduced inositol levels by 4.7%, inositol‐deficient diet by 5.1%, and Li plus inositol‐deficient diet by 10.8%. However, feeding with the inositol‐deficient diet did not enhance the behavioral effect of Li in the Li‐pilocarpine seizure model. Fifteen patients participated in an open clinical study of the inositol‐deficient diet: six rapid cycling bipolar patients responding inadequately to Li or valproate in different phases of illness; two Li‐treated bipolar outpatients with residual symptomatology, and seven inpatient Li‐treated bipolar patients in non‐responding acute mania. The diet had a major effect in reducing the severity of affective disorder in 10 of the patients within the first 7–14 days of treatment.Conclusion:  These results suggest that dietary inositol restriction may be useful in some bipolar patients, but controlled replication is necessary.
Comorbidity of attention deficit hyperactivity disorder in juvenile bipolar disorder
Authors: Jaideep T , Janardhan Reddy YC , Srinath S 
Published: March 2006

Objective:  There is some evidence to suggest that attention deficit hyperactivity disorder (ADHD) and juvenile bipolar disorder could be related. This is based on studies of comorbidity and some preliminary family study data. However, doubts continue to be raised about the relationship between the two disorders. This study examined the comorbidity of disruptive behavior disorders (DBD) that include ADHD, oppositional defiant disorder (ODD) and conduct disorder (CD) in juvenile bipolar disorder.Method:  Seventy‐three subjects with onset of bipolar disorder at age 18 years or younger were evaluated using structured interviews (Missouri Assessment of Genetics Interview for Children, Structured Clinical Interview for DSM‐IV Axis I disorders – Clinician Version, and Operational Criteria Checklist for Psychotic Disorders version 3.4). Information was collected from subjects as well as from their parents. Patients with comorbid DBD were compared with patients without DBD.Results:  Ten subjects (14%) had one or more comorbid DBD. ADHD, CD, and ODD were present in three (4%), two (3%), and eight (11%) subjects, respectively. Those with DBD had earlier onset of bipolar disorder and spent more time ill compared to those without DBD.Conclusions:  The rates of comorbid DBD in juvenile bipolar disorder are low. The study does not support a definite relationship between ADHD and juvenile bipolar disorder. Higher rates reported previously may be due to differing methods of subject ascertainment. Samples recruited from community and general psychiatric settings may help to clarify the relationship between bipolar disorder and ADHD.
Inositol augmentation of lithium or valproate for bipolar depression
Authors: Eden Evins A , Demopulos Christina , Yovel Iftah , Culhane Melissa , Ogutha Jacqueline , Grandin Louisa D , Nierenberg Andrew A , Sachs Gary S 
Published: March 2006

Objective:  Despite promising new therapies, bipolar depression remains difficult to treat. Up to half of patients do not respond adequately to currently approved treatments. This study evaluated the efficacy of adjunctive inositol for bipolar depression.Methods:  Seventeen participants with DSM‐IV criteria for bipolar depression and a 17‐item Hamilton Rating Scale for Depression (HRSD) ≥15 on proven therapeutic levels of lithium or valproate for >2 weeks were randomized to receive double‐blind inositol or placebo for 6 weeks. At the end of double‐blind treatment, subjects were eligible for an 8‐week open‐label trial of inositol.Results:  Response was defined a priori as >50% reduction in the HRSD and a Clinical Global Impression of 1–2. Four of nine subjects (44%) on inositol and zero of eight subjects on placebo met response criteria (p = 0.053). There was no difference between groups in the average change score for the HRSD or Young Mania Rating Scale (YMRS). Response to inositol was highly variable. Of nine subjects randomized to inositol, two had >50% worsening in HRSD scores at the end of treatment, three had no change and four had >50% improvement. Those who had worsening in depressive symptoms on inositol had significantly higher scores at baseline on the YMRS total score and irritability, disruptive/aggressive behavior and unkempt appearance items.Conclusions:  There was a trend for more subjects on inositol to show improvement in bipolar depression symptoms, but, on average, inositol was not more effective than placebo as an adjunct for bipolar depression. Baseline levels of anger or hostility may be predictive of clinical response to inositol.
Unique donor‐suitability issues
Authors: Reik R. A. , Burch J. W. , Vassallo R. R. , Trainor L. 
Published: March 2006

On occasion, there arise questions or situations involving blood‐donor eligibility determination, which are not adequately addressed by the existing regulations and standards. In such instances, even the most experienced blood collector may be uncertain regarding the best course of action and unable to find adequate guidance in the standard blood banking references, regulations and literature. In order to examine this area in greater depth, the American Association of Blood Banks (AABB) sponsored a short topic session on ‘Unique Donor Suitability Issues’ at their 2004 annual meeting. The invited speakers were four seasoned physician medical directors, with a combined experience of over 40 years in blood collection at both regional and national levels. They were tasked with identifying and researching problematic areas in donor‐suitability determination, and suggesting an overall approach to dealing with such issues. They determined that three of the most problematic areas of eligibility evaluation included donors with: (1) disabilities, (2) disorders of haemostasis, and (3) trans‐sexual, homosexual and other unusual gender‐related issues. Each of these topics was presented in a 10‐min lecture, followed by an open format consisting of audience participation and panel discussion by the speakers. The session was additionally enhanced by a representative of the United States Food and Drug Administration (FDA) who participated as a member of the audience. This review presents the contents of the short topic session in an expanded form.
Fluorescence quencher improves scansystem™ for rapid bacterial detection
Authors: Schmidt M. , Hourfar M. K. , Wahl A. , Nicol S.‐B. , Montag T. , Roth W. K. , Seifried E. 
Published: March 2006

Background and Objectives  The optimized scansystem™ could detect contaminated platelet products within 24 h. However, the system's sensitivity was reduced by a high fluorescence background even in sterile samples, which led to the necessity of a well‐trained staff for confirmation of microscope results.Materials and Methods  A new protocol of the optimized scansystem™ with the addition of a fluorescence quencher was evaluated. Pool platelet concentrates contaminated with five transfusion‐relevant bacterial strains were tested in a blind study.Results  In conjunction with new analysis software, the new quenching dye was able to reduce significantly unspecific background fluorescence. Sensitivity was best for Bacillus cereus and Escherichia coli (3 CFU/ml).Discussion  The application of a fluorescence quencher enables automated discrimination of positive and negative test results in 60% of all analysed samples.
Expression of Cyclooxygenase‐1 and ‐2 in the Porcine Endometrium during the Oestrous Cycle and Early Pregnancy
Authors: Blitek A , Waclawik A , Kaczmarek MM , Stadejek T , Pejsak Z , Ziecik AJ 
Published: March 2006

ContentsCyclooxygenase (COX) is the rate‐limiting enzyme that catalyses the initial step in prostaglandins (PGs) production. In the present studies, endometrial COX‐1 and COX‐2 expression throughout the oestrous cycle and early pregnancy was analysed in pigs using real‐time reverse transcriptase‐polymerase chain reaction (RT‐PCR), Western blot and immunohistochemistry. There were no changes in messenger RNA (mRNA) and protein expression for COX‐1 in cyclic pigs. In pregnant animals, mRNA levels of this enzyme increased on days 22–25 (p < 0.001). However, no upregulation of COX‐1 protein was detected. Quantification of COX‐2 mRNA expression during the oestrous cycle revealed significant increases on days 10–12 and 14 (p < 0.001 and p < 0.01 vs days 2–4, respectively). Protein levels were also increased on day 14 when compared with days 2–12 and 18–20 after oestrus. In pregnant animals, the patterns of both COX‐2 mRNA and protein expression were similar. Messenger RNA levels were higher on days 16 and 22–25 (p < 0.01 vs day 10). Moreover, the protein content tended to increase on days 16 and 22–25. COX‐1 and COX‐2 were localized in the luminal and glandular epithelium as well as in the uterine stroma. In contrast to COX‐1, a positive immunostaining reaction for COX‐2 was detected only on days 12–16 after ovulation and on days 14–16 of pregnancy. In conclusion, these results indicate specific patterns of COX‐1 and COX‐2 expression in the porcine endometrium throughout the oestrous cycle and early pregnancy. COX‐2 rather than COX‐1 seems to be the primary enzyme responsible for modulated PGs production at the time of luteolysis in cyclic and during implantation in pregnant animals.
A Urethrorectal Fistula due to Prostatic Abscess Associated with Urolithiasis in a Dog
Authors: Agut A , Lucas X , Castro A , De Membiela F , Soler M , Belda E 
Published: March 2006

ContentsAn 8‐year‐old, entire male crossbreed dog had a 2‐day history of abdominal pain and straining to urinate and defecate. A diagnosis of urolithiasis with urinary retention, and probable prostatitis was made. The dog was treated with fluids and enrofloxacin. Five days later, ultrasonography of the prostate showed two hypoechoic areas compatible with abscesses. Twelve hours later, the patient started to urinate from the rectum during micturition and urethrorectal fistula was diagnosed. The omentalization of the prostatic abscesses and castration were performed and calculi were removed. The urethrorectal fistula was treated conservatively with an indwelling urinary catheter, a low residue diet and antibiotics. The dog recovered uneventfully without recurrence of the fistula.