bluuebunny/crossref_metadata_2025_split huggingface dataset:
Personal understandings of illness among people with type 2 diabetes
Authors: Hörnsten Åsa , Sandström H. , Lundman B. 
Published: June 2004

Background.  Professionals and patients understand the experience of illness from different worlds. Professionals’ explanatory models focus on aetiology, diagnosis, pathophysiology and treatment, while patients’ explanatory models are more focused on consequences and influences on daily life. The differences between patients and professionals in their understanding often result in conflicting expectations about treatment, priorities and outcomes of care.Aim.  The aim of this study was to describe personal understandings of illness among people with type 2 diabetes in Sweden.Method.  A sample of 44 patients, 47–80 years, diagnosed with type 2 diabetes within the last 2 years, was recruited from four health care centres. Narrative thematic interviews were used covering the areas of developing, coping with and living with diabetes. Qualitative content analysis was performed.Findings.  The findings were formulated into six categories: image of the disease, meaning of the diagnosis, integration of the illness, space for the illness, responsibility for care and future prospects.Conclusions.  The findings demonstrate that patients’ personal understanding of illness is an important complement to the traditional professional view of diabetes. They could serve as a foundation for development of health history interviewing, as well as development of systems of documentation. Patients’ personal understandings of diabetes in their daily lives are considered to be an important shared source of information for planning meaningful care.
Utilization of research findings by graduate nurses and midwives
Authors: Veeramah V. 
Published: June 2004

Background.  There is mounting pressure on nurses and midwives in the United Kingdom to use research findings to inform their practice. However, many still find research difficult to understand and are poorly prepared by education to make use of it. Hence, there is a pressing need to evaluate the research education included in nursing and midwifery curricula.Aim.  This paper reports a study assessing the impact of research education on the attitudes towards research and use of research findings in practice by graduate nurses and midwives.Method.  A cross‐sectional survey using a self‐completed postal questionnaire was conducted with a sample of 340 nurse and midwife graduates in the South East of England.Findings.  A response rate of 51% was obtained. A large number of respondents stated that their critical appraisal (96%) and search skills (87%) had improved following graduation and they reported using research findings in practice (16·8% all the time, 50·5% frequently and 32·6% sometimes). Furthermore, the majority expressed positive attitudes towards research and these were related to the research education received. However, a significant number reported finding statistics difficult to understand, lack of time to read research and limited access to research findings at their place of work. Also, a number of respondents would still like more help with searching the literature, implementing research findings in practice and developing their critical appraisal skills further.Conclusion.  It is crucial that some of the major barriers to research utilization are addressed at both individual and organizational levels if evidence‐based care is to become a reality. Also, health service managers should consider a number of strategies suggested by respondents to increase the use of research findings in clinical settings.
Postdischarge nursing interventions for stroke survivors and their families
Authors: McBride Kelly L. , White Carole L. , Sourial Rosa , Mayo Nancy 
Published: June 2004

Background.The physical, cognitive, and emotional sequelae of stroke underscore the need for nursing interventions across the continuum of care. Although there are several published studies evaluating community interventions for stroke survivors, the nursing role has not been clearly articulated.Aim.The aim of this paper is to report a study to describe, using a standardized classification system, the nursing interventions used with stroke survivors during the initial 6 weeks following discharge home.Methods.In the context of a randomized controlled trial, two nurse case managers provided care to 90 community‐dwelling stroke survivors who were assigned to the intervention arm of the trial. The nursing documentation was analysed, using the Nursing Intervention Classification (NIC) system, to identify and quantify the interventions that were provided.Findings.Stroke survivors received, on average, six different interventions. There was a trend for those who were older, more impaired, and who lived alone to receive more interventions. The most commonly reported interventions included those directed towards ensuring continuity of care between acute and community care, family care, and modifying stroke risk factors. The study was limited to the nursing documentation, which may represent an underestimation of the care delivered.Conclusions.The NIC system was useful in capturing the interventions delivered by the nurse case managers. Nursing interventions are often not clearly articulated and less often use standardized terminology. Describing nursing activities in a standard manner will contribute to an increase in nursing knowledge and to evidence‐based practice.
Nurses’ use of online clinical evidence
Authors: Gosling A. Sophie , Westbrook Johanna I. , Spencer Rosemary 
Published: June 2004

Background.  The ‘information explosion’ presents a significant challenge to the nursing profession. One way to assist access to information is to provide electronic information resources at the point of care. A large‐scale survey of nurses working in the public health system in New South Wales, Australia, was undertaken as part of a 2‐year evaluation of the Clinical Information Access Program (CIAP). This is a website which provides 24 hour, online access to a range of evidence sources at the point of care.Aim.  This paper reports a study to investigate factors influencing nurses’ use of online evidence available at the point of care and to examine differences between nurses in different roles.Method.  Nurses from 65 randomly selected hospitals were surveyed. A convenience sample representing 25% of nursing staff at these hospitals was sought. Eighty‐four per cent of the survey quota was met and 3128 questionnaires were completed and returned.Results.  The results showed that 58% of nurses had heard of the CIAP and, of those, 70% had used the website's resources. Senior nurses had greater awareness and use than others. The most frequent reasons for use were to fill a knowledge gap and for personal education. Lack of training was the most frequently cited reason for not using the website. Use of online evidence, particularly amongst senior staff, was higher than reported in previous studies.Conclusion.  Use of online evidence was associated with nursing role, and with managerial and organizational support. Diffusion of innovation theory can help to explain some of the patterns observed. The use and impact of online evidence should be interpreted in the context of nursing practice and culture.
Characteristics of falls in hospitalized patients
Authors: Kerzman Hana , Chetrit Angela , Brin Luna , Toren Orly 
Published: June 2004

Background.  The high incidence of patient falls in a hospital setting is a major concern in any health system. Research findings have reported the risk factors for these falls as age, gender, certain medications, mental status, chronic diseases and environmental factors. Falls may lead to fear, pain, slight or severe injuries, increase the duration of hospital stay, cause patient discomfort and affect quality of life.Aim.  The aim of this paper is to report a study of the characteristics of patient falls during hospitalization in 1998 and compare them with those in the period 1978–1981.Methods.  A retrospective study was performed in a large, 2000‐bed medical center in Israel. Reports of 711 fall incidents in 1998 were compared with 328 reports in 1978–1981. Information gathered included age, gender, department, shift, reasons, severity of injury, tests and treatment after injury.Results.  The rates of falls per 1000 admissions in psychiatric, elder care and rehabilitation departments in 1998 were statistically significantly higher than in the earlier period. Rates of 115, 91, 85, respectively, per 1000 admissions were reported in 1998 compared with 34, 9, 19, respectively, in the period 1978–1981. The percentage of reported falls in the younger age group (under 50) was higher in the later survey (1998), and a higher proportion occurred outside the patient's room. Most of the reported falls in 1998 occurred during the morning shift (P < 0·001).Conclusions.  The increased number of falls could be an outcome of increased awareness. Nevertheless, the causes and place of falls differ for the two periods. Some of the reasons may be related to an intervention programme carried out after the first survey. The latest survey results will serve as an important basis for a further intervention programme in specific departments to ensure patient safety.
Interdisciplinary preoperative patient education in cardiac surgery
Authors: Tromp Fred , van Dulmen Sandra , van Weert Julia 
Published: June 2004

Background.  In 1998, we carried out a study of interdisciplinary preoperative education in cardiac surgery given by nurses, physicians and health educators. Overlaps were found in gathering and providing information by physicians, nurses and health educators, and gaps were found in providing psychosocial information and emotional support. Based on these findings, an information protocol was developed.Aim.  This paper reports a study examining the effects of the implementation of the information protocol on the content and process of preoperative education.Methods.  Dialogues between health educators and patients were videotaped at the preoperative clinic (n = 54) and on the day of admission (n = 53), and analysed using a checklist of 123 specific topics.Results.  The information given by health educators at the outpatient clinic and on the day of admission accorded with the information protocol to a large extent. There was also an increase in the number of psychosocial issues raised. Nurses raised significantly more psychosocial issues in comparison with before implementation of the protocol. After implementation, patients spent approximately 3 minutes less talking with the health educator and about 7 minutes less talking with a nurse. This suggests that on the day of admission a more time‐efficient co‐ordination in patient education was achieved.Conclusions.  Implementation of the information protocol led to a better interdisciplinary division of labour. The education is tailored more to the needs of the patient, and psychosocial items are mentioned more frequently. This straightforward intervention gave very positive results. Inconsistencies, gaps and overlaps in information provision can be avoided by the unambiguous delineation of responsibilities and tasks in information provision by different health care providers.
The expression patterns of arabinogalactan‐protein AtAGP30 and GLABRA2 reveal a role for abscisic acid in the early stages of root epidermal patterning
Authors: Van Hengel Arjon J. , Barber Chris , Roberts Keith 
Published: June 2004

SummaryIn the Arabidopsis root, patterning of the epidermal cell types is position‐dependent. The epidermal cell pattern arises early during root development, and can be visualized using reporter genes driven by the GLABRA (GL)2 promoter as markers. The GL2 gene is preferentially expressed in the differentiating hairless cells (atrichoblasts) during a period in which epidermal cell identity is believed to be established. We show that AtAGP30 is also expressed in atrichoblasts. This gene encodes an arabinogalactan‐protein (AGP) that is known to play a role in root regeneration and increases abscisic acid (ABA)‐response rates. Although the expression level of this gene is regulated by the plant growth factors ABA and ethylene, only ABA was found to affect the tissue‐specific pattern of expression. ABA also disrupts the expression pattern of the GL2::GUS (β‐glucuronidase) reporter gene. Our results indicate that ABA regulates epidermal cell‐type‐specific gene expression in the meristematic zone of the Arabidopsis root, while ethylene is known to act at later stages of epidermal differentiation. Despite its effects on the early stages of root epidermal patterning, ABA does not affect root hair formation on mature wild‐type epidermal cells, suggesting that other developmental cues, like positional information, can progressively over‐ride the ABA‐mediated disruption of early epidermal patterning.
Catalase deficiency drastically affects gene expression induced by high light in Arabidopsis thaliana
Authors: Vandenabeele Steven , Vanderauwera Sandy , Vuylsteke Marnik , Rombauts Stephane , Langebartels Christian , Seidlitz Harald K. , Zabeau Marc , Van Montagu Marc , Inzé Dirk , Van Breusegem Frank 
Published: June 2004

SummaryIn plants, hydrogen peroxide (H2O2) plays a major signaling role in triggering both a defense response and cell death. Increased cellular H2O2 levels and subsequent redox imbalances are managed at the production and scavenging levels. Because catalases are the major H2O2 scavengers that remove the bulk of cellular H2O2, altering their levels allows in planta modulation of H2O2 concentrations. Reduced peroxisomal catalase activity increased sensitivity toward both ozone and photorespiratory H2O2‐induced cell death in transgenic catalase‐deficient Arabidopsis thaliana. These plants were used as a model system to build a comprehensive inventory of transcriptomic variations, which were triggered by photorespiratory H2O2 induced by high‐light (HL) irradiance. In addition to an H2O2‐dependent and ‐independent type of transcriptional response during light stress, microarray analysis on both control and transgenic catalase‐deficient plants, exposed to 0, 3, 8, and 23 h of HL, revealed several specific regulatory patterns of gene expression. Thus, photorespiratory H2O2 has a direct impact on transcriptional programs in plants.
Expression analysis suggests novel roles for the plastidic phosphate transporter Pht2;1 in auto‐ and heterotrophic tissues in potato and Arabidopsis
Authors: Rausch Christine , Zimmermann Philip , Amrhein Nikolaus , Bucher Marcel 
Published: June 2004

SummaryA cDNA encoding Pht2;1 from potato, a new member of the plant Pht2 gene family of low‐affinity orthophosphate (Pi) transporters, was isolated. The expression pattern of the corresponding gene as well as its ortholog from Arabidopsis was analyzed and the encoded proteins were localized in the two plants. Pht2;1 expression is strongly upregulated by light in potato and Arabidopsis leaf tissue. RNA gel blot analysis, reverse transcription‐polymerase chain reaction (RT‐PCR), promoter/GUS, and protein/green fluorescent protein (GFP) fusion studies, respectively, indicate that the gene is expressed in both auto‐ and heterotrophic tissues and its encoded protein is localized to the plastids. The similar patterns of Pht2;1 gene regulation in potato and Arabidopsis prompted us to screen publicly available gene expression data from 228 Arabidopsis oligonucleotide microarrays covering 83 different experimental conditions. Modulation of Pht2;1 transcript levels was overall moderate, except for a limited number of experimental conditions where Pht2;1 mRNA concentrations varied between 2‐ and 3.7‐fold. Overall, these analyses suggest involvement of the Pht2;1 protein in cell wall metabolism in young, rapidly growing tissues, independent of other Pi transporters such as the high‐affinity Solanum tuberosum Pi transporter 1 (StPT1). Cluster analysis allowed identification of colinear or antiparallel expression profiles of a small set of genes involved in post‐translational regulation, and photosynthetic carbon metabolism. These data give clues about the possible biological function of Pht2;1 and shed light on the complex web of interactions in which Pht2;1 could play a role.
Mutual antagonism of ethylene and jasmonic acid regulates ozone‐induced spreading cell death in Arabidopsis
Authors: Tuominen Hannele , Overmyer Kirk , Keinänen Markku , Kollist Hannes , Kangasjärvi Jaakko 
Published: June 2004

SummaryEthylene (ET) and jasmonic acid (JA) have opposite effects on ozone (O3)‐induced spreading cell death; ET stimulates, and is required for the spreading cell death, whereas JA protects tissues. We studied the underlying molecular mechanisms with the O3‐sensitive, JA‐insensitive jasmonate resistant 1 (jar1), and the O3‐tolerant, ET‐insensitive ethylene insensitive 2 (ein2) mutants. Blocking ET perception pharmacologically with norbornadiene (NBD) in jar1, or ET signaling genetically in the jar1 ein2 double mutant prevented the spread of cell death. This suggests that EIN2 function is epistatic to JAR1, and that the JAR1‐dependent JA pathway halts oxidative cell death by directly inhibiting ET signaling. JAR1‐dependent suppression of the ET pathway was apparent also as increased EIN2‐dependent gene expression and ET hypersensitivity of jar1. Physiological experiments suggested that the target of JA is upstream of Constitutive Triple Response 1 (CTR1), but downstream of ET biosynthesis. Gene expression analysis of 1‐aminocyclopropane‐1‐carboxylic acid (ACC)‐treated and O3‐exposed ein2 and jar1 revealed reciprocal antagonism: the EIN2‐mediated suppression of the JA pathway. The results imply that the O3‐induced spreading cell death is stimulated by early, rapid accumulation of ET, which can suppress the protecting function of JA thereby allowing cell death to proceed. Extended spreading cell death induces late accumulation of JA, which inhibits the propagation of cell death through inhibition of the ET pathway.
Metabolic engineering of monoterpene biosynthesis: two‐step production of (+)‐trans‐isopiperitenol by tobacco
Authors: Lücker Joost , Schwab Wilfried , Franssen Maurice C. R. , Van Der Plas Linus H. W. , Bouwmeester Harro J. , Verhoeven Harrie A. 
Published: June 2004

SummaryMonoterpenoid biosynthesis in tobacco was modified by introducing two subsequent enzymatic activities targeted to different cell compartments. A limonene‐3‐hydroxylase (lim3h) cDNA was isolated from Mentha spicata L. ‘Crispa’. This cDNA was used to re‐transform a transgenic Nicotiana tabacum‘Petit Havana’ SR1 (tobacco) line expressing three Citrus limon L. Burm. f. (lemon) monoterpene synthases producing (+)‐limonene, γ‐terpinene and (−)‐β‐pinene as their main products. The targeting sequences of these synthases indicate that they are probably localized in the plastids, whereas the sequence information of the P450 hydroxylase indicates targeting to the endoplasmatic reticulum. Despite the different location of the enzymes, the introduced P450 hydroxylase proved to be functional in the transgenic plants as it hydroxylated (+)‐limonene, resulting in the emission of (+)‐trans‐isopiperitenol. Some further modifications of the (+)‐trans‐isopiperitenol were also detected, resulting in the additional emission of 1,3,8‐p‐menthatriene, 1,5,8‐p‐menthatriene, p‐cymene and isopiperitenone.
Delaying evolution of insect resistance to transgenic crops by decreasing dominance and heritability
Authors: Tabashnik B. E. , Gould F. , Carrière Y. 
Published: June 2004

Abstract
The refuge strategy is used widely for delaying evolution of insect resistance to transgenic crops that produce Bacillus thuringiensis (Bt) toxins. Farmers grow refuges of host plants that do not produce Bt toxins to promote survival of susceptible pests. Many modelling studies predict that refuges will delay resistance longest if alleles conferring resistance are rare, most resistant adults mate with susceptible adults, and Bt plants have sufficiently high toxin concentration to kill heterozygous progeny from such matings. In contrast, based on their model of the cotton pest Heliothis virescens, Vacher et al. (Journal of Evolutionary Biology, 16, 2003, 378) concluded that low rather than high toxin doses would delay resistance most effectively. We demonstrate here that their conclusion arises from invalid assumptions about larval concentration-mortality responses and dominance of resistance. Incorporation of bioassay data from H. virescens and another key cotton pest (Pectinophora gossypiella) into a population genetic model shows that toxin concentrations high enough to kill all or nearly all heterozygotes should delay resistance longer than lower concentrations.
Fine-scale genetic structure and gene dispersal in Centaurea corymbosa (Asteraceae) I. Pattern of pollen dispersal
Authors: Hardy O. J. , González-Martínez S. C. , Fréville H. , Boquien G. , Mignot A. , Colas B. , Olivieri I. 
Published: June 2004

Abstract
Pollen dispersal was characterized within a population of the narrowly endemic perennial herb, Centaurea corymbosa, using exclusion-based and likelihood-based paternity analyses carried out on microsatellite data. Data were used to fit a model of pollen dispersal and to estimate the rates of pollen flow and mutation/genotyping error, by developing a new method. Selfing was rare (1.6%). Pollen dispersed isotropically around each flowering plant following a leptokurtic distribution, with 50% of mating pairs separated by less than 11 m, but 22% by more than 40 m. Estimates of pollen flow lacked precision (0–25%), partially because mutations and/or genotyping errors (0.03–1%) could also explain the occurrence of offspring without a compatible candidate father. However, the pollen pool that fertilized these offspring was little differentiated from the adults of the population whereas strongly differentiated from the other populations, suggesting that pollen flow rate among populations was low. Our results suggest that pollen dispersal is too extended to allow differentiation by local adaptation within a population. However, among populations, gene flow might be low enough for such processes to occur.
Cheating is not always punished: killer female plants and pollination by deceit in the dwarf palm Chamaerops humilis
Authors: Dufaÿ M. , Anstett M.-C. 
Published: June 2004

Abstract
Because the interests of mutualists are not perfectly aligned, conflicts between partners often arise, rendering mutualism unstable by allowing the evolution of cheating. The dwarf palm Chamaerops humilis is engaged in a nursery pollination mutualism with a specific weevil Derelomus chamaeropsis. In exchange for pollen dispersal, dwarf palms provide pollinators with food, shelter and egg-laying sites, but pollinators can develop only within male inflorescences. Here we show that weevils lay eggs in female inflorescences but processes associated with fruit development prevent larval development. The cost imposed by developing larvae probably differs between male and female plants, explaining why only females defend their inflorescences. Female palms thus cheat their pollinating weevil, and pollinators are expected to ‘punish’ (avoid) them. We found no evidence for such punishment: weevils visit female plants and the duration of visits to male and female inflorescences does not differ. Thus mutualists do not always co-operate and cheating may not be necessarily punished.