bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cathepsin D is up-regulated in inflammatory bowel disease macrophages
Authors: HAUSMANN M , OBERMEIER F , SCHREITER K , SPOTTL T , FALK W , SCHÖLMERICH J , HERFARTH H , SAFTIG P , ROGLER G 
Published: March 2004

SUMMARYDown-regulation of receptors involved in the recognition or transmission of inflammatory signals and a reduced responsiveness support the concept that macrophages are ‘desensitized’ during their differentiation in the intestinal mucosa. During inflammatory bowel disease (IBD) intestinal macrophages (IMACs) change to a reactive or ‘aggressive’ type. After having established a method of isolation and purification of IMACs, message for cathepsin D was one of the mRNAs we found to be up-regulated in a subtractive hybridization of Crohn's disease (CD) macrophages versus IMACs from control mucosa. The expression of cathepsin D in intestinal mucosa was analysed by immunohistochemistry in biopsies from IBD and control patients and in a mouse model of dextran sulphate sodium (DSS)-induced acute and chronic colitis. IMACs were isolated and purified from normal and inflamed mucosa by immunomagnetic beads armed with a CD33 antibody. RT-PCR was performed for cathepsin D mRNA. Results were confirmed by Northern blot and flow cytometrical analysis. Immunohistochemistry revealed a significant increase in the cathepsin D protein expression in inflamed intestinal mucosa from IBD patients compared to non-inflamed mucosa. No cathepsin D polymerase chain reaction (PCR) product could be obtained with mRNA from CD33-positive IMACs from normal mucosa. Reverse transcription (RT)-PCR showed an induction of mRNA for cathepsin D in purified IMACs from IBD patients. Northern blot and flow cytometry analysis confirmed these results. Cathepsin D protein was also found in intestinal mucosa in acute and chronic DSS-colitis but was absent in normal mucosa. This study shows that expression of cathepsin D is induced in inflammation-associated IMACs. The presence of cathepsin D might contribute to the mucosal damage in IBD.
Patients with comorbidities: perceptions of acute care services
Authors: Williams Allison 
Published: March 2004

Background.  Advances in medical science and improved lifestyles have reduced mortality rates in Australia and most Western countries. As a result, there is an ageing population with a concomitant growth in the number of people living with chronic illnesses. Indeed, a significant number of people will experience multiple chronic illnesses (comorbidities) and may require admission to hospital for acute care that is superimposed on their chronic illnesses.Aim.  The aim of this study was to investigate perceptions of quality of care by patients experiencing comorbidities who required an acute hospital stay.Method.  A qualitative descriptive design was adopted, informed by Colaizzi's phenomenological method. Single semi‐structured interviews were conducted with 12 patients within 14 days of being discharged home after an acute illness episode.Findings.  Data analysis revealed three themes: poor continuity of care for comorbidities, the inevitability of something going wrong during acute care and chronic conditions persisting after discharge. Combinations of chronic illnesses and treatments affected these patients’ experiences of acute care and recovery postdischarge. Medicalized conceptualizations of comorbidity failed to capture the underlying health care needs of these patients.Limitations.  No generalizations can be drawn because the findings and conclusions were derived from a purposive sample of patients who agreed to participate.Conclusion.  These findings have implications for a comprehensive and co‐ordinated approach to this group of patients, and inform the body of nursing knowledge about how patients with comorbidities experience nursing care.
Socio‐cultural influences on Chinese women's attendance for cervical screening
Authors: Holroyd Eleanor , Twinn Sheila , Adab Peymane 
Published: March 2004

Background.  Compared with other countries, Hong Kong has a relatively high rate of cervical cancer. Much of this morbidity should be avoidable with cervical screening, but uptake rates for screening in Hong Kong are low. In programmes to promote cervical screening attendance, it is essential that aspects of the socio‐cultural system be taken into account to provide appropriate preventive health strategies.Aim.  This paper outlines an investigation of the cultural and social factors contributing to Chinese women's attendance for cervical screening.Method.  A mixed methods design was employed, combining and comparing two data sets. The initial data set was drawn from 10 focus groups involving both screened and unscreened Chinese women (n = 54). The second data set was drawn from a total population of Hong Kong doctors, and involved face‐to‐face semi‐structured interviews (n = 28).Results.  Thematic analysis of the data from women indicated that the social factors of cost, educational base, knowledge of risk, the social value of early detection and cultural issues such as modesty and embarrassment contributed to screening attendance. The doctors perceived a cultural tendency towards fatalism, as well as seeing the gender, interpersonal and interprofessional skills of the practitioner to be important in influencing levels of Chinese women's shyness and discomfort, and hence affecting attendance. The lay and practitioner data sets varied in the perceptions of women's pain, embarrassment and risk factors.Conclusion.  Programmes providing services for Chinese women need to ensure that the philosophy of the staff and the approach and materials used are culturally relevant. Recommendations are that nurses equipped with relevant social and cultural knowledge of population groups should have a central role in health promotion and screening services.
Reported pain after day surgery: a critical literature review
Authors: Coll Anne Marie , Ameen Jamal R.M. , Moseley Laurence G. 
Published: March 2004

Background.  Despite technological advancements in anaesthesia and analgesia, reported pain levels after day surgery remains high. Whilst it is unrealistic to expect no pain, the level that constitutes ‘acceptable’ pain remains unclear because of inconsistencies in reporting. These inconsistencies have resulted from different interpretations of what pain is and the use of different measurement tools.Aim.  The aim of this paper is to report a study investigating any disparity in reported levels of pain following day surgery, within different specialities and in relation to specific operative procedures.Method.  Nursing and health care papers published since 1983 were sought using the keywords: postoperative pain, postoperative complications, pain after day surgery, day surgery, ambulatory surgery, nursing, operation types, operative procedures, surgical procedures, descriptors of pain, pain intensity, verbal descriptor scale, numerical rating scale, visual analogue scale, validity, reliability, design, sample size, data collection methods and their various combinations. Databases searched were Medline, CINAHL, Nursing Collection, Embase, Healthstar, BMJ and several on‐line Internet journals, specifically Ambulatory Surgery. The search was restricted to publications in the English language.Findings.  Twenty‐four papers were identified. Inconsistencies in the reported intensity of pain are highlighted, in relation to different operative procedures and specialities. Data in the papers are based on different descriptors, measurement tools and data collection methods. In many cases, sample size, and validity and reliability can also be questioned.Conclusions.  There is a disparity in reported levels of pain after day surgery. It is important that a unified day surgery pain measurement strategy is established, so that patients can be informed about the intensity of pain that they are likely to experience following specific procedures.
Primary mental health workers in child and adolescent mental health services
Authors: Macdonald Wendy , Bradley Sally , Bower Peter , Kramer Tami , Sibbald Bonnie , Garralda Elena , Harrington Richard 
Published: March 2004

Background.  The interface between primary care and specialist services is increasingly seen as crucial in the effective management of child and adolescent mental health (CAMH) problems. In the United Kingdom, a new role of primary mental health worker (PMHW), has been established in order to achieve effective collaboration across the interface through the provision of clinical care in primary care settings and by improving the skills and confidence of primary care staff. However, little is known about the development of this innovative role in service contexts. Issues raised during the early stages of implementation may have important implications for the preparation and development of professionals who undertake the role.Aims.  The aim of this paper is to report on a study that examined key issues in implementation of the PMHW role in six health authorities in England.Methods.  Case study evaluation was conducted, using thematic analysis of 75 qualitative interviews with key stakeholders from different professions (e.g. PMHWs, general practitioners, health visitors, psychiatrists and service managers) and representing different sectors (primary care, specialist services and community child health services).Findings.  The study identified three models of organization (outreach, primary care‐based and teams). Each was associated with different advantages and disadvantages in its effects on referral rates to specialist services and the development of effective working relationships with primary care providers. Problems associated with accommodation and effective integration of PMHWs with specialist services, and tensions caused by the two different roles that PMHWs could undertake (direct clinical care vs. consultation‐liaison) were common across all sites.Conclusions.  The PMHW role is an important development that may go some way towards realizing the potential of primary care services in CAMH. The implementation of new roles and models of working in primary care is complex, but may be facilitated by effective planning with primary care providers, clear goals for staff, and a long‐term perspective on service development.
A community survey of loneliness
Authors: Lauder William , Sharkey Siobhan , Mummery Kerry 
Published: March 2004

Background.  Loneliness is associated with an increased incidence of a wide range of physical and mental health problems. The detection, prevention and amelioration of loneliness is an important public health issue for nurses.Methods.  This study reports findings from the 2002 Central Queensland Social Survey. The aims of the study were to (i) establish the extent of loneliness in a community sample; and (ii) to identify the factors that are predictors of loneliness. A random sample of 1241 subjects were interviewed by Computer‐Assisted Telephone Interviewing. This interview included the Loneliness Scale formulated by De Jong Gierveld and Kamphuis.Findings.  Loneliness is a common phenomenon and risk factors include experience of domestic violence in current relationship, not having recent paid employment, not being married/partnered, and the number of children under 18 years in a household. Loneliness is not associated with higher rates of health care professional consultations.Conclusion.  Loneliness is a very common problem and should be seen as a major public health issue. Nurses, through a community capacity building framework, have a major role to play in the prevention of loneliness.
Cyclosporin A: a new drug in the field of canine dermatology
Authors: Guaguère Eric , Steffan Jean , Olivry Thierry 
Published: March 2004

Abstract In the last few years, there has been growing interest in the use of cyclosporin to treat canine skin diseases. Cyclosporin exhibits potent immunomodulating properties that reflect its ability to block the transcription of cytokines genes in activated T lymphocytes. Cyclosporin also inhibits a number of immune allergic reactions that occur after activation of mast cells, Langerhans cells, eosinophils and keratinocytes. In randomized controlled trials, cyclosporin has proven to be as effective as glucocorticoids for treatment of canine atopic dermatitis at the inducing dosage of 5 mg kg−1. The drug has also proven beneficial for the treatment of perianal fistulas in dogs. Other potential applications are suggested from small pilot open trials using dogs affected with various immune‐mediated dermatological diseases. The pharmacokinetic properties of cyclosporin are very similar in dogs and man, but its safety margin is much wider in dogs. Therefore, routine cyclosporin blood level monitoring does not appear necessary. Although in man renal impairment and hypertension are often seen, even at low doses, these effects are not observed in dogs. Adverse reactions consist mainly of transient emesis and diarrhoea occurring during the first days of treatment. Other adverse reactions, such as gingival hyperplasia, verruciform lesions and hypertrichosis, appear to be dose‐dependent, and occur rarely at therapeutic doses. An increased susceptibility to infections has not been reported in dogs receiving this drug.
Flora diversity of farm forestry plantations in southeast Queensland
Authors: Wang Jian , Borsboom Adrian C. , Smith Geoffrey C. 
Published: March 2004

Summary  Plant species composition in plantation monoculture of the native Gympie Messmate (Eucalyptus cloeziana F. Muell.) was assessed and compared with native eucalypt forest and cleared grazing land in southeast Queensland, Australia. A total of 18 sites (11 in the plantations, four in native eucalypt forests and three on cleared grazing land) were surveyed. The four plantation age classes during the 18‐month survey period were 0.3–1.8 (very young), 2.1–3.8 (young), 15–16.5 (mid‐aged) and 38–40.5 (old) years of age. Significantly more native plant species were recorded in the plantations, regardless of their age, than on cleared grazing land. The number of native plant species in the old plantations was not significantly different from the native eucalypt forests. Native tree and shrub species richness increased significantly with plantation age. Two species (Ricinocarpos speciosus Muell. Arg. and Xanthostemon oppositifolius F. M. Bailey) listed as Vulnerable and one species (Alyxia magnifolia F. M. Bailey) listed as Rare were recorded in the old plantations. Two Rare species (A. magnifolia and Acianthus amplexicaulis (F. M. Bailey) Rolfe) were recorded in the native eucalypt forests. Exotic plant species, consisting mainly of herbs, grasses and shrubs in the plantations, were significantly more abundant in the very young and young plantations. However, the number of exotic species decreased significantly with increasing age of the plantations. The results suggest that even small‐scale plantation can increase landscape heterogeneity and help protect biodiversity.
‘Dialectical process’ and ‘constructive method’: micro‐analysis of relational process in an example from parent–infant psychotherapy
Authors: Woodhead Judith 
Published: March 2004

Abstract:  Jung defined experience that takes place between therapist and patient as ‘dialectical process’, achieved through ‘constructive method’. Perspectives from attachment theory, neurobiology, cognitive science, systems thinking and infancy research confirm and extend his view of the centrality of relational process in the development of self. Interactional experiences are embedded within the history of the primary parent–infant relationship and structure within the mind implicit patterns of relating. These patterns influence capacities for managing a whole lifetime of affective relational experience within the self and with others. This paper shows how parent–infant psychotherapy seeks to intervene during the formation of disturbed relational patterns. I offer detailed micro‐analysis of the moment‐to‐moment ‘dialectical process’ that a mother, her four‐month‐old infant and myself ‘constructed’ together.
Representative Bureaucracy: Understanding Its Past to Address Its Future
Authors: Bailey Margo 
Published: March 2004

Julie Dolan and David H. Rosenbloom, eds., Representative Bureaucracy: Classic Readings and Continuing ControversiesNorma M. Riccucci, Managing Diversity in Public Sector WorkforcesMargaret C. Rung, Servants of the State: Managing Diversity and Democracy in the Federal Workforce, 1933–1953
Temporal association between serum prolactin concentration and exposure to styrene
Authors: Luderer U , Tornero-Velez R , Shay T , Rappaport S , Heyer N , Echeverria D 
Published: March 2004

Background:Previous studies have suggested that occupational exposure to styrene is associated with increased serum levels of the anterior pituitary hormone prolactin (PRL).Aims:To test the hypotheses that: (1) the effect of styrene exposure on PRL secretion is an acute effect, not a subchronic or chronic effect; (2) blood styrene, as a measure of absorbed dose, is a stronger predictor of serum PRL level than personal breathing zone air styrene concentration.Methods:Subjects were recruited from 17 workplaces in the reinforced plastics industry. Personal breathing zone air styrene, whole blood styrene, and serum PRL were measured during one to three sessions, approximately one year apart. Linear multiple regression was used to model the relations between acute (air styrene or blood styrene obtained at same time as PRL), subchronic (average air or blood styrene over two or three sessions), and chronic (years of work in industry or facility times average air styrene over all sessions) indices of styrene exposure and serum PRL.Results:Acute blood styrene concentration was the strongest predictor of serum PRL concentration, with the model predicting a 2.06-fold increase in PRL (95% CI 1.11 to 3.84) for every 10-fold increase in blood styrene. Serum PRL tended to increase with increasing styrene exposure in both men and women; however, women tended to have higher PRL levels. For women, the change in blood styrene between sessions 1 and 2 was a significant predictor of the change in serum PRL between sessions.Conclusions:Results confirm that styrene exposure enhances serum PRL concentrations and support an acute effect of styrene on PRL secretion.
Respiratory symptoms and airflow limitation in asphalt workers: Table 1
Authors: Randem B G , Ulvestad B , Burstyn I , Kongerud J 
Published: March 2004

Background:Asphalt workers are exposed to bitumen fume and vapour, and to exhaust from engines and passing traffic.Aims:To assess the occurrence of respiratory symptoms and signs of airflow limitations in a group of asphalt workers.Methods:All 64 asphalt workers and a reference group of 195 outdoor construction workers from the same company participated in a cross-sectional study. Spirometric tests and a questionnaire on respiratory symptoms and smoking habits were administered. Respiratory symptoms and lung function were adjusted for age and smoking.Results:The FEV1/FVC% ratio was significantly lower in the asphalt workers than in the referents. Symptoms of eye irritation, chest tightness, shortness of breath on exertion, chest wheezing, physician diagnosed asthma, and chronic obstructive pulmonary disease (COPD) were all significantly more prevalent among the asphalt workers.Conclusion:In asphalt workers there is an increased risk of respiratory symptoms, lung function decline, and COPD compared to other construction workers.
Particulate air pollution and panel studies in children: a systematic review
Authors: Ward D J , Ayres J G 
Published: March 2004

Background:Panel studies have been used to investigate the short term effects of outdoor particulate air pollution across a wide range of environmental settings.Aims:To systematically review the results of such studies in children, estimate summary measures of effect, and investigate potential sources of heterogeneity.Methods:Studies were identified by searching electronic databases to June 2002, including those where outcomes and particulate level measurements were made at least daily for ⩾8 weeks, and analysed using an appropriate regression model. Study results were compared using forest plots, and fixed and random effects summary effect estimates obtained. Publication bias was considered using a funnel plot.Results:Twenty two studies were identified, all except two reporting PM10(24 hour mean) >50 μg.m−3. Reported effects of PM10on PEF were widely spread and smaller than those for PM2.5(fixed effects summary: −0.012v−0.063 l.min−1per μg.m−3rise). A similar pattern was evident for symptoms. Random effects models produced larger estimates. Overall, in between-study comparisons, panels of children with diagnosed asthma or pre-existing respiratory symptoms appeared less affected by PM10levels than those without, and effect estimates were larger where studies were conducted in higher ozone conditions. Larger PM10effect estimates were obtained from studies using generalised estimating equations to model autocorrelation and where results were derived by pooling subject specific regression coefficients. A funnel plot of PM10results for PEF was markedly asymmetrical.Conclusions:The majority of identified studies indicate an adverse effect of particulate air pollution that is greater for PM2.5than PM10. However, results show considerable heterogeneity and there is evidence consistent with publication bias, so limited confidence may be placed on summary estimates of effect. The possibility of interaction between particle and ozone effects merits further investigation, as does variability due to analytical differences that alter the interpretation of final estimates.
Mortality of workers exposed to ethylene oxide: extended follow up of a British cohort
Authors: Coggon D , Harris E C , Poole J , Palmer K T 
Published: March 2004

Aims:To obtain further information about the risks of cancer associated with occupational exposure to ethylene oxideMethods:Follow up was extended by 13 years for a cohort of 2876 men and women with definite or potential exposure to ethylene oxide in the chemical industry or in hospital sterilising units. Subjects were traced through National Health Service and social security records, and their mortality was compared with that expected from rates in the national population by the person-years method.Results:Analysis was based on 565 deaths, of which 339 had occurred during the additional period of follow up. Mortality was close to or below expectation for all causes (565 deathsv607.6 expected), all cancers (188v184.2), and for all specific categories of malignancy including stomach cancer (10v11.6), breast cancer (11v13.2), non-Hodgkin’s lymphoma (7v4.8), and leukaemia (5v4.6). All five deaths from leukaemia occurred in the subset of subjects with greatest potential for exposure to ethylene oxide, but even in this group the excess of deaths was small (2.6 expected).Conclusions:The balance of evidence from this and other epidemiological investigations indicates that any risk of human cancer from ethylene oxide is low, particularly at the levels of occupational exposure that have occurred in Britain over recent decades. This may reflect the capacity of human cells to repair DNA damage caused by the chemical, which is a potent genotoxin and animal carcinogen.