bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expressions of power and powerlessness in discharge planning: a case study of an older woman on her way home
Authors: Efraimsson Eva , Rasmussen Birgit H. , Gilje Fredricka , Sandman Po 
Published: August 2003

Summary• The aim of this case study was to illuminate and describe the phenomenon of power as it appeared in a discharge planning conference. The patient was an older woman who needed long‐term care as a result of stroke and heart failure.• Data comprised transcriptions of a video‐recorded discharge planning conference and two audio‐recorded interviews focusing on the patient's experience of the discharge planning conference.• The findings reveal that the content of the discharge planning conference focused on the patient's medical state and routine administrative protocols. Analysis of the participants' activities, strategies and attitudes during the conference indicate that the professional carers dominated the conversation. Analysis further reveals that the patient experienced a feeling of powerlessness and of being treated as an object.• The findings are interpreted and discussed based on the concepts of ‘institutional frame’ and ‘client's frame', derived from Agar's theory of institutional discourse.
Beyond the metaphysical: health‐promoting existential mechanisms and their impact on the health status of clients
Authors: Whitehead Dean 
Published: August 2003

Summary• This paper aims to conceptualize the issues that surround the notion of existential health. It also seeks to establish the impact that existential issues have upon the health of the individual client and how these might explicitly be applied in clinical practice settings.• The ability of clients to draw upon their own existential resources as a fundamental part of their health care experience often goes unrecognized in nursing. Whilst existential mechanisms may be theoretically recognized, as a valid aspect of an individual's unique and personal identity, they are not an established part of the health care activity of nurses.• Entrenched biomedical frameworks of care delivery and the interchangeable use of metaphysical health states with existential health states in the established literature present particular dilemmas for the acknowledgement of existential health in clients.• A review of the literature has been conducted.• This account argues that the failure to recognize and assess a client's existential health status represents a major omission on the part of the clinical nurse. These nurses are, in effect, denying their clients the right to exercise and mobilize an important and valuable health resource.
In‐hospital social support for families of heart patients
Authors: Tarkka Marja‐Terttu , Paavilainen Eija , Lehti Kristiina , Åstedt‐Kurki Päivi 
Published: August 2003

Summary• Chronic illness in one family member influences all aspects of family life. Research has documented the positive contributions of social support in an unexpected and stressful event such as a family member's heart disease.• The aim of the study was to describe in‐hospital social support provided by nurses to families of heart patients and to identify factors related to social support.• Data were collected using a mailed questionnaire to family members of heart patients (n = 161) receiving treatment on two medical wards of a university hospital in southern Finland.• The results show that the family members were not very satisfied with the social support from nurses, because about 40% were dissatisfied with the concrete aid and affirmation they received and about 30% with emotional support. According to regression analysis the most important predictors of social support were family structure, patient's age, gender of family member and whether the patient had been hospitalized for cardiac symptoms.• This report shows that supporting families of cardiac patients need development according to the family nursing practice.
An exploration of the concept of comfort
Authors: Tutton Elizabeth , Seers Kate 
Published: August 2003

Summary• This paper explores the concept of comfort within conceptual frameworks that identify comfort as a key component. The paper focuses on two main issues: firstly, descriptions of comfort and how comfort is defined; secondly, the relationship between comfort and other core concepts and how it is similar to, or differs from these concepts.• The descriptions of comfort identify the difficulty of defining comfort and note that historical interpretations of comfort have changed over time. Key authors provide different perspectives of comfort and hence a uniform definition is not evident. The degree to which patients' perspectives are represented varies within the frameworks which suggests that further clarity is needed in this area. The relationship between comfort and other concepts considers the boundaries between comfort and two concepts: nursing as therapy and caring. Comfort tends to be seen as a minor aspect of these concepts focusing on relief of discomfort or actions that demonstrate caring.• The paper concludes that there is a lack of clarity around the use of the term comfort which fits with a view of comfort as an emerging concept. Descriptions of comfort are clearly evident in the literature but differ in relation to the authors' views of nursing. The relationship between comfort and nursing as therapy and caring is also complex and highlights the debate in relation to comfort as a part of caring or as the overall focus of care.
Patient education: perspective of adolescents with a chronic disease
Authors: Kyngäs Helvi 
Published: August 2003

Summary• The purpose of this study was to describe patient education from the perspective of adolescents.• Data were collected by interviewing adolescents who had asthma, epilepsy, juvenile rheumatoid arthritis, and insulin‐dependent diabetes mellitus. The sample consisted of 40 Finnish adolescents aged between 13 and 17 years. The interview data were analysed with methods of content analysis.• From the perspective of adolescents with a chronic disease, patient education can be divided into the following categories: routine programmes, problematic planning issues, atmosphere of patient education session and written patient education material. Some features of ideal patient education also emerged.• In a routine programme, patient education was based on the professional knowledge of the physicians and nurses rather than the needs of the adolescents. It was provided at a time that was good for the nurses or physicians. The level of education was not compatible with each developmental level of the adolescent.• Problematic planning issues included a poorly outlined plan of education and a lack of systematic and continuous education.• Educational communication consisted of dialogue between the adolescent and the educator. An encouraging atmosphere developed when the educators motivated the adolescents, respected them and their opinions and encouraged them to express their feelings, to ask questions and to relate experiences. Also, it was important that the adolescents’ opinions were respected.• In ideal patient education, the sessions had been planned well beforehand based on the adolescents’ needs and written patient education material. Ideal patient education helped adolescents to acquire skills to take care of themselves and provided information on how to adjust to different situations and problems.• The results provided useful insight into patient education and served to raise awareness of the problems and difficulties experienced by adolescents with a chronic disease.
Physical restraint use in a Korean ICU
Authors: Choi Eunha , Song Misoon 
Published: August 2003

Summary• This descriptive study investigated the patterns of use of physical restraints in a Korean Intensive Care Unit (ICU) with the aim of identifying the factors that would best discriminate the times of application and removal of restraints in the same patients.• The subjects of the study were 23 physically restrained patients out of 51 patients who were admitted to a medical ICU in a university hospital admitted during a 6‐week period, and the 29 nurses who applied or removed the restraints. Ninety‐four incidents of restraint application and removal on the 23 patients were analysed.• Data were collected using a self‐reporting questionnaire of attitudes towards restraint application for nurses, restraint document sheets, ICU flowsheets and patient chart reviews. Restraint‐related patient data were collected on a restraint document sheet by the nurse in charge at each instance of application and removal of restraint.• The most common type of restraint was the bilateral wrist restraint. The mean number of restraint applications per patient was 3.62 ± 3.56 (mean ± SD), and the mean restrained period per incident was 22.64 ± 58 hours. There were no significant differences in the frequency of restraint use during the day, evening and night shifts. The most significant discriminators for restraint application and removal were the restless‐behaviour score and the presence of a nasogastric tube – the classification accuracy by these two factors was 70.2%. More than 90% of the decisions to apply restraints were made by nurses. Nurses reported that preventing the patient from removing medical devices (48.6%) was the primary reason for application, and improvement of cognitive status (29.3%) was the primary reason for removal of restraint.• In conclusion, as the most discriminating factor of application or removal of restraints was the patient's restless behaviour, providing nurses with tools for the accurate evaluation of patient restlessness will shorten restraint application periods in ICUs.
Evidence‐based practice in Hong Kong: issues and implications in its establishment
Authors: Lee Linda Yin King 
Published: August 2003

Summary• Evidence‐based practice has been widely discussed in the literature, but it is not common or well adopted in nursing practice, both in Hong Kong and other countries.• This article aims to examine the relationships between three important elements of evidence‐based practice: systematic reviews, clinical guidelines and protocols. Current issues associated with evidence‐based practice in Hong Kong are explored.• Specific suggestions are given to researchers, practitioners, managers and academics so that the current situation can be advanced.
The site of cutaneous infection influences the immunological response and clinical outcome of hamsters infected with Leishmania panamensis
Authors: Osorio Yaneth , Melby Peter C. , Pirmez Claude , Chandrasekar Bysani , Guarín Nora , Travi Bruno L. 
Published: August 2003

SUMMARY We determined that the site of inoculation (foot or snout) influences the clinical evolution and immune responses of hamsters infected with Leishmania (Viannia) panamensis. Hamsters infected in the snout showed (i) a more rapid and severe lesion evolution at multiple time points (P < 0·05), (ii) a more extensive inflammatory infiltrate and tissue necrosis, (iii) a higher tissue parasite burden, (iv) a higher antibody titre (P < 0·01), but lower antigen‐specific spleen cell proliferative response (P = 0·02), and (v) a slower response to anti‐leishmanial drug treatment (P < 0·002). In both inoculation groups there was co‐expression of type 1 (IFN‐γ and IL‐12) and some type 2 (IL‐10 and TGF‐β, but not IL‐4) cytokines in the cutaneous lesions and spleen. Early in the course of infection, hamsters infected in the snout showed higher expression of splenic IL‐10 (P = 0·04) and intra‐lesional IFN‐γ (P = 0·02) than foot infections. No expression of IL‐12p40 or IL‐4 was detected. During the chronic phase, snout lesions expressed more IFN‐γ (P = 0·001), IL‐12p40 (P = 0·01), IL‐10 (P = 0·009) and TGF‐β (P = 0·001), and the level of expression of each of these cytokines correlated with lesion size (P ≤ 0·01). These results suggest that the site of infection influences the clinical outcome in experimental cutaneous leishmaniasis, and that the expression of macrophage‐deactivating type 2 cytokines and/or an exaggerated type 1 proinflammatory cytokine response may contribute to lesion severity.
The lack of suppressor of cytokine signalling‐1 (SOCS1) protects mice from the development of cerebral malaria caused by Plasmodium berghei ANKA
Authors: Bullen Denise V. R. , Hansen Diana S. , Siomos Mary‐Anne V. , Schofield Louis , Alexander Warren S. , Handman Emanuela 
Published: August 2003

SUMMARY Cerebral malaria is a severe complication of infection with Plasmodium berghei ANKA involving the Th1 cytokines TNF‐α and IFN‐γ. Suppressor of cytokine signalling‐1 (SOCS1) is an important component in the regulatory cascade controlling inflammatory responses and signalling through IFN‐γ. Contrary to the expectation that SOCS1‐deficient mice, in which IFN‐γ responses are uncontrolled and which are more sensitive to IFN‐γ, may show heightened susceptibility, mice lacking SOCS1 were protected from cerebral malaria. Unlike the controls and despite similar parasitaemia, infected SOCS1 null mice showed no inflammation or haemorrhaging in the brains. Mice lacking SOCS1 exhibited decreased splenic cellularity and a reduced ratio of CD4 : CD8 lymphocytes, which were maintained during infection. However, the ratio of IFN‐γ to IL‐4 mRNA expression during infection was similar in SOCS1 –/– and control mice suggesting that a dramatic shift in the ratio of Th1 : Th2 responses does not account for the resistance to disease. Resistance conferred by the lack of SOCS1 is specific since the related SOCS2, also implicated in Th1‐mediated responses, did not seem to be involved in the development of disease. Understanding the mechanism by which SOCS1 deficiency protects mice from cerebral malaria may allow the manipulation of its activity and alleviate pathology.
Immunomodulatory effects of Maxadilan and Phlebotomus papatasi sand fly salivary gland lysates on human primary in vitro immune responses
Authors: Rogers Kathleen A. , Titus Richard G. 
Published: August 2003

SUMMARY Leishmaniasis is a parasitic disease transmitted by the bite of Leishmania‐infected sand flies. Here we show for the first time the ability of Maxadilan (Max), a vasodilatory peptide isolated from the sand fly Lutzomyia longipalpis, and salivary gland lysate (SGL) from Phlebotomus papatasi to decrease the secretion of Type 1 cytokines and to enhance the production of the Type 2 cytokine interleukin (IL)‐6 by human peripheral blood mononuclear cells (PBMC) and monocytes. We found Max decreased the secretion of interferon (IFN)‐γ and IL‐12p40 by PBMC and TNF‐α by monocytes. SGL reduced the production of IFN‐γ by PBMC. In contrast, production of the Type 2 cytokine IL‐6 was increased in Max or SGL‐exposed cells. Finally, we determined that Max interacts with human cells through at least the pituitary adenylate cyclase activating polypeptide receptor. These results show that sand fly salivary gland components have an immunomodulatory effect on human cells, and this has important implications for the development of vaccines against leishmaniasis for humans.
A receptor for protein import into potato mitochondria
Authors: Heins Lisa , Schmitz Udo Klaus 
Published: August 2003

SummaryFive potential surface receptors for protein import into plant mitochondria were identified by gentle trypsin treatment of intact mitochondria from potato tubers and subsequent preparation of outer mitochondrial membranes. One of them, a 23 kDa protein, was purified to homogeneity and analysed by direct protein sequencing. Copy DNA clones encoding the corresponding polypeptide were isolated with labelled oligonucleotides derived from the amino acid data. The 23 kDa protein shares significant sequence similarity with protein import receptors from fungal mitochondria and contains one of their typical tetratricopeptide motifs. Its integration into the outer membrane is independent of protease accessible surface receptors and not accompanied by proteolytic processing. Monospecific antibodies against the 23 kDa protein significantly reduce import capacity of isolated mitochondria indicating that this component is indeed involved in the recognition or import of precursor proteins. As in fungi, immunological inhibition of protein import with IgGs against a single receptor is incomplete suggesting the existence of other receptors in the outer mitochondrial membrane of plant mitochondria.
Sucrose metabolism during cotyledon development of Vicia faba L. is controlled by the concerted action of both sucrose‐phosphate synthase and sucrose synthase: expression patterns, metabolic regulation and implications for seed development
Authors: Weber Hwans , Buchner Peter , Borisjuk Ljudmilla , Wobus Ulrich 
Published: August 2003

SummaryThe roles of sucrose‐phosphate synthase (Sps) and sucrose synthase (Sus) in developing embryos of Vicia faba have been characterized. In the cotyledons the expression of both Sps and Sus is initiated in cells differentiating into storage tissue. This stage is characterized by a switch in the carbohydrate state from a high to a low hexoses to sucrose ratio. The carbohydrate state was found earlier to be controlled by seed coat‐associated invertase. During cotyledon development the Sps‐enzyme undergoes a cycle of deactivation and reactivation: the activated state is associated with the prestorage phase, desiccation and germination and the deactivated state with the storage phase. Sus activity is associated with the storage phase. Sps and Sus are differentially influenced by free sugars. Feeding hexoses to storage phase cotyledons increases levels of Sps‐mRNA but not Sus‐mRNA, Sps activity and Sps activation state and impairs storage functions evidenced by an increased sucrose to starch ratio and a downregulation of storage protein legumin B‐mRNA. Sus enzyme activity is inhibited by free hexoses in vitro. It is proposed that the changing carbohydrate state during cotyledon development controls the ratio of Sps to Sus. Sps may have some significance for the initiation of the storage process possibly decreasing hexoses and/ or increasing sucrose. The relevance of the changing carbohydrate state with respect to development and storage processes is discussed.
The hypersensitive reaction, membrane damage and accumulation of autofluorescent phenolics in lettuce cells challenged by Bremia lactucae
Authors: Bennett Mark , Gallagher Matthew , Fagg Jean , Bestwick Charles , Paul Teresa , Beale Michael , Mansfield John 
Published: August 2003

SummaryThe expression of resistance to Bremia lactucae determined by the resistance genes Dm5/8 and Dm7 in lettuce was examined; incompatibility involved the hypersensitive reaction (HR) which occurred only within penetrated cells at early and late stages of fungal development, respectively. Autofluorescence observed under UV and blue light excitation in cells undergoing the HR was associated with the accumulation of ester‐linked syringaldehyde and caffeic acid on plant cell walls. Two phases of phenolic deposition were identified. The first was highly localized around penetration points and occurred during incompatible and compatible interactions. The second and major phase was only activated after the occurrence of irreversible membrane damage in the penetrated cell and was reduced by inhibitors of mRNA synthesis. Fungal structures, primary and secondary vesicles, intercellular hyphae and haustoria also became autofluorescent during incompatible interactions. Changes in the fluorescence due to preformed phenolics located in the plant cell vacuole were found just before plasma membrane damage became irreversible during the HR. In addition to localized deposition of phenolics, increases in the concentrations of the major free phenolic esters identified as dicaffeoyl tartaric and chlorogenic acids also occurred during incompatible interactions. The results suggest that membrane damage in penetrated cells occurs at different rates in resistance controlled by Dm5/8 and Dm7 and indicate an important role for irreversible membrane damage in lettuce as a key signalling event leading to widespread activation of defence responses in surrounding cells.
Members of a low‐copy number gene family encoding glutamyl‐tRNA reductase are differentially expressed in barley
Authors: Bougri Oleg , Grimm Bernhard 
Published: August 2003

SummaryIn plants tetrapyrrole synthesis is initially light regulated on the level of 5‐aminolevulinate (ALA) synthesis. ALA is formed from glutamate in three enzymatic steps. Glutamyl tRNA reductase (GluTR) catalyses the NADPH‐dependent reduction of glutamyl tRNA to glutamate 1‐semialdehyde. GluTR is encoded by a low‐copy gene family consisting of three to four genes. Three different cDNA clones are presented. Full‐length clones BHA1 and 87 differ in the length of the 3′ untranslated region and code for a 58.5 kDa protein. The sequence of the partial clone, BHA13, contains at least 87 base mismatches in the coding region for the mature GluTR resulting in 11 amino acid substitutions. Synthesis of a recombinant mature and a truncated GluTR lacking the first 19 amino terminal amino acids in Escherichia coli lead only in the latter case to complementation of an E. coli hemA mutant. Steady‐state level of BHA1‐ and BHA13‐specific mRNA encoding GluTR were analysed by Northern blot hybridization using cDNA‐specific oligo nucleotides and quantitative reverse transcriptase‐polymerase chain reaction. Accumulation of the two RNA species is light induced in greening barley and controlled during cellular development. In contrast to BHA13, BHA1 transcripts are present in roots and are elevated after cytokinin treatment of dark‐grown seedlings. Furthermore, BHA1 mRNA shows oscillation under circadian growth conditions. GluTR transcript levels correlate with the capacity for ALA synthesis indicating that the rate‐limiting substrate flux through the ALA synthesizing pathway can be at least partially attributed to GluTR expression. Consequences of the initial control of the chlorophyll metabolic pathway on the level of ALA formation are discussed.
Post‐transcriptional transgene silencing and consequent tospovirus resistance in transgenic lettuce are affected by transgene dosage and plant development
Authors: Pang Sheng‐Zhi , Ja Fuh‐Jyh , Carney Kim , Stout John , Tricoli David M. , Quemada Hector D. , Gonsalves Dennis 
Published: August 2003

SummaryTransgenic lettuce plants expressing the nucleocapsid (N) protein gene of the lettuce isolate of tomato spotted wilt virus (TSWV‐BL) were protected against TSWV isolates via transgenic N protein when the protein accumulated at high levels or via an N transgene silencing mechanism activated by its overexpression. In a transgenic lettuce line, post‐transcriptional gene silencing was activated at a relatively earlier developmental stage in homozygous than in hemizygous progenies. As a result, the homozygous progenies generally showed a uniform suppression of N protein accumulation and consequently high levels of virus resistance in all leaves of the silenced plants. in contrast, N protein accumulated at high levels in the lower leaves of the hemizygous progenies and at much reduced levels (due to transgene silencing) in the successive leaves, resulting in moderate levels of virus resistance. It was also observed that the timing of the N transgene silencing in both homozygous and hemizygous plants was affected by environmental factors.