bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mothering in Public: A Meta‐Synthesis of Homeless Women With Children Living in Shelters
Authors: Meadows‐Oliver Mikki 
Published: August 2004

ISSUES AND PURPOSE The purpose of this paper is to synthesize the current qualitative literature on homeless women with children living in shelters.METHODS Eighteen qualitative studies on homeless women with children living in shelters were included in the synthesis. The meta‐synthesis was conducted using the meta‐ethnographic approach of Noblit and Hare (1988).RESULTS Six reciprocal translations (themes) of homeless mothers caring for their children in shelters emerged: On becoming homeless, protective mothering, loss, stressed and depressed, survival strategies, and strategies for resolution.PRACTICE IMPLICATIONS The results may be used by healthcare workers as a framework for developing intervention strategies directed toward helping mothers find new solutions to dealing with shelter living and innovative ways to resolve their homelessness.
The Development of Trust in Parents of Hospitalized Children
Authors: Thompson Virginia L. , Hupcey Judith E. , Clark Mary Beth 
Published: August 2004

ISSUES AND PURPOSE The purpose of this study was to investigate the development of trust in parents of hospitalized children.METHODS Using grounded theory, semistructured interviews were conducted with 15 parents of children previously hospitalized, focusing on parents' experiences during their child's hospitalization. Data were analyzed using a constant comparative process. Themes and the core variable were identified and a model of trust developed.RESULTS The core variable related to the development of trust in healthcare providers was whether parents' expectations for care were met. Thematic areas that influenced whether expectations for care were met included preexisting trust; evaluation of care, including evaluation of technical skills and the meeting of parental and child needs; and behaviors of nurses and other healthcare providers that inhibited and fostered trust.PRACTICE IMPLICATIONS Strategies to enhance trust are discussed.
Ethical Considerations for a Child's Participation in Research
Authors: Kanner Sheri , Langerman Susan , Grey Margaret 
Published: August 2004

ISSUES AND PURPOSE To analyze ethical considerations for a child's involvement in research.CONCLUSIONS Pediatric research can proceed only when the welfare of children is protected. Although research with children as research subjects constitutes only a small portion of research efforts, its continual growth requires nurses be aware of the rights of pediatric subjects.PRACTICE IMPLICATIONS As nursing research increases in sophistication, the nurse should include an assessment of the informed consent process in the care of the patient, including the child's comprehension, the age and development of the child, and the child's perception of the research.
Waiting Together: Translating the Principles of Therapeutic Relationships One Step Further
Authors: Allenbach Alyce , Steinmiller Elizabeth A. 
Published: August 2004

ISSUES AND PURPOSE Inconsistent nursing practices created nurse‐patient boundary issues on a cardiac step‐down unit related to confidentiality, limit setting, and professionalism with patients and families awaiting organ transplantation.CONCLUSIONS A staff work group designed and implemented a plan to translate the principles of therapeutic relationships into daily practice.PRACTICE IMPLICATIONS A work plan developed for nursing staff outlined concrete solutions and resources available within the hospital. This framework can be used to empower staff in the ongoing effort to manage relationships with chronically ill patients and their families.
Clinicians' Views on Reproductive Needs and Services for Teens With Negative Pregnancy Tests
Authors: Daley Alison Moriarty , Sadler Lois S. , Leventhal John M. , Cromwell Polly , Reynolds Heather D. 
Published: August 2004

ISSUES AND PURPOSE To explore services available to adolescent girls at the time of the negative pregnancy test (NPT) in an urban community.DESIGN AND METHODS Clinicans focus groups were conducted to identify the needs of adolescents at the time of a NPT result.RESULTS Teens access care in a variety of ways, services provided at the time of a NPT were agency and clinical dependent, and strategies for follow‐up care often were unstructured. Few services were available for parents or partners. Barriers included difficulty communicating with agencies, lack of staff trained to work with adolescents, and time/financial constraints.CONCLUSION Adolescents need comprehensive, teen‐friendly reproductive care at the time of a NPT results.
Impoverished Children With Asthma: A Pilot Study of Urban Healthcare Access
Authors: Wallace Andrea , Scott Jill , Klinnert Mary , Anderson Mark E. 
Published: August 2004

ISSUES AND PURPOSE Using Andersen's Behavioral Model of Health Care Use, this pilot study was conducted to better understand the experiences of children with asthma as they access an urban healthcare system.DESIGN AND METHODS This descriptive study used a convenience sample of 34 families of pediatric asthma patients who participated in semistructured interviews and closed medical record review.RESULTS Only one patient reported having a written exacerbation management plan. Beliefs regarding medication addiction and side effects were frequently reported as barriers to medication adherence, and children seeking asthma care in primary care settings saw many care providers.PRACTICE IMPLICATIONS Exploring how expanded nursing roles can help address both family and system factors serving as barriers to health care ought to be a key priority for nursing.
Liver Transplantation in Children: Maternal and Family Stress, Coping, and Adaptation
Authors: LoBiondo‐Wood Geri , Williams Laurel , McGhee Charles 
Published: August 2004

ISSUES AND PURPOSE This study examined the relationship of family stress, severity of the stressor, uncertainty, coping, and family adaptation from pretransplantation to posttransplantation.DESIGN AND METHODS A descriptive, longitudinal study of 15 mothers whose children were at least 5 years posttransplantation.RESULTS Maternal stress, coping, and uncertainty demonstrated significant changes over time, whereas family stress did not. Pretransplantation family stress, anger, and confusion were related to poorer family adaptation.PRACTICE IMPLICATIONS Interventions for mothers pretransplantation should account for the coping, levels of stress, and uncertainty present at each phase of the transplantation process. Interventions need to be tailored to the transplantation phase. Long‐term interventions remain necessary and should be directed at reinforcement of teaching, as well as assessment and provision of parental support relevant to the long‐term needs of the family.
Haematopoietic stem cell transplantation for autoimmune disorders: the American perspective
Authors: Popat Uday , Krance Robert 
Published: August 2004

SummaryThe hypothesis that haematopoietic stem cell transplantation (HSCT) might be useful in treating refractory autoimmune diseases (AID) was suggested by studies in animal models and by the improvement of concurrent autoimmune diseases in patients who had undergone transplantation for haematological disorders. This concept has now been tested in a substantial number of phase I/II clinical trials of autologous HSCT. These early results are promising, even in patients who have failed on multiple standard therapies for AID. Transplantation‐related toxicity has decreased with growing experience in the application of this procedure, better patient selection and the modification of treatment protocols. Randomized trials currently under way or under consideration should clarify the role of HSCT in patients with autoimmune disorders.
Deep vein thrombosis in patients with multiple myeloma treated with thalidomide and chemotherapy: effects of prophylactic and therapeutic anticoagulation
Authors: Zangari Maurizio , Barlogie Bart , Anaissie Elias , Saghafifar Fariba , Eddlemon Paul , Jacobson Joth , Lee Choon‐Kee , Thertulien Raymond , Talamo Giampaolo , Thomas Teri , Rhee Frits Van , Fassas Athanasios , Fink Louis , Tricot Guido 
Published: August 2004

SummaryA group of 256 newly diagnosed myeloma patients were enrolled in a phase III study that included 4 monthly cycles of induction chemotherapy and tandem transplant. All patients were randomized to either receive or not receive thalidomide. A total of 221 patients (86%) received no prophylactic anticoagulation (cohort I); 35 patients received low dose coumadin (cohort II). The incidence of deep vein thrombosis (DVT) was significantly higher in the thalidomide arm hazard ratio: 4·5; P < 0·0001). As low dose coumadin (1 mg/d) failed to decrease thrombotic complications in 35 patients (cohort II), low molecular weight heparin (LMWH, enoxaparin 40 mg s.c. q.d.) was instituted as DVT prophylaxis in the thalidomide‐treated patients (n = 68) of the subsequent cohort (n = 130, cohort III). This intervention eliminated the difference in DVT incidence between the two arms (thalidomide and no thalidomide). Within cohorts I and II, 36 patients, in whom thalidomide was discontinued after experiencing a thrombotic episode during chemotherapy, subsequently resumed the drug on full anticoagulation; with a median follow‐up of 22 months, DVT recurred in four patients (11%). After completing induction and tandem transplantation, 55 patients were re‐exposed to thalidomide and chemotherapy during consolidation treatment. Thrombotic complications were observed in 4%. Our experience, although not based on a randomized study, suggests that the excess frequency of thrombosis in patients treated with chemotherapy and thalidomide can be safely reduced by the prophylactic use of LMWH. The rate of DVT recurrence observed in our study upon thalidomide resumption was sufficiently low to allow its continuation in patients who may benefit from this therapeutic intervention.
β‐thalassaemia‐87 C→G: relationship of the Hb F modulation and polymorphisms in compound heterozygous patients
Authors: De Angioletti Maria , Lacerra Giuseppina , Pagano Leonilde , Alessi Mario , D'Avino Rossana , Manca Laura , Carestia Clementina 
Published: August 2004

SummaryA clinical, haematological, biochemical and molecular study was carried out in 17 patients affected with thalassaemia intermedia, who were compound heterozygotes for the β‐thalassaemia mutation β‐87 C→G to determine the genetic basis of their clinical heterogeneity. The β‐87 was found associated with haplotype VIII (β‐87/VIII) or V (β‐87/V). The 10 patients with the β‐87/VIII showed milder clinical conditions, with significantly higher levels of haemoglobin (Hb) (9·8 ± 1·1 g/dl vs. 8·5 ± 1·3 g/dl) and fetal haemoglobin (Hb F) (6·2 ± 1·5 g/dl vs. 2·6 ± 1·5 g/dl; P = 0·0034) and higher synthesis of Gγ (Gγ/Totalγ 69·4 ± 2·6% vs. 42·8 ± 16·2%; P = 0·0042) than the seven patients with the β‐87/V. The β‐87/VIII showed a configuration of rare polymorphisms in the 5′ sub‐haplotype, which have been reported to exert an increasing effect on Hb F. They were ‘T’−158 Gγ‐globin gene, T‐A‐G in pre‐Gγ framework, (TG)11(CG)3 in the Gγ‐IVS2, (AT)9N12(AT)10 in LCR‐HS2; in contrast, the haplotype V had, respectively, ‘C’, T‐G‐A (TG)19(CG)2CACG in the Gγ‐IVS2, and (AT)10N12(AT)11. In all patients the β‐87 was associated with the (AT)9T5 motif 5′ β‐globin gene with increased affinity for the BP‐1 protein, and with the (TG)13 in the Aγ‐IVS2. The high increase of the Hb F, mostly of the Gγ‐type, strongly suggests the hypothesis that the ‘T’−158 Gγ plays a principal role and that the other polymorphisms could exert a cooperative role in the modulation of Hb F in patients with erythropoietic stress.
Role of receptor activator of nuclear factor‐kappa B ligand (RANKL), osteoprotegerin and macrophage protein 1‐alpha (MIP‐1a) in monoclonal gammopathy of undetermined significance (MGUS)
Authors: Politou Marianna , Terpos Evangelos , Anagnostopoulos Athanasios , Szydlo Richard , Laffan Michael , Layton Mark , Apperley Jane F. , Dimopoulos Meletios‐Athanasios , Rahemtulla Amin 
Published: August 2004

SummaryThe aim of this study was to evaluate the role of markers of bone remodelling, and osteoclast activation/function in patients with monoclonal gammopathy of undetermined significance (MGUS). We have measured serum levels of soluble RANKL (sRANKL), osteoprotegerin (OPG), macrophage inflammatory protein‐1alpha (MIP‐1α), markers of bone resorption [N‐telopeptide of collagen type‐I (NTX), and tartrate‐resistant acid phosphatase isoform‐5b (TRACP‐5b)] and bone formation [bone‐alkaline phosphatase (bALP)] in 40 MGUS patients. These parameters were compared with those of 42 newly diagnosed myeloma patients, and 45 healthy, gender‐ and age‐matched controls. MGUS patients had elevated levels of NTX, sRANKL, and sRANKL/OPG ratio compared with controls (P < 0·0001). Furthermore, TRACP‐5b, MIP‐1α and NTX were decreased in patients with MGUS compared with myeloma patients (P < 0·001), while OPG and bALP were increased (P < 0·001). Serum levels of MIP‐1α, as well as TRACP‐5b, and sRANKL/OPG ratio were reduced, while bALP was increased in MGUS patients, even when compared with myeloma patients who had stage I/II disease. These results demonstrate that increased osteoclastogenesis leading to increased bone resorption is present in MGUS but seems to be compensated for by normal bone formation, which is absent in MM. Furthermore MIP‐1α, bALP, and sRANKL/OPG may be useful tools for distinguishing between cases of MGUS and early myeloma.
Clearance of coagulation factor VIII in very low‐density lipoprotein receptor knockout mice
Authors: Bovenschen Niels , van Dijk Ko Willems , Havekes Louis M. , Mertens Koen , van Vlijmen Bart J. M. 
Published: August 2004

SummaryLow‐density lipoprotein receptor‐related protein (LRP) contributes to factor VIII (FVIII) catabolism in vivo. Besides LRP, FVIII also interacts with very low‐density lipoprotein receptor (VLDLR) in vitro. We investigated the physiological role of VLDLR in FVIII catabolism, using knockout mouse models for VLDLR and LRP, alone and in combination. VLDLR−/− mice displayed normal plasma FVIII, whereas VLDLR−/− LRP− double‐knockout mice had slightly increased FVIII compared with LRP‐deficient mice. Remarkably, VLDLR deficiency slightly accelerated FVIII clearance. Adenovirus‐mediated overexpression of VLDLR did not lower plasma FVIII in LRP‐deficient mice. We conclude that VLDLR does not act in concert with LRP in FVIII clearance in vivo.
Clinical significance of neutrophil CD177 mRNA expression in Ph‐negative chronic myeloproliferative disorders
Authors: Passamonti Francesco , Pietra Daniela , Malabarba Lucia , Rumi Elisa , Porta Matteo Giovanni Della , Malcovati Luca , Bonfichi Maurizio , Pascutto Cristiana , Lazzarino Mario , Cazzola Mario 
Published: August 2004

SummaryThe PRV‐1 gene has been proposed as a marker of polycythaemia vera (PV). PRV‐1 and NB1 are alleles of the polymorphic gene CD177, which belongs to the Ly‐6/uPAR superfamily, and their coding regions differ at only four nucleotides. We studied neutrophil CD177 mRNA levels in normal subjects and in 235 patients with Ph‐negative chronic myeloproliferative disorders (CMD), including PV, essential thrombocythaemia and myelofibrosis with myeloid metaplasia. Additional disease states were investigated for comparison. Highly variable neutrophil CD177 mRNA levels were observed in normal individuals. Neutrophils isolated from the bone marrow, or from peripheral blood following granulocyte colony‐stimulating factor administration showed markedly higher CD177 expression than circulating granulocytes on steady state. Increased neutrophil CD177 mRNA levels were detected in all CMD. Elevated values were also found in reactive conditions and in disorders such as chronic myeloid leukaemia and myelodysplastic syndromes. In the differential diagnosis between PV and secondary erythrocytosis, the assay sensitivity was 68% while its specificity was 60%. These findings indicate that an elevated neutrophil CD177 mRNA level is not a specific marker for the diagnosis of PV nor for that of CMD. From a clinical viewpoint, neutrophil CD177 mRNA overexpression is rather a marker of abnormal neutrophil production and/or release in patients with CMD.
Human herpesvirus 6 antigenaemia in allogeneic stem cell transplant recipients: impact on clinical course and association with other beta‐herpesviruses
Authors: Volin Liisa , Lautenschlager Irmeli , Juvonen Eeva , Nihtinen Anne , Anttila Veli‐Jukka , Ruutu Tapani 
Published: August 2004

SummaryHuman herpesvirus 6 (HHV‐6) antigenaemia was prospectively studied in 58 adult allogeneic stem cell transplant (SCT) recipients. Altogether 42 of 58 recipients (72%) demonstrated HHV‐6 specific antigens in peripheral blood mononuclear cells after SCT, 22 of 36 (61%) when the donor was a sibling and 20 of 22 (91%) when the donor was unrelated. The cumulative incidence of HHV‐6A, HHV‐6B, HHV‐7, and cytomegalovirus antigenaemia during the first 6 months after SCT was 33%, 62%, 44% and 63% respectively. The median day of the onset of each antigenaemia was +24, +4, +59, and +46 after SCT respectively. There were no clinical findings related to HHV‐6A and HHV‐7 antigenaemias. A rash was diagnosed in 10 of 38 (26%) HHV‐6B antigenaemia positive patients during the first month after SCT compared with one of 20 (5%) HHV‐6B negative patients. Of the HHV‐6B antigenaemia cases, six of 10 rashes were treated as acute graft‐versus‐host disease (GVHD) and four of 10 were considered to be of a viral origin. Fifteen patients had acute GVHD diagnosed. Acute GVHD manifested statistically significantly (P = 0·034) earlier in the nine patients with HHV‐6B antigenaemia compared with the six patients who were HHV‐6B negative.
Suppressor of cytokine signalling‐1 gene silencing in acute myeloid leukaemia and human haematopoietic cell lines
Authors: Watanabe Dai , Ezoe Sachiko , Fujimoto Minoru , Kimura Akihiro , Saito Yoshiyuki , Nagai Hisaki , Tachibana Isao , Matsumura Itaru , Tanaka Toshio , Kanegane Hirokazu , Miyawaki Toshio , Emi Mitsuru , Kanakura Yuzuru , Kawase Ichiro , Naka Tetsuji , Kishimoto Tadamitsu 
Published: August 2004

SummaryThe aim of this study was to investigate whether the suppressor of cytokine signalling (SOCS)‐1 can act as a tumour suppressor when functioning as a negative regulator of the Janus family tyrosine kinases (JAKs), which have been reported to play important roles in leukaemogenesis. For this purpose, we carried out molecular analysis of the SOCS‐1 gene in human acute myeloid leukaemia (AML) and human haematopoietic cell lines. Sequencing alterations in the coding region were found in two of 90 primary AML samples and one of 17 cell lines. Hypermethylation of the SOCS‐1 gene was also observed in 72% of primary cases and 52% of cell lines and aberrant methylation strongly correlated with reduced expression. Transfection of SOCS‐1 into Jurkat cells harbouring the mutation and methylation suppressed cell growth at a low serum concentration. These findings indicate that SOCS‐1 is frequently silenced in haematopoietic malignancies, mainly as a result of hypermethylation, and suggest that SOCS‐1 may be able to function as a tumour suppressor.
Kinetic of regulatory CD25high and activated CD134+ (OX40) T lymphocytes during acute and chronic graft‐versus‐host disease after allogeneic bone marrow transplantation
Authors: Sanchez Joaquin , Casaño Javier , Alvarez Miguel A. , Roman‐Gomez Jose , Martin Carmen , Martinez Francisco , Gomez Pedro , Serrano Josefina , Herrera Concepcion , Torres Antonio 
Published: August 2004

SummaryGraft‐versus‐host disease (GVHD) is still a major complication after allogeneic stem cell transplantation. In murine models, freshly isolated or ex vivo expanded CD4+CD25high regulatory T cells (Treg) are able to ameliorate GVHD while maintaining graft‐versus‐leukaemia reactions. However, in the human setting, prospective studies of this population and its interaction with activated non‐regulatory CD134+ (OX40) lymphocytes during post‐transplant follow‐up are lacking. In this study, we prospectively quantified CD4+CD25high and activated CD134+ lymphocytes in 119 peripheral blood samples from 35 consecutive patients who underwent allogeneic bone marrow transplantation (BMT). Fifty‐five samples obtained less than 100 d after allogeneic BMT, were not statistically different regarding CD4+CD25high Treg or CD134+ lymphocytes compared with those obtained from patients with (n = 35) or without (n = 20) acute GVHD. Chronic GVHD was associated with a small, but not statistically significant, increase in the number of Treg (9·9 vs. 6·7 × 106/L). However, the CD134/CD25high ratio was significantly higher during chronic GVHD (cGHVD) when compared with either patients without cGVHD (67·7 ± 40·3 vs. 4·0 ± 0·9, P < 0·01) or cGVHD after treatment (67·7 ± 40·3 vs. 3·7 ± 0·8, P < 0·01). Our findings suggest that the suppressive activity of CD4+CD25high Treg could be abrogated in vivo during cGVHD by CD134 expression in a much higher number of activated donor T lymphocytes. In addition to CD4+CD25highex vivo expansion protocols, OX40 blocking might be crucial to optimize the use of Treg to prevent GVHD.
Detection of serine 473 phosphorylated Akt in acute myeloid leukaemia blasts by flow cytometry
Authors: Tazzari Pier Luigi , Cappellini Alessandra , Grafone Tiziana , Mantovani Irina , Ricci Francesca , Billi Anna Maria , Ottaviani Emanuela , Conte Roberto , Martinelli Giovanni , Martelli Alberto M. 
Published: August 2004

SummaryThe phosphoinositide 3‐kinase/Akt signalling pathway is a recently recognized important parameter in the prognosis and the response to treatment of acute myeloid leukaemia (AML). Akt kinase is activated by phosphorylation on Thr 308 and Ser 473. Active Akt promotes cell growth and survival to apoptotic insults. Thus, it seems important to evaluate Akt phosphorylation in AML blasts. This work aimed to establish whether it was possible to detect Akt phosphorylation on Ser 473 of AML blasts by means of flow cytometry. High levels of Akt activity and phosphorylation were detected in 13 of 15 cases of AML. Flow cytometric analysis revealed similar patterns of Ser 473 expression as was observed with Akt kinase activity and Western blot analysis of Thr 308 and Ser 473 phosphorylation. Double immunostaining enabled the simultaneous flow cytometric detection of an AML‐associated antigen (CD33) and Ser 473 phosphorylated Akt in leukaemic blast populations. Our results indicate that flow cytometry enabled the rapid and quantitative assessment of Ser 473 phosphorylated Akt of AML blasts that, when used in combination with cell surface staining, can provide more accurate phenotyping of AML blasts.