bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integration into higher education: key implementers' views on why nurse education moved into higher education
Authors: Burke Linda M. 
Published: May 2003

Aim. The aim of this paper is to discuss the opinions of the key individuals involved in implementing the integration of nurse education into higher education in the United Kingdom (UK) about why nurse education moved into higher education and why this happened when it did. Background. In 1995 the last of the old‐style schools of nursing in the UK was fully integrated into higher education and were detached financially, legally and organizationally from District Health Authorities. However, only 6 years before, when Working Paper 10 was produced, there were only a few nursing degree courses located within higher education. What made this move into higher education particularly noteworthy was that there was never a clear statement of intent from the government that this integration of health care education was intended. Despite the fact that this is one of the most significant changes ever to take place in nurse education, there has been relatively little empirical research about why the development occurred. Methods. A qualitative approach was selected for this study and the methods used were policy analysis and interviews. A purposeful sample of 70 implementers involved in the integration process was selected and asked for their views on this issue. Findings. Participants believed that integration had occurred because of a combination of complex factors, but there was a division between those who thought that it was centrally planned and others who felt that it was an accidental outcome of the particular events of the time. Conclusions. It is not clear whether policy was influencing action or action influencing policy. Understanding of why this change occurred is needed if health care professionals wish to have greater control over future changes in education.
Irish nursing students' changing self‐esteem and fear of negative evaluation during their preregistration programme
Authors: Begley Cecily M. , White Patricia 
Published: May 2003

Background. Studies on Irish nursing and midwifery professions have demonstrated that stress and bullying are frequent problems that may lead to depression and low self‐esteem. Self‐esteem is linked to social anxiety and is therefore related to fear of negative evaluation. It is important to study nursing students' feelings about self‐esteem and negative evaluation, and to assess whether or not both these constructs change as students progress through their preregistration education programme. Aim. This study explored nursing students' perceived levels of self‐esteem and their fear of negative evaluation prior to, and nearing the completion of, their 3‐year preregistration programme. Methods. A descriptive, quantitative, comparative survey design was used. All students in the first intake of 1995 in two general nursing schools in Southern Ireland agreed to take part (n = 72). A questionnaire developed from the Rosenberg Self‐esteem Scale and the Watson and Friend Fear of Negative Evaluation Scale was used to collect data at the start of their programme and again 2 months before completion. Results. In general, students' reported self‐esteem rose as they neared the end of their education programme and their fear of negative evaluation decreased; however, their overall self‐esteem levels at their highest were only average. Conclusions. Many of the studies examining self‐esteem have produced contradictory results. An examination of the organizational factors that contribute to self‐esteem may increase our understanding of the phenomenon. Self‐esteem is a complex, multifaceted phenomenon. While there is no single factor that can increase or decrease a person's self‐esteem, this study has explored the potential impact of the fear of negative evaluation on self‐esteem. Nursing students' self‐esteem might be increased by expansion of intrinsic job characteristics, improving their job satisfaction and providing frequent positive feedback.
Measuring nursing workload in intensive care: an observational study using closed circuit video cameras
Authors: Adomat Reneé , Hicks Carolyn 
Published: May 2003

Background. There is an increasing demand for intensive care provision in the United Kingdom (UK), partly because of a national shortage of intensive care beds. The problem is compounded by the current method for calculating the nurse: patient ratio using a Nurse Workload Patient Category scoring system or similar adaptations used in many intensive care units. This ratio is calculated by using patient category or dependency scales, which operate on the assumption that the more critically ill the patient, the more nurse time is needed to care for the patient. However, many mechanically ventilated critically ill patients (allocated a high category of care) may need less nursing care than patients who are self‐ventilating and allocated a lower level of dependence. Purpose. In this study, a video recorder was used to document nurse activity for 48 continuous shifts in two intensive care units to determine the accuracy of the Nursing Workload Patient Category scoring system in measuring nurse workload. Methods. The video data were correlated later with the Patient Category allocated to the patient by the nurse at the time. Results. The results of this observational study demonstrated that, despite complex care needs, a high percentage of nursing activities observed in each unit consisted of low skill activity. Furthermore, nurses spent less time with patients categorized as in need of intensive care than those in need of high dependency care in both units. Conclusion. The findings suggest that existing nurse:patient ratio classifications may be inappropriate, since nurses spent less time with critically ill patients. Radical reconsideration of nursing levels and skill mix might make it possible to increase intensive care provision because fewer nurses would be needed to staff each bed. The findings support alternative and more flexible systems for assessing workload and the use of different nurse:patient ratios.
Primary health care provision for adults with a learning disability
Authors: Elaine Powrie 
Published: May 2003

Background. During the last decade, primary care has been designated as the main provider of health care to people with learning disabilities. Practice nurses based in primary care teams are increasingly the first points of contact with health services. They make an important contribution to promoting good health, with health screening and illness prevention work being a significant part of their role. However, little is known about their views or involvement regarding the provision of primary care for people with learning disabilities. There is therefore a need to explore the nursing perspective, from within primary care, on the current provision of care for people with a learning disability. Research aim. To inform the learning disability service of the role of primary care in current service provision for people with learning disabilities. Research method. A survey of all practice nurses currently employed by Grampian Health Board in Aberdeen was conducted in June 2001. An initial pilot study was conducted in primary care and learning disability services. Data collection took place during June and July 2001. All practice nurses working in the geographical region of Grampian were invited to participate. Results. Communication barriers exist, preventing access to health screening and treatment for some people with learning disabilities. Independent living skills, for example dietary management and budgeting, require additional community support. These conditions pose complex problems for practice nurses and other members of the primary care team. Conclusion. This study indicates a need for closer support and partnership with the learning disability service. The factors necessary for providing health care to people with learning disabilities extend beyond the domain of primary care teams. The findings of this survey have important implications for education and support to enable carers and professionals to provide a high standard of care.
A preliminary report on a computer‐assisted dental cast analysis system used for the prosthodontic treatment
Authors: Kojima T. , Sohmura T. , Nagao M. , Wakabayashi K. , Nakamura T. , Takahashi J. 
Published: May 2003

summary To accomplish computerized 3D morphological analyses of maxillary and mandibular casts with malocclusions on the same co‐ordinate system, a new reference co‐ordinate located on soft tissue has been proposed consisting of the top of maxillary bilateral tubercles and incisive papilla on the maxillary cast. To test the validity of this co‐ordinate system, the angles of the occlusal plane in this system were examined on 10 subjects with normal occlusion. In addition, to analyse maxillary and mandibular casts on the same co‐ordinate system, a bite block was made under the intercuspal position. The maxillary cast was measured by 3D measuring system, then, the bite block was placed on maxillary casts, and measured similarly. To examine the position reproducibility of this method, 3D co‐ordinates of the apex of the buccal cusp of the mandibular pre‐molar in five bite blocks were determined. The angles formed of the occlusal plane were 1·3 ± 1·3° and 0·2 ± 1·1° on the sagittal and frontal base plane, respectively. This co‐ordinate system had enough stability to replace the occlusal plane. By the measurement of bite blocks, the co‐ordinates of the mandibular cusp tips were determined within the deviation of 0·2 mm.
Interleukin‐8 Production in Tuberculous Pleurisy: Role of Mesothelial Cells Stimulated by Cytokine Network Involving Tumour Necrosis Factor‐α and Interleukin‐1β
Authors: Park J. S. , Kim Y. S. , Jee Y. K. , Myong N. H. , Lee K. Y. 
Published: May 2003

AbstractInterleukin‐8 (IL‐8) plays an important role in the host immune response to Mycobacterium tuberculosis by recruiting inflammatory cells to the site of infection. Here, we investigated the role of pleural macrophages and mesothelial cells in the production of IL‐8 in tuberculous pleurisy. Large concentrations of IL‐8 were detected in tuberculous pleural effusions, but not in pleural effusions associated with congestive heart failure (CHF). Tuberculous pleural macrophages and M. tuberculosis‐infected CHF pleural macrophages produced large concentrations of IL‐8. When immunohistochemistry was performed on pleural tissues, antigenic IL‐8 was detected in the mesothelial cells lining the tuberculous pleura. Direct stimulation of cultured CHF pleural mesothelial cells with M. tuberculosis induced IL‐8 secretion. However, conditioned media from M. tuberculosis‐infected pleural macrophages (CoMTB) induced greater mesothelial cell IL‐8 secretion. Tumour necrosis factor‐α (TNF‐α) and IL‐1β induced mesothelial cell IL‐8 mRNA expression, and neutralizing anti‐TNF‐α antibody and IL‐1 receptor antagonist nearly completely obliterated CoMTB‐induced mesothelial cell IL‐8 mRNA expression and protein secretion. These findings demonstrate that both pleural macrophages and mesothelial cells produce IL‐8 in tuberculous pleurisy, and cytokines produced by M. tuberculosis‐infected macrophages mediate mesothelial cell IL‐8 production.
Cellular Mechanism of Thymic Involution
Authors: Li L. , Hsu H.‐C. , William G. E. , Stockard C. R. , Ho K.‐J. , Lott P. , Yang P.‐A. , Zhang H.‐G. , Mountz J. D. 
Published: May 2003

AbstractInvolution of the thymus and alterations in the development of thymocytes are the most prominent features of age‐related immune senescence. We have carried out a comparative analysis of thymocyte and stroma in rapid thymic involution DBA/2 (D2) strain of mice compared with slow involution C57BL/6 (B6) strain of mice. Analysis of mice at 15 months of age suggested an age‐related decrease in the thymocyte cell count, a block in the development of T cells and cortical involution in D2 mice compared with 3‐month‐old mice. TUNEL (terminal‐deoxynucleotidyl‐transferase‐mediated dUTP–digoxigenin nick end labelling) staining and fluorescence‐activated cell sorter (FACS) analysis showed that there was a significant increase in apoptotic cells in the cortex region of thymus in 15‐month‐old D2 mice compared with the same aged B6 mice. The thymocyte proliferation rate, as assessed by bromodeoxyuridine (BrdU) staining and [3H]‐thymidine incorporation assay, was lower in 3‐month‐old D2 mice compared with the same age B6 mice. Immunohistochemical staining showed that the arrangement of MTS (mouse thymus stromal)‐10+ epithelial cells and MTS‐16+ connective tissue staining pattern had become disorganized in 15‐month‐old D2 mice but remained intact in B6 mice of the same age. These results suggest that, in D2 mice, both the thymocytes and stromal cells exhibit age‐related defects, and that the genetic background of mice plays an important role in determining age‐related alterations in thymic involution.
Comparison of Immunoglobulin Heavy Chain Rearrangements Between Peripheral and Glandular B Cells in a Patient with Primary Sjögren's Syndrome
Authors: Hansen A. , Jacobi A. , Pruss A. , Kaufmann O. , Scholze J. , Lipsky P. E. , Dörner T. 
Published: May 2003

AbstractMyoepithelial sialadenitis (MESA) of the major salivary glands is a characteristic feature of primary Sjögren's syndrome (pSS). To delineate systemic and organ‐specific influences on B cells in a patient with pSS and benign MESA, individual B cells were simultaneously obtained from the peripheral blood and inflamed parotid gland. Immunoglobulin variable heavy chain (VH) rearrangements in single sorted CD19+ B cells were subsequently amplified, sequenced and analysed. Despite the presence of two clonal expansions using VH1‐08 and VH2‐70 segments, respectively, the majority of glandular B cells were polyclonal, resembling the VH gene usage and mutational pattern of the corresponding blood population. However, striking differences were observed in the proportion of cells expressing mutated VH rearrangements (blood, 28.9% versus parotid, 80.4%; P < 0.0001). Moreover, the glandular productive VH rearrangements differed significantly from their blood counterparts by a higher mutational frequency (P < 0.0001), shorter CDR3 lengths (P = 0.001) and a less frequent usage of JH6 (P = 0.0292), indicating an accumulation of memory B cells in the inflamed parotid. Thus, both preferential influx/homing of memory B cells and local proliferation may contribute to the pattern of benign MESA in pSS. Notably, one of the glandular clonal rearrangements (using VH1‐08) was also detected in the patient's peripheral repertoire.
The Cholera Toxin B Subunit is a Mucosal Adjuvant for Oral Tolerance Induction in Type 1 Diabetes
Authors: Bregenholt S. , Wang M. , Wolfe T. , Hughes A. , Bærentzen L. , Dyrberg T. , Von Herrath M. G. , Petersen J. S. 
Published: May 2003

AbstractWhen conjugated to various proteins, the nontoxic B‐chain of cholera toxin (CTB) significantly increases the ability of these proteins to induce immunological tolerance after oral administration. Here, we investigated if a nonconjugated form of CTB enhances the induction of immune tolerance after oral insulin administration. Induction of immunological tolerance was studied after oral administration of insulin preparations in three mouse models; an insulin/ovalbumin coimmunization model, a model of virus‐induced diabetes in transgenic RIP‐LCMV‐NP mice and in nonobese diabetic (NOD) mice serving as a model of spontaneous diabetes. In the immunization model, we demonstrate that mixing with CTB increases the tolerogenic potential of insulin, approximately 10 fold. Titration of the CTB concentration in this system revealed that an insulin : CTB ratio of 100 : 1 was optimal for the induction of bystander suppression. Further studies revealed that this insulin : CTB ratio also was optimal for the prevention of diabetes in a virus‐induced, transgenic diabetes model. In addition, the administration of this optimal insulin–CTB preparation significantly prevented the onset of diabetes in old NOD mice with established islet infiltration. The data presented here demonstrate that CTB, even in its unconjugated form, functions as a mucosal adjuvant, increasing the specific tolerogenic effect of oral insulin.
Regulator T Cells: Specific for Antigen and/or Antigen Receptors?
Authors: Rubin B. , Diaz de Durana Y. , Li N. , Sercarz E. E. 
Published: May 2003

AbstractAdaptive immune responses are regulated by many different molecular and cellular effectors. Regulator T cells are coming to their rights again, and these T cells seem to have ordinary α/β T‐cell receptors (TCRs) and to develop in the thymus. Autoimmune responses are tightly regulated by such regulatory T cells, a phenomenon which is beneficial to the host in autoimmune situations. However, the regulation of autoimmune responses to tumour cells is harmful to the host, as this regulation delays the defence against the outgrowth of neoblastic cells. In the present review, we discuss whether regulatory T cells are specific for antigen and/or for antigen receptors. Our interest in these phenomena comes from the findings that T cells produce many more TCR‐α and TCR‐β chains than are necessary for surface membrane expression of TCR‐αβ heterodimers with CD3 complexes. Excess TCR chains are degraded by the proteasomes, and TCR peptides thus become available to the assembly pathway of major histocompatibility complex class I molecules. Consequently, do T cells express two different identification markers on the cell membrane, the TCR‐αβ clonotype for recognition by B‐cell receptors and clonotypic TCR‐αβ peptides for recognition by T cells?
Quantification of Cytokine Gene Expression Using an Economical Real‐Time Polymerase Chain Reaction Method Based on SYBR® Green I
Authors: Ramos‐Payán R. , Aguilar‐Medina M. , Estrada‐Parra S. , González‐y‐Merchand J. A. , Favila‐Castillo L. , Monroy‐Ostria A. , Estrada‐Garcia I. C. E. 
Published: May 2003

AbstractAssessment of cytokine expression has become crucial to understand host responses to infections as well as autoimmunity. Several approaches including Northern blot, RNase protection assay and enzyme‐linked immunosorbent assay have been used for this purpose, but they are time consuming, labour intense, and relatively large quantity of the samples is usually required. Recently, a technique termed real‐time reverse transcriptase‐polymerase chain reaction (RT‐PCR) has been developed to determine genetic expression with great sensitivity and specificity; however, specialized instrumentation and costly reagents are usually needed. We aimed at using low‐cost reagents for real‐time PCR. This was achieved by adapting a conventional RT‐PCR protocol to the quantitative real‐time format, by the addition of the SYBR® Green I reagent. We validated the approach by assessing the cytokine gene expression of murine splenocytes upon stimulation with phorbol 12‐myristate 12‐acetate (PMA)–ionomycin. The results using this technique were compared with those obtained with the well‐established gene array method. We conclude that the use of the SYBR® Green I reagent during real‐time RT‐PCR provides a highly specific and sensitive method to quantify cytokine expression with accuracy and no post‐PCR manipulation.
Interferon‐γ Receptor‐1 Gene Polymorphism in Tuberculosis Patients from Croatia
Authors: Fraser D. A. , Bulat‐Kardum L. , Knezevic J. , Babarovic P. , Matakovic‐Mileusnic N. , Dellacasagrande J. , Matanic D. , Pavelic J. , Beg‐Zec Z. , Dembic Z. 
Published: May 2003

AbstractRecent studies have indicated that the interleukin‐12/interferon‐γ (IFN‐γ) axis is important in mycobacterial infection susceptibility. Using an intronic (CA)n polymorphic microsatellite marker within the IFN‐γ receptor‐1 (IFNGR1) gene, we have compared the allelic frequencies of this marker in hospitalized tuberculosis patients (n = 120) with that of controls (n = 87) from Rijeka, Croatia. We identified 13 (CA)n alleles in the tuberculosis patients, whereas only 10 were found in the controls. A significant difference between one allelic marker and the control group was observed (P = 0.02, 95% confidence interval 0.14–0.94), suggesting a possible protective association. In contrast, several other allelic markers showed a trend towards association with the disease. We also found a trend towards an increased frequency in homozygosity of one allelic marker in patients (11.7%) as compared with controls (4.6%). We conclude that there is no evidence for disease association of the IFNGR1 gene marker in Mendelian‐type (single‐allele) inheritance. However, our results also suggest that unidentified allelic variations in the IFNGR1 gene might elevate or decrease the risk in this ethnic population, as a part of the multigenic predisposition to tuberculosis.
Cloning, Sequencing and Expression of Immunoglobulin Variable Regions of Murine Monoclonal Antibodies Specific for the P1.7 and P1.16 PorA Protein Loops of Neisseria meningitidis
Authors: Ihle Ø. , Beckstrøm K. J. , Michaelsen T. E. 
Published: May 2003

AbstractThe P1.7 and P1.16 epitopes on the PorA protein on the outer membrane of Neisseria meningitidis can induce protective antibodies upon vaccination. Structural analysis of antibodies to these targets can give information on the immune response induced by these epitopes and can reveal any structural similarities among the antibodies. To do so, we have isolated the immunoglobulin (Ig) variable genes from four mouse hybridomas expressing antibodies against the P1.7 and P1.16 epitopes. These V genes were successfully expressed as functional chimeric (ch) mouse/human IgG1 antibodies by subcloning them into expression vectors containing the constant genes of human heavy and light chains. Sequencing the two sets of V genes against P1.16 revealed a high degree of homology, similar to that previously published for P1.7 V genes. The close homology allowed us to interchange heavy and light chains between antibodies in some instances to construct new antibodies that bind the original antigen. This study demonstrates that the immune response in mice against the meningococcal PorA protein epitopes P1.7 as well as P1.16 is limited to few and very similar germline genes, and therefore the P1.7‐ and P1.16‐specific antibodies share high degree of similarities amongst each other. These V genes were used to construct chimeric antibodies with conserved antigen‐binding activity.