bluuebunny/crossref_metadata_2025_split huggingface dataset:
The urban geography of SARS: paradoxes and dilemmas in Toronto's health care
Authors: Affonso Dyanne D. , Andrews Gavin J. , Jeffs Lianne 
Published: December 2004

Background.  Severe acute respiratory syndrome (SARS) has impacted heavily on both Canada's society and its health care system. Quite unexpectedly, hospitals and health care workers became facilitators of disease diffusion. This experience has demonstrated the need for a comprehensive disease control strategy.Aims.  The aims are threefold. First, to examine the subtle and changing spatial characteristics of SARS during the short but critical period of its rapid spread in the Greater Toronto Area. Second, to make salient three paradoxes, and their associated dilemmas, faced by nurses and other health care professionals challenged with caring for the sick and containing the rapid spread of the disease. Third, to propose some ways of approaching these dilemmas, as well as some broader preventative and mitigating strategies.Methods.  The crosscutting concepts of ‘clinical uncertainty’ and ‘flow of human contacts’ are used to explain disease transmission characteristics and urban spatial diffusion and to guide the particular strategies developed. Evidence for the paper comes from public health records, governmental and non‐governmental health statements and the initial epidemiological research on SARS. Direct insights are also gained from recent first‐hand experiences of Toronto's health care system during the crisis.Discussion.  The concepts of clinical uncertainty and the flow of human contacts provide in‐depth insights that complement the findings of large‐scale epidemiological studies, and help operationalize their general calls for enhanced control measures. The comprehensive disease control strategy proposed includes the creation of a hospital infrastructure specific to the containment of biological threats; an advisory coalition of disease control specialists; the development of a biological threat‐and‐containment simulation laboratory and three specific programmes in patient safety, risk assessment and community mobilization.Conclusion.  It is argued that containment alone, while a necessary and urgent priority, cannot be seen as an end in itself and might better be understood as one possible trajectory within a comprehensive problem‐solving strategy. The experiences in Toronto may offer insights to other cities and countries that currently lack such strategies and hence may be vulnerable to similar outbreaks of dangerous infectious diseases.
Stimulatory effect of octopamine on β3‐adrenoceptors to lower the uptake of [14C]‐deoxy‐D‐glucose into rat adipocytes in vitro
Authors: Yen S. T. , Li M. H. , Hsu C. T. , Lee T. L. , Cheng J. T. 
Published: December 2004

Summary

The effect of octopamine on β3‐adrenoceptors has been studied in isolated adipocytes of Wistar rats using uptake of [14C]‐deoxy‐D‐glucose as the indicator.
Octopamine (0.1–1 nmol 1−1) induced a concentration‐dependent decrease of [14C]‐deoxy‐D‐glucose uptake into the adipocytes and this inhibition was not influenced by halperidol at concentrations sufficient to block dopaminergic receptors.
Pindolol and propranolol reversed this inhibition of octopamine in a concentration‐dependent manner. The effect of octopamine was reduced in the presence of Rp‐cyclic AMPS triethylamine, the membrane‐permeable antagonist of cyclic AMP (cAMP), indicating the mediation of cAMP in this inhibition.
A direct effect of octopamine on β3‐adrenoceptors was proved using the application of antibodies. In the presence of an antibody for β3‐adrenoceptors, the actions of octopamine were concentration‐dependantly reduced in a manner similar to the decrease of BRL37344‐induced inhibitions.
The same degree of diminished activities for octopamine as that of BRL37344, the well‐known specific agonist of β3‐adrenoceptors, was also obtained in isoprenline‐desensitized adipocytes. Insulin‐stimulated uptake of [14C]‐deoxy‐D‐glucose into adipocytes was not modified by isoprenaline induced desensitization.
These results suggest that octopamine can activate β3‐adrenoceptors to lower the glucose uptake through an increase of cAMP in rat white adipocytes.
Differential regulation of mesenteric and femoral blood flow in the rat as revealed by computerized data acquisition and evaluation
Authors: Heinemann A. , Wachter C. H. , Holzer P. 
Published: December 2004

Summary

A set‐up for computerized acquisition and evaluation of haemodynamic data was constructed. Blood flow (BF) in the superior mesenteric and femoral artery of urethane‐anaesthetized rats was measured with the ultrasonic transit time shift technique. The signals for arteial blood pressure and BF were fed into a personal computer via an analogue‐digital converter. Mean arterial blood pressure, heart rate and vascular conductance (CV) were calculated on‐line. For subsequent analysis of the data, algorithms were programmed to filter the data, and to determine average and peak values for each parameter.
Systemic hypertension induced by phenylephrine (3–300 nmol kg−1), angiotensin II (0.1–3.0 nmol kg−1) and arginine vasopressin (0.03–1.0 nmol kg−1) was accompanied by constriction of the mesenteric artery. In contrast, the femoral artery responded to phenylephrine with constriction, to angiotensin II with dilatation and to arginine vasopressin with dilation followed by constriction. The haemodynamic effects of endothelin‐1 (0.03–3.0 nmol kg−1) were generally biphasic, the initial hypotension being associated with dilatation, and the delayed hypertension being accompanied by constriction of both the mesenteric and femoral arterial bed.
Terbutaline (3–1.0 nmol kg−1) and calcitonin gene‐related peptide (0.03–1 nmol kg−1) caused systemic hypotension along with mesenteric and femoral vasodilatation.
Telmisartan (1 mg kg−1), an angiotensin AT1 receptor antagonist, dilated the mesenteric artery, but had no effect on femoral VC. In contrast, the α1‐adrenoceptor antagonist prazosin (0.1 mg kg−1), dilated the femoral artery without altering mesenteric VC. Similarly, the β‐adrenoceptor antagonist propranolol (1 mg kg−1) had no effect on mesenteric VC, but constricted the femoral arterial bed.
These data demonstrate that the haemodynamic effects of exogenously administered drugs can widely differ between the mesenteric and femoral arterial beds of urethane‐anaesthetized rats. Furthermore, vascular tone of these two arterial beds in maintained by different vasoconstrictor systems. While the femoral artery is mainly under adrenergic control, the renin‐angiotensin axis is predominant in the mesenteric arterial bed. In addition, this study also demonstrates that computerized analysis enables quick and accurate estimation of haemodynamic drug effects, and is superior to ‘by hand’ evaluation of peak changes in the functional diameter of the vascular bed under study.
Dopamine D2‐like receptors in the kidney of spontaneously hypertensive rats: a radioligand binding assay and light microscope autoradiography study
Authors: Barili P. , Fringuelli Ch. , Baldoni E. , Mignini F. , Zaccheo D. , Amenta F. 
Published: December 2004

Summary

Dopamine D2‐like receptors were investigated in sections of kidney from male spontaneously hypertensive rats (SHRs) at 6 and 14 weeks of age using radioligand binding assay and autoradiographic techniques with [3H]‐spiperone as a ligand.
Systolic blood pressure values were slightly higher in 6‐week‐old SHRs in comparison with agematched normotensive Wistar‐Kyoto (WKY) rats and considerably higher in 14‐week‐old SHRs in comparison with the other groups investigated. Renal dopamine levels were higher in SHRs aged 6 and 14 weeks in comparison with age‐matched WKY rats. Noradrenaline concentrations were similar in 6‐week‐old SHRs and normotensive WKY rats, and increased slightly in SHRs aged 14 weeks.
The density of [3H]‐spiperone binding sites was similar in SHRs and WKY rats at 6 weeks of age, and decreased in SHRs at 14 weeks in comparison with age‐matched normotensive animals. Light microscope autoradiography revealed the accumulation of silver grains in the tunica adventitia, in the adventitia‐media border of intrarenal arteries and within cortical tubules. A few specific silver grains were also developed in the glomerular tuft. No changes in the density and pattern of silver grains were noticeable between SHRs and WKY rats at 6 weeks of age, whereas a reduction in silver grains largely affecting vascular binding sites was observed at 14 weeks of age.
Renal denervation considerably decreased the density of [3H]‐spiperone binding sites in sections of rat kidney, with an almost complete loss of vascular binding sites.
The above findings indicate the occurrence of a decrease of dopamine D2‐like receptors in the kidney of SHRs with the progress of hypertension. Dopamine D2‐like receptors which are mainly prejunctional are involved in the modulation of sympathetic neurotransmission in the kidney. The loss of these receptors in SHRs may contribute to the pathophysiology of hypertension.
In vitro excitatory actions of corticotropin‐releasing factor on rat colonic motility
Authors: Mancinelli R. , Azzena G. B. , Diana M. , Forgione A. , Fratta W. 
Published: December 2004

Summary

Corticotropin‐releasing factor (CRF) has been shown to affect gastrointestinal functions, however, a direct effect of CRF on the intestine has not been demonstrated.
To determine the direct effect of CRF and its antagonist α‐helical‐CRF9–41 (α‐h‐CRF) on the enteric nervous system, we studied the action of these substances on electrical and mechanical parameters of peristaltic activity on isolated distal colon of the rat.
The effects of CRF were evaluated in vitro on rat isolated colonic segments in which intraluminal pressure, longitudinal displacement, ejected fluid volume and extracellular electrical activity were simultaneously recorded during colonic peristaltic reflex.
The addition of CRF (10−10–10−8 M) to the bath fluid provoked a concentration‐dependent increase of both mechanical and electrical peristaltic activity. The CRF‐receptor antagonist α‐h‐CRF dose‐dependently (10−10–10−7 M) induced a decrease of the colonic mechanical and electrical activity and prevented (10−8–10−6 M) CRF (10−8 M) maximal effects.
These results indicate: (a) CRF can exert its effects on colon functions by a direct action, (b) a specific CRF‐receptor is present in the rat colon. Indeed, CRF effects are antagonized by the specific CRF antagonist α‐h‐CRF, (c) the fact the αs‐h‐CRF displays an activity on its own reveals that colonic functions are controlled by an endogenous CRF tonic activity.
Transmitter release and uptake evoked by the amphibian skin alkaloid, pumiliotoxin‐B (PTX‐B), in the electrically stimulated mouse vas deferens preparation (MVD)
Authors: Severini C. , Erspamer G. Falconieri , Erspamer V. 
Published: December 2004

Summary

Upon electrical stimulation three transmitters are known to be released from the adrenergic nerve terminals of the isolated MVD preparation: two motor transmitters (noradrenaline (NA) and ATP) acting synergistically to provoke twitch contraction, and an inhibitory transmitter, the peptide NPY.
The frog alkaloid pumiliotoxin‐B (PTX‐B) displayed two opposite effects on the electrically stimulated MVD: at low concentrations (0.1–0.3 μM) it caused twitch depression, at higher concentrations (0.5–2 μM) there was a potent twitch stimulation. Transmitters and/or receptors involved in the depressive effect could not be clearly identified, although interference with NPY is possible. On the other hand, the potent twitch stimulation caused by PTX‐B may be due to exaggerated release of the same transmitters (NA and ATP) involved in twitch stimulation produced by electrical stimulation.
Opening by PTX‐B of the Na+ channels on the membrane of the adrenergic nerve terminals causes activation of the amine pump facilitating re‐uptake of not only endogenous NA but also of exogenous catecholamines.
From plains to inselbergs: species in special habitats as indicators for climate change?
Authors: Burke Antje 
Published: December 2004

AbstractAim  This study proposes a process to select plant species that would provide suitable candidates for monitoring climate change impacts in areas where complete biological inventories are lacking.Location  Inselberg floras of nine inselberg landscapes (i.e. isolated mountains) in the arid Desert and Nama Karoo biome in Namibia were analysed to develop a selection process.Methods  Data from detailed field surveys were summarized to determine species only occurring on inselberg habitats (i.e. inselberg specialists). Detrended correspondence analysis and a step‐by‐step selection process based on species distribution patterns were used to determine species occurring on inselbergs beyond their zonal distribution ranges.Results  The systematic selection process initially identified 88 plant species. Based on field observations and published sources eliminating species (1) with a wide distribution elsewhere, (2) distribution influenced by local effects and (3) for which their status of knowledge of distribution was clearly inadequate, this list was further reduced to 25 species. This included southern species occurring on inselbergs likely beyond their zonal distribution, such as Adenolobus garipensis, Aloe dichotoma and Euphorbia gummifera, as well as savanna and escarpment species at their western zonal distribution edge (e.g. Cordia sinensis, Commiphora glaucescens and Moringa ovalifolia).Main conclusions  The step‐by‐step selection process proposed in this study to assist with the selection of indicators for climate change provides an objective tool in areas where biodiversity coverage is not adequate and little is known about physiology, growth and reproductive patterns of individual species. As such it introduces a method for preliminary screening of species, but will require further input based on field observations and expert knowledge.
Spatial congruence of ecological transition at the regional scale in South Africa
Authors: Van Rensburg Berndt J. , Koleff Patricia , Gaston Kevin J. , Chown Steven L. 
Published: December 2004

AbstractAim To determine whether patterns of avian species turnover reflect either biome or climate transitions at a regional scale, and whether anthropogenic landscape transformation affects those patterns.LocationSouth Africa and Lesotho.Methods Biome and land transformation data were used to identify sets of transition areas, and avian species occurrence data were used to measure species turnover rates (β‐diversity). Spatial congruence between areas of biome transition, areas of high vegetation heterogeneity, high climatic heterogeneity, and highβ‐diversity was assessed using random draw techniques. Spatial overlap in anthropogenically transformed areas, areas of high climatic heterogeneity and highβ‐diversity areas was also assessed.Results Biome transition areas had greater vegetation heterogeneity, climatic heterogeneity, andβ‐diversity than expected by chance. For the land transformation transition areas, this was only true for land transformation heterogeneity values and for one of theβ‐diversity measures. Avian presence/absence data clearly separated the biome types but not the land transformation types.Main conclusions Biome edges have elevated climatic and vegetation heterogeneity. More importantly, elevatedβ‐diversity in the avifauna is clearly reflected in the heterogeneous biome transition areas. Thus, there is spatial congruence in biome transition areas (identified on vegetation and climatic grounds) and avian turnover patterns. However, there is no congruence between avian turnover and land transformation transition areas. This suggests that biogeographical patterns can be recovered using modern data despite landscape transformation.
‘Rage against the machine?’: nurses’ and midwives’ experiences of using Computerized Patient Information Systems for clinical information
Authors: Darbyshire Philip 
Published: December 2004

Background.  Computerized Patient Information Systems (CPIS) are used increasingly in health care, yet few studies have asked clinicians to describe their experiences of using these systems and what they mean to their practice and patient care.Aims and objectives.  The aim of this study was to explore clinical nurses’ and midwives’ perceptions and understandings of computerized information systems in everyday practice. The objective was to provide a detailed and faithful account of clinicians’ experiences of using such systems.Design.  A qualitative design was used, based upon interpretive phenomenology.Methods.  A total of 13 focus groups involving 53 practitioners was conducted in hospitals across five Australian states with nurses and midwives from a wide range of practice settings. The participants ranged from Level 1 RNs to Clinical Nurse Consultants and nurses with an IT project management role.Results.  This study focuses specifically on clinicians’ experiences of using CPIS to manage clinical information. Clinicians’ experiences were characterized by digital disappointment rather than electronic efficiencies. Clinicians reported generally that computerization had neither enhanced their clinical practice nor patient care, nor had it improved patient outcomes.Conclusions.  Participants’ experiences were predominantly negative and mostly critical of CPIS and their: perceived inability to capture ‘real nursing’, difficulty in use, incompatibilities, non‐responsiveness and irrelevance to patient care and meaningful clinical outcomes.Relevance to clinical practice.  Technological ‘solutions’ to health care problems are endlessly seductive and easily entrance policy and decision makers. Computerization will continue to impact upon clinical practice and cannot be wished away. Today's computerized systems may have been developed with scant regard for clinician end‐users. A crucial issue facing everyone in health informatics is how point‐of‐care systems can be developed in ways that involve clinicians meaningfully and which recognize and respond to the complexity and subtlety of the world of nursing and midwifery practice.
Spirituality: the emperor's new clothes?
Authors: Bash Anthony 
Published: December 2004

Background.  This paper explores the concept of ‘spirituality’ with reference to the Patients’ Charter that stipulates that a person's religious, spiritual and cultural needs should be respected at all times.Aims and objectives.  The aim is to offer a critical analysis of what the word ‘spirituality’ may mean when used in the Patients’ Charter and to explore the implications of this for clinical practice.Design.  A critical discussion based on a literature review, examining in particular methodological presuppositions.Methods.  The meaning of ‘spirituality’ in the Judaeo–Christian biblical traditions is explored. Some of the heuristic assumptions in contemporary research on ‘spirituality’ are examined. Philosophical (i.e. non‐scientific) and scientific questions to do with ‘spirituality’ are disentangled.Results and conclusions.  The paper concludes that: (i) ‘Spirituality’ is an elastic term not capable of universal definition as each person's spirituality is an individual matter for them and (ii) tools that are being developed for identifying a person's spirituality run the risk of making wrong presuppositions about what comprises spirituality.Relevance to clinical practice.  It is unlikely that tools can be developed that are widely applicable for identifying and assessing spirituality.
Violence in the care of adult persons with intellectual disabilities
Authors: Strand MarieLouise , Benzein Eva , Saveman Britt‐Inger 
Published: December 2004

Background. Violence, for example physical, psychological, financial and sexual abuse and neglect, exists and is an under‐reported problem in caring situations involving adult persons with intellectual disabilities and their caregivers, where both parties can be seen as victims and perpetrators.Aims and objectives. To investigate violent situations involving Swedish adult persons with intellectual disabilities and their caregivers in group‐dwellings.Design. A total population‐based survey.Methods. A questionnaire, including violence towards adults with intellectual disabilities and violence towards staff members during 1 year, was sent to all staff members (n = 164) from 17 care settings for adults with intellectual disabilities with a response rate of 74%.Results. Thirty‐five per cent of 122 respondents admitted they had been implicated in or witnessed a violent incident towards an adult person with intellectual disabilities and 14% of the staff members admitted they themselves had been the perpetrators. Sixty‐one per cent of the staff members described various situations when they were exposed to violence from an adult person with intellectual disabilities. Physical violence was most frequently reported. Most of the aggression occurred in helping situations when persons with intellectual disabilities did not co‐operate or when both actors reacted with violence. The violent situations led the staff members to feel powerless and inadequate. In order to cope they discussed with each other or with the manager.Conclusions. Violence seems to be accepted as a natural part of the daily care for adult persons with intellectual disabilities. Most of the violence is physical and psychological and occurs in close helping situations.Relevance to clinical practice. Supportive interventions, i.e. supervision for the staff members and training of communication skills individually or in group for the adults with intellectual disabilities.
Chronic renal failure: assessing the Fatigue Severity Scale for use among caregivers
Authors: Schneider Robert A. 
Published: December 2004

Background.  Quality of life for caregivers of end‐stage renal disease patients has not been well addressed yet the physical and psychological status of this overlooked group can be important in the recovery or adaptation of patients with chronic renal failure, not to mention the caregivers themselves. One particular feature of the overall quality of life of such caregivers is that of fatigue.Aims and objectives.  The purpose of the study was to test the Fatigue Severity Scale for potential usefulness in assessing fatigue among a non‐medical population, caregivers of end‐stage renal disease patients.Methods.  Subjects completed a short battery of measures at either a dialysis centre or at home.Results.  The Short Form‐12 of the Short Form‐36 and the Center for Epidemiologic Studies Depression Scale accounted for 56% of the variance on the Fatigue Severity Scale. The results suggest that physical fatigue may be more prominent than mental fatigue as a feature of caregiver quality of life.Conclusions.  The Fatigue Severity Scale which has been used for multiple sclerosis patients may prove to be useful as a short assessment of fatigue among the non‐medical population of end‐stage renal disease caregivers. This may result in improved interventions for the population of caregivers.Relevance to clinical practice.  Physicians, nurses and allied health professionals will be called on more frequently to assess and intervene with fatigued and overburdened caregivers in addition to patients themselves. A more thorough understanding of the nature of caregiver fatigue may drive changes or innovations with caregivers who are too often overlooked in the current era of scarce resources. Accordingly results of the study suggest that the direction in intervention may focus more on rest and respite as opposed to a need for psychosocial support or counselling. While there are various modes for assessing end‐stage renal disease caregivers’ fatigue, a simple measure like the Fatigue Severity Scale is brief enough to be administered without undue demand on practitioners or caregivers.