bluuebunny/crossref_metadata_2025_split huggingface dataset:
What Works for us – Boys' Views of Their Experiences in a Former List D School
Authors: Smith Mark , McKay Euan , Chakrabarti Mono 
Published: May 2004

This article reports boys' experiences of life in a former residential school. The authors are all based at the University of Strathclyde in Glasgow. Mark Smith, who was a practitioner and manager in child and youth care settings in Scotland for many years, is currently course director of the MSc in Advanced Residential Child Care. Euan McKay is a research fellow in the Quality in Education Centre and has research interests in school self‐evaluation, parental involvement and provision for ‘looked after’ children. Mono Chakrabarti, who has published across a range of areas, including residential child care, is emeritus professor of social work. Their article reveals some fascinating and unusual perspectives.Residential schools from the approved, or, in Scotland, List D tradition, have rarely been seen as a placement of choice by the social work profession within which they have been located over the past 30 years. Despite this, there is some evidence to suggest that the experience of such provision can be a positive one for the children and young people who attend the schools. Drawing upon a wider evaluation of a residential education and care establishment which has recently extended the range of services it offers, this article considers pupils' views of their placement experiences. Their identification of what they consider to be important to life in the centre yields some surprising insights. Mark Smith, Euan McKay and Mono Chakrabarti use the pupils' comments about structure and routine, relationships with adults, school activities and family contact to generate a provocative commentary on the provision of residential care and education services.
Conducting Evaluation and Research with and for ‘Disaffected’ Students: Practical and Methodological Issues
Authors: Wellington Jerry , Cole Pam 
Published: May 2004

In the late 1990s, the Department for Education and Employment in England set out to motivate and engage teenage students who were said to be ‘disaffected’ with the traditional school curriculum. Jerry Wellington, Professor of Education at the University of Sheffield, and Pam Cole, research fellow in the University of Sheffield School of Education, were asked to evaluate one of the 21 projects that were set up across the country. The pupils involved were partially disapplied from the National Curriculum in order to follow a work‐related scheme set up by two schools, a Chamber of Commerce and a local Learning and Skills Council.In this article, Jerry Wellington and Pam Cole explore some of the difficulties that accompany evaluation, and particularly a review of the impact of interventions involving so‐called ‘disaffected’ pupils. They describe some of the practical and methodological difficulties faced in such an evaluation, as well as highlighting the positive aspects of the task. They reflect on a range of unforeseen and unpredictable dilemmas that faced them in this work, and note some of the interesting significant strengths that developed from the project. At the end of their article, Jerry Wellington and Pam Cole summarise what they have learned from the evolving methodology of this evaluation and present a case for increased levels of collaboration, between practitioners and researchers and between professionals and pupils, in future projects of this kind.
Treatment of isolated central nervous system relapse in high‐risk lymphoid malignancy with allogeneic bone marrow transplantation and extended intrathecal therapy
Authors: Nagatoshi Yoshihisa , Kawano Yoshifumi , Nagayama Jun , Okamura Jun 
Published: June 2004

SummaryWe performed allogeneic bone marrow transplantation (BMT) with an extended period of post‐transplant intrathecal (IT) chemotherapy for five patients with acute lymphoblastic leukaemia and non‐Hodgkin's lymphoma who had relapsed in the central nervous system either in the very early phase or more than twice. Post‐transplant IT was scheduled for a total of 12 doses over 18 months. One patient was found to have subclinical leucoencephalopathy. Disease relapse occurred in one patient and the other patients remained in complete remission for 39–196 months post‐BMT. The estimated event‐free survival was 80 ± 17·9% (standard error).
Haematopoetic stem cell transplantation for refractory autoimmune cytopenia
Authors: Passweg J. R. , Rabusin M. , Musso M. , Beguin Y. , Cesaro S. , Ehninger G. , Espigado I. , Iriondo A. , Jost L. , Koza V. , Lenhoff S. , Lisukov I. , Locatelli F. , Marmont A. , Philippe P. , Pilatrino C. , Quartier P. , Stary J. , Veys P. , Vormoor J. , Wahlin A. , Zintl F. , Bocelli‐Tyndall C. , Tyndall A. , Gratwohl A. ,   Autoimmune Disease Working Party of the EBMT
Published: June 2004

SummaryThis study describes the outcome of patients receiving haematopoietic stem cell transplantation (HSCT) to treat severe refractory autoimmune cytopenia. The registry of the European Group of Blood and Marrow Transplantation holds data on 36 patients receiving 38 transplants, the first transplant was autologous for 27 and allogeneic for nine patients. Patients had autoimmune haemolytic anaemia (autologous: 5; allogeneic: 2), Evans's syndrome (autologous: 2; allogeneic: 5); immune thrombocytopenia (autologous: 12), pure red cell aplasia (autologous: 4; allogeneic: 1), pure white cell aplasia (autologous: 1; allogeneic 1), or thrombotic thrombocytopenic purpura (autologous: 3). Patients had longstanding disease having failed multiple prior treatments. Among 26 evaluable patients mobilized for autologous HSCT, three died of treatment‐related causes, one died of disease progression, seven were non‐responders, six patients had transient responses and nine had continuous partial or complete remission. Of the seven evaluable patients receiving allogeneic HSCT, one died of treatment‐related complications, one with transient response died of progressive disease and five had a continuous response. Autologous and allogeneic HSCT may induce a response in a subset of patients with autoimmune cytopenia of long duration albeit at the price of considerable toxicity.
Platelet degranulation and monocyte–platelet complex formation are increased in the acute and convalescent phases after ischaemic stroke or transient ischaemic attack
Authors: McCabe Dominick J. H. , Harrison Paul , Mackie Ian J. , Sidhu Paul S. , Purdy Gordon , Lawrie Andrew S. , Watt Hilary , Brown Martin M. , Machin Samuel J. 
Published: June 2004

SummaryFlow cytometric studies suggest that platelets are activated in ischaemic stroke or transient ischaemic attack (TIA). However, few studies have measured circulating leucocyte–platelet complexes in this patient population. Whole blood flow cytometry was used to quantify the expression of CD62P‐, CD63‐, and PAC1‐binding, and the percentages of leucocyte–platelet complexes in acute (1–27 d, n = 79) and convalescent (79–725 d, n = 70) ischaemic cerebrovascular disease (CVD) patients compared with controls without CVD (n = 27). We performed a full blood count, and measured plasma levels of soluble P‐selectin, soluble E‐selectin, and von Willebrand factor antigen (VWF:Ag) as additional markers of platelet and/or endothelial cell activation. The median percentage CD62P expression and the median percentage monocyte–platelet complexes were higher in both acute and convalescent CVD patients than controls (P ≤ 0·02). The mean white cell count and mean VWF:Ag levels were significantly elevated in the acute and convalescent phases after ischaemic stroke or TIA (P ≤ 0·02). Otherwise, there was no significant increase in any other marker of platelet or endothelial activation in CVD patients. There was a positive correlation between the percentage expression of CD62P and the percentages of both neutrophil–platelet and monocyte–platelet complexes in the acute phase, and the percentages of all leucocyte–platelet complexes in the convalescent phase after ischaemic CVD. This study provides evidence for ongoing excessive platelet and/or endothelial activation in ischaemic CVD patients despite treatment with antithrombotic therapy.
Nursing care at night: an evaluation using the Night Nursing Care Instrument
Authors: Oléni Magnus , Johansson Peter , Fridlund Bengt 
Published: May 2004

Introduction.  Night nurses carry overall nursing responsibility for approximately half the time that patients spend in hospital. However, there is a paucity of literature that focuses on nursing care provided at night.Aim.  The aim of this study was to evaluate nursing care provided at night from the perspective of both nurses and patients.Methods.  The study, which had an evaluative and a comparative design, was carried out using the Night Nursing Care Instrument at a hospital in southern Sweden. Nurses (n = 178) on night duty were consecutively selected, while the patients (n = 356) were selected by convenience sampling.Results.  The results showed a statistically significant difference between nurses’ assessments and patients’ perceptions of the nursing care provided at night in nursing interventions (P < 0·0001). In the areas of medical interventions and evaluation, no statistically significant differences were found between nurses and patients. For eight of 11 items, patients reported that they were satisfied (≥80%) with the nursing care provided at night.Conclusions.  These findings suggest that night nurses need to improve their ability to assess patients’ needs for nursing care at night. A first step in this direction is for them to become aware of how patients perceive night nursing. As a second step, nurses need to increase their knowledge of which nursing actions promote patients’ rest at night.
Midlife experiences of Thai women
Authors: Arpanantikul Manee 
Published: May 2004

Background.  Midlife is not a universal notion because the conception of midlife arises from specific historical and social conditions. This can be a challenging time for women; however, the study of Thai women in the middle years has received relatively little attention.Aim.  This paper reports a study exploring the meaning of midlife to Thai women currently residing in Bangkok.Method.  The integration of Heideggerian phenomenology and feminist theory guided data collection. Experiential understanding of midlife phenomena was obtained through interviewing 32 Thai women with diverse educational and socioeconomic backgrounds. Each description was analysed to identify themes pertinent to the individual midlife experience. Emergent themes were extracted from the similarities and differences across descriptions to depict the broad points of view of women's midlife experiences.Findings.  Five collective themes were identified: being stereotyped, transforming, being vulnerable to poor health, adapting, and thinking ahead.Conclusion.  The findings reflected the fact that these women's midlife experiences were the product of the interrelationship of biological, psychological, and sociocultural factors. Awareness of these interrelationships in mind could enrich understanding of midlife experience in women, guide family members and friends in supporting midlife women, including helping to uphold their dignity, and raise the consciousness of health planners and health care professionals for developing effective programmes and interventions to promote wellness for Thai midlife women. The findings could help nurses to build their practice on a significant philosophical foundation and increase their sensitivity with regard to holistic care for midlife women.
Groningen Orthopaedic Social Support Scale: validity and reliability
Authors: Van Den Akker‐Scheek Inge , Stevens Martin , Spriensma Alette , Van Horn Jim R. 
Published: May 2004

Background.  Social support is an important factor in the rehabilitation process, as it has a positive influence on patients’ health, functioning and recovery. In particular, perceived social support and instrumental support are important after total hip or knee arthroplasty. However, nursing staff often appear to estimate the amount of support available to patients by number of visitors. Until now, no suitable Dutch‐language scale was available to measure social support in orthopaedic patients.Aim.  The aim of this paper is to describe the development and initial validity and reliability testing of the Groningen Orthopaedic Social Support Scale, a self‐report questionnaire to measure social support in patients after total hip or knee arthroplasty.Methods.  A total of 119 people who had had arthroplasty completed the Groningen Orthopaedic Social Support Scale and a control scale. The reliability and validity of the questionnaire were analysed.Results.  Reliability of the Groningen Orthopaedic Social Support Scale can be considered satisfactory, with a Cronbach's alpha of 0·89. Analysis of construct validity by means of factor analysis yielded two factors: perceived social support and instrumental support. A Pearson's correlation between these subscales was moderate (r = 0·61 and statistically significant). Concurrent validity can be considered satisfactory, with a Pearson correlation of 0·72 (P < 0·001) between the Groningen Orthopaedic Social Support Scale and the control list.Conclusions.  The Groningen Orthopaedic Social Support Scale can be considered suitable for measuring social support. It can be used to help nursing staff determine if a patient's need for social support is fulfilled, and to advise family and friends on the basis of the results. The questionnaire can also be used to establish the role of social support as a factor in supportive interventions during and after hospital stay.
What counts as evidence in evidence‐based practice?
Authors: Rycroft‐Malone Jo , Seers Kate , Titchen Angie , Harvey Gill , Kitson Alison , McCormack Brendan 
Published: May 2004

Background.  Considerable financial and philosophical effort has been expended on the evidence‐based practice agenda. Whilst few would disagree with the notion of delivering care based on information about what works, there remain significant challenges about what evidence is, and thus how practitioners use it in decision‐making in the reality of clinical practice.Aim.  This paper continues the debate about the nature of evidence and argues for the use of a broader evidence base in the implementation of patient‐centred care.Discussion.  Against a background of financial constraints, risk reduction, increased managerialism research evidence, and more specifically research about effectiveness, have assumed pre‐eminence. However, the practice of effective nursing, which is mediated through the contact and relationship between individual practitioner and patient, can only be achieved by using several sources of evidence. This paper outlines the potential contribution of four types of evidence in the delivery of care, namely research, clinical experience, patient experience and information from the local context. Fundamentally, drawing on these four sources of evidence will require the bringing together of two approaches to care: the external, scientific and the internal, intuitive.Conclusion.  Having described the characteristics of a broader evidence base for practice, the challenge remains to ensure that each is as robust as possible, and that they are melded coherently and sensibly in the real time of practice. Some of the ideas presented in this paper challenge more traditional approaches to evidence‐based practice. The delivery of effective, evidence‐based patient‐centred care will only be realized when a broader definition of what counts as evidence is embraced.
Competition for attachment of aquaculture candidate probiotic and pathogenic bacteria on fish intestinal mucus
Authors: Vine N G , Leukes W D , Kaiser H , Daya S , Baxter J , Hecht T 
Published: May 2004

AbstractProbiotics for aquaculture are generally only selected by their ability to produce antimicrobial metabolites; however, attachment to intestinal mucus is important in order to remain within the gut of its host. Five candidate probiotics (AP1–AP5), isolated from the clownfish, Amphiprion percula (Lacepéde), were examined for their ability to attach to fish intestinal mucus and compete with two pathogens, Aeromonas hydrophila and Vibrio alginolyticus. Two different radioactive isotopes were used to quantify competition between pathogens and probionts. Attachment of the pathogens was enhanced by the presence of the candidate probiotics. However, the addition of the candidate probiotics after the pathogens resulted in reduced pathogen attachment. Only AP5 caused lower attachment success of V. alginolyticus when added before the pathogen. When AP5 was added first, the average attachment change was 41% compared with 72% when added after V. alginolyticus, suggesting that the probiotic is displaced but that enhanced attachment of the pathogen does not occur. Conversely, when V. alginolyticus was added first, followed by AP5, attachment change was 37% while AP5 had 92% attachment change when added second. This implies that the pathogen was displaced by the candidate probiotic and therefore it appeared that, based on the ability of probiont AP5 to attach to mucus, the growth of the pathogen in the digestive tract might be suppressed by the candidate probiont's presence.
The effect of metformin on blood pressure, plasma cholesterol and triglycerides in type 2 diabetes mellitus: a systematic review
Authors: Wulffelé M. G. , Kooy A. , de Zeeuw D. , Stehouwer C. D. A. , Gansevoort R. T. 
Published: June 2004

Abstract.Background.  The UKPDS 34 showed that intensive treatment with metformin significantly reduces macrovascular end‐points and mortality in individuals with newly diagnosed type 2 diabetes compared with intensive treatment with insulin or sulphonylurea derivatives, despite similar glycaemic control. How this should be explained is as yet unclear. We hypothesized that metformin may have a glucose‐lowering independent effect on blood pressure and lipid profile. In order to test this hypothesis we systematically reviewed the literature and pooled the data obtained in a meta‐analysis.Methods.  Included were randomized‐controlled trials in patients with type 2 diabetes mellitus and metformin treatment lasting at least 6 weeks. To identify all eligible trials we conducted electronic searches using the bibliographic databases Medline and Embase, contacted the manufacturer and checked obtained publications for cross‐references.Results.  Forty‐one studies (3074 patients) provided data on blood pressure and/or lipid profile. When compared with control treatment, metformin associated effects on systolic and diastolic blood pressure and HDL cholesterol were small and statistically not significant [−1.09 mmHg 95% confidence interval (−3.01–0.82), P = 0.30; −0.97 (−2.15–0.21) mmHg, P = 0.11 and +0.01 (−0.02–0.03) mmol L−1, P = 0.50, respectively]. Compared with control treatment, however, metformin decreased plasma triglycerides, total cholesterol and LDL cholesterol significantly [−0.13 (−0.21–−0.04) mmol L−1, P = 0.003; −0.26 (−0.34–−0.18) mmol L−1, P < 0.0001 and −0.22 (−0.31–−0.13) mmol L−1, P < 0.00001, respectively]. We found no indications for publication bias. Of note, glycaemic control as assessed by HbA1c was better with metformin than with control treatment [−0.74 (−0.84–−0.65) percentage point; P < 0.00001]. When studies were subdivided into tertiles according to increasing difference in glycaemic control between metformin and control treatment, it appeared that in case of near similar glycaemic control metformin had no effect versus control treatment on triglycerides, whereas still there was a significant effect on total and LDL cholesterol.Conclusions.  This meta‐analysis of randomized‐controlled clinical trials suggests that metformin has no intrinsic effect on blood pressure, HDL cholesterol and triglycerides in patients with type 2 diabetes. This drug, however, independent of its effect on glycaemia, reduces total and LDL cholesterol significantly, but the reductions in these variables are relatively small.
Lipoprotein lipase gene variants and progression of nephropathy in hypercholesterolaemic patients with type 2 diabetes
Authors: Solini A. , Passaro A. , Fioretto P. , Nannipieri M. , Ferrannini E. 
Published: June 2004

Abstract.Objective.  Recent prospective studies have identified hyperlipidaemia as an independent determinant of diabetic nephropathy. Lipoprotein lipase (LPL) is a key enzyme in the postprandial processing of triglycerides and VLDL. Among a number of common sequence variants of the LPL, HindIII has been associated with coronary heart disease and, more recently, with microalbuminuria in type 2 diabetes. We evaluated the progression of renal disease in hypercholesterolaemic type 2 diabetic patients in relation to this polymorphism.Design and subjects.  We followed up for 4 years 65 consecutively enrolled microalbuminuric patients with type 2 diabetes; of whom 28 had hypercholesterolaemia (6.62 ± 0.9 mmol L−1, group A) and 37 were normocholesterolaemic (4.68 ± 0.5 mmol L−1, group B).Main outcome measures.  After performing the genetic analyses, albumin excretion rate (AER) and estimated glomerular filtration rate (GFR), calculated by the simplified equation of the MDRD Study Group, were repeated every year.Results.  In group A, AER increased more (∂AER: 11 [38] vs. 4 [18] μg min−1 per year in group B, P < 0.0001) while GFR declined faster (−3.5 ± 2.1 vs. −2.0 ± 1.4 mL min−1 per year, P < 0.02). Patients homozygous for the allele + of HindIII showed a significantly faster decline of GFR and a higher increase of AER (both P = 0.0001) even after adjustment for cholesterol levels and anthropometric variables.Conclusions.  In hypercholesterolaemic type 2 diabetic patients with microalbuminuria, the renal disease has an accelerated course, particularly in those carrying the H+/H+ genotype of the HindIII polymorphism at the LPL locus.
The incidence and survival of acute de novo leukaemias in Estonia and in a well‐defined region of western Sweden during 1982–1996: a survey of patients aged ≥65 years
Authors: Luik E. , Palk K. , Everaus H. , Varik M. , Aareleid T. , Wennström L. , Juntikka E.‐L. , Safai‐Kutti S. , Stockelberg D. , Holmberg E. , Kutti J. 
Published: June 2004

Abstract.Objectives.  To compare the incidence and survival of acute de novo leukaemias with particular reference to political/socio‐economic and environmental factors in two neighbouring countries over the three 5‐year periods (1982–1996).Patients.  The present report covers only patients diagnosed when aged ≥65 years.Setting.  A well‐defined area of Sweden, the so‐called Western Swedish Health Care Region and Estonia. Population‐wise, the western Swedish Region and Estonia are very similar; area‐wise they are also well comparable.Results.  The number of acute de novo leukaemias was quite dissimilar in the two countries (Estonia, n = 137, Sweden, n = 354). The age standardized incidence rates regarding the total number of acute de novo leukaemias was 5.31 per 100 000 inhabitants/year for Estonia and 7.99 for Sweden, this difference being statistically significant. However, the difference was merely attributable to incidence rates as regards acute myeloblastic leukaemias (AML); on the contrary, differences as regards acute lymphoblastic leukaemias (ALL) and non‐classifiable, undifferentiated or biphenotypic acute leukaemias (uAL) were negligible. The relative survival for the total material of patients was significantly higher for Swedish when compared with Estonian patients (P < 0.001). Thus, the relative survival for the total material of patients aged ≥65 years in Estonia at 1 year was 8.5% and at 3 years 3.5% respectively. The corresponding figures for the Swedish patients were considerably higher, 22.7 and 7.7% respectively. This difference, however, applied only for patients with AML (P < 0.001), whereas the results for patients with ALL and uAL were equally dismal.Conclusion.  The results clearly reflect how political and socio‐economic factors may influence the survival of acute leukemia patients in two neighbouring countries.