bluuebunny/crossref_metadata_2025_split huggingface dataset:
Skin as cover: the discursive effects of 'covering' metaphors on wound care practices
Authors: Rudge Trudy 
Published: March 2003

Skin as cover: the discursive effects of 'covering' metaphors on wound care practicesThis paper outlines a Foucauldian analysis of interactions between nurses and patients during wound care procedures in a burns unit. It explores the use of Kristeva's psychoanalytic concepts of abjection and the abject body to illuminate the emotional affects of wounds on nurse and patient. In this process, I identify how cultural metaphoric understandings about skin influence and organise the care of burns patients. Such analysis suggests the import of the complete skin, the medical scientific control over the definition of this work, and the emotional forces that resist such control.
Feeling old: being in a phase of transition in later life
Authors: Nilsson Margareta , Sarvimäki Anneli , Ekman Sirkka‐Liisa 
Published: March 2003

Feeling old: being in a phase of transition in later life The aim of the study was to illuminate very old persons’ experiences of feeling old in order to get a nuanced understanding of the ageing process in later life. Fifteen persons 85–96 years of age, living in their own homes, were interviewed in‐depth. Data were analysed utilising a phenomenological‐hermeneutic approach. Eight persons reported that they felt old. The experience of feeling old entailed four characteristics: being able to date the beginning of feeling old, fear of helplessness and of being unable to manage one’s life situation, not recognising one’s former self, and feeling different from others. These characteristics corresponded to the main properties of a transition process. The comprehensive understanding was that the very old persons who also felt old were in a phase of transition. The distinguishing qualities of those that felt old were also found to be in line with the dystonic dominance in the ninth stage designated by Joan Erikson of the previously described life cycle. Knowledge about transition processes and sensitivity to very old people’s experiences of feeling old are of great importance to nursing in order to provide adequate health care services and prevent unhealthy transitions.
The impact of managed care on nurses’ workplace learning and teaching*
Authors: White Jerry P. , Armstrong Hugh , Armstrong Pat , Bourgeault Ivy , Choiniere Jacqueline , Mykhalovskiy Eric 
Published: March 2003

The impact of managed care on nurses’ workplace learning and teaching This paper examines the impact of managed care on the informal learning process for nurses in a major US‐based health organisation. Through the analysis of focus group data we report the nurses’ view of the effect recent changes have had on the nurse/patient/care relationship. Managed care, our research indicates, has transformed the learning milieus for nurses with two effects. First, nurses have seen their need for informal learning increase while the time and context for that learning has diminished. Second, the process of teaching patients and families has also been adversely affected even as managed care creates the need for more patient education. We report the analysis of the data collected at group interviews involving nurses working in both hospital and community settings of a leading US‐based HMO. All interviews took place during September of 1997 at various sites in California. This study is part of a larger Social Science Research Council of Canada funded investigation into managed care in the US and Canada.
Silence in court: the devaluation of the stories of nurses in the narratives of health law
Authors: Chiarella Mary 
Published: March 2003

Silence in court: the devaluation of the stories of nurses in the narratives of health lawThis paper sets out to address one of the major findings from an extensive analysis of case law involving nurses from 1904 to 1999. The 180 cases were collected from the civil, coronial, professional and industrial jurisdictions of Australia, Canada and the UK. It specifically examines the way in which nurses’ voices and experiences are excluded from legislation and case law, and the resultant effect which this has on the status of the nurse in clinical and healthcare decision‐making. It addresses two of the many issues which emerged from the research, but which are particularly problematic for nurses. The first is that doctors are not necessarily required to heed the clinical concerns of nurses, and the second is that nurses are not necessarily expected to intervene to prevent imminent harm to the patient. This paper also suggests some possible solutions to these issues.
Precedents of perceived social support: Personality and early life experiences
Authors: Kitamura Toshinori , Kijima Nobuhiko , Watanabe Kyoko , Takezaki Yoshie 
Published: March 2003

AbstractIn order to examine the effects of personality and early life experiences on perceived social support, a total of 97 young Japanese women were investigated. Current interpersonal relationships were measured by an interview modified from Henderson et al.’s Interview Schedule for Social Interaction (ISSI). Personality was measured by Cloninger et al.’s Temperament and Character Inventory. Early life experiences at home and outside of home were also identified in the interview. The number of sources of perceived support was correlated with self‐directness, while satisfaction with perceived support was correlated with novelty seeking and with low harm avoidance. No early life experiences — early loss of a parent, perceived parenting, childhood abuse experiences, experiences of being bullied and/or other life events — showed significant correlations with the number or satisfaction of supportive people. The quantity and quality of perception of social support differ in their link to personality, and perceived social support may, to some extent, be explainable in terms of personality.
Autonomic function in the early stage of panic disorder: Power spectral analysis of heart rate variability
Authors: Ito Takashi , Inoue Yuichi , Sugihara Tokurou , Yamada Harumi , Katayama Seiji , Kawahara Ryuzo 
Published: March 2003

AbstractPrevious studies of autonomic nervous system (ANS) function in panic disorder (PD) patients have yielded conflicting results. We speculate that these differences might result from the variety of clinical stages of PD. In order to investigate this, we compared ANS activity in untreated patients in the early stage of PD with control subjects using power spectral analysis of electrocardiogram R‐R intervals (PSR‐R) in supine rest and during head‐up tilt, which was performed according to the maximum entropy method (MEM). It recognizes two main components: high‐frequency power (HF), which mainly reflects cardiac parasympathetic activity, and low‐frequency power (LF), which reflects both cardiac sympathetic and parasympathetic activity. The patients with PD had significantly higher values for all components of PSR‐R only in tilt position total power (TP), LF, and HF than did the control subjects (P < 0.01, < 0.01, < 0.02, respectively). However, the LF/HF ratio which indicated sympathovagal balance did not differ significantly between the two groups in tilt position. Our findings suggest that patients with PD in the early stage of illness have co‐activation of sympathetic and parasympathetic nervous systems, which might act to maintain a balance between the two autonomic systems.
Myotonic dystrophy associated with 47 XYY syndrome
Authors: Asano Atsutoshi , Motomura Naoyasu , Yokota Shingo , Yoneda Hiroshi , Sakai Toshiaki , Tsutsumi Shigetoshi 
Published: March 2003

AbstractA case of myotonic dystrophy with 47 XYY presented with tall stature and mental retardation. The patient was a 37‐year‐old male. In addition to grip myotonia and percussion myotonia, severe weakness and atrophy were noted in the face and the neck muscles and in the distal muscles of the four limbs. He also had diabetes mellitus, cataracts and sexual behavior abnormalities. He was found to be 47 XYY from chromosomal examinations. The combination of 47 XYY syndrome and myotonic dystrophy has not been reported previously.
A clinical study on suicide among schizophrenics
Authors: Funahashi Tatsuhide , Ibuki Yasuo , Domon Yuji , Nishimura Tsutomu , Akehashi Daiji , Sugiura Hideo 
Published: March 2003

AbstractWe conducted a clinical investigation of 80 suicides who met the DSM‐III‐R criteria for schizophrenia. The results using this approach showed no significant difference with those of preceding studies, and general features regarding the phenomenology of suicide among schizophrenics worldwide were recognized. The present study, however, served to underscore the following points: (i) suicide of schizophrenics must be considered a concern at all stages of the disease; (ii) the subjective strength of the will to die may be more important for the committing suicides than the lethality of the methods employed; and (iii) a change in the environment, for example, a hospital admission or discharge, may trigger suicide. A control group of 80 living schizophrenics with no past attempted suicide was then matched to the suicide group with respect to sex and illness duration, in order to identify the predictors of suicide. In a logistic regression analysis, the presence of suicidal ideation, degree of anxiety estimated by positive and negative syndrome scale, and birth order were revealed as predictors of suicide. As to the birth order, the risk is higher in middle children.
Functional significance of stimulatory GTP‐binding protein in hippocampus is associated with kindling‐elicited epileptogenesis
Authors: Iwasa Hiroto , Kikuchi Shuichi , Mine Seiichiro , Sugita Katsuo , Miyagishima Hiro , Hasegawa Shuji 
Published: March 2003

AbstractIn order to evaluate the involvement of the stimulatory G‐protein (Gs)‐related transduction system in the basic mechanisms of epilepsy, we examine the expression levels of Gsα mRNA and specific GTP‐binding ability in the hippocampus of amygdaloid‐kindled rats at various seizure stages. Northern blot analysis showed a significant increase in the Gsα mRNA expression level in the bilateral hippocampus at 24 h after the last generalized seizure. The [3H]‐GTP‐binding assay with isoproterenol (IPN), a β‐receptor agonist, revealed a remarkable increase of Bmax values in the sham‐operated control and partially kindled groups. However, the IPN‐induced increase of Bmax values was abolished on both sides of the hippocampus at 24 h after and at 4 weeks after the last generalized seizure in fully kindled rats. These data suggest that alteration in the Gs function and β‐adrenergic receptor‐Gs coupling might be implicated in the neurobiological basis of the induction mechanisms of the generalization of seizures and the mechanisms of the maintenance of enduring epileptogenesis. Conversely, the Gs‐related transduction system might have a lesser impact on the acquisition process of epileptogenesis.
An unusual case of rhythmic movement disorder
Authors: Kaneda Reizo , Furuta Hisakazu , Kazuto Kosaka , Arayama Kotaro , Sano Joh , Koshino Yoshifumi 
Published: March 2003

AbstractRhythmic movement disorder is one of the sleep–wake transition disorders listed in the International Classification of Sleep Disorders. According to this classification, the condition commonly occurs in infants and toddlers, and persistence beyond 4 years of age is unusual. Recently, we encountered a case in which rhythmic movement disorder persisted up until the age of 12 years with spikes registering on the sleep electroencephalogram. Epileptic seizure was ruled out because of the characteristic rolling movement, absence of any other epileptic symptoms (e.g. vocalization and tonic‐clonic seizure) and cessation as a result of removal of the blanket.
Ethanol effect on sleep electroencephalogram by the correlation dimension
Authors: Kobayashi Toshio , Madokoro Shigeki , Wada Yuji , Misaki Kiwamu , Nakagawa Hiroki 
Published: March 2003

AbstractThe influence on sleep of alcohol (ethanol) was investigated in nine males using the correlation dimension (CD). Polysomnography (PSG) was recorded on a baseline night (BL‐N) and on an ethanol (0.8 g/kg) night (Et‐N). The mean correlation dimensions on Et‐N, as well as on BL‐N, significantly decreased from sleep stage ‘awake’ to sleep Stages 1, 2 and 3 and increased during rapid eye movement (REM) sleep. The mean correlation dimensions of the sleep EEG during sleep Stage 2 and those for the second sleep cycle on the Et‐N were significantly higher than those on the BL‐N. The changes in the correlation dimensions between sleep cycles were reduced on Et‐N as compared to BL‐N.
Effects of bright light at lunchtime on sleep in patients in a geriatric hospital II
Authors: Fukuda Noriko , Kobayashi Riko , Kohsaka Masako , Honma Hiroshi , Sasamoto Yoichi , Sakakibara Satoshi , Koyama Emi , Nakamura Fumihiro , Koyama Tsukasa 
Published: March 2003

AbstractInpatients with sleep disturbances in a geriatric hospital received 1 h of exposure to approximately 8000 lx bright light per day for 3 weeks. Polysomnogram was recorded for four female patients. Two (aged 68 and 87 years) were non‐demented patients with weak cataracts and the other two (aged 92 and 93 years) were demented patients with severe cataracts. Electroencephalogram results showed that light exposure decreased the proportion of Stage W, while increased the proportion of Stage 2, and these effects continued for at least 3 weeks after the cessation of light exposure. These results suggest that exposure to bright light is effective in improving the disturbed sleep of patients.
The effects of oral melatonin on the autonomic function in healthy subjects
Authors: Kitajima Tsuyoshi , Kanbayashi Takashi , Saitoh Yasushi , Ogawa Yuriko , Sugiyama Tomonari , Kaneko Yoshihiko , Sasaki Yoshiko , Aizawa Rika , Shimisu Tetsuo 
Published: March 2003

AbstractWe investigated the influence of melatonin on the human autonomic functions by measuring muscle sympathetic nerve activity (MSNA). Five healthy male volunteers took 3 mg of melatonin, and their plasma melatonin concentration, blood pressure, heart rate, and burst rate of MSNA were then recorded. The peak level of melatonin concentration showed a marked interindividual variation. Blood pressure was reduced significantly, while heart rate and burst rate of MSNA did not change significantly. These results indicate that melatonin has a hypotensive effect on blood pressure, and the central cardiovascular regulatory mechanism such as lowering of the baroreflex setpoint would be involved in the effect.
Differential judgement of static facial expressions of emotions in three cultures
Authors: Huang Yueqin , Tang Siu , Helmeste Daiga , Shioiri Toshiki , Someya Toshiyuki 
Published: March 2003

AbstractJudging facial expressions of emotions has important clinical value in the assessment of psychiatric patients. Judging facial emotional expressions in foreign patients however, is not always easy. Controversy has existed in previous reports on cultural differences in identifying static facial expressions of emotions. While it has been argued that emotional expressions on the face are universally recognized, experimental data obtained were not necessarily totally supportive. Using the data reported in the literature, our previous pilot study showed that the Japanese interpreted many emotional expressions differently from USA viewers of the same emotions. In order to explore such discrepancies further, we conducted the same experiments on Chinese subjects residing in Beijing. The data showed that, similar to the Japanese viewers, Chinese viewers also judged many static facial emotional expressions differently from USA viewers. The combined results of the Chinese and the Japanese experiments suggest a major cross‐cultural difference between American and Asian viewers in identifying some static facial emotional expressions, particularly when the posed emotion has negative connotations. The results have important implications for cross‐cultural communications when facial emotional expressions are presented as static images.
Serial magnetic resonance angiography in cerebral infarction after varicella infection
Authors: KIMURA MASAHIKO , HASEGAWA YUKI , SEJIMA HITOSHI , INOUE MAKOTO , YAMAGUCHI SEIJI 
Published: March 2003

AbstractThe case of a 1‐year‐8‐month‐old‐boy with cerebral infarction after varicella infection is reported here. Brain magnetic resonance (MR) angiography revealed segmental narrowing of the left middle cerebral artery which became normal 8 months later. The MR angiography well demonstrated the time course of the vascular involvement in the present patient. In cerebral infarction after varicella infection, the proximal portion of the main cerebral arteries were frequently damaged therefore MR angiography is useful for diagnosis and therapeutic decision‐making. Moreover, serial MR angiographic studies can clarify the natural course of vascular changes in varicella virus‐related cerebral infarction.
INDETERMINATE RESULTS IN CORE BIOPSIES OF BREAST FROM MAMMOGRAPHICALLY DETECTED LESIONS: OUTCOMES OF EXCISION BIOPSY
Authors: J Harvey , GF Sterrett , FA Frost 
Published: March 2003

INTRODUCTION: Protocols for excision of mammographically detected lesions following core biopsy include all diagnoses of atypical ductal hyperplasia (ADH) or intraductal atypia of uncertain significance (AUS). The aims of this study were to look at: i) the prevalence of reporting ADH and AUS, ii) the proportion of cases where excision revealed breast carcinoma, iii) whether any cases could be downgraded to hyperplasia on review.METHODS: Breast core biopsy reports from the SCGH Breast Centre for the years 1999–2000 were retrieved. The results of excision biopsy were obtained and slides reviewed.RESULTS: There were 1048 core biopsies from 911 women. Breast carcinoma was diagnosed in 197 samples (18.8%) including 88 with invasive carcinoma (8.4%), 109 with ductal carcinoma in situ (10.4%) and 3 samples (2.9%) suspicious of invasive carcinoma. The suspicious cases all proved to be invasive carcinomas. There were 53 samples (5.1%) with a diagnosis of ADH or AUS. 46 were excised, showing 7 invasive carcinomas 15 DCIS, 11 ADH, 2 lobular carcinoma in situ (LCIS), 1 mucocoele‐like lesion, 1 fibroadenoma and 9 fibrocystic change (FCC). The 22 malignancies represented 47.8% of the excised lesions. At review, 8 of the 53 original diagnoses were downgraded to benign hyperplasia; 5 underwent excision; 2 showed ‘incidental’ invasive carcinomas, 1 ‘incidental’ LCIS, 1 ADH and 1 FCC.CONCLUSIONS: There was a low prevalence of reporting of ADH and AUS in core biopsies (5.1%) and a high rate of carcinoma (47.8%) in subsequent excision biopsies. Very few diagnoses of ADH/AUS were downgraded at review. Current protocols for excision of lesions with a core biopsy diagnosis of ADH/AUS appear to be justified.
Intermittent hypoxaemia without orthodeoxia due to right‐to‐left shunting related to an elongated aorta
Authors: Tan Keng‐Leong , Robinson Ttracey D , Celermajer David S , Hughes Clifford F , Young Iven H 
Published: March 2003

AbstractAn elderly woman presented with unexplained, intermittent hypoxaemia unrelated to posture. Subsequent investigations revealed intermittent and variable right‐to‐left interatrial shunting through a patent foramen ovale in the presence of normal pulmonary arterial and intracardiac pressures, caused by right atrial compression from a horizontal, elongated ascending aorta. Surgical closure of the foramen resulted in marked clinical improvement.
Sleep apnoea syndrome in Ramathibodi Hospital: Clinical and polysomnographic baseline data
Authors: Charoenpan Poonkasem , Thanakitcharu Sitthep , Muntarbhorn Kanit , Kunachak Somyos , Boongird Prasert , Likittanasombat Khanchit , Suwansathit Woragod 
Published: March 2003

Objective:The aim of this study was to determine clinical and baseline polysomnographic data on obstructive sleep apnoea (OSA) in Thai patients. This prospective study was performed at the Sleep Laboratory Center, Ramathibodi Hospital, Mahidol University, Thailand. Methodology: Ninety adult cases clinically suspected of having OSA were studied. The study included clinical, blood chemistry, electrocardiogram, chest radiograph, arterial blood gas, spirometry and full night polysomnography. Results: Fifty‐nine cases (65.6%) out of a total of 90 cases had an abnormal apnoea (i.e. apnoea index (AI) of 5 or more). The incidence of upper airway abnormality among cases with AI of 5 or more was 79.7% (47/59 cases). Among 59 patients with abnormal AI, associated medical problems comprised hypertension (n = 22), obesity hypoventilation (n = 9), hypothyroidism (n = 4), chronic airflow obstruction (n = 4), diabetes mellitus (n = 3) and chronic renal failure (n = 1). Obstructive sleep apnoea was present in all 59 cases. Central apnoea and mixed apnoea were rare. Conclusion: Symptoms and signs suggestive of OSA can lead to a high detection rate and confirmation of OSA by polysomnography. The OSA characteristics of Thai patients were similar to the patients in the Western world.
Interleukin‐4‐producing cells in idiopathic pulmonary fibrosis: An immunohistochemical study
Authors: Ando Masaru , Miyazaki Eishi , Fukami Tetsujiro , Kumamoto Toshihide , Tsuda Tomiyasu 
Published: March 2003

Objective:Interleukin‐4 stimulates collagen synthesis in fibroblasts in vitro. The purpose of this study was to clarify the role of interleukin‐4 in the pathogenesis of idiopathic pulmonary fibrosis. Methodology: We compared interleukin‐4 expressing cells in tissues from 11 patients with pathologically confirmed idiopathic pulmonary fibrosis with early stage inflammatory lesions versus advanced lesions. We also performed double staining in order to elucidate which inflammatory cells produce interleukin‐4 in idiopathic pulmonary fibrosis. Results: Greater numbers of interleukin‐4 positive cells were observed in the advanced lesions than in the early lesions. We also found that early stage lesions showed a predominance of CD3/interleukin‐4 double positive cells whereas, the advanced stage lesions had higher percentages of the EG2/interleukin‐4 double positive cells and the tryptase/interleukin‐4 double positive cells. Conclusions: Our results suggest that interleukin‐4 may be involved in progression of interstitial fibrosis in idiopathic pulmonary fibrosis, in which we confirmed a significant contribution of eosinophils and mast cells to interleukin‐4 production.
The interaction of neutrophils with respiratory epithelial cells in viral infection
Authors: Wang Shan‐Ze , Forsyth Kevin D 
Published: March 2003

Abstract:Viral respiratory infection is very common. Respiratory syncytial virus (RSV) infects almost all children during the first 2 years of life. Respiratory syncytial virus is the most frequent cause of bronchiolitis, which is strongly linked with asthma. However, the pathophysiology of RSV bronchiolitis is unclear. Neutrophils are the predominant airway leucocytes in RSV bronchiolitis and other viral infections. Neutrophils and their products are likely to play an important role in viral infection. Current evidence indicates that: (i) viral infection of epithelial cells increases the production of neutrophil chemoattractants or chemokines, which induce neutrophil migration into the inflammatory sites; (ii) the expression of adhesion molecules on neutrophils and epithelial cells is up‐regulated in viral infection, and neutrophil‐epithelial adhesion is increased; (iii) neutrophils augment epithelial damage and detachment induced by viral infection and contribute to the pathophysiology of viral disease; (iv) neutrophil apoptosis is up‐regulated in RSV infection, which may be an in vivo mechanism to limit neutrophil‐induced epithelial damage; (v) inhibitors of chemokines, adhesion molecules or neutrophil proteases may be useful in prevention of neutrophil‐induced epithelial damage. In conclusion, neutrophils play an important role in viral infection, and intervention to prevent neutrophil‐induced epithelial damage may be a potential clinical therapy.