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Objective Nurse practitioners (NPs) have drawn significant attention recently and played a major role in healthcare. We aim to find the evaluation of NPs through published studies and then visualize the research status and hotspots in this field. Methods All data came from the Web of Science Core Collection, and the data were counted and entered into Excel 2016. The key documents nodes were excavated by analyzing the knowledge network map using CiteSpaceV software. In this study, these nodes of “author, country, institution, keyword, co-citation (reference\cited-author\cited-journal), and grant” were harvested for analysis and comparison. Results A total of 4912 records, which were published between 2007 and 2018 and pertained to NPs, were retrieved from the Web of Science Core Collection database (WoSCC) from a diversity of languages. The total and the annual number of publications and citations of these continually increased over time. Most publications were in 2018 (618 records). This study involved 8241 authors located in 98 countries and 4557 institutions totally. The United States (2737 records) and the University of Michigan (90 records) dominated in publication frequency. There are 902 journals and 2449 articles with funding support that have been analyzed. Most articles were from JAMA: The Journal of the American Medical Association (1386, IF = 47.661), followed by the Journal of Advanced Nursing (1359, IF = 2.267), and The New England Journal of Medicine (1109, IF = 79.258). The reference “The Role of Nurse Practitioners in Reinventing Primary Care” was co-cited most frequently, which revealed it as the highest landmark article in NP. The top-ranked keyword was “Care,” other than “Nurse practitioner,” which has an ultra-high frequency. Some of the high-frequency keywords represent the significant direction of NPs. Conclusions NPs are at the crux of health-care delivery and play an important role in providing high-quality nursing. Publications on NPs in WoSCC have increased notably during the recent years, and have appeared in some journals that have a high impact factor. Research frontiers and developmental trends were revealed by the analysis in this study, which can be used to forecast future research developments in NPs and taken as a reference to choose the right directions by subsequent researchers who wish to use these results. However, the grant support from administration or research institutions is still in need of improvement and the scope of research in NPs should be broadened in the future.

Introduction and Aims. Alcohol- and other drug-use disorders have been found to be associated with mental disorders, however, complete characteristics of these comorbid mental disorders are not completely clear in early population based studies. This study aimed to explore the extent and profiles of comorbid mental disorders with alcohol- and other drug-use disorders using a large inpatient dataset. Methods. The data source was the New South Wales (NSW) Inpatient Statistic Data Collection which collects the clinical data of hospital admissions in NSW, Australia. The data were coded using the International Classification of Diseases—10th Revision (ICD-10). The data were from 1 July 2005 to 30 June 2006 the Australian financial year and statistical analysis was performed using SAS. Results. Of 1 592 156 patients admitted, 91 510 (6%) had at least one mental disorder diagnosis and 18 283 (1.1%) had at least one alcohol- or other drug-related diagnosis. Of these patients, an overall 9.6% had dual diagnoses. Comorbidity was nearly five times higher in alcohol- and other drug-use disorders than in mental health disorders (52.4% vs. 10.5%). Comorbidity was higher in males than females (12% vs. 7.1%) and was the most common in patients aged from 20 to 49 regardless of sex. There was a significantly increased risk of developing a comorbid condition in all age groups above 10 years. The most common mental health disorders were major depressive disorders, followed by dementia, anxiety and severe stress. Alcohol-use disorder was the most common diagnosis, followed by cannabis and opioids. Discussion and Conclusion. This study shows the characteristics of comorbid mental and alcohol- or other drug-use disorders. The study extends our understanding of issues addressed in previous population studies.[Lai HMX, Huang QR. Comorbidity of mental disorders and alcohol- and drug-use disorders: Analysis of New South Wales inpatient data. Drug Alcohol Rev 2009]

Interleukin 12 (IL-12) production is believed to be impaired in individuals with HIV infection and this impairment manifests early in disease, when the CD4(+) cell counts are within normal values. The reduced antigen-specific and mitogen-stimulated T cell-proliferative responses that occur in HIV infection can be corrected by the addition of recombinant human interleukin 12 (rhIL-12). As the IL-12 receptor (IL-12R) is central to the IL-12 signaling pathway, we examined whether the augmentation of antigen-specific proliferation of HIV(+) peripheral blood mononuclear cells (PBMCs) related to altered IL-12R expression. rhIL-12 augmented antigen-specific proliferation of HIV(+) PBMCs but not of HIV(-) PBMCs. Examination of resting PBMCs from HIV(+) and HIV(-) donors showed that neither of these populations expressed IL-12R beta 1 or IL-12R beta 2 chains on their cell surface as detected by flow cytometry. However, examination of mRNA showed that both IL-12R beta 1 and IL-12R beta 2 mRNAs were markedly reduced in HIV(+) PBMCs when compared with HIV(-) PBMCs. After mitogen activation there was an increase in IL-12R beta 1 expression on the cell surface of HIV(+) and HIV(-) PBMCs and this level was not altered by coculture with rhIL-12 or interferon gamma (IFN-gamma). However, coculture of phytohemagglutinin (PHA)-activated HIV(+) or HIV(-) PBMCs with rhIL-12 (but not IFN-gamma) increased IL-12R beta 2 expression on the cell surface of both populations. Examination at the message level showed a correction of IL-12R beta 1 to normal levels with activation that was further enhanced by rhIL-12 coculture for both the HIV(+) and HIV(-) PBMCs. However, although the level of IL-12R beta 2 for the HIV(+) PBMCs was normalized by PHA, rhIL-12 caused a further augmentation. This information provides a strong link between IL-12R upregulation, and the significant improvement in antigen-specific HIV-proliferative responses seen with the addition of rhIL-12. It also reveals that the dysfunction in IL-12R expression seen in cells from HIV(+) patients occurs at the transcriptional level. In addition, we provide further evidence that IL-12R beta 1 and IL-12R beta 2 regulation in human PBMCs is independent of IFN-gamma.

Apo-1/Fas (CD95) is a transmembrane protein expressed on the cell surface that is involved in apoptosis and plays an important role in the function and regulation of the immune system. Aberrant expression of the Apo-1/Fas gene product has been reported in a number of immune-related disorders, such as autoimmune lymphoproliferative syndrome and systemic lupus erythematosus in humans. Mutations in the coding sequence of the Apo-1/Fas gene have been reported in the former condition, whereas no abnormalities of the gene have been found to account for the increased gene expression noted in SLE. We screened the whole 5' flanking region of the Apo-1/Fas gene encompassing over 2000 bp for mutation(s)/polymorphism(s) using multiplex PCR, single-strand conformation polymorphism (SSCP) analysis and sequencing techniques, and identified two polymorphisms in this region. The first polymorphism is a CG-->CA substitution at -1377 nucleotide position within the silencer region, which neither creates or deletes any restriction enzyme sites but alters the transcription factor SP-1 binding site. This polymorphism is noted in 20% of normal Caucasians. The second polymorphism is an GA-->GG substitution at -670 nucleotide position in the enhancer region that creates a MvaI restriction fragment length polymorphism (RFLP) and abolishes the binding site of nuclear transcription element GAS. The MvaI RFLP is polymorphic with heterozygosity of 52% and the frequency of G and A alleles are 0.49 and 0.51, respectively. The identification and characterisation of these two new polymorphisms, particularly the MvaI RFLP marker, provides new genetic markers and may prove useful for further studies on the regulation of apoptosis mediated by the Apo-1/Fas gene on human chromosome 10q23.

Alcohol is one of the most commonly used legal psychoactive substances, and its use often coexists with mental health disorders. This study explores the relationships between alcohol use and some common mental health disorders. Admissions to all New South Wales (NSW) hospitals were analyzed. The data were extracted from the NSW Department of Health Inpatient Statistics Data Collection for the period 1 July 2006 to 30 June 2007. Readmissions within 28 days were excluded. Data extraction and analyses were performed by using the SAS program. Chi-square tests and odds ratio were used to measure the association. Of the 1.8 million admissions, associations between alcohol use disorders and mental health disorders were strong (odds ratio 7.8 to 10.7, P < .001). A 33.8% of patients who used alcohol had at least 1 identifiable mental disorder. Higher comorbidity rates were observed for females (39.6%) and for those aged between 30 and 49 years. The most common mental disorders were anxiety disorders, bipolar affective disorders, major depressive disorders, personality disorders, schizophrenia, and severe stress disorders. Comorbidity with one of these mental disorders ranged from 1% to 17.6%, with significant associations (odds ratio 5.6 to 14.1). The average length of stay (ALOS) for alcohol use disorders were 6.4 days and the ALOS for the most common mental health admissions was 11.2 days. This study provides detailed information about the association between alcohol use and mental health disorders and extends our understanding of comorbidity presentations in inpatient admissions.

Alcohol- and other drug-use disorders have been found to be associated with mental disorders, however, complete characteristics of these comorbid mental disorders are not completely clear in early population based studies. This study aimed to explore the extent and profiles of comorbid mental disorders with alcohol- and other drug-use disorders using a large inpatient dataset.The data source was the New South Wales (NSW) Inpatient Statistic Data Collection which collects the clinical data of hospital admissions in NSW, Australia. The data were coded using the International Classification of Diseases-10th Revision (ICD-10). The data were from 1 July 2005 to 30 June 2006 the Australian financial year and statistical analysis was performed using SAS.Of 1 592 156 patients admitted, 91 510 (6%) had at least one mental disorder diagnosis and 18 283 (1.1%) had at least one alcohol- or other drug-related diagnosis. Of these patients, an overall 9.6% had dual diagnoses. Comorbidity was nearly five times higher in alcohol- and other drug-use disorders than in mental health disorders (52.4% vs. 10.5%). Comorbidity was higher in males than females (12% vs. 7.1%) and was the most common in patients aged from 20 to 49 regardless of sex. There was a significantly increased risk of developing a comorbid condition in all age groups above 10 years. The most common mental health disorders were major depressive disorders, followed by dementia, anxiety and severe stress. Alcohol-use disorder was the most common diagnosis, followed by cannabis and opioids.This study shows the characteristics of comorbid mental and alcohol- or other drug-use disorders. The study extends our understanding of issues addressed in previous population studies.

To make an epidemiological investigation on clonorchiasis sinensis and relevant factors in the south of Hunan Province.One village from each of Lengshuitan District and Qiyang County was selected for the survey from November to December in 2006. Stool samples from villagers were collected and examined by modified Kato-Katz method. Questionnairing was performed for relevant knowledge and attitude among residents. The infection rate in animal reservoirs and intermediate hosts were detected.A total of 586 cases with Clonorchis sinensis infection were found from 777 people with a prevalence of 75.4%. The average egg density was 451 eggs per gram (EPG) feces. Light, moderate and heavy infections occupied 85.5% (501/586), 14.0% (82/586), and 0.5% (3/586) respectively. Prevalence in males and females was 76.9% (316/411) and 73.8% (270/366) respectively with no significant difference (chi2 = 1.013, P0.05). Infections were found in all age groups, with the highest prevalence in the group of 70 to 79 years (85.7%, 30/35). By occupations, the prevalence was 82.5% (447/542) in peasants, 79.3% (42/53) in doctors, 73.7% (28/38) in teachers, and 73.5% (25/34) in local cadres. The infection rate was 17.4% (29/167) and 7.4% (2/27) in Parafossarulus seriatulus and Alocinma longicornis, and 69.2% (9/13) and 5.3% (1/19) in Carassius auratus and Cyprinus carpios respectively. Adult worms were found in all 3 dogs dissected. Over 80% inhabitants did not know that this disease can be acquired by eating raw fish. 95.6% (153/160) of the farmers and 56.7% (349/616) of the students had a history of eating raw fish. The water was contaminated with C. sinensis eggs by using untreated feces as fertilizer for farming and by scrubbing pail latrines in the ponds.The prevalence of clonorchiasis in human population is high in Lengshuitan District and Qiyang County of Hunan Province. Eating raw fish and using untreated feces as fertilizer are the most important epidemiological factors of the disease.

OBJECTIVES: Obstructive sleep apnea often results in a wide range of comorbid conditions. Although some conditions have been clearly identified as comorbid, a full clinical pattern of associated diseases has not been systematically documented. This research aimed to reveal the full pattern of comorbid conditions associated with OSA by employing a data mining technique. METHODS: A large data repository (the New South Wales inpatient Data Collection) collected between 1999 and 2004 was mined, and all clinical diagnoses were coded with ICD-10-AM codes. RESULTS: A total of 60,197 cases (4% of total records) were identified as related to OSA (72.2% males, 27.8% females). OSA occurrence showed 2 peaks at 0-4 years and 55-59 years. A strikingly low occurrence was observed for the adolescent years. Conditions comorbid with OSA in adults by descending frequency were essential hypertension, obesity, hypercholesterolemia, type 2 diabetes, past or current tobacco use, and ischemic heart conditions. Obesity and OSA showed a similar time course of onset, with a latent period of 5 years for hypertension and type 2 diabetes and 15 years for chronic ischemic heart conditions. Comorbid conditions were predominantly of the cardiovascular, endocrine/metabolic and respiratory systems. The data also indicated OSA patients are high users of health services. CONCLUSIONS: The data mining technique confirms the prevalence of the disease, describes the age distribution patterns and time courses of disease development from obesity and OSAto comorbid conditions, and implicates possible interrelationships among these conditions and high cost of treating OSA patients.

With rapid advances in genetics and increased public awareness of genetic testing for many hereditary diseases, the demand for genetic services may increase. We wondered how developments in genetics have impacted on general practice and the position general practitioners have taken in practising the new genetics.A qualitative study using semi-structured interviews conducted during 2003-2004 with 15 GPs practising in Sydney (New South Wales) and the Australian Capital Territory.General practitioners reported that genetic services had minimal impact on their practice and the number of consultations related to genetic conditions was insignificant. They felt they were often not included in the 'referral loop' of such patients. Their knowledge of advances in genetics was limited. They were wary of the possible costs of testing and the time taken to provide genetic counselling.General practitioners' attitudes toward modern genetics seems to be disengaged, and they are ambivalent toward the role they now play, or will play, in genetic services.

The internet has become a powerful tool to disseminate health information and there are millions of people accessing this free information for a second medical opinion. Consumers seeking information from this resource are more responsible for their own health. However, the quality of health information on the internet varies and there is no simple instrument that can effectively evaluate its quality.This paper reviews recent studies on the validity of instruments or guidelines developed for evaluating health information. It describes government initiatives around the world in establishing quality health information and proposes an alternative way of empowering consumers with reliable health information. It emphasises the importance of the role of primary family physicians in this consumer education process.The debate over the quality of health information on the internet and the attempt to use instruments to evaluate the quality of web information are discussed. The relationship between family physicians and consumer informations in this information age is also addressed.

Apoptosis mediated by the Apo-1/Fas and Fas ligand pathways has been implicated in many disorders, including autoimmunity and tumorigenesis. The recent identification of two polymorphisms on the 5' flanking region of the human Apo-1/Fas gene has provided useful markers for investigation of the genetic contribution of the Apo-1/Fas gene in these diseases. The Mval polymorphism at the -670 nucleotide position is frequent in the normal population, with 51% heterozygosity. The other polymorphism, a result of single nucleotide G-->A substitution at the -1377 position, does not create or delete any restriction enzyme digestion sites. In this paper, we describe a simple and rapid method for detecting the -1377 polymorphism by using allele-specific amplification (ASA). Using the ASA method, the -1377 polymorphism in a normal Caucasian population was characterised. Frequencies of 0.13 and 0.87 for allele A and G, respectively, were observed and the homozygosity of the mutant allele (A) was found in only 2% of the population. We subsequently examined the -1377 polymorphism in sporadic systemic lupus erythematosus (SLE) patients (n = 86). The results showed that both genotype distribution and allele frequencies in SLE patients were similar to that in controls, suggesting that the -1377 promoter polymorphism is unlikely to be associated with SLE susceptibility. The description of this rapid detection method and characterisation of the -1377 polymorphism are useful means for future genetic studies in diseases in which the Fas-mediated apoptosis may be involved.