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PubMed1990

The immuno-suppressed patient--what are the implications?

Dentists, doctors, and other health professionals are increasingly involved in interacting with immunosuppressed and immuno-deficient patients. As the medico-legal and health-economic environments change, an increasing range of progressively more difficult problems is developing. Like other health professionals, dentists must accept their role as advocates for patients, despite the stresses that this will entail. The psychological and social stresses inherent in handling life-long management problems based upon immuno-suppression and immuno-deficiency exceeds the hazards to dentists and others which result from exposure to various viruses and bacteria. There are implications in terms of history taking, organisation of laboratory and organ-imaging investigations, for continuing education, and for intra-professional referral procedures.

Attitude↗

PubMed1989

Toward the necessary universalizing of a disability policy.

Issues confronting people with disabilities do not result solely from physical or mental impairment, but from the fit between impairments and practically every feature of the social, economic, physical, and political environment. Changes in housing, transportation, and employment policies would augment the quality of daily living for those with disabilities today and in the future. With the entire population facing chronic illness and activity limitations, a universal approach to disability is virtually required, rather than policies focusing exclusively on a person's special needs. The absence of such a universal perspective will lead to the expansion and perpetuation of the segregated and unequal society visible at present.

Aged↗

PubMed1988

Polymorphism of rat gastric mucosal histidine decarboxylase: effects of the coenzyme and sulfhydryl groups.

Several factors are examined for their implication in the charge heterogeneity and form conversion of rat gastric mucosal histidine decarboxylase. The apoenzyme and the holoenzyme are undistinguishable with respect to their pI and to the distribution of enzyme activity in the three forms. The latter are not produced by differential coenzyme binding. Studies for glycoprotein characterization provide evidence that the heterogeneity does not arise from enzyme-bound carbohydrate. Oxidative or reductive environments change the distribution between forms without modifying the molecular weight. Conversion of form III to forms I and II can be effected by treatment with dithiothreitol. A similar loss of negatively charged form occurs upon ageing and is not prevented by an alkylating agent. All three forms show equal sensitivity to N-ethylmaleimide and dithiothreitol inhibitions. The oxidation-reduction state of exposed sulfhydryl groups may be responsible at least in part for the charge heterogeneity.

Animals↗

PubMed1986

Developmental concerns and the health of midlife women.

Prior to providing anticipatory guidance to a woman approaching or at middle age, the nurse should explore her own and her client's expectations of middle age and work to dispel any existing myths. Menopause is not inevitably a time of increased depression or nervous symptomatology. In addition, women whose children are gone from the home are not at increased risk for depression or low life satisfaction. However, we do know that the majority of women experience vasomotor symptoms including hot flashes and night sweats which are directly attributable to the hormonal changes accompanying menopause. The middle-aged woman may begin to note changes in her physical appearance and level of physical energy. This point in life can also be associated with a variety of transitions, including changes in the parental and marital role, the care and death of aging parents, and the loss of a spouse through death or divorce. As the familial environment changes for a woman, work outside the home may take on a different meaning. This stage of life can be one of growth as the woman seeks new directions or it can be a time of dissatisfaction. No one factor distinguishes those who cope well from those who do not. When identifying those women at risk for midlife developmental crises, the nurse must consider the interaction risk for midlife developmental crises, the nurse must consider the interaction of multiple factors. Preliminary evidence suggests that some women may experience a decreased sense of life satisfaction at the time of menopause.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Psychological↗

PubMed1986

Regulation of hematopoiesis in rats exposed to antiorthostatic hypokinetic/hypodynamia: II. Mechanisms of the "anemia".

Results are presented which demonstrate a close similarity between the ability of antiorthostatic hypokinetic/hypodynamia and orthostatic hypokinetic/hypodynamia to induce anemia in laboratory rats. The "restraint anemia" (whether mediated directly by reduced activity or indirectly by possible changes in blood circulation or in altered weight-bearing capacity of the skeleton) was largely due to reduced food and/or water consumption and displayed the classical symptoms of inadequate nutrition, i.e. decreased serum erythropoietin (Ep) titers and reduced Ep sensitivity of hematopoietic tissue. Only changes in red blood cell (RBC) clearance were unique to the head-down (antiorthostatic) posture. During suspension, RBC clearance was reduced and then accelerated when suspension was terminated or the cells transfused into a normal environment. Changes in RBC clearance were due to both cell-associated and cell-independent factors and may be related to the alterations in RBC survival seen in rats during or immediately after space flight. In both suspension and weightlessness, these changes were limited to alterations in the force and/or direction of the gravity vector.

Anemia↗

PubMed1967

Qualitative and quantitative characteristics adult Culex pipiens fatigans populations according to time, site and place of capture.

The composition of a vector population is largely influenced by the pressures and modifying effects of the environment. Changes in the latter, whether natural or induced (e.g., by insecticides) will be reflected in the former. Thus if the existing characteristics of a vector population are determined, the parameters can subsequently be used to assess the effect of control measures.The effect of environmental conditions on the density and parity of Culex pipiens fatigans in catches in Burma is illustrated by a comparison of results obtained in Kemmendine, which is served by a bucket system for the removal of night-soil, with those from South Okkalapa, which has pit latrines; in the latter area there is a large preponderance of young mosquitos in the monsoon period, in contrast to the situation in Kemmendine.In Kemmendine, the inside-biting catch is reduced by about one-half if an inside-resting catch is made simultaneously. This suggests that C. p. fatigans rests indoors before biting indoors and that an efficient insecticide for inside application would markedly reduce the mosquito population. When a correction is made for the inside-resting catch it is shown that there is little to choose between inside- and outside-biting catches as measures of the activity of C. p. fatigans. The chances of acquiring infection are at least as great out of doors as indoors and this may account for differences in infectivity among different ethnic groups, according to the extent that they sleep out of doors.Differences in parity and in the state of infection of mosquitos according to the type of catch and the time of catching are discussed. Finally, it is noted that, although most male mosquitos are obtained in inside-resting catches, a considerable number, surprisingly, are taken on bait; the reason for this is not yet known.

Adaptation, Biological↗

PubMed1977

Carboxyhaemoglobin saturation in relation to smoking and various occupational conditions.

The effects of smoking and occupational conditions on COHb saturation were studied among employees on traffic duty, in restaurants, in iron foundries, and in an office. The subjects were 139 smokers and 152 nonsmokers working in the same environments. Changes in COHb saturation were observed in samples of blood obtained before and after the working period. Samples of air were collected during the working hours in restaurants, in foundries and in office, 190 samples in all, for the determination of content of CO. Among the nonsmokers there was no change in COHb saturation in restaurants and in office work. On traffic duty and in iron foundries the increase was significant, but the values after work were less than half the permitted occupational threshold limit value (TLV) level of 6 per cent units. In the smoking group the mean values of COHb saturation before work were about twice the mean COHb saturation in the nonsmokers after work. In office work and in foundries the mean COHb saturations after the work exceeded the permitted TLV.

Adolescent↗

PubMed1982

In vivo distribution of carrier protein/67Ga-complexes.

The uptake of 67Ga as citrate, chloride and complexed by carrier-proteins (lactoferrin and transferrin) has been studied in tumor- and inflammatory lesion-bearing rats. Different uptake patterns are shown by tumors and lesions. 67Ga-transferrin complexes are taken up to the highest extent by tumors and inflammatory lesions. The comparative distribution studies using normal animals indicate a systemic increase of 67Ga uptake by tumor- and lesion-bearing animals which might be of importance in explaining the mechanism of 67Ga accumulation. The role of ionic environment changes and radioactivity concentration by isomorphous ionic replacement is discussed.

Animals↗

PubMed1981

Is the doubly deleted alpha-thalassemia gene a "fugitive" allele?

The alpha-thalassemias (particularly in Asia) can be considered as a three-allele system, with one "normal" allele (N) consisting of a pair of closely linked alpha-chain loci, a second "single" allele (S) in which one of the loci has been lost by deletion, and a third "double" allele (D) in which both have been lost. Representatives of all the sets of fitnesses leading to the maintenance of this condition by selection for malaria resistance have been explored, and after the discarding of unlikely sets of fitnesses, it is found that there will be three outcomes: (1) the S chromosome is fixed, (2) the S and N chromosomes form a stable polymorphism, and (3) the N and D chromosomes form a stable polymorphism, but this can be lost and the population forced to fixation by the introduction of sufficiently large number of S chromosomes. Some Melanesian populations appear to have reached outcome (1), while frequencies in African, Mediterranean, and Middle Eastern populations are not incompatible with outcome (2). Southeast Asian populations, however, which carry S and D chromosomes in high frequency, may be in a state of flux. The D chromosome may form a polymorphism with N locally, but it can be driven from the local population by the introduction of large numbers of S chromosomes. The D chromosome would thus be somewhat analogous to a fugitive species, which can only exist in certain transient environments and is displaced as the environment changes. The possibility that N, S, and D are coexisting as a stable polymorphism can almost certainly be ruled out by a consideration of fitness sets required.

Alleles↗

PubMedDate not supplied

Iron, intracellular calcium ion, lipid peroxidation and carcino-genesis.

The evaluation of the accumulated experimental results on the action of complexed iron on cells indicates that the provoked cell injury is rather the consequence of an inhibition of the cytosolic Ca2+ concentration regulatory system than an effect of iron-induced lipid peroxidation. The role of the consequent intracellular ionic environment change in the preneoplastic and neoplastic transformation of the cell is discussed.

Animals↗

PubMedDate not supplied

Moving from the operating room to home care.

Although a change in career can be frightening, a nurse can reap many benefits in a change to home care nursing. With the health care environment changing, home care is increasing and offers a nurse a chance to refresh her enthusiasm for individual patient care and put to use her collective skills learned along the way.

Career Mobility↗

PubMed1976

Lac Repressor. Fluorescence of the two tryptophans.

By comparing the fluorescence emission properties of the wild type lac repressor with two lac repressors altered at tryptophan 190 and 209, respectively, we show that tryptophan residue 209 has its environment changed, either by its own motion, or that of the surrounding amino acids when an inducer molecule is bound. Substitution of this tryptophan with other amino acids results in lac respressor molecules with reduced affinity for inducer molecules, indicating that the geometry at residue 209 affects the geometry of the inducer-binding site. From the results of potassium iodide quenching of fluorescence from the tryptophans, and from attempts to react the native lac repressor with dimethyl(2-hydroxy-5-nitrobenzyl) sulfonium bromide and 2-hydroxy-5-nitrobenzyl bromide, we propose that tryptophan residue 209 is involved in a conformational change of the protein upon binding of inducer, but does not come in direct contact with inducer.

Amino Acids↗

PubMed1994

Reorganization: premises, processes, and pitfalls.

As the technological environment changes and libraries assume new and more active roles in their institutions, the traditional library hierarchy ceases to be an effective organizational structure. Guided by theories that emphasize teamwork, quality, and employee empowerment and participation, libraries are developing flatter, more networked organizations. The Health Sciences Library at Columbia University in New York, New York, recently underwent a reorganization in an effort to become a more resilient, more flexible organization. The process was beneficial overall. While some errors and confusion occurred, these are seen as opportunities for learning and evidence of the library's new atmosphere of creativity and experimentation.

Hospital Restructuring↗

PubMedDate not supplied

[Common memory aids of younger and older people].

This study investigates the use of internal and external mnemonics in everyday life. External mnemonics were assumed to be less capacity demanding than internal ones. Additionally, we expected the use of internal techniques to be reduced in western societies because of an environment changing towards a "world of external storing devices". Thirty students and 20 institutionalized old people were interviewed about their everyday use of mnemonics. The interviews were based on Harris' mnemonics questionnaire (1980). Our results indicate students using internal as well as external mnemonics, although for more external ones. In general, the same is true for the institutionalized elderly. However, 1) they mainly use external aids, and 2) in total, they use fewer mnemonics than students. These results contradict the general assumption of old people compensating for memory problems by increasingly relying on mnemonics. Instead, the dominance of external aids indicates a tendency to process information more economically. Overall, the results suggest the necessity of further investigating the conditions for a successful use of external aids in everyday life.

Adult↗

PubMedDate not supplied

How a better understanding of transformational leadership can help improve your practice as a nurse administrator.

Nursing administrators of today find themselves practising in an environment of permanent whitewater--an environment of chaotic change. Not only is the environment changing, so too are our employees: their needs, motives and priorities are vastly different than those we knew 20 years ago. The challenges of permanent whitewater cannot be overcome without effective leadership. Theorists agree that most North American organizations are currently overmanaged and underled. Certainly the leadership record of Canadian health care institutions has not been impressive. This paper will examine a selected set of concepts which the author believes are essential for nursing administrators who wish to provide real leadership to their departments and organizations: transformational (as compared to transactional) leadership; feminine (as compared to masculine) leadership; and empowerment. The literature review draws out both theory and practical applications.

Female↗

PubMed1995

From a regulatory lens: a perspective on the delegation of nursing activities to unlicensed assistive personnel.

Along with the reforming of health care, nursing services and related regulatory approaches are concurrently adapting. As the health care environment changes, the number and preparation of individuals who perform health-related activities has increased dramatically. Heightened interest is expressed at both ends of the nursing care delivery spectrum, unlicensed and advanced nursing practice. Boards of nursing, the States' regulatory arm over the profession, pay particular attention to public health and safety issues attached to the delegation of nursing tasks to unlicensed assistive personnel (UAPs). Equally important to the appropriate use of delegation is the provision of adequate supervision of those who are serving in the role of "delegatee." Mechanisms exist in a number of states whereby professional nurses can ascertain the level of competence of a UAP and feel assured that safe and appropriate care can be delegated. It is the role of the professional nurse to provide the required supervision, once a nursing activity is delegated. Nurse practice acts should not be used as barriers to escape required and prudent alterations to the traditional delivery of nursing care. Conversely, these same acts should not be manipulatively circumvented solely in the name of cost containment and as a needed response to "health care reform." As health care reforms, humanity would be best served with public or patient safety and protection as a guiding principle.

Facility Regulation and Control↗

PubMed1997

Prenatal stress induces high anxiety and postnatal handling induces low anxiety in adult offspring: correlation with stress-induced corticosterone secretion.

It is well known that the hypothalamo-pituitary-adrenal (HPA) axis is altered by early environmental experiences, particularly in the perinatal period. This may be one mechanism by which the environment changes the physiology of the animal such that individual differences in adult adaptative capabilities, such as behavioral reactivity and memory performance, are observable. To determine the origin of these behavioral individual differences, we have investigated whether the long-term influence of prenatal and postnatal experiences on emotional and cognitive behaviors in adult rats are correlated with changes in HPA activity. To this end, prenatal stress of rat dams during the last week of gestation and postnatal daily handling of rat pups during the first 3 weeks of life were used as two environmental manipulations. The behavioral reactivity of the adult offspring in response to novelty was evaluated using four different parameters: the number of visits to different arms in a Y-maze, the distance covered in an open field, the time spent in the corners of the open field, and the time spent in the open arms of an elevated plus-maze. Cognitive performance was assessed using a water maze and a two-trial memory test. Adult prenatally stressed rats showed high anxiety-like behavior, expressed as an escape behavior to novelty correlated with high secretion of corticosterone in response to stress, whereas adult handled rats exhibited low anxiety-like behavior, expressed as high exploratory behavior correlated with low secretion of corticosterone in response to stress. On the other hand, neither prenatal stress nor handling changed spatial learning or memory performance. Taken together, these results suggest that individual differences in adult emotional status may be governed by early environmental factors; however, perinatal experiences are not effective in influencing adult memory capacity.

Analysis of Variance↗

PubMedDate not supplied

IAIMS: planning for change.

The success of IAIMSs and other information technology plans depends to a great extent on the fit between the planning process and the nature of the organization. Planning processes differ as a function of both plurality of goals and the degree to which technology or the external environment changes. If all members of an organization share a common goal and the organization is in a relatively stable environment, the classic "plan, prototype, implement, evaluate" process may be appropriate. Most health care organizations are not consistent with this model. The components of the organization may have different goals, and both the health care environment and roles for technology are changing rapidly. In these circumstances, planning takes on a different light. This paper outlines approaches to IAIMS planning in various environments and provides a framework for IAIMS planning in rapidly changing environments.

Integrated Advanced Information Management Systems↗