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Copper in seminal plasma: comparison of two processing methods for atomic absorption spectrophotometry.

Fifty-three randomly selected seminal plasma samples were assayed for copper by atomic absorption spectrophotometry. All the samples had undergone two accepted processing methods--wet oxidation and dilution. The results were compared, and a highly significant difference was seen (p less than 0.001). The dilution method gave the better reading and was simpler in processing. The author recommends the dilution method for elemental study in seminal plasma by using atomic absorption spectrophotometry.

Copper

The use of cowpeas (Vigna unguiculata) in improving a popular Nigerian weaning food.

A weaning food commonly used in Nigeria was simulated by mixing processed sorghum (Sorghum bicolor) with skim-milk powder (830: 170, w/w). Replacing 310 g/kg sorghum with processed cowpeas (Vigna unguiculata) resulted in an increase in protein content from 96 to 113 g/kg and an increase in biological value of the protein from 0.74 to 0.87. The two mixtures were compared with an established commercial baby food by a panel of Nigerian mothers and all three foods were found to be equally acceptable. Processing the cowpeas by pressure cooking followed by roller-drying reduced the trypsin-inhibitor content to minimum levels. It is concluded that the protein and quality of the weaning mixture popularly used in Nigeria could be improved by partially replacing the sorghum with cowpeas.

Amino Acids

Drugs or drums: what relieves postoperative pain?

The cybernetic model of analgesia is a simple servo-loop: altered sensory input--complaints--medication--temporary restoration of acceptable processing of the sensory input--return of altered sensations. Under ordinary clinical circumstances the functioning of this mechanism is masked by "noise" generated by the interaction of several persons who provide the medication and time factors prolonging the interval between the onset of complaints and the action of the medication. Demand analgesia (DA) has been designed to provide prompt pain relief under the patient's direct control. The technique turned out to be useful also for the investigation of acute pain's course. The present protocol was designed to study the precision with which patients respond to minute changes in the level of a narcotic (hydromorphone) at the target site: this was achieved by varying in a double-blind fashion the amount of narcotic delivered in response to triggering the apparatus and noting how the patient adapts the dosing interval in response to the imposed changes. Thirty-four patients were studied following extensive surgery. Observation times ranged from 16 to 75 h (median 45 h) during which 89 dose changes were initiated. While the majority of subjects adapted successfully to up to 4-fold variations in drug delivery, a sizeable minority (7/34) triggered the apparatus in response to some clue other than the amount of drug received. These non-drug responders seem to correspond to the "placebo reactors" of other therapeutic settings. Our calculations allowed the estimation of how large was the contribution of drug action and non-drug action to the overall therapeutic effect. In the drug-responsive group, the mean contribution of drug action was 78%, while among the non-drug responders this amounted to only 40%. The difference between these two figures is statistically significant (P less than 0.02), at the same time it also reveals important contributions of non-drug factors in drug responders and vice versa. Whether a subject behaves as a placebo reactor or not might depend on the circumstances rather than on innate mechanisms.

Analgesia

'Can I put--I want a slippers to put on': young children's development of request forms in a code-switching environment.

This paper concerns the development of semi-modal want/want to, and modals may, can and could in two Trinidadian children, whose Verb Phrase development was studied in naturalistic settings, between the ages of 2;3 and 4;1, and 2;4 and 4;9. The similarities and differences in development between the two are important for underlining a number of key factors in the acquisition process. Accepting the salience of requests/demands in early child language, the study draws attention to the child's propensity for using the means most readily available to him/her in the input, for expression of this function. Additionally, there is evidence of the child's ability to make stylistic discriminations at a very early age and of the propensity for making semantic distinctions among forms. The study indicates that work on the development of grammatical features is incomplete without consideration of sociolinguistic aspects of usage as integral to grammatical acquisition from the outset.

Child

Practical strategies for CNS role implementation.

Methods of implementing the clinical nurse specialist (CNS) role can be approached in many ways. Providing the clinical specialist with concrete strategies to use during role implementation or expansion can aid in expediting the acceptance process for the CNS. Some authors have discussed phases the CNS encounters during role development. Time span of these phases vary greatly, dependent not only on the individual specialist, but also on the system for which they are employed. Kramer's four phases detailing the adjustment period of the newly practicing nurse may be used when discussing CNS role implementation. These four phases are: honeymoon, shock/rejection, recovery, and resolution. Practical suggestions to expedite role implementation can make progression through these phases easier and less overwhelming. Although obstacles will often be present, the CNS must then become a catalyst by using creative ideas and effective coping mechanisms to effect change and advance the role.

Adaptation, Psychological

Microcomputer processing of film radiographs.

An inexpensive image processing system, assembled from commercially available components and driven by "in-house" software, was tested as a means of processing radiographs obtained in a radiology department. In this preliminary study, the main interest was to investigate, through subjective appraisal, the ability of the system to recover the image quality of poorly exposed radiographs. Subsidiary objectives were to obtain some information regarding the specification limits of the system and its components, as well as some quantitative estimate of its advantages for clinical diagnosis. The system was used to process a set of film radiographs of an anthropomorphic chest phantom, produced under conditions that were designed to provide a wide range of image qualities. Following this, four sets of randomly ordered processed and unprocessed images were formally assessed by a group of experienced observers. Consensus opinion from the group indicated that significant improvement could be obtained through simple image processing. Some radiographs regarded as unacceptable became, after processing, acceptable to viewers.

Humans

[Child and adolescent psychiatry--how, where, for whom? Questions on medical care and medical care research].

Regarding the question of child psychiatry--how, where, for whom? research of medical care can provide some answers, which are referred to here. However, many questions regarding epidemiology and research of structure, use and development remain open. Because of constant urgency to take action provisional situations have to be accepted, processes have to be attended to, statements have to be examined concerning their validity and theories concerning their range.

Adolescent

[Dynamics of the lipoprotein distribution in early hypercholesterolemia characterizes the activation of cholesterol transport].

Using gradient gel electrophoresis, the levels of major classes of rabbit blood sera lipoproteins were studied over a period of 28 days. Hypercholesterolemia persisted up to the 4th day with a subsequent decrease. This was paralleled with an increase in the levels of triglyceride-rich and apoB-containing particles. The decrease of the electrophoretic mobility of low density lipoproteins correlated with an increased content of the intermediate fraction. On the 28th day after the beginning of experiment the concentration of total high density lipoproteins showed an increase. The subfractional redistribution of HDL3 and HDL2 subclasses pointed to the stimulation of the accepting process and the overall reverse cholesterol transport system. A comparison of experimental results with literary data allowed to conclude that the relative decrease of the serum cholesterol level typical of hypercholesterolemia of one month duration is due to the activation of specific and nonspecific preventive mechanisms.

Animals

Degree of pathology as related to readiness to accept labels in process and reactive schizophrenics.

Two experiments were performed in order to determine whether readiness to accept deviant labels, as measured by acquiescence set, interacts with type of schizophrenia (process vs. reactive) to influence level of pathology. It was found on both a behavioral measure and a psychometric measure of psychopathology that high acquiescent process schizophrenics manifested more pathology than did either low acquiescent process or reactive schizophrenics, both of whom showed more pathology than high acquiescent reactive schizophrenics. The results suggest that one's acceptance of deviant labels as well as one's past history of being assigned social and evaluative labels may influence the patient's level of pathology. Scheff (1966), in viewing the mental patient from a sociological perspective, suggests that an important determinant of mental disorder is the acceptance by the deviant individual of the various labels which stigmatize him as mentally ill. If this is the case, then individual differences in readiness to accept or agree with labels about oneself may be related to the degree of pathology manifested in a psychiatric population. The present authors sought to determine if acquiescence set, as measured by the Agreement Response Scale (Couch & Keniston, 1960), is related to degree of pathology in schizophrenic patients. The Agreement Response Scale was used as a measure of the general tendency to acquiesce to or agree with personality statements or labels. The investigators performed two experiments, in Experiment 1 a behavioral measure of pathology was used and in Experiment 2 a psychometric measure of pathology was used. In addition, the schizophrenic Ss were grouped according to the process-reactive distinction as the reactive schizophrenic may be expected to have a more favorable history of labeling than would the process schizophrenic.

Adult

Analysis of patient response to preoperative computerized video imaging.

Preoperative computer-assisted video imaging was performed on 50 consecutive rhinoplasty candidates, along with routine preoperative photographs and assessment. Each patient then completed a questionnaire dealing with the imaging process. Patient acceptance of the imaging process was excellent. Responses indicated that most patients felt that video imaging improved communication between patient and surgeon, increased patient confidence in surgery and surgeon, and enhanced the patient-physician relationship. The future use of computer-assisted video imaging in teaching, preoperative planning, and improved post-operative patient satisfaction is discussed.

Adult

Signal processing: from mathematical theory to clinical acceptance or vice-versa?

Signal processing in physiology and medicine hasn't developed as well as one could have hoped in spite of important efforts in research. The bases for present techniques in signal processing are evaluated for the two types of signals encountered in physiology, namely, continuous signals and point processes. It seems that morphological analysis ought to be adapted to the study of continuous physiological signals and that point processes constitute an important form of signals. The principal areas where industrial development can be expected are explored.

Action Potentials

Accepting criticism. A positive process.

Criticism often has negative connotations, even when it is a planned supervisory technique and is part of a comprehensive approach aimed at improving employee behavior without damaging employee morale. The nurse may be the target of criticism from a variety of other people that he or she encounters in the health care setting. The nurse's response to criticism is important to optimal conflict resolution and to maintaining relationships with integrity. The nurse's actions and attitudes in response to criticism should be planned deliberately and directed at resolving the conflict.

Anger

Uniform guidance for medical care. A description of the process for preparing guidelines accepted by different levels of care.

Advice by telephone is an important part of primary health care service. Telephone advice is given at different levels of care. In order to give people confidence in the health care system it is important that personnel at different levels give similar advice for the same symptom or complaint. In order to establish generally accepted guidelines, discussions were held between personnel at different levels of care. This procedure was laborious but successful. Generally accepted guidelines could be agreed upon for all the symptoms and complaints discussed, altogether more than 60. This paper describes the procedure used during the collaborative work to provide these guidelines. It must be emphasised, though, that the guidelines should be adapted to local circumstances before being used as a practical aid in the health care service at health centres and at other outpatient units.

Clinical Protocols