How to do it: making audit work

The orthodontic Audit Working Party of the Faculty of Dental Surgery, Royal College of Surgeons of England, in collaboration with the Centre for Medical Education, Ninewells Hospital and Medical School, Dundee developed an audit project entitled 'Clinical Audit: Scenarios for Evaluation and Study'. The aim of the project was to contribute to the construction of clinical guidelines for orthodontists. This article, the first of a short series, describes the background to and general results of the study. Further articles will study individual aspects of the project.     

Inhibition of protein synthesis by zinc: comparison between protein synthesis and RNA synthesis

Inhalation of zinc fumes may lead to the acute respiratory distress syndrome. The mechanisms of pulmonary zinc toxicity are not yet understood. Therefore we investigated zinc-dependent depression of protein and RNA synthesis in rat and human lung cell lines. 1. After exposure to 120 or 150 micromol/l zinc, RNA synthesis as assessed by uridine incorporation decreased by 60-70% between 0 and 2 h exposition in rat alveolar type II cells (L2 cells) and human fibroblast-like cells (11Lu and 16Lu cells), and by 90% between 0 and 4 h in carcinoma-derived cells (A549 cells). 2. After 2 h exposure, L2, 11Lu, and 16Lu cells were half-maximally inhibited by 50 micromol/l zinc, whereas A549 cells were more resistant with half-maximal inhibition at 100 micromol/zinc. 3. Protein and RNA synthesis was inhibited in parallel in L2, 11Lu, and A549 cells as indicated by simultaneous determination of uridine and amino acid incorporation. In 16Lu cells, the decline in protein synthesis preceded RNA synthesis inhibition. Pretreatment with RNA synthesis inhibitors (amanitin or actinomycin D) had no effect on time curve and intensity of RNA synthesis inhibition. Taken together, our results indicate that the suppression of RNA and protein synthesis likely are independent phenomena, due to direct zinc effects on these biosynthetic pathways.     

Performance monitoring: How it affects work productivity.

Performance monitoring refers to gathering information about the work effectiveness of others. Traditionally, monitoring has been assumed to influence people's work behavior only to the extent that it is accompanied by additional managerial action (e.g., delivering positive or negative performance consequences). It seems likely, however, that performance monitoring may also have an independent effect on work behavior by influencing the perceived importance of the monitored task. This hypothesis was tested in a laboratory experiment in which subjects worked at 2 tasks for 2 hrs. Ss' work output was significantly affected both by monitoring alone and by monitoring coupled with contingent performance consequences, and the effect of monitoring alone was mediated by perceptions of task importance. The latter result is discussed in terms of social-information-processing theory, especially as it relates to role-making processes in organizations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Recovery from work shifts: How long does it take?

Although regulations on work hours usually include a minimum weekly rest period, there is little empirical evidence concerning recovery from work. Shift-working nurses (N?=?61) used a handheld computer for 28 days to complete self-ratings, cognitive-performance tasks, and a sleep diary. Many measures were worse on rest days that followed a night shift rather than a day shift and tended to be worse on 1st rest days compared with subsequent rest days. Alertness was lowest on the 1st rest day following a night shift. Social satisfaction was better on workdays that were preceded by 2 rather than 1 rest day. Reaction time (RT) decreased over consecutive night shifts and tended to increase over rest days following night shifts. The results are interpreted as being consistent with the combined adaptive costs of fatigue and adjustment to and from a nocturnal routine. The practical implications for scheduling rest days are considered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive-behavior therapy for older adults: How does it work?

The basic premise of cognitive-behavior therapy (CBT) is that depression is mediated by depressogenic patterns of thinking. Research with a general adult population has not consistently supported the proposed mediational effect of depressogenic thinking (M. Whisman, 1993), as measured by the Dysfunctional Attitudes Scale (DAS) of A. T. Beck et al (1991). Research suggests that the mediational effect of the DAS is even weaker with an older adult population. Proposed reasons for this age difference include a greater effect of the "common factors" of psychotherapy (S. Ilardi and W. Craighead, 1994) and an increased need to specifically treat hopelessness in older adults. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Ribosomes: protein synthesis in slow motion

Using image reconstruction methods, electron microscopists can now visualize ribosomes at resolutions so high that the changes in the positions of ribosome-bound tRNAs which occur during protein synthesis can be seen.     

Chemical protein synthesis

Chemical protein synthesis is a field in transition. Previously, the synthetic accomplishment itself was the major focus of work in this field. Increasingly, chemical synthesis is now being applied to understanding how biological function originates in the structure of the protein molecule. A novel approach--'chemical ligation', which is the chemoselective reaction of unprotected peptide segments in water at pH7--has made the total synthesis of proteins a robust and practical route to the study of structure-function relationships. For certain protein families, chemical protein synthesis is the most effective way to obtain functional proteins direct from genome sequence data.     

How nurses can work with the EC Commission

For nurses in the European Community it is important that their voice be heard in Brussels, particularly when new initiatives are being developed. Below, the author introduces nurses to the workings of the Commission.     

How education can work to improve care standards

Community care provision often fails elderly and vulnerable people because of a lack of coordination between health and social services and increasing pressure on budgets. With the closure of many long-stay beds in the NHS, more people with greater dependencies are being cared for in independent sector residential and nursing homes. The quality of their care cannot be guaranteed and the role of nursing is often under threat. This paper outlines how an educational framework for health professionals and care workers could work towards improving care standards.     

Instruments for assessing competency to stand trial: How do they work?

Previous research has demonstrated that the Competency Screening Test (CST) and a revised version of the Georgia Court Competency Test (GCCT-MSH [Mississippi State Hospital]) accurately predict competency decisions made by forensic examiners. We used internal consistency analyses, item analyses, and factor analyses to determine how the instruments predict the competency criterion. These analyses failed to reveal a clear basis for the predictive power of the CST. We were unable to establish correlates of the better predictors or to label the item clusters that emerged from the factor analyses. In contrast, analyses of the GCCT-MSH revealed a straightforward internal structure that comprised three factors. The factor that predicted staff decisions most accurately (Specific Legal Knowledge) consisted of items that were relevant for the individual defendant's case and that appeared to tap psychopathology as well as intellectual ability. This study highlights the need for investigators to examine the empirical relationships between psychological constructs and defendants' legally relevant functional abilities. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

RNA synthesis in alpha-amanitin-poisoned rats: prevention of recovery by inhibition of protein synthesis

The treatment with cycloheximide of rats previously poisoned with alpha-amanitin hinders the recovery of RNA synthesis observed in the liver of rats treated with alpha-amanitin alone. The recovery of RNA synthesis can be ascribed to the capability of poisoned rats to synthesize new RNA-polymerase II.