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41.
Recent research has found that family caregivers do not discuss their caregiving in terms of tasks but instead describe their care as shaped by concerns, commitments and goals. The purpose of this paper is to challenge the ways in which nurses approach the family caregiving process and to explore possibilities for evolving nursing knowledge by questioning existing practice in the light of developing insight into the ways in which being a family caregiver is meaningful. A critique of the philosophical orientations of rationalism and empiricism provides a platform to discuss the merits of a Heideggerian phenomenological approach in assisting nurses to better understand family caring experience. Such critique serves to support the notion of displacing the traditional scientific view as the prime means of disclosing truth, acknowledging alternative ways of knowing.  相似文献   
42.
BACKGROUND: Fever is commonly observed in patients with human immunodeficiency virus (HIV) disease and frequently eludes diagnosis. The role of bone marrow biopsy in the diagnosis of fever of unknown origin in patients infected with HIV remains controversial. PATIENTS AND METHODS: One hundred twenty-three consecutive patients with 137 episodes of fever lasting 10 or more days without diagnosis after 1 week of hospitalization were evaluated by bone marrow biopsy. RESULTS: Overall, a specific diagnosis was achieved in 52 episodes by means of culture and histopathological examination (diagnostic yield, 37.9%). Three types of disease were found: mycobacterial infections (n = 36, 69% of documented episodes), including 18 patients with disseminated tuberculosis and 14 with Mycobacterium avium-intracellulare complex infections; non-Hodgkin lymphomas (n = 12, 23%); and visceral leishmaniasis (n = 4, 8%). Although bone marrow cultures were more sensitive than microscopic examination with special stains for the diagnosis of mycobacterial infections, the pathological examination of bone marrow led to a more rapid diagnosis of disease. In addition, the histopathological examination of bone marrow alone led to the diagnosis of a specific condition in 43 episodes (31.3% of all episodes). CONCLUSIONS: Bone marrow biopsy is a useful procedure for the diagnosis of fever in patients with advanced HIV disease, particularly in areas where tuberculosis and leishmaniasis are prevalent. Involvement of the marrow may be the first indication of the existence of extranodal non-Hodgkin lymphoma. For Mycobacterium avium-intracellulare complex infection, blood cultures were more sensitive than bone marrow biopsy.  相似文献   
43.
Development of an octocalcium phosphate cement   总被引:2,自引:0,他引:2  
From previous studies it is known that alpha-tertiary calcium phosphate and dicalcium phosphate form a cement upon mixing with water. In this study this cement was optimized in terms of the milling of the constituents, their molar ratio, the amount of hydroxyapatite added and the water/powder ratio. The optimum Ca/P molar ratio of the cement mixture was 1.36±0.03. X-ray diffraction showed the reaction product to be octocalcium phosphate. Addition of precipitated hydroxypatite of over 3% diminished the final strength of the cement significantly. However, admixtures of only 2% of precipitated hydroxyapatite (a) kept the final compressive strength at 30±5 MPa after soaking in Ringers solution at 37°C, (b) diminished the initial setting time from 27.5 to 10 min and the final setting time from 65 to 40 min, (c) diminished the time in which the final strength was reached from 36 to less than 14 h. The tensile strength of this cement is 19±1% of its compressive strength. The optimum water/powder ratio as found in this study was 0.30 g/g.  相似文献   
44.
OBJECTIVE: The clinical course of transitional cell carcinoma of the bladder can be difficult to predict due to its potential to invade the muscle layer and/or develop to a high grade lesion. Bladder carcinoma can arise from genetic changes that may activate the oncogenes (-c-erbB2, c-erbB1, c-myc, ras, etc.) and/or inactivate the suppressor genes (p53, Rb). The aim of the present study is to continue a study protocol on the molecular biology of bladder tumors. METHODS/RESULTS: From January, 1993 to January, 1995, 85 patients were studied. These patients were divided into two groups: the first group comprised 14 controls of urothelial tissue and the second comprised 65 cases of transitional cell carcinoma of the bladder. p53 expression was determined by an immunohistochemical method (NCL-p53-DO7 monoclonal antibody). Quantification of the p8 oncoprotein in cytosol and EGFR (epidermal growth factor receptor) in membrane was performed by ELISA (Oncogene Science) and RIA (Vienna Lab), respectively. A statistically significant relationship between the expression of p53 and EGFR with tumor stage and grade was found. Quantification of p185 and EGFR showed higher values in the tumor tissue than in the control samples, but a worse survival could not be determined. CONCLUSIONS: The present study shows that p53 expression can be considered to be a prognostic factor. It provides useful information on the aggressive behaviour of the tumor and has a direct relation with the survival rates.  相似文献   
45.
This study examined the nature and impact of dyadic perfectionism over a 3-month interval within a sample of 116 college students who were currently involved in an intimate heterosexual relationship. Dyadic perfectionism scores were stable and correlated as expected with scores on concurrent measures of adult attachment orientations and relationship satisfaction. Logistic regression analyses revealed that, controlling for initial commitment status and adult attachment orientations, Time 1 dyadic perfectionism scores significantly and uniquely predicted relationship continuity 3 months later. Lastly, controlling for social desirability, relationship commitment status, and Time 1 adult attachment orientation scores, Time 1 dyadic perfectionism scores also uniquely predicted Time 2 relationship distress. Findings provide additional evidence that dyadic perfectionism is a risk factor for relationship dysfunction. (PsycINFO Database Record (c) 2010 APA, all rights reserved)  相似文献   
46.
A method is proposed for calculating the stress intensity factor KI of a surface semielliptical crack for almost any monotonie stress function in the crack section. The equations are derived for calculating correction and adjustment coefficients Mi and Ai. Computed values of KI are compared with the published data. The results of comparison show that agreement between these results is satisfactory.Translated from Problemy Prochnosti, No. 1, pp. 33–36, January, 1992.  相似文献   
47.
Protein kinase C (PKC) isoforms are altered in colon tumors and upon exposure of intestinal mucosa to nutrients. We evaluated the effects of the PKC inhibitors staurosporine and calphostin C on human Caco-2 intestinal epithelial proliferation, motility, and differentiation. Motility was quantitated by monolayer expansion and the brush border enzymes dipeptidyl dipeptidase (DPDD) and alkaline phosphatase (AP) by synthetic substrate digestion. Staurosporine (0.03-1.0 ng/ml) and calphostin C (10(-12) M-10(-4) M) dose-dependently inhibited monolayer expansion and AP but stimulated DPDD. Proliferation was also inhibited but the effects of each inhibitor on motility, AP, and DPDD were preserved after mitomycin C proliferative blockade, suggesting that these effects were proliferation-independent. PKC inhibitors independently inhibit motility, AP and proliferation in human intestinal Caco-2 epithelial cells, but selectively stimulate the small intestinal differentiation marker DPDD. PKC may regulate small intestinal epithelial differentiation.  相似文献   
48.
Blends of polyamide and high‐density polyethylene show adequate properties for a large range of applications: they are used for the production of filaments, containers, and molding resins. The effect of the addition of 2 wt % of a compatibilizer, maleic anhydride grafted polyethylene, to the blend was studied and compared to the use of postconsumer polyethylene. The samples were extruded with single‐ and twin‐screw extruders with 25, 50, or 75 wt % f polyethylene, and the test specimens, molded by injection, were characterized by stress–strain tests, thermal properties, and morphologies. Processing the blends with postconsumer polyethylene in both extruders improved the mechanical properties in comparison to the blends processed with high‐density polyethylene and the compatibilizer. The morphologies of these blends showed that there was a decrease in the domain size of the disperse phase with the use of the compatibilizer or postconsumer polyethylene. The results indicate that for this blend, postconsumer polyethylene substituted, with advantages, for the necessity of a compatibilizer and the use of the high‐density polyethylene. © 2008 Wiley Periodicals, Inc. J Appl Polym Sci, 2008.  相似文献   
49.
Extended Hyperbolic Model for Sand-to-Concrete Interfaces   总被引:1,自引:0,他引:1  
A relatively simple, four-parameter extended hyperbolic model for interfaces was developed for use in soil-structure interaction analyses. The model accommodates arbitrary stress path directions and includes three important elements: (1) development of a yield surface during interface shear; (2) a formulation for yield-inducing shear stiffness that is applicable to any stress path orientation; and (3) a formulation for unloading-reloading shear stiffness. The model was evaluated against the results of shear tests performed at the interface between three different types of sand and a concrete surface under a variety of stress paths. Comparisons between measured and calculated interface response indicate that the model provides accurate estimates of the response of sand-to-concrete interfaces.  相似文献   
50.
BACKGROUND: Nisin is a commercially available bacteriocin produced by Lactococcus lactis ATCC 11454 and used as a natural agent in the biopreservation of food. In the current investigation, milk whey, a byproduct from dairy industries was used as a fermentation substrate for the production of nisin. Lactococcus lactis ATCC 11454 was developed in a rotary shaker (30 °C/36 h/100 rpm) using two different media with milk whey (i) without filtration, pH 6.8, adjusted with NaOH 2 mol L?1 and without pH adjustment, both autoclaved at 121 °C for 30 min, and (ii) filtrated (1.20 µm and 0.22 µm membrane filter). These cultures were transferred five times using 5 mL aliquots of broth culture for every new volume of the respective media. RESULTS: The results showed that culture media composed of milk whey without filtration supplied L. lactis its adaptation needs better than filtrated milk whey. Nisin titers, in milk whey without filtration (pH adjusted), was 11120.13 mg L?1 in the second transfer, and up to 1628‐fold higher than the filtrated milk whey, 6.83 mg.L?1 obtained in the firstt transfer. CONCLUSIONS: Biological processing of milk byproducts (milk whey) can be considered a profitable alternative, generating high‐value bioproducts and contributing to decreasing river disposals by dairy industries. Copyright © 2008 Society of Chemical Industry  相似文献   
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