Doctoral education in nursing for practitioner knowledge and for academic knowledge: the University of Adelaide, Australia

A retrospective review was made of 49 survivors who were mechanically ventilated for more than 48 hours in the neurosurgical ICU. Thirty-two patients (Gp I) were successfully extubated, 9 patients (Gp II) underwent tracheostomy after one or more failed extubations, and 8 patients (Gp III) underwent elective tracheostomy. Glasgow Coma Scale (GCS) scores at extubation were 11.3 +/- 2.8 (mean (SD) for Gp I vs 7.8 +/- 2.7 for Gp II (P = n.s.) and at elective tracheostomy (Gp III) was 5.4 +/- 2.3. Incidence of ventilator-associated pneumonia were 35% in Gp I vs 100% of patients in Gp II and III (P < 0.05). Reasons for reintubation in 7 of 9 patients (Gp II) were upper airway obstruction and tenacious tracheal secretions while 14 of 17 patients were weaned off the ventilator within 48 hours of tracheostomy. The length of stay in ICU was 16.8 +/- 7.1 days in Gp II vs 11.7 +/- 2.9 days in Gp III (P < 0.05). In our study, elective tracheostomy for selected patients with poor GCS scores and nosocomial pneumonia has resulted in shortened ICU length of stay and rapid weaning from ventilatory support.     

Human Resource Management for Continuous Improvement

This paper investigates the relationship between HRM practices and Continuous Improvement (CI) activities in order to gain an understanding of how the HRM function may be utilized to improve CI implementation success, and consequently, company performance. The paper begins with a brief review of the HRM and CI literature and then presents statistical analyses of data collected from the Continuous Improvement Network Survey (2003), which demonstrate that HRM has a significant effect on CI behaviour and company performance, with the strongest relationship between HRM, CI and performance occurring when companies align their CI activities with their strategic objectives and use systems, procedures and processes to measure the results of their CI activities.     

Quantitative effects of acquisition duration and temporal resolution on the measurement accuracy of prostate dynamic contrast-enhanced MRI data: a phantom study

Objectives

The aim of this study was to investigate the effect of the temporal resolution (T _res) and acquisition duration (AD) on the measurement accuracy of contrast concentration–time curves (CTCs), and derived phenomenological and pharmacokinetic parameter values, in a dynamic contrast-enhanced MRI experiment using a novel phantom test device.

Materials and methods

‘Ground truth’ CTCs were established using a highly precise optical imaging system. These precisely known CTCs were produced in an anthropomorphic environment, which mimicked the male pelvic region, and presented to the MRI scanner for measurement. The T _res was varied in the range [2–24.4 s] and the AD in the range [30–600 s], and the effects on the measurement accuracy were quantified.

Results

For wash-in parameter measurements, large underestimation errors (up to 40%) were found using T _res values ≥16.3 s; however, the measured wash-out rate did not vary greatly across all T _res values tested. Errors in derived K ^trans and v _e values were below 14 and 12% for acquisitions with {T _res ≤ 8.1 s, AD ≥ 360 s} and {T _res ≤ 16.3 s, AD ≥ 360 s}, respectively, but increased dramatically outside these ranges.

Conclusions

Errors in measured wash-in, wash-out, K ^trans, and v _e parameters were minimised using T _res ≤ 8.1 s and AD ≥ 360 s, with large errors recorded outside of this range.

     

Housing quality and resilience in New Zealand

There is extensive research on the negative health impacts of poor housing quality. However, little is known about the potential health benefits of high-quality housing in poor neighbourhoods. Neighbourhoods with unexpectedly good health outcomes despite high levels of deprivation have been deemed resilient places and housing quality in these areas may be a contributor to this resilience. This study aimed to evaluate whether an indicator of neighbourhood housing quality was associated with a previously quantified resilience index (RINZ) in New Zealand. It was found that areas with high housing quality tended to have higher median income, greater proportions of partnered people and shorter-term residents, and very low proportions of Māori. A positive association was found between housing quality and resilience, after adjustment for deprivation. There was no indication of differences by heterogeneity in housing quality within the aggregate unit of analysis. These findings pose the hypothesis that improving housing quality in similarly deprived areas that have poor health outcomes could potentially boost health. To extend this understanding, further development of a more sophisticated housing quality indicator is recommended.     

Partially observed epidemics in wildlife hosts: modelling an outbreak of dolphin morbillivirus in the northwestern Atlantic,June 2013–2014

Morbilliviruses cause major mortality in marine mammals, but the dynamics of transmission and persistence are ill understood compared to terrestrial counterparts such as measles; this is especially true for epidemics in cetaceans. However, the recent outbreak of dolphin morbillivirus in the northwestern Atlantic Ocean can provide new insights into the epidemiology and spatio-temporal spread of this pathogen. To deal with uncertainties surrounding the ecology of this system (only stranded animals were observed), we develop a statistical framework that can extract key information about the underlying transmission process given only sparse data. Our self-exciting Poisson process model suggests that individuals are infectious for at most 24 days and can transfer infection up to two latitude degrees (220 km) within this time. In addition, the effective reproduction number is generally below one, but reaches 2.6 during a period of heightened stranding numbers near Virginia Beach, Virginia, in summer 2013. Network analysis suggests local movements dominate spatial spread, with seasonal migration facilitating wider dissemination along the coast. Finally, a low virus transmission rate or high levels of pre-existing immunity can explain the lack of viral spread into the Gulf of Mexico. More generally, our approach illustrates novel methodologies for analysing very indirectly observed epidemics.     

Effect of exogenous somatotropin in Holstein calves on mammary gland composition and proliferation

Pubertal mammary gland growth and development are hormonally regulated, but the details are poorly understood in calves. Our purpose was to evaluate the effects of exogenous growth hormone (GH) on the biochemical composition of the prepubertal mammary gland, mRNA expression of selected genes, and histological characteristics of the developing parenchyma (PAR). In this experiment, 19 calves (7 ± 4 d of age) were randomly assigned to 1 of 2 treatments: bovine somatotropin (bST, 500 mg; n = 10) or placebo (Sal; 0.9% saline; n = 9). Animals were treated every 3 wk beginning on d 23. Calves were assigned to an early (65 d; tissue harvested after 2 treatment injections) or late collection time (107 d; tissue harvested after 4 treatment injections). Calves were fed milk replacer and calf starter for 8 wk and starter and hay thereafter. Parenchyma and mammary fat pad (MFP) from one udder half were harvested for analysis of protein, lipid, and DNA. Additional tissues were preserved for histological analysis or snap-frozen for quantitative real-time PCR. Somatotropin treatment did not significantly alter the mass of PAR or MFP or the general pattern of development of epithelial structures. Significant increases were observed in protein/100 kg of body weight (BW), total protein, DNA concentration, DNA/100 kg of BW, and total DNA in 107-d calves, and a significant treatment by day interaction was observed for DNA and lipid concentrations in PAR. In MFP, a significant decrease was observed in protein/100 kg of BW in bST-treated calves and in total MFP protein in 65-d calves. A treatment by day interaction was found for total protein, DNA, and protein/100 kg of BW. In PAR, relative expression of ATPase-binding cassette 3 and growth hormone receptor were reduced by bST and both were lower in 107-d-harvest calves. Epithelial cell retention of bromodeoxyuridine (BrdU; possible indicator of stem-like cells) was greatest in 65-d bST-treated calves, and a significant time of sampling response and treatment × time interaction were observed. Expression of the proliferation marker protein Ki67 was numerically higher in bST-treated calves but the difference was nonsignificant. Retention of the BrdU label was reduced in 107-d calves. Exogenous growth hormone given to calves may affect mammary tissue composition and epithelial cell gene expression in subtle ways but exogenous supplementation with bST alone is not likely to alter overall development patterns or affect the mass of mammary parenchymal tissue. Whether such subtle changes have an effect on subsequent development or function is unknown.     

Preliminary isotopic studies of fluids from the Cerro Prieto geothermal field

Preliminary isotopic studies of Cerro Prieto geothermal fluids and earlier studies of Mexicali Valley ground waters suggest local recharge of the geothermal system from the area immediately to the west. Oxygen isotope exchange of water with reservoir rock minerals at temperatures increasing with depth has produced fluids with oxygen-18 contents increasing with depth, and pressure drawdown in the southeastern part of the field has allowed lower oxygen-18 fluids to invade the production aquifer from above. The contents of tritium and carbon-14 in the fluid suggest only that the age of the fluid is between 50 and 10,000 years. The isotopic compositions of carbon and sulfur are consistent with a magmatic origin of these elements but a mixed sedimentary-organic origin appears more likely for carbon and is also possible for sulfur. Investigations of the isotopic compositions of geothermal and cold ground waters continue and are being expanded as fluids become available and as separation and analysis methods are improved.     

Muscle growth and exercise

This paper first reviews muscle growth and then considers the influence of exercise in growth. Knowledge about how muscle cells grow and some factors that may influence the growth pattern are discussed first since these effects must be considered before the influence of exercise becomes clear. Growth of muscle can occur in three ways: (1) by an increase in muscle cell numbers, (2) by an increase in muscle fiber diameter, and (3) by an increase in fiber length. All three of these mechanisms are involved in muscle growth. However, growth in cell numbers is limited to the prenatal and immediately postnatal period, with the animals and man being born with or soon reaching their full complement of muscle cells. Thus, growth occurs by either hypertrophy of the existing muscle fibers by adding additional myofibrils to increase the muscle mass or by adding new sarcomeres to the ends of the existing muscle fibers to increase their length. Both of these mechanisms occur during the growth process. Growth in the girth of the muscle fibers appears to take place by splitting of the myofibrils. This may be stimulated by development of stress creating an unequal pressure with splitting at the Z-band and development of additional SR and T-tubule systems. This adds to the diameter or girth of myofibers without any hyperplasia. The growth in length occurs at either end of the fibers and results in addition of new sarcomeres. In both cases, new myofibrillar protein must be synthesized and deposited in the muscle cells. It is suggested that adaptation by adding or removing sarcomeres is physiologically determined by the degree of force a muscle can generate that is in turn dependent on the degree of overlap of the thick and thin filaments. Thus, the amount of tension would control the number of in-series sarcomeres in a single muscle fiber. Nutrition is also known to play an important role in muscle and was discussed from the standpoint of the effects of nutritional adequacy and restriction. Although a nutritionally balanced and calorically adequate diet is required to achieve optimum muscle growth, it may be less efficient in terms of protein deposition than a moderately restricted diet. Muscle and bone deposition, however, can be limited on severely restricting the dietary intake. Although fat deposition is the first tissue to suffer on a severely restricted diet, muscle and bone follow next with the nervous system, brain and eyes being the last systems to be affected.(ABSTRACT TRUNCATED AT 400 WORDS)     

Update on Glycosphingolipids Abundance in Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is the most frequent type of primary liver cancer. Low numbers of HCC patients being suitable for liver resection or transplantation and multidrug resistance development during pharmacotherapy leads to high death rates for HCC patients. Understanding the molecular mechanisms of HCC etiology may contribute to the development of novel therapeutic strategies for prevention and treatment of HCC. UDP-glucose ceramide glycosyltransferase (UGCG), a key enzyme in glycosphingolipid metabolism, generates glucosylceramide (GlcCer), which is the precursor for all glycosphingolipids (GSLs). Since UGCG gene expression is altered in 0.8% of HCC tumors, GSLs may play a role in cellular processes in liver cancer cells. Here, we discuss the current literature about GSLs and their abundance in normal liver cells, Gaucher disease and HCC. Furthermore, we review the involvement of UGCG/GlcCer in multidrug resistance development, globosides as a potential prognostic marker for HCC, gangliosides as a potential liver cancer stem cell marker, and the role of sulfatides in tumor metastasis. Only a limited number of molecular mechanisms executed by GSLs in HCC are known, which we summarize here briefly. Overall, the role GSLs play in HCC progression and their ability to serve as biomarkers or prognostic indicators for HCC, requires further investigation.