Caring for dying children: nurses' experiences

Interviews with 25 nurses in this grounded theory study show that when nurses recognized that a child's death was inevitable, they struggled with both grief distress and moral distress. Their distress occurred within the context of the nurse-patient relationship. Nurses employed a range of strategies to manage their distress. Several conditions facilitated or constrained nurses' strategies, and resulted in far-reaching implications both professionally and personally.     

A preliminary study of parental stress and child behaviour in families with twins conceived by in-vitro fertilization

This paper reports on a preliminary study of parenting quality, parental stress and child behaviour in families with twins conceived by in-vitro fertilization (IVF) in comparison with families with naturally conceived twins. No differences were found between the types of family in parenting quality or child behaviour. However, parents whose children were conceived by IVF reported greater stress associated with parenting than parents with naturally conceived twins.     

Calculated hardenability for improved consistency of properties in heat treatable engineering steels

Hardenability is one of the most important parameters controlling the heat treated properties of engineering steels. It affects the consistency of response for microstructure, hardness, strength, toughness, and dimensional change (distortion). This study illustrates that a major benefit of controlling hardenability is improving the consistency of dimensional distortion resulting from heat treatment. To facilitate the supply of steels to hardenability limits, especially restricted hardenability, a new technique was developed for the prediction of Jominy hardenability from chemical composition. The technique, termed the “Database Method,” uses measured Jominy hardenability and chemical composition data, contained in a database, to calculate the hardenability for a query composition. Using up to ten known steels, selected from the database with compositions closely matching that of the query steel, a small adjustment is made to the measured hardenability of each known steel allowing for the small difference in composition between the query and chosen steel. The final calculated result for the query steel is taken as the average of the various estimates. The basis of the Database Method is explained, and the advantages are illustrated for selecting engineering grades.     

Inhibition by 5-(tetradecyloxy)-2-furoic acid of fatty acid and cholesterol synthesis in isolated rat hepatocytes

Fatty acid and cholesterol synthesis in isolated rat hepatocytes were strongly inhibited by 5-(tetradecyloxy)-2-furoic acid. With either³H₂O or [2-¹⁴C]acetate as the labeled precursor, the concentrations of inhibitor causing 50% decrease in fatty acid and cholesterol synthesis were, respectively, <0.005 mM and 0.020 mM. At 0.1 mM inhibitor, citrate concentration in cells from fed rats was increased by 75%; lactate and pyruvate concentrations were decreased by 30%; ethanol oxidation was decreased by 20%; with cells from starved rats, the mitochondrial [NAD⁺]/[NADH] was decreased. Other parameters were unaffected. Both its potency and its specificity indicate that 5-(tetradecyloxy)-2-furoic acid will be useful in studies on the regulation of lipid biosynthesis.     

Insulin depletion leads to adipose-specific cell death in obese but not lean mice

Mutation of the obese gene produces obesity, hyperinsulinemia, and compensatory "overexpression" of the defective gene. As insulin activates obese gene expression, it seemed possible that hyperinsulinemia might be responsible for overexpression of the gene. To address this question we rapidly neutralized circulating insulin by injection of an insulin antibody. Unexpectedly, insulin depletion in obese (ob/ob or db/db) mice caused massive adipose RNA degradation confirmed by histological analysis to result from adipocyte cell death by a largely necrotic mechanism. This effect was not observed in lean littermates and was completely corrected by coadministration of insulin. Comparison of multiple tissues demonstrated that the effect was restricted to adipose tissue. Insulin depletion in obese mice by administration of streptozotocin also led to cell death, but this death was less extensive and appeared to be apoptotic in mechanism. Thus insulin may promote the survival side of the physiological balance between adipocyte survival and death.     

Dynamic fatigue of brittle materials containing indentation line flaws

A study is made of the dynamic fatigue response of brittle materials containing indentation-induced line flaws. The theoretical fracture mechanics of median crack evolution to failure under applied tension are first developed, with special emphasis on the role of residual contact stresses. In particular, it is shown that use of fatigue curves to evaluate the exponent in an assumed power-law crack velocity function may result in systematic error, by as much as a factor of two, if proper account is not taken of this residual contact contribution. Data from strength tests on soda-lime glass bars in water, using a tungsten carbide cutting wheel to introduce the median pre-cracks, confirm the basic predictions. The results suggest that extreme care needs to be exercised when using surfaces with a contact history, e.g. as with machining damage, in fatigue test programmes for materials analysis.     

Bypass surgery for vascular disease of the carotid system

A series of 58 operations on 56 patients, in whom a branch of the superficial temporal artery was anastomosed to a branch of the middle cerebral artery (STA-MCA bypass or Yasargil procedure), is reviewed. These operations were performed chiefly for occlussions or for inaccessible stenotic lesions of the internal carotid or middle cerebral arteries. Patency in eight patients operated on from April 1971 through November 1973 was low (25%). Patency in patients operated on since July 1974 has been high (95%). There have been no deaths and no major ischemic strokes attributable to the surgery. The rationale for this procedure is considered in relationship to the anatomy and physiology of the cerebral circulation and the pathogenesis of syndromes of cerebral ischemia. The operation appears to have a low morbidity in good-risk patients. The role of this operation in managing common manifestations of cerebral vascular disease such as focal transient cerebral ischemic attacks (TIAs) and amaurosis fugax, although not fully established, appears encouraging. The procedure seems useful for orthostatic cerebral ischemia caused by multiple occlusions of major extracranial (and intracranial) vessels and, occasionally, for progressing strokes related to internal carotid artery occlusion, both of which are relatively uncommon manifestations of cerebral vascular occlusive disease. It may have application in the rare "slow stroke." The procedure is probably of limited value, if any, in the management of large completed infarcts but may be indicated in selected patients with small infarctions who have preserved most of their cerebral function and who have had evidence of subsequent focal ischemic events. The procedure is useful for bypassing giant aneurysms or basofrontal tumors invading major vessels. It may have a role in the management of fibromuscular disease of the internal carotid artery.     

Discriminative Stimulus, Reinforcing, Physical Dependence, and Antinociceptive Effects of Oxycodone in Mice, Rats, and Rhesus Monkeys.

Despite oxycodone's (4,5-epoxy-14-hydroxy-3-methoxy-17-methylmorphinan-6-one) history of clinical use and the attention it has received as a drug of abuse, few reports have documented its pharmacology's relevance to its abuse or its mechanism of action. The purposes of the present study were to further characterize the analgesic effects of oxycodone, its mechanism of action, and its effects in terms of its relevance to its abuse liability. The results indicate that oxycodone had potent antinociceptive effects in the mouse paraphenylquinone writhing, hot-plate, and tail-flick assays, in which it appeared to be acting as a μ-opioid receptor agonist. It generalized to the heroin discriminative stimulus and served as a positive reinforcer in rats and completely suppressed withdrawal signs in morphinedependent rhesus monkeys. These results suggest that the analgesic and abuse liability effects of oxycodone are likely mediated through μ-opioid receptors and provide the first laboratory report of its discriminative stimulus, reinforcing, and morphine cross-dependency effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The accuracy of refractive and absorptive indices derived from reflectance measurements on low-reflecting materials

Errors in the refractive and absorptive indices derived from reflectance measurements on relatively low-absorbing organic substances in two media are discussed, with particular reference to coal macerals and cokes. Variation of errors in refractive and absorptive indices at different levels of reflectance, and the effect of different combinations of sign and magnitude of reflectance error on the two parameters, are presented in both tabulated form and as diagrams. The errors in the refractive and absorptive indices vary in relation to reflectance level, the reflectance difference between standard and unknown, the difference between the refractive indices of the unknown and the immersion oil and the wavelength of reflectance measurement within the visible spectrum. Despite the variation, it is possible to obtain useful values for the parameters within the low-absorbing range. If the absorption is negligible, it may not be possible to obtain realistic values for absorptive index, but even where this is the case, satisfactory values for refractive index can still be obtained. Suggestions are made on how to minimize reflectance errors and to increase the accuracy of dispersion curves for derived refractive and absorptive indices within the visible spectrum.