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.     

Nodular and granulomatous form of periarteritis nodosa caused by the hepatitis B virus

Human herpesvirus type 6 DNA derived from human breath was discovered to contaminate PCR reactions during routine reaction preparation. Parallel PCR experiments were conducted in which expiratory secretions were blocked by a surgical mask, while others were performed without any attempt to circumvent respiratory contamination. The experimenter was previously determined to harbor HHV-6 DNA in the saliva. All reactions in which expiration was obstructed were negative for HHV-6 DNA via PCR. Reactions in which there was no attempt to obstruct respiratory secretions were positive for HHV-6 DNA. These data suggest that PCR assays investigating the presence of HHV-6 may be highly susceptible to contamination from the experimenter leading to false positive results.     

Open heart surgery in adults at Ramathibodi Hospital

Two hundred and thirty consecutive adult patients underwent open heart surgery at Ramathibodi Hospital from January 1, 1994 to December 31, 1995. The patients were categorised into 4 groups, A, B, C and D; consisting of 52 (22.4%) with adult congenital heart disease, 121 (52.2%) with acquired valvular heart disease 52 (22.4%) with coronary heart disease and 7 (3%) with diseases of the aorta. The mortality in various groups were analyzed separately each year, in 1994 and 1995. The overall mortality, in adult congenital heart disease, was 5.7 per cent consisting of acquired valvular heart disease (6.6%), coronary artery disease (CAD) (3.8%) and diseases of the aorta (14.2%). We found that the incidence of CAD and the patients underwent CABG were increasing. The overall mortality for open heart surgery in adults was 6 per cent. Though the number of patients who underwent open heart surgery did not truly represent all heart diseases, trends of coronary artery disease seem to be increasing. Risk factors of coronary artery disease and low mortality from CABG might be the main reasons that CABG has increased obviously.     

The relationship of individual and family factors to the psychological well-being of junior high school students living in urban poverty

This study examined the contribution of individual and family factors to psychological adjustment in a sample of junior high school students living in urban poverty. Identity development and perceived parental treatment were hypothesized to serve as mediating, or protective, factors between economic hardship and levels of self-esteem, depression, and loneliness. Consistent with the hypotheses, identity development did serve as a mediator between poverty and psychological adjustment. While perceived parental treatment was not related to economic hardship, it was clearly associated with well-being in this sample. Findings are discussed in terms of the differing contributions of family and individual development, as well as the importance of mediators in assessing the effects of poverty on young adolescents.     

Interferon-alpha in the idiopathic hypereosinophilic syndrome: consideration of five cases

A consortially developed continuing education series for rural nurses was implemented using videoconferencing technology. This article provides an overview of distance education technologies, the history and goals of the demonstration project at Edinboro University, and the coordination activities and instructional issues faced by the faculty. Participants became acquainted with distance education technology as they developed a process for program development, delivery, evaluation, and for awarding continuing education credits. The project was well received by instructors and students and testified to previous findings in the literature that distance education is a viable delivery system in terms of a teaching tool, learner satisfaction, and cost effectiveness.     

Molecular biological approach to functions of telencephalin, a cell adhesion molecule and HNK-1 carbohydrate epitope, which is commonly expressed on cell adhesion molecules in the nervous system

Cell surface carbohydrates modulate a variety of cellular functions, including recognition and adhesion. The HNK-1 carbohydrate epitope, which is recognized by the monoclonal antibody HNK-1, is specifically expressed on a series of cell adhesion molecules and also on some glycolipids in the nervous system over a wide range of species from insect to mammal. The HNK-1 epitope is spatially and temporally regulated during the development of the nervous system and associated with neural crest cell migration, neuron to glial cell adhesion, outgrowth of astrocytic processes and migration of cell body, as well as the preferential outgrowth of neurites from motor neurons. These observations together with the unusual chemical nature of the HNK-1 epitope, namely a non-reducing terminal 3-sulfoglucuronic acid residue, prompted us to study the biosynthesis of the NHK-1 epitope, in which a unique glucuronyltransferase(s) plays a key role. We found that the respective glucuronyltransferases are involved in the biosynthesis of the HNK-1 epitope on glycoproteins (GlcAT-P) and on glycolipids (GlcAT-L). Then, we isolated a novel glucuronyltransferase (GlcAT-P) specific for glycoprotein substrates and its cDNA from the rat brain. The primary structure deduced from the cDNA sequence predicted a type II transmembrane protein with 347 amino acids. Transfection of the GlcAT-P cDNA into COS-1 cells induced not only expression of the HNK-1 epitope on the cell surface but also marked morphological changes of the cells, suggesting that the HNK-1 epitope was associated with the cell-substratum interaction. The GlcAT-P cDNA obtained in this study will be a useful molecular tool to open the way for further steps in the elucidation of the biological function of the HNK-1 carbohydrate epitope in the development of the nervous system.