Ca2+/calmodulin-dependent protein phosphorylation is not altered by amygdaloid kindling

Kindling is a process in which episodic electrical stimulation permanently increases seizure susceptibility. One mechanism to account for a change in seizure susceptibility is some alteration in signal transduction, possibly at the level of second messenger systems. In this study, male Long-Evans rats were kindled in the amygdala, and Ca2+/calmodulin (Ca2+/CaM)-dependent protein phosphorylation was assessed at the site of the primary kindled focus using one- and two-dimensional gel electrophoresis. In vitro phosphorylation of membrane and cytosol fractions in the presence of absence of Ca2+/CaM did not differentiate kindled from nonkindled amygdaloid tissue. These results suggest that changes in Ca2+/CaM-dependent phosphorylation are not related to the mechanism(s) underlying the establishment of an amygdaloid kindled focus.     

A study to explore the role of a community oncology nurse specialist

Cancer patients are increasingly being cared for in the community. However, the role of the community oncology nurse specialist (CONS) remains a rare appointment in the United Kingdom. There is little research evidence to substantiate the view that this is a worthwhile and effective role. This study aimed to explore the role of one CONS using a qualitative case study approach. The sample consisted of the CONS, seven patients, no relatives and five community nurses. Semi-structured interviews were used to elicit the view of these participants. In addition, documents containing details of the CONS's work to date were reviewed. A number of the CONS's role components were identified by the different respondent groups. Five themes were identified within the data collected: functions of the CONS, communication between the CONS and other health care professionals, structural and organizational factors, characteristics of the service and benefits to patients and their families. Furthermore, all respondent groups were positive about the service offered by the CONS, and felt that the role was valuable. Some negative features were identified and these were concerned with organizational aspects of the service. The findings suggest the need for further research and evaluation in this area.     

Improved quality of care and reduction of housestaff workload using trauma nurse practitioners

The University of California, Davis, Medical Center introduced the use of nurse practitioners (NPs) to the trauma service in fiscal year 1986-87 to alleviate the increasing burdens placed on the surgical housestaff in their attempt to accommodate the rising patient volume and acuity. The use of NPs was associated with a decrease in average length of stay for the seriously injured patients from 8.10 to 7.05 days while the length of stay for other patients in the hospital remained unchanged. Documentation of quality of care in the medical record increased substantially. For example, discharge summaries that were dictated by the NPs were judged complete in all aspects in at least 95% of sampled records compared with approximately 75% of records that were dictated by the residents. With introduction of the NPs, outpatient clinic waiting times decreased from 41 to 19 minutes. Patient complaints regarding the trauma team decreased from 16 to seven/year. Time saved for the housestaff averaged 352 minutes/day while the NPs were on duty. The NPs were well received by the hospital nurses, hospital quality assurance personnel, and ancillary services. They have proved to be of great value to the patients, the patients' families, the hospital, and the trauma team.     

A critical reflection on the personal impact of managerial hegemony within nurse education

This paper, written by two male nurse teachers, describes and analyses their experience of working in a nurse education culture permeated by the philosophy of business management The introduction of business management practices to nurse education is discussed as a reflection of the current political hegemony of market forces and individualism The authors discuss the implications for nurse teachers of being continually exposed to these politically motivated forces which increasingly provide the paradigm for service developments within the United Kingdom health services In discussing the impact of this exposure it is argued that at the personal level individual teachers are experiencing a degree of apathy and personal dissonance which undermines their professional value system, resulting in emotional distress and a crisis of identity It provides a critical reflection on the way organizational dynamics and power relations influence the subjective sense-making of individuals The authors use a multiplicity of perspectives, including those provided by individual psychology, power relations, feminism and personhood, to argue for the need to develop an alternative paradigm which is characterized by the valuing of individual persons, empathic sensitivity and the fostering of creativity been important to us from a personal and professional