The insect cytochrome oxidase I gene: evolutionary patterns and conserved primers for phylogenetic studies

Insect mitochondrial cytochrome oxidase I (COI) genes are used as a model to examine the within-gene heterogeneity of evolutionary rate and Its implications for evolutionary analyses. The complete sequence (1537 bp) of the meadow grasshopper ( Chorthippus parallelus ) COI gene has been determined, and compared with eight other Insect COI genes at both the DNA and amino acid sequence levels. This reveals that different regions evolve at different rates, and the patterns of sequence variability seems associated with functional constraints on the protein. The COOH-terminal was found to be significantly more variable than Internal loops (I), external loops (E), transmembrane helices (M) or the NH2 terminal. The central region of COI (M5-M8) has lower levels of sequence variability, which Is related to several Important functional domains In this region. Highly conserved primers which amplify regions of different variabilities have been designed to cover the entire insect COI gene. These primers have been shown to amplify COI in a wide range of species, representing all the major insect groups; some even In an arachnid. Implications of the observed evolutionary pattern for phylogenetic analysis are discussed, with particular regard to the choice of regions of suitable variability for specific phylogenetic projects.     

Syringomyelia: an expanding problem

Syringomyelia, a central cavitation of the spinal cord, was once thought to be a rare disorder. Associated with congenital malformations as well as trauma and tumors, a syringomyelia can cause a variety of sensory complaints, including parasthesias, changes in temperature recognition, and pain. Other symptoms may range from gastrointestinal problems to shoulder arthropathy. Left unchecked, a syringomyelia can expand and lead to permanent disability. The nurse practitioner should be suspicious of the presence of a syrinx in patients who have otherwise unexplained sensory deficits that follow cervical or thoracic dermatomes.     

Cultural competence: an evolutionary perspective

PROBLEM: The need for conceptual clarity, which is essential for effective communication related to cultural competence. Practice, education, administration, and research are identified. METHODS: Rodgers' (2000) method of concept analysis. FINDINGS: Attributes of cultural competence were identified as cultural awareness, cultural knowledge, cultural understanding, cultural sensitivity, and cultural skill. CONCLUSIONS: Cultural competence can best be identified as a nonlinear dynamic process that is never ending and ever expanding. It is built on increases in knowledge and skill development related to its attributes.     

Fatigue in children with long-term conditions: an evolutionary concept analysis

Title.  Fatigue in children with long-term conditions: an evolutionary concept analysis.
Aim.  This paper is a report of a concept analysis of fatigue in children with long-term conditions.
Background.  There is little research focused on the experience of fatigue in children. Previous work has focused primarily on children living with cancer. It is necessary to clarify and refine the concept, and add to the knowledge base that supports ongoing theoretical work in order to improve the clinical care of children with long-term conditions who experience fatigue.
Method.  English language literature published from 1989 to 2007 was searched using the CINAHL, Medline and PsychINFO data bases. Sixty-two papers and two book chapters were used in this concept analysis. Rodgers' method of evolutionary concept analysis was used. This inductive method helps us to view the concept in a sociocultural and temporal context.
Findings.  The number of publications focusing on fatigue in children is increasing. The analysis yielded two surrogate terms, five attributes, three antecedents and seven consequences. Based on this analysis, fatigue in children with long-term conditions appears to be a subjective experience of tiredness or exhaustion that is multidimensional and includes physical, mental, and emotional aspects.
Conclusions.  Evidence suggesting children with long-term conditions experience fatigue is increasing, but conceptual gaps remain. This analysis has yielded a view of fatigue in children that illustrates healthcare professionals' limited yet growing awareness of the symptom. Ongoing study as a means to refine our understanding of the concept could potentially lead to important contributions to clinical care of children with long-term conditions.     

Myopathic dropped head syndrome: an expanding clinicopathological spectrum

OBJECTIVE: A number of neuromuscular conditions may lead to a dropped head syndrome (DHS), with some patients developing a late onset noninflammatory myopathy affecting only, or predominantly, neck extensor muscles (NEM). The cause, pathogenesis, and nosological classification of this condition are unclear. To further investigate this condition, the authors evaluated the clinical, electrodiagnostic and pathologic findings in seven patients with a myopathic DHS. DESIGN: Analysis of clinical data, electrodiagnostic studies, and muscle biopsies of seven patients, including one set of identical twins, who developed a very late onset myopathy with severe NEM weakness. RESULTS: Age of onset was 61-79 yrs, with the pair of identical twins developing NEM weakness within 1 yr of each other (ages 63 and 64, respectively). Seven patients developed weakness (six slight weakness and one more severe) in muscles other than NEM. The group was characterized by the electromyography (EMG) showing a "myopathic" pattern in cervical paraspinal muscles (7/7), muscle biopsies with nonspecific myopathic changes on histologic stains (7/7), marked abnormalities in NADH dehydrogenase-reacted sections (6/7), desmin-positive sarcoplasmic deposits (1/7), low carnitine levels by biochemical assays (2/7), and mitochondrial changes (3/7). CONCLUSIONS: Myopathic DHS encompasses a wide spectrum of conditions that strongly affect NEM; however, as documented in the monozygotic twins, some patients may suffer from a distinct, genetically determined form of late-onset restricted myopathy leading clinically to DHS.     

Chronic fatigue: an evolutionary concept analysis

Title.  Chronic fatigue: an evolutionary concept analysis.
Aim.  This paper is a report of a concept analysis of chronic fatigue.
Background.  Fatigue is a prevalent symptom encompassing both acute and chronic manifestations. It is chronic fatigue that is most problematic because of its duration and impact on life quality. The rise in prevalence of chronic conditions will result in a need to address coexistent symptoms, clarification of which is needed. Chronic fatigue is one of the most common symptoms in chronic illness. Clarification of the concept and an understanding of its use by discipline are needed.
Data sources.  The evolutionary method of concept analysis was used to ascertain the attributes, antecedents, consequences and surrogate terms for chronic fatigue. A review of the literature published between 1966 and 2007 was carried out to determine the contextual use of the concept of chronic fatigue among disciplines. Sources used for this analysis included CINAHL, Medline, PsychINFO and Social Work Abstracts and the search yielded 66 papers.
Results.  The chronic fatigue experience is associated with a multitude of physical, psychological and social factors. The defining attributes of chronic fatigue are constancy, abnormality, whole-body experience, inexplicability and disabling. The antecedents of chronic fatigue are physical disease, psychopathology, female gender and a history of abuse. Consequences found include social isolation and stigmatization, physical inactivity, psychological disturbances and a reduced quality of life.
Conclusion.  Further research is needed to identify the aetiology of chronic fatigue and to address the social context of living with this disabling symptom.     

Community health: an evolutionary concept analysis

Title.  Community health: an evolutionary concept analysis.
Aim.  This paper is a report of a concept analysis of community health.
Background.  Community health is a term that has been broadly used in both research and practice. Although local communities are invested in community health improvement, this process often occurs without a clear definition of the concept of community health .
Data sources.  Data sources included a sample of 537 papers covering the period 1990 to 2004 and representing the disciplines of nursing, public health, medicine and sociology and landmark works concerning community health, six community health assessment instruments and interviews with seven key community health informants.
Review methods.  Rodgers' Evolutionary Method of Concept Analysis was used to design the study and analyse the data. The professional literature was analysed and compared with the use of the concept of community health in community health assessment instruments and by key informants.
Results.  Dynamic and contextual, community health is achieved through participatory, community development processes based upon ecological models that address broad determinants of health. The primary focus of this collaborative work is population-based health promotion and disease prevention.
Conclusion.  The definition derived from the concept analysis of community health makes explicit the importance of community-based participatory action in local health improvement processes. Identification of the attributes of community health will enhance communication across disciplines involved in community health practice, research and education.     

Adolescent resilience: an evolutionary concept analysis

Resilience is a concept that has enormous utility in nursing, although there is a need for concept clarity as it relates to adolescence. The purpose of this article is to describe the concept and apply the Evolutionary Model of Concept Analysis to resilience in adolescents. A literature search and an analysis of 22 articles specific to the adolescent population were completed. The literature review revealed adolescent resilience to be a composite of attributes that include the characteristics of the adolescent, sources of social support, and available resources. Implications for nursing and a proposed model of adolescent resilience are presented.     

Ethical multiculturalism: an evolutionary concept analysis

A concept analysis of ethical multiculturalism using Rogers' evolutionary approach is presented. It includes attributes, antecedents, and consequences of ethical multiculturalism. Attributes include moral reasoning, cultural competence, beneficence/nonmaleficence, and respect for persons and communities. Antecedents are culture knowledge; cultural awareness, sensitivity, encounters, and skill; and understanding of ethical principles. Consequences include protection of human subjects, preservation of cultural norms, dignity of participants and communities, and perceived value by individuals and communities. Ethical multiculturalism is defined as the use of moral reasoning to apply the ethical principles of beneficence and respect for persons and communities in a culturally competent manner to research in various societies or cultures.     

Nursing practice with Aboriginal communities: expanding worldviews

Through advances in interpretive inquiry, diverse ways of knowing and experiencing reality are increasingly made explicit in nursing literature. Nevertheless, the privileges of empiricism continue alongside a lack of language to consider other realms of reality. In this column, Aboriginal ways of constituting health and reality are explored. Morley's four categorizations of health belief systems provide a useful tool for understanding diverse worldviews. In contrast, Atleo drew on Nuu-chah-nulth origin stories to address the complexities and ambiguities of Aboriginal health beliefs. Approaches for bridging cultural differences are explored with a view toward inclusive healthcare and nursing practice.