Effect of relaxation on the level of nursing internshipstudents＇ stress

Objective： To explore how relaxation reduce the effect of stress in Iranian nursing students. Methods： A total of 40 nursing students were randomly selected and divided into two groups of test and control each with 20 students. An exam questionnaire consisting of the stress test of Spilberger and control of physiological determinants （blood pressure, pulse respiration, temperature） was performed to two groups. The practice of relaxation continued for two weeks and three times a day. Data were collected and analysed using t-test and Chi-square. Results： Two groups did not show any difference in relation to the average of physiological determinants before and after investigation. However, pulse was significantly different between the two groups. The average scores of stress before and after relaxation were significantly differed between the two groups investigation so that the level of stress was reduced in the test group （t= 2.5, df =39, P= 0.02）. Conclusion： To alleviate stressors associated with clinical practice and create a healthy work environment for practice it is recommended that nursing students have some relaxation before entering practical environments.     

Key points in the nursing of large area burn patients treated with skin regenerative medical technique

Key points in the nursing of large area burn patients treated with skin regenerative medical technique@刘爱兰$Peop Hosp,Linqu County,Shandong 262600     

Possible Role of the Submandibular Gland in the Development of Obesity in Mice

The possible role of submandiblular glands(SMG) in the development of obesity was studiedintwo types of genetically obese mice,ob/ob and yellow A:Obesity is caused by hyperplasia followed by hypertrophy in ob/ob mice and mainly by hypertrophy in A mice.The histological features of SMGs exhibited clear sexual dimorphism in both mice similar to lean controls.The SMGs of ob/ob mice was smaller in size and had smaller granular convoluted tubular portions than lena controls,while the SMGs of A mice did not differ from lean controls.Sialoadenectomy before and after development of obesity generally reduced the gain of body weights in both sexes of A mice but not in ob/ob mice.The content of epidermal growth factor(EGF) in the SMGs was higher in A mice and lower in ob/ob mice than their controls.The possible role of EGF in the SMGs in the development of obesity is discussed.     

Autonomy or protection from harm? Judgements of German courts on care for the elderly in nursing homes

The increase in life expectancy in developed countries has lead to an increase in the number of elderly people cared for in nursing homes. Given the physical frailty and deterioration of mental capacities in many of these residents, questions arise as to their autonomy and to their protection from harm. In 2005, one of the highest German courts, the Bundesgerichtshof (BGH) issued a seminal judgement that dealt with the obligations of nursing homes and with the preserving of autonomy and privacy in nursing home residents. An elderly woman had sustained a fracture of the neck of the femur during a fall. The health insurance company held that the nursing home had breached its obligations to protect her from falling and sued the home for the hospital costs of her treatment. However, the BGH maintained that the case of the health insurance was not justified. It held that obligations of nursing homes have to be limited to normal arrangements within reasonable financial and personal effort, and that the autonomy of residents had to be protected from unnecessary interference. Permanent control or even restraining measures to reduce each risk would deprive the patient fully of her autonomy, and must therefore be hindered. Other judgments of other courts have emphasised the "protectionist" approach. The article deals with these different approaches and comments on both rationales. It will be shown that both approaches must be differentiated to establish fully autonomy and protection for nursing home residents.     

The change of unit discharges in the dorsomedial nucleus of the hypothalamus and the effect of electroacupuncture on it in tr

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Does the upgrading of the radio communications network in health facilities reduce the delay in the referral of obstetric emergencies in Southern Malawi?

Setting

Mwanza, Phalombe and Zomba districts in the Southern Region of Malawi.

Background

Radios have been installed in many health centers in the Southern Region of Malawi but communication is often indirect. Messages get re-channeled from one health center to another before reaching district hospitals. In an attempt to strengthen the obstetric referral system, the Safe Motherhood Project installed a repeater-based VHF radio communication system in three pilot districts. The overall goal of the new network was to enable the health centers to communicate directly to their district health offices (DHOs) for an ambulance when they have an emergency obstetric complication for referral to the hospital.

Aim

This study aimed to determine whether or not improving the radio communications system reduces the delay in referral of obstetric emergencies from health center to hospital.

Materials and methods

Data collection was conducted between 2001 and 2003 using a range of data collection methods. Radio communications register books were placed at each participating health center to record information on all women with emergency obstetric complications referred to the hospital for further management. An obstetric referral form was completed on each woman referred to the hospital. And using the same referral form, the referral hospital was required to give feedback to the health centers on discharge of the patient. Existing maternity registers or HMIS registers were reviewed to obtain additional information not captured in radio communication registers. Interviews with health center staff were conducted to obtain their communication experiences before and after the new network was installed.

Results

The average number of obstetric admissions per month and the proportion of referrals in the participating health centers significantly increased during the post-intervention period. Significantly more emergency obstetric referrals were collected under 1 hour between decision to refer by the midwife at the health center and arrival of transport from the DHO or base station in the post-intervention period than pre-intervention period (p<0.02). However, some patients still waited for more than 13 hours for transportation in the post-intervention period. The median time interval between decision to refer and arrival of transport was 3 h. versus 2 h. 3 min. in the pre- and post-intervention periods respectively.

Conclusion

This study has demonstrated that the new VHF radio network system has, without doubt, improved the radio communication system in the three pilot districts. However, although the time interval between the decision to refer and arrival of transport significantly improved after the intervention, the majority of transportation still took too long, particularly for someone with postpartum hemorrhage. It is very important to improve the management/control of obstetric ambulances at district level so as to complement efforts of an improved radio communication system in reducing delays in the referral of obstetric emergencies.Open in a separate window     

Subtype of Opioid Receptor in Airway SmoothMuscle and the Role of the Receptor in Asthmatic Attacks

IntroductionOpioidreceptorsdistributethroughouttheCNSandothertissues.OpioidsactasagonistontheCNSopioidreceptorsandtheeffectofnarcoticsontherespiratorycenterhadbeenstudiedindepth'--'l.InhumanandanimalmodelsMor,PetandFenallinduceASMcontractions2-4-].Itisattributedtoanincreaseofthecentralvagaltone,thehistaminerelease,theexcitationofthe(L--adrenergicreceptorsortheMcholinergicreceptorsintheASMandthedirecteffectontheASM.However,theroleofopioidreceptorintheASMhasnotbeendeeplyinvestigated.I…     

Response of the xenograft endothelium in the concordant xenotransplantation

Objective: To investigate the response of the xenograft endothelium in the concordant hamster to rat cardiac xenotransplantation and the mechanism of acute vascular rejection. Methods: The animals were divided into 5 groups randomly: control group,CsA group, splenectomy group, D0 splenectomy CsA group and D3 splenectomy CsA group. Hamster heart was heterotopicaly transplanted to rat abdominal cavity. The graft survival was monitored by palpation of the rat abdominal wall. The histological and ultrastructural changes of the xenogafts were investigated. NF-κB and P-selectin expression in the xenograft were detected. Hene Oxigenase-1 and Bcl-2 expression were also detected in the xenografts of different groups. Results: The mean survival time of the xenografts in control group, CsA group, splenectomy group, D0 splenectomy CsA group and D3 splenectomy CsA group was 3.4±0.55, 3.8±0.45, 6.4±1.52, 30 and 7.4±1.14 days. The rejected graft showed typical acute vascular rejection in control group, CsA group,splenectomy group and D3 splenectomy CsA group. Endothelial cells of the rejected xenograft showed dramatic assembly of ribosomes and expansion of the rough endoplasmic reticulum. However, the endothelium of the long-term survived grafts in D0 splenectomy CsA group showed normal architecture. NF-κB and P-selectin expression were detected in the rejected xenografts. HO-1 expression was observed in the long-term survived xenografts in D0 splenectomy CsA group. Conclusion: The endothelial cells of the xenograft might be activated during the acute vascular rejection. Expression of HO-1 might inhibit the upregulation of NF-κB and adhesion molecular which decreases the activation of the endothelium of the graft.     

Distribution of peptidergic neurons in the hypothalamic paraventricular nucleus of the rat

Distribution of peptidergic neurons in the hypothalamic paraventricular nucleus(PVN)of the rat was investigated by means of immunohistochemical technique,and thearea,perimeter,maximum diameter,minimum diameter and grey scale of peptidergicneuronal cell bodies were measured with an image analyser.All of these peptidergicneurons,oxytocin(OXY)-,vasopressin(VP)-,substance P(SP)-,corticotropin releasingfactor(CRF)-,thyrotropin releasing hormone(TRH)-,neurotensin(NT)-,cholecystokinin(CCK)-,somatostatin(SOM)-,galanin(GAL)-,leucine-enkephalin(L-ENK)-,vasoactive intestine polypeptide(VIP)-,and ACTH-like neurons,were ob-served in the PVN.The data of image analysis showed that the area of peptidergicneuronal cell bodies in the magnocellular subnucleus part of the PVN was similar,but wasdifferent in the parvocellular subnucleus part of the PVN.     

Efficacy of Dlfferent Drugs in the Treatment of Ulcers

One hundred and fifty-six out patientswith peptic ulcer confirmed by endoscopicexamination were divided into three groupsand were treated separartely with gastro-pin and probanthin(GP), ranitidine(R) andfurazolidone (F). After treatment,patientswere followed for half a year. Results     

CPR in the nursing home: fool’s errand or looming dilemma?

Background

The indications for CPR (cardiopulmonary resuscitation) have expanded greatly since the technique was introduced and theoretically it can be attempted on all prior to death. Policy initiatives (such as the British Medical Association/Royal College of Nursing guidelines) have attempted to provide a clinical rationale for the withholding of inappropriate CPR. Traditionally a care home was felt to be an inappropriate environment to attempt CPR but increased use of advance directives may bring the issue to the fore in this setting.

Aims

We elicited the views of managers of care homes regarding resuscitation strategies in hypothetical situations and in actual practice.

Method

A purpose designed questionnaire in two parts was compiled, gathering factual information and employing a Likert scale to gauge opinion about this issue. The survey was conducted among 187 continuing care homes in South London the subjects being the care managers of the homes surveyed.

Results and conclusion

Responses were obtained from 86 care homes. Care managers would resuscitate 66% of cases of witnessed cardiac arrest but few efforts were reported. Policies in assigning ‘Do not resuscitate’ orders were referred to by only 9% of homes but 80% of facilities would welcome them, yet 50% would exclude the patient from this discussion. Clear policy guidelines are required for continuing care homes, and advance statements about CPR as part of residents care plans could reduce inappropriate resuscitative efforts and hospital transfers.     

Therapeutic Effect of Propofol in the Treatment of Endotoxin-induced Shock in Rats

Lipopolysaccharide (LPS) ,amaincomponentofgram negativebacterialendotoxin[1] ,istheleadingcauseofsepsisorendotoxicshock ,andwhenadmin isteredexperimentallytoanimals ,mimicsthesameinflammatoryresponse The pathophysiologicalchangesseeninsepsisareoftennotduetotheinfec tiousorganismitselfbuttotheuncontrolledproduc tionofinflammatorymediators ,includingtumornecrosisfactor (TNF) α ,nitricoxide (NO)andneu trophilaccumulation Accumulationoftheseleadstotissuedamage ,ultimately producingthelethalit…     

Importance of the Development of Veterinary Toxicology in Argentina

The different types of toxic substances that affect farm animals in Argentina are described. These substances include (a) toxic plants, such as Solanum glaucophyllum. Baccharis coridifolia, Festuca arundinacea; (b) mycotoxins, such as zearalenone, tremorgenic mycotoxins, and ergoalkaloid; (c) trace elements, such as fluorine, copper, molybdenum, and arsenic; and (d) others, such as toxic algae and pesticides. The direct and indirect economic loss of farm animals associated with these toxic substances in Argentina is roughly estimated at 50 million dollars a year. A number of recommendations are made to ameliorate the situation. 1989 Academic Press, Inc.     

Evaluation of MRI in the diagnosis of hepatic tuberculoma

Tuberculosis is common in developing countries but hepatic tuberculosis is rare, especially in the form of hepatic tubereulomas or maeronodular tubereuloma. Most of the eases have been misdiagnosed as hepatic tumours on medical imaging. Many reports have described its magnetic resonance image (MRI) and differential diagnosis. This paper is a summary of MRI findings and analysis of 10 cases with hepatic tubereuloma.