Eugenics and its relevance to contemporary health care

Recently there has been a revival of interest in the theory and practice of eugenics by both academics and lay people. The ongoing revolution in biology and the increasing ability to acquire genetic information has led to concerns about genetics being used again for sinister eugenic ends. Although the goals behind traditional eugenics--the minimization of disease and the improvement of human health--remain unchanged, the means by which these goals should be achieved have altered significantly. However, in debates about the impact of human genetic research, eugenics is sometimes viewed as a purely historical phenomenon and its relevance to the current situation is minimized. This article outlines the history of the eugenics movement, describes some eugenic practices, and explores why an appreciation of these historical debates is important for nurses.     

The low-affinity site of the beta1-adrenoceptor and its relevance to cardiovascular pharmacology

beta-Adrenoceptor blocking agents (beta-blockers) that at low concentrations antagonize cardiostimulant effects of catecholamines, but at high concentrations also cause cardiostimulation, have been appearing since the late 1960s. These cardiostimulant beta-blockers, coined non-conventional partial agonists, antagonize the effects of catecholamines through a high-affinity site (beta(1H)AR), but cause cardiostimulation mainly through a low-affinity site (beta(1L)AR) of the myocardial beta(1)-adrenoceptor. The experimental non-conventional partial agonist (-)-CGP12177 increases cardiac L-type Ca(2+) current density and Ca(2+) transients, shortens action potential duration but augments action potential plateau, increases heart rate and force, as well as causes arrhythmic Ca(2+) transients and arrhythmic cardiocyte contractions. Other beta-blockers, which do not cause cardiostimulation, consistently have lower affinity for beta(1L)AR than beta(1H)AR. These sites were verified and the cardiac pharmacology of non-conventional partial agonists confirmed on recombinant beta(1)-adrenoceptors and on beta(1)-adrenoceptors overexpressed into the heart. A targeted mutation of Asp138 to Glu138 virtually abolished the pharmacology of beta(1H)AR but left intact the pharmacology of beta(1L)AR. Non-conventional partial agonists may be beneficial for the treatment of peripheral autonomic neuropathy but probably due to their arrhythmic propensities, may be harmful for the treatment of chronic heart failure.     

Apelin receptor: its responsiveness to stretch mechanisms and its potential for cardiovascular therapy

It has recently been demonstrated that the apelin receptor (APJ) plays a significant role in mediating the stretch response within the heart in a G-protein-independent and β-arrestin-dependent fashion. This discovery adds to the consolidated literature describing the potential benefits of APJ agonists. In this review, the authors will examine the functional selectivity of APJ and stretch with respect to their ability to signal via both G-protein-dependent and G-protein-independent mechanisms, with a focus on the multifunctional protein, β-arrestin. The possibility of selecting or designing novel ligands that differentially activate only a subset of functions via a single receptor holds great promise for the treatment of diseases such as heart failure and hypertension. Finally, hypothetical approaches to target APJ, taking into account its downstream pathways, will be described.     

Willingness and its relevance to nursing

Nursing practice is embedded in contexts that inhibit or constrain emancipatory relationships. This article explores willingness in relation to agency and actualization fostered by emancipative relationships in nursing practice. Opportunities for emancipative choice are possible only when nurses are willing to engage in critical reflection, authentic discourses, and risk congruent action within the constraints of dominant paradigms.     

Lifelong education and its relevance to nursing

This paper explores the distinction between education and learning in relation to the whole of the professional lifespan. After an initial conceptual discussion, there are two main sections: the first looks at lifelong learning and learners in relation to nursing while the second focuses upon lifelong education. It is argued that the prevalence of lifelong learning is unknown amongst nurses since little research exists on the subject, although it is frequently regarded as an essential component of professionalism. In order to create lifelong learners it is suggested that changes are necessary in nurse education and managerial practice. If lifelong learning were actually fostered in nursing then continuing education might be less necessary. However, continuing education is expanding and some principles for its implementation are considered in the second section.     

Frailty: an indication for palliative care

Chronological age alone does not determine the vulnerability or frailty of an older adult.Frailty can, however, profoundly affect the quality of an older adult's life. Frail adults could benefit from palliative care provided by an interdisciplinary team. The principles of palliative care apply to any population that could benefit from a comprehensive, person-centered plan of care from the time of diagnosis through the illness trajectory. This article presents a conceptual overview of frailty and describes its clinical presentation and treatment options, including palliative care, an intervention used by gerontological nurses to improve the quality of life for frail older adults.     

A Nightingale-based model for dementia care and its relevance for Korean nursing

This article addresses the synchrony between a Western middle-range theory of care for persons with dementia and traditional Korean nursing care. The Western theory is called a need-driven, dementia-compromised behavior model and is heavily influenced by the assessment categories outlined in Nightingale's work. This model is presented as congruent with Nightingale's work and then viewed from the perspective of traditional Korean nursing. Several congruencies and a few incongruencies are found between these Western and Eastern views, and suggestions are made for greater consistency between these views.     

Cognitive behavioural therapy and its relevance to nursing

Over the last 20 years, cognitive behavioural therapy (CBT) has gained considerable momentum in mental healthcare practice. Its extensive evidence base for the treatment of mental health problems is well documented with the National Institute for Health and Clinical Excellence (2007a; b), which has recommended CBT as a key treatment modality in its best practice guidelines. More recently, the use of CBT has widened to a diverse range of physical healthcare environments, including dentistry, occupational therapy, palliative care and physiotherapy (Chartered Society of Physiotherapists, 2004; Buchanan and Zakrzewska, 2008; Donaghy et al, 2008; Hesslop, 2009), with preliminary research highlighting its use in improving patient outcomes both in terms of reduction in morbidity and improved quality of life. In this article, the authors outline the principles and techniques of CBT, give examples of how this form of psychotherapy can be applied within nursing practice, and discuss the theoretical and practical underpinnings that align CBT and nursing.     

Intravenous nicardipine: cardiovascular effects and clinical relevance

Nicardipine hydrochloride is the first intravenous dihydropyridine calcium antagonist to become available in the United States. Its chemical structure makes it unique among its drug class and confers clinically useful properties for the treatment of acute cardiovascular conditions, such as ischemia, hypertension, congestive heart failure, cerebrovascular disease, and related disorders. For patients with coronary artery disease, IV nicardipine reduces myocardial oxygen demand by reducing afterload and increases myocardial oxygen supply through coronary vasodilatation. Preliminary data suggest that nicardipine also has cardioprotective and vascular antispastic effects. Nicardipine has been shown to be effective in the treatment of mild to moderate hypertension both as monotherapy and in combination with other antihypertensive agents. In congestive heart failure, nicardipine enhances left ventricular pumping activity and augments coronary blood flow beyond that required by increased myocardial oxygen consumption. Its lack of major effects on sinoatrial and atrioventricular conduction makes it safe for use in patients with certain types of conduction disturbances. Nicardipine's rapid onset and short duration of action are additional advantages for use in the management of acute cardiovascular disorders.     

Feminist research: its relevance to nursing

It is the author's intention to explore feminist research and discover its relevance to nursing practice In order to achieve this, definitions of feminism and feminist research will be made From these it will be possible to place the feminist research process within a historical context to further understand its focus Then an analysis of feminist research will be made, examining feminist epistemology, feminist methodology and the methods used by feminist researchers At this point an examination of who should or can do feminist research will be made, followed by a discussion about the validity of feminist research     

Frailty and its significance in older people's nursing

The term frail is commonly used to describe older people, but reports on the care of older adults in hospital highlight that the clinical implications of frailty are not understood fully by all nurses. Frailty can be an indicator of older people's health status and healthcare needs. An understanding of frailty and its mechanisms will help nurses to determine care priorities, particularly the urgency for anticipatory, proactive, preventive and compensatory care to prevent unnecessary mortality and morbidity. This article discusses the significance of frailty in older people's nursing. It highlights the responsibility of registered nurses to recognise deterioration in health as a result of frailty and to implement appropriate interventions.     

Human reticulocyte maturation and its relevance to erythropoietic stress

A comparative study of circulating human reticulocytes by phase-contrast microscopic observation and NMB staining revealed two different forms of reticulocytes which could be clearly distinguished by their distinctive morphologic appearance. These were (1) a multilobular motile form and (2) a cup-shaped nonmotile form. Sequential studies of different populations in the circulation of newborns showed that the multilobular form was the youngest and the cup-shaped form the more mature reticulocyte. The multilobular form was found in the circulation only under conditions of erythropoietic stress and could not be detected in the circulation of hematologically normal individuals. The presence of these characteristic forms in peripheral blood can be used as a reliable indicator of transient or persistent erythropoietic stress.     

Neuropharmacology of emesis and its relevance to anti-emetic therapy

 Recent great advances in the neuropharmacology of the emetic pathways have led to better therapy and improved insight into pathophysiological processes in patients undergoing chemo- and radiotherapy. This article gives an overview of the area, outlines current controversies and makes recommendations for future clinical studies.