Relation between in vivo abscess localization and in vitro migration and adherence of neutrophils

Rabbit peripheral blood and glycogen-stimulated peritoneal neutrophils were labeled with [111In]indium oxine and transfused intravenously into recipient rabbits with experimental abdominal abscesses due to Staphylococcus aureus. Peritoneal neutrophils harvested 4 hr after glycogen infusion localized within the abscesses to a greater extent than did peripheral blood neutrophils (P less than .002). In an in vitro chemotaxis under-agarose assay, peripheral blood neutrophils had greater random migration (P less than .002) and directed migration (P less than .01) than did peritoneal cells. In an in vitro glass slide adherence assay, peritoneal neutrophils were more adherent than were blood neutrophils (P less than .05). The discrepancy between in vivo and in vitro findings may be due to the increased adherence of peritoneal neutrophils. Glycogen-stimulated peritoneal neutrophils have been exposed in vivo to C5a, which is known to decrease migration and increase adherence in vitro of polymorphonuclear neutrophils; consequently, in vivo exposure of neutrophils to C5a may mean in vitro migration data may be misleading in predicting results in vivo.     

Aspects of the nurse tutor-student nurse relationship

This paper is focused on selected items from an exploratory study of nurse tutor-student nurse role-relationships. Aspects of the teacher-student and counsellor-client dimensions of the relationship are reported. The research was conducted from a sociological perspective using role theory as the organizing theoretical framework. An 'ideal type' tutor-student relationship was proposed from the findings. There was concensus between tutors and students that tutors acted in a caring way towards students but many constraints were identified which inhibited students with problems from seeking help from tutors and prevented tutors from offering all the help which they wished to give to students.     

The rationale for the use of risk calculators in pressure sore prevention, and the evidence of the reliability and validity of published scales

Recent studies have shown an increase in pressure sore prevalence rates However, methodological inconsistencies and demographic considerations, which include an ageing population, make it difficult to interpret and compare results A multiplicity of intrinsic and extrinsic factors are thought to be associated with increased risk The development of risk calculators which incorporate these factors has been an attempt to identify which subjects are most at risk so that equipment and nursing interventions can be allocated appropriately Since the 1960s there has been a proliferation of risk assessment scales which have not been subjected to rigorous scrutiny of then- reliability and validity, and this is held to represent a failure of nursing research Recent evidence suggests that if critical cut-off points for'at-nsk'vs'no risk'are adjusted for particular patient populations the validity of existing scales can be improved Missing from the literature are research reports of studies earned out in the community As a result of demographic changes and community care policies, more'at-nsk'patients are likely to be nursed at home Future research needs to include community studies, and a more systematic approach in general, to the study of the predictive value of existing scales     

Paediatric day surgery: day-case unit admission compared with general paediatric ward admission

A small exploratory study ( n = 20) is described which compares the experience of children admitted to a day-case unit with that of children admitted to a general paediatric ward. Both samples received inadequate amounts of information, particularly prior to discharge. The care offered in the day-case unit was found to be woefully deficient in many areas and the wisdom of utilizing occasional sessions in an adult day-case unit is questioned. The crucial role of skilled nurses trained in the care of sick children is emphasized.     

Preparing for Trust status–an investigation into the morale of nurses undergoing change

The morale of nurses is a phenomenon often open to public comment without substantiated evidence. This study objectively explored the morale of nurses in a large district general hospital preparing for transition to National Health (NHS) Trust status. Information was sought using a 72-item questionnaire. The investigation was firmly centred around a structured theory which construes morale in terms of nine dimensions. The notion of morale being a construct synthesized of nine dimensions adds to the uniqueness of the study. Other studies fail to differentiate between the dynamic morale construct and the more complacent attitudes of job satisfaction.     

Effects of biliary obstruction on hepatic clearance of bacteria

High surgical mortality in patients with obstructive jaundice and sepsis have been attributed to reticuloendothelial system (RES) depression. The purpose of this study was to clarify the effects of mechanical biliary obstruction on RES clearance of pathogenic bacteria by comparing the phagocytic index (K) with the directly measured hepatic uptake of indium 111-labeled bacteria injected into the portal vein of normal dogs and dogs with partial (PBO) or complete biliary obstruction (CBO). No significant difference was observed between the K in normal dogs (0.19 +/- 0.08; n = 6) and that in dogs with PBO (0.24 +/- 0.06; n = 5) or CBO (0.21 +/- 0.03; n = 4). There was no significant difference in uptake of radiolabel by the liver among the three groups of dogs. In our model, biliary obstruction had no effect on hepatic RES function and may not represent a significant determinant of mortality in patients with obstructive jaundice.