How satisfied are parents supported by nurses with the NIDCAP model of care for their preterm infant?

The main purpose of implementing the Newborn Individualized Developmental Care and Assessment Program (NIDCAP) in our neonatal intensive care unit from the perspective of quality of care was to bring about an improvement in the satisfaction of parents. This was measured by means of the NICU-Parent Satisfaction Form and the Nurse Parent Support Tool. Parents were significantly more satisfied with care given according to NIDCAP principles than they were with the traditional care for their premature born babies.     

A new diagnostic assay for glycogen storage disease type II in mixed leukocytes

We have established a new method for the enzymatic diagnosis of glycogen storage disease type II (Pompe disease or acid maltase deficiency) using mixed leukocytes. The method employs glycogen and 4-methylumbelliferyl-alpha-D-glucopyranoside (4MU-alphaGlc) as substrates for measuring the lysosomal acid alpha-glucosidase (acid alphaGlu) activity, and incorporates acarbose to eliminate the interference of unrelated alpha-glucosidases (predominantly maltase-glucoamylase). It is shown that 3.0 micromol/L acarbose completely inhibits the maltase-glucoamylase activity at pH 4.0, but the lysosomal acid alphaGlu activity by less than 5%. With this method, we determined the acid alphaGlu activity in mixed leukocytes from 25 patients with glycogen storage disease type II (2 infantile and 23 late-onset cases), one GAA2/GAA2 homozygote and 30 healthy subjects. In the assay with glycogen as substrate, the addition of acarbose created a clear separation between the patient and the control ranges. In the assay with 4MU-alphaGlc as substrate, the two ranges were fully separated but remained very close despite the use of acarbose. The separation of the patient and normal ranges was improved considerably by taking the ratio of acarbose-inhibited over uninhibited activity. A GAA2/GAA2 homozygote was correctly diagnosed with 4MU-alphaGlc but misdiagnosed as patient when glycogen was used as substrate. We conclude that the inclusion of 3.0 micromol/L acarbose in the assays with glycogen and 4MU-alphaGlc substrates at pH 4.0 allows for the specific measurement of lysosomal acid alphaGlu activity in mixed leukocytes, thus enabling a reliable diagnosis of glycogen storage disease type II in this specimen.     

The role of sinus disease in asthma

PURPOSE OF REVIEW: Some time ago, a link between upper and lower respiratory disease was described, which gave rise to the concept of 'united airways disease'. This concept primarily refers to the well established link between allergic rhinitis and asthma, but it also covers a possible link between sinus disease and asthma (allergic or nonallergic) and other lower airway disease. RECENT FINDINGS: The current classification of chronic rhinosinusitis (CRS) includes disease without and with nasal polyps, which are considered subgroups of CRS. Different patterns of inflammatory and regulatory cytokines (involving distinguishable T-helper lymphocyte populations) and of remodelling markers, however, were recently described to differentiate nasal polyposis from CRS, yielding two discrete entities. These patterns resemble those of lower airway diseases, such as asthma and chronic obstructive pulmonary disease, and suggest a common aetiological/pathogenetic background. Whereas the link between nasal polyps and asthma is well established (indeed, asthma improves after medical or surgical treatment of sinus disease), that between CRS and lower airway disease is not well understood. Recently, Staphylococcus aureus enterotoxins, acting as superantigens, were identified as a possible link between nasal polyps and asthma, resulting in severe disease manifestations in both upper and lower airways. SUMMARY: The role played by sinus disease in asthma is only partially understood, largely because of deficits in the clinical classification and in basic knowledge of pathophysiological pathways. Recent research into upper airway and sinus inflammation and remodelling may reveal new perspectives and lead to a classification of sinus disease, which will facilitate appropriate clinical and epidemiological studies.     

FISH and array-CGH analysis of a complex chromosome 3 aberration suggests that loss of CNTN4 and CRBN contributes to mental retardation in 3pter deletions

Imbalances of 3p telomeric sequences cause 3p- and trisomy 3p syndrome, respectively, showing distinct, but also shared clinical features. No causative genes have been identified in trisomy 3p patients, but for the 3p- syndrome, there is growing evidence that monosomy for one or more of four genes at 3pter, CHL1, CNTN4, CRBN, and MEGAP/srGAP3, may play a causative role. We describe here an analysis of a complex chromosome 3p aberration in a severely mentally retarded patient that revealed two adjacent segments with different copy number gains and a distal deletion. The deletion in this patient included the loci for CHL1, CNTN4, and CRBN, and narrowed the critical segment associated with the 3p- syndrome to 1.5 Mb, including the loci for CNTN4 and CRBN. We speculate that the deletion contributes more to this patient's phenotype than the gains that were observed. We suggest that 3p- syndrome associated features are primarily caused by loss of CNTN4 and CRBN, with loss of CHL1 probably having an additional detrimental effect on the cognitive functioning of the present patient.     

Belgian nurses' views on codes of ethics: development, dissemination, implementation

The aim of this study was to explore how Belgian nurses view issues related to the development, dissemination and implementation of a code of ethics for nurses. Fifty nurses took part in eight focus groups. The participants stated that, on the whole, a code of ethics for nurses would be useful. They stressed that a code should be a practical and useful instrument developed by nurses for nurses, and that it should be formulated and presented in a practical way, just as educational courses dealing specifically with codes of ethics require a practical approach to be effective. They emphasized that the development of a code should be an ongoing process, enabling nurses to provide input as they reflect on the ethical issues dealt with in the code and apply the code in their practice. Finally, they stressed the need for support at institutional level for the effective implementation of a code.     

Synthesis and characterization of hyperbranched polyglycerol hydrogels

Hyperbranched polyglycerol (HyPG; M(n) 2000g/mol) was derivatized with glycidyl methacrylate (GMA) in dimethyl sulfoxide using 4-(N,N-dimethylamino)pyridine as a catalyst to obtain methacrylated HyPG (HyPG-MA). The degree of substitution (DS, the percentage of derivatized hydroxyl groups), established by NMR and RP-HPLC, was fully controlled in the range of 0.7-70 by varying the molar ratio of GMA to HyPG in the reaction mixture. This indicates that for e.g. a DS of 28, 9 out of the 32 hydroxyl groups of a HyPG molecule were esterified with methacryloyl groups. Under the selected conditions, the reaction reached an equilibrium within 4h. Furthermore, it was demonstrated that under the applied conditions the reaction was reversible. Hydrogels were obtained by crosslinking HyPG-MA in aqueous solutions using potassium peroxodisulfate (KPS) and N,N,N',N'-tetramethylethylenediamine (TEMED) as initiator and catalyst, respectively. Within 10min, 99% of the methacryloyl groups were polymerized. Rheological analysis showed that the storage modulus of these gels could be tailored by varying the concentration of HyPG-MA in the aqueous solution as well as by the DS. Moreover, the obtained hydrogels have a limited swelling capacity indicating that rather dimensionally stable networks were obtained. As an alternative for radical polymerization with KPS and TEMED, the HyPG-MA could also be crosslinked by photopolymerization using Irgacure 2959 as photoinitiator. A methacrylate conversion of 99% was obtained within 3min of illumination. As for the gels prepared with KPS and TEMED, networks formed by photopolymerization also had a high shear storage modulus and showed limited swelling. Hydrogels based on HyPG have great potential as drug delivery matrices and for tissue engineering purposes.     

Sexual behaviour of second generation Moroccan immigrants balancing between traditional attitudes and safe sex

Young Moroccan Islamic immigrants are balancing the challenges of modern society and the influences of their cultural and social backgrounds. Prevention and information programs need insights into their knowledge, attitudes and behaviour concerning choice of partner, sexuality, contraception, STD and AIDS prevention. In a qualitative research project, Moroccan adolescents were invited to focus groups. The results show the specific influence of family, religion and tradition, the importance of virginity at marriage for girls, and the "almost evidence" of premarital coitus for boys. These adolescents have limited knowledge of contraceptives, STD and AIDS. Some boys pretend to perform safe sex in certain "unfixed" circumstances but show no concern about the possible risks for future virgin spouses. Most of the girls do not consider safe sex before or after marriage. There is a taboo on homosexuality.