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991.
Chronic treatment of cycling rhesus monkeys with low doses of the antiprogestin ZK 137 316: morphometric assessment of the uterus and oviduct 总被引:6,自引:5,他引:1
Slayden OD; Zelinski-Wooten MB; Chwalisz K; Stouffer RL; Brenner RM 《Human reproduction (Oxford, England)》1998,13(2):269-277
The long-term effects of the antiprogestin ZK 137 316 on reproductive tract
morphology in rhesus macaques were investigated. The monkeys were injected
daily (i.m.) for five menstrual cycles with vehicle or 0.01, 0.03 or 0.1 mg
ZK 137 316/kg body weight. Reproductive tracts (n = 3/ group) were
collected during the mid-luteal phase (day 8) of the fifth cycle in the
control, 0.01 and 0.03 mg/kg groups, or 6-7 days after the oestradiol peak
in the 0.1 mg/kg group. ZK 137 316 treatment resulted in a dose-dependent
atrophy of the endometrium, marked by reduced mitotic activity in the
glands, compaction of the stroma, degradation of spiral arteries and
dilation of veins. There was no effect of ZK 137 316 on myometrial or
oviductal weight. Treatment with 0.1 and 0.03 mg/kg, but not 0.01 mg/kg
resulted in fully ciliated and secretory oviducts, indicating a
dose-dependent blockade of progesterone antagonism of oestrogen-dependent
oviductal differentiation. In the endometrium, the suppressive action of
progesterone on oestrogen and progestin receptors was also blocked by ZK
137 316 in a dose-dependent manner. However, endometrial atrophy appeared
due to inhibition of progesterone action together with a blockade of
oestrogen-dependent proliferation. The profoundly suppressed endometrium
produced by chronic low-dose ZK 137 316 treatment is unlikely to support
implantation. Such treatment may therefore provide a novel contraceptive
modality.
相似文献
992.
Beverley Chalmers DSc PhD Janusz Kaczorowski PhD Cheryl Levitt MBBCh CCFP FCFP Susie Dzakpasu MHSc Beverley O’Brien RM DNSc Lily Lee BN MPH MSN Madeline Boscoe RN David Young MD MSc FRCSC Public Health Agency of Canada 《分娩》2009,36(1):13-25
ABSTRACT: Background: Intervention rates in maternity practices vary considerably across Canadian provinces and territories. The objective of this study was to describe the use of routine interventions and practices in labor and birth as reported by women in the Maternity Experiences Survey of the Canadian Perinatal Surveillance System. Rates of interventions and practices are considered in the light of current evidence and both Canadian and international recommendations. Methods: A sample of 8,244 estimated eligible women was identified from a randomly selected sample of recently born infants drawn from the May 2006 Canadian Census and stratified primarily by province and territory. Birth mothers living with their infants at the time of interview were invited to participate in a computer‐assisted telephone interview conducted by Statistics Canada on behalf of the Public Health Agency of Canada. Interviews averaged 45 minutes long and were completed when infants were between 5 and 10 months old (9–14 mo in the territories). Completed responses were obtained from 6,421 women (78%). Results: Women frequently reported electronic fetal monitoring, a health care practitioner starting or speeding up their labor (or trying to do so), epidural anesthesia, episiotomy, and a supine position for birth. Some women also reported pubic or perineal shaves, enemas, and pushing on the top of their abdomen. Conclusions: Several practices and interventions were commonly reported in labor and birth in Canada, although evidence and Canadian and international guidelines recommend against their routine use. Practices not recommended for use at all, such as shaving, were also reported. (BIRTH 36:1 March 2009) 相似文献
993.
Aims To determine the importance of strategy in nursing management and to establish if strategic management has entered the lexicon of nurses' vocabulary.
Background Developing and managing strategy is a critical success factor for health care managers. It remains unclear if nurse managers view strategy development as their role.
Methods A review of scholarly International nursing and management literature, available through CINAHL and PUBMED Data Bases was undertaken. The titles of 1063 articles, published between 1997 and 2007 were examined in order to determine the profile of strategy in those titles. Documentary analysis was undertaken on a random sample of 250 of those articles and on the full text of a further 100.
Results Less than 10% of journal titles contained the word strategy . What was presented as strategy was in the majority of cases describing policy, administration or management. Little formal strategy theory was evident.
Conclusion The nursing profession does not appear to have adopted the terms strategy or strategic management to any great extent.
Implications for nursing management Nurse Managers could play a greater role in enhancing healthcare delivery if an understanding of, and acceptance of the importance of strategy in health care delivery was promoted. 相似文献
Background Developing and managing strategy is a critical success factor for health care managers. It remains unclear if nurse managers view strategy development as their role.
Methods A review of scholarly International nursing and management literature, available through CINAHL and PUBMED Data Bases was undertaken. The titles of 1063 articles, published between 1997 and 2007 were examined in order to determine the profile of strategy in those titles. Documentary analysis was undertaken on a random sample of 250 of those articles and on the full text of a further 100.
Results Less than 10% of journal titles contained the word strategy . What was presented as strategy was in the majority of cases describing policy, administration or management. Little formal strategy theory was evident.
Conclusion The nursing profession does not appear to have adopted the terms strategy or strategic management to any great extent.
Implications for nursing management Nurse Managers could play a greater role in enhancing healthcare delivery if an understanding of, and acceptance of the importance of strategy in health care delivery was promoted. 相似文献
994.
995.
996.
Aim The aim of the study was to identify how clinical leadership skills are perceived by Public Health Nurses' in the course of their everyday work and the effectiveness and consequences of such skills in primary care delivery.
Background Public health nurses deliver primary care to children and adults as part of small teams or in individual situations. Leadership skills are needed to fulfil their many roles.
Method Rigorous analysis of narrative interviews with public health nurses working in primary care environments in Ireland was undertaken. Narrative information was obtained by having conversations with 20 public health nurses relating to their perceptions on what clinical leadership meant to them and how their leadership skills influenced effective primary care delivery.
Results Analysis of conversations identified the tensions existing between the various roles and responsibilities of the public health nurse and other primary care workers. This tension was perceived by the nurses as being the main barrier to effective primary care delivery from their perspective.
Conclusions Clinical leadership is viewed narrowly by public health nurses as management skills rather than leadership skills were mainly identified. Education for the role was identified as a critical success factor.
Relevance to nurse managers Public health nurses are well placed to shape and influence health service culture through effective clinical leadership. 相似文献
Background Public health nurses deliver primary care to children and adults as part of small teams or in individual situations. Leadership skills are needed to fulfil their many roles.
Method Rigorous analysis of narrative interviews with public health nurses working in primary care environments in Ireland was undertaken. Narrative information was obtained by having conversations with 20 public health nurses relating to their perceptions on what clinical leadership meant to them and how their leadership skills influenced effective primary care delivery.
Results Analysis of conversations identified the tensions existing between the various roles and responsibilities of the public health nurse and other primary care workers. This tension was perceived by the nurses as being the main barrier to effective primary care delivery from their perspective.
Conclusions Clinical leadership is viewed narrowly by public health nurses as management skills rather than leadership skills were mainly identified. Education for the role was identified as a critical success factor.
Relevance to nurse managers Public health nurses are well placed to shape and influence health service culture through effective clinical leadership. 相似文献
997.
Ingrid EJM Schiks Lisette Schoonhoven Wim RM Aengevaeren Coby Nogarede‐Hoekstra Theo Van Achterberg Freek WA Verheugt 《Journal of clinical nursing》2009,18(13):1862-1870
Aim and objectives. To investigate if ambulation four hours after sheath removal can replace ambulation 10 hours or more after sheath removal with regard to puncture site complications after percutaneous coronary interventions and to examine patient comfort in both groups. Background. Early ambulation after percutaneous coronary intervention may facilitate earlier hospital discharge. Whether this approach is safe, is unknown. Design. A non‐randomised comparative study. Methods. Percutaneous coronary intervention was performed by femoral approach. Registered nurses of the ward removed the sheath and haemostasis was achieved by manual compression. After bed rest with a compression bandage for four hours, the patients in the early ambulation group were ambulated. The patients in the control group stayed in bed till the next morning. Primary study endpoint was the composition of puncture site complications: haematoma, bleeding, false aneurysm and arteriovenous fistula. Secondary endpoints were occurrence of vasovagal collapse after mobilisation, back pain and problems with voiding. Results. In the early ambulation group (n = 329) the total number of complications was nine (2·7%), vs. six (3·0%) in the control group (n = 202). The complication rate in the early ambulation group is not increased compared to the control group (test for non‐inferiority p = 0·002). Hence non‐inferiority is accepted and practical equivalence shown. There were no statistically significant differences concerning patient comfort between the groups. Conclusions. Early ambulation four hours after femoral sheath removal is feasible and safe. The incidence of puncture site complications in the early ambulation group is not increased in comparison with the group with prolonged bed rest. Relevance to clinical practice. Patients could possibly be discharged earlier after percutaneous coronary intervention, allowing percutaneous coronary intervention in an ambulant setting. Further research should confirm these findings and extend the research to the effect of various closure devices in early ambulation and on patients’ well‐being. 相似文献
998.
999.
1000.
Background: Several papers have called for a trial of planned cesarean section versus planned vaginal birth for low‐risk women—a recommendation that is fiercely debated. Although proponents of a trial have voiced their support, evidence suggests that in the United Kingdom few midwives and obstetricians believe such a trial to be feasible, and no studies reporting women's views on the prospect of such a trial have been published. The purpose of this study is to explore women's views of participation in a trial of planned cesarean birth versus planned vaginal birth. Methods: A qualitative study was conducted using in‐depth interviews in a large maternity hospital in the United Kingdom. Sixty‐four women were interviewed 12 months after giving birth. Women were asked “How do you think you would have felt if you had been approached to take part in such a trial during your first pregnancy?” Data were analyzed thematically. Results: Only 3 of the 64 women stated that they would have participated in a trial of planned vaginal birth versus planned cesarean section, had they been asked. However, five other women said that they would have consented to participate if they had been asked during pregnancy, but with hindsight, would have regretted that decision. The remainder of women would not have participated, unless a preference arm was offered. Three main themes were identified: “feeling cheated,”“let nature take its course, ” and “just another trauma that you don't need.” Conclusions: Few women supported a trial and most suggested that it was intuitively wrong. Given the strong views voiced by women, it is unlikely that a trial of planned vaginal delivery versus planned cesarean delivery would be feasible. 相似文献