In vivo biocompatibility of porous silicon biomaterials for drug delivery to the heart

Myocardial infarction (MI), commonly known as a heart attack, is the irreversible necrosis of heart muscle secondary to prolonged ischemia, which is an increasing problem in terms of morbidity, mortality and healthcare costs worldwide. Along with the idea to develop nanocarriers that efficiently deliver therapeutic agents to target the heart, in this study, we aimed to test the in vivo biocompatibility of different sizes of thermally hydrocarbonized porous silicon (THCPSi) microparticles and thermally oxidized porous silicon (TOPSi) micro and nanoparticles in the heart tissue. Despite the absence or low cytotoxicity, both particle types showed good in vivo biocompatibility, with no influence on hematological parameters and no considerable changes in cardiac function before and after MI. The local injection of THCPSi microparticles into the myocardium led to significant higher activation of inflammatory cytokine and fibrosis promoting genes compared to TOPSi micro and nanoparticles; however, both particles showed no significant effect on myocardial fibrosis at one week post-injection. Our results suggest that THCPSi and TOPSi micro and nanoparticles could be applied for cardiac delivery of therapeutic agents in the future, and the PSi biomaterials might serve as a promising platform for the specific treatment of heart diseases.     

Improved sensitivity of restriction endonuclease analysis of herpes simplex virus type 2 DNA with polyacrylamide gradient gel electrophoresis

Polyacrylamide gradient gel electrophoresis was used to resolve fragments of herpes simplex virus type 2 (HSV-2) DNA, produced by the restriction endonucleases Alu I, Bam HI, Pst I, and Sma I, which cleave the HSV-2 DNA into more than 30 fragments each. HSV-2 strains isolated from different individual patients could be easily distinguished from each other by the endonucleases Bam HI and Sma I. Successive virus isolates from a single person, analyzed using Alu I and Sma I, showed variability of fragment patterns. The effect of passaging the virus in cell cultures for several cycles was evaluated with the restriction endonuclease Alu I. No differences were found after 29 successive passages in VERO cells. Polyacrylamide gradient gel analysis of restriction endonuclease digests of HSV-2 DNA enables the use of enzymes that cleave the DNA into a great number of fragments, thus improving the sensitivity of analysis.     

Specific effects of endurance and sprint training on protein expression of calsequestrin and SERCA in mouse skeletal muscle

Calsequestrin (CSQ) is the main Ca2? binding protein inside the sarcoplasmic reticulum (SR) of skeletal and cardiac muscle. The present study demonstrates the specific effects of different training regimens on CSQ isoform 1 (CSQ1, the primary isoform) and SR Ca2?-ATPase (SERCA1, 2) expression in various skeletal muscles of mouse. CSQ1, SERCA1, and SERCA2 protein expression was determined with Western blot in m. soleus (SOL), m. extensor digitorum longus (EDL), m. gastrocnemius (GAS), m. rectus femoris (RF), and m. tibialis anterior (TA) muscles after completing a 6-week endurance or sprint training program. Endurance training induced decrease in CSQ1 concentration in SOL (p < 0.001) and in SERCA1 levels in GAS (p < 0.05), whereas increase in CSQ1 expression was detected in EDL (p < 0.01). After sprint training the concentration of CSQ1 increased in GAS (p < 0.01) and EDL (p < 0.01). Additionally, sprint exercise induced an increase in SERCA1 in GAS (p < 0.001) and a decline in TA (p < 0.05). SERCA2 was up-regulated with sprint training in GAS (p < 0.01). Myosin heavy chain (MHC) based fibre type composition altered differently depending on the muscle and the training regimen.These results indicate that (1) diverse training strategies used affect differently CSQ1 and SERCA1 concentrations in the skeletal muscle, (2) the regulation of CSQ1 and SERCA1 does not necessary follow the fast-slow definition despite the correlation between MHC isoforms, and (3) the changes in CSQ1 concentration occur prior to SERCA1 or SERCA2.     

Evaluating nursing documentation – research designs and methods: systematic review

Title.  Evaluating nursing documentation – research designs and methods: systematic review.
Aim.  This paper is a report of a review conducted to assess the research methods applied in the evaluation of nursing documentation.
Data sources.  The material was drawn from three databases: CINAHL, PubMed and Cochrane using the keywords nursing documentation , nursing care plan , nursing record system , evaluation and assessment . The search was confined to relevant electronically-retrievable studies published in the English language from 2000 to 2007. This yielded 41 studies, including two reviews.
Methods.  Content analysis produced a classification into three themes: nursing documentation, patient-centred documentation and standardized documentation. Each study was assessed according to its research design, methodology, sample size and focus of data collection. In addition, the studies categorized under the heading of standardized documentation were assessed in terms of their outcomes.
Results.  Most of the studies ( n  = 19) focused on patient-centred documentation. Most ( n  = 20) were retrospective studies and used data collected from patient records ( n  = 35). An audit instrument was used to assess nursing documentation in almost all the studies. Studies classified under the heading of standardized documentation showed more positive than negative effects with respect to quality, the nursing process and terminology use, knowledge level and acceptance of computer use in documentation.
Conclusion.  The use of structured nursing terminology in electronic patient record systems will extend the scope of documentation research from assessing the quality of documentation to measuring patient outcomes. More data should also be collected from patients and family members when evaluating nursing documentation.     

Longitudinal factorial invariance of the Maslach Burnout Inventory‐General Survey among employees with job‐related psychological health problems

The study provides new knowledge about the longitudinal factorial invariance of the Maslach Burnout Inventory‐General Survey (MBI‐GS). In order to investigate the factor structure of the MBI‐GS and its invariance across time, a full panel data with two measurements gathered among employees with job‐related psychological health problems was used. Consistent with previous study findings, the results indicated that the correlated three‐factor model of the MBI‐GS (i.e. exhaustion, cynicism and professional efficacy) showed a better fit with the data than the alternative factor models. The correlated three‐factor structure was invariant across time, indicating that the scale has good construct validity, thus producing evidence that the MBI‐GS is a valid scale to measure job burnout. The novel finding of the study was that the professional efficacy dimension was a more central symptom of the burnout syndrome than previous research evidence among healthy employees has established. Copyright © 2011 John Wiley & Sons, Ltd.     

Associations between psychosomatic symptoms in adolescence and mental health symptoms in early adulthood

Kinnunen P, Laukkanen E, Kylmä J. International Journal of Nursing Practice 2010; 16 : 43–50
Associations between psychosomatic symptoms in adolescence and mental health symptoms in early adulthood
This longitudinal study explored associations between psychosomatic symptoms in adolescence and mental health symptoms in early adulthood. The baseline data were collected in 1996 from 14-year-old pupils ( n  = 235; 116 girls, 119 boys) at schools using a structured questionnaire that included a 14-item scale of psychosomatic symptoms. The follow-up data were collected in 2006 from the same persons at the age of 24 using the Symptom Checklist-90. Follow-up questionnaires were returned by 149 (63.4%) young adults (88 women and 61 men). Young adults who had many psychosomatic symptoms in adolescence suffered more often than the others from somatization and anxiety symptoms in early adulthood. In addition, women had more symptoms of depression and paranoid ideation, and men had more interpersonal sensitivity and psychotic symptoms. Psychosomatic symptoms in adolescence might be important signals of mental health and this should be taken seriously in school health and in general primary care.     

Prioritization attitudes among doctors and nurses examined by a scenario method

OBJECTIVES: To investigate doctors' and nurses' attitudes toward 14 potential prioritization criteria. METHODS: This study was performed by using the random paired scenario method. The respondents received a questionnaire with 12 pairs of scenarios, imaginary patient cases, each of which contained two to three different prioritization criteria (e.g., child, old patient, poor patient). Respondents were asked which one of each scenario pair they would choose if only one patient could be treated. The scenarios were randomly put into 30 different questionnaire sets. There was a random selection of 241 doctors and 151 nurses in Finland, with response rates of 60.3% and 50.3%, respectively. RESULTS: Doctors prioritized young patients, severe disease, expensive treatments and posteriorized (negatively prioritized) demented or institutionalized patients, and patients having a self-caused disease. Children were strongly prioritized, even over serious diseases. Expensive treatments appeared to be favored by doctors, and this result cannot be explained by severity of disease. Nurses' attitudes were similar to those of doctors. CONCLUSIONS: Children were strongly prioritized. Elderly persons were posteriorized if they had dementia or were living in institutions. Patients having a self-caused disease are posteriorized, more often by nurses than by doctors.     

Healing of subcapital femoral osteotomies fixed with self-reinforced poly-L-lactide screws: an experimental long-term study in sheep

Subcapital femoral osteotomies of ten young adult sheep were fixed with two bioabsorbable, self-reinforced, poly- L-lactide (SR-PLLA) lag screws of 4.5 mm in diameter. At 3 weeks radiographs were taken to check the reduction and fixation achieved. After follow-up periods of 12 weeks, 1 year and 3 years with three sheep in each group, and of 7 years and 4 months with one sheep, the sheep were killed, and the healing of the osteotomies, degradation and tissue response of the implants were examined radiographically, histologically and microradiographically. All osteotomies healed with a firm bony union. There was no dislocation or wound infection. Histologically, there was no marked tissue response in the bone tissue. At 12 weeks the implants were grossly intact, at 1 year granulation tissue and new bone formation had started to penetrate into the implant, and at 3 years the implant area was mostly replaced by connective tissue and new bone, but implant material was still seen as little islands surrounded by some lymphocytes. At 7 years and 4 months, the implant material had been degraded and replaced by tight bone. Self-reinforced poly- L-lactide lag screws seem to possess adequate mechanical properties and good biocompatibility for this demanding fixation.     

Integrated regional services: are working process changes desirable and achievable?

In the hospital district of Helsinki and Uusimaa, 32 municipalities with one or more health centres provide primary care to their residents. Legal and organizational barriers between primary care and hospital care impede the continuity of patient care. Integrating primary and secondary care with the aid of information technology may facilitate a virtual electronic patient record, in which the viewing of images and other patient data is possible regardless of the organization that produced them. For example, in one trial, diabetic patients sent their home blood glucose measurements by modem to their health centre. Preliminary observations suggest that they could increase their glucose testing largely because they were able to transmit the results to the database and receive teleconsultations. Also, a picture archiving and communication system (PACS) has been in operation in two clinics of the Helsinki University Central Hospital for over two years and seven hospitals had become filmless by the end of 2001. A regional PACS is planned to be completed by the year 2004.