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OBJECTIVE: To examine factors that affect pelvic muscle response to 12 weeks of pelvic muscle exercise. DESIGN: Repeated measures design in which intravaginal pressures during pelvic muscle contractions were recorded at baseline and after four exercise levels. SETTING: College of Nursing research site in Gainesville, Florida. PARTICIPANTS: Eighty-five parous, community-dwelling women, aged 35-78 years and without incontinence as a primary concern. INTERVENTIONS: A 12-week graded program of regular (three times per week, every other day) pelvic muscle exercise at home. MAIN OUTCOME MEASURES: The hypotheses were that younger age, lower parity, higher baseline intravaginal pressures, and adherence to the pelvic muscle exercise program each would result in significant improvement in maximum intravaginal pressures. RESULTS: The only factor showing significance in predicting a successful outcome was age (t = -2.29, df = 41, one-tail probability = .0136). CONCLUSIONS: Regular, graded exercise over several weeks is needed to build pelvic muscles, and some women who exercise do not improve. Although the reasons for not improving are unclear, age is a significant factor.  相似文献   
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Nurses need to take advantage of multiple internships and fellowships to learn about and experience the daily work of making health policy in Washington, DC. This article lists several of the current programs available for nurses and other health professionals. These internships and fellowships are career-changing experiences. Additionally, new relationships will be built with other health professionals that nurses will be able to use for years to come. Finally, if one of the structured experiences doesn't fit the nurse's timeframe, there is always the possibility to create a special internship to meet the nurse's needs.  相似文献   
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Fipronil is a phenylpyrazole insecticide designed to selectively inhibit insect gamma-aminobutyric acid (GABA) receptors. Although fipronil is often used in or near aquatic environments, few studies have assessed the effects of this neurotoxicant on aquatic vertebrates at sensitive life stages. We explored the toxicological effects of fipronil on embryos and larvae using the zebrafish (Danio rerio) experimental model system. Embryos exposed to fipronil at nominal concentrations at or above 0.7 microM (333 mug/l) displayed notochord degeneration, shortening along the rostral-caudal body axis, and ineffective tail flips and uncoordinated muscle contractions along the body axis in response to touch. This phenotype closely resembles zebrafish locomotor mutants of the accordion class and is consistent with loss of reciprocal inhibitory neurotransmission by glycinergic commissural interneurons in the spinal cord. Consistent with the hypothesis that notochord degeneration may be due to abnormal mechanical stress from muscle tetany, the expression patterns of gene and protein markers specific to notochord development were unaffected by fipronil. Moreover, the degenerative effects of fipronil (1.1 microM) were reversed by coexposure to the sodium channel blocker MS-222 (0.6mM). The notochord effects of fipronil were phenocopied by exposure to 70 microM strychnine, a glycinergic receptor antagonist. In contrast, exposure to gabazine, a potent vertebrate GABA(A) antagonist, resulted in a hyperactive touch response but did not cause notochord degeneration. Although specifically developed to target insect GABA receptors with low vertebrate toxicity, our results suggest that fipronil impairs the development of spinal locomotor pathways in fish by inhibiting a structurally related glycine receptor subtype. This represents an unanticipated and potentially novel mechanism for fipronil toxicity in vertebrates.  相似文献   
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We all work in a multigenerational workforce. With extremes in generations, skills are needed to foster understanding among staff. There are many myths and realities about the age-related generations. While there are challenges in working in a multigenerational workforce, the generational differences tend to be exaggerated while the similarities are overlooked. A better understanding of these generations allows us to prevent communication breakdown and to close the communication gaps where they exist, creating a unit of harmony rather that discontent.  相似文献   
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