Disease-causing dysfunctions of barttin in Bartter syndrome type IV

Bartter syndrome type IV is an inherited human condition characterized by severe renal salt wasting and sensorineural deafness. The causal gene, BSND, encodes barttin, an accessory subunit of chloride channels located in the kidney and inner ear. Barttin modulates the stability, cell surface localization, and function of ClC-K channels; distinct mutations cause phenotypes of varying severity. For definition of the molecular basis of this diversity, the functional consequences of six disease-causing mutations (R8L, R8W, G10S, Q32X, G47R, and E88X) on ClC-K channel properties were studied by heterologous expression in renal cell lines, electrophysiology, confocal imaging, and biochemical analysis. Three missense mutations (R8L, R8W, and G10S) eliminated the function of ClC-K/barttin channels but did not prevent the insertion of the channels into the surface membrane. Another mutant that produces a mild renal phenotype (G47R) was capable of performing all functions of wild-type barttin but bound to ClC-K channels less effectively. The nonsense mutation E88X affected epithelial sorting, leading to equal amounts of barttin inserting into the basolateral and apical membranes, contrasting with the preferential apical insertion of wild-type barttin. Last, the nonsense mutation Q32X allowed barttin to associate with ClC-K channels but prevented surface membrane insertion and channel activation. These results demonstrate that Bartter syndrome type IV can be caused by various derangements in the function of barttin, likely contributing to the diversity of observed phenotypes.     

Monitoring of Ceratopogonidae in Southwest Germany

Within the entomological monitoring program of the German federal ministry of food, agriculture, and user protection (BMELV), at 12 cattle farms in Rhineland-Palatinate and two in Saarland, ultraviolet lamp traps were used to monitor the distribution and seasonal appearance of potential vectors of the bluetongue virus, with special consideration of species of Culicoides. Using the traps during the first seven nights of each month from April 2007 to May 2008, 5,000–120,000 ceratopogonids were caught at different locations, in total about 500,000 and mainly females. Ninety-four percent belonged to the genus Culicoides, and of these, 90% were Culicoides obsoletus s.l., 6% were Culicoides pulicaris s.l., and 4% were other species of this genus. In all traps, the first ceratopogonids were caught in April 2007, the total number peaking in August 2007. After a reduction in September, a lower peak occurred in October. During the whole winter, some ceratopogonids were active. At nearly all locations, the total numbers of C. obsoletus s.l., C. pulicaris s.l., and of other ceratopogonids were significantly correlated with the temperatures, and higher population densities of C. obsoletus s.l. seemed to occur at altitudes of about 300 m above sea level. Bettina Vorsprach and Christian Karl Meiser contributed equally to this study.     

Who is doing well? A typology of newly homeless adolescents

There is growing evidence to support developing new typologies for homeless adolescents. Current typologies focus on the risks associated with being homeless, with less consideration of the positive attributes of homeless adolescents. The authors examined both risk and protective factors in a sample of newly homeless adolescents. Using cluster analysis techniques, they identified three distinct clusters of newly homeless adolescents: those who are protected and doing relatively well while out of home with more protective than risk factors, those who are at‐risk, and those who are risky with more risk than protective factors. Over half (51.9%) of these newly homeless adolescents were in the protected cluster. This typology has implications for the design and implementation of services and interventions for newly homeless adolescents to reconnect them with stable housing situations. © 2009 Wiley Periodicals, Inc.     

The trifecta: harnessing the power of philanthropy, joint appointments, and practice to ease the faculty shortage: academia, practice, and philanthropy

Partnerships between clinical facilities and academia are critical in supporting undergraduate and graduate nursing education. The authors discuss a unique model that blends academia, clinical practice, and philanthropy and uses grateful patient benefactors to assist in providing clinical instructor support for affiliated nursing schools. The authors review the process of proposal development, solicitation of benefactors, and results of the model.     

Exercise intensity: platelet function and platelet-leukocyte conjugate formation in untrained subjects

INTRODUCTION: Strenuous and exhaustive exercise intensifies platelet activity as shown in the literature but effects of moderate exercise are still in discussion. The present study investigated effects of two different standardised exercise intensities controlled by individual anaerobic threshold (IAT) on platelet function and conjugate formation. METHODS: 20 healthy male non-smokers underwent two exercises at 80% (moderate) of IAT which corresponded to about 57% of peak oxygen consumption (peak VO(2)) in our subjects and 100% (strenuous) of IAT, corresponding to about 69% peak VO(2). Blood samples were taken after 30 min rest and immediately after exercise. CD62P expression and differentiated platelet-leukocyte conjugates (CD45, CD14, CD41) as well as microparticles and platelet-platelet aggregates were detected flow cytometrically with and without TRAP-6-stimulation. RESULTS: CD62P expression and the number of aggregates were increased (P< or =0.05) after exercise in the TRAP-stimulation experiment independent of exercise intensity. The number of platelet-granulocyte (rest 5.7+/-1.8 to post 8.1+/-1.7 (80%) vs. 6.2+/-1.9 to 10.3+/-2.0 (100%)), platelet-monocyte (5.3+/-3.6 to 8.5+/-3.7 (80%) vs. 7.4+/-3.5 to 11.7+/-4.8 (100%)), and platelet-lymphocyte conjugates (4.4+/-1.2 to 6.4+/-1.3 (80%) vs. 4.6+/-1.7 to 7.8+/-1.8% positive cells (100%)) were also higher after both exercises but increased significantly weaker (P< or =0.05) after moderate exercise. These results were confirmed by the TRAP-stimulation experiment. CONCLUSION: Although moderate exercise led to an increase in platelet reactivity and platelet-leukocyte conjugate formation the changes in conjugate formation were significantly weaker compared to strenuous exercise. Therefore it is recommended that submaximal endurance performance should be individually developed in order for everyone to be able to carry out normal daily activities and also to exercise well below the IAT.     

The theory-practice gap: ECMO research example

AIM: The time taken for research findings to enter clinical practice can be very lengthy. A contributing factor is the time lag between the research literature identifying the issue, and medical and nursing texts discussing it. The example of ECMO (Extracorporeal Membrane Oxygenation) is used to examine this issue, specifically the extent to which relevant nursing journals and textbooks discuss the effects of ECMO on medication. METHOD: A systematic review of papers identifying the problem (pharmacokinetics in ECMO patients) and the dissemination of this to clinicians was undertaken. Publications used by those exploring the problem were most likely to be found in Medline, and those disseminating to nurses in CINAHL. Textbooks on neonatal nursing and paediatric intensive care with sections on ECMO were also explored. RESULTS: There are several studies that show drug delivery is altered in patients receiving ECMO, dating back to 1989. Only three papers likely to be accessed by clinicians were found to address the effect of ECMO on drug delivery. Two of the textbooks addressed these issues but it took eight years from the issue being first raised to any medical or nursing text discussing it. CONCLUSION: Nurses will most likely not be aware of the latest research in their area if they rely on textbooks. Advanced education that gives critical appraisal and literature-searching skills, such as found in master's courses, should help the clinical nurse employ evidence based practice.     

Exploring the technology readiness of nursing and medical students at a Canadian University

Technology readiness is a well-established construct that refers to individuals' ability to embrace and adopt new technology. Given the increasing use of advanced technologies in the delivery of health care, this study uses the Technology Readiness Index (Parasuraman, 2000) to explore the technology readiness of nursing and medical students from the fall 2006 cohort at Memorial University of Newfoundland. The three major findings from this study are that (i) rural nursing students are more insecure with technology than their urban counterparts, (ii) male medical students score higher on innovation than their female counterparts and have a higher overall technology readiness attitude than female medical students, and (iii) medical students who are older than 25 have a negative technology readiness score whereas those under 25 had a positive score. These findings suggest health care professional schools would be well served to implement curricular changes designed to support the needs of rural students, women, and those entering school at a non-traditional age. In addition, patterns such as those observed in this study highlight areas of emphasis for current practitioners as health care organizations develop continuing education offerings for staff.