Using a manpower database to model nurse turnaround and return to service

A manpower database for nurses employed by the Department of Health and Social Services in Northern Ireland has been developed. This database contains information on all nurses employed between March 1977 and July 1988 and consists of data on all posts held in this period, including breaks in service. The authors show how these data may be used to analyse the durations of spells in post and spells out of service prior to departure to a number of destinations for the sister and staff nurse grades. The results are presented in a graphical format which enables us to evaluate the relative proportion of departures to each destination and at what stage in service these departures are likely to occur. Such a methodology provides a valuable tool for the nurse manpower planner, and utilizes personnel data which are routinely collected by most health authorities.     

Lack of preferential Vβ usage in synovial T cells of rheumatoid arthritis patients

The T-cell receptor Vβ subfamily repertoires of synovial and peripheral T cells of 8 rheumatoid arthritis (RA) patients were determined using the polymerase chain reaction. Three normal controls were included. Some of the rheumatoid synovial samples did not express the complete range of Vβ families and lacked as many as 6 gene families. However, these patients showed considerable individual variation in expression. Overall, the data do not support preferential T-cell receptor Vβ usage in synovial T cells of RA patients either in comparison to their autochthonous peripheral T cells or to peripheral T cells of normal subjects.     

A Retrospective Study of Determinants of Length of Stay in a Geropsychiatric State Hospital

This pilot study investigated the importance of social, clinical, and discharge factors in predicting extended length of stay (LOS) in a state geropsychiatric hospital. The authors reviewed medical records of all first time admissions during a 22 month period. A total of 272 patients age 60 and older were admitted for the first time during this period. Nine variables comprised of medical, demographic, social, and discharge information were examined in a retrospective analysis to assess their relationship to LOS. The mean and standard deviation of days spent in hospital was 392.3 +/– 752.81. The median number of days of hospitalization was 72.0. Single marital status, type of living arrangement, polypharmacy, and limited functional status were predictive of LOS. Our findings underscore the challenge within geropsychiatry of treating patients with coexisting medical conditions who also have significant behavioral, mood, and/or cognitive disturbances.     

Challenging graduate nursing students to think for the future

Integrating concepts from nursing, administration, and education into a core graduate nursing course at the University of Nebraska College of Nursing, USA, is described. Specific issues facing nursing are considered. These and other elements of the students personal, as well as practical political, economic, and social forces are examined. The widespread applicability of concepts such as management, decision-making, change, learning, conflict and evaluation to nursing administration and education is discussed. A specific example of how these concepts may be applied to a current nursing issue is presented.     

Evidence that phospholipase A2 (PLA2) inhibitors can selectively block PLA2-mediated contractions of guinea pig lung pleural strips.

We have demonstrated previously that porcine pancreatic phospholipase A2 (PLA2)-induced contractions of guinea pig lung pleural strips can be abated by inhibitors of cyclooxygenase and 5-lipoxygenase pathways, suggesting the liberation of arachidonic acid. To validate further the involvement of a PLA2-related mechanism, the effects of three known inhibitors of PLA2 were evaluated. Manoalogue, an irreversible inhibitor of PLA2, parabromophenacyl bromide, an irreversible, active site directed inhibitor and a transition-state analog, a competitive inhibitor of PLA2 were used. Transition-state analog (3-30 microM), added to the tissues for 30 min before PLA2, shifted the PLA2 curves to the right in a concentration-related manner. In contrast, the reported inactive enantiomer of transition-state analog failed to alter the PLA2 curves. Manoalogue and para-bromophenacyl bromide, at concentrations up to 40- and 50-fold higher than the enzyme concentration, respectively, were incubated in Krebs' buffer with the enzyme for 24 hr before challenging the tissues. Under these conditions, the PLA2-induced contractions were suppressed markedly. In contrast, neither reduced nor methylated manoalogue, incubated at a 20-fold molar excess with PLA2 for 24 hr, suppressed the maximal PLA2-induced responses. These results demonstrate that inhibitors of secretory PLA2, acting by different mechanisms, can alter the contractile responses induced by PLA2 on pleural strips from guinea pig lung.     

Genetic analysis of natural recombinant Brazilian Toxoplasma gondii strains by multilocus PCR-RFLP.

Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) at eight independent loci was used to determine the types (I, II or III) lineage of 20 Toxoplasma gondii strains isolated from humans and animals in Brazil. RH (type I, highly virulent), ME49 (type II, avirulent) and VEG (type III, avirulent) were used as reference strains. Differently from expected frequencies, all Brazilian strains showed to have recombinant genotypes, with typical alleles of types I, II or III at almost all loci assessed. The cB21-4 locus, a microsatellite marker, showed a higher allelic polymorphism with seven alleles among strains under analysis. Data have also shown that many Brazilian T. gondii strains presented a new haplotype at the L363 locus. When results of the eight loci were combined, 14 schizodemes were characterized out of the 20 T. gondii strains isolated in Brazil. The phenogram representing PCR-RFLP data separated Brazilian strains into two distinct genetic groups associated with murine virulence phenotype, termed groups I-A and I-B. Strains from group I-A (AS28, BV and N) that were highly virulent in BALB/c mice, were clustered with RH reference strain. Only those strains presented the haplotype I at the L363 locus, suggesting that this could be a possible marker of highly virulent strains. Strains from group I-B (cystogenic strains) showed a more heterogeneous behavior regarding virulence: a few of them (EGS, RAR, SAF, D5 and D6) were virulent, others (C4, P and D8) avirulent and most of them (D1, D2, D3, D4, D7, EFP, CH1, CH2 and CH3) intermediate virulent in mice. A significant linkage disequilibrium was observed in the population surveyed. However, the role of sexual recombination in the population structure of T. gondii in Brazil seems to be more central than in Europe and North America, where most studies have been performed.