Safety,risk, and aggression: Health professionals’ experiences of caring for people affected by methamphetamine when presenting for emergency care

The crystalline form of methamphetamine, commonly known as crystal meth (crystal methamphetamine) or ICE, is a highly‐addictive and powerful stimulant. Users of crystal meth often require emergency care, and are associated with a substantial burden of care by emergency care providers. The aim of the present qualitative study was to explore health professionals’ experiences of providing care for patients affected by ICE who presented to the emergency department (ED). Nine semistructured interviews were conducted. The major theme, ‘staying safe’, was revealed, in which participants described their experiences of being exposed to potentially unsafe situations, and their responses to challenging behaviours, including aggression. The findings highlight the need for ED staff to understand the nature of ICE use and its adverse impact on the mental and physical health of users. Furthermore, it is clear that establishing and maintaining safety in the emergency care setting is of utmost importance, and should be a priority for health‐care managers.     

Nurses' attitudes and concerns pertaining to HIV and AIDS

A pilot study was conducted to identify nurses' attitudes and concerns pertaining to the care of people with human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) Data were collected using an anonymous, voluntary questionnaire, which was made available to all nurses at a Wellington Area Health Board (New Zealand) hospital Of 562 nursing staff, 286 (51%) responded, of which 74 (25 9%) had previously attended an HIV/AIDS workshop for Area Health Board staff Of those staff handling blood, 132 (49 4%) always wore gloves, and only half of the respondents (n = 148, 51%) treated all body fluids as potentially HIV positive The possible attrition rate from nursing positions in the canvassed hospital was 2 8%, with a further 43 (15 0%) undecided about resigning from their post Only 56 nurses (12 5%) believed the employer did not provide adequate safety measures The provision of education regarding HIV/AIDS, by the employer, was considered inadequate by 61 (213%) respondents This study demonstrates that further safety and education needs should be attended to or reinforced     

Withdrawal of life-support treatment: the experience of critical care nurses

Technological advances in health care have made it possible to restore and prolong life for patients who would have died in the past. Unfortunately, one consequence of this is that some patients linger in intensive care units (ICUs), dependent on the technologies but with no hope of recovery. Therefore, decisions regarding withdrawal of life-support treatment are increasingly being faced by the health-care team.

This study aimed to explore the lived experience of critical care nurses who had cared for patients during withdrawal of life-support. The methodology employed was interpretive phenomenology. Interviews were conducted with seven critical care nurses, with the meanings of the experience of withdrawal of life-support treatment for these nurses extrapolated from the narratives and clustered into themes.

The study highlighted the importance of honest communication during the processes of decision-making and withdrawal of treatment. It was important for these nurses to be sure that family members were well-informed regarding the process of withdrawal of life-support treatment and that they could provide support and ensure that the patient's comfort and dignity were maintained during the process. The need to debrief after the event became evident but formal debriefing processes were rarely undertaken.     

The efficacy and safety of early supplementation of iron polymaltose complex in preterm infants

The purpose of this study was to examine the efficacy and safety of early nonionic iron supplementation in preterm infants. Infants with gestational age < or = 32 weeks who were fed enriched human milk were assigned concurrently to receive 5 mg/kg/d enteral iron polymaltose complex (IPC) at 2 or 4 weeks of age. The levels of hemoglobin, reticulocytes, serum iron, ferritin, and soluble transferrin receptor were recorded at 2, 4, and 8 weeks of age. The incidence of morbidities associated with prematurity and the need for red blood cell transfusions (RBCTs) were recorded. The 2-week group (n = 32) had a better iron status than the 4-week group (n = 36) at 4 weeks and at 8 weeks of age. The incidence of morbidities associated with prematurity was not different among the groups ( P = 0.26). RBCT was required in one infants of the 2-week group and in 10 infants in the 4-week group ( P = 0.045). The number needed to treat to prevent one RBCT was five. Supplementation of 5 mg/kg/d enteral IPC to preterm infants fed enriched human milk as early as 2 weeks of age was more beneficial to iron status than at 4 weeks of age, and was associated with decreased need for RBCTs and no increase in the incidence of morbidities associated with prematurity.     

夜班护士麻痹症状群:临床心理学的一种新现象?

夜间工作被认为可破坏生理节奏[1] ,而另一些卫生学专家认为夜间工作能引起抑郁症状反应[2 ] 。夜班护理工作确实可能成为一种特别的应激[3 ] ;因此实习护士常常需要心理支持 ,以帮助他们作好应对和适应的准备[4] 。对“夜班护士麻痹症状群”(ｎｉｇｈｔｎｕｒｓｅｓ’ｐａｒａｌｙｓ ｉｓ)这一现象曾有过报导[5] ,但尚没有科学研究来证明这种现象的存在。这种现象被描述为往往当护士在寂静不动时 ,有一种无力的感觉。例如护士在夜间坐病室观祭台执行观察任务时 ,神志清醒 ,但在短时间内不能按要求移动肢体。在这种情况下 ,他人的触动或低声…     

Osteopontin expression correlates with nuclear factor-κB activation and apoptosis downregulation in clear cell renal cell carcinoma

Osteopontin (OPN) is a phosphoglycoprotein implicated in tumorigenesis and tumor cell metastasis. Apoptosis inhibition is one of the mechanisms that contribute to development and progression of cancer, and might be initiated by OPN interaction with tumor cells. The aim of this study was to analyze the relation between OPN and nuclear factor-kappa B (NF-κB) expression in clear cell renal cell carcinoma (CCRCC), as well as their relation to apoptotic activity of tumor cells.Expression of OPN protein and p65 NF-κB subunit was analyzed immunohistochemically in 87 CCRCC samples, and compared mutually and with apoptotic index. Expression of OPN mRNA was analyzed using quantitative real-time PCR and compared with OPN and NF-κB protein expression in 22 CCRCC samples.Statistical analysis showed an association of p65 NF-κB with OPN mRNA (p = 0.015) and protein (p < 0.001). Also, we found an inverse relationship of OPN with NF-κB protein expression and apoptotic activity of tumor cells (p = 0.006 and p = 0.022, respectively). Our results indicate that p65 NF-κB signaling pathway may be involved in OPN-mediated CCRCC progression, partly by protecting tumor cells from apoptosis. Therefore, both molecules can constitute potential targets for therapeutic intervention in CCRCC.