Conversations between persons with dementia disease living in nursing homes and nurses – qualitative evaluation of an intervention with the validation method

Living with dementia disease (DD) can include difficulties describing experiences of everyday lives, which can lead to withdrawal, social isolation or existential homelessness. Persons with DD living in nursing homes are mainly dependent on the nurses for establishing and maintaining relationships with those around them. It can be challenging for nurses to understand what a person with DD is trying to express and to make themselves understood in turn. The validation method is intended to facilitate communication with persons with DD, but to our knowledge, there have been no qualitative studies of how this influences persons' communication. This study aimed to illuminate the actions and reactions of persons with DD living in nursing homes in one‐to‐one conversations with nurses during 1 year of validation method training, as observed in videotapes. Four persons with DD were involved in videotaped conversations with four nurses who were participating in a validation method training programme. Videotapes with at least 5 months between the first and last recording were analysed and compared qualitatively. The findings are presented in four categories that were identified to various degrees in conversations at the beginning and at the end of the programme: being uninterested in or unable to answer questions, talking about more than one topic of conversation at the same time, trying to talk about what is on one's mind and speaking more freely about what is on one's mind. In the videotaped conversations at the end of the programme, the persons had the opportunity to use their remaining communication abilities. This may have been related to the development of the nurses' communication skills during the training programme, and so it is possible that persons with DD could benefit from communicating with nurses trained in the validation method.     

Chemical aspects on dental hard tissues in primary teeth from preterm infants

Rythén M, Sabel N, Dietz W, Robertson A, Norén JG. Chemical aspects on dental hard tissues in primary teeth from preterm infants. Eur J Oral Sci 2010; 118: 389–395. © 2010 The Authors. Journal compilation © 2010 Eur J Oral Sci Preterm children with very low birth weight suffer from several neonatal and postnatal complications that may affect the mineralization of teeth. Clinical and morphological studies have shown enamel aberrations in teeth from preterm children. In this study, the chemical composition in enamel and dentin was compared in primary teeth from preterm children and full‐term children, and the relationship between the chemical composition and the morphological appearance was investigated. Enamel and dentin in 17 exfoliated primary teeth, from 14 children with a gestational age below 29 wk, were investigated and compared with 36 exfoliated primary teeth from full‐term children, using X‐ray microanalyses (XRMA). In comparison with the teeth from the controls, the teeth from preterm children had a higher relative value of carbon (C), a lower relative value of calcium (Ca), a lower ratio of calcium/phosphorus (Ca/P) and a lower ratio of Ca/C throughout the outer part of the enamel. In dentin, the relative values for P were higher, and Ca/P ratio was lower, at the dentin–pulp junction. The Ca/P ratio indicated normal hydroxyapatite in the crystals in enamel and dentin. The lower ratio of Ca/C in the bulk and outer part of the enamel indicated more porous enamel.     

The influence of accommodative insufficiency on reading

Background: It is not known how accommodative insufficiency influences reading performance. Methods: Reading eye movements were recorded before and after treatment for accommodative insufficiency in 12 school children (eight to 16 years). During the eight‐week treatment period all subjects wore a +1.00 D addition when reading. Results: Large variations in reading patterns were found. Despite successful accommodative treatment (p < 0.001), no correlation was found to suggest improved reading velocity. Discussion: Three case reports will be presented and the implications discussed.     

Age-related hair cell loss in spontaneously hypertensive and normotensive rats

In the spontaneously hypertensive (SH) rat, a hereditary form of hypertension and widespread vascular abnormalities develop. In the present study the inner ear degeneration pattern in SH and normotensive (N) rats not exposed to noise was investigated and correlated with frequency-specific auditory brainstem response (ABR) thresholds. Rats of both strains were found to have a spontaneous loss of apical hair cells, but this was slightly more pronounced in SH. In SH rats, but not in those of the N strain, there was an age-related progressive loss of outer hair cells in the region 3–5 mm from the stapes, and a slight additional loss at the most basal end. According to available frequency maps, the hair cell loss should correspond to hearing loss between 6 and 24 kHz. In the SH rats hearing loss was not observed in the whole of this range, only at 16 and 20 kHz. It cannot be determined to what extent the localized spontaneous loss of hair cells is caused by vascular factors and what other mechanisms are involved, but vascular factors probably only play a minor role.     

Chronic fluoride toxicity decreases the number of nicotinic acetylcholine receptors in rat brain

In order to investigate the molecular mechanism(s) underlying brain dysfunction caused by chronic fluorosis, neuronal nicotinic acetylcholine receptors (nAChRs) in the brain of rats receiving either 30 or 100 ppm fluoride in their drinking water for 7 months were analyzed in the present study employing ligand binding and Western blotting. There was a significant reduction in the number of [³H]epibatidine binding sites in the brain of rats exposed 100 ppm of fluoride, but no alteration after exposed to 30 ppm. On the other hand, the number of [¹²⁵I]-BTX binding sites was significantly decreased in the brains of rats exposed to both levels of fluoride. Western blotting revealed that the level of the nAChR 4 subunit protein in the brains of rats was significantly lowered by exposure to 100 ppm, but not 30 ppm fluoride; whereas the expression of the 7 subunit protein was significantly decreased by both levels of exposure. In contrast, there was no significant change in the level of the β2 subunit protein in the brains of rats administered fluoride. Since nAChRs play major roles in cognitive processes such as learning and memory, the decrease in the number of nAChRs caused by fluoride toxicity may be an important factor in the mechanism of brain dysfunction in the disorder.     

Detection and characterization of a novel functional polymorphism in the GSTT1 gene

A novel functional polymorphism in the GSTT1 gene associated with the non-conjugator phenotype has been identified. Sequencing of GSTT1 cDNA revealed a single nucleotide substitution, 310A>C, that altered the amino acid residue 104 from threonine to proline (T104P). Modelling studies of GSTT1 have suggested that residue 104 is located in the middle of alpha-helix 4. Introduction of an alpha-helix-disrupting proline most likely distorts the conformation of the protein. Individuals that lacked GSTT1 activity and carried the variant allele, tentatively denoted GSTT1*B, had no detectable GSTT1 immunoreactive protein. An allele-specific polymerase chain reaction method was developed to determine the frequency of the GSTT1*B allele. In 497 ethnic Swedes, the frequency of the active GSTT1*A allele was 0.65 [95% confidence interval (CI) 0.62-0.68] whereas the frequencies of the non-functional alleles GSTT1*O and the novel GSTT1*B allele were 0.34 (CI 0.31-0.37) and 0.01 (CI 0.01-0.02), respectively. In 100 Swedish Saamis, the GSTT1*B allele appeared to be slightly more common with a frequency of 0.03 (CI 0.01-0.07). The GSTT1 enzyme activity was measured in erythrocytes using methyl chloride as substrate. Individuals with the GSTT1*A/*A genotype had a two-fold higher GSTT1 activity compared to individuals with the GSTT1*A/*B genotype and subjects with the GSTT1*O/*B genotype totally lacked GSTT1 activity, indicating a strict gene-dose effect. By combining the analyses for the novel single nucleotide polymorphism with analyses for the deletion polymorphism, the accuracy in predicting all three GSTT1 conjugator phenotypes was improved from 96% to 99%.     

A quantitative real-time PCR method for tissue factor mRNA

BACKGROUND: Tissue factor (TF) is primarily known for its function to initiate blood coagulation. The range of in vivo expression of TF is wide and requires a dynamic assay for monitoring. A general method for TF mRNA quantitation that is dynamic, sensitive and applicable to a variety of experimental systems or clinical situations is therefore desirable. OBJECTIVES: To develop a method for sensitive and dynamic quantitation of TF mRNA in human blood cells. METHODS: TF mRNA expression was analysed and evaluated in monocyte isolations, in whole blood (healthy volunteers and patients scheduled for percutaneous coronary intervention, PCI) and in a panel of human cell lines. RNA was extracted, reverse transcribed and subjected to real-time PCR amplification, according to the TaqMan technology. A TF plasmid was constructed as calibrator of the assay. Two housekeeping genes used as endogenous controls for cDNA quality and integrity were evaluated. RESULTS: The assay was linear by seven orders of magnitude and detected down to 10(2) copies of the TF plasmid. The coefficient of variation was 4% intra-assay and 28% between the assays when using beta2MG as endogenous control. The beta-actin gene expression was induced by treatment with lipopolysaccharide (LPS) in blood leukocytes and could not be used as an endogenous control. However, beta2MG showed only minor variations upon treatment with LPS. The TF mRNA and antigen expression, measured in a Western blot, correlated well (R(2)=0.903) in a panel of 11 human cell lines. CONCLUSIONS: We have established a method for sensitive and dynamic quantitation of TF mRNA in experimental systems and for clinical situations.     

Bonded resin sealant on smooth surface dental enamel--an in vitro study

The aim of this study was to in vitro evaluate the micro leakage of a fissure sealant on sound and demineralized enamel using thermo cycling. The effect of the sealing procedure on sound and demineralized enamel were assessed on human premolars that were divided into one Control group and two Test groups. The Control group served as a baseline reference for the subsequent test procedures. The crowns of five teeth were covered with wax leaving three separate windows on the buccal surfaces. The enamel in one window was acid-etched, in the second window demineralized, and in the third window demineralized and subsequently acid-etched. In Test group 1, containing ten teeth, a defined enamel area on the buccal surfaces was acid-etched and sealed. The sealed area and a border of sound enamel around it were subjected to the demineralizing procedure. In Test group 2, a defined enamel window of 13 teeth was demineralized and subsequently etched and sealed. The sealed area and a border of surrounding enamel were subjected to a new cycle of demineralization. The longitudinal, bucco-lingual sections were examined in polarized light. When placed on acid-etched surfaces, the resin adhered firmly to the enamel with no evidence of demineralization or enlargement of previously demineralized areas underneath the sealants.