Sample size considerations when groups are the appropriate unit of analysis.

This article discusses issues to be considered by nurse researchers when groups should be used as the unit of randomization. Advantages and disadvantages are presented, with statistical calculations needed to determine the effective sample size. Examples of these concepts are presented using data from the Black Cosmetologists Promoting Health Program. Different hypothetical scenarios and their impact on sample size are also presented. Given the complexity of calculating the sample size when using groups as the unit of randomization, it is advantageous for researchers to work closely with statisticians when designing and implementing studies that anticipate the use of groups as the unit of randomization.     

Food and health at work–a review. The costs and benefits of a policy approach

The workplace is an important setting for health promotion and provides an ideal opportunity for shaping healthy eating patterns in occupational groups for whom inequalities have been identified (DHSS, 1980). Workplace food/health policies provide an intermediate and pragmatic step towards achieving the dietary targets set out in the Government's white paper Health of the Nation and the most recent COMA report (DoH, 1991,1992). Food/health policies have been widely adopted in the NHS (Gibson & Kallevik, 1990) and preliminary research suggests that they are an effective means of intervention (Wallis & Poulter, 1988; Frost et al., 1991). Industry has been slower to link food and health promotion to a policy making process. Surveys imply that action on healthy eating in companies often originates in the occupational health department and is based on individualistic approaches with little energy being put into preventive activities which would originate in the canteen (Mclnerney & Cooper, 1989; Poulter, 1990). Policies provide a means of balancing the environmental and educational paradigms of health promotion. If food/health policies are to grow in the private sector then industry has to be convinced that the benefits Justify the costs. Some philanthropic employers are motivated by interests other than financial gain, but others are commercially led. There is little hard evidence to demonstrate that any type of employer-sponsored healthy eating initiative provides a favourable return for investment. It has been ‘guesstimates’ and extrapolation from other situations which have provided the justification for UK companies to allocate any resources towards addressing food/health issues. In April 1990 the National Grid Company adopted a comprehensive food/health policy. This paper draws on the experiences in developing and implementing the policy document to discuss the issues around evaluative activity in a commercial setting. Views are expressed on the feasibility of measurement and the value of the informaton collected. One aim of the future should be to research this under-examined area to establish a solid body of information. This would raise the level of debate from one which is currently based on anecdotal evidence to a sounder scientific footing and, therefore, ensure the future growth of such policies in the corporate sector.     

Reflective practice: a critique of the work of Argyris and Schön

The seminal work of Argyris and Schon on action theories, technical rationality and reflective practice is reviewed, it is argued that their work reflects important inconsistencies between their theorizing and the pedagogical interventions they implemented/recommended The implications of the results of these inconsistencies, which appear mirrored in nurse-education programmes in the United Kingdom and Australia, are discussed Tentative suggestions for the provision of a more adequate practical pedagogy are included     

Hippocampal NMDA receptor mRNA undergoes subunit specific changes during developmental lead exposure

The N-methyl- -aspartate (NMDA) receptor has shown to play an important role in the cognitive deficits associated with developmental lead (Pb) exposure. In this study, we examined the effects of low-level Pb exposure on NMDA receptor subunit gene expression in the developing rat brain. The pattern of NR1, NR2A, NR2B, and NR2C subunit mRNA in situ hybridization was consistent with previous studies. Brain levels of NR1 and NR2A mRNAs were lowest shortly after birth, increasing to reach peak levels by 14 or 21 days of age and subsequently decreasing at 28 days of age. NR2B mRNA levels were highest during early development and decreased as the animals aged. NR2C subunit mRNA was restricted to the cerebellum and a signal was not detectable until the second week of life. Lead exposure resulted in significant and opposite effects in NR1 and NR2A subunit mRNA expression with no changes in NR2B or NR2C subunit expression. The Pb-induced changes in NR1 and NR2A subunit mRNA were mainly present in the hippocampus. Hippocampal NR1 mRNA levels were significantly increased in the CA1 (15.3%) and CA4 (26.8%) pyramidal cells from 14-day-old Pb-exposed rats. At 21 days of age, only the NR1 mRNA at the CA4 subfield remained significantly elevated (10.3%). Lead exposure caused reductions of NR2A mRNA levels (11.9–19.3%) in the pyramidal and granule cell layers of the hippocampus at 14 and 21 days of age. NR1 mRNA levels were also significantly increased (14.0%) in the cerebellum of 28-day-old rats with no change in NR2A mRNA at any age. No significant changes in subunit mRNA levels were present in cortical or subcortical regions at any age. The Pb-induced changes in hippocampal NMDA receptor subunit mRNA expression measured in the present study may lead to modifications in receptor levels or subtypes and alter the development of defined neuronal connections which require NMDA receptor activation.     

Long-latency auditory-evoked potentials: Role of polysensory association cortex in the cat

The objective of this study has been to define the role of polysensory association cortex in the generation of "wave NA" and of "wave C," long-latency auditory-evoked potentials recorded from the vertex of conscious cats as, respectively, a marked negative potential of latency 30-48 msec followed by a broad positive wave of latency 50-75 msec. Wave C may represent the feline analogue of the longer latency human auditory-evoked potential wave P2, insofar as both waveforms are very large amplitude, long duration positivities characterized by long recovery cycles. Based on previous studies of wave C and the generators of other middle-latency evoked potentials, we hypothesized that both wave NA and wave C might reflect, at least in part, the cortical culmination of a nonlemniscal line auditory association system arising in reticulothalamic projections to intralaminar and associated ventral thalamic regions. Relays from these thalamic areas are known to project to polysensory association cortex, including pericruciate gyrus, anterolateral gyrus, and medial suprasylvian gyrus. Therefore we implemented a series of lesion experiments to characterize the role of each of these cortical areas in the production of wave NA and wave C. Our results indicate that all three polysensory association areas contribute significantly to both waves NA and C, although the largest effects followed ablation of the pericruciate area alone. Thus, the generator substrates of waves NA and C appear to involve a long-recovery cycle system which functionally incorporates activation of association cortex.     

Age and simple reaction time: decade differences for 5,325 subjects

In a booth at a public exhibition entitled "Medicines for Man," 5,325 men, women, and children carried out a 1-minute test of simple reaction time (RT) with 1 to 10 second randomized variable preparatory interval (PI). They recorded their ages by decade. Average RT over the last eight (of ten) trials increased progressively from the 20s up to age 60 and over, and downward to the teens and under 10s. The single fastest RT in each test varied much less with age, only the 20s being clearly faster than the rest, with the under 10s slower. Within-subject variability of RT was increased only in the under 10s and over 60s. Ability to sustain attention during the longer PIs may underlie the gross average RT differences with age, and possibly some more basic neural property the superiority of the 20s in fastest RT.     

Some factors affecting the strength of the cement-metal interface

A manufacturing technique to increase the bonding between bone cement and metal prostheses has been assessed in the laboratory by "push-out" tests, and the effects of contamination of the cement and of the prosthesis with blood and intramedullary contents have been studied. The technique, known as pre-coating, increases bond strength; this increase is preserved after contamination of the cement which does, however, cause some lowering of interface shear strength. The implications for clinical practice are discussed.