Perceived professional support and the use of blocking behaviours by hospice nurses

A prospective study of the impact of training 41 hospice nurses in assessment skills was used to test hypotheses that blocking behaviours would be used more when patients disclosed feelings and used less when nurses perceived that they had satisfactory professional support Each nurse was asked to assess a patient's current problems before and after feedback training and 8 months later Audiotape recordings of these interviews were rated by trained raters They determined the frequency of nurses' responses which had the function of blocking patient disclosure and the emotional level of patient disclosure Before each patient assessment each nurse was interviewed and questionnaires administered to measure her perceptions of the support she received Blocking behaviours were most evident when patients disclosed their feelings (Kendalls r=0 36, P < 0 001) In interviews containing most patient disclosure of feeling, blocking was significantly less (r= - 0 24, P < 0 5) when the nurse felt that practical help would be available if needed and when the nurse felt that her direct supervisor was concerned about the nurse's own welfare (r= -0 37, P < 0 005)     

Familial polyposis coli: growth characteristics of karyotypically variable cultured fibroblasts, response to epidermal growth factor and the tumour promoter 12-0-tetradecanoyl phorbol-13-acetate.

Growth in low serum and cell saturation density was investigated in 20 skin fibroblast cultures from 17 patients with the autosomal dominant cancer prone condition, familial polyposis coli (FPC). Compared with non-fetal control cultures, the grouped FPC cultures showed significantly better growth in low serum and approximately 30% increase in saturation density. Neither of these properties was correlated with high tetraploidy or clonal rearrangement of the chromosomes. No difference in response to epidermal growth factor was demonstrable between cultures from normal and affected subjects. The tumour promoter, 12-0-tetradecanoyl phorbol-13-acetate (TPA), had no differential effect on growth in high and low density cultures of FPC and normal cells in short term experiments; both cell types displayed a biphasic response to the agent at low cell density. However, in long term experiments FPC skin cultures showed growth stimulation and greater resistance to the toxic effects of TPA than normal cells. Cells from both fetal and non-fetal controls as well as from FPC subjects displayed anchorage independent growth after treatment with TPA, but in general FPC cultures from skin and colon responded to a greater extent than non-fetal controls. Marked change in tetraploidy after treatment was evident only in those FPC and control cultures which were highly chromosomally abnormal. Both groups showed a slight increase in stable and unstable chromosome rearrangements with treatment but one FPC culture became totally chromosomally abnormal and cloned in agar with high efficiency, as did one of the treated fetal controls which, however, had normal chromosomes.     

A new apheresis procedure for the preparation of high-quality red cells and plasma

BACKGROUND: Multicomponent apheresis is an alternative way of preparing blood components that avoids the delay between collection and separation seen with standard whole-blood techniques. STUDY DESIGN AND METHODS: An apheresis device has been modified to facilitate the combined collection of a unit (250 mL) of red cells (RBCs) and a high-volume unit (475 mL) of plasma. The procedure, using 8-percent ACD-A, has been tested in two European blood centers. Each center performed 20 procedures for in vitro evaluation of collected RBCs and plasma and 10 procedures for evaluation of in vivo RBC recovery. All RBCs were white cell reduced by filtration. One-half of the RBC units were stored in the additive solution Adsol and one-half in another such solution (Erythro-Sol). RESULTS: The target volumes of RBCs and plasma were obtained in 27 minutes (range, 20-44 min) by using three to six cycles in a single-needle procedure. Saline (275 mL) was used to replace fluid volume withdrawn in excess of standard whole-blood donation. No side effects occurred, with the exception of minor signs of hypocalcemia. RBC ATP was well maintained (>65% at Day 42) during storage; 2,3-DPG was less well maintained, with virtually none remaining at Day 21 in either Adsol or Erythro-Sol. The RBC in vivo recoveries, after 42 days of storage at 4+/-2 degrees C determined by the single-label method, were 86.7+/-7.2 percent (Erythro-Sol) and 84.4+/-8.1 percent (Adsol). Mean plasma factor VIII levels were >100 percent in all test groups. CONCLUSION: A novel automated technique for the simultaneous collection and preparation of RBCs and plasma has been evaluated. The apheresis procedure was acceptable and well tolerated by donors, and it resulted in high-quality blood components. Further optimization of the system should yield a practicable component suitable for routine use in blood banks.     

Aspects of the nurse tutor-student nurse relationship

This paper is focused on selected items from an exploratory study of nurse tutor-student nurse role-relationships. Aspects of the teacher-student and counsellor-client dimensions of the relationship are reported. The research was conducted from a sociological perspective using role theory as the organizing theoretical framework. An 'ideal type' tutor-student relationship was proposed from the findings. There was concensus between tutors and students that tutors acted in a caring way towards students but many constraints were identified which inhibited students with problems from seeking help from tutors and prevented tutors from offering all the help which they wished to give to students.     

Exercise rapidly increases eukaryotic elongation factor 2 phosphorylation in skeletal muscle of men

Protein synthesis in skeletal muscle is known to decrease during contractions but the underlying regulatory mechanisms are unknown. Here, the effect of exercise on skeletal muscle eukaryotic elongation factor 2 (eEF2) phosphorylation, a key component in protein translation machinery, was examined. Eight healthy men exercised on a cycle ergometer at a workload eliciting ∼67% peak pulmonary oxygen consumption     with skeletal muscle biopsies taken from the vastus lateralis muscle at rest as well as after 1, 10, 30, 60 and 90 min of exercise. In response to exercise, there was a rapid (i.e. < 1 min) 5- to 7-fold increase in eEF2 phosphorylation at Thr56 that was sustained for 90 min of continuous exercise. The in vitro activity of skeletal muscle eEF2 kinase was not altered by exercise indicating that the increased activity of eEF2 kinase to eEF2 is not mediated by covalent mechanisms. In support of this, the increase in AMPK activity was temporally unrelated to eEF2 phosphorylation. However, skeletal muscle eEF2 kinase was potently activated by Ca²⁺–calmodulin in vitro , suggesting that the higher eEF2 phosphorylation in working skeletal muscle is mediated by allosteric activation of eEF2 kinase by Ca²⁺ signalling via calmodulin. Given that eEF2 phosphorylation inhibits eEF2 activity and mRNA translation, these findings suggest that the inhibition of protein synthesis in contracting skeletal muscle is due to the Ca²⁺-induced stimulation of eEF2 kinase.