Analysis of job-share as a process of change

This paper describes the introduction of a district nursing job-share in a primary health care team. Exploring change theory and different strategies for organizational change, the implications for members of the team are considered. In addition, changes in the balance of power which resulted in conflict within the district nursing team are discussed.     

Effects of the sulphydryl inhibitor N-ethyl-maleimide on the phrenic nerve and diaphragm muscle of the rat

N-Ethyl-maleimide (NEM, 2.5 x 10(-5) M) inhibited the compound action potential of the phrenic nerve and increased the spontaneous release of transmitter from the nerve terminals, recorded as miniature endplate potentials. The first effect was the cause of a blockade of the phrenic nerve diaphragm preparation, during indirect stimulation. The left phrenic nerve was more susceptible to inhibition than the right. An increase of the threshold was observed during the progression of the inhibition. The inhibition was not use-dependent and there was no synergistic interaction with the local anaesthetic drug, tetracaine. The inhibition was partly antagonized by di-thio-threitol (3.0 x 10(-3) M). The increase of spontaneous release of transmitter was not accompanied by an increase of the stimulus-evoked release since the amplitude of the endplate potential was not increased and partial inhibition caused by d-tubocurarine or magnesium chloride was not antagonized. When the concentration of NEM was increased to 2.75 x 10(-4) M, the directly-elicited twitches were inhibited, and the baseline tension was increased. This increase of tension was slightly reduced in a preparation depolarized with potassium chloride; a small depolarization could partly explain this effect. It was not reduced by dantrolene or in a calcium-free solution. The inhibition of the twitch and the increased baseline tension (probably a rigor) might be caused by a reduced sensitivity of the contractile proteins for calcium ions and an inhibition of the myosin ATPase activity, respectively.     

灼皮美容术的临床与实验研究

为了探索治疗天花、痤疮遗留表浅瘢痕与大面积色素斑较简易有效的新方法，利用ＧＸ－Ⅱ型多功能电离子手术治疗机烧灼皮肤至真皮浅层代替皮肤磨削这种传统术式。采用动物皮肤烧灼试验，切片显微观察其病理反应及愈合情况，并对６８例患者进行了临床疗效观察。结果显示：动物皮肤烧灼深度达真皮浅层，甚或毛囊破坏（已达真皮深层），但大部分区域表皮通过毛囊再生而全层修复，少部分区域也为单层基底细胞被覆，表明灼皮术后皮肤的良好修复过程。临床应用不仅疗效好，而且较皮肤磨削术具有易操作，安全，无菌条件要求低，术中及术后不出血，疼痛不明显，术后不必包扎、换药等优点。动物试验表明：表皮全层灼烧气化后，真皮浅层也呈现不同程度的灼伤，因此在操作时应注意掌握深度。     

Pregnant dreaming: Search for a typology of a proposed dream genre

Dreams during pregnancy were collected from post-partum women on the maternity ward of an Israeli hospital. Our data indicate that primipara women and women with complicated obstetrical histories were more likely to report increased dreaming during pregnancy. The collected dream corpus suggests that dreams during pregnancy can be viewed as a distinct dream genre. This paper develops a tentative typology of that genre. In addition, the authors argue that the context of disclosure was highly relevant to the sorts of manifest contents that were reported.     

Developing nurse practitioners to develop practice: the experiences of nurses working on a Nursing Development Unit

Aim To elicit nurses' accounts of their involvement with nursing research and their interpretations of the meaning of these projects for their practice.
Background The links between research and practice development in health care are poorly understood and require further exploration in the light of the emerging research and development agenda within the National Health Service.
Methods Semi-structured interviews were conducted with 15 qualified nurses working on a Nursing Development Unit. The interviews were tape recorded, transcribed and analysed thematically.
Findings Data analysis identified two distinct groups—a core group of nurses actively engaged in the research projects and a peripheral group involved in data collection. The characteristics of the core group mirror the characteristics of those involved in non-research-based practice development activities.
Conclusions Engaging in research activities does not always result in the development of practice, however, there appears to be a link between practice development and critical thinking.     

Beta-defensin genomic copy number is not a modifier locus for cystic fibrosis

Human beta-defensin 2 (DEFB4, also known as DEFB2 or hBD-2) is a salt-sensitive antimicrobial protein that is expressed in lung epithelia. Previous work has shown that it is encoded in a cluster of beta-defensin genes at 8p23.1, which varies in copy number between 2 and 12 in different individuals. We determined the copy number of this locus in 355 patients with cystic fibrosis (CF), and tested for correlation between beta-defensin cluster genomic copy number and lung disease associated with CF. No significant association was found.     

Oligomerization and polymerization of the filovirus matrix protein VP40

The matrix protein VP40 from Ebola virus plays an important role in the assembly process of virus particles by interacting with cellular factors, cellular membranes, and the ribonuclearprotein particle complex. Here we show that the N-terminal domain of VP40 folds into a mixture of two different oligomeric states in vitro, namely hexameric and octameric ringlike structures, as detected by gel filtration chromatography, chemical cross-linking, and electron microscopy. Octamer formation depends largely on the interaction with nucleic acids, which in turn confers in vitro SDS resistance. Refolding experiments with a nucleic acid free N-terminal domain preparation reveal a mostly dimeric form of VP40, which is transformed into an SDS resistant octamer upon incubation with E. coli nucleic acids. In addition, we demonstrate that the N-terminal domain of Marburg virus VP40 also folds into ringlike structures, similar to Ebola virus VP40. Interestingly, Marburg virus VP40 rings reveal a high tendency to polymerize into rods composed of stacked rings. These results may suggest distinct roles for different oligomeric forms of VP40 in the filovirus life cycle.     

Quality of life in Palestinian patients with end-stage renal disease receiving treatment by haemodialysis: a cross-sectional study

Background

Haemodialysis is a life-saving but burdensome therapy for patients with end-stage renal disease, which can substantially impair health-related quality of life (HRQOL) and outcomes. The aim of this study was to determine the patterns of HRQOL and to identify the risk factors for reduced HRQOL in Palestinian patients receiving treatment by haemodialysis.

Global research trends in the microbiome related to irritable bowel syndrome: A bibliometric and visualized study

BACKGROUNDIrritable bowel syndrome (IBS) is a common functional gastrointestinal disorder. Dysregulation of the gut–brain axis plays a central role in the pathophysiology of IBS. It is increasingly clear that the microbiome plays a key role in the development and normal functioning of the gut–brain axis.AIMTo facilitate the identification of specific areas of focus that may be of relevance to future research. This study represents a bibliometric analysis of the literature pertaining to the microbiome in IBS to understand the development of this field. METHODSThe data used in our bibliometric analysis were retrieved from the Scopus database. The terms related to IBS and microbiome were searched in titles or abstracts within the period of 2000–2019. VOSviewer software was used for data visualization. RESULTSA total of 13055 documents related to IBS were retrieved at the global level. There were 1872 scientific publications focused on the microbiome in IBS. There was a strong positive correlation between publication productivity related to IBS in all fields and productivity related to the microbiome in IBS (r = 0.951, P < 0.001). The United States was the most prolific country with 449 (24%) publications, followed by the United Kingdom (n = 176, 9.4%), China (n = 154, 8.2%), and Italy (n = 151, 8.1%). The h-index for all retrieved publications related to the microbiome in IBS was 138. The hot topics were stratified into four clusters: (1) The gut–brain axis related to IBS; (2) Clinical trials related to IBS and the microbiome; (3) Drug-mediated manipulation of the gut microbiome; and (4) The role of the altered composition of intestinal microbiota in IBS prevention. CONCLUSIONThis is the first study to evaluate and quantify global research productivity pertaining to the microbiome in IBS. The number of publications regarding the gut microbiota in IBS has continuously grown since 2013. This finding suggests that the future outlook for interventions targeting the gut microbiota in IBS remains promising.