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1.
Fluid role boundaries: exploring the contribution of the advanced nurse practitioner to multi‐professional palliative care
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2.
Martha A. Warpehoski Paul J. Buscemi David C. Osborn Birdwell Finlayson Eugene P. Goldberg 《Calcified tissue international》1981,33(1):211-222
Summary The quantity of protein and carbohydrate comprising the matrix of calcium oxalate monohydrate (COM) renal stones was found
to decrease with distance from the surface of the stone. The average organic concentration of stones 3 to 30 mm in diameter
ranged from 5.7% at the surface to 2.7% at the core. This concentration gradient suggests matrix involvement in a “growth
front” on stone surfaces with migration of organic material from the “older” interior. The matrix distribution was not readily
correlated with density variations or with the presence of hydroxyapatite or calcium oxalate dihydrate. Surface matrix concentrations
were greater than amounts predicted by physical adsorption. Electron microscopy confirmed the presence of the organic-rich
surface layer and also suggested that increase in stone size occurs predominantly by crystal growth with microcrystal aggregates
as growth centers. 相似文献
3.
Thane Lawrie Catriona Matheson Christine Bond Kay Roberts 《The International journal on drug policy》2003,14(5-6):445
Community pharmacists contribution to the management of drug problems is considerable. As the use of illicit drugs has increased, pharmacists have come under increasing pressure to offer services to problem drug users. However, there is concern among some pharmacists that offering such services may deter other customers. There is particular concern among some pharmacists about needle exchange services. Only 9.5% of Scottish pharmacies offer needle exchange services compared to 69% which are dispensing methadone (57% of which supervise methadone consumption). Qualitative interviews were used in a purposive sample of 10 pharmacies in Scotland. Eight customers were interviewed in each pharmacy to ascertain pharmacy customers’ views on these services. The majority of customers were supportive of these services. Customers were often unaware that the pharmacy they were interviewed in was offering services for people with drug problems. Pharmacy customers were more knowledgeable about, and more supportive, of needle exchange services than they were of methadone. This was because they believed needle exchange services helped to reduce the amount of discarded needles in public places. Pharmacy customers also recognised that needle exchange helped reduce the spread of disease. These findings should be used to encourage more pharmacists to offer needle exchange services. 相似文献
4.
Histopathological characterisation of effects of the mouse Pax6 missense mutation on eye development
Thaya Ramaesh Steven E. Williams Catriona Paul Kanna Ramaesh John D. West 《Experimental eye research》2009,89(2):263-273
Mutations in PAX6/Pax6 lead to a variety of ocular anomalies in humans and mice. The aim of the study was to characterise the ocular abnormalities caused by the missense Pax6Leca4 mutation and compare them to published observations on Pax6 alleles that are functionally equivalent to Pax6− null alleles (such as Pax6Sey and Pax6Sey-Neu) and human inherited eye diseases. Ocular features of homozygous Pax6Leca4/Leca4 and heterozygous Pax6Leca4/+ embryos at E12.5-E18.5, heterozygous Pax6Leca4/+ young mice at P18 and heterozygous Pax6Leca4/+ adults at 12 weeks were analysed histologically with their wild-type Pax6+/+ littermates. Homozygous Pax6Leca4/Leca4 fetuses died perinatally with no eyes although an optic cup rudiment with pigmented cells developed. Pax6Leca4/+ mice were microphthalmic and a range of other severe ocular phenotypes affected both the anterior and the posterior segments. In contrast to Pax6+/−, the Pax6Leca4/+ eyes had no goblet cells in the corneal epithelium, the iris was not hypoplastic and there was no lens-corneal epithelial plug. However, microphthalmia was more severe, corneal vascularisation occurred earlier (during fetal stages), pigmented cells were present in the vitreous and corneal stroma and the ciliary body was malformed or abnormal. These results show that, although Pax6Leca4/+ lacked some eye abnormalities commonly seen in Pax6Sey/+ and Pax6Sey-Neu/+ eyes, in most respects their eyes were more severely affected. These differences probably reflect both differences between the Pax6Leca4 and the Pax6Sey-Neu mutations and differences in modifier gene expression in different genetic backgrounds. The presence of pigmented cells in the cornea is a novel observation. Some Pax6Leca4/+ ocular abnormalities were similar to those present in human Peters' anomaly and persistent hyperplastic primary vitreous (PHPV) so Pax6Leca4/+ mice provide a useful model for some inherited eye diseases. 相似文献
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Marcia Finlayson 《The American journal of occupational therapy》2004,58(1):54-63
Multiple sclerosis (MS) is a chronic, progressive neurological disease that causes demyelination of the central nervous system. Typically diagnosed in adulthood, it does not significantly reduce life expectancy. The goal of this exploratory study was to describe the health-related concerns and service needs of 27 older adults with MS, ages 55 to 81 years. Through in-depth interviews using a phenomenological approach, fear of the future was found to be a predominant concern among the participants. Within this fear, participants expressed particular concerns about experiencing further losses of mobility and independence, becoming a burden on caregivers, and having to move to a nursing home. The findings raise three major challenges for occupational therapists that include: (1) developing or modifying interventions that can enable older adults with MS to gain a sense of control over their future, (2) working with families affected by MS together with other disciplines such as psychology and social work, and (3) advocating for more and better community support options for persons with MS. 相似文献
8.
The ureteral access set was used 43 times during an 18-month period between 1984 and 1985. Stones lodged throughout the ureter and in the renal pelvis were extracted with a success rate of 51 per cent. Of the upper tract strictures 92 per cent were dilated successfully. Filling defects were diagnosed in 88 per cent of the cases. Foreign bodies were retrieved, Double-J stents were placed and biopsies were successful in each case. Ureteral perforation in 28 per cent of the cases was caused by the dilator in 8 of 12 (19 per cent over-all). The technique and short-term results are discussed. Long-term followup data are not yet available. 相似文献
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Use of the "blast path" may be helpful in patients where positioning for ESWL treatments is difficult. Good pressures are maintained along the blast path and an alternate fracture mechanism may be in effect. The rate of fragmentation, assessed using model material, decreases with distance beyond F2. 相似文献