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To address claims of human exceptionalism, we determine where humans fit within the greater mammalian distribution of reproductive inequality. We show that humans exhibit lower reproductive skew (i.e., inequality in the number of surviving offspring) among males and smaller sex differences in reproductive skew than most other mammals, while nevertheless falling within the mammalian range. Additionally, female reproductive skew is higher in polygynous human populations than in polygynous nonhumans mammals on average. This patterning of skew can be attributed in part to the prevalence of monogamy in humans compared to the predominance of polygyny in nonhuman mammals, to the limited degree of polygyny in the human societies that practice it, and to the importance of unequally held rival resources to women's fitness. The muted reproductive inequality observed in humans appears to be linked to several unusual characteristics of our species-including high levels of cooperation among males, high dependence on unequally held rival resources, complementarities between maternal and paternal investment, as well as social and legal institutions that enforce monogamous norms.

Understanding the structure-function relationships of macromolecules, such as proteins, at the molecular level is vital for biomedicine and modern drug discovery. To date, X-ray crystallography remains the most successful method for solving three-dimensional protein structures at atomic resolution. With recent advances in serial crystallography, either using X-ray free electron lasers (XFELs) or synchrotron light sources, protein crystallography has progressed to the next frontier, where the ability to acquire time-resolved data provides important mechanistic insights into the behavior of biological molecules at room temperature. This protocol describes a straightforward high-throughput (HTP) workflow for screening crystallization conditions through the use of a 96-well dialysis plate. These plates follow the Society for Biomolecular Screening (SBS) standard and can be easily set up using any standard crystallization laboratory. Once optimal conditions are identified, large quantities of crystals (hundreds of microcrystals) can be produced using the dialyzer. To validate the robustness and versatility of this approach, four different proteins were crystallized, including two membrane proteins.

We examined how convenience and financial incentives influence patient willingness to dispose of leftover prescription opioids after surgery. We also identified additional barriers and facilitators to disposal., Background: In the United States, up to 70% of surgical patients are prescribed opioids and up to 92% will have leftover tablets. Most do not dispose of leftover opioids, increasing the risk for opioid-related harm. Current interventions promoting opioid disposal have shown mixed success., Methods: We conducted a mixed methods study using a standard gamble survey and semi-structured interviews. Participants estimated willingness to dispose in 16 scenarios with varying convenience (time requirements of <5, 15, 30, and 60 minutes) and financial incentives ($0, $5, $25, $50). We estimated the likelihood of disposal using a multivariable mixed effects modified Poisson regression model. Semi-structured interviews explored how convenience, financial incentives, and other barriers and facilitators influenced decisions to dispose., Results: Fifty-five participants were surveyed and 42 were interviewed. Most were willing to dispose when the time required was <15 minutes. Few were willing to dispose if the process required 60 minutes, although a $50 financial incentive increased rates from 9% to 36%. Anxiety about future pain, opioid scarcity, recreational use, family safety, moral beliefs, addiction, theft, and environmental harm also influenced decision-making., Conclusions: Interventions promoting opioid disposal should focus on convenience, but the selective use of financial incentives can be effective. Tailoring interventions to individual barriers and facilitators could also increase disposal rates., Competing Interests: Disclosure: The authors declare that they have nothing to disclose. The research reported in this publication was supported by the University of Utah Population Health Research (PHR) Foundation, with funding in part from the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grants UL1TR002538 (formerly 5UL1TR001067-05, 8UL1TR000105 and UL1RR025764) and Award Number KL2TR002539., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: The initial interaction between an older person and a nurse, and how the older person interprets this interaction, is important and sometimes overlooked. Evidence suggests that the way healthcare workers speak to older people can negatively affect older people's well-being., Aim: To interview community-dwelling older people aged ≥65 years who had recently held a conversation with a healthcare worker and to understand the meanings older people attributed to these conversations., Method: Ten community-dwelling older people were recruited and interviewed. Interviews were recorded and transcribed verbatim. Qualitative analysis was informed by narrative methods., Findings: Participants freely and readily interpreted their conversations with healthcare workers in terms of the values and attitudes conveyed. Their preferences for forms of address ranged from formal to informal. They were sensitive to a range of contextual factors shaping the use of language. While they were generally tolerant of forms of address that did not match their personal preferences, some inferred disrespect from the unthinking use of first names and some resented assumptions being made based on age., Conclusion: Nurses are encouraged to be skilful and sensitive when speaking to older people. It is advisable to follow older people's preferences regarding forms of address, as these are important markers of dignity and respect., Competing Interests: None declared, (© 2020 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.)

Nearly one fifth of the US population has a disability that impacts their communicative, mental or physical function. There are often not enough opportunities for people with disabilities to receive basic emergency preparedness training to help them be more resilient in times of crisis as preparedness education typically targets the general population. The Kent County Health Department, in collaboration with local disability advocates and preparedness educators, developed an inclusive preparedness programme to provide basic preparedness training for the whole community. This paper describes the evolution of the programme along with lessons learned by the participants and instructors.

A paper was published in 2003 discussing the ethics of nurses participating in executions by inserting the intravenous line for lethal injections and providing care until death. This paper was circulated on an international email list of senior nurses and academics to engender discussion. From that discussion, several people agreed to contribute to a paper expressing their own thoughts and feelings about the ethics of nurses participating in executions in countries where capital punishment is legal. While a range of opinions were presented, these opinions fell into two main themes. The first of these included reflections on the philosophical obligations of nurses as caregivers who support those in times of great need, including condemned prisoners at the end of life. The second theme encompassed the notion that no nurse ever should participate in the active taking of life, in line with the codes of ethics of various nursing organisations. This range of opinions suggests the complexity of this issue and the need for further public discussion.

Monogamy appears to have become the predominant human mating system with the emergence of highly unequal agricultural populations that replaced relatively egalitarian horticultural populations, challenging the conventional idea-based on the polygyny threshold model-that polygyny should be positively associated with wealth inequality. To address this polygyny paradox, we generalize the standard polygyny threshold model to a mutual mate choice model predicting the fraction of women married polygynously. We then demonstrate two conditions that are jointly sufficient to make monogamy the predominant marriage form, even in highly unequal societies. We assess if these conditions are satisfied using individual-level data from 29 human populations. Our analysis shows that with the shift to stratified agricultural economies: (i) the population frequency of relatively poor individuals increased, increasing wealth inequality, but decreasing the frequency of individuals with sufficient wealth to secure polygynous marriage, and (ii) diminishing marginal fitness returns to additional wives prevent extremely wealthy men from obtaining as many wives as their relative wealth would otherwise predict. These conditions jointly lead to a high population-level frequency of monogamy., (© 2018 The Authors.)

Aims and Objectives: To investigate the beliefs of recently bereaved people about death and to explore the implications of these beliefs for bereavement care., Background: Little is known about recently bereaved people's beliefs about death, although there is evidence that these beliefs may have an impact on health. The funeral provides an opportunity for bereaved people to reflect on their beliefs about death., Design: A qualitative approach., Methods: This paper describes one aspect of an interdisciplinary study of the spirituality of contemporary funerals. We obtained access to 46 funerals through funeral directors and other contacts, and interviewed principal mourners to explore their beliefs. Interviews were recorded, transcribed verbatim and analysed thematically., Results: Three themes emerged that reflected the beliefs and experiences of bereaved people. The first theme describes people's understanding of death in terms of five positions: religious, dualist, eco-spiritualist, materialist and death-as-transition. The second theme addresses a range of views about the possibility of life after death: resurrection, reuniting and reincarnation. The third theme describes ways in which people felt that their relationship with the deceased person continues after death: continuity as sense of presence and continuity as memory, legacy and love. Some people were reluctant to express a firm view about death., Conclusions: People express a spectrum of beliefs about death. Their beliefs are infrequently linked to formal religious or spiritual perspectives but seem to have an important role in coping with bereavement., Relevance to Clinical Practice: This is a unique study illustrating the complexity of bereaved people's beliefs about death. The study provides a research-based framework within which to understand contemporary beliefs about death, and contributes to our understanding of how health professionals can support recently bereaved people., (© 2013 John Wiley & Sons Ltd.)

The authors discuss ways in which nurses speak to older people. Research shows that the words nurses use can have a powerful effect on the wellbeing of older people. An experimental project developed at the University of Hull is described in which creative writing techniques were used to increase nursing students' and staff's sensitivity to the importance of language in care. The project enabled participants to co-create a body of work that was subsequently displayed in the faculty reception, and it showed how trusting relationships could be developed between participants. The authors are working to extend the project by finding ways to embed creative writing in the undergraduate nursing curriculum.

Aims: To describe the current 'state of the art' in relation to spiritual assessment, focusing on quantitative, qualitative and generic approaches; to explore the professional implications of spiritual assessment; and to make practical recommendations to managers seeking to promote spiritual assessment in their places of work., Method: The paper integrates aspects of a recent systematic review of quantitative approaches to measuring spirituality and a recent meta-synthesis of qualitative research into client perspectives of spiritual needs in health and the principles of generic assessment, before drawing on the wider literature to discuss a number of professional implications and making recommendations to nurse managers., Implications for Nursing Management: The issues to emerge from this paper are (1) that spiritual assessment is an increasingly important issue for nursing practice, (2) that the range of reliable and valid quantitative instruments for use in clinical practice is limited, (3) that there is overlap in the domains and categories of spirituality identified by quantitative and qualitative researchers, and (4) that nurse managers seeking to introduce spiritual assessment will do so in the context of a professional debate about the relevance of spirituality to contemporary practice., (© 2012 Blackwell Publishing Ltd.)

The aim of this study was to investigate the prevalence of depression in pediatric oncology patients in Jordan, comparing them with peers who suffered from chronic conditions or were healthy. The authors investigated 58 children with cancer, 56 with chronic illnesses, and 64 healthy controls using the Arabic version of the Children's Depression Inventory (CDI). There was no significant difference in CDI scores between children with cancer, children with chronic illnesses, and healthy controls. Using the conventional cutoff point of a score of 20 gives a prevalence of 20.68% for child-reported depression in the cancer group. This is toward the high end of the range for similar studies in other countries. The results suggest that children with cancer undergoing chemotherapy are no more likely to be depressed than children with chronic illnesses or healthy controls, although further research is warranted.

Background: A range of scales is available to measure health-related quality of life. Recently, established quality of life scales have been translated for use in a wide range of Western and non-Western cultures. One of the most widely used health-related quality of life scales for use with children is the PedsQL™ 4.0. In this paper, we describe the process of translating this scale into Arabic and establishing its reliability and validity., Aim: This paper has three aims: first, to explain the process of translating the PedsQL™ (4.0) self- and proxy-reports for the ages 8-12 and 13-18, from English into Arabic; second, to assess the reliability of the new Arabic version of the scale and third, to assess its validity., Method: The scale was translated from English to Arabic and back-translated to ensure accuracy. The Arabic version was administered to healthy children and those with cancer and a range of chronic illnesses in Jordan. Statistical methods were used to test the psychometric properties (reliability and validity) of the Arabic version of the PedsQL™ (4.0) and its ability to discriminate between children in the above groups., Results: Cronbach's alpha coefficients for child self- and parent proxy-reports exceeded 0.7 for the total scores, health summary scores and psychological health summary scores. Testing for discriminant validity showed that the healthy (control) group had a higher health-related quality of life than children and young people with cancer and chronic illness. The children with chronic illnesses had the lowest scores for physical, emotional and school functioning., Conclusion: Initial testing of the Arabic version of the PedsQL™ (4.0) suggests that the scale has satisfactory psychometric properties., (© 2011 The Authors. Scandinavian Journal of Caring Sciences © 2011 Nordic College of Caring Science.)

This paper reviews the UK evidence in relation to support for disabled student nurses from admission to qualification. The review was undertaken with a view to informing the provision of more effective support for disabled student nurses both within university and clinical practice, focusing on students with learning difficulties, mental health problems and unseen disabilities such as diabetes as these are the most commonly reported categories of disability in the Nursing and Midwifery Admissions System (NMAS). Evidence is available that highlights barriers for disabled students and provides recommendations for support strategies; however, few papers actually discuss how effective these strategies are once in place. This review therefore recommends further research that considers how effective and appropriate adjustments in university and clinical settings are for disabled student nurses., (Copyright © 2010 Elsevier Ltd. All rights reserved.)

Background: Patients with brain tumors form a heterogeneous group in terms of clinical presentation and pathology. However, the impact of the disease on patients' families is often more homogenous and frequently quite profound. A considerable body of literature is available on the management of brain tumors and recently, the National Institute for Clinical Excellence has developed guidelines on the care of brain tumor patients that should improve the overall outcome for the patient from both the disease and psychological aspects., Objectives: An increasing number of studies have attempted to address the impact of the disease on the care givers and relatives of these patients, but few have considered the problem simultaneously from both the patient's and care giver's perspective. In this study, we analyzed the psychosocial and general health of brain tumor patients and related this to the care givers., Materials and Methods: This is a questionnaire-based postal survey of 168 patients and their relatives. We examined how the health and psychological well-being of the caregiver may affect the quality of care., Results: There is significant physical, social, and psychosocial morbidity associated with caring for brain tumor patients. Patients worry about their care givers and this constitutes additional stress for the patient., Conclusions: No constructive and lasting improvement can be made to the quality of life of patients with brain tumor until the health and welfare of their care givers are factored into the care package. With better service to the patient, it is hoped that the burden of care will lighten for the care givers.

We study a limit of the nearly Peccei-Quinn-symmetric next-to-minimal supersymmetric standard model possessing novel Higgs and dark matter (DM) properties. In this scenario, there naturally coexist three light singletlike particles: a scalar, a pseudoscalar, and a singlinolike DM candidate, all with masses of order 0.1-10 GeV. The decay of a standard model-like Higgs boson to pairs of the light scalars or pseudoscalars is generically suppressed, avoiding constraints from collider searches for these channels. For a certain parameter window annihilation into the light pseudoscalar and exchange of the light scalar with nucleons allow the singlino to achieve the correct relic density and a large direct-detection cross section consistent with the DM direct-detection experiments, CoGeNT and DAMA/LIBRA, preferred region simultaneously. This parameter space is consistent with experimental constraints from LEP, the Tevatron, Υ, and flavor physics.

Due to variations in the production levels, a full-scale sequencing batch reactor (SBR) for post-treatment of tannery wastewater was exposed to low and high ammonia load periods. In order to study how these changes affected the N-removal capacity, the microbiology of the reactor was studied by a diverse set of techniques including molecular tools, activity tests, and microbial counts in samples taken along 3 years. The recover capacity of the biomass was also studied in a lab-scale reactor operated with intermittent aeration without feeding for 36 days. The results showed that changes in the feeding negatively affected the nitrifying community, but the nitrogen removal efficiencies could be restored after the concentration stress. Species substitution was observed within the nitrifying bacteria, Nitrosomonas europaea and Nitrobacter predominated initially, and after an ammonia overload period, Nitrosomonas nitrosa and Nitrospira became dominant. Some denitrifiers, with nirS related to Alicycliphilus, Azospirillum, and Marinobacter nirS, persisted during long-term reactor operation, but the community fluctuated both in composition and in abundance. This fluctuating community may better resist the continuous changes in the feeding regime. Our results showed that a nitrifying-denitrifying SBR could be operated with low loads or even without feeding during production shut down periods.

Background: There is a professional requirement for student nurses to achieve competence in the delivery of spiritual care. However, there is no research exploring students nurses perceptions of being educated in these matters., Aim: This paper explores the ethical basis of teaching student nurses about the concepts of spirituality and spiritual care by reporting the findings from the first year of a 3 year investigation., Design: An exploratory longitudinal design was used to obtain student nurses perceptions of spirituality and spiritual care as they progressed through a 3 year programme., Method: A questionnaire incorporating the Spirituality and Spiritual Care Rating Scale was distributed to 176 pre-registration nursing students undertaking either the Advanced Diploma or Bachelor of Science degree programmes., Results: A response rate of 76.7% was obtained. Findings reveal that the majority of student nurses perceived spirituality to be a universal phenomenon of a type that can be associated with existentialism. Some students were very uncertain and apprehensive about being instructed in spiritual matters., Conclusion: A cohort of student nurses held similar understandings of spirituality to those presented in the nursing literature. However the results also suggest an overwhelming majority felt it was wrong for spirituality to imply that some people are better than others and most were uncertain whether spirituality was related to good and evil. RELEVANCE TO NURSE EDUCATION: The investigation reveals that there are a number of ethical concerns surrounding the teaching of spirituality to student nurses that need to be resolved.

Student nurses spend one half of their educational programme in the clinical area. The success of an educationally sound clinical placement is crucial to forming a professional nursing identity that will encompass the seen and 'unseen' aspects of the nurses' role. The aim of this study was to explore the clinical nursing environment through the perceptions of first year student nurses. Semi-structured interviews were used to collect data from 12 student nurses who each had four weeks clinical experience, representing 21 wards and five hospitals. Results suggest that these student nurses were disillusioned with the reality of clinical nursing and that their expectations of nursing were not realised. They perceived that paperwork, completing tasks and meeting targets were dominant features of nursing work at the expense of patient contact and communication. A majority indicated that nursing was not as caring as they expected and vowed to hold on to their personal values of caring about patients and forming communicative, interpersonal relationships with them.

New heteroallyl-containing 5-nitrofuranes were synthesized as potential anti-Trypanosoma cruzi agents with a dual mechanism of action, oxidative stress and inhibition of membrane sterol biosynthesis. Some of the derivatives were found to have high and selective activity against the proliferative stages of the parasite, with IC(50) values against the clinically relevant intracellular amastigote forms in the low micromolar to sub-micromolar range. Oxidative stress was verified measuring cyanide dependent respiration. Inhibition of the de novo sterol biosynthesis at the level of squalene epoxidase was confirmed, using high-resolution gas-liquid chromatography coupled to mass spectrometry, by the disappearance of the parasite's mature sterols and the concomitant accumulation of squalene. The in vitro activities of these novel compounds were superior to that of nifurtimox, a nitrofuran currently used in the treatment of human Chagas' disease, and terbinafine, a commercially available allylamine-based squalene epoxidase inhibitor. The results support further in vivo studies of some of these nitrofuran derivatives.

Objective: Cross-cultural research must always deal with the problem that meaning systems and behaviors cannot be readily compared from one culture to the next because the sociocultural context can vary so widely., Design: The organizers of Project AGE: Age, Generation, and Experience, a multicultural study of aging, recognized this problem and devised instruments for studying age that allowed for cultural variation as well as researchers made every effort to gain an emic understanding (understanding based on categories recognized by the local respondents) of people's attitudes about aging in the several cultures in which we worked. For comparison to take place, we needed to use similar question frames to elicit comparable information across societies of different types., Results: Many questions put to people about their attitudes toward their own and other persons' aging were readily understood by our respondents. But some topics proved difficult to investigate systematically across cultures., Conclusions: In hindsight, we could have achieved additional value from our interviews if we had incorporated some independent measures of physical health and capacity. Such data would have added depth to our discussion of within-site and across-site differences on both the independent measures themselves and their possible correlation with attitudinal data.

Aims: The aim of this study was to investigate the impact of stroke on the patient's spouse, paying particular attention to psychiatric morbidity and the strain of caring, and correlating these with the degree of disability of the patient. The impact of impairment of speech was also investigated., Background: The impact of a stroke is not limited to the person who suffers it but also to the family, with the patient's spouse being particularly vulnerable. The literature suggests that the consequences for the spouse can be physical, psychological, economic and social., Methods: A quantitative approach was employed to investigate 44 couples who volunteered to participate in the study. A small battery of validated instruments was used to describe the patient's degree of disability, and psychiatric morbidity and the strain of caregiving in the spouse. Pearson's Correlation and Mann-Whitney U-test were used in data analysis., Results: The spouses were found to have a greater degree of psychiatric morbidity than a reference group and a large proportion of them found caregiving to be stressful. Psychiatric morbidity and strain in the spouses were not directly proportional to the extent of the patient's disability. Spouses whose partners' speech was affected by the stroke were more likely to experience strain than those who were unaffected in this way., Conclusions: This study contributes to our knowledge of the relationship between patients' physical disability and the level of strain and psychiatric morbidity in spouses. The relationship is a complex one, in which it is not possible to predict with confidence which spouses will be most vulnerable., Relevance to Clinical Practice: Caring for a patient following a stroke is very stressful, particularly in cases where the patient's speech is affected and there is also likely to be a significant effect on the psychological well-being of the spouse. This information is relevant to all nurses caring for patients with stroke and the patients' spouses.

Mycobacteria are characterized by an unusual cell wall that controls nutrient and small hydrophilic compound permeability. Porin-like proteins are necessary to ensure the transport of molecules into the cell. Here, we investigated the pore-forming properties of OmpATb, a porin from Mycobacterium tuberculosis, in lipid bilayers. Multi-channel experiments showed an asymmetric behaviour with channel closures at negative critical voltages (Vc) and a strong decrease in Vc at acidic pH. Single-channel experiments gave conductance values of about 850 +/- 80 pS in 1 M KCl and displayed a weak cationic selectivity in 4-8 pH range. The production and characterization of a series of truncated OmpATb proteins, showed that the central domain (OmpATb73-220) was sufficient to induce the ion channel properties of the native protein in lipid bilayers, i.e. asymmetric insertion, pH-dependent voltage closure, cationic selectivity and similar conductance values in 1 M KCl. Western blot analysis suggests that the presence of OmpATb is only restricted to certain pathogenic species. Therefore, the propensity of channels of native OmpATb to close at low pH may represent an intrinsic property allowing pathogenic mycobacteria to adapt and survive to mildly acidic conditions, such as those encountered within the macrophage phagosome.

Slaughterhouse wastewater is a complex effluent with an important content of organic nitrogen. After an anaerobic treatment where most of the organic matter is removed, the nitrogen, remains as ammonium and post-treatment of the effluent is necessary. Sequencing batch reactor (SBR) technology has been developed to completely remove nitrogen in one single reactor combining aerobic and anoxic stages. Under oxygen limited conditions only nitrite is produced with concomitant energy saving. The stability and diversity of the microbial community from a nitrifying denitrifying SBR operated under oxygen limited conditions were studied using molecular and respirometric methods. The AOB (ammonia oxidizing bacteria) community was relatively stable Nitrosomonas being the dominant genera although Nitrosospira and Nitrosococcus were detected in low proportions. Nitrite oxidizing bacteria were out competed during the operation under oxygen-limited conditions. After an increase of the DO in the reactor Nitrobacter spp were detected suggesting that they remained in the system. Changes in the AOB and denitrifying communities were observed after the DO increase. Sedimentation problems were detected during operation, this could be related to the predominance of Thauera spp detected by FISH and T-RFLP.

As a contribution to the development of novel vanadium complexes with pharmacologically interesting moieties, new dioxovanadium(V) semicarbazone complexes with the formula cis-VO(2)L, where L=5-bromosalicylaldehyde semicarbazone and 2-hydroxynaphtalen-1-carboxaldehyde semicarbazone have been synthesized and characterized by (1)H and (13)C NMR, Raman and FTIR spectroscopies. Results were compared with those previously reported for other three analogous complexes of this series. The five complexes were tested in three different human tumor cell lines for bioactivity as potential anti-tumor agents, showing selective cytotoxicity on TK-10 cell line. Results showed that structural modifications on the semicarbazone moiety could have a significant effect on the anti-tumor activity of the vanadium complexes. In addition, the electrochemical behavior of all the complexes was studied. No apparent correlation could be demonstrated between reduction potentials of the complexes and their anti-tumor activities. The molecular structure of the novel [V(V)O(2)(5-bromosalicylaldehyde semicarbazone)] complex was solved by X-ray diffraction methods. The vanadium atom shows a distorted square pyramidal coordination sphere. The (VO(2))(+) cation is coordinated to a nearly planar (L)(-) anion acting as a tridentate ligand through both oxygen and one nitrogen atoms.

Considerable research on helpers-at-the-nest demonstrates the positive effects of firstborn daughters on a mother's reproductive success and the survival of her children compared with women who have firstborn sons. This research is largely restricted to agricultural settings. In the present study we ask: "Does 'daughter first' improve mothers' reproductive success in a hunting and gathering context?" Through an analysis of 84 postreproductive women in this population we find that the sex of the first- or second-born child has no effect on a mother's fertility or the survival of her offspring. We conclude that specific environmental and economic factors underlay the helpers-at-the-nest phenomenon.

Over the last decade there has been an increasing awareness that psychosocial problems may persist in patients who have made apparently good recoveries after aneurysmal subarachnoid haemorrhage (ASAH). The caregivers of these patients are often relatives and it is becoming apparent that these carers frequently suffer psychosocial stress with associated morbidity. Previous studies have looked primarily at patients and few have included carers. We exclusively studied carers using simple validated questionnaires. We measured the effect on general and psychosocial health of the carers of patients treated for ASAH, 2-3 years after discharge. The majority of the carers (88.1%) were close relatives; 53.8% were experiencing social or emotional stress and 46.4% of these felt completely overwhelmed. The level of stress correlated positively with management complications, but not site of aneurysm or other aspects of treatment. We conclude that there is an argument for priority assistance for those carers predicted to be vulnerable to stress.

Aim: To discuss the use of patronizing patterns of speech and modified forms of address in conversations between nurses and other health workers, and older people., Rationale: The impetus for this paper was the publication of the National Service Framework for Older People, which draws attention to the prevalence of age discrimination and the need to provide individualized care., Approach: The literature between 1990 and 2001 was reviewed in a systematic way. Certain key, older texts were also identified. Twenty-four publications were found, which examine the ways in which nurses and other health workers modify their speech when conversing with older people, discuss what older people think about this practice, or otherwise contribute to this issue., Results: The paper uses speech accommodation theory to explain how the language addressed to older people is sometimes modified. The practice of over-accommodation is also described. This happens when older people are addressed in a simplified vocabulary with a high-pitched tone of voice and slow speech. The extent of over-accommodation is discussed, and its impact on older people is considered in terms of fostered dependence and lowered self-esteem., Conclusion: The findings of the review in the context of current policy related to older people and implications for nursing education are discussed.

The functions of OmpATb, the product of the ompATb gene of Mycobacterium tuberculosis and a putative porin, were investigated by studying a mutant with a targeted deletion of the gene, and by observing expression of the gene in wild-type M. tuberculosis H37Rv by real-time polymerase chain reaction (PCR) and immunoblotting. The loss of ompATb had no effect on growth under normal conditions, but caused a major reduction in ability to grow at reduced pH. The gene was substantially upregulated in wild-type bacteria exposed to these conditions. The mutant was impaired in its ability to grow in macrophages and in normal mice, although it was as virulent as the wild type in mice that lack T cells. Deletion of the ompATb gene reduced permeability to several small water-soluble substances. This was particularly evident at pH 5.5; at this pH, uptake of serine was minimal, suggesting that, at this pH, OmpATb might be the only functioning porin. These data indicate that OmpATb has two functions: as a pore-forming protein with properties of a porin, and in enabling M. tuberculosis to respond to reduced environmental pH. It is not known whether this second function is related to the porin-like activity at low pH or involves a completely separate role for OmpATB. The involvement with pH is likely to contribute to the ability of M. tuberculosis to overcome host defence mechanisms and grow in a mammalian host.

A postal survey, containing a questionnaire and covering letter, was distributed to 1029 ward-based nurses, of all grades, in a Large NHS Trust in an attempt to establish how nurses perceived spirituality and spiritual care. A response rate of 55.3% (n = 549) was obtained. Part of the questionnaire contained "The Spirituality and Spiritual Care Rating Scale" (SSCRS) a newly constructed instrument to aid the investigation and measurement of Spirituality and Spiritual Care. Factor Analysis was performed in an attempt to establish construct validity and to identify any underlying associations between items in the scale. It suggested a 17-item instrument with four factor-based subscales: Spirituality, Spiritual Care, Religiosity and Personalised Care. The 17-item SSCRS demonstrated a reasonable level of internal consistency reliability, having a Cronbach's alpha coefficient of 0.64. Confirmatory Factor Analysis is recommended in order to cross-validate and refine this new Rating Scale., (Copyright 2002 Elsevier Science Ltd.)

We present a search for charged Higgs bosons in decays of pair-produced top quarks in pp collisions at sqrt[s] = 1.8 TeV recorded by the D0 detector at the Fermilab Tevatron collider. With no evidence for signal, we exclude most regions of the ( M(H+/-),tan(beta)) parameter space where the decay t--> H(+)b has a branching fraction >0.36 and B(H+/--->tau(nu)(tau)) is large.

We describe QUAERO, a method that (i) enables the automatic optimization of searches for physics beyond the standard model, and (ii) provides a mechanism for making high energy collider data generally available. We apply QUAERO to searches for standard model WW, ZZ, and t t macro production, to searches for these objects produced through a new heavy resonance, and to the first direct search for W'-->WZ. Through this interface, we make three data sets collected by the D0 experiment at square root of [s] = 1.8 TeV publicly available.

We present results of searches for technirho (rho(T)), techniomega (omega(T)), and Z' particles, using the decay channels rho(T),omega(T),Z'-->e(+)e(-). The search is based on 124.8 pb(-1) of data collected by the D0 detector at the Fermilab Tevatron during 1992-1996. In the absence of a signal, we set 95% C.L. upper limits on the cross sections for the processes pp-->rho(T),omega(T),Z'-->e(+)e(-) as a function of the mass of the decaying particle. For certain model parameters, we exclude the existence of degenerate rho(T) and omega(T) states with masses below about 200 GeV. We exclude a Z' with mass below 670 GeV, assuming that it has the same couplings to fermions as the Z boson.

Aims of the Paper: This paper reviews some of the limited nursing research-based literature, orientated towards the use of spiritual coping strategies in illness. This review aims at identifying those spiritual coping strategies used by the believers and nonbelievers followed by implications for holistic nursing care., Literature Search: The CINAHL and MEDLINE CD Rom databases were searched, identifying literature published from 1975 onwards which amounted to 187 articles. The majority of the literature traced were found anecdotal with only few studies investigating directly spiritual coping strategies. Following scrutiny of the available articles, only five research studies explored directly the spiritual coping strategies used in various illness, four of which were conducted in USA and one in UK. Because of the small scale research studies, generalization of the findings of this review is limited to the samples used., Theoretical Background: Research suggests that spiritual coping strategies, involving relationship with self, others, Ultimate other/God or nature were found to help individuals to cope with their ailments. This may be because of finding meaning, purpose and hope, which may nurture individuals in their suffering. Spirituality is oftenly referred by literature as being synonymous with religiosity. Thus the use of spiritual coping strategies is restricted to individuals who hold religious beliefs. However, the definition of spirituality indicates that this concept is broader than religiosity. The theories on stress-coping (Folkman & Lazarus 1984) and the numinous experience (Otto 1950) outline the rationale for the use of these strategies which are applicable to both the believers and nonbelievers., Implications: This review suggests that the onset of illness may render the individual, being a believer or nonbeliever to realize the lack of control over his/her life. However the use of spiritual coping strategies may enhance self-empowerment, leading to finding meaning and purpose in illness. This implies that holistic care incorporates facilitation of various spiritual coping strategies to safeguard the wholeness and integrity of the patients.

We apply a quasi-model-independent strategy ("Sleuth") to search for new high p(T) physics in approximately 100 pb(-1) of pp collisions at square root of (s) = 1.8 TeV collected by the D0 experiment during 1992-1996 at the Fermilab Tevatron. We systematically analyze many exclusive final states and demonstrate sensitivity to a variety of models predicting new phenomena at the electroweak scale. No evidence of new high p(T) physics is observed.

The D0 Collaboration has measured the inclusive jet cross section in barpp collisions at square root of s = 630 GeV. The results for pseudorapidities (eta)<0.5 are combined with our previous results at square root of s = 1800 GeV to form a ratio of cross sections with smaller uncertainties than either individual measurement. Next-to-leading-order QCD predictions show excellent agreement with the measurement at 630 GeV; agreement is also satisfactory for the ratio. Specifically, despite a 10% to 15% difference in the absolute magnitude, the dependence of the ratio on jet transverse momentum is very similar for data and theory.

We report on a study of the ratio of inclusive three-jet to inclusive two-jet production cross sections as a function of total transverse energy in p&pmacr; collisions at a center-of-mass energy sqrt[s] = 1.8 TeV, using data collected with the D0 detector during the 1992-1993 run of the Fermilab Tevatron Collider. The measurements are used to deduce preferred renormalization scales in perturbative O(alpha(3)(s)) QCD calculations in modeling soft-jet emission.

We report a new measurement of the pseudorapidity (eta) and transverse-energy ( E(T)) dependence of the inclusive jet production cross section in pp(macro) collisions at square root of s = 1.8 TeV using 95 pb(-1) of data collected with the D0 detector at the Fermilab Tevatron. The differential cross section d(2)sigma/(dE(T)d eta) is presented up to eta = 3, significantly extending previous measurements. The results are in good overall agreement with next-to-leading order predictions from QCD and indicate a preference for certain parton distribution functions.

We report a search for effects of large extra spatial dimensions in pp collisions at a center-of-mass energy of 1.8 TeV with the D0 detector, using events containing a pair of electrons or photons. The data are in good agreement with the expected background and do not exhibit evidence for large extra dimensions. We set the most restrictive lower limits to date, at the 95% C.L. on the effective Planck scale between 1.0 and 1.4 TeV for several formalisms and numbers of extra dimensions.