Search

Aim: To review published literature descriptions of advanced practice nurses' roles in low‐ and lower middle‐income countries. Background: Advanced practice nurse roles have the potential to address insufficient healthcare resources in low‐ and lower middle‐income countries. Introduction: This integrative review highlights advanced practice nurses' roles in the delivery of healthcare services in low‐ and lower middle‐income countries. Methods: Three electronic databases PubMed, CINAHL complete and ProQuest Health & Medicine were searched. No limits by year or language were set. The names for low‐ and lower middle‐income countries and combinations 'related to advanced practice nurses' titles were used to identify papers. In addition, a review of publication type was performed. Themes found within the publications were assessed against the advanced practice nurses' International Council of Nurses' characteristics. An integrative review facilitated an appraisal of the papers identified. Results: The initial search identified 5778 publications in 16 languages. This number was reduced to 23, from 18 low‐ and lower middle‐income once exclusion criteria were applied. Six publications were from 1977 to 1999, and six between 2000 and 2010, with the remaining 11 from 2011 to 2018. Zambia had the most publications. Notably, 63 countries were not represented. Of those meeting inclusion criteria, the majority addressed education with a lesser extent focusing on practice and regulation of advanced practice nurse's roles. The majority were published during the last decade. Discussion: This review of the published literature identified advanced practice nurses' roles and function within some healthcare systems. However, not all components were reported. Examination of the grey literature could provide additional information about the actual and potential benefits of advanced practice nurses' in low‐ and lower middle‐income countries. Conclusion: The published literature that referred to advanced practice nurses' identified their contribution to positive impacts on health care over the last 40 years. However, with only 11 publications identified in the last 7 years, further review is required to understand the advanced practice nurses' roles in these countries. Implications for nursing and/or health policy: Further development of advanced practice nurses' in low‐ and lower middle‐income countries is supported by the lack of published literature. [ABSTRACT FROM AUTHOR]

Akt signaling regulates diverse physiologies in a wide range of organisms. We examine the impact of increased Akt signaling in the fat body of 2 mosquito species, the Asian malaria mosquito Anopheles stephensi and the yellow fever mosquito Aedes aegypti. Overexpression of a myristoylated and active form of A. stephensi and Ae. aegypti Akt in the fat body of transgenic mosquitoes led to activation of the downstream signaling molecules forkhead box O (FOXO) and p70 S6 kinase in a tissue and blood meal-specific manner. In both species, increased Akt signaling in the fat body after blood feeding significantly increased adult survivorship relative to nontransgenic sibling controls. In A. stephensi, survivorship was increased by 15% to 45%, while in Ae. aegypti, it increased 14% to 47%. Transgenic mosquitoes fed only sugar, and thus not expressing active Akt, had no significant difference in survivorship relative to nontransgenic siblings. Expression of active Akt also increased expression of fat body vitellogenin, but the number of viable eggs did not differ significantly between transgenic and nontransgenic controls. This work demonstrates a novel mechanism of enhanced survivorship through increased Akt signaling in the fat bodies of multiple mosquito genera and provides new tools to unlock the molecular underpinnings of aging in eukaryotic organisms. [ABSTRACT FROM AUTHOR]

Invasive fungal infections ( IFIs) are a major cause of morbidity and mortality in paediatric acute myeloid leukaemia ( AML). This study describes risk factors for IFI and IFI-related sepsis in this population. We conducted a population-based, retrospective cohort study of children with AML in Canada. IFIs during chemotherapy and prior to haematopoietic stem cell transplantation, relapse, persistent disease or death were identified. Risk factors for proven or probable IFI were examined. Among courses complicated by IFI, risk factors for sepsis were also evaluated. There were 341 children with AML included of which 41 (12.0%) experienced 46 different episodes of IFI. Candida species accounted for 23 (50.0%) of IFIs and Aspergillus spp. accounted for 14 (30.4%). Days of broad-spectrum antibiotics, days of corticosteroids and neutropenia at start of the course were independently associated with IFI. Only days of fever were independently associated with IFI-related sepsis. Invasive fungal infections occurred in 12.0% of paediatric AML patients. Risk factors for IFI and IFI-related sepsis were identified. This knowledge may help to consider targeted strategies. [ABSTRACT FROM AUTHOR]

Depressive symptoms may compromise the ability of low-income Latina mothers with limited English language proficiency to parent their infants or toddlers. Eighty Early Head Start Latina mothers with limited English language proficiency were randomized to an advanced practice nurse-delivered, culturally tailored, in-home psychotherapy intervention, or to usual care. Repeated measures regression analysis showed a significantly greater decrease in depressive symptoms for intervention mothers compared to the usual care group at 22 and 26 weeks (4 weeks post intervention). Intervention mothers' reports of their child's aggression diminished significantly from T1 to T4 compared to usual care mothers (p = .03). Self-efficacy appeared to only partially mediate the intervention effect, and maternal health moderated the intervention impact. Results indicate that the intervention reduced depressive symptoms and, compared to previous studies in this population, retention of mothers in both intervention and control conditions was improved. © 2009 Wiley Periodicals, Inc. Res Nurs Health 33:60-76, 2010 [ABSTRACT FROM AUTHOR]

Competence in object search and pretend play are argued to reflect young children's representational abilities and appear delayed in children with Down syndrome relative to social and imitative skills. This paper explores the effects on object search and play of this social strength in children with Down syndrome. Three experiments compared performance on traditional tasks with modified tasks designed to assess the role of imitation in object search and pretend play. Children with Down syndrome, relative to typically-developing children, were able and willing to imitate hiding actions when no object was hidden (Experiment 1). When imitation was prevented in object search, children with Down syndrome searched less effectively than typically-developing children (Experiment 2). In play, children with Down syndrome expressed more willingness to imitate a counter-functional action, modelled by the experimenter, despite apparent competence in spontaneous functional play (Experiment 3). These findings indicate that object search and play behaviours of children with Down syndrome rely more heavily on imitation than is the case for typically-developing children. The implications for the development of children with Down syndrome and models of representational development are discussed. [ABSTRACT FROM AUTHOR]

Lawyers are often called upon by their older clients to draft contracts, make up wills or powers of attorney, or provide other forms of legal advice or service. With the increasing numbers of older people in the population, the numbers of older clients for legal practitioners is likely to increase. Older people are also at increased risk for impaired cognitive processes that can affect their ability to make reasoned judgements in civil contracts and other legal arrangements. Here we report on the results of a survey of 302 Australian solicitors as to their experience and practices in determining the capacity of older clients to make legal decisions. The responses, reflecting a 20.7% return rate, showed a wide range of experience in conducting capacity assessments, with a mean of 15.7 years (SD = 10.59). There was a very wide range of practices in determining capacity with no consensus. The most frequent form of questions older clients were asked related to personal and family history. Less than one-quarter asked for the rationale of the decision: the most appropriate form of question in the literature. The results suggest a need for further training of solicitors in the assessment of the capacity of older clients to make legal decisions. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

We investigated the effects of the selective NK3 tachykinin receptor antagonist, SB-235375, on noxious signalling from gut and skin and on intestinal motility in anaesthetized rats. We also measured penetrance into brain and spinal cord. Nociceptive responses in reaction to colorectal distension and skin pinch were assessed by recording the electromyogram (EMG) from the external oblique muscle (a visceromotor response). Motility was measured by recording intraluminal pressure waves during changes in baseline pressure in the jejunum. Colorectal compliance was assessed by measuring luminal pressure change during isovolumic distension. SB-235375 (20 mg kg−1, by i.v. bolus) reduced the EMG response to colorectal distension by over 90%. The reduction was slow at onset, peaked at about 60 min, and lasted for over 2 h. Responses to noxious skin pinch were unchanged. Amplitudes of propulsive waves in the jejunum were slightly reduced, but their frequency of occurrence was unchanged. SB-235375 decreased colorectal compliance by 5–10%. There was undetectable penetration of i.v. SB-235375 into brain or spinal cord. We conclude that SB-235375 acts peripherally to substantially reduce nociceptive signalling from colorectum without affecting noxious signalling from skin and with little effect on intestinal motility. [ABSTRACT FROM AUTHOR]

The relationship between parent-child interaction and child pedestrian behaviour was investigated by comparing parent-child communication to road-crossing behaviour. Forty-four children and their parents were observed carrying out a communication task (the Map Task), and were covertly filmed crossing roads around a university campus. The Map Task provided measures of task focus and sensitivity to another's current knowledge, which we predicted would be reflected in road-crossing behaviour. We modelled indices of road behaviour with factor scores derived from a principal-component analysis of communication features, and background variables including the age, sex and traffic experience of the child, and parental education. A number of variables were significantly related to road crossing, including the age and sex of the child, the length of the conversation, and specific conversational features such as the checking and clarification of uncertain information by both parent and child. The theoretical and practical implications of the findings are discussed. [ABSTRACT FROM AUTHOR]

Summary In Bacillus subtilis , the activity of the nitrogen regulatory factor TnrA is regulated through a protein– protein interaction with glutamine synthetase. During growth with excess nitrogen, the feedback-inhibited form of glutamine synthetase binds to TnrA and blocks DNA binding by TnrA. Missense mutations in glutamine synthetase that constitutively express the TnrA-regulated amtB gene were characterized. Four mutant proteins were purified and shown to be defective in their ability to inhibit the in vitro DNA-binding activity of TnrA. Two of the mutant proteins exhibited enzymatic properties similar to those of wild-type glutamine synthetase. A model of B. subtilis glutamine synthetase was derived from a crystal structure of the Salmonella typhimurium enzyme. Using this model, all the mutated amino acid residues were found to be located close to the glutamate entrance of the active site. These results are consistent with the glutamine synthetase protein playing a direct role in regulating TnrA activity. [ABSTRACT FROM AUTHOR]

Parkinson's disease (PD) is a common disabling neuro-degenerative disorder the cardinal clinical features of which include tremor, rigidity and slowness of movement (Fahn and Przedborski 2000). These symptoms are attributed mainly to a profound reduction of dopamine in the striatum due to a dramatic loss of dopaminergic neurons in the substantia nigra pars compacta (SNpc) (Fahn and Przedborski 2000). Thus far, both the cause and the mechanisms of PD remain unknown. Over the years, investigators have used experimental models of PD produced by several compounds such as reserpine, 6-hydroxydopamine, methamphetamine, and 1-methyl-4-phenyl-l,2,3,6-tetrahydropyridine (MPTP) to provide insights into the mechanisms responsible for the demise of dopaminergic neurons in PD. To this end, MPTP has emerged unquestionably as a popular tool for inducing a model of PD in a variety of animal species including monkeys, rodents, cats, and pigs (Kopin and Markey 1988). The sensitivity to MPTP and therefore its ability to induce parkinsonism closely follows the phylogenetic tree where the species most closely related to humans are the most vulnerable to this neurotoxin. Due to the significant neurotoxicity of MPTP, it is important that researchers appreciate the potential hazards of this toxin. Given this, the purpose of this review is to inform the researcher of the hazardous nature of MPTP and to provide guidance for its safe handling and use. [ABSTRACT FROM AUTHOR]

The article presents the author's insights on the political teaching of Plato as presented in "Seventh Letter." The author mentions that letter reveals the structure of Plato's approach to political questions and the differentiations within the unified teaching. Moreover, the two dialogues of Plato, the "Republic" and "Laws," are discussed.

It is well established that certain aspects of play in young children are related to their emerging linguistic skills. The present study examined the relationships between functional play, symbolic play, non-verbal ability, and expressive and receptive language in normally developing children aged between 1 and 6 years using standardized assessment procedures, including a recently developed Test of Pretend Play (ToPP). When effects of chronological age were partialled out, symbolic play remained significantly correlated with both expressive and receptive language, but not with functional play or non-verbal ability; and functional play was only correlated significantly with expressive language. It is concluded that ToPP will provide practitioners with a useful way of assessing symbolic ability in children between the ages of 1 and 6 years, and will contribute to the assessment and diagnosis of a number of communication difficulties, and have implications for intervention. [ABSTRACT FROM AUTHOR]

Reports that a transcription-repair coupling factor is involved in carbon catabolite repression (CCR) of the Bacillus subtilis hut and gnt operons. Model in which the Mfd protein displaces RNA polymerase stalled at downstream cre sites; Regulation of the hut expression by CCR; Loss-of-function mutations in the Bacillus subtilis ccpA gene.

The Atlantic menhaden Brevoortia tyrannus is a pelagic, obligate filter-feeding fish. Although much of the primary literature indicates that amorphous matter is a major component of the stomach contents of Atlantic menhaden, the diet of these fish is typically perceived to consist primarily of phytoplankton and zooplankton. This disparity between observation and perception results from the belief that amorphous matter in the stomachs is the remnants of plankton that were ingested alive or that it is detritus of low nutritional value and only incidentally ingested. In this study, we found that the stomach contents of juvenile and adult Atlantic menhaden in estuarine creeks were 81% amorphous matter, 17% phytoplankton, and 1% zooplankton, by dry weight. Sampling in two estuarine creeks in North Carolina revealed no seasonal change in diet. Stomachs of fish collected from coastal waters contained smaller amounts of amorphous matter (47%) and higher amounts of phytoplankton (36%) and zooplankton (18%) than stomachs of fish from estuarine creeks. The higher concentration of plankton in the diet of fish in coastal locations probably reflects the lower concentration of suspended amorphous matter and higher relative abundance of plankton typical of that environment. In stomachs that contained largely amorphous matter, the concentrations of ash (70%, dry weight) and humic compounds (38%, ash-free dry weight [AFDW]) were high and the carbohydrate content was moderately low (14%, AFDW). On the basis of reported concentrations of these compounds in plankton and amorphous aggregates, we conclude that the amorphous matter we found in the stomachs of Atlantic menhaden was not recently ingested living or moribund plankton, but was probably material that was produced in the environment by the aggregation of dissolved organics from various detrital sources, including decaying vascular plants. If vascular plants contribute to the production of amorphous matter, their role in coastal and estuarine energy flow and fishery production may be underestimated. [ABSTRACT FROM AUTHOR]

Introduction: Atrial arrhythmias are a frequent clinical complication following open heart surgery. We compared the Class III agents d,l-sotalol and ibutilide fumarate in an intravenous cross-over study using the canine atrial sterile pericarditis model. Methods and Results: We studied pacing-induced sustained atrial flutter over a 7-day post-surgical period in conscious dogs, alternating analysis of ibutilide (1.0 to 30.0 µg/kg) and d,l-sotalol (0.1 to 3.0 mg/kg). Ibutilide significantly increased atrial flutter cycle length (AFL CL) II ± 2 msec and atrial effective refractory period (AERP) 13 ±2 msec, and terminated atrial flutter in all cases (n = 12) following a mean dose of 6 ± 2µg/kg. Plasma concentrations of ibutilide were 53± 13 ng/mL. Ventricular effective refractory period (VERP) was not significantly affected (4 ± 2 msec). Following termination with ibutilide. atrial flutter could he reinitiated in 1 of 12 trials, and was nonsustained (40-sec duration). Sotalol significantly increased AFL CL 23 ± 3 msec and terminated atrial flutter in 8 of 12 trials following a mean dose of 1.5 ± 0.4 mg/kg. AERP and VERP were significantly increased 20 ± 6 and 12 ± 2 msec, respectively. The incidence of reinduced atrial flutter was 9 of 12 trials (P ≤ 0.05 vs ibutilide) (7 nonsustained 57 ± 7 sec duration, and 2 sustained). Sotalol failed to terminate atrial flutter in two dogs on days 1 and 5, despite increases in AFL CL (21 ± 8 msec) and AERP (16 ± 9 msec), whereas on day 3, ibutilide (20 ± 7µg/kg) terminated atrial flutter in those two dogs while increasing AFL CL and AERP 18 ± 6 and 15± 0 msec, respectively. Conclusion: Both sotalol and ibutilide terminate atrial flutter in this model. Ibutilide converted atrial flutter in dogs in which sotalol was not successful. Following atrial flutter termination, ibutilide had a lower incidence of reinduced arrhythmias compared to sotalol. Ibutilide produced atrial antiarrhythmic effects while having no significant electrophysiologic effects on the ventricle. [ABSTRACT FROM AUTHOR]

Expression from the Bacillus subtilis nrg-21 locus increases 26-fold during nitrogen-limited growth. The DNA corresponding to this locus was cloned and sequenced. The nucleotide sequence revealed a gene that could encode a protein with sequence similarity to the Escherichia coliγ-aminobutyric acid (GABA) permease. A transposon insertion in this locus eliminated the uptake of GABA and severely inhibited the utilization of GABA as a nitrogen source. Primer extension analysis revealed that the B. subtilis gabP gene was transcribed from two overlapping promoters. Transcription from the P1 promoter was repressed during growth in the presence of amino acids. The product of the codY gene proved to be required for this repression. Transcription from the P2 promoter increased during nitrogen-limited growth and was dependent upon the product of the tnrA gene. Deletion analysis revealed that activation of the P2 promoter during nitrogen-limited growth requires a nucleotide sequence located upstream of its -35 region. Regulation of gabP expression by the CodY and TnrA regulatory systems, which respond to different physiological signals, allows for a wide range of gabP expression during growth on various nitrogen sources. [ABSTRACT FROM AUTHOR]

Despite recognition of the western drywood termite, Incisitermes minor (Hagen), as one of the most economically important and destructive termite species in the USA, both its population and colony breeding structure genetically remain unclear. Here, we present primer sequences and initial characterization for 15 polymorphic microsatellite loci. In a sample of 30 individuals, representing six geographically distinct locations collected in California, USA, three to 15 alleles were detected segregating per locus. Within a single population observed heterozygosity ranged from 0.050 to 0.866. [ABSTRACT FROM AUTHOR]

The article focuses on a 55-year-old woman patient with a two-year history of fingertip dermatitis. She had worked as a secretary in a ceramic factory, but never had been employed as a ceramic production worker. On focused questioning, the patient recalled using a rubber kidney, which was used by the production workers to smooth decorative adhesive designs onto ceramic products, as a stress ball during her coffee breaks. Since she had not handled a kidney, her hand dermatitis stopped.

Reports on a case of allergic contact dermatitis to drometrizole trisiloxane in a sunscreen with concomitant sensitivities to other sun screens. Clinical manifestations; Patch testing results.

This article focuses on the impact of lifestyles and quality of life of patients with natural rubber latex (NRL) alergy. 50 consecutive NRL-allergic patients, seen in 2 specialist contact dermatitis centres in Swansea and Cardiff, were sent a postal questionnaire. 33% of patients had experienced difficulties when visiting their doctor or dentist, sometimes requiring return visits when gloves were available, having to explain the necessary precautions, and even supplying their own latex-free gloves.

Reports on allergic contact dermatitis (ACD) in 191 consecutively patch tested children in Great Britain. Prevalence of ACD; Identification of allergens particularly relevant to childhood ACD.

Siltation of spawning gravels in upland rivers appears to be an increasing hindrance to salmonids' spawning success. River managers seek an effective and non-labour intensive means of loosening gravel and reducing fine material, so improving spawning success; this study compared three practical gravel cleaning techniques, applied at realistic(rather than intensive) levels, by assessing survival to hatching ofburied brown trout, Salmo trutta L., ova at five sites on four rivers with gravel substrate in southern England. Each site consisted of six reaches, of which three were cleaned by tractor rotovating, high pressure jet washing and pump washing; these were compared with adjacent, untreated reaches. Brown trout ova were buried in both fine mesh and coarse mesh boxes in each reach. Significant improvements (at P<0705) in survival (number of live alevins) were found in three of the five pump washed reaches, two of the five tractor rotovated reaches and one pressure washed reach when the data were analysed by site. When data from all five sites were analysed together, all treated reaches showed a significant improvement (at P<0705) in egg survival to hatching compared with control reaches for fine mesh egg boxes; for coarse mesh boxes only pump washed reaches showed such an improvement. Wefeel that pump-washing provides the most effective, inexpensive and suitably non labour-intensive means of improving gravel, although ultimately it may be better to reduce the silt load of rivers. Freeze core bed samples taken before and immediately after cleaning were analysed for silt content; pump washing and high pressure washing may havereduced the amount of fine material. Copyright (c) 1999 John Wiley &Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objectives/hypothesis: This study examined changes in voluntary cough airflow measures immediately following in-office injection of Radiesse in patients diagnosed with glottic insufficiency. Due to significant comorbidities, these patients were poor candidates for medialization under general anesthesia. Each patient presented with dysphonia and dysphagia and ineffective voluntary cough, resulting in a poor clearing of secretions and a presence of ingested fluids on examination., Study Design: Prospective cohort and case series study., Methods: Three patients with a diagnosis of glottic insufficiency were included for study based on flexible endoscopy and laryngostroboscopic examination. Voluntary cough airflow measures were obtained approximately 30 minutes before and after the Radiesse injections. The airflow measures were: compression phase duration (CPD), expiratory rise time (EPRT), expiratory phase peak airflow (EPPF), and cough volume acceleration (CVA)., Results: Injection of Radiesse was found to improve voluntary cough airflow measures., Conclusion: The immediate increase in the objective airflow measures obtained from voluntary cough production after Radiesse injections can be used to document airway protection improvements. Cough airflow is a straightforward measure to obtain and is considered an objective measure of cough function., Level of Evidence: 4., (© 2013 The American Laryngological, Rhinological and Otological Society, Inc.)

The aetiology of idiopathic Parkinson's disease (PD) is poorly defined but environmental aggression may be relevant. Here, we report a new model of PD in mice, based on chronic inoculation with neurotoxins in the nasal cavity, which is a natural route of contact with the environment. C57BL/6 mice, submitted to daily intranasal inoculation with MPTP for 30 days, developed motor deficits that correlated with a progressive and severe depletion of striatal dopamine levels, and loss of tyrosine hydroxylase and dopamine transporter staining in substantia nigra and striatum. Moreover, mice intranasally inoculated with MPTP developed strong astrogliosis and microgliosis in substantia nigra and striatum. Consistent with these observations, a role for oxidant aggression was demonstrated by increased levels of Mn-superoxide dismutase. However, alpha-synuclein aggregation was not observed. This new animal model provides a new tool for studying PD symptoms that develop slowly over time, and it may be used to asses risk from environmental neurotoxins.