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Children's nurses deal with the family on a daily basis. There are many theories about the family, and there is good supporting evidence focusing on the family as it interacts with healthcare professionals. Modern technology and the structure of today's society have influenced the way families function. This article considers some of the cornerstone theories about the family, looks at family stages, relates these to the healthcare setting and in particular examines the family under stress. Each family is (or has the potential to be) a unique dynamic, functional system of childrearing, care and support for its members. Children are often admitted to hospital for short periods or can be discharged home while still fairly dependent. This can mean a heavy family commitment, and how the family functions results in several issues for children's nurses to reflect on. It is too simplistic to state that standards of care depend on how the family copes under pressure, but undoubtedly this would have some influence. Children's nurses need to be able to assess the family in order to promote coping and to equip the family to deal with the stresses of extraordinary care demands, which can result in having a sick or dependent child at home. The aim should be to enable the family to find the caring experience a positive one and to be able to keep a balance and a quality to family life so that all the family members' needs are met.

Jockeys are required to maintain very low body weight and precise weight control during competition. This study examined the weight loss and weight management strategies of professional horseracing jockeys in the state of Victoria, Australia. An anonymous, self-completed questionnaire was administered (55% response rate, n = 116). Almost half (43%) reported that maintaining riding weight was difficult or very difficult, with 75% routinely skipping meals. In preparation for racing, 60% reported that they typically required additional weight loss, with 81% restricting food intake in the 24 hours prior to racing. Additionally, sauna-induced sweating (29%) and diuretics (22%) were frequently employed to further aid in weight loss prior to racing. These rapid weight loss methods did not differ between the 51% of jockeys who followed a weight management plan compared to those who did not. The impact of these extreme weight loss practices on riding performance and health remains unknown.

A swine model was developed to investigate the efficacy of percutaneous venous catheters with anti-microbial coatings. The catheters used in the study consisted of silver-coated and uncoated catheters, both designed for percutaneous venous access. Five commercial pigs were each implanted with three venous catheters and followed for a period of 90 days. Two of the three catheters were coated and one was uncoated. To evaluate the percutaneous aspects of the catheters in the model, two venous access catheters were implanted percutaneously, parallel to the dorsal midline. These catheters were just caudal to the region that is dorsal to the scapula in each animal. In each case, the catheter to the left of the dorsal midline was silver-coated while the catheter to the right of the dorsal midline was uncoated. A silver-coated catheter was also implanted in the left external jugular vein of each animal and buried subcutaneously in order to evaluate the elution of the coating through the body under venous contact. Over the 90 day period, the concentration of silver in the blood rose to a mean peak level of 23.2 ppb following implantation of the catheters and then decreased after the second post-surgery week. The histological evaluation and macroscopic inspection at necropsy revealed minimal tissue response to both coated and uncoated materials. Data on bacterial growth indicated that bacteria were present at the terminal subcutaneous end of two of the uncoated percutaneous catheters. Based upon serum silver levels, exudate formation, histological examination, and bacterial growth information, the swine model was deemed to be suitable for testing the efficacy of catheters containing anti-microbial coatings.

The general public, police, service providers, and users/ex-users were asked their views about options for trial design and trial outcomes with regard to a proposal for experimental controlled heroin availability. There was substantial agreement between the samples on issues concerning trial design. In general, the samples from the community, service providers and users/ex-users were more likely to report that a trial would result in positive outcomes, whereas the police sample was more likely to report that a trial would result in negative outcomes. This study illustrates the value of systematic consultation of key groups in exploring the options for change, raising potential difficulties, and highlighting different interests.

Nuclear magnetic resonance (NMR) studies of the c subunit of F1F0 ATP synthase from Escherichia coli are presented. A combination of homonuclear (1H-1H) and heteronuclear (1H-15N) 2D and 3D methods was applied to the 79-residue protein, dissolved in trifluoroethanol. Resonance assignment for all the backbone amide groups and many C alpha H side-chain protons was achieved. Analysis of inter- and intraresidue 1H-1H nuclear Overhauser effect (NOE) data and scalar coupling constant information indicates that this protein contains two extended regions of predominant alpha-helical character (residues 10-40 and 48-77) separated by an eight-residue segment which displays little evidence of ordered secondary structure. This model is consistent with information about the molecular motion of the protein deduced from 15N-1H heteronuclear NOE data and observed pKa values of carboxylic acid groups.

Extracorporeal membrane oxygenation (ECMO) provides support for neonates who do not respond to ventilation therapy and pharmacological support. Although used outside the UK, it still has to be widely implemented here. ECMO is simple to set up, but requires extensive nursing care.

This study evaluates the long-term outcome of 99 women who underwent hysterectomy for pelvic pain of at least 6 months' duration. All had symptoms and physical examination findings suggestive of disease confined to the uterus. Patients were excluded if there was previously documented extrauterine pelvic disease, extrauterine pelvic disease at the time of surgery, or uterine weight exceeding 200 g. Histopathologic analysis revealed leiomyomata in 12 (12.1%), adenomyosis in 20 (20.2%), and both leiomyomata and adenomyosis in two (2.02%). The average uterine weight was 91.1 g (range 24-198). Patients were followed after hysterectomy for an average of 21.6 months (range 15-64), with 77 of 99 (77.8%) showing significant improvement and 22 (22.2%) having persistent pelvic pain. Despite preoperative history and physical findings suggesting and histologic findings confirming uterine disease, nearly a quarter of the patients had persistent pelvic pain after hysterectomy for chronic pelvic pain. These findings should have a significant impact on the therapeutic choices recommended by gynecologists and may alter the informed consent that patients give in such cases.

The HDHQ (Foulds, Caine & Creasy, 1960) was administered to 100 long-term prisoners as part of routine psychological assessment prior to their allocation to training prisons. The questionnaire results were analyzed in terms of the prisoners' past and present criminal and institutional behaviour. Additionally they were used to test Megargee's (1966) hypothesis that extremely assaultive individuals are generally overcontrolled and will thus express less hostility than moderately assaultive individuals. The results showed that the sample of long-term prisoners had a significantly higher total hostility score than normals but did not differ significantly in the direction of their hostility. Violent offenders were significantly more extrapunitive than non-violent offenders, and prisoners who had attempted suicide were more extrapunitive than those with no history of attempted suicide. Apart from these findings no significant relations were found between the HDHQ results and criminal and institutional behaviour, whether violent or non-violent. Megargee's (1966) over- and under-controlled hypothesis failed to receive support. The results suggest that the HDHQ would be of little value in making predictions about future violent or criminal behaviour.

A random population survey of 406 Adelaide women who were aged 18 to 86 years, which was conducted in July, 1986, showed that in the previous year 68% of the women had exercised, 38% of the women had dieted, 15% of the women had fasted, 10% of the women had taken slimming tablets, 6% of the women had used diuretic agents and 3% of the women had used laxative agents in order to reduce or to control their weight. At the time of the survey 43% of women (60% of overweight women and 34% of non-overweight women) were attempting to lose weight. The most common reasons for wishing to lose weight were: to feel better (75% of women); to look better (65% of women); and health or medical reasons (33% of women). In addition, a majority of the women were dissatisfied with the shape of their stomach, hips, midriff, waist, thighs and buttocks. The family doctor, books and magazines acted as the major sources of information on dieting and weight control. However, most of the women felt that their doctors did not provide them with enough advice on this topic, and the women were almost unanimous in their criticism of the preoccupation of magazines with slimness. The results suggest that health professionals need to provide women with more advice on safe weight-control strategies and sensible body-weight goals.

Data from the Apparent Consumption of Foodstuffs publications of the Australian Bureau of Statistics have, until recently, been the major source of information in Australia about the consumption of refined sugars. This database, which relies on national figures for production, importation, export, storage and stocks, and on population statistics, had indicated that some 14% of the total energy that was available in Australia was derived from refined sugars. Similar figures have been derived for both the United States and United Kingdom by means of this kind of national food-availability database. However, a recent reanalysis of a large-scale dietary survey of individuals in the United States has indicated a much lower level of consumption of refined sugars. In recent years, several large-scale surveys of individuals' consumption patterns in the Australian population have been carried out by the Social Nutrition Program at the CSIRO Division of Human Nutrition. These surveys indicate that the mean level of consumption of refined sugars is not as high as that which previously was estimated from Apparent Consumption data. However, there was a wide range of intakes and a substantial proportion of individuals with intakes that were above recommended levels.

A random State-wide nutrition survey of the population of Victoria that was carried out in late 1985 demonstrated that the total fat and saturated fat intake of Australians had changed little since studies that were carried out in the 1970s. However, since that time, there has been a considerable increase in the contribution of polyunsaturated fats with a consequent improvement in the polyunsaturated-to-saturated fatty-acid ratio in the diet. The survey was carried out by means of a postal technique and a semiquantified food-frequency questionnaire which allows for the characterization of usual dietary intake in individuals. The survey served to highlight the value of collecting nutrient, food and food-habits data in the same individuals and demonstrated that relatively cost-effective surveys of this type make feasible the regular continuing surveillance of the usual nutrient intakes of large numbers of individuals.