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Vice Presidents of Nursing in 250 hospitals throughout the United States were asked whether they have someone who is responsible for the nursing division budget as well as coordinating all the department's financial matters. Job duties believed to be relevant to a Director of Nursing Finance position were explored as well as who within the hospital's organizational structure typically performs these job duties. [ABSTRACT FROM AUTHOR]

The advent of cloud computing and a multi-platform digital environment is giving rise to a new phase of human identity called "The Distributed Self." In this conception, aspects of the self are distributed into a variety of 2D and 3D digital personas with the capacity to reflect any number of combinations of now malleable personality traits. In this way, the source of human identity remains internal and embodied, but the expression or enactment of the self becomes increasingly external, disembodied, and distributed on demand. The Identity Mapping Project (IMP) is an interdisciplinary collaboration between psychology and computer Science designed to empirically investigate the development of distributed forms of identity. Methodologically, it collects a large database of "identity maps" - computerized graphical representations of how active someone is online and how their identity is expressed and distributed across 7 core digital domains: email, blogs/personal websites, social networks, online forums, online dating sites, character based digital games, and virtual worlds. The current paper reports on gender and age differences in online identity based on an initial database of distributed identity profiles.

Every collecting duct (CD) of the rat inner medulla is uniformly surrounded by about four abutting ascending vasa recta (AVR) running parallel to it. One or two ascending thin limbs (ATLs) lie between and parallel to each abutting AVR pair, opposite the CD. These structures form boundaries of axially running interstitial compartments. Viewed in transverse sections, these compartments appear as four interstitial nodal spaces (INSs) positioned symmetrically around each CD. The axially running compartments are segmented by interstitial cells spaced at regular intervals. The pairing of ATLs and CDs bounded by an abundant supply of AVR carrying reabsorbed water, NaCl, and urea make a strong argument that the mixing of NaCl and urea within the INSs and countercurrent flows play a critical role in generating the inner medullary osmotic gradient. The results of this study fully support that hypothesis. We quantified interactions of all structures comprising INSs along the corticopapillary axis for two rodent species, the Munich-Wistar rat and the kangaroo rat. The results showed remarkable similarities in the configurations of INSs, suggesting that the structural arrangement of INSs is a highly conserved architecture that plays a fundamental role in renal function. The number density of INSs along the corticopapillary axis directly correlated with a loop population that declines exponentially with distance below the outer medullary-inner medullary boundary. The axial configurations were consistent with discrete association between near-bend loop segments and INSs and with upper loop segments lying distant from INSs.

Sexual signals are considered costly to produce and maintain under the handicap paradigm, and the reliability of signals is in turn thought to be maintained by these costs. Although previous studies have investigated the costly nature of signal production, few have considered whether honesty might be maintained not by the costliness of the signal itself, but by the costs involved in producing the signalled trait. If such a trait is itself costly to produce, then the burden of energetic investment may fall disproportionately on that trait, in addition to any costs of signal maintenance that may also be operating. Under limited resource conditions, these costs may therefore be great enough to disrupt an otherwise reliable signal-to-trait relationship. We present experimental evidence showing that dietary restriction decouples the otherwise honest relationship between a signal (dewlap size) and a whole-organism performance trait (bite force) in young adult male Anolis carolinensis lizards. Specifically, while investment in dewlap size is sustained under low-resource condition relative to the high-resource treatment, investment in bite force is substantially lower. Disruption of the otherwise honest dewlap size to bite force relationship is therefore driven by costs associated with the expression of performance rather than the costs of signal production in A. carolinensis.

Recent anatomic findings indicate that in the upper inner medulla of the rodent kidney, tubules, and vessels are organized around clusters of collecting ducts (CDs). Within CD clusters, CDs and some of the ascending vasa recta (AVR) and ascending thin limbs (ATLs), when viewed in transverse sections, form interstitial nodal spaces, which are arrayed at structured intervals throughout the inner medulla. These spaces, or microdomains, are bordered on one side by a single CD, on the opposite side by one or more ATLs, and on the other two sides by AVR. To study the interactions among these CDs, ATLs, and AVR, we have developed a mathematical compartment model, which simulates steady-state solute exchange through the microdomain at a given inner medullary level. Fluid in all compartments contains Na(+), Cl(-), urea and, in the microdomain, negative fixed charges that represent macromolecules (e.g., hyaluronan) balanced by Na(+). Fluid entry into AVR is assumed to be driven by hydraulic and oncotic pressures. Model results suggest that the isolated microdomains facilitate solute and fluid mixing among the CDs, ATLs, and AVR, promote water withdrawal from CDs, and consequently may play an important role in generating the inner medullary osmotic gradient.

The present study compared communication patterns and satisfaction levels between three-dimensional (3D) and real-life intimate relationships using a sample of 71 participants who were concurrently involved in an intimate relationship within Second Life and a separate real-life romantic relationship. Participants indicated that the quality of their communication was significantly better in their Second-Life relationship and that they experienced higher levels of satisfaction with their virtual partners. The more positive or idealized view of the 3D relationships may have been due to higher levels of focused interaction and reduced stressors in the virtual world and the greater length, and associated problems, in participant's real-life relationships. In addition, the presence of a concurrent relationship within Second Life could have negatively affected participant's judgments of their real-life relationships. These data offer the first detailed assessment of communication patterns and satisfaction levels in intimate relationships across the real and 3D virtual realms as the number of users and romantic partners in immersive virtual environments continue to grow.

Objective: To investigate whether trends in tuberculosis (TB) rates across Europe are linked to patterns of migration., Design: Descriptive analysis of Organisation for Economic Co-operation and Development population statistics and EuroTB data for 21 European countries for 1996-2005., Results: TB notification rates increased in only three of the 21 countries: the United Kingdom, Norway and Sweden. In all three countries, approximately three quarters of cases were foreign-born. The UK had the third highest number of foreign nationals overall, but the highest number from a country with a TB incidence > or =250 cases/100000 (219000, 13%). European countries with declining TB rates had varying patterns of migration, but did not generally receive migrants from very high-incidence countries and/or had a smaller proportion of their total TB cases in their migrant population., Conclusions: The increase in the rate of TB in the UK, which contrasts with most other European countries, may, at least in part, be due to the fact that a high proportion of UK cases occur in the foreign-born, coupled with a comparatively large number of foreign nationals from countries with a very high incidence of TB.

Setting: England and Wales, 2001-2003., Objectives: To describe demographic and clinical characteristics of tuberculosis (TB) in non-UK-born persons and compare with UK-born cases to inform public health action and health service provision., Design: Analysis of surveillance data., Results: Among the 67% of cases who were non-UK-born, TB incidence was 88/100000 compared to 4/100000 among the UK-born. UK-born minority ethnic groups were also at increased risk of TB. Although the highest TB incidence occurred in recent entrants to the UK, nearly half the cases had been resident for >or=5 years. The majority of non-UK-born cases originated from South Asia (48%) and sub-Saharan Africa (35%). The demographic characteristics of non-UK-born and UK-born cases differed. In addition, non-UK-born cases were less likely to have pulmonary TB than the UK-born (52% vs. 73%, chi(2) P<0.001), but were more likely to have isoniazid-resistant disease (8% vs. 6%, chi(2) P=0.002), depending on region of birth., Conclusions: During 2001-2003, most TB cases were non-UK-born. TB services need to take the characteristics of TB in this group into account. Furthermore, awareness of the risk of disease is required among the non-UK-born for many years after arrival into the UK, and among UK-born minority ethnic groups.

In December 2001, an increase in cases of hepatitis A was observed in South Yorkshire. Cases were predominantly young males who reported injecting drug use. A community-based vaccination programme was introduced in November 2002, but new cases continued to occur. In March 2003, a vaccination campaign was implemented in the local prison for a four-week period. One thousand two hundred and thirty-six (91%) prisoners were vaccinated. Two thirds (895/1,363) of the prisoners came from the area affected by the outbreak and 52% (465/895) reported injecting drugs. The median age of injectors was 25 years. Notifications of cases of hepatitis A from South Yorkshire ceased in August 2003. Although on this occasion the prison vaccination campaign was probably implemented too late to have had a significant impact on the local outbreak, a large number of young male injectors from the local area were successfully vaccinated. This suggests that a prison-based intervention offers a potentially effective way of immunising the IDU population and interrupting a community-based outbreak.

The most frequently reported risk factor for hepatitis B infection in England and Wales is injecting drug use (38%). Since approximately 61% of injecting drug users (IDUs) had been imprisoned and less than 40% had received hepatitis B vaccine, a prison based hepatitis B vaccination programme was set up in 2001. At the 42 establishments participating in this study, all prisoners were offered vaccine at reception. Prisoners over 18 years were vaccinated using the 0, 7 and 21 days schedule and those under 18 years, using the 0, 1 and 2 months schedule. As far as possible a fourth dose was given to all after 12 months. In 2003, 14,163 prisoners received at least one dose of vaccine and altogether 26,265 doses were administered. A further 1111 prisoners reported they had already been vaccinated against hepatitis B. The median vaccine coverage rate was 17% (range 0-94%). Despite low coverage levels, the vaccination programme in prisons can be said to have vaccinated a sizable number of young, male prisoners, a group that have previously been shown to be at high risk of infection. The prisons which achieved vaccine coverage levels over 50% had designated nursing staff who ran the vaccination clinics.

Fifty-two total ear canal ablation (TECA) procedures in 44 cats were reviewed. The indication for surgery was neoplasia in 41 per cent of the cats, 86 per cent of which had ceruminous gland adenocarcinoma. Chronic inflammatory or polypoid disease accounted for 50 per cent of surgical procedures. Postoperative complications included Horner's syndrome (42 per cent) and facial paralysis (56 per cent) and these were permanent in 14 per cent and 28 per cent of cases, respectively, with the rest resolving in the ensuing weeks or months. The higher incidence of Horner's syndrome and facial paralysis in the cat, compared to the dog, was attributed to greater fragility of the feline tympanic plexus and facial nerve. The median survival time of cats with ceruminous gland adenocarcinoma was 50-3 months, and did not differ significantly from that for inflammatory or polypoid disease. A potential prognostic indicator for this tumour was the mitotic index (MI): cases with MI < or = 2 survived significantly longer than those with MI > or = 3.

In November 1999, universal leucoreduction of blood components was introduced in the UK to minimise the risk of variant Creutzfeldt-Jakob Disease (vCJD) transmission by blood transfusion. The UK specifications for leucodepletion processes state that 99% of leucodepleted components should contain < 5 x 10(6) leucocytes/unit, within 95% confidence limits. However, this leucocyte concentration is below the detection limits of standard haematology analysers. The development of a fluorometric immunoassay to detect the residual donor leucocytes in leucoreduced blood components is described. Monoclonal antibodies to leucocyte-specific cell surface antigens, CD45 and CD15, were adsorbed to the well surface in 96-well microplates. Red blood cell samples containing low numbers of leucocytes were added to the wells and the cells of interest captured by the monoclonal antibodies. Since leucocytes are the only nucleated cells found in significant numbers in blood components they were quantified using PicoGreen, a fluorescent stain specific for dsDNA. In comparison to flow cytometry, the method currently used to detect low numbers of leucocytes, the microplate assay demonstrated excellent sensitivity (1.00) and acceptable specificity (0.81) when standard leucodepleted samples were tested. There was no significant difference between the two methods (p < or = 0.175). In conclusion, the fluorescence microplate assay represents a simple, high throughput alternative to flow cytometry for monitoring leucodepletion compliance in blood banks.

Objectives: To describe the distribution and changes in CD4 cell counts (both initial and subsequent) in HIV-infected persons over time and determine the factors influencing these counts., Design: Reports were requested from laboratories measuring CD4 cell counts in England and Wales. Initial counts were analysed and median counts were followed over time., Methods: Time trends and the relationship between initial CD4 cell count and age, sex, and HIV risk category were studied using quantile regression methods or chi-square tests., Results: Between 1990 and 1998, 9553 adults were newly diagnosed with HIV infection and had a CD4 cell count within 6 months of HIV diagnosis. Over 50% of initial CD4 cell counts in each major risk category were below 350 cells/mm3. Older age (P < 0.001), male sex (P < 0.013) and heterosexual risk (P < 0.001) were independently associated with lower initial CD4 cell counts. For heterosexually infected adults, the median initial CD4 cell count was significantly negatively associated with the year of diagnosis (P = 0.03) and the median age increased through the time period examined (P < 0.001), whereas for men who have sex with men (MSM), there was no significant change in these values over time. For each year cohort of newly diagnosed individuals, the median CD4 cell count in subsequent years decreased until 1996 and then increased thereafter, consistent with a treatment effect., Conclusion: Across all major risk groups, a large proportion of HIV-infected adults are being diagnosed late in the course of HIV disease. For the heterosexually infected, the data suggest an ageing cohort effect, whereas for MSM the data are consistent with continuing transmission.

From the time Dan was 12 years old to the present, he always was the explorer of life. He was very fortunate in having an opportunity to see how life exists in several human societies around the world. His many professional foreign travels are presented. Dan went to a 1959 meeting in Argentina, to England in 1963, and to Chile in 1963. After he married Claire, she accompanied him on his 44 day around the world trip in 1965 and on all his later foreign trips. In 1966, there was a Latin American trip on the way to doing research at a laboratory in Chile. Next on his travels was being a consultant in Venezuela in 1969 and attending a meeting in Russia in 1972. His son Raymond joined in trips to France in 1977, to Australia in 1983, to a 1990 trip to a Peruvian meeting, and finally joined the 1991 meeting to a meeting in Japan, with a side trip to China where Dan gave lectures. The last 2 foreign trips for Dan with Claire, but not with Raymond, were the meetings in 1994 in Buenos Aires, Argentina, and the 1998 meeting, which was held in both Israel and Jordan.

Certain CpG-containing DNA sequences from bacteria, viruses, or invertebrates elicit responses in the vertebrate innate immune system. These responses also account for many nonspecific effects of oligodeoxynucleotides used for antisense approaches. Here we describe a sequence from an acutely pathogenic simian immunodeficiency virus (SIV) that induces release of cytokines from macrophages and B lymphocyte proliferation. Furthermore, several similar sequences in other immunodeficiency viruses were found that also activate macrophages. These results led to the question if CpG-containing DNA, which is thought to play an immunostimulatory role in bacterial infections, has a similar role in infections by immunodeficiency viruses.

Varicella-zoster virus (human herpesvirus 3; VZV) is one of eight herpes viruses that routinely infect humans. It is classified as a member of the genus Varicellovirus, subfamily Alphaherpesvirinae, family Herpesviridae. Of the other human herpes viruses it is most closely related to the herpes simplex viruses (also members of the Alphalerpesvirinae). Like all herpes viruses, the virus has a large double-stranded DNA genome within an icosahedral nucleocapsid. This is surrounded by a proteinaceous tegument and a trilaminar membrane derived from host-cell membranes into which the viral glycoproteins are inserted. The structure of the virion is summarized in Fig. 1.

Somatostatin regulates diverse cellular effectors, including adenylyl cyclase, ion channels, and ion exchangers. We expressed two somatostatin receptor subtypes, SSTR1 and SSTR2, stably in mouse fibroblast Ltk- cells and transiently in human embryonic kidney HEK293 cells to investigate subtype-specific pharmacological and functional properties. The effects of GTP gamma S and pertussis toxin on [125I-Tyr11]somatostatin-14 binding indicated that SSTR2 may couple exclusively to pertussis toxin-sensitive G proteins, whereas SSTR1 may couple to both pertussis-sensitive and -insensitive G proteins. When expressed either stably or transiently, both receptor subtypes mediated somatostatin inhibition of cAMP accumulation by a pertussis toxin-sensitive mechanism. In contrast, only SSTR1 mediated somatostatin inhibition of Na(+)-H+ exchange activity, and this action was insensitive to pertussis toxin. We generated two chimeric receptors by replacing sequential residues of SSTR2 with cognate sequences of SSTR1 to identify molecular determinants unique to SSTR1 that may confer coupling to the exchanger. SSTCR4 included a SSTR1 segment encompassing determinants within the fifth and sixth hydrophobic domains and the entire third cytoplasmic loop, while SSTCR5 contained a SSTR1 segment spanning the second through sixth hydrophobic domains, including both second and third cytoplasmic loops. Although both chimeric receptors mediated somatostatin inhibition of cAMP accumulation, only SSTCR5 mediated the inhibition of Na(+)-H+ exchange activity, and this effect was pertussis-insensitive. These findings demonstrate both pharmacological and functional differences between SSTR1 and SSTR2. The ability of SSTR1 to selectively attenuate Na(+)-H+ exchange activity requires determinants outside the third cytoplasmic domain.

Activity of the ubiquitous Na-H exchanger (NHE1) is regulated by a number of receptors with tyrosine kinase activity as well as by several classes of receptors coupled to heterotrimeric GTP-binding proteins. We previously demonstrated that the beta 2-adrenergic receptor and other receptors that stimulate adenylyl cyclase by activating Gs stimulate NHE1 by a guanine nucleotide-dependent mechanism that is independent of receptor coupling to Gs. Now we report that a recently identified G alpha subunit, alpha 13, activates the exchanger. Transient expression of mutationally activated alpha 13 constitutively stimulates Na-H exchange; moreover, an alpha 13/alpha z chimera, designed to respond to stimulation by Gi-coupled receptors, mediates stimulation of Na-H exchange by one such receptor, the dopamine2 receptor. Mutationally activated alpha 13, however, does not stimulate adenylyl cyclase activity or phosphoinositide hydrolysis, indicating that its action on NHE1 occurs independently of these two effector pathways. These findings reveal the first known signaling function of alpha 13 and identify a new G protein involved in the regulation of NHE1.

Inhibitors of myristoylation and analogues of myristic acid inhibit the replication of some retroviruses including human immunodeficiency virus, but no studies with other virus families have been reported. We have shown that replication of varicella-zoster virus (VZV) in tissue is inhibited by DL-2-hydroxymyristic acid at concentrations similar to those required for inhibition with acyclovir. Protein synthesis is not inhibited, but protein myristoylation is non-specifically reduced. Despite this lack of specificity, DL-2-hydroxymyristic acid inhibits VZV replication without apparent cytotoxicity. This is in agreement with our earlier suggestion that non-specific inhibitors of myristoylation could have antiviral effects without toxicity to cells due to the stability of cellular myristoylproteins. This supports suggestions that myristoylation inhibitors have potential as antiviral drugs against the many viruses that produce myristoylproteins.

The content analysis of five-minute speech samples obtained from detoxified chronic alcoholic patients is a valid test for measuring cognitive impairment during the course of treatment. Such cognitive impairment scores six months after hospital discharge can be predicted using the variables of age, educational level, certain drinking patterns and cognitive impairment scores at the time of hospital admission. Patients who abstain for six months following hospital discharge have less cognitive impairment than those patients who resume drinking.

Sober chronic alcoholic males, sober nonalcoholic males, and intoxicated nonalcoholic males were assessed along several psychological dimensions by means of the content analysis of speech. Average cognitive impairment scores were significantly greater among intoxicated nonalcoholics than sober chronic alcoholics and significantly greater in sober chronic alcoholics than in sober nonalcoholics. Sober chronic alcoholics, also, had a significantly higher score than sober nonalcoholics on depression, social alienation-personal disorganization (schizoid traits), separation, guilt, and diffuse anxiety, and hostility inward. The general mental health, including cognitive function, of sober chronic alcoholics is clearly impaired when compared to sober nonalcoholic individuals.