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Traumatic brain injuries and damage are major causes of death and disability. We propose a 3D fully coupled electro-mechanical model of a nerve bundle to investigate the electrophysiological impairments due to trauma at the cellular level. The coupling is based on a thermal analogy of the neural electrical activity by using the finite element software Abaqus CAE 6.13-3. The model includes a real-time coupling, modulated threshold for spiking activation, and independent alteration of the electrical properties for each 3-layer fibre within a nerve bundle as a function of strain. Results of the coupled electro-mechanical model are validated with previously published experimental results of damaged axons. Here, the cases of compression and tension are simulated to induce (mild, moderate, and severe) damage at the nerve membrane of a nerve bundle, made of 4 fibres. Changes in strain, stress distribution, and neural activity are investigated for myelinated and unmyelinated nerve fibres, by considering the cases of an intact and of a traumatised nerve membrane. A fully coupled electro-mechanical modelling approach is established to provide insights into crucial aspects of neural activity at the cellular level due to traumatic brain injury. One of the key findings is the 3D distribution of residual stresses and strains at the membrane of each fibre due to mechanically induced electrophysiological impairments, and its impact on signal transmission., (Copyright © 2017 John Wiley & Sons, Ltd.)

Background: Legacy-making, actions or behaviors aimed at being remembered, may be one strategy to enhance coping and improve grief outcomes for bereaved parents and siblings. While legacy interventions have been developed and tested in pediatric and adult populations, legacy activities specific to bereaved parents in the neonatal intensive care unit remain unexplored. This study explored bereaved parents' perceptions of a digital storytelling legacy-making intervention for parents after the death of an infant., Methods: Six bereaved mothers and fathers participated in a focus group interview three to 12 months after the death of an infant in the NICU. A semi-structured interview guide with open-ended questions was used to obtain parent self-reports. Qualitative content analysis identified emerging themes., Results: Four major themes emerged regarding participants' perceptions of a legacy intervention: (a) parents' willingness to participate in a legacy intervention, (b) parents' suggestions for a feasible intervention, (c) parents' suggestions for an acceptable intervention, and (d) parents' perceived benefits of legacy-making., Conclusions: Participants reported that a legacy-making intervention via digital storytelling would be feasible, acceptable, and beneficial for NICU parents. Study results support the need and desire for legacy-making services to be developed and offered in the NICU.

Axonal damage is one of the most common pathological features of traumatic brain injury, leading to abnormalities in signal propagation for nervous systems. We present a 3D fully coupled electro-mechanical model of a nerve bundle, made with the finite element software Abaqus 6.13-3. The model includes a real-time coupling, modulated threshold for spiking activation and independent alteration of the electrical properties for each 3-layer fibre within the bundle. Compression and tension are simulated to induce damage at the nerve membrane. Changes in strain, stress distribution and neural activity are investigated for myelinated and unmyelinated nerve fibres, by considering the cases of an intact and of a traumatized nerve membrane. Results show greater changes in transmitting action potential in the myelinated fibre.

Background: Numerous studies have shown that baseline drug resistance patterns may influence the outcome of antiretroviral therapy. Therefore, guidelines recommend drug resistance testing to guide the choice of initial regimen. In addition to optimizing individual patient management, these baseline resistance data enable transmitted drug resistance (TDR) to be surveyed for public health purposes. The SPREAD program systematically collects data to gain insight into TDR occurring in Europe since 2001., Methods: Demographic, clinical, and virological data from 4140 antiretroviral-naive human immunodeficiency virus (HIV)-infected individuals from 26 countries who were newly diagnosed between 2008 and 2010 were analyzed. Evidence of TDR was defined using the WHO list for surveillance of drug resistance mutations. Prevalence of TDR was assessed over time by comparing the results to SPREAD data from 2002 to 2007. Baseline susceptibility to antiretroviral drugs was predicted using the Stanford HIVdb program version 7.0., Results: The overall prevalence of TDR did not change significantly over time and was 8.3% (95% confidence interval, 7.2%-9.5%) in 2008-2010. The most frequent indicators of TDR were nucleoside reverse transcriptase inhibitor (NRTI) mutations (4.5%), followed by nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.9%) and protease inhibitor mutations (2.0%). Baseline mutations were most predictive of reduced susceptibility to initial NNRTI-based regimens: 4.5% and 6.5% of patient isolates were predicted to have resistance to regimens containing efavirenz or rilpivirine, respectively, independent of current NRTI backbones., Conclusions: Although TDR was highest for NRTIs, the impact of baseline drug resistance patterns on susceptibility was largest for NNRTIs. The prevalence of TDR assessed by epidemiological surveys does not clearly indicate to what degree susceptibility to different drug classes is affected., (© The Author 2015. Published by Oxford University Press for the Infectious Diseases Society of America.)

Equivalence is one of most popular techniques to simulate the behavior of systems governed by the same type of differential equation. In this case, a thermo-electrical equivalence is considered as a method for modelling the inter-dependence of electrical and mechanical phenomena in biological tissue. We seek to assess this approach for multi-scale models (from micro-structure to tissue scale) of biological media, such as nerve cells and cardiac tissue, in which the electrical charge distribution is modelled as a heat distribution in an equivalent thermal system. This procedure allows for the reduction in problem complexity and it facilitates the coupling of electrical and mechanical phenomena in an efficient and practical way. Although the findings of this analysis are mainly addressed towards the electro-mechanics of tissue within the biomedical domain, the same approach could be used in other studies in which a coupled finite element analysis is required.

Background/objectives: Thoracic radiotherapy (RT) is associated with acute toxicities, including oesophagitis, which can have an impact on nutritional intake and subsequently lead to malnutrition. This study aimed to identify RT dosimetric factors associated with ⩾5% weight loss in patients receiving treatment for non-small-cell lung cancer (NSCLC)., Methods: Radiation dose data to the oesophagus (including mean, maximum dose and oesophageal length) were retrospectively analysed for a cohort of 54 NSCLC patients treated with concurrent chemoradiotherapy between 2004 and 2006. Weight change was calculated using the lowest weight during the 90 days from RT commencement compared with the start of RT., Results: Four patients for whom weight was not available at the start or end of treatment were excluded, leaving 50 patients for analysis. The prevalence of significant weight loss during the 90 days from RT commencement was 22% (median weight loss=9.1%, range=5.9-22.1). Dosimetric factors significantly associated with ⩾5% weight loss were maximum dose to the oesophagus (P=0.046), absolute oesophageal length receiving 40 Gy (odds ratio (OR)=1.18, P=0.04), 50 Gy (OR=1.20, P=0.02) and 60 Gy (OR=1.32, P=0.005) to the partial circumference, relative oesophageal length receiving 50 Gy (OR=1.03, P=0.03) and 60 Gy (OR=1.07, P=0.005) to the partial circumference., Conclusions: Multiple dosimetric factors were associated with significant weight loss. Of these factors, absolute and relative length of the oesophagus receiving 60 Gy to the partial circumference were more strongly related. Understanding the dosimetric factors associated with weight loss may aid early identification and intervention in patients at nutritional risk.

In spring 2008, an influenza A subtype H3N2 outbreak occurred in a long stay psycho-geriatric ward and two wards in the intellectual disability services (IDS), part of a large psychiatric hospital. The attack rate in the index ward was 90% (18/20) for patients and 35% (7/20) for staff. It was 14% (1/7) and 17% (2/12) in the affected IDS wards for patients and 0% (0/20) and 4% (1/25) for staff. Many of the laboratory-confirmed cases did not have a fever >38 °C, a typical sign of influenza. Control measures included oseltamivir treatment for cases and prophylaxis for contacts, standard and droplet infection control precautions, active surveillance for early detection and isolation of potential cases. As a result, the outbreak did not spread throughout the hospital. Although the staff vaccination rate (10%) prior to the outbreak was low, we observed a much lower vaccine effectiveness rate in the patients (11%) than in the staff (100%) in the index ward. Vaccination of residents and staff of such facilities remains the key influenza prevention strategy.

Bacterial wilt, caused by Erwinia tracheiphila, is a major disease of cucurbit crops in the United States. Management of the disease relies on controlling two vector species, striped (Acalymma vittatum) and spotted (Diabrotica undecimpunctata) cucumber beetles. Six field trials were conducted at Iowa State University research farms during 2007, 2008, and 2009 to assess the efficacy of delayed removal of spunbond polypropylene row covers to control bacterial wilt on muskmelon (Cucumis melo). Treatments were (i) row cover removed at anthesis (conventional timing of removal), (ii) covers removed 10 days after row cover ends were opened at anthesis, (iii) covers removed 10 days after bumble bee hives were inserted under row covers at anthesis, and (iv) a noncovered control. In two field trials during 2007 and 2008, the delayed-removal row-cover treatments significantly suppressed bacterial wilt throughout the growing season and enhanced yield compared with the noncovered and removal-at-anthesis controls. In Gilbert in 2008, however, bacterial wilt suppression was equivalent among all three row-cover treatments. No bacterial wilt was observed during three trials in 2009, and there was minimal difference in marketable yield among treatments. Net returns were compared using partial budget and sensitivity analyses. Melon prices and occurrence of bacterial wilt had a strong impact on net returns. Using row covers increased production costs by 45%. In site years in which bacterial wilt occurred, delaying removal of row covers resulted in the highest returns. When bacterial wilt was absent, however, the delayed-removal row-cover treatments had the lowest returns. Results of the sensitivity analysis indicated that delaying removal of row covers for 10 days could be a cost-effective component of an integrated bacterial wilt suppression strategy for muskmelon where bacterial wilt occurs ≥50% of production seasons.

This study investigates several sources of uncertainty associated with the application of optically stimulated luminescence (OSL) to personal dosimetry. A commercial OSL system based on Al(2)O(3):C was used for this study. First, it is demonstrated that the concept of repeated evaluation (readout) of the same dosemeter, often referred to as 're-analysis', can introduce uncertainty in the re-estimated dose. This uncertainty is associated with the fact that the re-analysis process depletes some of the populated traps, resulting in a continuous decrease of the OSL signal with each repeated reading. Furthermore, the rate of depletion may be dose-dependent. Second, it is shown that the previously reported light-induced fading in this system is the result of light leaks through miniature openings in the dosemeter badge.

The phototransferred thermoluminescence (PTTL) technique is applied to the Harshaw LiF:Mg,Cu,P material. It is demonstrated that using 254-nm UV light, dose levels as low as 0.2 mGy can be re-estimated. The PTTL efficiency was found to be ∼ 6 % in the dose range of 0.2 mGy-1 Gy, and it appears to be dose-independent. This implies that a simple calibration factor could be applied to the PTTL data for the re-estimation of dose levels. It was demonstrated that with a proper choice of the TL readout parameters, and the UV-light irradiation conditions, dose levels that are relevant to personal or environmental dosimetry can be re-estimated.

Background: There is evidence that excessive protease activity in the skin is an important factor in the development of atopic dermatitis. SRD44 is a topically formulated novel protease inhibitor that selectively inhibits Staphylococcal-derived aureolysin and matrix metalloproteinases (MMPs)., Methods: This was a double-blind, vehicle-controlled randomized trial conducted in thirteen hospital dermatology outpatient clinics in Germany (9), Bulgaria (3) and Finland (1). Ninety-three out of 103 screened adult subjects with confirmed atopic dermatitis affecting ≤ 20% of body surface area, with an IGA score of 2 or 3 at randomization were randomized following a washout period to either SRD441 ointment or matching vehicle twice daily for 28 days. The primary efficacy endpoint was the clearance of Atopic dermatitis (AD score of 0 or 1 IGA) at Day 21. Secondary endpoints included measures of SCORing Atopic Dermatitis, pruritus self-assessment, rescue medication use and occurrence of new exacerbations. A range of safety and tolerance endpoints were included., Results: There were no significant treatment differences in IGA success rates at Day 21 (SRD441 ointment, 11.1%; vehicle ointment, 12.5%; P = 1.000). Evaluation of secondary efficacy variables revealed no clinical or important statistical differences between treatment groups. Eighteen subjects (19.4%) discontinued the study drug because of an AE (seven subjects [15.6%] in the SRD441 group and 11 subjects [22.9%] in the vehicle group). Twenty-seven subjects (60.0%) in the SRD441 group and 34 subjects (70.8%) in the vehicle group reported an adverse event (AE)., Conclusions: SRD441 ointment did not demonstrate efficacy in the treatment of atopic dermatitis raising questions on the effectiveness of MMPs as a target for the treatment of atopic dermatitis. NCT00882245., (© 2010 John Wiley & Sons A/S.)

A prospective study of norovirus outbreaks in Ireland was carried out over a 1-year period from 1 October 2004 to 30 September 2005. Epidemiological and molecular data on norovirus outbreaks in the Republic of Ireland (ROI) and Northern Ireland (NI) were collected and combined in real time in a common database. Most reported outbreaks occurred in hospitals and residential institutions and person-to-person spread was the predominant mode of transmission. The predominant circulating norovirus strain was the GII.4-2004 strain with a small number of outbreaks due to GII.2. This study represents the first time that enhanced epidemiological and virological data on norovirus outbreaks in Ireland have been described. The link established between the epidemiological and virological institutions during the course of this study has been continued and the data is being used as a source of data for the Foodborne Viruses in Europe Network (DIVINE-NET).

Purpose: Ileal pouch-anal anastomosis remains the "gold standard" in surgical treatment of ulcerative colitis and familial adenomatous polyposis. Pouchitis occurs mainly in patients with a background of ulcerative colitis, although the reasons for this are unknown. The aim of this study was to characterize differences in pouch bacterial populations between ulcerative colitis and familial adenomatous pouches., Methods: After ethical approval was obtained, fresh stool samples were collected from patients with ulcerative colitis pouches (n = 10), familial adenomatous polyposis (n = 7) pouches, and ulcerative colitis ileostomies (n = 8). Quantitative measurements of aerobic and anaerobic bacteria were performed., Results: Sulfate-reducing bacteria were isolated from 80 percent (n = 8) of ulcerative colitis pouches. Sulfate-reducing bacteria were absent from familial adenomatous polyposis pouches and also from ulcerative colitis ileostomy effluent. Pouch Lactobacilli, Bifidobacterium, Bacteroides sp, and Clostridium perfringens counts were increased relative to ileostomy counts in patients with ulcerative colitis. Total pouch enterococci and coliform counts were also increased relative to ileostomy levels. There were no significant quantitative or qualitative differences between pouch types when these bacteria were evaluated., Conclusions: Sulfate-reducing bacteria are exclusive to patients with a background of ulcerative colitis. Not all ulcerative colitis pouches harbor sulfate-reducing bacteria because two ulcerative colitis pouches in this study were free of the latter. They are not present in familial adenomatous polyposis pouches or in ileostomy effluent collected from patients with ulcerative colitis. Total bacterial counts increase in ulcerative colitis pouches after stoma closure. Levels of Lactobacilli, Bifidobacterium, Bacteroides sp, Clostridium perfringens, enterococci, and coliforms were similar in both pouch groups. Because sulfate-reducing bacteria are specific to ulcerative colitis pouches, they may play a role in the pathogenesis of pouchitis.

We report the first study of R-134a (also known as HFC-134a and CF3CFH2) refrigerant leakage from air conditioning (AC) systems of modern vehicles. Twenty-eight light duty vehicles from five manufacturers (Ford, Toyota, Daimler Chrysler, General Motors, and Honda) were tested according to the USEPA (Federal) extended diurnal test procedure using the Sealed Housing for Evaporative Determination (SHED) apparatus. All tests were conducted using stationary vehicles with the motor and air conditioning system turned off. R-134a was measured using gas chromatography (GC) with a flame ionization detector (FID). All vehicles exhibited measurable R-134a leakage over the 2-day diurnal test. Leak rates of R-134a ranged from 0.01 to 0.36 g/day with an average of 0.07+/-0.07 g/day. When combined with leakage associated with vehicle operation, servicing, and disposal we estimate that the lifetime average R-134a emission rate from an AC equipped vehicle is 0.41+/-0.27 g/day (the majority of emissions are associated with vehicle servicing and disposal). Assuming that the average vehicle travels 10 000 miles per year we estimate that the global warming impact of R-134a leakage from an AC equipped vehicle is approximately 4-5% of that of the CO2 emitted by the vehicle. The results are discussed with respect to the contribution of vehicle emissions to global climate change.

This article compares the service quality expectations of residents, family, and administrators within a long-term-care context. Expectations for service quality are measured using the SERVQUAL scale. The results support the reliability of the SERVQUAL instrument for nursing home residents. Resident expectations were significantly different from administrators' expectations on all dimensions of quality. The findings are interpreted in terms of expectation formation and the nature of service encounters.

Attempts to estimate the time of origin of human immunodeficiency virus (HIV)-1 by using phylogenetic analysis are seriously flawed because of the unequal evolutionary rates among different viral lineages. Here, we report a new method of molecular clock analysis, called Site Stripping for Clock Detection (SSCD), which allows selection of nucleotide sites evolving at an equal rate in different lineages. The method was validated on a dataset of patients all infected with hepatitis C virus in 1977 by the same donor, and it was able to date exactly the known origin of the infection. Using the same method, we calculated that the origin of HIV-1 group M radiation was in the 1930s. In addition, we show that the coalescence time of the simian ancestor of HIV-1 group M and its closest related cpz strains occurred around the end of the XVII century, a date that could be considered the upper limit to the time of simian-to-human transmission of HIV-1 group M. The results show also that SSCD is an easy-to-use method of general applicability in molecular evolution to calibrate clock-like phylogenetic trees.

Although still in its infancy, the World Wide Web presents unparalleled opportunities for harnessing the power of the Internet to collect data from populations of interest in an economical and efficient manner. Web-based surveys offer a number of strengths including access to specific populations, speed of data access, and decreased data collection and data entry costs. These advantages are likely to increase as more people begin to use the Web as their primary means of communication. Nurse researchers who embrace this technology will become the pioneers in the new age of nursing research.

Ophthalmologists are often in a position to diagnose Wegener's granulomatosis and prevent significant morbidity. The past 2 years have seen advances in diagnosis and management strategies for this condition. Orbital magnetic resonance imaging and histologic profiles have been better characterized. Perhaps the greatest advance has been the recognition of promising therapeutic alternatives to the current standard cytotoxic protocol. Trimethoprim-sulfamethoxazole or methotrexate may be valuable in selected patients with limited forms of Wegener's granulomatosis. Finally, new insights into the mechanisms of disease activation and tissue injury may lead to better treatment and long-term prognosis.

Object: Thrombotic complications (deep vein thrombosis and/or pulmonary embolization [DVT/PE]) occur in 18 to 50% of patients harboring brain tumors who undergo neurosurgical procedures. Such patients are at risk for DVT/PE because of immobility, paresis, hypovolemia, and lengthy surgery. The present study was undertaken to see whether tumor patients at highest risk for DVT/PE could be identified so that augmentation of prophylactic measures might be used to reduce the incidence of thrombotic complications., Methods: The authors conducted a retrospective analysis of 488 patients enrolled in their brain tumor registries between 1988 and 1995, identifying 57 patients (12%) with recorded symptomatic DVT, PE, or both postoperatively. In 24 of these 57 cases histological specimens were retrievable for review, allowing an in-depth analysis. Forty-five patients were lost to follow-up review, and the remaining 386 patients had no record of systemic thrombosis. Slides of pathological specimens were retrievable in 50 cases in which there was no DVT/PE. From these 50 cases, 25 were selected at random to represent the control group by a blinded observer. Seventeen (71%) of the 24 brain tumor specimens obtained in patients with DVT/PE stained positively for intraluminal thrombosis (ILT) after hematoxylin and eosin had been applied. The odds ratio associated with the presence of ILT was 17.8, with a confidence interval ranging from 4 to 79.3. No evidence of ILT was found in 22 patients (88%) within the control group (p < 0.0001, Fisher's exact test). Other factors that may predispose patients with brain tumors to DVT/PE-limb paresis, extent of tumor removal, and duration of the surgery-were also analyzed and found not to be statistically significant. Therefore, these factors were not the basis for differences seen between the study and control groups., Conclusions: These preliminary observations suggest that the presence of ILT within malignant glioma or glioblastoma tumor vessels may represent a marker of tumor-induced hypercoagulability.

Psychologists in Long-Term Care (PLTC), a national network established in 1983, has developed, with input from colleagues and consumers, standards for psychological practice in long-term care facilities. These standards address provider characteristics, methods of referral, assessment practices, treatment, and ethical issues. This article describes the document's development and offers suggestions for its use.

Aim: To establish the proportion of patients with unstable angina in whom adequate anticoagulation is achieved using a standard regime of intravenous heparin., Method: A prospective series of 108 Emergency Department attendees over a six-month period with a clinical diagnosis of unstable angina for whom anticoagulation with heparin was prescribed were included in the study. The standard regime was a 5000 unit bolus followed by an intravenous infusion of 1000 units per hour (1200 units if the patient's weight was greater than 80 kg), with subsequent adjustments being made by reference to a nomogram. The activated partial thromboplastin time (APTT) was measured at six and 12 hours after treatment began. Two commonly used criteria for adequate heparinisation were compared: 1. APTT greater than 1.5 times control and 2. APTT in the range of 60-85 seconds., Results: There were valid data for 90 patients at six hours and 79 at 12 hours. Compared to the criterion for adequate anticoagulation of APTT greater than 1.5 times the control, 25% of patients were subtherapeutic at six hours and 12% at 12 hours. Compared to the criterion APTT greater than 60 seconds, 53% of patients were subtherapeutic at 6 hours and 47% at 12 hours. At 6 hours, 26% of patients were over-anticoagulated as defined as APTT greater than 85 seconds. This had reduced to 13% by 12 hours., Conclusions: In the context of recent research suggesting that an APTT of greater than 1.5 times the control is sufficient to reduce complications in unstable angina, our results demonstrate that a standard regime of heparinisation will achieve this goal in the majority of patients within 6 hours of starting heparin therapy. However, if an APTT of 60-85 seconds is the goal, this standard regime is inadequate.

How do people choose an action to satisfy a goal from among the actions that are afforded by the environment? In 3 experiments the action modes used by actors to reach for a block placed at various distances from them were observed. In each experiment, when actors were not restricted in how they could reach for the object, the transition from their reaching using only arm extension to a mode of reaching in which they used the upper torso to lean forward occurred at closer distances than each actor's absolute critical boundary, beyond which the former action was no longer afforded. In Experiments 2 and 3 actors' seated posture was varied so that the effect of postural dynamics on the distance at which actors actually chose to make the transition between action modes, the preferred critical boundary, could be examined. The results are consistent with the proposal that the preferred critical boundary reflects the relative comfort of available modes of reaching.

The purpose of this study was to describe the decision-making processes of 369 public health nurses in Canada, Finland, Norway, and the United States, and to discuss any differences observed among these countries. The results indicate that public health nurses used different decision-making models on the job and that these models varied considerably. Five different decision-making models were identified, each exhibiting features of different decision-making theories. The differences between decision making of public health nurses in different countries were statistically significant. The differences in decision making appear to be due to differences in health care systems in the 4 countries and the nature of the nursing task and context.

Objective: To demonstrate an unusual form of inpatient geriatric assessment with unique outcomes., Design: A prospective evaluation of patients admitted to a community hospital-based inpatient geriatrics unit utilizing traditional members of the assessment team along with educational assessment of nurses and satisfaction profiles of patients and/or families., Setting: A non-profit community hospital in Northeast Washington, DC., Participants: All patients older than age 62 admitted to the 42-bed Geriatric Unit during a 4 1/2 year time period., Measurements: Number of total and category recommendations taken by attending physicians from the Inpatient Geriatric Assessment Team, periodic evaluation of unit nurses' geriatric knowledge base and certification, and patient satisfaction through periodic surveys., Results: More than 4500 patients have been evaluated during the past 4 1/2 years. The number of recommendations taken by attending physicians has averaged 31.3 to 50.7% during four consecutive chart reviews involving the first 25 consecutive patients for the month each performed every six months (n = 100). The average age of patients evaluated was 77.2 (minimum of 62 and maximum of 97); 67% were females and 33% males. The average number of recommendations communicated per patient was 4.1, and the average number adhered to 1.6/patient. The overall knowledge base and certification in geriatric nursing has increased significantly over a 2.5-year period. Composite monthly unit patient satisfaction survey scores increased as well., Conclusions: The program is unique in its development, limitations, and outcomes. Other than the cost of limited geriatric nurse practitioner and faculty salary support, the program has been implemented using only current hospital department personnel. The role of the assessment team is to educate attending nurses and staff physicians. It has not yet been possible to measure objective outcomes. However, the current program also serves the purpose of introducing a new medical program to a community hospital in a nonthreatening way and offers opportunities for research. In addition, the program offers further opportunity for expansion and change.

The purpose of this study was to examine if registered nurses' (RNs) reports of the structure, work processes and performance of Massachusetts hospitals have changed over a five year period. Responses of 928 randomly selected RNs surveyed in 1989 and 858 randomly selected RNs in 1994 to the RN Quality of Worklife Survey (RNQOWS) were compared. Data analysis was performed with a between-subjects multivariate analysis of covariance, controlling for number of years as an RN and as a member of a collective bargaining unit. Significant differences were found in the variables that measure human resources, administrative motivating conditions, task effectiveness, and efficiency (p < 0.001). The implications of the findings for nursing practice in hospitals is discussed and recommendations are made for further research.

Purpose: Do tumor cells which survive high dose fractionated irradiation exhibit modified metastasis activity, proliferation kinetics, and/or radiation sensitivity? To address this question experimentally, we have studied three recurrent human tumor xenograft systems., Methods and Materials: Three models were derived from a soft tissue sarcoma (HSTS26T), a colon adenocarcinoma (HCT15), and a glioblastoma (HGL21) which had recurred after 90 Gy, 109 Gy, or 77.4 Gy administered in 30 equal doses, respectively. Their production of spontaneous metastasis and cell proliferation characteristics were studied in early generation xenografts in SCID mice, and were compared to those in their previously unirradiated counterparts. As a control, we have also studied each tumor as a post-surgical recurrence. Specimens from the irradiated recurrent and their unirradiated primary tumors were cultured in vitro and their radiation sensitivity determined by clonogenic assay., Results: The three irradiated recurrent tumor systems retained the individual histological features of their unirradiated primary xenografts. A lower metastatic incidence was observed in two of the three irradiated recurrent tumor lines in comparison with their unirradiated control tumors and their surgical recurrent counterparts. No significant differences were found between the irradiated recurrent tumors and their unirradiated counterparts with respect to: volume doubling time, growth time, potential doubling time, mitotic index, PCNA index, and SF2 values., Conclusions: High dose irradiation given in 30 fractions did not increase the metastatic activity in the three human tumor xenograft systems. Furthermore, the fractionated irradiation did not significantly change their proliferation characteristics and cellular radiation sensitivity.

Gel retardation assays using a probe containing the repeat region of a Schizosaccharomyces pombe chromosomal telomere identified four specific DNA- protein complexes in S. pombe total protein extracts (I, I', IIa and IIb). The proteins responsible for these complexes bound to the telomeric repeat region irrespective of whether or not the repeats were in close proximity to the end of a DNA molecule, and none of them bound strongly to single-stranded DNA. The protein responsible for complex I (TeRF I) was separated from the activity responsible for complexes IIa and IIb (TeRF II) using heparin-Sepharose chromatography. Both factors were efficiently cross-competed by an oligonucleotide containing the 18 bp sequence 5'-GGTTACAGGTTACAGGTT-3', which corresponds to two complete telomeric repeat units. Mutation of the T residues at positions 4 and 11 in the oligonucleotide dramatically reduced binding by TeRF II, but had no affect on binding by TeRF I. The protein responsible for complex I' did not bind strongly to either the wild-type or mutant oligonucleotide.

This study has evaluated the impact of the suppression and recovery of the residual immunity in NCr/Sed nude (nu/nu) mice after whole-body irradiation using xenotransplantability and tumor control probability as the end points. For this investigation the xenograft was a human soft tissue sarcoma (HSTS26T). Two assays, the TD50 (the number of tumor cells required to induce a tumor in 50% of the recipients) and the TCD50 (the radiation dose required to control 50% of tumors) were used. For TD50 assays, tumor cells were injected subcutaneously (sc) into the legs of control and whole-body- irradiated nude mice at 1 day or 4, 8 or 12 weeks after irradiation. For TCD50 assays, tumors were transplanted sc into the legs of nude mice which had not been irradiated or which had been given whole-body irradiation at 1 day or 12 weeks prior to transplantation. The tumors were given single-dose irradiation when they reached 6 mm mean diameter under clamp-hypoxic conditions. The results show that the TD50's of mice receiving the injection 1 day and 4 and 8 weeks after whole-body irradiation were 3.6 to >100 times lower than that of unirradiated mice. Two groups which showed a statistically significant difference in TD50 's were those which received the injection 1 day and 8 weeks after whole-body irradiation (P < 0.01 and P < 0.05, respectively). No difference was found in TD50 values between mice that received injection 12 weeks after whole-body irradiation and those which were not irradiated. The TCD50 values of tumors in nonirradiated mice and in mice which had received whole-body irradiation 1 day and 12 weeks prior to to transplantation were 26.8, 44.1 and 33.9 Gy, respectively. Significantly lower TCD50 values were found in groups of nonirradiated mice or mice which received whole-body irradiation 12 weeks prior to transplantation in comparison with the group of mice that received whole-body irradiation on day 1 (both P < 0.05). No significant difference was found between the TCD50 values of the group of mice that received whole-body irradiation 12 weeks prior to transplantation and those for nonirradiated controls. Our conclusion is that the whole-body irradiation can enhance the transplantability of the HSTS26T tumor in nude mice significantly; this enhancing effect will decrease to the pre-irradiation level by 12 weeks after whole-body irradiation. Also, the suppression and recovery of residual immunity after whole-body irradiation can influence the TCD50 values of the same tumor xenografts in nude mice significantly. The changes in TD50 and TCD50 values correlate with the depletion and recovery of the total splenic lymphoid cell number, and especially in natural killer cell activity. We recommend that further immunosuppression in nude mice is necessary when using this model system for studies of human tumors.