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Minor Alterations (minor + alteration)
Selected AbstractsBeing an outsider: nurses' statements about a vignette of an elderly resident with a schizophrenia diagnosis and dementia behaviourJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2004O. HELLZÉN rn phd In an exploratory study of nurses' approach to elderly people with a diagnosis of long-term schizophrenia, the aim was to investigate nurses' views of the care of an elderly fictitious person with long-term schizophrenia. All the nurses in one municipality in northern Sweden working at seven different units were investigated. A vignette, which was based on a case description in a previous study of an 84-year-old woman with severe dementia and problematic behaviour, was used after a minor alteration. In this study, the woman's age in the case description was changed from 84 to 68 years and the diagnosis was changed from severe dementia to long-term schizophrenia; otherwise, the description was the same as in the original case. The main finding was the nurses' inability to see the resident as anything other than what the ,label', the diagnosis, said. The nurses are interpreted as being caught in a dilemma of loyalty , on the one hand, the loyalty to the organization with its traditional goals and means and, on the other hand, the loyalty to the resident with her wishes in the forefront of their minds. [source] An evaluation of pharmacist-written hospital discharge prescriptions on general surgical wardsINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 3 2005Mohamed H. Rahman Principal pharmacist, surgical services Objective To evaluate the quality of pharmacist-written hospital discharge prescriptions (DPs) in comparison to those written by doctors. Method The study was carried out in two, week-long phases on the general surgical wards in one UK hospital. In phase 1, doctors wrote the DPs, which were then checked by the ward pharmacist. In phase 2, ward pharmacists wrote the DPs which were then checked by the patient's junior doctor. In both phases, the clinical dispensary pharmacist made their routine check of the prescription prior to dispensing. All interventions were recorded on a pre-piloted data collection form. Key findings In phase 1, doctors wrote 128 DPs; in phase 2, pharmacists wrote 133 DPs. There were 755 interventions recorded during phase 1 in comparison to 76 during phase 2. In phase 1, transcription errors accounted for 118 interventions, 149 were due to ambiguity/illegibility; 488 amendments were to facilitate the dispensing process e.g. clarification of patient, medical and drug details, and dosage form discrepancies. In phase 2, transcription errors accounted for one intervention, 50 interventions were due to ambiguities or illegibility; 25 amendments were to facilitate the dispensing process. During phase 2, doctors made 10 minor alterations to pharmacist-written DPs. On 52 occasions during phase 2, the ward pharmacist had to clarify, prior to writing the DP, either the dose of a drug, or, whether a drug should be continued on discharge, and if so, for what duration. Conclusion Pharmacist-written DPs contained considerably fewer errors, omissions and unclear information in comparison to doctor-written DPs. Doctors recorded no significant alterations when validating pharmacist-written DPs. [source] X-ray structural analysis of the ligand-recognition mechanism in the dual-affinity labeling of c-type lysozyme with 2,,3,-epoxypropyl ,-glycoside of N -acetyllactosamineJOURNAL OF MOLECULAR RECOGNITION, Issue 2 2003Michiro Muraki Abstract In spite of the belonging to the same c-type lysozyme family, hen egg-white lysozyme (HEWL) was much less susceptible to the dual-affinity labeling with 2,,3,-epoxypropyl ,-glycoside of N -acetyllactosamine (Gal,1,4GlcNAc-Epo) than human lysozyme (HL). The three-dimensional structures of the HEWL labeled with single Gal,1,4GlcNAc-Epo and the Glu102-mutant HL labeled with double Gal,1,4GlcNAc-Epo were determined by X-ray crystallography at resolutions of 1.85 and 2.0,Å, respectively. The overall conformation and the interaction mode of the carbohydrate ligand part in the singly labeled HEWL and the doubly labeled Glu102-mutant HL were basically identical to those of the correspondingly labeled wild-type HL with minor alterations in some stereochemical parameters. A detailed comparison of the structures revealed the key protein,carbohydrate and carbohydrate,carbohydrate interactions essential for the dual labeling. It was suggested that the difference in the efficiency of the dual labeling was caused by the structural difference between Gln104 in HL and Asn103 in HEWL. The relevance to our previous study and the carbohydrate,carbohydrate interaction on cell-surface membranes were discussed. Copyright © 2003 John Wiley & Sons, Ltd. [source] Inguinal hernia repair: Where to next?ANZ JOURNAL OF SURGERY, Issue 8 2002Martina Zib Background: Hernia repair is one of the most frequently performed operations in general surgery , a total of 39 000 elective inguinal hernia repairs were performed in public and private hospitals in Australia between July 1998 and June 1999 , and, as such, even minor alterations in outcome and resource use have appreciable impact. However, decisions regarding choice of operation for hernia repair remain controversial. The purpose of the present paper is to critically evaluate the evidence available regarding recently introduced open mesh repair techniques and to try to identify meaningful directions for future hernia research. Methods: A thorough search of all published surgical literature was undertaken. Medline, EMBASE and the Cochrane databases were searched by title, by key words and by author. References in review articles and in textbooks were pursued. The manufacturing companies were contacted for trials evaluating their product. Results: Eight original articles evaluating either the Kugel Patch, the PerFix Plug or the Prolene Hernia System were located. None of these trials directly compared two or more of these repair systems. To date, there has been no published review of the evidence regarding the newer mesh repair techniques. With one exception, all of these articles qualify as Level IV evidence. Highlighted is the lack of evidence regarding chronic significant posthernioplasty pain , this has an incidence of 6,12%. This complication is 3,5 times more common than recurrence after open repair, is clinically relevant, is poorly understood and has been poorly studied. Arguably it is a more important end point than recurrence. Conclusion: Only one study comparing the newer techniques of open hernia repair (PerFix Plug) constitutes Level II evidence. The PerFix Plug appears to be quicker to insert and uses a smaller incision. Chronic significant posthernioplasty pain is a more important endpoint in hernia research than is recurrence, and this review concludes with a proposal for a multicentre, randomized, controlled trial evaluating the incidence of chronic significant posthernioplasty pain following elective mesh repair of primary, unilateral hernias. [source] The role of the cellular prion protein in the immune systemCLINICAL & EXPERIMENTAL IMMUNOLOGY, Issue 1 2006J. D. Isaacs Summary Prion protein (PrP) plays a key role in the pathogenesis of prion diseases. However, the normal function of the protein remains unclear. The cellular isoform (PrPC) is expressed widely in the immune system, in haematopoietic stem cells and mature lymphoid and myeloid compartments in addition to cells of the central nervous system. It is up-regulated in T cell activation and may be expressed at higher levels by specialized classes of lymphocyte. Furthermore, antibody cross-linking of surface PrP modulates T cell activation and leads to rearrangements of lipid raft constituents and increased phosphorylation of signalling proteins. These findings appear to indicate an important but, as yet, ill-defined role in T cell function. Although PrP,/, mice have been reported to have only minor alterations in immune function, recent work has suggested that PrP is required for self-renewal of haematopoietic stem cells. Here, we consider the evidence for a distinctive role for PrPC in the immune system and what the effects of anti-prion therapeutics may be on immune function. [source] Bone reactions to controlled loading of endosseous implants: a pilot studyCLINICAL ORAL IMPLANTS RESEARCH, Issue 11 2008H. W. Anselm Wiskott Abstract Objectives: To validate an experimental setup designed to apply load onto bone tissue using osseointegrated implants in a rabbit model. Specifically, (1) to design an apparatus capable of generating controlled forces, (2) to assess implant placement, maintenance and loading and (3) to evaluate outcome variables using three radiological methods. Material and methods: New Zealand White rabbits were used. Two dental implants were inserted 15,18 mm apart in the animals' tibiae. After 3 months of healing, the implants were loaded normal to their long axes using a pneumatically activated device. A 15 min load regimen at 1 Hz was applied 5 days per week. Every week the applied load was increased by 5 N up to week 8 and by 10 N up to 100 N by week 14. Groups of animals (n=3) were sacrificed at load levels 25, 50 and 100 N. One unloaded controlateral implant in each group provided the baseline data. The rabbits were computer tomography (CT) scanned and radiographed using conventional frames every 4,5 weeks. After sacrifice, a volume of interest (VOI) located in the inter-implant zones and a VOI set as a ring surrounding the distal implant were analyzed using micro computer tomography (,CT). Results: A variety of osseous responses was observed, ranging from minor alterations to significant increases in porosity and lamelling of the cortical layer. ,CT data of the inter-implant VOI demonstrated an initial increase in total volume (upto 50 N) followed by stabilization. Concomitantly, bone volumetric density first decreased and then augmented until the end of the experiment. This phenomenon was not observed in the peri-implant VOI, for which volumetric density augmented from the beginning to the end of the experiment. Conclusions: 1. In future trials the loading devices must be constructed so as to sustain heavy cyclic loads over prolonged periods. 2. When properly handled, rabbits are cooperative animals in this application. In a third of the sites, signs of inflammation were observed. 3. In the inter-implant VOI, the cortical bone tended to react in two phases: first, as an increase in porosity and lamelling and second, as an augmentation of bone volumetric density. The peri-implant VOI adapted only by augmenting volumetric density. [source] | ||||||||||