Exercise: a unitary concept.

Nursing science provides the opportunity to frame one's vision of humans and health and create interventions that facilitate wellness. This article contributes to nursing science by reconceptualizing exercise as a unitary concept using Parse's process of concept inventing. Concept inventing is a way to uncover the uniqueness of particular concepts and articulate their essence within the simultaneity paradigm. It differs from traditional, linear processes that are derived from the totality paradigm. Through the process of concept inventing, exercise is described within Rogers's science of unitary human beings and conceptualized as the purposeful, rhythmic flow of human movement.

Changes in hope and power in lung cancer patients who exercise.

Using Rogers' science of unitary human beings, changes in hope and power among 104 lung cancer patients were examined in relation to participation in a preoperative exercise program. Participants were randomly assigned to exercise or no-exercise and a repeated measures ANOVA was employed. The exercise group's power increased while the no-exercise group's power decreased. No differences in hope emerged. Positive correlations between hope and power were observed. Findings suggest that exercise is a form of knowing participation in change and illustrate a relation between one's ability to envision a better future and one's potential to actualize options through choice.

Lymphomatoid contact dermatitis due to ethylenediamine dihydrochloride.

A case of contact sensitivity to ethylenediamine dihydrochloride is reported. The clinical and histological features were in keeping with early mycosis fungoides. The eruption cleared with avoidance of the allergen. Continued contact with the allergen was traced to its retention in a trouser pocket lining. The term "lymphomatoid contact dermatitis" should be confined to cases where the lymphomatoid features are due to a positively reacting allergen.

Nickel penetration through rubber gloves.

Positive patch tests confirm nickel penetration through rubber gloves. Dimethylglyoxime (DMG) results indicate that nickel reactivity may occur where DMG testing is negative.

A follow-up study of occupational skin disease in Western Australia.

From a total of 993 previously reported cases of occupational skin disease (OSD), 954 (96%) were contacted and 711 (75%) examined. The review time (i.e., period from original diagnosis of OSD until review) varied from a minimum of 6 months to a maximum of over 8 years. Over 60% of cases were reviewed more than 2 years after the original diagnosis was made. More than 50% were still suffering from OSD or consequences related thereto. Clearance was less likely in those who remained in their original, or similar, occupational environment. However, of those who changed their job due to OSD, many suffered aggravation of the dermatitis from factors in the new work environment. Over 10% of cases had evolved into a persistent postoccupational dermatitis without obvious cause. This condition is responsible for considerable impairment and is of medicolegal importance due to confusion as to its relationship to the original occupational factors.

Occupational skin disease in Western Australia.

993 cases of occupational skin disease (OSD) were diagnosed in a private dermatology practice over an 8-year period. Dermatologists were the major source of referral. The sex ratio was 2.4 males to 1 female. Patch tests were conducted in 79% of cases. Wet work industries predominated in females; in males the causative industries were more varied. Apprentices were affected in a high proportion of hairdressers and food handlers. Atopics accounted for 75% of the apprentice hairdressers. Atopics also were more prevalent in females with OSD than males. 29% of all cases had suffered from OSD for over 2 years before diagnosis. 75% of patients with OSD were less than 40 years of age at onset of OSD. Irritant contact dermatitis predominated over allergic contact dermatitis in all age groups except those over 60 years of age. Nickel was the predominant occupational allergen in females, whereas chromate was the predominant occupational allergen in males. 46% had been in the causative occupation for over 2 years before developing irritant contact dermatitis. Some new occupational allergens have emerged in recent years. OSD in Western Australia does not appear to differ in any major way from that reported from other countries.

Occupational nickel dermatitis in the electroforming industry.

An outbreak of occupational dermatitis in an electroforming plant where there was heavy exposure to nickel is described. Patch test investigations confirmed nickel allergy in 13 of 27 exposed individuals. Nickel chloride was found to be a more reliable patch test allergen than nickel sulphate. Improvements in industrial hygiene led to an immediate decrease in the incidence of dermatitis. Persistent patch test sensitivity to nickel was found in three individuals who had been removed from the process chemicals for some years.

Long term effect on epidermal dendritic cells of four different types of exogenous inflammation.

In the present study we produced allergic, irritant, ultraviolet and liquid nitrogen inflammation in human volunteers. Biopsies were taken from each test site and adjacent normal skin as control 4-5 weeks later. The monoclonal antibodies OKT 6 and HLA-DR were used for light microscopic detection of Langerhans' cells (LC). At all 4 post-inflammatory test sites the number of epidermal LC (OKT 6 positive as well as HLA-DR positive) were significantly increased compared to normal skin. Also, the density of dermal dendritic cells was increased in post-inflammatory test sites. The increased number of epidermal LC seems to be a result of inflammation and not a specific event strongly related to certain cutaneous inflammatory disorders. The present investigation supports the theory that epidermal LC play a role in skin homeostasis.

Open, closed and intradermal testing in nickel allergy.

Open, closed and intradermal testing with NiCl2 was performed in 15 subjects with patch-test-proven allergy to 5% NiSO4 in pet. Intradermal testing proved to be a reliable method in confirming nickel sensitivity within 24 h. Open testing with non-toxic concentrations of NiCl2 in alcohol resulted in 73% and 93% positive reactions at 24 h and 48 h readings, respectively. This test method can be used as a reliable screening method in nickel allergy. Open testing often resulted in positive reactions within a few hours. This makes it possible to investigate pathogenetic events of acquired allergic contact dermatitis at a much earlier stage than with the usual 48-h occlusion. 24-h occlusion with Finn Chambers is not sufficient if one is to avoid false negative reactions in nickel allergy. Occlusion with Finn Chambers seems to delay the reaction.

Attitudes towards and knowledge of occupational skin disease amongst support personnel.

Liaison with support personnel is important in the management of workers with occupational skin disease (OSD). This study shows that there are many areas of concern regarding the knowledge and understanding of OSD in these groups. There needs to be a comprehensive education programme concerning OSD within the working community and support personnel. Dermatologists need to simplify their "language' in the reporting of OSD. Insurers need to take a more sympathetic attitude towards the partially fit worker. Rehabilitation personnel must become more familiar with OSD.

Virus warts in meat handlers.

An epidemiological study has been made of virus warts on the hands of all workers in a large meat processing factory. The meat handled is pork and beef. A total of 1141 employees were examined, 687 of whom were constantly handling meat. The plant outline and the work of the 144 workers in the butchery section are described in detail. The prevalence of warts in meat handlers was 33.6-70.4% in different sections. The prevalence in non-meat handlers varied from 18.2% to 44.4%. Half of the employees with warts were unaware of them, particularly in regard to plane warts.

Does sodium cromoglycate have an effect on contact dermatitis?

Sodium cromoglycate was applied to the forearm of 9 subjects with known delayed hypersensitivity, and to the back of 14 dinitrochlorobenzene-sensitized guinea pigs before challenge with the allergen and sodium lauryl sulphate. Sodium cromoglycate did not decrease the intensity of allergic of toxic-irritant reactions in either humans or guinea pigs.

Prognosis of occupational chromate dermatitis.

To elucidate further the natural history and prognosis of occupational chromate dermatitis, 120 affected patients, diagnosed between 1980 and 1989, were reviewed. The incidence of chromate dermatitis in Western Australia appeared to remain unchanged over the decade. 65% of patients were construction workers with cement-induced chromate dermatitis. Workers at greatest risk of sensitization were those mixing bagged cement at the work site. The median age at onset of symptoms was 34 years, with 48% having been exposed to chromate for 5 years or less. Only 37% presented to the dermatologist within 12 months of developing symptoms. 76% of patients had ongoing dermatitis at the time of review. Although 48% of the study population had completely changed their occupation to avoid chromate exposure, symptoms persisted in 69%. A delayed diagnosis of chromate sensitivity was noted to be a predictor of chronicity. In view of the potential chronicity of chromate dermatitis and its associated social and occupational impairment, we recommend the addition of ferrous sulphate while mixing bagged cement at the work site. This simple technique targets the workers at greatest risk of becoming sensitized.

UVB serum factor: suppression of allergic contact dermatitis in guinea pigs.

Serum from guinea pigs exposed to a single high dose of UVB and from controls was injected into the spleen of normal animals 5 days prior to sensitization. When 1.0 ml was transferred 4.5 h after irradiation, immunosuppression was obtained. Transfer of 1.5 ml of serum 2.5 h after irradiation failed to induce immunosuppression. This experimental model in guinea pigs might be valuable in further studies investigating the effect of other modalities of ultraviolet exposure (e.g., PUVA or high-dose UVA) on the release of soluble serum factor(s) inducing immunosuppression in allergic contact dermatitis.