RESUMO
Our objectives were to evaluate the impact of supplementary trace mineral (TM) form-inorganic salts (STM; Co, Cu, Mn, Zn sulfates, and Na selenite) or organic (OTM; Co, Cu, Mn, Zn proteinates, and selenized yeast)-in the prepartum diet on quantity and quality of colostrum, passive immunity, antioxidant biomarkers, cytokine responses to lipopolysaccharide (LPS), health, and growth of newborn calves. Pregnant heifers (n = 100) and cows (n = 173) were enrolled at 45 d before calving, blocked by parity and body condition score, and allocated randomly to STM (50 heifers; 86 cows) or OTM (50 heifers; 87 cows) supplementation. Cows in both treatments were fed the same diet, except for the source of supplementary TM. Within 2 h of calving, dams and calves were separated, colostrum was harvested, the yield was measured, and a sample was saved for posterior analyses of colostrum quality. A subgroup of calves (n = 68) had a blood sample collected before colostrum feeding. After colostrum feeding, all samples and data collection were limited to 163 calves (STM = 82; OTM = 81) fed 3 L of good quality (Brix% >22) maternal colostrum via nipple bottle minutes after harvesting. Concentration of IgG in colostrum and serum was determined 24 h after colostrum feeding using radial immunodiffusion. Concentration of TM in colostrum and serum were performed by inductively coupled plasma mass spectrometry. Activity of glutathione peroxidase, ferric reducing ability of plasma, and concentration of superoxide dismutase were evaluated in plasma by colorimetric assays. Ex vivo whole blood stimulation with LPS was performed on d 7 of life to evaluate cytokine responses in a subgroup of 66 calves. Health events were recorded from birth to weaning, and body weight was recorded at birth (all calves) and on d 30 and 60 (heifers only). Continuous variables were analyzed by ANOVA and binary responses were analyzed by logistic regression. Complete replacement of STM by OTM in prepartum diet resulted in greater concentration of Se (461 vs. 543 ± 7 µg/g; ± SEM) but did not alter the concentration or total mass of other TM and IgG in colostrum. Female calves of the OTM group had greater concentration of Se in serum at birth (0.23 vs. 0.37 ± 0.05 µg/mL), were lighter in weight at birth (40.9 vs. 38.8 ± 0.6 kg) and weaning (93.2 vs. 89.7 ± 1.6 kg) than those of the STM group. Maternal treatments did not affect passive immunity or antioxidant biomarkers. On d 7, basal concentrations (log10 of concentration in pg/mL) of IFNγ (0.70 vs. 0.95 ± 0.083) and LPS-stimulated concentrations of CC chemokine ligand 2 (CCL2; 2.45 vs. 2.54 ± 0.026), CC chemokine ligand 3 (CCL3; 2.63 vs. 2.76 ± 0.038), IL-1α (2.32 vs. 2.49 ± 0.054), and IL-1ß (3.62 vs. 3.86 ± 0.067) were greater in OTM than in STM. Supplementation with OTM in pregnant heifers, but not in pregnant cows, reduced the incidence of preweaning health problems in their calves (36.4 vs. 11.5%). Complete replacement of STM by OTM in the prepartum diet did not cause major changes in colostrum quality, passive immunity, and antioxidant capacity, but increased cytokine and chemokine responses to LPS on d 7 of life and benefited preweaning health of calves born to primiparous cows.
Assuntos
Colostro , Oligoelementos , Gravidez , Animais , Bovinos , Feminino , Animais Recém-Nascidos , Oligoelementos/análise , Sais , Antioxidantes/análise , Ligantes , Lipopolissacarídeos/análise , Imunoglobulina G , Dieta/veterinária , Quimiocinas CC/análise , Ração Animal/análise , Suplementos Nutricionais/análiseRESUMO
Cardiac reserve is a widely used health indicator and prognostic tool. Although it is well established how to assess cardiac reserve clinically, in preclinical models, it is more challenging lacking standardization. Furthermore, although cardiac reserve incorporates both systolic (i.e., contractile reserve) and diastolic (i.e., relaxation reserve) components of the cardiac cycle, less focus has been placed on diastolic reserve. The aim of our study was to determine which technique (i.e., echocardiography, invasive hemodynamic, and Langendorff) and corresponding parameters can be used to assess the systolic and diastolic reserves in preclinical models. Healthy adult male and female CD-1 mice were administered dobutamine and evaluated by echocardiography and invasive hemodynamic, or Langendorff to establish systolic and diastolic reserves. Here, we show that systolic reserve can be assessed using all techniques in vivo and in vitro. Yet, the current indices available are ineffective at capturing diastolic reserve of healthy mice in vivo. When assessing systolic reserve, sex affects the dose response of several commonly used echocardiography parameters [i.e., fractional shortening (FS), ejection fraction (EF)]. Taken together, this study improves our understanding of how sex impacts the interpretation assessment of cardiac reserve and establishes for the first time that in healthy adult mice, the diastolic reserve cannot be assessed by currently established methods in vivo.NEW & NOTEWORTHY Cardiac reserve is a globally used health indicator and prognostic tool that is used by clinicians and preclinical scientists. In physiology, we have a long-standing appreciation of how to assess systolic reserve but lack insight into sex differences and have no frame of reference for measuring diastolic reserve to certainty across cardiac techniques or the influence of sex. Here, we show that the primary means for assessing diastolic reserve is incorrect. Furthermore, we provided proof and clarity on how to correctly measure systolic and diastolic reserve capacities. We also highlight the imperative of sex differences to the measures of both systolic and diastolic reserves using several techniques (i.e., echocardiography, invasive hemodynamics, and Langendorff) in mice.
Assuntos
Ecocardiografia , Coração , Masculino , Feminino , Animais , Camundongos , Diástole/fisiologia , Sístole , Ecocardiografia/métodos , Hemodinâmica , Volume SistólicoRESUMO
Our objectives were to evaluate the effect of the form of supplementary trace minerals-inorganic salts (STM: Co, Cu, Mn, and Zn sulfates and Na selenite) or organic (OTM: Co, Cu, Mn, Zn proteinates, and selenized yeast)-fed at 100% of recommended levels in both pre- and postpartum diets on in vitro phagocytic activity of neutrophils, and in vivo IgG responses to an ovalbumin challenge during the transition period. In addition, we investigated the associations of these immunological responses with incidence of postpartum clinical diseases and the dynamic changes of metabolic markers during the transition period. Pregnant heifers and cows (n = 273) were enrolled at 45 ± 3 d before expected calving, blocked by parity and body condition score, and allocated randomly to STM or OTM supplementation. Cows in both treatments were fed the same diet, except for the form of supplementary trace minerals. Automatic feeding gates were used to assign treatments to individual cows. Blood was collected on d -7 ± 3 and 7 ± 3 relative to calving in a subgroup of cows (n = 131 and 133, respectively) to measure phagocytic activity of neutrophils in vitro using flow cytometry. Subcutaneous immunization with 0.5 mg of chicken egg ovalbumin was performed in a subgroup of cows (n = 181) on d -45, -21, and 3 relative to calving. Concentration of anti-ovalbumin IgG in serum was measured by ELISA on d -45, -21, 3, 7, and 21. Trace mineral concentrations in blood were measured by inductively coupled plasma mass spectrometry on d -45, -21, -7, 0, 7, and 21 relative to calving. Selected metabolites were measured on d -21, -10, -3, 0, 3, 7, 10, 14, and 21 relative to calving. Treatment did not affect the percentage of neutrophils performing phagocytosis on d -7 or 7 but the median fluorescence intensity of phagocytosis on d 7 was greater for OTM than STM. We found no differences between treatments in the level of anti-ovalbumin IgG in serum on any of the sampling days. Changes in neutrophil function from prepartum to postpartum were associated with incidence of postpartum clinical disease, postpartum feed intake and milk production, concentrations of Ca, K, Se, Mn, Co, and total protein in serum. Immunoglobulin G responses to ovalbumin injections were not associated with incidence of postpartum clinical disease but were associated with body weight, feed intake, energy balance, and concentrations of nonesterified fatty acids, aspartate aminotransferase, gamma-glutamyl transpeptidase, albumin, Na, P, and Cu in serum. In conclusion, replacement of STM by OTM improved one measure of phagocytic capacity of neutrophils in vitro, which was also greater in cows that did not develop postpartum clinical disease. The associations of innate and acquired immune responses with feed intake, energy balance, and circulating concentrations of key macro and micronutrients reinforce the importance of nutritional management for the health of dairy cows during the transition period.
Assuntos
Oligoelementos , Gravidez , Bovinos , Animais , Feminino , Oligoelementos/metabolismo , Lactação/fisiologia , Neutrófilos/metabolismo , Leite/química , Formação de Anticorpos , Período Pós-Parto , Imunoglobulina G/análiseRESUMO
Our objectives were to evaluate the effects of complete replacement of supplementary inorganic salts of trace minerals (STM) by organic trace minerals (OTM) in both pre- and postpartum diets on feeding behavior, ruminal fermentation, rumination activity, energy metabolism, and lactation performance in dairy cows. Pregnant cows and heifers (n = 273) were blocked by parity and body condition score and randomly assigned to either STM or OTM diets at 45 ± 3 d before their expected calving date. Both groups received the same diet, except for the source of trace minerals (TM). The STM group was supplemented with Co, Cu, Mn, and Zn sulfates and Na selenite, whereas the OTM group was supplemented with Co, Cu, Mn, and Zn proteinates and selenized yeast. Treatments continued until 156 days in milk and pre- and postpartum diets were formulated to meet 100% of recommended levels of each TM in both treatments, taking into consideration both basal and supplemental levels. Automatic feed bins were used to assign treatments to individual cows and to measure feed intake and feeding behavior. Rumination activity was monitored by sensors attached to a collar from wk -3 to 3 relative to calving. Blood metabolites were evaluated on d -21, -10, -3, 0, 3, 7, 10, 14, 23, and 65 relative to calving. Ruminal fluid samples were collected using an ororuminal sampling device on d -21, 23, and 65 relative to calving, for measurement of ruminal pH and concentration of volatile fatty acids. Cows were milked twice a day and milk components were measured monthly. Cows supplemented with OTM tended to have longer daily feeding time (188 vs. 197 min/d), and greater dry matter intake (DMI; 12.9 vs. 13.3 kg), and had a more positive energy balance (3.6 vs. 4.2 Mcal/d) and shorter rumination time per kg of dry matter (DM; 40.1 vs. 37.5 min/kg of DM) than cows supplemented with STM during the prepartum period. In the postpartum period, OTM increased DMI in multiparous cows (24.1 vs. 24.7 kg/d) but not in primiparous cows (19.1 vs. 18.7 kg/d). The difference in DMI of multiparous cows was more evident in the first 5 wk of lactation, when it averaged 1 kg/d. Milk yield was not affected by treatment in multiparous cows (44.1 vs. 44.2 kg/d); however, primiparous cows supplemented with OTM had lesser yields than primiparous cows supplemented with STM (31.9 vs. 29.8 kg/d). Cows supplemented with OTM had a greater percentage of protein in milk (3.11 vs. 3.17%), reduced concentration of nonesterified fatty acids in serum (0.45 vs. 0.40 mmol/L), and rumination activity (30.1 vs. 27.8 min/kg of DM) than cows supplemented with STM. At the end of the transition period, cows supplemented with OTM had reduced molar proportion of acetate, reduced pH, and tended to have a greater concentration of total volatile fatty acids in ruminal fluid. In conclusion, complete replacement of STM by OTM caused modest changes in rumen fermentation, feeding behavior, energy metabolism, and performance of dairy cows, improving postpartum DMI in multiparous cows and reducing circulating levels of nonesterified fatty acids. The pre-absorptive effects of TM source and the parity specific responses on performance warrant further research.
Assuntos
Oligoelementos , Animais , Bovinos , Dieta/veterinária , Ácidos Graxos não Esterificados/metabolismo , Ácidos Graxos Voláteis/metabolismo , Comportamento Alimentar , Feminino , Fermentação , Lactação/fisiologia , Leite/metabolismo , Período Pós-Parto , Gravidez , Rúmen/metabolismo , Sais/metabolismo , Oligoelementos/metabolismoRESUMO
AIM: We address issues and challenges in nursing in Sri Lanka with the aim of identifying where and how policy changes need to be made. BACKGROUND: Increased global interconnectivity calls for professional leadership, research, education, and policy reform in nursing as these are identified as enhancing health workforce performance and professionalization, thereby improving health systems. SOURCES OF EVIDENCE: We draw on first-hand knowledge of health care and nursing in Sri Lanka and a recent survey of nurses at a large urban government hospital in Sri Lanka, followed by discussion and proposed action on themes identified through analysis of published and unpublished literature about the nursing profession. DISCUSSION: Policy and action are needed to: (a) establish mandatory nurse licensure in the public and private healthcare sectors; (b) implement realistic policies to further develop nursing education; (c) develop a professionalization process to support nursing autonomy and voice; and (d) promote systematic processes for educational accreditation, curriculum revision, continuing professional development, evidence-based practice, research, leadership, and information systems. CONCLUSION: There is a policy vacuum that requires careful analysis and strategic planning by formal nurse leaders. IMPLICATIONS FOR NURSING AND HEALTH POLICY: Implementing change will require political and professional power and strategic, innovative, and evolutionary policy initiatives as well as organizational infrastructure modifications best achieved through committed multidisciplinary collaboration, augmented research capacity, bolstered nursing leadership, and promotion of partnerships with policy makers.
Assuntos
Educação em Enfermagem/organização & administração , Política de Saúde , Programas Nacionais de Saúde/organização & administração , Cuidados de Enfermagem/organização & administração , Competência Profissional/normas , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Humanos , Sri LankaRESUMO
Proteus mirabilis forms extensive crystalline biofilms on urethral catheters that occlude urine flow and frequently complicate the management of long-term-catheterized patients. Here, using random transposon mutagenesis in conjunction with in vitro models of the catheterized urinary tract, we elucidate the mechanisms underpinning the formation of crystalline biofilms by P. mirabilis. Mutants identified as defective in blockage of urethral catheters had disruptions in genes involved in nitrogen metabolism and efflux systems but were unaffected in general growth, survival in bladder model systems, or the ability to elevate urinary pH. Imaging of biofilms directly on catheter surfaces, along with quantification of levels of encrustation and biomass, confirmed that the mutants were attenuated specifically in the ability to form crystalline biofilms compared with that of the wild type. However, the biofilm-deficient phenotype of these mutants was not due to deficiencies in attachment to catheter biomaterials, and defects in later stages of biofilm development were indicated. For one blocking-deficient mutant, the disrupted gene (encoding a putative multidrug efflux pump) was also found to be associated with susceptibility to fosfomycin, and loss of this system or general inhibition of efflux pumps increased sensitivity to this antibiotic. Furthermore, homologues of this system were found to be widely distributed among other common pathogens of the catheterized urinary tract. Overall, our findings provide fundamental new insight into crystalline biofilm formation by P. mirabilis, including the link between biofilm formation and antibiotic resistance in this organism, and indicate a potential role for efflux pump inhibitors in the treatment or prevention of P. mirabilis crystalline biofilms.
Assuntos
Biofilmes/crescimento & desenvolvimento , Cateteres de Demora/microbiologia , Proteus mirabilis/fisiologia , Análise de Variância , Antibacterianos/farmacologia , Cálcio/análise , Movimento Celular , Elementos de DNA Transponíveis/fisiologia , Perfilação da Expressão Gênica , Humanos , Testes de Sensibilidade Microbiana , Microscopia Eletroquímica de Varredura , Microscopia Eletrônica de Varredura , Dados de Sequência Molecular , Mutagênese , Proteus mirabilis/efeitos dos fármacos , Proteus mirabilis/genética , Análise de Sequência de DNA , Urease/metabolismo , Cateterismo Urinário/instrumentaçãoRESUMO
BACKGROUND: Internationalization, an integral part of strategic planning initiatives in universities around the world, is occurring within the context of globalization. As we move toward greater internationalization in nursing education, we must understand the ideologies that currently underpin globalization and their fit with the vision and mission of nursing. AIM: To outline the current debates surrounding internationalization and globalization and their potential consequences for universities. METHODS: The historical and current interest in internationalization and globalization are reviewed briefly in order to set the context for this discussion. CONCLUSIONS: What emerges from an analysis of current internationalization directions is the complexity of the relationship between internationalization and the conflicting ideologies underpinning globalization. Nursing can play a key role within universities to ensure that varying viewpoints are debated and the implications of varying internationalization decisions are understood.
Assuntos
Bacharelado em Enfermagem/organização & administração , Cooperação Internacional , Diversidade Cultural , Currículo , Humanos , Modelos Educacionais , Avaliação das Necessidades/organização & administração , Papel do Profissional de Enfermagem , Objetivos Organizacionais , Política , Desenvolvimento de Programas , Mudança Social , Universidades/organização & administraçãoRESUMO
Maternal hypothyroidism impairs fetal growth in the rat, but the mechanisms by which this occurs are unknown. Since the fetus derives its glucose supply from the mother, and maternal thyroidectomy may disturb maternal and placental glucose metabolism, we postulated that maternal and/or placental glucose metabolic compromise may contribute to fetal growth retardation in hypothyroid dams. Feto-placental growth, tissue glycogen stores and glucose levels in sera and amniotic fluid were determined in rat dams partially thyroidectomized (TX) before pregnancy and in euthyroid controls. Fetal body weight at 16, 19 and 21 days gestation (d.g.) was related to pre-mating maternal serum total thyroxine (TT(4)) levels; permanent fetal growth retardation occurred in severely (TX(s); pre-mating maternal serum TT(4)Assuntos
Retardo do Crescimento Fetal/metabolismo
, Glicogênio/metabolismo
, Hipotireoidismo/metabolismo
, Fígado/metabolismo
, Placenta/metabolismo
, Complicações na Gravidez/metabolismo
, Líquido Amniótico/química
, Análise de Variância
, Animais
, Glicemia/análise
, Feminino
, Sangue Fetal/química
, Idade Gestacional
, Glucose/análise
, Gravidez
, Ratos
, Ratos Sprague-Dawley
, Análise de Regressão
, Tiroxina/sangue
RESUMO
The influence of maternal hypothyroxinemia on the expression of the glucose transporters, GLUT1 and GLUT3, in rat fetal brain and placenta was investigated. Fetal growth was retarded in hypothyroxinemic pregnancies, but only before the onset of fetal thyroid hormone synthesis. Placental weights were normal, but placental total protein concentration was reduced at 19 days gestation (dg). Immunoblotting revealed a decreased abundance of GLUT1 in placental microsomes at 16 dg, whereas GLUT3 was increased. Fetal serum glucose levels were reduced at 16 dg. In fetal brain, the concentration of microsomal protein was deficient at 16 dg and the abundance of parenchymal forms of GLUT1 was further depressed, whereas GLUT3 was unaffected. Northern hybridization analysis demonstrated normal GLUT1 mRNA levels in placenta and fetal brain. In conclusion, maternal hypothyroxinemia results in fetal growth retardation and impaired brain development before the onset of fetal thyroid function. Glucose uptake in fetal brain parenchyma may be compromised directly, due to deficient GLUT1 expression in this tissue, and indirectly, as a result of reduced placental GLUT1 expression. Though corrected by the onset of fetal thyroid hormone synthesis, these deficits are present during the critical period of neuroblast proliferation and may contribute to long term changes in brain development and function seen in this model and in the progeny of hypothyroxinemic women.
Assuntos
Encéfalo/metabolismo , Retardo do Crescimento Fetal/etiologia , Hipotireoidismo/metabolismo , Proteínas de Transporte de Monossacarídeos/metabolismo , Proteínas do Tecido Nervoso , Placenta/metabolismo , Animais , Encéfalo/embriologia , Feminino , Retardo do Crescimento Fetal/sangue , Retardo do Crescimento Fetal/metabolismo , Expressão Gênica , Transportador de Glucose Tipo 1 , Transportador de Glucose Tipo 2 , Transportador de Glucose Tipo 3 , Hipotireoidismo/sangue , Proteínas de Transporte de Monossacarídeos/análise , Proteínas de Transporte de Monossacarídeos/genética , Placenta/química , Gravidez , RNA Mensageiro/análise , Ratos , Ratos Sprague-Dawley , Tiroxina/sangue , Tri-Iodotironina/sangueRESUMO
Part of an investigation of data collection methods in epidemiologic studies of farmers evaluated exposures received by farmers from the application of insecticides to animals. Twenty farmers were monitored during a normal application using a fluorescent dye surrogate for the active ingredient (AI). Two exposure measures were estimated, AI concentration and the time-weighted average for the application period (TWAa). Four application methods were used: high- (n = 5) and low-pressure (n = 3) spraying, backpack (n = 2) and pour-on (n = 10). The two farmers using a backpack sprayer had nondetectable levels of dye. Only two of the farmers using the pour-on method had detectable dye levels, but these levels were high. All of the low- and high-pressure sprayers had detectable amounts of dye. Multiple layers of clothing, gloves, and boots (n = 10) were associated with a low mean AI concentration for the exposed farmers (18 micrograms) and more than two-thirds of the farmers wearing this amount of clothing had nondetectable exposures. In contrast, clothing providing little or no protection was associated with a significantly higher (p < 0.01) average AI concentration (4420 micrograms), and less than a third of the farmers with this degree of protection had nondetectable exposures. Poor work practices (leaking equipment, contact with wet animals or fences, and back splash) were associated with statistically higher exposure levels (p < 0.01) than the absence of such practices. There was a moderate statistically significant association between AI concentration and TWAa with total volume of the AI/dye/water mixture using the Spearman coefficient. Time was significantly inversely proportional to the two exposure measures. The association between the two exposure measures and AI volume was not significant.
Assuntos
Criação de Animais Domésticos , Monitoramento Ambiental , Inseticidas/análise , Exposição Ocupacional/análise , Criação de Animais Domésticos/instrumentação , Criação de Animais Domésticos/métodos , Vestuário , Monitoramento Ambiental/métodos , Corantes Fluorescentes , Humanos , Iowa , Exposição Ocupacional/prevenção & controle , Fatores de Risco , Estatísticas não Paramétricas , Gravação de VideoteipeRESUMO
OBJECTIVES: The goal of this study was to measure dermal and inhalation exposures to phosmet during application to animals and to identify what determinants of exposure influence the exposure levels. METHODS: Ten farmers were monitored using dermal patches, gloves, and air sampling media during normal activities of applying phosmet to pigs for insect control. Exposures were measured on the clothing (outer), under the clothing (inner), on the hands, and in the air. Possible exposure determinants were identified, and a questionnaire on work practices was administered. RESULTS: The geometric mean of the outer exposure measurements was 79 microg/h, whereas the geometric mean of the inner exposure measurements was 6 microg/h. The geometric mean for hand exposure was 534 microg/h, and the mean air concentration was 0.2 microg/m3. Glove use was associated with the hand and total dermal exposure levels, but no other determinant was associated with any of the exposure measures. The average penetration through the clothing was 54%, which dropped to 8% when the farmers wearing short sleeves were excluded. The farmers reported an average of 40 hours a year performing insecticide-related tasks. CONCLUSIONS: Farmers who applied phosmet to animals had measurable exposures, but the levels were lower than what has been seen in other pesticide applications. Inhalation exposures were insignificant when compared with dermal exposures, which came primarily from the hands. Clothing, particularly gloves, provided substantial protection from exposures. No other exposure determinant was identified.
Assuntos
Criação de Animais Domésticos , Inseticidas/análise , Exposição Ocupacional/análise , Fosmet/análise , Animais , Luvas Protetoras , Humanos , Exposição por Inalação , Iowa , Exposição Ocupacional/prevenção & controle , Roupa de Proteção , Análise de Regressão , Absorção Cutânea , SuínosAssuntos
Enfermagem em Saúde Comunitária/organização & administração , Cultura , Emigração e Imigração , Enfermagem Transcultural/organização & administração , Alberta , China/etnologia , Hong Kong/etnologia , Humanos , Índia/etnologia , Avaliação de Programas e Projetos de Saúde , Medicina Estatal/organização & administraçãoRESUMO
A strong partnership between clinical practice and nursing education is essential to innovative home health care services. Nevertheless, these two components have not always worked in close association for mutual benefit--bringing the two together has been a continuing challenge. Recently, such an alliance was achieved in Edmonton, Alberta, brought on by necessity and triggered by rapid and substantial changes in both home health care and nursing educational environments.
Assuntos
Enfermagem em Saúde Comunitária/educação , Enfermagem em Saúde Comunitária/organização & administração , Bacharelado em Enfermagem/organização & administração , Serviços de Assistência Domiciliar/organização & administração , Relações Interinstitucionais , Garantia da Qualidade dos Cuidados de Saúde/organização & administração , Alberta , HumanosRESUMO
Research in Nepal, conducted in 1991-1992, yielded interesting information on issues confronting nurse educators in that country. What this author found particularly interesting is that, while the specific problems were different, the underlying nursing education issues were remarkably similar to those encountered by nurse educators in her home country of Canada. Data from questionnaires, interviews, and government and other documents have been synthesized in this discussion of issues in nursing education in Nepal. Categories for discussion include students, faculty, curriculum and institutional constraints.
Assuntos
Educação em Enfermagem/organização & administração , Docentes de Enfermagem/organização & administração , Currículo , Humanos , Avaliação das Necessidades , Nepal , Pesquisa em Educação em Enfermagem , Estudantes de Enfermagem/psicologia , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
As health reforms gain momentum in Canada, a critical need has been identified for the development of standardized health information across the continuum of health services. Although vast amounts of data are collected, deficiencies and gaps in current information systems seriously limit its effective use. As provinces and territories move toward more integrated health services systems, the necessity for a comprehensive and systematic analysis of health information requirements, and the development of requisite standards has never been greater. To begin addressing this need, the Canadian Institute for Health Information (CIHI) established a number of interrelated projects in 1995. This paper describes the goals of these projects, as well as the approach used to assess information needs across health services and to develop required standards.
Assuntos
Necessidades e Demandas de Serviços de Saúde , Serviços de Informação/normas , Canadá , Serviços de Saúde/classificação , Humanos , Gestão da Informação , Informática Médica/normas , Avaliação das NecessidadesRESUMO
A proportionate mortality study of a cohort of golf course superintendents was conducted using death certificates for 686 deceased members of the Golf Course Superintendents Association of America who died from 1970 to 1992. White males were included in the study population from all 50 states. The study objective was to compare mortality from this cohort to the general U.S. white male population. The proportionate mortality ratio (PMR) for all types of cancer was 136 (CI: 121, 152). Significant excess mortality from smoking-related diseases was observed. The PMR for arteriosclerotic heart disease was 140, which was significantly elevated (CI: 127, 155). In addition, the PMR for all respiratory diseases was 176 (CI: 135,230), while the PMR for emphysema was 186 (CI: 101,342). The PMR for lung cancer was 117 (CI: 93, 148). Mortality for four cancer types--brain, lymphoma (non-Hodgkin's lymphoma, NHL), prostate, and large intestine--occurred at elevated levels within this cohort: brain cancer PMR = 234 (CI: 121,454), non-Hodgkin's lymphoma (NHL) PMR = 237 (CI: 137,410), prostate cancer PMR = 293 (CI: 187,460), and large intestine cancer PMR = 175 (CI: 125,245). The PMR for diseases of the nervous system was 202 (CI: 123,333). A similar pattern of elevated NHL, brain, and prostate cancer mortality along with excess deaths from diseases of the nervous system has been noted among other occupational cohorts exposed to pesticides.
Assuntos
Golfe , Doenças Profissionais/mortalidade , Agricultura , Arteriosclerose/mortalidade , Causas de Morte , Humanos , Masculino , Neoplasias/mortalidade , Exposição Ocupacional , Praguicidas , Análise de Sobrevida , Estados Unidos/epidemiologiaRESUMO
In 1991 and '92 I developed and implemented a research project that was a case study of nurses and primary health care in Nepal. Data were gathered from a variety of sources, but what I found particularly interesting were the interviews with nurses and my observations of them at work.
PIP: Literature on nursing has reported nursing issues to be universal despite widely varying contexts across nations. The author in 1991 and 1992 developed and implemented a research project which was a case study of nurses and primary health care in Nepal. Although data were gathered from a variety of sources, the interviews with 43 nurses and observations of them at work were the most interesting aspect of the study. The author was quite surprised to identify so strongly with some of the Nepalese nurses' themes. Nurses in Canada are also concerned with shifting roles, standards, employment options and terms of employment, living conditions, status, and a lack of solidarity among nurses. Role definition, standards, status, working conditions, living conditions, and employment policies are discussed.