Decreased hepatic expression of the low-density lipoprotein (LDL) receptor and LDL receptor-related protein in aging rats is associated with delayed clearance of chylomicrons from the circulation.

Aging in both humans and rats is associated with the development of insulin resistance and the ensuing alterations in the plasma lipoprotein profile. In this study, young (2 months) and old (15 months) Sprague-Dawley (SD) rats were used to investigate age-related alterations in the chylomicron clearance pathway. Clearance from the blood of an intravenously injected bolus of 14C-labeled cholesterol ester (CE) and 3H-labeled triacylglycerol (TAG) lymph chylomicrons was markedly delayed in the old rats (P < .05). Hepatic expression of the two principal receptors of chylomicron remnant removal, the low-density lipoprotein (LDL) receptor and LDL receptor-related protein (LRP), was determined by ligand blotting and immunoblotting. The old rats expressed 43%+/-7% of the level of LDL receptor in the young animals (P < .05) and 45%+/-16% of the corresponding level of LRP (P < .05). The results suggest that the delayed clearance of chylomicron remnants in this animal model of aging and insulin resistance is due, at least in part, to a decrease in the hepatic expression of LDL receptor and LRP.

Socialization into nursing: nursing students as learners.

In this article, we describe how the functionalist and interactionist approaches to socialization are exemplified in the learning experiences of nursing students in a 4-year baccalaureate program. A qualitative longitudinal exploratory research design was used to study the socialization of baccalaureate nursing students in a large western Canadian university. The findings suggest that student learning reflects a combination of functionalist and interactionist approaches, with the relative emphasis of each approach varying over the 4 years. In the first year, functionalist learning predominates as students learn the "ideal." In second and third year, students are confronting and adapting to reality, which requires a more interactionist approach. Fourth year students look beyond their practice situation as they anticipate and prepare for a reality beyond the student world. This article concludes with implications for nursing education.

Becoming a father. First-time fathers' experience of labor and delivery.

In this study, ethnographic interviews were used to identify first-time fathers' experiences of the birth of their first child. Fourteen fathers were interviewed, and prenatal expectations of the experience are compared with the fathers' perceptions after the birth. Although the fathers expected to be treated as part of a laboring couple, they found that they were relegated to a supporting role. Initially the fathers were confident of their ability to support their wives, but they found that labor was more work than they had anticipated. They became fearful of the outcome, but hid these fears from their partners. Later, they found that their focus moved from their wives to their babies at the time of birth. The men all completed the experience with an enhanced respect for their wives. Fathers should be included in labor management plans and need support for their role as coach, particularly when their wives experience pain. They also need to be encouraged to eat and take a break from their wives' labor when appropriate.

Students' evolving beliefs about nursing: from entry to graduation in a four-year baccalaureate programme.

Students become socialised into nursing during an educational programme through interaction with faculty members, classes and seminars, and by the experience of practicing nursing. In this paper, some results from a qualitative study that examined the socialisation of nursing students from one four-year baccalaureate programme are described. The changes in the students' attitudes and values are presented. Davis' (1975) theory of doctrinal conversion is used to examine progress in the process of socialisation. There is evidence that students moved from a lay to a professional image of nursing over the course of their four-year programme. While they tended to remain idealistic, elements of realism were evident in the final year as they looked toward their role as a registered nurse and recognised the constraints inherent in the hospital system.

Learning to nurse in the clinical setting.

The findings reported in this paper are part of a larger study examining student socialization into nursing. In analysing the data, it became evident that two major factors influenced the students' learning in the clinical setting: the first was the clinical instructor, the second peer support. Instructors who were organized, encouraging, outgoing, and who had good relationships with students, patients and nursing staff were seen as 'good' role models. When instructors were unable to establish rapport on a unit, negative feedback from nursing staff could be detrimental to student learning. Peer support encompassed three dimensions: facilitating learning, providing emotional support, and assisting with physical tasks. There was evidence that practising faculty had a stronger influence in shaping students' attitudes towards nursing than classroom teachers.

A comparison of symptoms used by mothers and nurses to identify an infant with colic.

In this survey research a comparison was made between symptoms used by mothers and nurses which led them to think the baby might be "colicky." Two questionnaires, one for mothers and one for nurses, were used to collect the data. The mothers most frequently selected passes gas rectally, clenches fists, draws-up legs, cries late afternoon and evening, holds body straight, and wants to be held. The nurses selected mother states baby is inconsolable, cries more than 4 hours in 24, draws up legs and wants to feed but won't. Parents believed the colic to be related to a variety of factors; these included baby's eating behaviour, maternal anxiety, baby's and mother's diets, and baby's stress. Ten parents reported pain and screaming as symptoms of colic.

Teaching and support: nursing input in the postpartum period.

The findings from two studies, surveys of hospitals and community health units in Alberta, Canada, to determine the policies, procedures and content related to postpartum teaching are presented in this paper. While content covered was extensive the limited time available for teaching suggested that material would have to be presented at a superficial level, with little time for reinforcement. The average time for a home visit by the nurse was 7-12 days post-discharge and in some instances staff shortages precluded a second visit. The most frequent reason for follow-up visits in the community was problems with newborn feeding. Volunteer services in the community, such as the La Lêche League, were frequently not recommended to mothers by hospital nurses, so breastfeeding mothers were left without support at a critical time. While the study did not support the mother's contention in an earlier study that they did not receive information, the lack of opportunity for expansion and reinforcement of provided information would mitigate against adequate maternal education.

Impressions of women's health in New Zealand.

In this paper the author presents a personal view of women's health in New Zealand. As in other countries the women are working toward a sane, humane and ecological model of health care but the male, hyper-expansionist model of health care is likely to continue to receive priority funding at least for some years to come.

Effectiveness and efficacy of antenatal care.

Antenatal care is recommended to pregnant women to improve the outcomes of childbirth. A common pattern of provision is seen in those parts of the industrialised world which have been influenced by British settlers. This paper presents the evolution of the current patterns of care, and the effectiveness and efficacy of the present system are discussed.

Implementing change in nursing education.

Nursing education faces a period of change within the next decade. Blueprints for educational change have been developed in the United Kingdom, Australia and Canada. Change in education needs to be planned rather than a reaction to internal or external pressures. Blueprints for education should extend beyond the entry to practice level and include specialisation, baccalaureate and graduate education. A plan for practice for the future should encompass both hospital and community based health care. Nursing practitioners as well as nurse educators need to be involved in educational planning. In light of the changing student body and societal needs, consideration must be given to the development of a variety of models for nursing education. Prior to instituting wholesale change, pilot projects need to be developed and tested. Plans for preparing adult educators competent in the use of modern technology, are a necessary adjunct to new programme development. Education also needs to be available to the practising nurse to enable professional growth. Professional associations must play a role in educating nurses, other professionals and consumers of nursing care on the changing roles and functions of the nurse, as movement is made toward the goal of 'Health For All By The Year 2000'.

Management behaviour of one community health nurse supervisor.

Mintzberg's theoretical framework of management, which examines the roles and functions of a manager in relation to effective communication, is used to analyse observational data of managerial conflict within a community health setting. In this setting the manager failed to establish sound interpersonal relations with her peers or with the clinic nurses. This led to a poor information base from which she could make decisions. The result was that the group became stressed and developed signs of disintegration.

Practices and policies in the initiation of breastfeeding.

Despite increasing knowledge about factors affecting the initiation of breastfeeding, many mothers still encounter problems and discontinue breastfeeding earlier than desired. Many hospitals still have not implemented the practices that are known to be helpful in the establishment of breastfeeding. As a result, a study was conducted to examine the policies and practices affecting breastfeeding in hospitals in Alberta, Canada. A questionnaire-based survey of all Alberta hospitals (including directors of nursing and staff nurses) found that many practices were still relatively inflexible; did not always reflect accurate, research-based information; and were not geared to the needs of mothers and infants. The implications of these findings are discussed.

The impact of nursing theory on the clinical decision making process.

The concepts of the nursing process and nursing diagnosis are related to models of nursing. The use of nursing diagnosis in relation to Orem, Neuman and Roy's models is presented. Benner's work, describing the development of the nurse from novice to expert, is used to demonstrate strategies that can be used to enhance the decision making process, and the role of the nursing process and models in decision making is explicated.