Pain and nutrition as experienced by patients with hip fracture.

The purpose of this study was to investigate patients' experiences of care in connection with hip fracture. The care process was examined through non-participant observation, informal field interviews and healthcare records. The findings showed that many factors in the healthcare services directly or indirectly influence patients' perceptions of the quality of care. Some of these factors may depend upon a varying knowledge and empathy, while others are due to a lack of agreed protocols/procedures. Patients' needs with respect to pain relief and nutrition are discussed.

A tentative model for developing strategic and clinical nursing quality indicators: postoperative pain management.

The purpose of the study was to evaluate the usefulness of a tentative model, based on important aspects of surgical nursing care, for designing strategic and clinical quality indicators. Objective postoperative pain management was chosen for the model because it is a priority area in surgical nursing care. Items within a questionnaire were designed by using the tentative model as a base and by means of a literature review. The questionnaire, directed to clinical nurses (n = 233), was compiled to establish the validity and the usefulness of the indicators. Fourteen items were assessed as essential for achieving high quality outcomes in postoperative pain management (11 as realistic to carry out, and 13 as possible for nurses to influence) with mean scores > or = 4 (on a 5-point scale). The conclusion reached was that the tentative model combined with a literature search was found to be effective for designing items that might be useful as strategic and clinical indicators of quality in postoperative pain management.

Important aspects of nursing care in surgical wards as expressed by nurses.

The aim of this study was to find out clinical nurses' perceptions of important aspects of nursing care that might have an impact on quality of care in surgical wards. A qualitative approach using focus group interviews was used. The data analysis revealed 15 categories of important aspects of care which could be condensed into two dimensions, here called 'prerequisites' (i.e., staffing, routines and attitudes) and 'elements of performance' (i.e., detecting and acting on signs and symptoms and acting on behalf of the patients). These aspects could be a starting point for developing quality indicators. Carper's four fundamental patterns of knowing were used to make a theoretical interpretation, and three of them were identified.

Transformation of wheat with high molecular weight subunit genes results in improved functional properties.

The high molecular weight (HMW) subunits of wheat glutenin are major determinants of the elastic properties of gluten that allow the use of wheat doughs to make bread, pasta, and a range of other foods. There are both quantitative and qualitative effects of HMW subunits on the quality of the grain, the former being related to differences in the number of expressed HMW subunit genes. We have transformed bread wheat in order to increase the proportions of the HMW subunits and improve the functional properties of the flour. A range of transgene expression levels was obtained with some of the novel subunits present at considerably higher levels than the endogenous subunits. Analysis of T2 seeds expressing transgenes for one or two additional HMW subunits showed stepwise increases in dough elasticity, demonstrating the improvement of the functional properties of wheat by genetic engineering.

Quality indicators in clinical nursing: a review of the literature.

The purpose of the present study was, by means of a literature review, to describe and analyse the characteristics of clinical indicators used to assess and promote quality improvement in nursing care. It was found that a generally accepted definition of a clinical indicator is a 'quantitative measure that can be used as a guide to monitor and evaluate the quality of important patient care and support service activities'. By the seriousness of the event and the degree to which it can be avoided, clinical indicators are described as sentinel event or rate-based indicators. They can measure structure, process or outcome of care. Authors have had different approaches in focus when selecting and developing indicators viz. specific aspects of care/nursing diagnosis, medical diagnosis, generic aspects of care and clinical areas. These different points of departure were influenced by research knowledge, theories/frameworks, or by the opinions of patients or staff. The threshold of an indicator is essential when measuring the quality of care as it describes a critical level between what is considered good or not. Thresholds should be dynamic, realistic, and improve over time. However, the literature on how to establish specific thresholds is limited. The review has also revealed that there is an uncertainty regarding the use of terms such as indicators, standards, norm, criteria and aspects of care.

Development of a panel of monochromosomal somatic cell hybrids for rapid gene mapping.

We have assembled a panel of monochromosomal somatic cell hybrids for use in gene mapping. DNA from each individual hybrid was used as a probe on normal human metaphases to identify the human chromosome and any fragments by reverse painting. To test the efficiency of the panel PCR amplification of DNA from the monochromosomal somatic cell hybrid panel was used in combination with human specific oligonucleotide primers to assign alpha-catenin (CTNNA1) and p21/WAF1 to chromosomes 5 and 6 respectively. These genes were localized further using hybrids containing specific translocations to 5q11-qter and 6p21 respectively. We also developed primers to enable us to assign 17 ESTs sequenced by the HGMP Resource Centre. The hybrid panel was developed with support of the UK HGMP and the DNA is available to all registered users.

King's framework and theory in Japan, Sweden, and the United States.

In this article, we present our work in extending and testing Imogene King's conceptual framework and theory in Japan, Sweden, and the United States. Comparing and contrasting cultural relevance, methodology, and issues of validity provide examples of international scholarship and knowledge development that result from networking and collaboration.

[Quality assurance by developing strategical and professional nursing care goals]. / Kvalitetssäkring genom att utveckla strategiska och professionella omvårdnadsmål.

Quality assurance by developing strategical and professional nursing care goals. The purpose of this study was to develop strategical and professional nursing care goals. The theoretical base for the study was the 'VIPS-model' This model includes four concepts: well-being, integrity, prevention and safety, from which a taxonomy is generated. In order to measure the quality of nursing care the DySSSy-model was used. Four standards, based on the previously mentioned concepts were developed and evaluated at two surgical wards. The ward nurses were asked through a questionnaire how they valued the strategical and professional nursing care goals. The conclusion from the study is (1) that the taxonomy can be useful for structuring strategical and professional nursing care goals (2) that three of the developed standards are useful at surgical wards, and (3) that the questionnaire can be used as an instrument for defining how nurses value the chosen nursing care goals.

The fibroblast growth factor receptor 3 gene (FGFR3) is assigned to human chromosome 4.

Fibroblast growth factor receptors (FGFRs) have recently been isolated and shown to be transmembrane tyrosine kinase receptors. The FGFR1 gene has previously been assigned to human chromosome 8 and the FGFR4 gene to human chromosome 5. Here we demonstrate, by using somatic cell hybrids, that the FGFR3 gene localizes to human chromosome 4, showing that it, too, resides on a chromosome distinct from those on which other FGFRs have been localized.

Tagging genomic sequences that direct transgene expression by activation of a promoter trap in plants.

As part of a gene tagging strategy to study the developmental regulation of patterns of plant gene expression, a promoterless uidA (gusA) gene, encoding the beta-glucuronidase (GUS) reporter, was introduced into populations of tobacco, Arabidopsis and potato by Agrobacterium-mediated gene transfer. The objective was to generate random functional fusions following integration of the gusA gene downstream of native gene promoters. We describe here a detailed analysis of levels and patterns of gusA activation in diverse organs and cell types in those populations. gusA activation occurred at high frequency in all three species, and unique patterns of fusion gene expression were found in each transgenic line. The frequency of gusA activation was differentially biased in different organs in the three species. Fusion gene activity was identified in a wide range of cell types in all organs studied, and expression patterns were stably transmissible to the T2 and T3 progeny. Developmentally-regulated and environmentally-inducible expression of gusA is described for one transgenic line. Phenotypic variants were detected in the transgenic population. These results demonstrate the potential of T-DNA insertion as a means of creating functional tags of genes expressed in a wide spectrum of cell types, and the value of the approach as a complement to standard T-DNA insertional mutagenesis and transposon tagging for developmental studies is discussed.

Chromosomal localization of human p85 alpha, a subunit of phosphatidylinositol 3-kinase, and its homologue p85 beta.

The human phosphatidylinositol (PI) 3-kinase p85 alpha subunit gene and its homologue p85 beta were assigned to human chromosomes by analysis of their segregation in a panel of somatic cell hybrids using human-specific polymerase chain reaction primers. The p85 alpha locus was only present in hybrids retaining the human chromosome 5q. The presence of the p85 beta locus coincided with the presence of chromosome 19. The precise chromosomal sublocalization of these two genes was then determined by in situ hybridization. We confirmed the localization of the p85 alpha gene at 5q12-q13, as recently described (Cannizzaro, L.A., Skolnik, E.Y., Margolis, B., Croce, C.M., Schlesinger, J. & Huebner, K. (1991). Cancer Res., 51, 3818-3820) and positioned the p85 beta locus at 19q13.2-q13.4.

Canadian physiotherapists' professional identity: an exploratory survey.

This survey was funded and conducted by the Ontario and Canadian Physiotherapy Association Task Force on Professional Identity. Professional identity influences the image an occupation projects to its clients, the public, other occupations and governments. As an aid to planning strategy for advancing the professional image of physiotherapy, an open-ended questionnaire explored Canadian physiotherapists' professional identity. Professional identity is promoted by Canadian Physiotherapy Association (CPA) branches and districts. Most therapists identified their skills and potential benefit for patients, but only 15% identified themselves as a member of a health profession involved in a rewarding career. Physiotherapists have achieved many characteristics of an independent profession, but expressed frustration reveals that some members lack power on a personal and professional level.

Confirmation of the assignment of the vitronectin (VNRA) and fibronectin (FNRA) receptor alpha-subunits.

The receptors for the extracellular structural components fibronectin and vitronectin each consist of two subunits called alpha and beta. Using human-rodent somatic cell hybrids and cDNA probes corresponding to the alpha-subunits, we have confirmed the mapping of the fibronectin receptor (FNRA) to chromosome 12 and the vitronectin receptor (VNRA) to chromosome 2.

Assignment of eight human genomic DNA sequences detecting high frequency restriction fragment length polymorphisms.

From a lambda Charon 4A library digested with EcoRI, eight human genomic clones have been isolated, each detecting a high frequency RFLP. These phage clones have been assigned to eight different human chromosomes using Southern blot analysis and human-rodent somatic cell hybrids.