Translation, cultural adaptation and validation of the Systemic Lupus Erythematosus Activity Questionnaire (SLAQ) in a cohort of Italian systemic lupus erythematosus patients.

Introduction The Systemic Lupus Erythematosus Activity Questionnaire (SLAQ) is a patient-reported instrument for the assessment of disease activity in systemic lupus erythematosus (SLE). The aims of the present study are translation, cultural adaptation and validation of an Italian version: the SLAQit. Methods The process of translation and cultural adaptation followed published guidelines. SLAQit was pretested in a group of 35 SLE patients to evaluate acceptability, comprehension and feasibility. Internal consistency, test-retest validity and external validity were tested on consecutive SLE patients attending the clinic. Results In total, 135 SLE patients were enrolled in this study. The pilot test provided a 99.9% response rate and demonstrated feasibility and comprehensibility of the questionnaire. A good internal consistency was found among the three components of the score (SLAQ score, numerical rating scale (NRS), patient global assessment question (PGA); α = 0.79). SLAQit showed very high reliability (test-retest α > 0.8). NRS and PGA showed a strong positive correlation with both Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) ( p = 0.002 and p < 0.001, respectively) and European Consensus Lupus Measurement (ECLAM) scores ( p = 0.01 and p < 0.001, respectively), while the SLAQ score did not. A significant agreement was observed between the physician's intention to treat and both the NRS and PGA scores, while no significant association was reported with the SLAQ score. Conclusions SLAQit was demonstrated to be a reliable and valid instrument for self-assessment of disease activity in SLE patients.

Magnetic trapping of cold bromine atoms.

Magnetic trapping of bromine atoms at temperatures in the millikelvin regime is demonstrated for the first time. The atoms are produced by photodissociation of Br2 molecules in a molecular beam. The lab-frame velocity of Br atoms is controlled by the wavelength and polarization of the photodissociation laser. Careful selection of the wavelength results in one of the pair of atoms having sufficient velocity to exactly cancel that of the parent molecule, and it remains stationary in the lab frame. A trap is formed at the null point between two opposing neodymium permanent magnets. Dissociation of molecules at the field minimum results in the slowest fraction of photofragments remaining trapped. After the ballistic escape of the fastest atoms, the trapped slow atoms are lost only by elastic collisions with the chamber background gas. The measured loss rate is consistent with estimates of the total cross section for only those collisions transferring sufficient kinetic energy to overcome the trapping potential.

Insights to the clarification of sugar cane juice expressed from sugar cane stalk and trash.

Processing of juice expressed from green sugar cane containing all the trash (i.e., tops and leaves, the nonstalk component) of the sugar cane plant during sugar manufacture has been reported to lead to poor clarified juice (CJ) quality. Studies of different liming techniques have been conducted to identify which liming technique gives the best clarification performance from juice expressed from green cane containing half of all trash extracted (GE). Results have shown that lime saccharate addition to juice at 76 °C either continuous or batchwise gives satisfactory settling rates of calcium phosphate flocs (50-70 cm/min) and CJ with low turbidity and minimal amounts of mineral constituents. Surprisingly, the addition of phosphoric acid (≤ 300 mg/kg as P2O5), prior to liming to reduce juice turbidity (≤ 80%), increased the Mg (≤ 101%) and Si (≤ 148%) contents particularly for clarified GE juices. The increase was not proportional with increasing phosphoric acid dose. The nature of the flocs formed, including the zeta potential of the particles by the different liming techniques, has been used to account for the differences in clarification performance. Differences between the qualities of the CJ obtained with GE juice and that of burnt cane juices with all trash extracted (BE) have been discussed to provide further insights into GE processing.

Production of cold bromine atoms at zero mean velocity by photodissociation.

The production of a translationally cold (T < 1 K) sample of bromine atoms with estimated densities of up to 10(8) cm(-3) using photodissociation is presented. A molecular beam of Br(2) seeded in Kr is photodissociated into Br + Br* fragments, and the velocity distribution of the atomic fragments is determined using (2 + 1) REMPI and velocity map ion imaging. By recording images with varying delay times between the dissociation and probe lasers, we investigate the length of time after dissociation for which atoms remain in the laser focus, and determine the velocity spread of those atoms. By careful selection of the photolysis energy, it is found that a fraction of the atoms can be detected for delay times in excess of 100 µs. These are atoms for which the fragment recoil velocity vector is directly opposed and equal in magnitude to the parent beam velocity leading to a resultant lab frame velocity of approximately zero. The FWHM velocity spreads of detected atoms along the beam axis after 100 µs are less than 5 ms(-1), corresponding to temperatures in the milliKelvin range, opening the possibility that this technique could be utilized as a slow Br atom source.

Papaya latex enzymes capable of detoxification of gliadin.

Assay of fractions obtained from ion exchange chromatography of papaya latex on CM Sephadex-C50, size exclusion chromatography on Sephacryl S-300 and size exclusion HPLC have provided an insight into the relative contributions of the gluten-detoxifying enzymes present. This outcome has been achieved by the use of the above chromatographic techniques, coupled with assays of lysosomal activity, protease activity using benzylarginine ethyl ester (BAEE) as substrate, prolyl endopeptidase (PEP) using glycylprolylnitroanilide and a prolidase assay using acetylprolylglycine. These procedures have shown that the activity in papaya latex is due largely to caricain and to a lesser extent, chymopapain and glutamine cyclotransferase. The presence of caricain and these other enzymes was confirmed by mass spectrometry of trypsin digests of the most active fraction obtained by CM Sephadex-C50 chromatography and size exclusion HPLC. Fractions rich in caricain would be suitable for enzyme therapy in gluten intolerance and appear to have synergistic action with porcine intestinal extracts.

Low magnetic moment PIN diodes for high field MRI surface coils.

Positive-intrinsic-negative (PIN) silicon diodes are commonly used in magnetic resonance imaging (MRI) coils to perform active or passive blocking and detuning, or to disable circuit functions. However, diode packages with large magnetic moments are known to cause image artifacts in high field MRI systems. In this study, diode packages with low magnetic moment were designed by compensating components of ferromagnetic nickel and paramagnetic tungsten with diamagnetic silver. The new diodes have an initial positive susceptibility up to fields of 1 T and a negative susceptibility from 1 to 7 T. Their magnetic moments are one to two orders of magnitude smaller than those of standard diodes; moments as small as 20 nJ/T at 7 T were achieved.

Protection of cattle from Culicoides spp. in Australia by shelter and chemical treatments.

Trials were conducted in three regions of Australia to investigate the potential for improvised shelters and chemical treatments to reduce feeding by Culicoides on cattle and thereby minimise the risk of bluetongue transmission during transport of cattle to ports. Various designs and combinations of roofs and walls were placed around penned cattle. Chemical treatments were applied to other penned cattle. Culicoides were collected from the cattle by vacuum samplers or by light traps in the pens. Roofs alone did not consistently reduce the numbers of Culicoides brevitarsis or C. fulvus and increased the numbers of C. actoni collected. Walls alone reduced the numbers of C. wadai but not C. brevitarsis. Roofs and walls in combination reduced the numbers of C. brevitarsis and C. wadai. The chemical treatments 'Flyaway' (a blend of repellents) and fenvalerate reduced the numbers of C. brevitarsis and C. wadai up to 52 h post treatment.

TENA flex: a new concept in disposable incontinence pads.

The development of adult or larger-sized all-in-one incontinence products continues to improve. The latest addition to the many products available for the management of moderate to heavy urinary incontinence is TENA flex, manufactured by SCA Hygiene Products. TENA flex is an all-in-one belt-style product, which does not require separate fixation as with a pad and pant system, and relies upon a different measurement process to ensure proper pad selection, fitting and positioning. The range of TENA flex features will be discussed in this article.

Urinary sheaths: assessment, prescription and evaluation.

Urinary sheaths are a common solution to male urinary incontinence, but can be a source of much anxiety and discomfort if incorrectly fitted. This article discusses the process of assessment that must precede the prescription of a urinary sheath system. Assessment of bladder function and correct fitting and sizing are essential. The article also discusses the range of urinary sheath systems available, some of the problems that may arise in their use, and the processes of evaluation that should accompany use.

Promoting planned care for patients with indwelling catheters.

Indwelling urinary catheters are common among patients in the community. Use of a catheter entails a significant lifestyle adjustment on the part of the patient, who must learn a new regime of self-care. In order to help patients to cope with the new device, it is essential that nurses play an active role in educating patients and involving them in the decision-making process. By empowering patients through knowledge of their condition and care, nurses can encourage greater compliance with care plans and reduce the risk of potentially distressing complications that can arise from indwelling catheters.

Family therapists, community, and civic renewal.

In this article, we review family therapy's history regarding community concerns and broader societal issues; offer a model of levels of therapists' involvement with communities and community systems; and propose that family therapists join the citizen activation movement by becoming catalytic partners with families in communities. We call for a new kind of community practice that is driven less by therapist-defined problems and professional expertise, and more by community-defined problems and families' own expertise.

Urinary sheaths and drainage bags available from Manfred Sauer.

This article looks at the wide range of sheaths, adhesives and leg bags manufactured and supplied by Manfred Sauer. The company designs from the user's perspective and has a unique range of products from condom-type drainage systems to leg bags. The company also markets URIbags which are reusable, pocket-sized urinals for men and women.

Indwelling catheters: practical guidelines for catheter blockage.

Catheterization is a medical decision and requires a team approach involving, where possible, the patient and carer, as well as those professionals administering care. Catheterization and subsequent effective catheter drainage is associated with many dangers and complications (Lowthian, 1998) and therefore the decision to catheterize someone should not be taken lightly. Catheterization should only be used in intractable incontinence when all other measures have been tried and proven to be ineffective. This article identifies some of the problems associated with the care of patients with indwelling catheters in the community setting, and examines the issues that can cause pain, distress and discomfort to patients. It looks at the various types of solutions to problems associated with catheterization. Case histories are used to illustrate the types of patients who may have been catheterized. It is hoped that nurses can learn from these examples, so that they will not only cope more effectively with these individuals, but also observe their own practice when initiating indwelling catheterization and developing care packages.

The Sims Portex Catheter Valve: an alternative to the leg bag.

Any patients who would normally use a catheter and leg bag could benefit from exchanging their leg bag for a catheter valve, as long as they have the manual dexterity to open their valve at regular intervals and remember to do so. The Sims Portex Catheter Valve is a lightweight and compact catheter valve that is discrete and offers more comfort than a leg bag system, especially to the more mobile patient. This article examines this type of catheter valve and assesses its relevance for use in both the community and the acute sector.

Indications for and principles of intermittent self-catheterization.

Intermittent self-catheterization (ISC) or carer/nurse assisted intermittent catheterization has developed over the past few years as a means of treating patients with bladder emptying problems. Initially the process was designed for patients with the dexterity to carry out the procedure; today, however, more nurses are trained in the technique and are therefore able to support people with coordination problems in carrying out the procedure. Education programmes on catheterization are becoming increasingly popular and many district nurses have become skilled in its practice. This article describes some of the conditions that may be associated with bladder dysfunction and which warrant ISC. The support required from nurses in the planning, implementing, intervention and evaluation of a package of care are discussed. Simple advice such as avoiding constipation, monitoring urine to identify infection and general measures to improve hygiene all play a role in maintaining good health.

Instillagel: an anaesthetic antiseptic gel for use in catheterization.

Instillagel is a prefilled syringe containing lignocaine 2% and chlorhexidine 0.25% in a sterile lubricant gel. It is available in two sizes, 11 ml and 6 ml, for male and female catheterization respectively, and for intermittent self-catheterization. It has been used successfully for these purposes for many years, and its usage in the community setting is increasing. It is used for surface anaesthesia by many UK urologists. It is easily applied by both nurse and patient and remains the product of choice when performing indwelling catheterization. It also has an important role in stricture therapy where patients require extra lubrication for the passage of a catheter or an anaesthetic effect to provide patient comfort following the procedure. Instillagel has the added benefit of an antibacterial effect due to its chlorhexidine content.

Trident T2: a new development in urine bag tap design.

This article looks at Seton Scholl Continence Care's Simpla Trident T2 leg bag with the new advanced lever-action tap which has recently won the Independent Living Design Award. This easy-to-use lever-action tap has a simple, positive action which allows more independence and less intervention from carers. The lever-action tap enables the patient with limited hand coordination or poor finger/thumb dexterity to operate it effectively. The tap is smooth to the touch and the corners have been rounded to reduce any sharpness. The Simpla Trident T1 and T2 bags have the protected sample port to allow safe urine sampling without the need to break the system.