Andreev level qubit.

We investigate the dynamics of a two-level Andreev bound state system in a transmissive quantum point contact embedded in an rf SQUID. Coherent coupling of the Andreev levels to the circulating supercurrent allows manipulation and readout of the level states. The two-level Hamiltonian for the Andreev levels is derived, and the effect of interaction with the quantum fluctuations of the induced flux is studied. We also consider an inductive coupling of qubits and discuss the relevant SQUID parameters for qubit operation and readout.

Combination of phenylbutyrate and 13-cis retinoic acid inhibits prostate tumor growth and angiogenesis.

Differentiation-inducing agents, such as retinoids and short-chain fatty acids, have an inhibitory effect on tumor cell proliferation and tumor growth in preclinical studies. Clinical trials involving these compounds as single agents have been suboptimal in terms of clinical benefit. Our study evaluated the combination of phenylbutyrate (PB) and 13-cis retinoic acid (CRA) as a differentiation and antiangiogenesis strategy for prostate cancer. On the basis of previous evidence, common signal transduction pathways and possible modulation of retinoid receptors and retinoid response elements by PB could be responsible for such activities. We assessed the effect of the combination of PB and CRA on human and rodent prostate carcinoma cell lines. The combination of PB and CRA inhibited cell proliferation and increased apoptosis in vitro in an additive fashion as compared with single agents (P < 0.014). Prostate tumor cells treated with both PB and CRA revealed an increased expression of a subtype of retinoic acid receptor (retinoic acid receptor-beta), suggesting a molecular mechanism for the biological additive effect. The combination of PB and CRA also inhibited prostate tumor growth in vivo (up to 82-92%) as compared with single agents (P < 0.025). Histological examination of tumor xenografts revealed decreased in vivo tumor cell proliferation, an increased apoptosis rate, and a reduced microvessel density in the animals treated with combined drugs, suggesting an antiangiogenesis effect of this combination. Thus, endothelial cell treatment with both PB and CRA resulted in reduced in vitro cell proliferation. In vivo testing using the Matrigel angiogenesis assay showed an additive inhibitory effect in the animals treated with a combination of PB + CRA (P < 0.004 versus single agents). In summary, this study showed an additive inhibitory effect of combination of differentiation agents PB and CRA on prostate tumor growth through a direct effect on both tumor and endothelial cells.

Promoting screening and early detection of cancer in men.

Gender is a factor in the risk assessment for many diseases. It may also impact on the way in which men assess their personal health or illness status and take action to prevent illness or promote well-being. This paper is focused on three objectives: (i) to foster an understanding of gender differences in health promoting behaviors; (ii) to review three health issues affecting males for which dissemination of health education, increased personal awareness and early detection may be beneficial in the reduction of morbidity and mortality; and (iii) to offer suggestions for nurses and other health care professionals to promote positive patient-provider interactions within a health-care framework for action.

Nurses' unique roles in randomized clinical trials.

Nurses are in an ideal position to promote patients' awareness of the role played by clinical trials in the advancement of health science and the subsequent improvement of patient care. The history of clinical trials and the four phases of clinical trials are described. Nurses' professional roles in clinical trial participation, such as helping the patient to identify open clinical trials and acting as clinical interpreter and patient advocate during the patient's participation in a trial, are detailed. Professional considerations that must be addressed by the nurse are reviewed and include ensuring that the trial has received approval from an Institutional Review Board for the participation of human subjects; that the responsibilities of participation are congruent with the nurse's personal values and workplace obligations; and that once engaged, the nurse can make the commitment to sustain participation in the trial. Most important, the nurse must keep the patient's needs and values uppermost in mind during the evaluation of potential clinical trials. Nurses have a critical role to play in the promotion of clinical trials, the recruitment of patients for clinical trial participation, the education of the patient and family, and the clinical care and support of patients throughout their participation in clinical trials.

Competitive styles in men and women.

Competition is a function intrinsic to current clinical practice. Of the two competitive styles, goal competitiveness is found by both men and women to be more worthy of respect. Interpersonal competitiveness is manifested more by highly competitive women than by highly competitive men, especially in relationships with female co-workers, representing a significant problem for organizations and employees. The styles and their effects are described, their possible sources discussed, additional research outlined, and recommendations proposed.

Breast cancer among men: raising awareness for primary prevention.

The American Cancer Society estimated that in 1993 1,000 new cases of male breast cancer would be diagnosed in the United States and 300 men would die from the disease. The clinical picture of breast cancer among men resembles that seen in women, and the development of the disease among men has been attributed to similar hormonal and genetic causes. The mortality rate from breast cancer is also similar, when corrected for chronological age and stage of the disease at the time of diagnosis and treatment. Guidelines for patient education, health screening, and patient support are presented.

A systematic tool to assess urinary incontinence parameters: a closer look at unfamiliar parameters.

The Joseph Continence Assessment Tool, originally published in 1993, is further evaluated in terms of content validity. Nine nurses in practice and 9 nurses expert on the topic of incontinence evaluated each component of the tool as to whether they seemed quite relevant, somewhat relevant, or not relevant. The total results and a discussion of items that seemed somewhat or not relevant are presented.

Perceptual and enactment measurement of self-care.

The concept of self-care was conceptualized as having three major components: enabling perceptual elements (motivation, values, responsibility, and decision making); domains for enactment (cognitive/ perceptual, psychosocial/affective, and physical functioning); and self-care enactment factors (capacity), which included self-care action and knowledge adequate for self-care. A new tool, The Self-Care Agency Inventory, was designed to discriminate between those who will enact self-care and those who will not because of either a lack of knowledge or a lack of motivation. Content validity was demonstrated (.77 or greater from each scale) and concurrent validity documented. Alpha reliability for the new scale and principal components factor analysis of the scale items did not achieve desired levels, although a pilot sample demonstrated test-retest reliability of .82. The conceptual model is presented.

Age effects on measures of hearing disability.

This study investigated the effects of age on self-perceived hearing disability among young and elderly people with comparable hearing sensitivity. Subjects were young (18-40 yr) and elderly (65-75 yr) listeners with either normal hearing sensitivity or mild-to-moderate sloping sensorineural hearing loss. The Hearing Handicap Inventory for the Elderly was presented to the older subjects and the Hearing Handicap Inventory for Adults was presented to the younger subjects. Statistical analyses revealed an interaction between age and hearing loss, in which younger subjects with hearing loss reported more handicapping effects of sensitivity loss than the elderly subjects with hearing loss. This age effect was not attributed to differences in hearing sensitivity between the young and elderly subjects with hearing impairment.

Collaborative research-academic appointments: the myth and the reality.

The following article is written from the experience of its authors with a collaborative research-academic appointment. Many advantages and disadvantages were found. The disadvantages included the division of time, responsibilities, loyalties, and energy required by two work settings rather than one. When the challenges are met, however, the rewards are many for the institution, its professional staff, its patients, and the researcher. The joint research appointment brings to the institution, clinicians, students of the researcher, and to the researcher a broadening of the professional practice and experience. Opportunities develop that would have been impossible in other situations. The quality of the teaching may improve and the quality of patient care is enhanced. The profession is advanced. The authors conclude that the additional time and effort necessary to maintain a collaborative research appointment are more than compensated.

Meaning and the family life cycle.

In this article, the authors integrate Viktor Frankl's concept of the "Will to Meaning" with a family-life-cycle model. This integration offers an overview of the opportunities for spiritual growth and the development of a sense of purpose for both the family and its individual members. Clinical illustrations highlight applications of the approach in actual practice.

A community strategic planning process for elder services.

Dynamic changes in population, patient demographics, and healthcare financing mechanisms create shifting service priorities. Strategic planning has become a vitally important skill for nurse executives, who must extend their efforts and influence beyond traditional agency boundaries. The authors present an application of the strategic planning process as it was used to develop recommendations for eldercare services in one southwestern, urban community.

Art, logotherapy, and the unconscious God.

In this article the author outlines how art can be used in Logotherapy and Existenzanalyse to help the client uncover, discover, and make use of the meaning and spiritual potentials in his or her life. In Logotherapy and Existenzanalyse art can be used to help over-come fear of verbal communication, to help overcome fear of the spiritual and meaning potentials in the client's life, and to help the client gain awareness and contact with the "unconscious God."

The level and focus of geriatric nursing content in ADN and BSN programs.

The didactic and clinical focus of geriatric curriculum content within both associate (ADN) and baccalaureate (BSN) schools of nursing in California was reviewed. Geriatric nursing content experts confirmed the detail of a geriatric nursing curriculum, then determined which of the content items were basic to both educational levels, and which might be appropriately deferred to programs of baccalaureate preparation. Nurse educators may use the results of this study to guide curriculum development in both depth and breadth of content.

Experimental photodynamic therapy with a copper metal vapor laser in colorectal cancer.

In an attempt to define the best conditions for an adjunctive treatment of residual colonic microtumors by photodynamic therapy (PDT), an experimental model has been defined. S.c. HT29 colonic-cancer-cell tumors grown in nude mice were used and, 48 hr after i.p. administration of 30 mg/kg Photofrin (PH), laser illumination was performed with 75 or 150 Joules/cm2. The efficiencies of 2 lasers, the classically used rhodamine laser (RL) and a copper metal vapor laser (CMVL), were compared. The effects of PDT were assessed by histological and immunocytochemical (detection of a digestive enzyme, dipeptidyl-peptidase IV, as a marker of cell viability) follow-up and by the growth curve of the tumors after illumination. We conclude that, although the depth of necrosis resulting from PDT was nearly 3 mm at 75 J/cm2 and nearly 4-5 mm at 150 J/cm2 with both lasers, complete necrosis was obtained only with the CMVL at 150 J/cm2 (in 50% of the tumors). Under the other conditions, a layer of unaffected cells persisted at the pole opposite to laser illumination, resulting in growth curves lower than but parallel to those of the controls. Analysis of drug concentrations in the tumors and various organs, 48 hr after injection, i.e., at the time of laser illumination, revealed the presence of 21 micrograms/g dry weight PH in the tumors. The tumor vs. host-organ ratios were equal to or higher than 1 for the small bowel, colon, stomach, lung, skin and muscle. In contrast, the ratios were below 1 for the spleen, pancreas, kidney and liver.