Solving the Orem mystery: an educational strategy.

Three years ago Orem's Self-Care Deficit Theory was introduced in five pilot units at the Toronto General Hospital. To augment the existing implementation program and to introduce the basic concepts of the theory to staff from nonproject units, the clinical nurse specialist group developed a multimedia exhibit showing the theory in action. The theory was interpreted within the framework of the nursing process. A case study approach was developed so that a global perspective of the actual application of the model could be readily visualized. This article describes the activities involved in producing a self-learning educational presentation that can be put to a variety of uses, such as orientation of new staff and a review for current project unit staff, and that can also be revised and augmented as use of the theory becomes more sophisticated.

Immunological approaches to contraception in dogs.

The demand for safe, effective and cost-efficient means of pet population control has generated interest in the development of alternatives to surgical gonadectomy. The purpose of this review is to discuss the potential of immunological approaches to fertility control and to outline recent developments that may aid their design. Among the most promising candidates for immunoneutralization is gonadotrophin releasing hormone (GnRH). We have developed a reliable and reproducible GnRH-protein conjugate antigen and demonstrated that immunologically induced infertility is possible in dogs.

A synthetic luteinizing hormone releasing hormone vaccine II. Temporal aspects of titer development and formulation trials in BALB/c mice.

Cysteine substituted analogues of luteinizing hormone releasing hormone (LHRH) were coupled to carrier molecules, and the resulting conjugates used to characterize the immune response to native LHRH generated in BALB/c mice and to formulate vaccines in an effort to maximize titer development. In an active immunization trial designed to characterize temporal aspects of anti-LHRH titer development, titers could be detected 1 week after initial immunization. No differences were observed in response between male and female mice. Booster immunizations could enhance the titers against LHRH. The titers developed against the carrier molecule were uniformly higher than the corresponding anti-LHRH titers throughout the course of the trial. In separate trials, vaccines were formulated and tested in BALB/c mice for titer development against LHRH. Adjuvants, carrier molecules, dosage and peptide to carrier ratio were considered. Dosages of 50 micrograms conjugate per immunization per mouse, at conjugation ratios of 3-12 peptides per 10(5) Da carrier molecule, were found to produce immune responses. Adjuvants including Havlogen and dimethyldioctadecylammonium bromide (DDA), and carrier molecules including keyhole limpet hemocyanin (KLH), porcine thyroglobulin (TGB) and equine gamma globulin (EGG) were all found to be effective.

A synthetic luteinizing hormone releasing hormone vaccine. I. Conjugation and specificity trials in BALB/c mice.

The immunobiology of luteinizing hormone releasing hormone (LHRH) was explored, to provide a conceptual and practical basis for the use of LHRH in immunocastration. Cysteine substituted analogues of LHRH were synthesized including Cys1-LHRH (C1-LHRH), Cys6-LHRH (C6-LHRH) and Cys10-LHRH (C10-LHRH). These were reacted to carrier molecules using the heterobifunctional cross-linking reagent m-maleimidobenzoylsulfosuccinimide ester (SMBS), producing peptide-carrier conjugates of known peptide content and conjugation orientation. This reaction regime was found to be rapid, efficient and allowed for easy control of peptide to carrier ratios. Conjugates were used in active immunization trials in BALB/c mice to characterize the murine immune response against LHRH. BALB/c mice were shown to have the capacity to recognise all three cysteine substituted LHRH analogues and to produce antibodies cross-reactive with native LHRH. The specificity of LHRH antisera generated was found to be dependent on the site of conjugation of the peptide to carrier molecule. C1-LHRH generated carboxy terminal directed antibodies, C10-LHRH generated amino terminal directed antibodies, while C6-LHRH could generate amino terminal directed or carboxy terminal directed antibodies, or both within a given animal. No intrinsically immunodominant epitopes were seen within the LHRH molecule.

Evaluation of the osmoregulatory function of taurine in brain cells.

Homogenous primary cultures of mouse astrocytes and cortical neurons were used to clarify the role of taurine in ion and osmoregulation in the CNS. This study indicates that both neurons and glial cells have uptake systems for taurine. The cell water content does not change during loading of cells with taurine. Chemical analysis indicates that part of the accumulated taurine is metabolized and that the product(s) are stored in the cells. Extracellular taurine (1 mM) has no effect on K+, Na+, Cl-, or Ca2+ movements in astrocytes. However, astrocytes loaded to a taurine content which corresponds a concentration of 60 mM (corresponds to normal mouse cortex levels) show a 50% reduction in their K+ accumulation by carriers and a 100% increase in Ca2+ turnover rates. Movements of Ca2+ and K+ are involved in neurotransmission. It appears that taurine stored in glial cells, has an important effect on ion homeostasis in the CNS and may act indirectly on neuronal excitability.

Initial experiences with continuous ambulatory peritoneal dialysis.

Continuous ambulatory peritoneal dialysis (CAPD) has been initiated on 51 patients: 27 females (mean age -- 43.9 years) and 24 males (mean age -- 46.4 years). This group has been observed for a total of 1420 patient weeks of treatment (27.3 patient years). Thirty-six episodes of peritonitis have been noted among 19 patients. The overall incidence was one episode per 39.4 patient weeks. Recurrent episodes of peritonitis resulted in discontinuation of CAPD in five (9.8%) of the patients. Three (5.9%) of the patients were unable to continue with CAPD because of its inability to control extracellular fluid balance. In the patients who transferred from intermittent peritoneal dialysis to CAPD, there was a 4.5 mg/dl drop in serum creatinine and a 34 mg/dl drop in mean BUN values. There was a rise of approximately 2 gm in the hemoglobin levels of this group of patients. If the problem of peritonitis can be solved, CAPD will become the dialytic treatment of choice for the majority of patients with end-stage renal disease.