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1.
J Clin Nurs ; 29(5-6): 720-735, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31856356

RESUMO

AIM: To better understand occupational stress faced by nurse academics. METHODS: A mixed-methods systematic review, following the Joanna Briggs Institute [JBI], (Joanna Briggs Institute Reviewers' Manual: 2014 edition, 2014) process. Studies were assessed for quality and risk of bias by using standardised critical appraisal instruments from the Joanna Briggs Institute. In addition, processes and reporting were checked against the Equator guidelines. See Appendix S1. RESULTS: The review revealed that nursing academics do experience occupational stress, including burnout. Occupational stress for academic nurses is associated with various factors including work-life balance, workload issues, resources and support, and adapting to change. However, much of the literature focuses on nurses during the initial transition from clinical to academic environment, with rather less focus on established mid-to-late career nurse academics. DISCUSSION: Occupational stress and burnout are evident in the university academic workforce, adversely affecting the well-being of academic nurses, and the long-term sustainability of the academic nursing workforce. While there is considerable literature focusing on the novice academic nurse, particularly during the transition period, rather less is known about occupational stress among academic nurses across the career trajectory. Various strategies to deal with the negative consequences of occupational stress are identified, including (a) quality mentors for novice and younger nursing academics; (b) training in resilience building for novice academics; (c) supporting collegial relationships and reducing bullying; (d) assistance for professional development and research; (e) better support and resources to overcome increasing workloads; and (f) greater work-related empowerment to enhance job satisfaction. CONCLUSION: There is a need for a broader whole-of-career research focus to more fully identify, explore and mitigate the occupational stressors that negatively affect the academic nurse workforce. RELEVANCE TO CLINICAL PRACTICE: A strong and resilient academic nurse workforce is essential for the sustainability of the profession. Organisations should review their work practices and provide greater work-related empowerment to reduce occupational stressors among nursing academics.


Assuntos
Esgotamento Profissional/psicologia , Docentes de Enfermagem/psicologia , Centros Médicos Acadêmicos , Humanos , Satisfação no Emprego , Mentores , Equilíbrio Trabalho-Vida , Carga de Trabalho/psicologia
2.
Front Immunol ; 10: 2661, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31798589

RESUMO

Current influenza vaccines manufactured using eggs have considerable limitations, both in terms of scale up production and the potential impact passaging through eggs can have on the antigenicity of the vaccine virus strains. Alternative methods of manufacture are required, particularly in the context of an emerging pandemic strain. Here we explore the production of recombinant influenza haemagglutinin using the ciliated protozoan Tetrahymena thermophila. For the first time we were able to produce haemagglutinin from both seasonal influenza A and B strains. This ciliate derived material was immunogenic, inducing an antibody response in both mice and non-human primates. Mice immunized with ciliate derived haemagglutinin were protected against challenge with homologous influenza A or B viruses. The antigen could also be combined with submicron particles containing a Nod2 ligand, significantly boosting the immune response and reducing the dose of antigen required. Thus, we show that Tetrahymena can be used as a manufacturing platform for viral vaccine antigens.

3.
Open Access Maced J Med Sci ; 7(4): 587-593, 2019 Feb 28.
Artigo em Inglês | MEDLINE | ID: mdl-30894917

RESUMO

BACKGROUND: The seroconversion is a significant health concern in patients with end-stage renal disease undergoing hemodialysis particularly in high endemic zones of HBV and HCV. PATIENTS AND METHODS: This prospective study was conducted from January 2009 to April 2018 at Sheri Kashmir Institute of Medical Sciences, Srinagar, Kashmir. A cohort of 459 end-stage renal disease patients on hemodialysis was enrolled from four dialysis centres and followed in a longitudinal manner. Their seroconversion rates, risk factors were studied. Positive patients were treated and followed up. RESULTS: This study demonstrated HBV seroconversion rate of 7.4 % (n = 34) and HCV seroconversion rate of 10% (n = 46) in a cohort of 459 patients on hemodialysis attending four dialysis centres of Kashmir. Patients with diabetes mellitus outnumbered in seroconversion rates of (43.75%) followed by patients with glomerulonephritis (23.75%). Of 15 patients who had undergone renal transplantation 10 (66.67%), patients had seroconversion on hemodialysis which was statistically significant (P < 0.001). Patients who were dialysed at multiple HD centres had significant seroconversion than those who followed up at a single center. Seroconversion was associated with longer duration of dialysis (80.30 ± 30.92 vs 61 ± 9.41months, P < 0.000). HBV vaccination of the ESRD patient on hemodialysis was significantly protective against seroconversion (P = 0.000). CONCLUSIONS: Hepatitis B vaccination, stringent precautions in all dialysis centres could help to reduce the high seroconversion rates which have a high financial burden on ESRD patients. Intense health education to both patients and medical staff will be beneficial to lower the seroconversion rates.

4.
Antimicrob Agents Chemother ; 60(2): 744-51, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26574007

RESUMO

As antibiotic resistance increases, there is a need for new therapies to treat infection, particularly in cystic fibrosis (CF), where Pseudomonas aeruginosa is a ubiquitous pathogen associated with increased morbidity and mortality. Bacteriophages are an attractive alternative treatment, as they are specific to the target bacteria and have no documented side effects. The efficacy of phage cocktails was established in vitro. Two P. aeruginosa strains were taken forward into an acute murine infection model with bacteriophage administered either prophylactically, simultaneously, or postinfection. The infective burden and inflammation in bronchoalveolar lavage fluid (BALF) were assessed at various times. With low infective doses, both control mice and those undergoing simultaneous phage treatment cleared P. aeruginosa infection at 48 h, but there were fewer neutrophils in BALF of phage-treated mice (median, 73.2 × 10(4)/ml [range, 35.2 to 102.1 × 10(4)/ml] versus 174 × 10(4)/ml [112.1 to 266.8 × 10(4)/ml], P < 0.01 for the clinical strain; median, 122.1 × 10(4)/ml [105.4 to 187.4 × 10(4)/ml] versus 206 × 10(4)/ml [160.1 to 331.6 × 10(4)/ml], P < 0.01 for PAO1). With higher infective doses of PAO1, all phage-treated mice cleared P. aeruginosa infection at 24 h, whereas infection persisted in all control mice (median, 1,305 CFU/ml [range, 190 to 4,700 CFU/ml], P < 0.01). Bacteriophage also reduced CFU/ml in BALF when administered postinfection (24 h) and both CFU/ml and inflammatory cells in BALF when administered prophylactically. A reduction in soluble inflammatory cytokine levels in BALF was also demonstrated under different conditions. Bacteriophages are efficacious in reducing both the bacterial load and inflammation in a murine model of P. aeruginosa lung infection. This study provides proof of concept for future clinical trials in patients with CF.


Assuntos
Carga Bacteriana/efeitos dos fármacos , Bacteriófagos/crescimento & desenvolvimento , Pulmão/microbiologia , Infecções por Pseudomonas/tratamento farmacológico , Pseudomonas aeruginosa/virologia , Animais , Líquido da Lavagem Broncoalveolar/citologia , Líquido da Lavagem Broncoalveolar/microbiologia , Modelos Animais de Doenças , Feminino , Inflamação/tratamento farmacológico , Pulmão/imunologia , Camundongos , Camundongos Endogâmicos BALB C , Neutrófilos/imunologia , Infecções por Pseudomonas/imunologia , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/imunologia
5.
Issues Ment Health Nurs ; 36(7): 528-37, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26309172

RESUMO

This article will present the findings of a research study that investigated the extent to which mental health nurses employed within rural and metropolitan areas of Australia are affected by burnout, using the Maslach Burnout Inventory (MBI) and a demographic questionnaire. The study also examined whether the Maslach Burnout Inventory (MBI) was a valid measure of mental health burnout within the Australian context and culture or alternatively, in what ways it needed to be refined? A cross-sectional study of mental health nurses (n  =  319) from the states of New South Wales, Victoria, Queensland and Western Australia was undertaken. The 22-item Maslach Burnout Inventory (MBI) was used to measure burnout and a demographic questionnaire utilising a cluster sampling, cross-sectional design survey method, was used to gather the data. The study found that gender and level of qualification were the two major factors that showed any significance, where males experienced a higher level of depersonalisation on the frequency and intensity sub-scale scores of the MBI and that the more qualified a nurse, the greater the level of depersonalisation they experienced. These results were true for participants in both rural and metropolitan settings within Australia. Age was the third most influencing factor in terms of emotional exhaustion, where younger participants (under 30) reported higher levels of emotional exhaustion. Younger male mental health nurses experienced higher levels of depersonalisation.


Assuntos
Esgotamento Profissional , Enfermagem Psiquiátrica , Serviços de Saúde Rural , Serviços Urbanos de Saúde , Adulto , Austrália , Estudos Transversais , Feminino , Humanos , Satisfação no Emprego , Masculino , Inquéritos e Questionários
6.
Nanoscale ; 6(14): 7959-70, 2014 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-24902783

RESUMO

This study deals with the exploration of NixCo1-xFe2O4 (x = 0.0, 0.2, 0.4, 0.6, 0.8, 1.0) ferrite nanoparticles as catalysts for reduction of 4-nitrophenol and photo-oxidative degradation of Rhodamine B. The ferrite samples with uniform size distribution were synthesized using the reverse micelle technique. The structural investigation was performed using powder X-ray diffraction, high-resolution transmission electron microscopy, energy dispersive X-ray and scanning tunneling microscopy. The spherical particles with ordered cubic spinel structure were found to have the crystallite size of 4-6 nm. Diffused UV-visible reflectance spectroscopy was employed to investigate the optical properties of the synthesized ferrite nanoparticles. The surface area calculated using BET method was found to be highest for Co0.4Ni0.6Fe2O4 (154.02 m(2) g(-1)). Co0.4Ni0.6Fe2O4 showed the best catalytic activity for reduction of 4-nitrophenol to 4-aminophenol in the presence of NaBH4 as reducing agent, whereas CoFe2O4 was found to be catalytically inactive. The reduction reaction followed pseudo-first order kinetics. The effect of varying the concentration of catalyst and NaBH4 on the reaction rates was also scrutinized. The photo-oxidative degradation of Rhodamine B, enhanced oxidation efficacy was observed with the introduction of Ni(2+) in to the cobalt ferrite lattice due to octahedral site preference of Ni(2+). Almost 99% degradation was achieved in 20 min using NiFe2O4 nanoparticles as catalyst.


Assuntos
Cobalto/química , Corantes/química , Compostos Férricos/química , Nanopartículas Metálicas/química , Níquel/química , Catálise , Luz , Nanopartículas Metálicas/ultraestrutura , Nitrofenóis/química , Oxirredução , Tamanho da Partícula , Fotólise/efeitos da radiação , Rodaminas/química , Difração de Raios X
7.
Int J Inj Contr Saf Promot ; 20(1): 59-67, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-22551169

RESUMO

Chaff cutter is an extensively used machine in Indian rural households to chop fodder for feeding draft and mulch to animals. A survey was conducted in five villages of Ghaziabad district of Uttar Pradesh (a northern state of India) to determine the causal factors responsible for chaff cutter injuries. It was observed that major injuries were caused during children playing with the machine and workers feeding the fodder in to the chute. Further, a survey of chaff cutter manufacturers was conducted to determine the critical dimensions of the machine so that safety interventions could be developed. Based on the survey results and mechanism of injuries, three safety interventions were developed to prevent the injuries. These interventions can be retrofitted on old machines and can be incorporated in new machines as well. Experiments were conducted using different fodder crops to observe difficulty in chaff cutting with the safety interventions. It was observed that incorporation of the interventions had no effect on performance of chaff cutting operation. These were retrofitted on existing machines at different locations and the response was very positive.


Assuntos
Criação de Animais Domésticos/instrumentação , Traumatismos Ocupacionais/prevenção & controle , Adolescente , Adulto , Fatores Etários , Amputação Traumática/epidemiologia , Amputação Traumática/etiologia , Amputação Traumática/prevenção & controle , Ração Animal , Criação de Animais Domésticos/métodos , Criação de Animais Domésticos/estatística & dados numéricos , Criança , Pré-Escolar , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Traumatismos Ocupacionais/epidemiologia , Traumatismos Ocupacionais/etiologia , População Rural , Segurança , Adulto Jovem
8.
Contemp Nurse ; 42(2): 156-66, 2012 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23181368

RESUMO

People from culturally and linguistically diverse (CALD) backgrounds hold attitudes, values and beliefs surrounding health, illness and mental health issues that are not fully in harmony with Western approaches to health care. In particular, mental health services do not adequately meet the specific needs of CALD communities, a situation that is a violation of sound health care access and rights. A number of damning government reports highlight the inadequacies of the system. CALD groups that experience mental illness have the problem of dual vulnerabilities. They are disadvantaged on at least two fronts: The marginalization and stigmatization associated with mental illness and the access and utilization of services. This paper reviews the context of mental health service delivery in Australia. There is agreement that the needs of these people are only marginally being met at best despite individual and collective efforts to address the issue.


Assuntos
Diversidade Cultural , Linguística , Transtornos Mentais/psicologia , Populações Vulneráveis , Humanos
10.
Trop Gastroenterol ; 31(2): 105-7, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20862984

RESUMO

OBJECTIVES: To identify the factors associated with intestinal parasitosis in rural and urban school children of Kashmir. METHODS: Single fresh stool samples from rural and urban school children in three age groups: a) 5 to < 8 years, b) 8 to < 11 years and c) 11-14 years were taken. Various demographic characteristics considered were source of drinking water, type of toilet used and social classes as per the Kuppuswamy social scale. Personal hygiene was assessed by the visiting physician based on length of nails, hair and frequency of bathing. Stool samples were analyzed for detection of motile forms of E. histolytica and microscopic examination under low power detected eggs of intestinal helminths. Concentration methods were used if egg count was low. RESULTS: 274 stool samples from rural school children and 240 samples were taken from urban school children respectively. 214 (46.7%) students had stool tests positive for parasitosis. Ascariasis was the most prevalent parasitosis (28%) followed by Giardiasis (7%), Trichuriasis( 5%) and Taeniasis( 4%). There was higher prevalence of parasitosis among rural orphanage children compared to urban orphanage students (76% vs. 48% p < or = 0.05). Highest prevalence of 70% was seen in the age group 8-11years. Students using river/stream water had higher rates of parasitosis compared to those who were using tap water. 202 students were found to have poor personal hygiene and parasitosis was higher in them compared to students with good personal hygiene (p < 0.05). CONCLUSION: Poor environmental sanitation, personal hygiene, type of toilet and water used were associated with recurrent intestinal infestation besides socio economic status. Regular deworming programmes need to be adopted at school level especially in 8-11 years old children to check the surge of intestinal parasites and their subsequent morbidities.


Assuntos
Enteropatias Parasitárias/epidemiologia , Adolescente , Criança , Pré-Escolar , Métodos Epidemiológicos , Fezes/parasitologia , Feminino , Humanos , Higiene , Índia/epidemiologia , Masculino , Valor Preditivo dos Testes , Prevalência , Fatores de Risco
11.
Mol Ther ; 18(6): 1173-82, 2010 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20332767

RESUMO

Gene therapy for cystic fibrosis (CF) is making encouraging progress into clinical trials. However, further improvements in transduction efficiency are desired. To develop a novel gene transfer vector that is improved and truly effective for CF gene therapy, a simian immunodeficiency virus (SIV) was pseudotyped with envelope proteins from Sendai virus (SeV), which is known to efficiently transduce unconditioned airway epithelial cells from the apical side. This novel vector was evaluated in mice in vivo and in vitro directed toward CF gene therapy. Here, we show that (i) we can produce relevant titers of an SIV vector pseudotyped with SeV envelope proteins for in vivo use, (ii) this vector can transduce the respiratory epithelium of the murine nose in vivo at levels that may be relevant for clinical benefit in CF, (iii) this can be achieved in a single formulation, and without the need for preconditioning, (iv) expression can last for 15 months, (v) readministration is feasible, (vi) the vector can transduce human air-liquid interface (ALI) cultures, and (vii) functional CF transmembrane conductance regulator (CFTR) chloride channels can be generated in vitro. Our data suggest that this lentiviral vector may provide a step change in airway transduction efficiency relevant to a clinical programme of gene therapy for CF.


Assuntos
Fibrose Cística/terapia , Terapia Genética , Vetores Genéticos , Lentivirus/genética , Vírus Sendai/genética , Proteínas do Envelope Viral/genética , Animais , Diferenciação Celular , Linhagem Celular , Feminino , Humanos , Camundongos , Camundongos Endogâmicos C57BL , Transdução Genética
12.
Acta Biochim Biophys Sin (Shanghai) ; 42(1): 45-51, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-20043046

RESUMO

The aim of the study was to assess if low-frequency ultrasound (US), in the range of 30-35 kHz, increases non-viral gene transfer to the mouse lung. US is greatly attenuated in the lung due to large energy losses at the air/tissue interfaces. The advantages of low-frequency US, compared with high-frequency US are: (i) increased cavitation (responsible for the formation of transient pores in the cell membrane) and (ii) reduced energy losses during lung penetration. Cationic lipid GL67/plasmid DNA (pDNA), polyethylenimine (PEI)/pDNA and naked pDNA were delivered via intranasal instillation and the animals were then exposed to US (sonoporation) at 0.07 or 0.1 MPa for 10 min. Under these conditions, US did not enhance GL67 or PEI-mediated transfection. It did, however, increase naked pDNA gene transfer by approximately 4 folds. Importantly, this was achieved in the absence of microbubbles, which are crucial for the commonly used high-frequency (1 MHz) sonoporation but may not be able to withstand nebulization in a clinically relevant setup. Lung hemorrhage was also assessed and shown to increase with US pressure in a dose-dependent manner. We have thus, established that low-frequency US can enhance lung gene transfer with naked pDNA and this enhancement is more effective than the previously reported 1 MHz US.


Assuntos
Pulmão/virologia , Polietilenoimina/química , Transfecção/métodos , Animais , Técnicas de Transferência de Genes , Pulmão/química , Camundongos , Transfecção/estatística & dados numéricos , Ultrassom
13.
Am J Respir Cell Mol Biol ; 43(1): 46-54, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-19648474

RESUMO

A clinical program to assess whether lipid GL67A-mediated gene transfer can ameliorate cystic fibrosis (CF) lung disease is currently being undertaken by the UK CF Gene Therapy Consortium. We have evaluated GL67A gene transfer to the murine nasal epithelium of wild-type and CF knockout mice to assess this tissue as a test site for gene transfer agents. The plasmids used were regulated by either (1) the commonly used short-acting cytomegalovirus promoter/enhancer or (2) the ubiquitin C promoter. In a study of approximately 400 mice with CF, vector-specific CF transmembrane conductance regulator (CFTR) mRNA was detected in nasal epithelial cells of 82% of mice treated with a cytomegalovirus-plasmid (pCF1-CFTR), and 62% of mice treated with an ubiquitin C-plasmid. We then assessed whether CFTR gene transfer corrected a panel of CFTR-specific endpoint assays in the murine nose, including ion transport, periciliary liquid height, and ex vivo bacterial adherence. Importantly, even with the comparatively large number of animals assessed, the CFTR function studies were only powered to detect changes of more than 50% toward wild-type values. Within this limitation, no significant correction of the CF phenotype was detected. At the current levels of gene transfer efficiency achievable with nonviral vectors, the murine nose is of limited value as a stepping stone to human trials.


Assuntos
Técnicas de Transferência de Genes , Nariz/patologia , Animais , Aderência Bacteriana , Fibrose Cística/genética , Citomegalovirus/genética , Elementos Facilitadores Genéticos , Feminino , Terapia Genética/métodos , Lipossomos/metabolismo , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Mutação , Plasmídeos/metabolismo , Regiões Promotoras Genéticas
14.
Int J Health Sci (Qassim) ; 3(2): 265-70, 2009 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21475547

RESUMO

Non alcoholic fatty liver disease occurs in those who don't consume alcohol in amounts considered harmful to the liver. It represents a spectrum of conditions characterized histologically by mainly macrovesicular hepatic steatosis. There are two histological patterns of NAFLD: fatty liver alone and steatohepatitis. In this brief review, clinical and histologic spectrum, natural history, diagnosis, and management of this condition are discussed.

15.
Congenit Heart Dis ; 3(5): 347-51, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18837814

RESUMO

We report an 8-year-old child presenting with classical features of hypertrophic obstructive cardiomyopathy and Noonan syndrome with New York Heart Association (NYHA) class III symptoms. Due to progressively worsening symptoms, the child was taken up for percutaneous transluminal septal myocardial ablation, which was successfully performed. Postextrasystolic gradient fell down from 125 to 35 mm Hg. Other than postprocedure bifascicular block, no complications were encountered till 1 year of follow-up.


Assuntos
Cardiomiopatia Hipertrófica/complicações , Cardiomiopatia Hipertrófica/cirurgia , Ablação por Cateter , Septos Cardíacos/cirurgia , Síndrome de Noonan/complicações , Cardiomiopatia Hipertrófica/diagnóstico , Criança , Eletrocardiografia , Humanos , Masculino
16.
Am J Respir Cell Mol Biol ; 39(4): 490-6, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18458238

RESUMO

Attempts at correcting the nasal potential difference (PD) in cystic fibrosis (CF) mice have long been used in preclinical gene and small molecule therapy development. However, in general, CF mice suffer from intestinal disease, are runted, and have high mortality rates; they are therefore difficult to work with, especially if large numbers are required. Because of this, large-scale PD studies in CF mice have not been performed. Working with CF mice has become substantially easier after the generation of the gut-corrected CF-knockout mouse. Fatty acid-binding promoter (FABp)-mediated expression of CFTR in the gut, but not the airways, prevents the intestinal disease of the CF knockout mouse. This model has given us the unique opportunity to systematically study PDs in large numbers of CF mice. The nose, but not the lungs, of these animals mimic the bioelectric defect seen in humans. We have therefore assessed the bioelectrics of the respiratory epithelium comparing FABp-CF and wild-type mice. The large body of data gathered in CF and wild-type mice allowed us, for the first time, to establish power calculations that should inform sample sizes required in gene and small molecule therapy development. In addition, we address the important issues of intra-animal variability as well as intra- and inter-operator variability for scoring the traces, and the effect of age and sex on nasal PD in CF mice. These data should allow a more informed use of CF animals in future studies.


Assuntos
Regulador de Condutância Transmembrana em Fibrose Cística/biossíntese , Fibrose Cística/fisiopatologia , Mucosa Nasal/fisiopatologia , Animais , Fibrose Cística/metabolismo , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Proteínas de Ligação a Ácido Graxo/genética , Feminino , Mucosa Intestinal/metabolismo , Masculino , Potenciais da Membrana , Camundongos , Camundongos Knockout , Mucosa Nasal/metabolismo , Regiões Promotoras Genéticas
17.
J Transcult Nurs ; 19(2): 140-50, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18174373

RESUMO

Increasing numbers of international students from Asia are attracted to Australian higher education institutions. For many of these students, English is their second language (ESL). This article describes the experiences of 21 Taiwanese baccalaureate and graduate nursing students studying at Australian universities. Using a qualitative framework, semistructured interviews were conducted in the students'first language. The Chinese and English translations of the transcripts were analyzed using thematic content analysis. A picture emerges of Taiwanese nursing students who, despite obstacles, found a "joy of learning" in Australia. They developed strategies to overcome obstacles to their learning and advocated greater institutional and faculty support, including mentorship, for international students. The findings reinforce the unique difficulties ESL nursing students experience and highlight institutional and nursing faculties' responsibilities to develop a curriculum framework that addresses the language, pedagogical, academic, clinical, and sociocultural needs of this unique group of international students.


Assuntos
Bacharelado em Enfermagem , Educação de Pós-Graduação em Enfermagem , Aprendizagem , Estudantes de Enfermagem/psicologia , Adaptação Psicológica , Adulto , Austrália , Humanos , Multilinguismo , Apoio Social , Taiwan/etnologia
19.
J Cardiothorac Vasc Anesth ; 20(2): 202-8, 2006 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-16616660

RESUMO

OBJECTIVE: To review the anesthetic management for percutaneous transcatheter closure of perimembranous ventricular septal defect (VSD) with an Amplatzer asymmetric occluder device and to highlight the hemodynamic effects and potential complications associated with its delivery. DESIGN: Retrospective review of prospectively collected data. SETTING: University-affiliated teaching hospital. PARTICIPANTS: Nine consecutive children undergoing elective percutaneous transcatheter closure of perimembranous VSD. INTERVENTIONS: General anesthesia with sevoflurane for cardiac catheterization and percutaneous transcatheter device placement. MEASUREMENTS AND MAIN RESULTS: Ten anesthetics were delivered in 9 children ages 23 to 65 months with perimembranous VSD for attempted placement of an Amplatzer asymmetric device. The device was successfully placed in 7 patients. In 1 patient the device embolized to the right femoral artery, and was retrieved with a bioptome. Fluoroscopy time (59.8 +/- 17.24 min) was prolonged compared to that in other studies of placement of this device. All patients had episodes of arrhythmia and hemodynamic disturbance. Arrhythmias ranged from atrial or ventricular ectopic events to various degrees of atrioventricular block. Complete heart block occurred during the procedure in 1 patient and after the procedure in another patient. Hypotensive episodes occurred in 7 patients, and were attributed to arrhythmias in 5 patients and hypovolemia in 2 patients. Two patients were given blood transfusions after the procedure because they had signs of hypovolemia and a greater than 10% decrease in hemoglobin levels. CONCLUSIONS: Anesthesia for perimembranous VSD occluder placement is associated with hemodynamic instability, arrhythmias, prolonged procedure times, and inevitable and sometimes substantial blood loss.


Assuntos
Anestesia Geral/métodos , Comunicação Interventricular/cirurgia , Implantação de Prótese/instrumentação , Pré-Escolar , Ecocardiografia Doppler , Feminino , Fluoroscopia , Seguimentos , Comunicação Interventricular/diagnóstico por imagem , Humanos , Lactente , Masculino , Desenho de Prótese , Estudos Retrospectivos , Resultado do Tratamento
20.
Respir Res ; 7: 26, 2006 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-16480492

RESUMO

BACKGROUND: The cationic lipid Genzyme lipid (GL) 67 is the current "gold-standard" for in vivo lung gene transfer. Here, we assessed, if GL67 mediated uptake of siRNAs and asODNs into airway epithelium in vivo. METHODS: Anti-lacZ and ENaC (epithelial sodium channel) siRNA and asODN were complexed to GL67 and administered to the mouse airway epithelium in vivo Transfection efficiency and efficacy were assessed using real-time RT-PCR as well as through protein expression and functional studies. In parallel in vitro experiments were carried out to select the most efficient oligonucleotides. RESULTS: In vitro, GL67 efficiently complexed asODNs and siRNAs, and both were stable in exhaled breath condensate. Importantly, during in vitro selection of functional siRNA and asODN we noted that asODNs accumulated rapidly in the nuclei of transfected cells, whereas siRNAs remained in the cytoplasm, a pattern consistent with their presumed site of action. Following in vivo lung transfection siRNAs were only visible in alveolar macrophages, whereas asODN also transfected alveolar epithelial cells, but no significant uptake into conducting airway epithelial cells was seen. SiRNAs and asODNs targeted to beta-galactosidase reduced betagal mRNA levels in the airway epithelium of K18-lacZ mice by 30% and 60%, respectively. However, this was insufficient to reduce protein expression. In an attempt to increase transfection efficiency of the airway epithelium, we increased contact time of siRNA and asODN using the in vivo mouse nose model. Although highly variable and inefficient, transfection of airway epithelium with asODN, but not siRNA, was now seen. As asODNs more effectively transfected nasal airway epithelial cells, we assessed the effect of asODN against ENaC, a potential therapeutic target in cystic fibrosis; no decrease in ENaC mRNA levels or function was detected. CONCLUSION: This study suggests that although siRNAs and asODNs can be developed to inhibit gene expression in culture systems and certain organs in vivo, barriers to nucleic acid transfer in airway epithelial cells seen with large DNA molecules may also affect the efficiency of in vivo uptake of small nucleic acid molecules.


Assuntos
Fibrose Cística/genética , Fibrose Cística/metabolismo , Marcação de Genes/métodos , Lipídeos/química , Oligonucleotídeos Antissenso/genética , RNA Interferente Pequeno/genética , Transfecção/métodos , Animais , Células Cultivadas , Células Epiteliais , Inativação Gênica , Humanos , Camundongos , Células NIH 3T3 , Oligonucleotídeos Antissenso/administração & dosagem , RNA Interferente Pequeno/administração & dosagem , Mucosa Respiratória
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