Potential value of tedera (B. bituminosa) as high protein resource for poultry feed.

Bituminaria bituminosa (C.H. Stirt.) is a drought tolerant legume that grows spontaneously in subtropical areas: Canary Islands (Spain) and in North African and Mediterranean regions, traditionally used as forage for ruminants. The aim of this research was to investigate the potential of B. bituminosa as a high protein resource for poultry feed by means of feed intake, growth, feed conversion rate (FCR), protein efficiency ratio (PER), and the influence of B. bituminosa feed form (fresh green and dried) on the preference by chicks. B. bituminosa showed higher crude protein content (CP), neutral detergent fiber (NDF), and gross energy than commercial feed. Average daily feed intake (ADFI) for the commercial feed group (control group) was higher than ADFI of the B. bituminosa group (experimental group). However, both groups had no significant differences in total crude protein intake, total NDF intake, average daily gain (ADG), FCR, and PER. The poultry's preference for fresh green B. bituminosa was higher than for dry B. bituminosa. Our results suggest that B. bituminosa (tedera) could be an alternative feedstuff in tropical countries or where protein sources are scarce and costly.

Phenolic and tannin compounds in subtropical shrubs (Bituminaria bituminosa, Chamaecytisus proliferus, and Adenocarpus foliosus) and the effects on in vitro digestibility.

The objective of this study was to contribute to the characterization of nutritional potentials, with special attention to the total phenol and condensed tannins content and the effects on in vitro digestibility of some browsing shrub legumes traditionally used for ruminant feeding. The varieties selected were Bituminaria bituminosa var. bituminosa (BBB), Bituminaria bituminosa var. albormaginata (BBA), Chamaecytisus proliferus var. palmensis (CPP), Chamaecytisus proliferus var. canariae (CPC), and Adenocarpus foliosus (AF). Chemical composition, in vitro digestibility, and net energy for lactation (NE) were analyzed and compared among varieties; the effects of total phenol (TP) and condensed tannins (CT) compounds on digestibility were estimated. Condensed tannins ranged from 1 to 5 g/kg DM of tannins, while total phenols ranged from 9 to 32 g/kg DM of tannins. In vitro organic matter digestibility (OMD) ranged from 0.52 to 0.71, and estimated net energy for lactation (NE) ranged from 4.2 to 5.8 MJ/kg DM, with significant differences among all the varieties. This Chamaecytisus varieties (CPC, CPP) have higher feeding values, following CPC > CPP > AF > BBB > BBA in order. Although there were condensed tannins and total phenols in all the shrubs analyzed, total phenol contents differed significantly between the shrubs. The effect of the content of the total phenols and of the tannins condensed in the OMD of the varieties of shrubs analyzed, shows that the higher amounts of total phenols in some of the varieties of shrubs analyzed, increased the in vitro digestibility (OMD) of the shrubs but high amounts of CT decreased OMD.

Effects of replacing rye-grass (Lolium spp.) hay by banana (Musa acuminata L.) by-products on feed intake, growth, and feed conversion rate of Canary hair sheep breed (Pelibuey) lambs.

The objective of this study was to evaluate the effects of replacing rye-grass (Lolium spp.) hay with banana (Musa acuminata L.) by-products on feed intake, average daily gain (ADG), and feed conversion rate (FCR) in Pelibuey (hair sheep breed) lambs. The lambs (n = 22; initial BW = 14.8 ± 2.5 kg) were individually housed and fed on two different types of diet for 58 days: the first group (experimental diet) received as forage a mixture of fresh banana by-products composed of leaves and pseudostem. The second group received commercial rye-grass hay (conventional diet) as a fiber source. Both groups received a supplementary commercial concentrate food. The total daily forage intake and FCR were lower (P < 0.001) in animals fed on the conventional diet (rye-grass hay) than animals fed on the experimental diet (banana by-products). However, there were no significant differences in total dry matter intake, total digestible energy intake, total body weight gain, and ADG between the two groups. The results obtained in this study suggest that banana by-products could be used as alternative forage for Pelibuey lambs raised in subtropical conditions.

Polyphenols journey through blood-brain barrier towards neuronal protection.

Age-related complications such as neurodegenerative disorders are increasing and remain cureless. The possibility of altering the progression or the development of these multifactorial diseases through diet is an emerging and attractive approach with increasing experimental support. We examined the potential of known bioavailable phenolic sulfates, arising from colonic metabolism of berries, to influence hallmarks of neurodegenerative processes. In silico predictions and in vitro transport studies across blood-brain barrier (BBB) endothelial cells, at circulating concentrations, provided evidence for differential transport, likely related to chemical structure. Moreover, endothelial metabolism of these phenolic sulfates produced a plethora of novel chemical entities with further potential bioactivies. Pre-conditioning with phenolic sulfates improved cellular responses to oxidative, excitotoxicity and inflammatory injuries and this attenuation of neuroinflammation was achieved via modulation of NF-κB pathway. Our results support the hypothesis that these small molecules, derived from dietary (poly)phenols may cross the BBB, reach brain cells, modulate microglia-mediated inflammation and exert neuroprotective effects, with potential for alleviation of neurodegenerative diseases.

Improvement of the stereoselectivity of the glycosylation reaction with 2-azido-2-deoxy-1-thioglucoside donors.

2-Azido-2-deoxy-1-thioglucoside donors with an electron withdrawing group at position 6 were employed to study the stereoselectivity of the glycosylation reaction with several acceptors, ranging from unhindered small primary alcohols to other sugars and steroids, using NIS/TfOH as promoter. p-Tolyl 2-azido-3,4-di-O-benzyl-6-O-chloroacetyl-2-deoxy-1-thio-α/ß-D-glucopyranoside afforded the higher α-selectivity, showing that a stronger electron withdrawing ester at O-6 influenced the anomeric selectivity towards the 1,2-cis glucosides. The anomeric stereoselectivity was highly dependent on the acceptor.

Effects of long-term optimization and short-term deterioration of glycemic control on glucose counterregulation in type I diabetes mellitus.

To assess the effects of glycemic control on glucose counterregulation, rates of plasma glucose recovery from hypoglycemia and counterregulatory hormonal responses were studied in 18 C-peptide-negative patients with insulin-dependent diabetes mellitus (IDDM) before and after either improvement, no change, or deterioration in glycemic control. Hypoglycemia was induced by an i.v. insulin infusion (30 mU/m2 X min for 1 h) after maintenance of euglycemia overnight with i.v. insulin. In 13 patients with long duration of IDDM (9 +/- 0.5 yr, mean +/- SEM) and initially poor glycemic control (mean diurnal blood glucose, MBG 199 +/- 8 mg/dl, ketoamine-HbA1 12.4 +/- 0.2%; nondiabetic subjects 104 +/- 4 mg/dl and 6.8 +/- 0.09%, respectively), rates of plasma glucose recovery from hypoglycemia (0.30 +/- 0.01 versus 0.60 +/- 0.01 mg/dl X min in nondiabetic subjects, P less than 0.001) and plasma glucagon (AUC 0.56 +/- 0.09 versus 6.3 +/- 0.50 ng/ml X 150 min in nondiabetic subjects, P less than 0.01) and epinephrine (AUC 16.9 +/- 0.2 versus 25.7 +/- 0.2 ng/ml X 150 min in nondiabetic subjects, P less than 0.001) responses to hypoglycemia were impaired. Intensive therapy (three daily injections of insulin) instituted in 7 out of 13 IDDM patients for up to 9 mo improved MBG (124 +/- 6 mg/dl, P less than 0.01) and ketoamine-HbA1 (7.9 +/- 0.02%, P less than 0.01) but not rates of plasma glucose recovery (0.31 +/- 0.01 mg/dl X min) and plasma glucagon (AUC 0.69 +/- 0.07 ng/ml X 150 min) and epinephrine (AUC 14.9 +/- 0.17 ng/ml X 150 min) responses.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of diethylamine on Stille alkylations with tetraalkylstannanes.

The addition of diethylamine to Stille alkylation reactions using stannanes improves yields by reducing beta-hydride elimination and reduction reactions, it also serves as a substitute for other additives such as Cu(I)I.

Focus groups: nursing staff's experiences using restraints.

A phenomenological approach was used to examine nursing staff's experiences using physical restraints. A total of 12 nurses from a tertiary hospital participated in one of three focus groups. Exploring the attitudes of nurses can contribute to a better understanding of how decisions are made concerning restraints. An analysis of the focus group data resulted in a description of the lived experiences of nurses using restraints. Seven themes emerged from the data, one of which reflected that the nurses felt ambiguous about restraints, yet they made judgments and justified their decisions after assessing patient characteristics, environmental safety, and unit traditions. Nurse clinicians could use the focus group method to sensitize themselves to the staff's needs and to allow staff the opportunity to share ideas and to dispel misconceptions about restraints.

An information synthesis to evaluate nurse practitioner effectiveness.

An information synthesis was conducted at the Department of Veterans Affairs Medical Center, Buffalo, New York, to determine the extent to which nurse practitioner (NP) effectiveness had been established in the existing literature. Three hundred fifty documents were reviewed by experts and 102 documents were deleted from the analysis phase. Fifty-six documents referred to as the Better Studies contained the most relevant and valid findings and were compared with a model developed to represent NP effectiveness. NPs were found to effectively provide a wide range of health care services. They can function as independent health care providers as well as collaborative members of the health care team. NPs have been found to have a positive influence on patient-related outcomes. There should be continued use and support of NPs in health care delivery systems. Recommendations for additional study are presented.

Research priorities for the care of the veteran patient.

The purpose of this project was to identify research priorities for the care of the veteran patient as identified by 367 various members of the Veterans Administration Nursing Service using the Delphi technique. A total of 1558 items were obtained and these were classified into categories from which 73 specific statements were written. Highest mean scores were obtained for items relating to interventions to decrease repeated admissions, care of the terminally ill, patient compliance, patient education, staffing, care planning, continuity post-hospitalization, quality nursing care, staff satisfaction, health promotion, and nursing intervention to assist patients and family in coping with illnesses.

Nurse practitioner perceptions of facilitators and constraints to practice.

The purpose of this study was to identify and explain conditions that served to constrain and/or facilitate the practice of Veterans Administration (VA) nurse practitioners (NPs). A 60% stratified random sample of all full-time VA NPs was surveyed. The sample represented NPs from the four hospital complexity levels and six geographic regions. A 92% response rate was obtained for a sample of 257 NPs. On the whole, VA NPs appeared to experience more facilitation than constraint. Areas that seemed to be especially positive for VA NPs were related to the direct delivery of care, and areas that interfered with their practice were related to administrative issues. NP practice is facilitated if there is a feeling of status, opportunity for professional growth, and NP personal satisfaction. Status can be influenced by independence in practice, support from top nurse administrators, and enough clerical support. Professional growth can be enhanced by providing opportunities for continuing education, research, physician back-up, and medical center committee membership. Personal satisfaction may be promoted through job security, independence in practice, fringe benefits, continuity of caseload, and opportunity for promotion. Throughout the analyses, independence repeatedly surfaced as an important criterion in the facilitation of NP practice.

Cost analysis of a nursing center for the homeless.

Single women and children now make up a third of the vulnerable U.S. homeless population who tend to seek health care only when their symptoms can no longer be ignored. The school of nursing at SUNY was one of the programs funded by HHS Division of Nursing to develop and implement a nursing center that would provide primary health services to the homeless. The cost of providing nursing services to homeless clients in nurse-managed centers was compared to costs for alternatives in the community including emergency department visits or care at the county supported nurse-run outpatient clinics. The four sites that served the homeless donated space for the SUNY project nurses to see patients. This enhanced accessibility, earlier intervention in health care problems, and decreased client cost (and time) for transportation to other service providers. The potential for earlier and less costly interventions confirmed the value of this humanistic nurse-run service for the homeless.

Long-term care nurses identify educational needs regarding quality assessment and improvement.

An increasing demand is being placed on nurses who are practicing in long-term care settings to conduct and/or participate in quality assessment and improvement (QAI) activities. A local survey of directors of nursing in long-term care indicated both personal interest and interest on the part of their staff nurses to attend continuing education (CE) programs regarding quality of care to increase their competencies in this area. Specific interest areas and recommendations for an educational offering regarding quality assessment and improvement for long-term care nurses are described.

Well-being and concerns of patients with peripheral arterial occlusive disease.

Peripheral arterial obstructive disease (AOD) affects an estimated 2.4 million persons in the United States, resulting in disability, morbidity, and even death in the elderly. Insight into the general well-being (GWB) of patients who have AOD can enhance the comprehensiveness of nursing care provided to these patients. GWB was examined in a study of 170 patients with peripheral AOD treated at a Veterans Affairs Medical Center (VAMC). The GWB instrument constructed by Dupuy and used extensively by the Rand Corporation was administered to provide an objective measure of well-being. Two open-ended questions regarding patients' concerns associated with their AOD provided more subjective information. The mean GWB score for the VAMC patients was lower than the mean score reported by the Rand Corporation for a group of healthy individuals, and this lent support to the construct validity of the instrument. The general health and vitality subscales appeared to have the widest difference in mean scores. Within the VAMC patient sample, GWB did not vary among age groups but did vary slightly in an inverse direction with the severity of the circulatory impairment. The concerns noted included fear of increased pain, lack of mobility, and fear of amputation.

Enhancing subject recruitment for nursing research.

Nursing research most often requires human subjects. Consequently, an essential component in planning and conducting research entails recruitment of subjects who knowledgeably consent to participate. A well-established theoretical base exists regarding sampling techniques and procedures for research methods. The operationalization of the theory into practical terms may be of interest to the clinical nurse specialist (CNS) who frequently assumes a leadership role to both conduct nursing research in practice settings and to advise other nurses interested in conducting research. The recruitment efforts in four different nursing studies were compared and contrasted in an effort to determine effective and efficient approaches to this issue. Sample populations included nurse practitioners, patients, nurse aides, and nurse educators. Methods of recruitment included direct contact, mail, and telephone contact. While the settings, purposes, and designs of the studies varied, some common elements regarding subject recruitment were suggested. The recruitment methods have been described, along with the implication in terms of practical application for conduct of nursing research by CNSs.

PVD: nurse--patient interventions.

The intervention program described began with teaching patients in simple terms about PVD, associated risk factors, and why change is important. Teaching aids such as posters and booklets were used to supplement discussion. Positive reinforcement was emphasized. Phone calls, follow-up visits, encouragement and praise were frequent. Newsletters focusing on different aspects of the various risk factors were developed and mailed monthly. Patients were encouraged and helped to develop an individualized program of change based on discussions and practicality. They were encouraged to start slowly and increase gradually. Emphasis was placed on reinforcement, self-help, and praise for efforts. Patients were encouraged to keep a brief daily log of progress and thoughts. Regularly scheduled physical assessments provided a tool to assess change and provide tangible evidence of their ability to set a goal, follow through, and make life-style change.

Future research recommendations for establishing NP effectiveness.

An information synthesis was conducted to examine nurse practitioner effectiveness as substantiated in existing literature. After an extensive computerized and manual search of the literature, 248 documents judged by staff to be relevant to the topic were reviewed by a content-area expert (N = 11 members), and a methodology expert (N = 8 members). Experts had been chosen on the basis of multiple nominations from an extensive national survey of professional nurses in leadership positions. Upon completing the respective reviews, experts identified key areas in support of NP effectiveness that had not been established or clarified in existing literature. A summary and discussion of the experts' recommendations for future studies in support of nurse practitioner effectiveness are presented.

Quality indicators: control maintains--propriety improves.

Continuous improvement of care depends upon the efforts of all nursing personnel. Supervisors facilitate quality program operations in their specific areas; head nurses document outcomes; and staff nurses identify problems and contribute to planning. All join in evaluating appropriateness of patient care and in modifying approaches for greater effectiveness.

Guidelines for writing for publication.

Publishing is a worthwhile goal, achievable when separated into manageable steps and when the science and art of writing are addressed. The value of publishing is explored and several approaches to developing and publishing a manuscript are presented.