Chemical and physical properties of mammalian mitochondrial aminoacyl-transfer RNAs. I. Molecular weights of mitochondrial leucyl- and methionyl-transfer RNAs. The sedimentation and electrophoretic properties of Syrian hamster cytosolix and mitochondrial methionyl- and leucyl- +RNAs have been compared under denaturing conditions. Mitochondrial leucyl-tRNA could be separated into three species by chromatography on RPC-5. Their apparent molecule weights as determined by polyacrylamide slab gel elecltrophoresis were 23 000 for one species and 24 000 for the other two compared to the five cytosolic leucyl-tRNA species whose apparent molecular weights ranged from 26 000 to 28 000. Mitochondrial leucyl-tRNAs sedimented more slowly than their cytosolic counterparts, again indicating a lower molecular weight. The apparent molecular weights of the mitochondrial methionyl-tRNAs were identical or only slightly lower than their cytosolic counterparts as determined by polyacrylamide slab gel electrophoresis but both mitochondrial methionyl-tRNA and formylmethionyl-tRNA sedimented slightly more slowly than cytolsolic methionyl-tRNA. It is suggested that mitochondrial tRNAs fall into the size range of other t RNAs and might be uniform in size.


Chemical and physical properties of mammalian mitochondrial aminoacyl-transfer RNAs. II. Analysis of 7-methylguanosine in mitochondrial and cytosolic aminoacyl-transfer RNAs. The 7-methylguanosine (m7G) content of two individual mitochondrial tRNAs, labelled in the aminoacyl moiety was assayed by the specific cleavage of the tRNA at this nucleotide followed by electrophoretic analysis to identify the 3'-terminal fragment of the tRNA. Neither Syriam hamster mitochondrial tRNALeu nor tRNAMet were found to contain m7G. In contrast, cytosolic tRNAMetS were cleaved indicating the presence of m7G, apparently 27--28 and 29 nucleotides from their 3' terminus. Cystolic tRNALeu was not cleaved. These results are discussed in relationship to the reported low content of methylated nucleosides in mitochondrial 4 S RNA.


Independent temporal expression of two N-substituted aminoacyl-tRNA hydrolases during the development of Artemia salina. Encysted embryos of the crustacean Artemia salina contain an enzymatic activity which hydrolyzes N-acetylphenylalanyl-tRNA to N-acetylphenylalanine and tRNA. The enzyme apparently does not hydrolyze other free or N-substituted aminoacyl-tRNAs. The levels of this enzyme do not significantly change during embryonic and early larval development. In contrast, an unspecific hydrolase active on several N-substituted aminoacyl-tRNAs is practically absent in the encysted embryos and during embryogenesis and appears abruptly during larval development. The independent temporal expression of these two hydrolases during Artemia salina differentiation makes this organism siuitable for the study of the physiological role of these enzymes.


Sensitivity of ribosomal bound N-acetylphenylalanyl-tRNA to hydrolysis by a spectific hydrolase. Binding of N-acetylphenylalanyl-tRNA, either enzymatically or non-enzymatically, to yeast 80-S ribosomes renders the substrate resistant to the hydrolytic action of a specific hydrolase present in yeast. In contrast, N-acetylphenylalanyl-tRNA bound to the 40-S ribosomal subunit is sensitive to enzymatic hydrolysis. The presence of the hydrolase in the aminoacyl-tRNA binding factor preparations greatly interferes with the formation of complexes between N-acetylphenylalanyl-tRNA and the small ribosomal subunit.


Thermodynamics of transfer ribonucleic acids: the effect of sodium on the thermal unfolding of yeast tRNAPhe.


Hepatotrophic factors. Introduction.

Hepatotrophic factors. Introduction.


Other views about the hepatotrophic concept. In this paper two main questions are approached. The first relates to the aspects of the proliferative response which are influenced by alleged hepatotrophic substances and experiments will be recounted which were designed to test whether hepatocyte enlargement and division are separable. Both short-term and long-term data suggest the need to consider that these two reactions may be controlled by different factors. The second question is concerned with the indentification of hepatotrophic substances and the circumstances in which these are found to be effective. Experiments have been carried out which attempt to assess the extent to which normal liver cells are affected by specific hepatotrophic substances in vivo. The findings do not completely support the hypothesis that the integrity of the liver cell is dependent on a single identifiable hepatotrophic substance.


Signals for glucagon secretion.

Signals for glucagon secretion. The normal physiological role of glucagon is in controlling hepatic glucose output. Glucagon subserves the role of homeostasis by maintaining plasma glucose and of a stress hormone by producing hyperglycaemia. While control of glucagon release by circulating metabolites and also other hormones is clearly important, it seems likely that the nervous system exerts an over-riding influence. The parasympathetic nervous system maintains homeostasis and the sympathetic acts in stress. Glucagon levels are found to be high in cirrhosis and also after acute hepatic failure. It is likely that these changes in glucagon concentration are secondary to metabolic abnormalities. While some glucagon is cleared by the liver, a similar clearance is seen by many other tissues and it is not likely that the elevation of glucagon seen in liver failure is due solely to a gross deficiency of glucagon clearance. No liver abnormality is seen in the glucagonoma syndrome, where glucagon concentration are chronically high, or in patients who have had a total pancreatectomy, where plasma glucagon is undetectably low. It thus seems unlikely that liver mass is importantly controlled by glucagon.


Liver atrophy, hypertrophy and regenerative hyperplasia in the rat: the relevance of blood flow. Liver perfusion can be measured sequentially by monitoring the clearance of 85krypton injected into the portal circulation. Preliminary studies in dogs show that the method reflects gas clearance from a homogeneously perfused liver parenchyma and correlates well with measurements of total hepatic blood flow. The method has been adapted to measurement of liver blood flow in normal rats, partially hepatectomized rats and after portacaval transposition with and without partial hepatectomy. There is a marked rise of approximately 250% in the first four hours after partial hepatectomy in the rat. After portacaval trans-position, liver blood flow remains within the normal range and no great rise occurs after partial hepatectomy. In animals subjected to portacaval transposition, there is a reduction in relative liver weight (liver weight/body weight ratio) and when partial hepatectomy is performed three weeks after portacaval transposition, the relative liver weight is regained within three weeks, and does not differ from that of non-hepatectomized controls. DNA synthetic activity, studied during the 72 hours after partial hepatectomy performed three weeks after portacaval transposition, shows an uptake of tritiated thymidine into liver DNA of the same magnitude as and contemporaneous with that of controls. Liver atrophy after portal diversion is not a result of a decrease in absolute liver blood flow. Regenerative hyperplasia appears to be independent of a direct supply of portal blood and occurs in the absence of the post-hepatectomy rise in liver blood flow seen in normal rats.


Insulin as a cellular growth regulator.

Insulin as a cellular growth regulator. Previous studies from this laboratory have shown that insulin treatment greatly stimulates liver cell growth in chronically diabetic rats. The effect is striking, being preceded by massive glycogen deposition and water imbibition as well as enchanced RNA and protein synthesis. More recently we have directly confirmed the stimulatory effects of insulin on liver RNA and glycogen synthesis in intact hepatocytes isolated from normal and diabetic rats. The hepatocytes specifically bind insulin (KD = 3.5X10(-9) M) and the bound hormone is degraded systematically, indicating the possibility of receptor-mediated uptake of the hormone. Recent studies in other laboratories of the growth factors, non-suppresible insulin-like activity (NSILA) and nerve growth factor (NGF), as well as of relaxin, have disclosed structural relationships between these peptides and pro-insulin, indicating the existence of families of closely related anabolic effectors. A new hypothesis regarding the role of the insulin-receptor complex in initiating the metabolic and mitogenic effects of the hormone is briefly discussed.


Insulin-induced liver hyperplasia: evidence for a negative liver-size-correcting process. The fate of the increased liver DNA induced by insulin treatment of rats with chronic steptozotocin-induced diabetes was studied. The DNA content of the organ was restored to normal by an active process having a half-time of 32 days. The half-time of disappearance of thymidine-labelled DNA in the same livers was 81 days. The results indicate the existence of a mechnanism which acts to restore normal liver cellularity when an over-production of cells has occurred.


Hepatotrophic effects of pancreatic and gastrointestinal hormones in the rat in vivo and in vitro. The role of gastrointestinal and pancreatic hormones in regulating liver growth was evaluated by measuring their effect on DNA synthesis in the normal and regenerating liver of rats in vivo and in maintenance cultures of adult rat hepatocytes in vitro. After partial liver resection DNA synthesis reached peak levels after 24 hours while serum concentrations of immunoreactive insulin in portal and peripheral blood at this time were still suppressed. Increase of endogenous insulin levels by intravenous glucose infusion or portal infusion of insulin, glucagon or both together with glucose did not change DNA synthesis in normal or regenerating rat liver. After acute carbon tetrachloride poisoning of rats, survival rate and degree of liver necrosis was not changed by intraperitoneal infusion of glucagon and insulin with glucose. In vitro, insulin, glucagon and somatostatin synergistically stimulated the specific thymidine uptake in seven-day-old maintenance cultures of rat hepatocytes. The hormones did not cause cell multiplication but enhanced cell survival, probably by improving the uptake and utilization of nutrients. Gastrin G-17, secretin and cholecystokinin (contaminated with gastric inhibitory polypeptide) had no effect. It is concluded that the results do not support the contention that liver regeneration is regulated by the known pancreatic hormones. However, a trophic effect of pancreatic hormones on liver cells in vitro could be demonstrated. Gastrointestinal hormones had no such effect.


Studies on plasma cytotoxicity and liver regeneration in fulminant hepatic failure. The possibility that the blood of patients with fulminant hepatic failure might contain substances which prevent or delay liver regeneration was investigated using a microcytotoxicity assay system based on the culture of isolated rabbit hepatocytes in vitro. Results showed significant cytotoxicity of the plasma as compared to controls, an effect which was reduced by charcoal haemoperfusion. The effect was also reduced in vitro by heating and dialysis. The bile acids chenodeoxycholic and lithocholic acid were cytotoxic when added to control human plasma. Evidence was also obtained from a completely different in vivo assay system that high blood levels of ammonia may inhibit hepatic regeneration.


Kinetics of hepatocellular proliferation as a function of the microvascular structure and functional state of the liver. An analysis of hepatocellular proliferation in regenerating rat liver reveals a dependence of kinetic parameters on the microvascular structure of the liver. Influx kinetics of hepatocytes into DNA synthesis as well as cell cycle phases vary in different parts of the liver lobule between the afferent and efferent vascular poles. Heterogeneity of the proliferative response and size limitations on cell cycle compartments appear to be intimately related to the actual functional state of the individual liver cell. Modifications of liver cell functions result in variations of the proliferative activity. Phenobarbital-induced hypertrophy of hepatocytes reveals a permissive action on G1- S influx. Selective destruction of the subpopulations, by allyl formate, leads to a new functional determination of the residual liver and to a change in proliferative compartments. Maximum modulation of cell cycle compartments is obtained by hydroxyurea-induced synchronization of hepatocytes after partial liver resection. During hydroxyurea treatment, the regenerating liver shows a pronounced cellular hypertrophy. After release from hydroxyurea block, cells embark on DNA synthesis simultaneously. The DNA synthesizing compartment comprises almost the entire liver cell population. Heptotrophic factors might play a part in regulating or modifying hepatocellular function and proliferative response after cell loss.


Hepatotrophic factors: implications for diabetes mellitus. In view of the importance of insulin in hepatic cell proliferation and regeneration, disturbances might be expected in these processes in diabetics. The relative importnace of insulin replacement given intraportally rather than subcutaneously is discussed. Results are presented showing that even when normoglycaemia is achieved with peripheral insulin infusion using the 'artificial pancreas' there are still abnormalities in intermediary metabolism. The incidence of cirrhosis in diabetes is reviewed and it is concluded that the evidence is poor for an increase in diabetics. Finally it is shown that in the normal diabetic rat changes are observed after partial hepatectomy consistent with an increase in redox potential within the regenerating liver. Insulin treatment improves redox status but does not completely reverse the changes shown.


Respiratory tract mucus. Chairman's opening remarks.


Regulation of Na+ and Cl- transport and mucous gland secretion in airway epithelium. Ussing's short-circuit technique was applied to canine airway epithelium in vitrol and a net flux of Cl- towards the airway lumen was demonstrated, with a smaller net flux of Na+ in the opposite direction. Furosemide decreased and acetylcholine, terbutaline, and histamine increased net ion transport towards the airway lumen. Associated changes in water content in the airway lumen could affect mucociliary clearance, and therefore inhibition of ion transport may play a role in disease states. To study secretions from submucosal glands in vivo, two techniques were used to identify the duct openings in the exposed canine tracheal epithelium. (a) The exposed mucosal surface was coated with powdered tantalum; accumulated secretions produced elevations under which the duct openings were located. (b) A vital dye (0.1% Neutral red) was placed on the exposed mucosal surface; the dye stained the duct openings. With these techniques, the innervation of the submucosal glands and the autonomic regulation of their secretions were studied. Micropuncture techniques were used to sample the secretions from the glands and ducts.


Chemical aspects of tracheal glycoproteins. The chemical characteristics of tracheal mucus obtained directly from the epithelial surface of the trachea indicate that the mucus from each animal source consists of a group of sulphated sialic acid-containing glycoproteins. Fractionation of the native glycoprotein from the cat by gel chromatography in the presence of urea and dithiothreitol suggests a value of about 3 X 10(6) for the molecular weights. The chief monosaccharide constituents are N-acetylneuraminic acid, N-acetylglucosamine, N-acetylgalactosamine, fucose and galactose. In the goose tracheal mucin, mannose is present (serum proteins being absent). Doubly labelled cat mucus, obtained by giving Na235SO4 and [3H]glucose simultaneously into the lumen of the trachea, is massively released by parasympathetic agents, e.g. pilocarpine. The resulting mucus has a high content of 35S and is derived largely from submucosal gland cells. Subsequent exposure to an irritant, ammonia, releases a low sulphation fraction, highly labelled with 3H, arising from goblet cells. Evidence supports the view that the overall mucus is composed of mixed secretions, chemically distinct, from different cellular synthesizing sites. Differential nervous stimulation of the various sites may cause far-reaching changes in the chemical and physical properties of the mucus by selective action on the secretion of one or more of the contributing glycoproteins.


The glycoproteins of secretory cells in airway epithelium. Quantitative histochemical methods demonstrate a variety of glycoproteins within mucus-secreting cells of airway epithelium. A single cell may synthesize one or a combination of four major types--(i) neutral glycoprotein, (ii) and (iii) sialylated either sensitive or resistant to sialidase and (iv) sulphated. In human airway disease, or in experimental response to inhalation of an irritant, there is mucus cell hyperplasia and change in the proportion of cells synthesizing the various types. Experimental studies show how speedily these changes occur. In rats exposed to tobacco smoke changes are found within 20 h of the first exposure. Only in the extrapulmonary epithelium is there discharge of  the secretions, with an apparent fall in cell number. Modification of glycoprotein may occur with an unchanged or increased cell number, suggesting that it occurs in existing and newly appearing secretory cells. Modification of the contents of the granule occurs toward the cell apex. Modification of glycoprotein synthesis towards the normal is also the most sensitive and earliest sign of recovery.


Structure and function of mucus.

Structure and function of mucus. A glycoprotein building block is common to mammalian mucins. This structure is composed of several protein chains having the same sequence. The carbohydrate side chains, which constitute over three-quarters of the weight, coat only some two-thirds of the backbone chain. The bare protein chains are linked by disulphide bridges and can be digested away with trypsin. Either procedure rapidly solubilizes mucus and results in a structural unit of about 500 000 molecular weight. Mucus solubilizes spontaneously. The first size unit which reaches solution is about 15 X 10(6) molecular weight but continues to break down further. Mechanical agitation considerably speeds up this process. The gel-like character which is an essential feature of mucus--which cannot otherwise act as transport coupler--is thus a transient phenomenon. The problem of how such a structure can arise from the building blocks known to be available is discussed.


Nasal mucociliary clearance in man.

Nasal mucociliary clearance in man. Nasal mucociliary clearance was measured in healthy young human subjects and tracheal clearance in the experimental animal under a wide variety of conditions. There is a broad range of clearance rates whether at standard ambient conditions (23 degrees C, 50% relative humidity) or in the face of a number of environmental variables. The degree to which those differences are attributable to the effectiveness of ciliary beating or the character of airway secretions is not known. Studies of tracheobronchial secretions simultaneous with clearance measurement in the anaesthetized dog have not yet provided a definite answer. Variations in upper respiratory defence mechanisms may bear some relationship to the aetiology of small airway disease in the lungs.


Tracheobronchial clearance in health and disease: with special reference to interciliary fluid. Rats were exposed to influenza B virus for 2 hours. Mucociliary function in the isolated airway preparation of these animals was studied from the first day after exposure and at regular intervals for up to 190 days. Transmission electron microscopy (TEM) studies were done at times corresponding to the mucociliary function studies. TEM studies confirmed the results of the mucociliary function studies: pathological changes were first apparent three days after exposure and began in the distal bronchioles. The morphological studies further demonstrated that the infection progressed proximally to include the entire tracheobronchial tree by the 18th day. The alterations observed included an increase in the number of goblet cells, a decrease in the number of microvilli and a reduction in the amount of interciliary fluid. The last two changes were closely correlated with the severity of the infection. The abnormalities found in mucociliary function included hypersecretion of mucus, inactive and hypoactive zones, synchronization of cilia beating, and a sticking together of the cilia tips.


Site of synthesis, intracellular transport and secretion of glycoprotein in exocrine cells. The site of attachment of the first sugar, N-acetylgalactosamine, to the seryl and threonyl residues of the protein chain is unknown in exocrine cells. The subsequent sugars of the carbohydrate side chains, galactose and N-acetylglucosamine alternately, and the end-group sugars, galactose, N-acetylgalactosamine and fucose, are attached in the Golgi complex. Sulphate too is attached in that structure. In the stomach, sulphate is probably transferred in the most mature cisterna of the Golgi stacks, galactose and fucose in other cisternae, suggesting a gradient in transferase activities along the stack. The possibilities of regulating the amount and relative sugar composition of the glycoproteins are discussed. The secretory product is stored in granules. Their polygonal, large and swollen appearance and complex formation by loss of bordering membranes, as observed in many kinds of glycoprotein-secreting cells ('mucous cells') might be caused by ineffective fixation techniques. Direct vascular perfusion results in a picture no different from what is found in non-mucous cells. Whether secretion is merely exocytotic, as in non-mucous cells, or whether it is accompanied by a loss of membrane and even cytoplasm needs thorough investigation, with the effects of various fixation techniques being compared.


The isolation and partial characterization of the major bronchial glycoproteins. Partial characterization of glycoprotein obtained from mucous secretion of the bronchi and stomach has been attempted. The isolated glycoproteins and the glycoproteins from gastric aspirates showed similar carbohydrate and amino-acid composition. They consist of a protein core to which are attached carbohydrate side chains of galactose, N-acetylglucosamine and N-acetylgalactosamine in the ratio of 4 : 3 : 1. Superimposed on this structure were additional sugar residues, the blood group determinants. The carbohydrate side chains are linked by an alkali-labile O-glycosidic linkage to the threonine and serine residues of the protein core, with N-acetylgalactosamine forming the link.


Criteria for evaluating mucus functions and their disorders in chronic bronchitis. In chronic bronchitis, disorders of the physical and chemical properties of mucus may contribute to bronchial obstruction. The abnormalities are analysed in sputum collected by physiotherapy. Measurements of the rheological properties (apparent viscosity and strain recovery), content analysis of secretory immunoglobulin A (S-IgA) and of serum albumin, and determination of the transport velocity of sputum on the ciliated frog palate provide reliable indices of the functional capacity of bronchial mucosa. The effectiveness of mucociliary clearance and coughing is analysed in patients by measuring the rate of removal of radioactive particles deposited on proximal airways. Different types of pathological secretions may be observed. In subjects with occasional cough and sputum, the secretions are characterized by a high content of S-IgA and serum albumin, and a high viscosity and low elasticity, reflecting their high degree of cross-linking. In chronic bronchitics, the S-IgA content and viscoelastic properties of sputum decrease as the illness progresses. During infection, purulent sputum exhibits high viscosity and low strain recovery. Such modifications of the rheological properties of mucus may impair mucociliary clearance. The role of the elastic component is predominant. Sputum, characterized by very low strain recovery (SR less than 4 units) or conversely by very high strain recovery (SR greater than 15 units), is transported at a low rate by mucociliary clearance. A marked hyperviscosity (no greater than 200 poises (120 N s m-2)) also appears as a limiting factor of the mucociliary clearance.


Animal models in clinical disease.

Animal models in clinical disease. Hypersecretion of mucus is a feature of several clinical diseases and in some is associated with mucous gland hypertrophy and goblet cell increase. In a variety of species these changes have been produced by irritants, by infection, or by administration of drugs. While the end result may appear the same, differences emerge in the type and amount of glycoprotein secreted and in the amount retained within the cell. Organ culture can be used to ascertain functional activity. The use of animal models has not only established that these environmental changes cause hypertrophy but indicated some of the intracellular events associated with their development. When new types of granules appear within a cell, they appear first at the apex: a flow chart is offered of the way of which individual cells change and hence the population. The nature of glycoprotein elaborated by a secretory cell can change within hours. A Clara or serous cell can develop into a mucus-secreting or goblet cell. The pattern of reversibility is emerging.


Respiratory tract mucus. Chairman's closing remarks.


Structure and function of mucus-secreting cells of cat and goose airway epithelium. In the cat and goose, studies have been undertaken to determine the ultrastructure of airway epithelia, the concentration and distribution of the secretory cells which produce respiratory tract mucus, and the histochemistry of mucins located within cells and on their luminal surfaces. By electron microscopy all the 11 cell types so far described can be found in the airways of the cat but not the goose. Both goblet cells and submucosal glands are abundant in the cat whereas the trachea of goose lacks the latter, having instead abundant goblet cells many of which form 'intraepithelial glands'. Histochemically, the goblet cells of the cat and goose are similar in that they contain mucins with a predominance of sulphate esters. A surface mucosubstance can be demonstrated which, histochemically, is similar to that described in dog and man. Interestingly, this surface layer may be sloughed in response to an inhaled irritant such as ammonia and thereby contribute to the respiratory tract mucus recovered experimentally. Incorporation into macromolecules of radioactively labelled mucin precursors is assessed by autoradiography of tissue sections, and preliminary results of experiments designed to test the response of mucus-secreting cells to airway irritation and the parasympathomimetic drug, pilocarpine, are also presented.


Stimulus-secretion coupling: variations on the  theme of calcium-activated exocytosis involving cellular and extracellular sources of calcium.


Studies on the control of mucin production. The process of synthesizing a mucin molecule is discussed, primarily from the standpoint of glycoconjugate biosynthesis. The control of the activation steps in the making of nucleotide sugars is detailed, stressing the molecular mechanisms operating. These include: supply of glycolytic intermediates; the pyridine nucleotide redox potential; the energy state as expressed in nucleotide potential; and feedback modifiers. Next, the glycosyl transferases are discussed, as are suggestions of control at the first committment step and the subjects of specificity of donor and acceptor molecules and the associational state of the glycosyl transferases. The secondpart of the paper describes a model system in vivo. The paired cat submandibular glands are exposed and, in one, blood supply and salivary duct are cannulated and the parasympathetic and sympathetic nerve exposed. This preparation uses the contralateral gland as control and enables certain questions to be asked: 1. Does the cell produce incomplete mucins when the biosynthetic rate is high? 2. Does the energy state of the cell 'keep up with' the high rates of synthesis? 3. What is the extent of post-synthetic modifications? 4. What cell types are involved in mucin elicited by different chemical or electrical stimuli? 5. What is the time involved in synthesis and storage?


Enzymatic inactivation of eukaryotic ribosomes by the pokeweed antiviral protein.


Initiator-tRNA recognizes a tetranucleotide codon during the 30 S initiation complex formation.


Is it bad to be 'bonny'?

Is it bad to be 'bonny'?


The health visitor as a link between home and education.


Are you paying lip service to breast feeding?


Computerisation of personal health records.


Health visitors and the TUC.

Health visitors and the TUC.


"Chemical aminoacylation" of tRNA's.

"Chemical aminoacylation" of tRNA's. Incubation of abbreviated tRNA's (tRNA-C-COH's) with (chemically) preaminoacylated P1, P2-di(adenosine 5'-)diphosphates in the presence of purified RNA ligase effected transfer of an aminoacyladenylate moiety to the 3'-terminus of the abbreviated tRNA's in good yield. Aminoacylated (or misacylated) tRNA's may thus be prepared from fractionated or unfractionated tRNA-C-COH's; each of the five aminoacylated dinucleoside diphosphates tested was utilized as a substrate by RNA ligase. That the resulting "chemically aminoacylated" tRNA's were identical with those prepared by enzymatic aminoacylation was judged by comparison of 1) chromatographic properties on benzolated diethylaminoethyl-cellulose, 2) rates of chemical deacylation, and 3) affinities for elongation factor Tu, as well as 4) the ability of misacylated tRNA's so derived to be deacylated chemically and then reactivated enzymatically with their cognate amino acids.


Susceptibility patterns of Staphylococcus in a family practice population. Nasal swabs were obtained from 408 patients seen in a family practice office in an attempt to identify Staphylococcus aureus carriers. Isolated strains were tested for sensitivity to 11 antibiotics. Study participants were interviewed to obtain the following data: age, history of recent hospitalization and/or recent antibiotic use, number of household members, and occupation, if employed in a health-care facility. S aureus was isolated from 109 nasal swabs. This represents a 26.7 percent carrier rate. Only 25.7 percent of the isolates were sensitive to penicillin G and ampicillin. No statistically significant association was found between the patient variables and either the carrier rate or the sensitivity of the S aureus isolates to penicillin. The sensitivity testing demonstrated that 94.5 percent of the isolates were sensitive to tetracycline and erythromycin. Ninety-nine to 100 percent of the isolates were sensitive to all other antibiotics tested. The authors conclude that penicillin G should not be used in the treatment of S aureus infections. Erythromycin, due to demonstrated sensitivity and reasonable cost, is recommended for mild to moderate infections.


A framework for ambulatory care evaluation.


Supervision and the informal organization.


Research utilization as an organizational process.


A "temporary systems" approach to nursing education in a health care organization.


Synthesis of potential antineoplastic agents XXVI: 1,3,4,6,7,11b-hexahydro-9,10-dimethoxy-2H-benzo[a]2-quinolizinone derivatives. A number of 3-alkyl-1,3,4,6,7,11b-hexahydro-9,10-dimethoxy-2H-benzo[a]2-quinolizinones and 2-substituted 3-ethyl-1,3,4,6,7,11b-hexahydro-9,10-dimethoxy-2H-benzo[a]quinolizines were prepared and submitted for antineoplastic and anticonvulsant screening.


Toward better patient teaching. Part 1.

Toward better patient teaching. Part 1.


Large volume parenterals.

Large volume parenterals.


A survey of the health science discipline -- its relationship to other academic disciplines.


Is a mandated comprehensive health education program a guarantee of successful health education? This study evaluated the health knowledge of a selected population of 12th grade students. A random selection of 30% of the total senior population from 7 public high schools was obtained. The Kilander-Leach Health Knowledge test was used. An analysis of variance was performed by sex and by health area. The FLSD multiple range test was utilized where significance was found among groups. The findings revealed that students' health knowledge was weak; moderate strength was indicated in the area of chronic disease; no significant differences were observed between males and females on the total test; there was significant differences in health knowledge on the total test among the schools.


Cardiovascular disease education in Texas health education classes -- a needs assessment. This study ascertained to what extent cardiovascular diseases and associated risk factors are taught in public secondary health education classes in Texas, the disparity between what is taught and what is desired in terms of time allotment and educational materials, to what extent health education teachers are academically prepared to teach cardiovascular diseases and associated risk factors, and to what extent teachers utilize self-instructional materials. A questionnaire was mailed to a random sample of health education teachers in Texas. There was a return of 45.4%. The findings indicated that more time is devoted to teaching the cardiovascular system than disease and risk factors; there is a disparity between what is taught and what is desired; the teachers rated their preparation as average; and the use of self-instructional materials by high school students as average to excellent.


A comparison of perceived and actual sexual behaviors of college students. This study investigated the relationships between reported sexual behaviors of college students and their perceptions of sexual behaviors of peers. Seventy-four subjects completed the survey instrument. Chi-square comparisons determined the relationship between reported sexual behaviors and perceived sexual activities. Males were more accurate than females in perceiving sexual activities of males but not of females. Females were unable to perceive accurately male or female behaviors.


The reduction in the intensity of meaning attached to sex words. This investigation utilized 192 college students to determine if the intensity of meaning attached to sex words could be reduced, if change in this meaning intensity was affected by the passage of time, if the intensity of meaning was related to the students' anxiety level, and if students felt more comfortable in using sex words after treatment than they did before treatment. Pretest instruments determined the intensity of meaning and anxiety level. A verbal satiation method was used with the experimental groups. Three posttest time delay measurements were taken in both experimental and control groups. It was concluded that technical health words and common health words produce communication blockages.


An instrument for the recording of student health complaints. This study described the development and uses of an instrument for the systematic collection of student health complaints in school. A booklet was prepared listing all student's names for one rural elementary school. A code to indicate date, class period, complaint, and outcome was utilized for collecting data. After a 2.5 month trial period, data were analyzed. The findings revealed 418 visits to the school health room -- range of visits by classroom was 3 to 71 -- most visits were for stomach ache or physical injury -- one classroom accounted for 16% of all visits -- fourth and sixth grades had a significantly larger number of visits than grades three, five, and seven.


An analytical study of selected writings and their relationship to health.


How medical doctors can meet the challenge of the registered nurse's expanded role.


Patient abuse: flurry, fanfare--fadeout?


Reasons why R.N.s should carry their own liability insurance.


The nursing practice act: legal parameters of nursing.


Developing a nursing care committee.

Developing a nursing care committee.


Treatment or torture?

Treatment or torture?


Treatment or torture.

Treatment or torture.


Which babies should be admitted to special care units?


When gambling becomes a problem.

When gambling becomes a problem.


Group help for young mothers.

Group help for young mothers.


The new wonder ingredients in breast milk.


Last rites and funeral customs of minority groups.


Subnormality in children.

Subnormality in children.


Contracts of employment.

Contracts of employment.


Unwelcome environment.

Unwelcome environment.


Mother-baby-nurse relationship.

Mother-baby-nurse relationship.


Antibiotic sensitivity of mouth anaerobes.


Nursing legislation.

Nursing legislation.


Challenges for caring about the elderly.


A guide to the role and utilization of the licensed practical nurse.


The expanding role in nursing.

The expanding role in nursing.


Psychological support of the ostomy patient.


The Graduate Record Examination: does it predict performance in nursing programs?


Draining the "fluid ear" with myringotomy and tube insertion.


Love and lavage. The urgent needs of children with Hirschsprung's disease.


Coping with a seductive patient.

Coping with a seductive patient.


"Driving" nurses to research.

"Driving" nurses to research.


Sam - the patient nobody wanted to visit.


Passive range-of-motion exercises. A handbook.


Answers to the 15 legal questions nurses usually ask.


Moving ahead. If you want to make a positive difference in nursing, become a nurse researcher.


The breath of life.

The breath of life.


Accountability and autonomy are more than rhetoric.


Audiometry on wheels.

Audiometry on wheels.


Safe use of lasers.

Safe use of lasers.


Into Europe--2. Italy.

Into Europe--2. Italy.


Professional accountability.

Professional accountability.


Fingertip injuries and the orthopedic nurse.


A rare metabolic birth defect.

A rare metabolic birth defect.


Internal fixation of trochanteric fractures by the Ender method.


Questions and answers about continuing education.


The AD graduate: from student to employee.


The novice employee in industry: applications for nursing.


Sexual difficulties as indicators of broader personal and interpersonal problems (as reflected in psychotherapy group).


A transition program for new graduates.

A transition program for new graduates.


Novice assignments and multi-level care.


AD graduates: can they fit your system's needs?


Changing attitudes toward homosexuality--or are they?


Divergence between nursing education and nursing service regarding the role of the associate degree graduate.


A psychoanalytic view of homosexuality: an interview with Joseph J. Geller. M.D.


Identifying the competencies and roles of the associate degree nurse graduate.


Performance of associate degree nurse graduates as perceived by nurse personnel.


The AD graduate: excellence in practice--fantasy or reality?


Inventing one's own wheel.

Inventing one's own wheel.


Nursing values in a changing society.

Nursing values in a changing society.


Teaching as coaching.

Teaching as coaching.


Levels of practice in a community health agency.


An insider's guide to field research.

An insider's guide to field research.


The integrated baccalaureate curriculum: an opinion survey.


A follow-up study of a master's program.


Establishing a nursing contract.

Establishing a nursing contract.


Class size and cost in ADN programs.

Class size and cost in ADN programs.


Cardiac rehabilitation: a patient education program. Hospitalized cardiac patients were given an education program that covered, in five 45-minute discussion sessions, anatomy and physiology, dietary management, appropriate activity programs, the adjustment process, risk factors, and signs and symptoms of complications of therapy. A sample of 36 patients was given pre- and posttests and followed at six weeks and three months postdischarge. Significant (p less than .05) increases in knowledge were found among study subjects which resulted in improved conditions for the subjects.


Abstracts--keys to the literature.

Abstracts--keys to the literature.


Increasing nurses' person-centeredness.

Increasing nurses' person-centeredness. In a two-phased study, two samples of registered nurses listened to audiotaped disclosure statements from simulated patients and responded to each statement "in as helpful a manner as possible." Their responses were judged for degree of "person-centeredness." Nurses in sample one (N=24) received no intervention between the two phases of the study; nurses in sample two (N=20), after completing phase I, listened to a brief message designed to enhance the helpfulness of their responses. No differences were found for the phase I person-centeredness scores; the nurses who received the intervention showed significant improvement in their degree of person-centeredness as compared to those who did not receive the intervention. Implications of these results are discussed.


Conceptual systems of undergraduate nursing students as compared with university students at large and practicing nurses. Phase I of a longitudinal study compared characteristics of abstractness-concreteness of junior-level baccalaureate nursing students at the University of Colorado with characteristics of practicing nurses and other college students. Three measurement instruments were used: Harvey's Conceptual Systems Test, the Role Survey, and the Self-Esteem Questionnaire. Nursing students were found to be more abstract than practicing nurses; no difference was found on abstractness-concreteness between nursing and the other students. More nursing students than practicing nurses or other students were found to have a need for structure and order. And, nursing students showed higher overall expanded role orientation than practicing nurses. Phases II and III of the study will examine nursing students' changes in abstractness-concreteness during the second and third years of study.


Methodologic dilemmas in tapping the concept of patient needs. Patients' awareness of their own physical and emotional needs during hospitalization and nurses' perception of those needs were tested by a questionnaire constructed for the purpose. The test took place in five units of a large university medical center and included 30 patients and their 20 nurses. A comparison group included ten patients and eight nurses. Despite apparent reliability after pretesting, the questionnaire proved unreliable after use with the study group. This difference may have resulted from differences in responses between the pretest and study groups or from interviewer variability. Or contrary to pretest findings, the real contents of physical and emotional needs may not have been tapped.


Sex-role stereotyping in assessments of mental health made by psychiatric-mental health nurses. To determine the amount of sex-role stereotyping in judgments of mental health made by psychiatric-mental health nurses, 150 of these nurses, divided into three equal groups, were asked to rate ideal states of mental health in males, females, and adults, respectively. An 83 percent return rate was obtained. Results showed: 1) there was less sex-role stereotyping than in a similar study reported in 1970 with other mental health professionals; 2) judgments of mental health closely resembled assessments of social desirability; 3) healthy females were rated closer to that which was considered desirable and closer to the healthy adult pole than males or adults; 4) healthy females possessed the valued male traits without losing the female-valued characteristics; and 5) nurses who had longer experience as therapists, who were older, and who were still practicing viewed men and women as more alike rather than placing higher expectations on women.


The BOEL test as a screening device for otitis media in infants. Two hundred and forty-five infants with a mean age of nine months were given screening tests in private pediatric offices by two nurses. Low scores on the BOEL test, a measure of selective attention developed at the Karolinska Institute in Sweden, were found to be significantly associated with the presence of otitis media. Of the 12 items on the BOEL, only the four relating to auditory orienting behavior were discriminative. As a screening device for otitis media, these four items had a validity of 87 percent correct predictions, with 11 percent false positives but only two percent false negatives. BOEL scores also had positive correlations with three of four areas tested by the Denver Developmental Screening Test, but these relationships were modest in magnitude, suggesting that the BOEL and the DDST measure different aspects of the infant's behavior.


Nursing research centers on the rise.

Nursing research centers on the rise.


Cognitive and affective consequences of formative evaluation in graduate nursing students. To test the effect of formative evaluations on cognitive learning and affective behaviors, 57 graduate nursing students were placed in experimental (E) and control (C) groups. Two hypotheses were stated: that E students learn and demonstrate affective behaviors significantly more than C group students. The 25 E group subjects were taught by means of formative evaluations. The 32 C group subjects were taught by lecture-discussion. The content taught dealt with conditions of learning and instruction in nursing. Pre- and posttests measured cognitive learning. Demographic data and affective measures were obtained only at the posttest. Results showed: The E group learned and demonstrated affective behaviors significantly more than the C group. Both groups learned significantly. Subjects preferred the formative evaluation technique significantly more than the LD. Significant positive correlation was found between amount of learning and affective behaviors. Implications were made for education of patients, students, and stall.


What problems are encountered in using patients' charts as sources of data for research?


Values and value changes of graduate nursing students: their relationship to faculty values and to selected educational factors. Values of 75 graduate nursing students in one university school of nursing were compared at times of entry into the program and at the completion of one academic year of study. Gordon's Survey of Interpersonal Values and Survey of Personal Values and a questionnaire were used to collect data. The students' perceived impact of certain educational factors was explored for possible relationship of these factors to changes that occurred. Values of the graduate nursing faculty and their perception of the importance of the same factors were obtained and compared with those of the students. Students showed signficant increases in values of support, recognition, and independence and significant decreases in benevolence, conformity, and practical mindedness. These changes bore similarity to those reported in previous studies of undergraduate nursing students and medical students. Differences between the students and faculty on two values, practical mindedness and independence, had disappeared by the end of one year; difference on one value, recognition, had appeared; and difference on one value, achievement, remained the same. The influence of specific educational factors was not clear. Faculty judged almost all factors as having a greater impact on students than students judged their impact to have been. Students' preestimate of probable influence of the same factors was significantly higher than their postestimate. Some uniform processes of socialization occurred even though students and faculty were not always in agreement about the importance of educational activities and outcomes.


Evening telephone call management by nurse practitioners and physicians. History-taking, disposition, and telephone communication skills of pediatric nurse practitioners, pediatric house officers, and practicing pediatricians were assessed and compared. To evaluate the management of five common acute pediatric problems, a "programmed mother" made 148 unidentified calls to these health professionals during evening hours. The calls were tape recorded, and scored for history-taking, disposition, and interviewing skills. The scoring system, developed by a panel of 11 experts, assessed the relevance and completeness of each history obtained. Nurse practitioners averaged 79.6 percent of the total possible score, as compared to 52.6 percent for pediatricians  (p less than .001). When disposition was similarly analyzed, the nurse practitioners scored significantly higher than pediatricians. Analyzing only those items of history-taking and disposition deemed most critical by the panel, nurse practitioners included 91 percent and pediatricians only 55 percent (p less than .001). Parameters of interviewing skill were scored by the interviewer and each author with agreement of 80 percent or above; nurse practitioners obtained significantly higher scores than pediatricians (p less than .001). Calls handled by nurses averaged 7.4 minutes, those by pediatricians 3.2 minutes (p less than .001). Nurse practitioners, it was concluded, can safely and effectively share responsibility with physicians for night and weekend telephone call coverage for a pediatric practice with adequate physician back up.


Using nursing research findings to meet the needs of grieving spouses. This article describes the utilization of nursing research findings in a coronary care setting. A standardized nursing care plan, based on Hampe's eight research-identified needs of grieving spouses, was developed by staff nurses in an intensive care unit. The 13 spouses of acutely ill coronary patients who had received specific nursing interventions reported more of their needs were met by nurses than did 13 spouses on whom base-line data were collected prior to the adoption of systematic nursing interventions.


An introduction to medical/nursing libraries and available resource tools.


Death and dying: selected attitudes of Minnesota's registered nurses. A study of attitudes toward dying patients of 1,061 Minnesota nurses who practiced in the metropolitan area (210 nurses) and outside the metropolitan area (851 nurses) revealed that they supported home care for dying children. They reported they would be willing to care for the dying adult or child in the home, but would feel more comfortable if they had added specialized preparation.


A proposed model for critical ethical analysis.


ODWIN expansion program: a study in success. Of 182 students who successfully completed an eight-week program for high school graduates with marginal credentials and who were admitted to schools of nursing, 125 (69 percent) subsequently received degrees or certificates. This success rate compares favorably with national and regional norms. This study documents the marginality of the students' credentials and evaluates their success rates. Of 11 academic variables correlated with successful completion of nursing programs, the two subjective evaluations of each student by the academic personnel teaching the eight-week program were the only variables to reach significance (p = .01).


Impact of a management-oriented course on knowledge and leadership skills exhibited by baccalaureate nursing students. This study evaluated the impact of a one-month management concept course on 80 senior baccalaureate nursing students. Findings revealed that leadership values held by nursing students did not affect their leadership behaviors. Nursing students who took the course demonstrated significantly more leadership behaviors and knowledge of leadership concepts than students who did not take the course. Reasons for the findings are discussed.


Nursings bid for increased status.

Nursings bid for increased status.


Nursing ethnics: theories and pragmatics.


Self-actualization and the baccalaureate nursing student's response to stress. A sample of 144 senior nursing students from four baccalaureate schools in the New York metropolitan area was used to study the relationship between self-actualization and the baccalaureate nursing student's response to stress. Levels of self-actualization and state and trait anxiety were measured at a time defined as low in stress; state and trait anxiety were measured again at two high-stress times. Instruments used for the study were Shostrom's Personal Orientation Inventory and the Spielberger et al. State-Trait Anxiety Inventory. The three hypotheses were supported by significant results (p less than .05), confirming the prediction that level of self-actualization is a factor in the differential perception of evaluative events as stressful. Findings are considered applicable to the revision of recruitment and selection procedures and to incorporating in baccalaureate nursing curriculums measures more likely to produce graduates who can sustain the personal values prerequisite to a professional level of nursing practice.


The normal curve theory of nursing.

The normal curve theory of nursing.


The nurse practitioner: role, physician utilization, patient acceptance. A comprehensive study of nurse practitioners was undertaken by the University of Virginia Schools of Medicine and Nursing in the summer of 1974 to evaluate nurse practitioner training programs of the University of Virginia and to determine the effectiveness and responsibilities of nurse practitioners in various practice settings. Data on nurse practitioners in a number of locations in Virginia and in the Philadelphia metropolitan area were collected and analyzed to determine the way in which the nurse practitioners' time was allocated among various duties and to evaluate nurse practitioner performance by physicians and patients. Nurse practitioners performed a wide variety of clinical and nonclinical tasks. Most physicians were satisfied with the practitioner's performance, although there was some inconsistency between physicians and nurse practitioners regarding actual duties performed. A high percentage of physicians stated they would hire a nurse practitioner to replace one who left their employ. Physicians' reasons for hiring a nurse practitioner, as well as their previous contact with such personnel, were examined. Regarding patient attitudes toward nurse practitioners, data indicated that patients were satisfied with nurse practitioners and felt comfortable being treated by them.


Pain response: the influence of psychosocial cultural factors.


Reality therapy: a realistic approach to enterostomy rehabilitation.


Comparison of manifest needs of nurses and physicians in primary care practice. Nurses, among other professionals, have been tested extensively using the Edwards Personal Preference Schedule. High scoring needs found in previous studies were order, deference, and endurance. In this study, questions focused on whether these needs remained prominent in a group of nurses, whether there were shifts in the need patterns over time, and how the nurses' needs compared with the needs of physicians. In this study 127 graduate nurses enrolled in a medical nurse practitioner program and 31 physician colleagues completed the EPPS. The rank order of needs among nurses was strikingly different from those collected in previous samples. Need for heterosexuality, dominance, intraception, change, and achievement consistently appeared highest since 1973, whereas need for deference, order, and endurance scored consistently among the lowest six needs. The rank-order correlation between nurses and physicians in this sample, all of whom were working in primary care settings, was high (r = .9). Only one of the 15 needs, intraception, differed significantly between the nurse and the physician groups, the nurses scoring higher. The shift in needs of the nurses and the high similarity of needs of the nurse and physician groups suggest an emerging assertiveness on the part of the nurses and a trend toward similarity of need patterns with physicians practicing in primary care.


Independent-individualized learning: the process and the processors.


The personal development of the nursing student as a conceptual frameworld.


An American adventure.

An American adventure.


Quarrymen's hospital.

Quarrymen's hospital.


Effect of negative pressure on tracheobronchial trauma. To test the effect of different negative pressures on tracheobronchial trauma in the presence of simulated mucus, measured amounts of simulated mucus were injected into the trachea of two anesthetized mongrel dogs. Suctioning was performed using a different negative pressure for each animal. To identify the effects of negative pressure alone, endotracheal tube size, suction catheter type, suction duration, and suction procedure were identical for both dogs and were selected on the basis of current practices at the hospital with which the investigator was affiliated. Arterial pressure and electrocardiogram were monitored throughout each experiment. The trachea was excised and examined for pathologic changes. Tracheobronchial trauma occurred with suctioning at negative pressures of 100 mm Hg and 200 mm Hg; damage was greater, however, at 200 mg Hg. Results were consistent with postulates made by other investigators in that the extent of tracheobronchial trauma was directly related to the magnitude of negative pressure applied. Comparison of this study with studies which omitted mucus simulation suggests that the amount of damage is not related to the amount of mucus in the trachea. In addition, aspiration efficiency proved to be the same regardless of the negative pressure used. Suctioning at 200 mg Hg recovered approximately the same amount of mucus as suctioning at 100 mm Hg.


Laminectomy. 2. Nursing vigilance.

Laminectomy. 2. Nursing vigilance.


Are we what we think we are?

Are we what we think we are?


Record keeping--a boon or a bind? 1. Record content.


The nursing officer's guide to management. 8. Numbers and management.


The nursing officer's guide to management. 7. Communication skills.


A voice through a cloud.

A voice through a cloud.


Pop come the health problems.

Pop come the health problems.


Saving a life after cardiac arrest.

Saving a life after cardiac arrest.


The case for central advisory service for the elderly.


Agency experience is good experience.

Agency experience is good experience.


Homeward bound.

Homeward bound.


Psychiatric nursing today. 2. Behaviour therapy and the nurse.


Psychiatric nursing today. 1. Protecting the patients.


Nursing care study: Tom: a boy with asthma.


A rural initiation.

A rural initiation.


Record keeping--a boon or a bind? 2. Nurses' views.


Look again at ODAs.

Look again at ODAs.


A patient speaks out.

A patient speaks out.


Asians and the NHS.

Asians and the NHS.


Histidine transfer RNA levels in Friend leukemia cells: stimulation by histidine deprivation. Friend leukemia cells incubated with sublethal concentrations of histidinol for 5 to 6 days show up to twofold increases in their relative concentrations of histidine transfer RNA and no change in the relative concentrations of leucine transfer RNA. A similar effect is seen when cells are grown to stationary phase in the presence of 0.2 times the amount of histidine in Eagle's minimum essential medium. These observations support the theory that the concentrations of specific transfer RNA's are regulated by a mechanism that is sensitive to the extent of their aminoacylation.


Who is the professional nurse? Law for the nurse supervisor.


The art and science of supervision. Control--a management tool.


Supervisor overseas. Illiterate nurses!

Supervisor overseas. Illiterate nurses!


The organization of nursing services. A model for the future.


Documentation of nursing process.

Documentation of nursing process.


Cost control in nursing.

Cost control in nursing.


The clinical specialist as performance appraiser.


Nursing care plans for the "older" graduate.


W. Va. health systems agency: where are the nurses? Where is NAACOG?


Are nursing students planning to relocate after graduation?


Programmed instruction: skin rashes in infants and children.


Diuretics.

Diuretics.


Nurses can change the social systems of hospitals.


When the walls listened.

When the walls listened.


AJN interviews the ANA president.

AJN interviews the ANA president.


Gift giving in the nurse-patient relationship.


Loop transverse colostomy.

Loop transverse colostomy.


A beginning nurse reacts.

A beginning nurse reacts.


From the ideal to the real.

From the ideal to the real.


Becoming comfortable with sexual assessment.


Liability in the emergency room.

Liability in the emergency room.


The nurses' health study.

The nurses' health study.


Cefuroxime, a beta-lactamase-resistant cephalosporin with a broad spectrum of gram-positive and -negative activity. The in vitro activity of cefuroxime, a cephalosporin antibiotic, was investigated against 604 isolates and compared with the activity of other beta-lactam compounds. Cefuroxime had activity comparable to that of other cephalosporins, including cefamandole and cefoxitin, against streptococcal and staphylococcal species; most streptococci were inhibited by 0.1 mug or less per ml, and staphylococci were inhibited by 1.6 mug or less per ml. Enterococci were relatively resistant. Cefuroxime inhibited beta-lactamase-producing Neisseria gonorrhoeae and Haemophilus influenzae. Cefuroxime had excellent activity against members of the Enterobacteriaceae; 83% of beta-lactamase-producing Escherichea coli, 100% of Salmonella, 100% of Klebsiella, 90% of Proteus mirabilis, 95% of Citrobacter, 56% of Enterobacter, and 58% of Shigella were inhibited by 12.5 mug/ml. Cefuroxime had activity comparable to that of cefamandole and cefoxitin; it inhibited isolates of E. coli and Klebsiella resistant to cefamandole and inhibited Enterobacter and Citrobacter resistant to cefoxitin. Many isolates of Serratia, some indole-positive strains of Proteus, and Bacteroides fragilis were resistant to cefuroxime. Resistance of cefuroxime to hydrolysis by beta-lactamases played a major role in its activity against both gram-positive and gram-negative organisms.


Antibacterial activity of apalcillin (PC-904) against gram-negative bacilli, especially ampicillin-, carbenicillin-, and gentamicin-resistant clinical isolates. Apalcillin (PC-904) is active against carbenicillin- and ampicillin-resistant strains of gram-negative bacilli. Among Pseudomonas aeruginosa strains highly resistant to carbenicillin (>/=3,200 mug/ml), half of them were susceptible to PC-904 at a concentration of 50 to 1,600 mug/ml. The minimal inhibitory concentration of PC-904 against P. aeruginosa strains resistant to carbenicillin (400 to 1,600 mug/ml) ranged from 3.1 to 25 mug/ml. Ampicillin- and carbenicillin-resistant Enterobacteriaceae strains were similarly susceptible to PC-904. However, drug resistance to PC-904 was already apparent among some strains of P. aeruginosa, Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, P. vulgaris, and P. morganii, recently isolated in Japan; i.e., 4, 35, 32, 4, 6, and 14% of strains isolated were resistant. PC-904 was more active, on the other hand, than ampicillin and carbenicillin against antibiotic-susceptible Enterobacteriaceae and also showed high activity against most species of Pseudomonadaceae, especially P. cepacia and P. aeruginosa. The minimum inhibitory concentrations of PC-904 were greatly affected by inoculum size when the organisms tested were strains producing large amounts of beta-lactamase.


Methicillin-resistant Staphylococcus aureus susceptibility testing by an automated system, Autobac I. The Autobac I system was used to evaluate the antibiotic susceptibility pattern of methicillin-resistant Staphylococcus aureus isolates. The results of the Autobac I were compared with the results of the disk diffusion method. The disk diffusion susceptibility pattern showed resistance to methicillin/oxacillin, penicillin, erythromycin, clindamycin, and kanamycin. All isolates were susceptible to cephalothin, chloramphenicol, tetracycline, and gentamicin. There was at least 96% agreement using the Autobac I system with all antibiotics except methicillin and clindamycin. Seventy percent of 57 isolates were recorded as susceptible to methicillin, whereas 9% had an intermediate susceptibility. With clindamycin, 14% were recorded as susceptible and 7% were recorded as intermediate. Upon prolonged incubation of the Autobac I cuvette, the agreement between the two methods was 44% for methicillin and 93% for clindamycin. Changes in the environmental conditions, such as use of 5% sodium chloride broth and a 32 degrees C incubation temperature, did not increase the detection of methicillin-resistant isolates by the Autobac I system.


Mechanism of penicillin-erythromycin synergy on antibiotic-resistant Staphylococcus aureus. Clinically isolated strains of Staphylococcus aureus that are inducibly resistant to both erythromycin and penicillin were susceptible to a combination of the two antibiotics. The synergistic effect of the combination results from an inhibition of penicillinase induction by erythromycin, sparing penicillin and allowing this drug to inhibit growth. When resistance to erythromycin is constitutive rather than inducible, the combination is no longer synergistic.


Some side effects in the mouth caused by drugs.


Developments in family planning overseas. An account of family planning education programmes in Britain, Italy, Hong Kong, Malaysia and Singapore. Part one--Britain.


Cholesteatoma--a case history.

Cholesteatoma--a case history.


The concept of sensory deprivation.

The concept of sensory deprivation.


How to acquire the healing touch.

How to acquire the healing touch.


Wastage in nursing training.

Wastage in nursing training.


The nurse within the bureaucracy.

The nurse within the bureaucracy.


Trends in nurse staffing patterns.

Trends in nurse staffing patterns.


Problems associated with the evaluation of nursing students undertaking the basic nursing course in Queensland.


Accreditation as seen by a medical surveyor.


Chemical modification as a probe of conformational changes in transfer ribonucleic acid on aminoacylation. Treatment of Escherichia coli CA265 phenylalanyl-tRNA with 3M-NaHSO3, pH6.0, at 25 degrees C resulted in modification of four bases and in the deacylation of the charged tRNAphe. The similarity of the rates of base modification and of the deacylation of the phenylalanyl-tRNA permitted the isolation of partially modified phenylalanyl-tRNAphe and partially modified deacylated tRNAphe. The sites and extents of base modification in these fractions were determined and found to be the same as those in uncharged tRNAphe modified under identical conditions. These findings are discussed in relation to previous evidence for and against a conformational change in tRNA on its aminoacylation. The methods described should prove adaptable to study of other aminoacyl-tRNA species.


Binding of reticulocyte elongation factor 1 to ribosomes and nucleic acids. The present study has examined the requirements for the binding of rabbit reticulocyte elongation factor 1 (EF-1) to ribosomes under different assay conditions. When a centrifugation procedure was used to separate the ribosome EF-1 complex, the binding of EF-1 to ribosomes required GTP and Phe-tRNA, but not poly(U). The results suggested that undr these conditions a ternary complex, EF-1 . GTP . aminoacyl-tRNA, is necessary for the formation of a ribosome . EF-1 complex. However, when gel filtration was used to isolate the ribosome . EF-1 complex, only template and tRNA were required. These studie emphasize the fact that the procedure used to isolate the ribosome . EF-1 complex determines the requirements for stable complex formation. EF-1 can also interact with nucleic acids such as 28 S and 18 S rRNA, messenger RNA and DNA. In contrast to the binding to ribosomes, EF-1 binding to nucleic acids requires only Mg2+.


The role of guanine nucleotides in protein biosynthesis. It is not possible to select one competing substrate molecule over another one when the selection system is at equilibrium. Therefore, it is convenient to view all substrate selections as transport phenomena. The requirement for a displacement from equilibrium to effect a substrate selection can be met in different ways. One particularly convenient way is to drive a nonselected substrate, such as GTP in protein synthesis, far from equilibrium. This allows the flux of selected substrate to be relatively slow, but effectively irreversible. Accordingly, the conventional view that GTP hydrolysis drives protein synthesis is amended. It is suggested that the regeneration GTP from GDP is the driving force for protein synthesis. Several different selection mechanisms are described in the context fof systems driven by displacements from equilibrium of the nonselected substrate. These are then evaluated in light of recent experimental results. The data argue against the relevance of proofreading mechanisms for aminoacyl-tRNA selection by the messenger RNA-programmed ribosome. Similarly, recent data suggesting that the translation of messenger RNA is not dependent on the presence of elongation factors and guanine nucleotides are reevaluated.


Project Iatrogenesis.

Project Iatrogenesis.


The distribution of illicit drug use: correlations between extent of use, heavy use and problems.


Nurse has central role in community-based cancer program.


Influence of photoperiodism on cannabinoid content of Cannabis sativa L. Cannabis sativa plants submitted to 10 and 12 hours of natural light showed different content in cannabinoids. An increase of exposure to natural light of only 2 hours a day, at least, doubled the average amoung of THC, but decreased that of cannabichromene.


Socio-economic aspects of drug control and related United Nations action.


Outcomes of 575 British opiate addicts entering treatment between 1968 and 1975. Five hundred and seventy-five opiate addicts (455 male, 120 female) who were treated at two clinics in London between 1968 and 1975 had their current situation reviewed in October 1975. Fifty-two per cent were still in treatment (258 at the clinics, 42 elsewhere), 28 per cent were not in treatment and not known to be using opiates, 11 per cent had died, 6 per cent were in custody and 3 per cent had left the country. Sixty-one per cent of the patients in treatment had remained so continuously. Twenty-eight per cent had also had in-patient hospital treatment. Some patients were very unstable and those treated as in-patients in hospital two or more times for drug abuse had an average of nine hospitalizations. Forty-six per cent of patients in clinic treatment said they were working regularly at the end of the study (23 per cent at entry). Some 7-8 per cent of patients left treatment each year and the death rate remained between 2 and 3 per cent each year. The prescribing of heroin for addicts was gradually superseded by the prescribing of injectable methadone. The authors concluded that a methadone maintenance programme probably had some value in the treatment of opiate dependence.


Drug abuse in Poland.

Drug abuse in Poland. The abuse of drugs in Poland, a lesser problem than that of alcoholism, has only recently become a subject of interest. Although at present it is not of crucial importance in the pathology of social life, it may still have serious effects on the individual and society. This paper discusses the results of several surveys carried out by different researchers in Poland to assess different aspects of the drug abuse phenomenon. Drug abuse patterns in Poland, as in other countries, change rapidly. Therefore, yesterday's situation may not be considered as valid today. The first part of this article presents some of the characteristics that were observed since 1968, when the phenomenon appeared, up to 1976. The second part describes the provisions of the Polish criminal law to fight drug abuse, and envisages some measures to better control this phenomenon in the future.


Cannabinoid composition and gland distribution in clones of Cannabis sativa L. (Cannabaceae).


Life skills.

Life skills.


Learning to discuss the unmentionable.

Learning to discuss the unmentionable.


The DES syndrome and clear cell adenocarcinoma in young women.


DES: a case study.

DES: a case study.


Assessing learning needs of nurses who care for persons with cancer.


Evaluating health care services.

Evaluating health care services.


Nursing diagnoses for cancer patients.

Nursing diagnoses for cancer patients.


You and the law: hospital hazards and the nurse.


Frankly speaking: what price cost cutting?


Chemotherapy: a manual for patients and their families.


BCG immunotherapy by the time technique: the nurses's role.


About multiple sclerosis.

About multiple sclerosis.


Psychosocial aspects of the cancer experience.


The games nurses play.

The games nurses play.


Rythmodan: a new cardiac depressant.

Rythmodan: a new cardiac depressant.


Cancer nursing and the law. Informed constent. Part III.


Cancer audit.

Cancer audit.


Programmed instruction: cancer care. Cancer chemotherapy.


DES action.

DES action.


Nursing consultant services for the small community hospital.


Cerebral energy consumption and provision: the predominance of neuronal oxidative metabolic processes.


Introduction: a multiple factor theory for control of cerebral vascular smooth muscle?


How vascular smooth muscle works.

How vascular smooth muscle works. Electrical recordings made from vascular smooth muscle during the last 15 years make it clear that the role of electrical activity in controlling contraction is often important but varies greatly both between different vessels and for different responses of a given vessel. Only a few mammalian vessels have widely conducted electrical activity, but others can develop this activity, with consequent rhythmical contraction, when made anoxic and stimulated. Action potentials play a part in smooth non-rhythmical responses of arteries to nerves and hormones, while passive conduction of depolarization round the vessel wall is responsible for ring contractions of arteries after local injury. Ca and K cause vasodilatation largely by hyperpolarizing the smooth muscle cells. Electrical activity plays no part in some responses. In particular noradrenaline can contract arteries by directly promoting entry of extracellular Ca, and also by releasing Ca stores by non-electrical means. These processes are particularly important in the inner muscle of arteries, which is not directly innervated.


Stimulation of enzymatic phe-tRNA binding to mammalian ribosomes by thallium ions at concentrations blocking other ribosomal functions. Thallium acetate (TIOAc) effectively stimulates poly(U)-directed Phe-tRNA binding to mouse ascitic tumour ribosomes under conditions when other ribosomal functions are completely blocked. The TI+ optimum is about 200 mM. The reaction is stimulated by EF-1, but not significantly by GTP. EF-1-dependent ribosomal GTPase is inhibited by T1+. The isolated Phe-tRNA . ribosome complex is relatively stable. The bound Phe-tRNA does not react with puromycin in the presence of 175 mM KCl. The complex formed in the presence of 90-100 mM TlOAc can, after isolation, be directly utilized for polyphenylalanine synthesis. The complex formed at 200 mM TlOAc is less active, apparently because of damage to the 60-S subunits. TlOAc at low concentrations (8 mM) stimulates K+ -containing poly(U)-translating systems, probably by stabilizing the translation complex.


Induced structural transitions in tRNA.

Induced structural transitions in tRNA.


Senator urges nurses to flex political muscles.


Nurse practitioners explore politics.

Nurse practitioners explore politics.


Current issues in health care.

Current issues in health care.


Why publish?

Why publish?


The generation and classification of nursing diagnoses: toward a theory of nursing.


A quality of care assessment: pediatricians and pediatric nurse practitioners.


Sensory deprivation.

Sensory deprivation.


California Filipino cardiovascular disease mortality 1968-1972: socioeconomic and demographic factors.


Guilt, attribution of responsibility, and resolution of the divorce crisis.


Nursing for export--let the buyer beware!


Directions in critical care nursing.

Directions in critical care nursing.


To be ill.

To be ill.


Oxygen therapy and delivery in obstructive pulmonary disease. The guidelines for O2 therapy in acute decompensation of COPD and even the indications for short-term use of O2 during periods of increased requirements in stable COPD are fairly clear-cut. With regard to continuous O2 therapy in hypoxemic patients with stable COPD, most would agree that in patients with cor pulmonale treatment with low concentrations of O2 for periods of more than 12 hours per day will result in improved pulmonary hemodynamics, mental function, polycythemia, and perhaps exercise tolerance. In similar patients without cor pulmonale the potential benefit of continuous O2 is unknown. Many other serious questions remain. The optimum duration of chronic O2 therapy must be clarified. More data are needed to determine the effect of continuous O2 therapy on mortality rate at both sea level and high altitude. It is not known whether O2 therapy has any prophylactic value in those patients with COPD who have not developed severe pulmonary hypertension. The potential value of O2 therapy in exercise rehabilitation programs needs further study. Finally, lightweight, longer-lasting, and less-expensive O2 delivery systems must be sought.


A system for maintaining invasive pressure monitoring.


Patients' thoughts and feelings while awaiting cardiac surgery.


Support of severely impaired cardiac performance with left-heart assist device following intracardiac operation.


Effects of oxygen on ischemic myocardium.


Professing nursing through the curriculum.


Prolongation of the Q-T interval with myocardial contusion.


A systems approach to the nursing process. This paper makes the point that for psychiatric patients the nursing process based on a systems approach may be more useful than that based on problem-solving or activities of daily living. Some of the key concepts used in this approach are (1) listing component parts of a system, (2) defining the inside and outside of systems, the outside being described as environment, (3) changing the boundaries or the interface of various systems, as appropriate, (4) observing the impact of the environment and especially of the nurse herself as a part of the system or the environment, (5) tracing input, output and throughput, and (6) drawing distinctions between open and closed systems and accounting for a steady state in the system.


A strategy for patient teaching.

A strategy for patient teaching. A theoretical model is described whose particular emphasis is directed towards operationalizing the statements: 'effective teaching bridges the gap between information and practice or 'teaching is more than telling'. It concentrates on nurse behaviours (facilitation) designed to actively engage the patient in learning whereby he accepts his diagnosis or situation, projects the effects of prescribed therapy on his future life, and commits his intentions to practice. It utilizes principles of learning derived from the perceptual (phenomenological) approach and indicates the nurses' responsibilities. The model identifies four critical elements in the engagement process--the patient's values, his perception of the disease threat, his perceived utility of prescription, and facilitating behaviours of the nurse. The strategy is adapted from a combination of the Health Belief Model and the Personal Choice Model.


Outbreak of a multiply resistant Acinetobacter in a surgical intensive care unit: epidemiology and control. During January, 1976 seven patients in an SICU became colonized or infected with Acinetobacter calcoaceticus (variation, anitratum) at an attack rate of 12.5 per cent. The organism showed a marked reduction in antimicrobial sensitivity from previous experience. Comparison with 34 uninfected control patients indicated that intubation and continuous ventilatory assistance were significantly associated with acquiring the organism (p = 0.0154). Acinetobacter was cultured from nurses' hands, AMBU adaptors, respirator apparatus, respirometers, and unlabeled bottles of saline used for tracheal irrigation. Control measures were designed to interrupt transmission. The investigation identified the nursing techniques and reservoirs that allowed this outbreak to occur, and we emphasize the need for close surveillance of patient care procedures in an intensive care unit.


Participation in decision-making in the health services. There is widespread discussion at the present time of 'participation'--allowing members of an organization to exert an influence on the process of decision-making. The National Health Service is not isolated from this debate and already a number of experiments have been carried out at various levels of the service to allow a wider range of opinion to influence decisions than hitherto. This paper reports on a study the author carried out into one such exercise, designed to assist a Health Board reach decisions about the longterm pattern of health care in its area. Nurses, paramedical staff and local authority staff, as well as doctors, were appointed to a series of programme planning committees to advise the Health Board on issues of longterm policy. After 2 years of operation, a study was carried out into the operation of the committees and the lessons drawn from the experience should be relevant to actual and potential members of any consultative or decision-making body.


The importance of direct measurements of arterial blood gases in drug-induced methemoglobinemia.


Cardiac rehabilitation in the coronary care unit. Part I.


The need for a comprehensive counselling service for nursing students. The responses to 'given situations' in a questionnaire administered to 50 nursing students indicate that they are conscious of high stress factors in nursing. Role conflict is created when they are given instructions in the wards contrary to what they are taught in the schools of nursing. Some of the responses also indicated that learners may be developing attitudes which are contrary to what they are taught in the schools of nursing. Some of the response also indicated that learners may be developing attitudes which are contrary to good nursing practice as a protection from external pressure. The majority of the respondents had opportunities for discussion of their problems, but 28% were unsure about available facilities. The author argues that the counselling needs of nursing students must be met by provision of a comprehensive counselling service.


Nurse--teacher behaviours in the clinical field: apparent effect on nursing students' learning. One primary source of feedback on the effectiveness of their teaching, which instructors may easily overlook, comprises of students' reactions. The purpose of this study is to identify students' perceptions of teacher behaviours, which either facilitate or hinder students' learning in the clinical field, and to determine if there is a difference in the perceptions of 1st and 2nd year students. This study is exploratory and descriptive in nature. Firstly, some research studies regarding effective clinical teaching in nursing are reviewed, followed by a discussion of the research design. The tool used for collecting data is a modified form of the critical incident technique. A description of illustrative incidents is requested within five divisions: professional competency, relationship, personal attributes, teaching methods, and evaluation of  practice. A system for analysis and coding of data is then discussed. Finally, the finding of this study is presented. It would seem ot the investigator that students in 1st year are particularly sensitive to how the teacher makes them feel, whereas students in the 2nd year would seem to be more concerned with the teacher's competency in teaching. The teacher behaviours reported as helpful or hindering to students' learning, as identified by the students, are outlined.


A study in intracardiac conduction.

A study in intracardiac conduction.


Use of swivel adapter aperture during suctioning to prevent hypoxemia in mechanically ventilated patient.


The use of non-ionic detergents in sanitary cleansing: a report of a preliminary trial. A preliminary trial was carried out to establish the most suitable hygienic wipe for sanitary cleansing in incontinence and to study and compare the difference between cleansing with soap and non-ionic detergents in incontinent patients. Four non-ionic detergents were tested against National Health toilet soap in 290 incontinent episodes. Other observations were made on the skin condition following cleansing, the ease of cleansing, odour control, detergency, and allergenicity. The results showed that a scrim wipe was the best for this purpose and also indicated that the non-ionic detergent Cetomacrogol 1000 B.P.C. to be preferential to all other creams and soap in the time taken for cleansing. The skin condition, odour control and detergent ability were all superior with this cream. It was revealed by the trial that in cleansing faecal incontinence with non-ionic detergent, an initial wipe, followed by about 7.0 grams of detergent on a moistened wipe to achieve emulsification and than followed by another dry wipe, is all that is required. The condition of the skin was recorded as excellent and the figures indicated a possible saving of 20% in nursing time.


Canada: Dalhousie University School of Nursing.


England: University of London Department of Nursing Studies.


Jamaica: University of West Indies Advanced Nursing Education Unit.


Nigeria: University of Ibadan Department of Nursing.


Republic of Ireland: University College, Dublin.


Scotland: University of Edinburgh Department of Nursing Studies.


U.S.A.: Loyola University of Chicago School of Nursing.


Summary report of working group on nursing aspects in the care of the elderly.


Summary report of a working group on the evaluation of inpatient nursing practice.


Anxiety during hemodialysis sessions: discrepant evaluations of patients and nurses.


The creation and correction of blood pressure crises in hemodialysis patients.


Positive thoughts on aging.

Positive thoughts on aging.


A study of reality orientation and resocialization groups with confused elderly.


Know your community resources: nursing service and nursing education: co-action to meet the health needs of the elderly.


Researcher applies biofeedback therapy to nursing home residents.


Must taking medication be a dilemma for the independent elderly?


Unintentional injury among the aged.

Unintentional injury among the aged.


Bladder training for the incontinent patient.


A case in point: professional practice at risk.


Dr. Butler advocates a more humanistic approach to dying patients.


Relocation of the elderly.

Relocation of the elderly.


International corporate audits.

International corporate audits.


Measuring the sealing force for parenteral vial closures.


The GLP's: why we need them; how we'll use them.


General guidelines for the visual inspection of parenteral products in final containers and in-line inspection of container components.


Reproducibility in visual inspection of parenterals.


Pharmaceutical water systems--design concepts.


A new economical process for low particle, in-line sterilization of glass containers.


Proposed GLP's and the contract testing laboratory.


Nutrition of fetus and newborn (new considerations)


The quality of water USP.

The quality of water USP.


Influence of sex of baby on serum alkaline phosphatase activity of lactating Ghanaian women.


Aspects on the European and especially Swedish MCH services.


Bacteriuria in malnourished Iranian children.


Possible service problems in the application of stainless steel.


Child nutrition and mortality in the rural Philippines: Is socioeconomic status important?


Calibration of microscopes for measuring particles found in parenteral solutions.


Comparison of optical electronic inspection and manual visual inspection.


Severe measles in Afghanistan.

Severe measles in Afghanistan.


Report on long term testing of a system to produce LVP-CGMP quality compressed air.


Childhood asthma in Malaysian children: the clinical spectrum.


Design concepts for automatic handling of syringes.


Early childhood survivorship related to the subsequent interpregnancy interval and outcome of the subsequent pregnancy.


Product filtration operation in a new sterile products facility.


Dehydration scoring system for infants.

Dehydration scoring system for infants.


Study on the etiology of diarrhea.

Study on the etiology of diarrhea.


A study on immunisation status of children in 1,000 family planning adopted families. In a survey, conducted in Tirupati, India, information on the immunization status of the children of a random sample of 1000 family planning acceptors were obtained.  The children of all the acceptors were protected against smallpox; however, only 81.5% were protected against polio, 57.2% against tuberculosis, and 10.7% against diphtheria, whooping cough, and tetanus.  863 of the family planning acceptors had adopted temporary family planning methods and 137 had chosen sterilization.  750 of the acceptors had 1-3 children and 250 had 4 or more children.  Additional efforts should be made to encourage family planning acceptors to have their children immunized.  This would help reduce child morbidity and mortality rates in those families in which the parents have decided to limit family size.  Tables showed 1) the number and % of acceptors whose children were immunized for each disease by type of family planning method and 2) the distribution of acceptors by income and by parity.


Field methods for calculating anthropometric results.


Role of village health worker in health problems of developing countries [proceedings].


Changing pattern of poisoning in children in a developing country [proceedings].


Tetanus of the newborn in Tehran. A ten year study of 880 cases [proceedings].


The environmental contribution of mental subnormality in Singapore children.


Genetic counselling in sickle cell disease. Ibadan (Nigeria) experience [proceedings].


Observations of sickle cell anaemia in Uganda 1976.


Adaptive suckling.

Adaptive suckling.


On your mark. Preparing candidates for the general nursing registration examination.


Should public smoking be banned?

Should public smoking be banned?


The nurse in industry: "Office situation.".


The development of the Occupational Health Service.


The future training of the psychiatric nurse.


Adolescents.

Adolescents.


Adolescents in present day society.

Adolescents in present day society.


Fetal movement and breathing.

Fetal movement and breathing.


A little help and understanding.

A little help and understanding.


Self-help in relation to health care.

Self-help in relation to health care.


Full time fatherhood.

Full time fatherhood.


Health centres.

Health centres.


Midwifery and professional training of the midwife in Israel.


Mother--baby--nurse relationship.

Mother--baby--nurse relationship.


Prospects and problems in health services research. Health services research has an important--and unique--role in affecting the climate of policy formulation and in defining future options. This very uniqueness, however, places the endeavor in a vulnerable position between the usual rigors of scientific investigation and the desire for simplicity and comprehensibility on the part of administrators and legislators. A constituency must be found to nurture the continuance of this modest but invaluable research activity.


Group practice recommendations of the Committee on the Costs of Medical Care: a new look at an old issue. The model of comprehensive group practice advanced by the CCMC in 1932 has been an elusive reformist vision. Changes in the techniques and techology of medical practive will require new professional agendas as well a new political constituencies. Analysis of the process of these changes must balance avocacy of any uptopian forms of practice.


Effects of hospital cost containment on the development and use of medical technology. The early hope for more effective, safer, and less expensive care through the "medical technological revolution" is critically examined. Inflated costs--and imperfect expectations--have led to broad proposals for hospital cost containment which may constrain development and use of new technology. But concerns for care and cost will be better served by selective shifts in the type of technology employed and incentives for its use.


Delay and noncompliance in cancer detection: a behavioral perspective for health planners. Professionals and public alike believe in the benefits of early cancer detection. Yet screening programs have encountered serious problems in engaging their clients to seek prompt medical follow-up. If benefits of early detection are to be achieved, and fear and mistrust overcome, a more reliable connection between screening and treatment must be forged.


Toward the measurement of primary care.

Toward the measurement of primary care. The renaissance of rhetoric about primary care--"continuous, coordinated, comprehensive, family-centered"--has paralleled the growth of entrants into formal training programs. The extent to which primary care is actually practiced this way has not been examined, nor have the routes to preparing for it. A preliminary set of measurements is suggested.


Managing the patient with abdominal aortic aneurysm.


The nursing care plan. A communication system that really works: nursing grand rounds.


Let's talk about menopause.

Let's talk about menopause.


Mrs. Vinson didn't want our help.

Mrs. Vinson didn't want our help.


4 steps for better cardiac care in the E.R.


Active range-of-motion exercise. A handbook.


Water-sports injuries: the old and the new.


How to become a better group leader? Learn to recognize the strange things that happen to some people in groups.


Sharing: Mr. Rope.

Sharing: Mr. Rope.


[Emergency medical technicians].

[Emergency medical technicians].


Fractures of the hip: a self study.

Fractures of the hip: a self study.


The use of the Vidal-Adrey external fixators for open fractures and nonunions.


A step forward in continuing education.

A step forward in continuing education.


Showcase for Oklahoma nurses 1978.

Showcase for Oklahoma nurses 1978.


Home care nursing program.

Home care nursing program.


Standards for nursing practice II. The scope of published standards.


Competence, credibility, and cohesiveness: trees in the forest of professional unity.


The ONA-AJN writing award winner for 1978: "The Turning" by Maureen Whitman, R.N., B.S.


Master's education in nursing: route to opportunities in contemporary nursing, 1978-79. Information about NLN-accredited Master's programs in nursing.


Board of Regents Health Manpower Planning Project. The LSNA point of view.


Baccalaureate programs accredited for public health nursing preparation 1978-9.


Criteria for the evaluation of diploma programs in nursing.


Role and competencies of graduates of diploma programs in nursing.


State-approved schools of nursing - R.N., 1978. Meeting minimum requirements set by law and board rules in the various jurisdictions.


The consumer's role in health care.

The consumer's role in health care.


Consumerism and health care.

Consumerism and health care.


Nursing's responsibility for patients' rights.


The consumer and the health care professional-contented marriage or shotgun wedding?


The patient's bill of rights - implications for the health care system.


Loving care would help.

Loving care would help.


Consumerism: its impact on America's health professionals.


Socialization for survival in the academic world.


Living with pain.

Living with pain.


Evaluating students' performance.

Evaluating students' performance.


Why RN students drop out.

Why RN students drop out.


Research committees in nursing programs.


Effects of self-study on achievement in a medical-surgical nursing course.


Competencies of the associate degree nurse on entry into practice.


The doctorate debated.

The doctorate debated.


The mentor relationship.

The mentor relationship.


Some problems in evaluating teaching effectiveness.


Precepts for practitioners.

Precepts for practitioners.


Nursing electives in a baccalaureate program.


No free lunch.

No free lunch.


Regrouping for an integrated curriculum.


Sexual abnormalities--1. Harmless variations.


Dignity and individual care.

Dignity and individual care.


Mystical seven.

Mystical seven.


Chaplaincy involvement in nurse education.


Professionalism in perspective.

Professionalism in perspective.


A unique school.

A unique school.


Nursing care study: a patient with severe femoral shaft fracture.


Drug dependence--1. The pattern of drug abuse.


Nursing care study: cataract extraction.


Equipment fit for purpose.

Equipment fit for purpose.


Harlow House.

Harlow House.


The clinical nurse specialist. 1. The introduction of nurse specialists.


Management of chronically ventilated infants.


Geriatrics--country style.

Geriatrics--country style.


Intensive care needed for all in ITUs.

Intensive care needed for all in ITUs.


Learning while living in hospital.

Learning while living in hospital.


Patient records: the importance of patient care records.


Confidentiality in psychiatric practice.


Patient record: the legal importance of nursing notes.


Patient records: the law relating to medical records.


The clinical nurse specialist. 2. The staging unit.


Nurses and the law. 4. Consent to treatment.


Long-term indwelling catheters.

Long-term indwelling catheters.


Body fluids. Pancreatic and intestinal juices.


Serum immunoglobulin levels in Crohn's disease: an investigation.


Occupational health in the NHS: an introduction.


I thought excess gave me credit until...


Clinical nurse specialist. 3. The role of the specialist in the breast unit.


Nursing care study: cervical spine injury.