Abstract
Mannose-binding lectin (MBL) is an innate immune system pattern recognition molecule that kills a wide range of pathogens via the lectin complement pathway. MBL deficiency is associated with ...severe infection but the best measure of this deficiency is undecided. We investigated the influence of MBL functional deficiency on the development of sepsis in 195 adult patients, 166 of whom had bloodstream infection and 35 had pneumonia. Results were compared with 236 blood donor controls. MBL function (C4b deposition) and levels were measured by enzyme-linked immunosorbent assay. Using receiver operator characteristics of MBL function in healthy controls, we identified a level of <0.2 U µL−1 as a highly discriminative marker of low MBL2 genotypes. Median MBL function was lower in sepsis patients (0.18 U µL−1) than in controls (0.48 U µL−1, P<0.001). MBL functional deficiency was more common in sepsis patients than controls (P<0.001). MBL functional deficient patients had significantly higher sequential organ failure assessment (SOFA) scores and higher MBL function and levels were found in patients with SOFA scores predictive of good outcome. Deficiency of MBL function appears to be associated with bloodstream infection and the development of septic shock. High MBL levels may be protective against severe sepsis.
Nurses spend more time with patients who are facing the end-of-life than any other member of the health care team. Yet, studies have shown that many nurses feel inadequately prepared to provide the ...comprehensive care so important at the end-of-life. Penny Marshall, RN, PhD nursing professor at Johnson County Community College has recently attended a three-day course on end-of-life care held in Pasadena, CA. The American Associate of Colleges of Nursing (AACN) and the City of Hope (COH) National Medical Center received a 3 1/2 year grant from the Robert Wood Johnson Foundation to conduct this training program for undergraduate nursing school faculty members (Geraldine Bednash, PhD, FAAN and Betty R. Ferrell, PhD, FAAN, Principal Investigators). The training program, entitled End-of-Life Nursing Education Consortium (ELNEC), was conducted by distinguished faculty of researchers, educators, authors, and leaders in the field of palliative care; and aimed to provide faculty with comprehensive information on end-of-life care and resources to integrate into nursing school programs. The following two articles draw on this extensive curriculum to discuss two important aspects of end-of-life care: 1) common ethical dilemmas and complex questions that arise in the practice setting; and 2) symptom management during palliative care.
The nursing process and patient care plan have been used as thinking exercises in nursing education for over thirty years. This study queried nurse educators from across the United States regarding ...their views of the nursing process and care plan as frameworks for promoting critical thinking and problem solving. The extent to which educators assign critical thinking activities in relation to the care plan exercise was also examined. Data were collected from a randomly selected sample of associate and baccalaureate degree nurse educators using a survey design. Data were analyzed using descriptive and univariate F-statistics, and correlational procedures. Significant mean differences between associate degree (ADN) and baccalaureate degree (BSN) educators were found on views of the nursing process and care plan. ADN respondents viewed both the nursing process and care plan more positively with regard to problem solving and critical thinking qualities. However, mean scores on both scales were neutral providing inclusive evidence supporting either as effective in promoting critical thinking. There was little support of the nursing process as a framework for ethical problem solving, or problem management when multiple viewpoints and alternatives are involved. Both respondent groups supported the use of other problem solving methods in conjunction with the nursing process for teaching critical thinking. Educators indicated they would not consider substituting the nursing process with other problem solving methods. There were no significant mean differences between ADN and BSN educators on assignment of critical thinking activities related to the care plan. Mean scores for both respondent groups fell at the upper end of the occasionally assign range. Evaluation and reasoning types of activities were assigned more often than activities involving divergent thinking. Pearson r correlation showed a significant positive relationship between views of the nursing process and care plan. Views of the patient care plan and assignment of critical thinking activities also correlated positively. Data suggested that conceptualization of the care plan may, in part, be contingent on how the exercise is operationalized with regard to assignment of critical thinking skills. Neither years of teaching experience nor educational preparation yielded significant effects on the study variables.
...we had a beautiful baby girl that July, and named her Tracy. Interview by Kara Cutruzzula Career Arc 1963 Gets pregnant at 19 during her junior year of college. 1971 Guest-stars on The Odd Couple, ...where she meets future husband Rob Reiner. 1976 Begins playing Laverne in the Happy Days spinoff Laverne & Shirley. 1988 Becomes first female director to break $100 million mark (with Big).
The objectives of the present study are to: (1) Describe the macro-invertebrate species composition and seasonal changes in abundance of the benthic infauna within an eelgrass bed; (2) Observe what ...immediate effects occur to the benthic community as a result of experimental removal of eelgrass plants from plants within the Zostera bed; (3) Measure the seasonal variation of eelgrass turion length over an annual cycle and determine its correlation to biomass (dry weight); (4) Examine, by means of field experiments, the importance of incident solar irradiation in affecting the seasonal growth of Zostera; and (5) Determine the relationship, if any, between the abundance of major invertebrate species and the abundance of eelgrass as determined by mean turion length.
PAPERS IN AGRICULTURE BEATTIE, WILLIAM; LANDAFF, R.; Atkinson, Robert ...
Transactions of the Society, Instituted at London, for the Encouragement of Arts, Manufactures, and Commerce,
01/1808, Letnik:
26
Journal Article
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