Characterization of the Microbiome along the Gastrointestinal Tract of Growing Turkeys.

The turkey microbiome is largely understudied, despite its relationship with bird health and growth, and the prevalence of human pathogens such as Campylobacter spp. In this study we investigated the microbiome within the small intestine (SI), caeca (C), large intestine (LI), and cloaca (CL) of turkeys at 6, 10, and 16 weeks of age. Eight turkeys were dissected within each age category and the contents of the SI, C, LI, and CL were harvested. 16S rDNA based QPCR was performed on all samples and samples for the four locations within three birds/age group were sequenced using ion torrent-based sequencing of the 16S rDNA. Sequencing data showed on a genus level, an abundance of Lactobacillus, Streptococcus, and Clostridium XI (38.2, 28.1, and 13.0% respectively) irrespective of location and age. The caeca exhibited the greatest microbiome diversity throughout the development of the turkey. PICRUSt data predicted an array of bacterial function, with most differences being apparent in the caeca of the turkeys as they matured. QPCR revealed that the caeca within 10 week old birds, contained the most Campylobacter spp. Understanding the microbial ecology of the turkey gastrointestinal tract is essential in terms of understanding production efficiency and in order to develop novel strategies for targeting Campylobacter spp.

A case of abdominal pain with dyslipidemia: difficulties diagnosing cholesterol ester storage disease.

Cholesterol ester storage disease is an exceptionally rare dyslipidemia with less than 150 cases reported in the medical literature. The diagnosis of Cholesterol Ester Storage Disease is often missed by virtue of the fact that the symptoms mimic both inborn metabolic defects and hepatic steatosis. Patients with Cholesterol Ester Storage Disease usually present with atypical complaints including abdominal pain from altered gut motility. Blood analysis typically reveals abnormal liver function tests with coincident dyslipidemia. We present a case of a young woman with Cholesterol Ester Storage Disease who was followed over two decades. We discuss issues common to her initial protracted diagnosis with management options over time.

Regulation of blood flow by aspirin following muscle ischemia.

BACKGROUND: The vascular endothelium secretes a balance of dilator and constrictor substances which regulate vascular tone. During ischemic stress, this balance changes. After a short period of ischemia, a protective mechanism known as reactive hyperemia (RH) contributes to a post-ischemic increase in blood flow. The agents regulating this phenomenon remain controversial. AIM: The purpose of this study was to examine whether aspirin regulates vascular endothelial function following ischemia. METHODS: Sixteen healthy volunteers presented for two visits, each serving as their own control, and randomized to receive 500 mg aspirin or placebo. Forearm blood flow (FBF) was measured at baseline and during reactive hyperemia (RH) which was induced by five minutes of arterial occlusion. Blood samples were analyzed for vWF and lipids. RESULTS: After ischemia, RH was attenuated when subjects were pre-medicated with 500 mg aspirin compared to placebo: AUC[aspirin] = 1450 +/- 201 mL/100 mL tissue/min vs. AUC[pIacebo] = 2207 +/- 294 mL/100 mL tissue/min; (p < 0.05). Separation of the subjects with high HDL or low HDL levels resulted in a similar peak FBF response with placebo, but in the high-HDL group only, aspirin ingestion attenuated peak FBF after ischemia compared to the placebo condition (22.6 +/- 1.7 m/100 mL tissue/min vs. 33.5 +/- 3.2 mL/100 mL tissue/min, respectively) (p < 0.05). CONCLUSIONS: Aspirin partially regulates the RH response following ischemia compared to placebo, and this effect appears to be more profound when adjusting for plasma HDL concentration in healthy individuals. This suggests that the post-ischemic RH response may be partially mediated by arachidonic acid-derived mediators such as the prostaglandins.

Downsizing-initiated job transfer of hospital nurses: how do the job transferees fare?

In this longitudinal panel study, the authors compared the reactions to hospital amalgamation of 66 nurses who had been transferred to a different unit for a downsizing-related reason (bumped/displaced, unit closed, redundancy) with the reactions of 181 nurses who remained on their same unit. Prior to any job transfers, the two groups perceived comparable levels of support and held similar attitudes towards their job and the hospital. Two years later, after job transfers had taken place, transferred nurses perceived significantly lower coworker support. They also reported a significantly greater decrease in organizational commitment than nurses who were not transferred. However, both groups reported a significant decrease between time a and time 2 in perceived organizational support, satisfaction with amount of work and career future, hospital identification, and organization trust. Overall, the results indicate that the downsizing associated with the amalgamation of the hospitals had a highly negative effects not only on those nurses who were transferred because of the downsizing but also on those nurses who remained on their original unit.

Advancing the development of human resources in nursing in Jordan.

BACKGROUND: This article describes a collaborative international health and development program between a Jordanian and a Canadian university. It presents a human resource development model in Jordan that has been the basis for a variety of developmental activities for practicing nurses and nurse educators in academic and clinical settings. METHOD: Reciprocal visits by leaders of the project, as well as continued collaboration between key members of the two universities were instrumental in ensuring success of this venture. RESULTS: The activities implemented in this project culminated in the development of a pragmatic human resource development model that is sensitive to issues particularly relevant to the Jordanian culture. CONCLUSION: The collaborative venture discussed in this article has enabled nurses and nurse educators to increase their academic and clinical skills and raised the profile of the nursing profession in Jordan.

Developing a programme-review process for a baccalaureate nursing programme in Jordan.

Programme review is one way of monitoring the quality of a programme of study and promoting the growth of nursing education. The Faculty of Nursing at the Jordan University of Science and Technology (JUST) demonstrated its professional maturity by participating in an international collaborative project with the University of Windsor in Canada, to review its baccalaureate programmes. This article outlines the rationale for undertaking a programme review and discusses key principles for inclusion in the development of such a process. It highlights some strategies for success, and suggests ways in which programmes can benefit from reviews and evaluations. This process has the potential to be used as a prototype for future reviews.

An Arabic language version of the health promotion lifestyle profile.

The purpose of this study was to assess the validity and reliability of an Arabic version of the Health-Promoting Lifestyle Profile instrument in Jordan, whose society and culture differ from that of North America, where the instrument was developed. The instrument was translated into Arabic, back-translated, and pilot tested to ascertain cultural sensitivity. The Arabic version was then evaluated using a convenience sample of 950 adults in the northern part of Jordan using a principal components factor analysis. The order of factors was not entirely identical to those isolated previously during the psychometric assessment of the English language version. Only the structure of three factors--self actualization, health responsibility--and exercise were the same as those obtained in the English version. The forced, six factor solution explained only 39.3% of the variance in the measure. The alpha reliability coefficients were 0.89 for the total scale and ranged from 0.85 to 0.60 for the subscales. It was concluded that the Arabic version of the Health-Promoting Lifestyle Profile has demonstrated initial reliability and validity. Further testing is recommended.

Using functional health patterns to predict outcome with seniors.

Two powerful forces in Canada's health care system today are the rapidly growing seniors population and the trend toward community care. Recently, five hospitals in southwestern Ontario initiated a program designed to avert the admission of seniors to hospital and provide them with supports at home to maintain their health. Simultaneous research was conducted to assess the impact and effectiveness of the program.

The impact of organizational downsizing on the job satisfaction of nurses.

Professional nurses across Canada are being affected by health reform initiatives designed to deinstitutionalize the health care system. This panel study examined the impact this restructuring has had on nurses' overall job satisfaction as well as their satisfaction with various aspects of their job and work environment. The participants consisted of 345 nurses employed in 3 community hospitals in southwestern Ontario. Hospital downsizing had relatively little effect on overall job satisfaction, satisfaction with kind of work, amount of work, and physical work conditions. However, compared to before the downsizing, nurses reported a significant deterioration in satisfaction with their career future, hospital identification, supervision, and co-workers following the implementation of restructuring initiatives. We discuss the organizational and management implications of these findings and suggest ways that hospital administrators can minimize the negative effects of downsizing on nursing professionals.

Improved survival in lupus nephritis in the modern era (1979 - 1989) using only oral corticosteroids and azathioprine as maintenance

The authors analysed outcome retrospectively in relation to treatment and disease stage in patients with systemic lupus erythematosus and glomerulonephritis; and compared these with similar patients referred to us during 1969 - 78; and other published series from the same period. Eighty two patients with lupus nephritis were referred during 1979 - 89. Of these; 73 were followed up for a mean of 58.1 (SD 34.5) months. The histological pattern in renal biopsies was WHO Class IV (diffuse proliferative glomerulonephritis) in 59 per cent of patients. In the acute phase 43 patients received intravenous nethyl-prednisolone IG daily; for three days; in 25 accompanied by daily 4 liter plasma exchanges on 5 to 10 days. Twelve patients received induction therapy using oral cyclophosphamide during the acute phase; for 8 - 12 weeks only. Maintenance therapy was with oral prednisolone in all patients; accompanied by azathioprine in 84 per cent of cases. Long term cyclophosphamide was never used; neither intravenously nor orally. At 10 years actuarially calculated patient survival was 87 per cent; and survival of renal function 86 per cent; compared with 57 per cent and 65 per cent respectively in 1970 - 78 (p less than 0.01). Survival was no different in patients with renal biopsies classified into the various WHO classes. In patients with Class IV biopsies; survival in those treated with prednisolone and azathioprine only was the same as that in those given intravenous methylprednisolone and/or plasma exchange as well. However; patients treated with methylprednisolone or plasma exchange tended to have more severe disease. At last followup; 24/82 patients were in complete remission; 23 had normal plasma creatinine concentrations but abnormal urine; ie proteinuria; heaematuria; or both; 16 had abnormal urine and elevated plasma creatinine concentrations; and 9 had started renal replacement therapy. Eight patients had died. The survival of patients with lupus nephritis has improved in the past decade in patients with comparable severity of disease; and renal failure is no longer the principle cause of death. Results of maintenance treatment using azathioprine as adjunct to oral prednisolone in patients with severe nephritis are as good as those in series published elsewhere describing regular intravenous cyclophosphamide. No clear advantage was evident from the additional use of intravenous methylprednisolone and/or plasma exchange in the acute phase; in patients with WHO Class IV severe diffuse proliferative glomerulonephritis

Job satisfaction, propensity to leave and burnout in RNs and RNAs: a multivariate perspective.

This investigation used a multivariate approach to examine similarities and differences between the job satisfaction, propensity to leave, and burnout of registered nurses (RNs) (n = 623) and registered nursing assistants (RNAs) (n = 231). At best, both groups were only moderately satisfied with their jobs, and there were no significant differences between the groups on the outcome measures of satisfaction, burnout or propensity to leave. However, RNs with more years of work experience reported highest job satisfaction, lowest levels of burnout, and were less likely to leave their positions. None of these variables were related to the length of time RNAs were employed. When comparative analyses were conducted by unit types, RNs in psychiatric settings were least satisfied with their jobs, more likely to leave their positions, and reported more burnout than did RNs in other settings. Implications of the study for interventions and future research are discussed.

Age-related changes in stress experienced by families with a child who has developmental delays.

The hypothesis that stress in families increases as a child with developmental delays grows older was evaluated. Mothers with children ranging in age from 2 to 18 years were assigned to a preschool, middle childhood, or adolescent group and asked to complete the Parenting Stress Index (PSI). Results indicated that Child Domain scores were high for all groups, but Parent Domain scores were within normal limits. The middle childhood group was consistently higher in both domains than either the younger or older groups. Degree of handicap was not associated with mothers' stress in the preschool group, but was related to PSI scores for both other groups. Behavior problems were highly correlated with maternal stress for the middle childhood and adolescent groups (data not available for preschool group).

Acute renal failure complicating diabetic ketoacidosis.

Two previously healthy children, aged 13 and 14 years, respectively, presented with diabetic ketoacidosis. Both children developed acute renal failure, a rare complication of diabetic ketoacidosis and required dialysis.

Coping with stress in families with children who have mental retardation: an evaluation of the double ABCX model.

The Double ABCX model of family stress and coping was evaluated using path analysis to determine the causal ordering of variables in 86 families raising children with mental retardation. The families' use of resources (B) and their perception of the stressor event (C) were examined to determine their relation to the stressor (A) and the stress experiences (X). The causal ordering of the model suggested an ACBX relation rather than an ABCX relation. Results were discussed in terms of the consistency of these findings with two models of clinical intervention.

Increased factor VIII as an index of vascular injury in cyclosporine nephrotoxicity.

Very high plasma concentrations of factor-VIII-related antigen (RAG) (VIII-RAG) were found in renal allograft recipients during periods of nephrotoxicity induced by cyclosporine. In eight recipients, who were investigated at weekly intervals, levels of factor-VIII-RAG fell toward normal as the dose of cyclosporine was reduced. Plasma levels of C-reactive protein, an acute phase reactant protein, were never raised in these recipients. These findings are further evidence that toxic doses of cyclosporine are associated with vascular injury.

A clinical view of analytical goals in clinical biochemistry.

The analytical goals inferred desirable by a group of clinicians for the imprecisions of a wide range of analytes have been studied by survey. The goals required have not in general become more stringent in the past decade and are not as demanding as those promulgated by laboratory professionals. Clinical biochemistry laboratories can now attain analytical imprecisions which satisfy the general demands of clinicians except for analyses of calcium and of low levels of glucose. The lack of published data on analytical goals does not allow wide comparison of criteria for performance standards with the results of this study.