Improving ambulatory oncology nursing practice. An innovative educational approach.

To meet the educational needs of ambulatory oncology nurses, an innovative and flexible program was created at a major cancer institute in Canada. Utilizing adult learning principles, standards of nursing practice, and departmental goals, the Clinical Nurse Specialists and Clinical Teachers creatively approached the need for extensive education. Five site specific educational workshops were provided to the nursing staff utilizing a self-directed learning style to capture the varied experiences, educational background, and motivations of the staff. This paper highlights the necessary program elements, implementation of, and evaluation of the educational program.

Changes in the physical and chemical properties of skin collagen from broiler chickens exhibiting oily bird syndrome.

The mechanical and thermal properties of the skin and some chemical characteristics of the skin collagen have been examined for broiler chickens exhibiting Oily Bird Syndrome (OBS) and compared with material from normal birds. Comparisons of skin thickness showed that there was no significant difference between the two groups. There was also no difference in the melting temperature of the skin collagen between the two groups when examined by the isometric melting method. The strength of the skin was examined at 36 C and at 93 C. At both temperatures, the skin from OBS birds was significantly weaker than skin from normal birds. Skin collagen was examined for birds from OBS flocks (greater than 20% OBS occurrence) without distinction of the characteristics of the individual birds and compared with the skin collagen birds from flocks where OBS was absent. Comparisons of cyanogen bromide-digested collagen from both groups by polyacrylamide gel electrophoresis showed a clear distinction between the groups. The observed differences suggested that a change that lowered the extent of collagen crosslinking was present in the birds from OBS flocks, and this observation is consistent with the weaker mechanical properties of the skin of these birds. All birds in these flocks show the difference even if the individual birds do not all show OBS. This suggests that a change leading to lowering of the structural integrity of the connective tissue is present in all birds in an OBS-affected flock, but that individual variation between birds determines those birds that actually exhibit OBS.

In vitro studies of the interaction between ascorbic acid and rat tail tendon.

Ascorbic acid (in its normal and oxidised forms) enhances the mechanical and thermal stability of rat tail tendon. Its effectiveness increases with the concentration but levels off at a value approximately 5 times normal physiological concentration (1--2 mg/100 ml). An analogue, D-isoascorbic acid is also effective, but to a lesser extent. There is some evidence that it reduces reducible aldimine links, especially in young tissues. However, for the most part, its effects are reversible.

Effect of some alcohols on in vivo and in vitro aged collagen.

1. The effects of mixtures of ethanol or n-propanol with 0.15 M NaCl or 0.1 N HCl on the isometric melting and load/extension behaviour of rat tail tendon were examined. 2. Both intra and intermolecular effects were observed but aging of the sample had little effect upon these. 3. The extension modulus in 0.15 M NaCl begins to decrease rapidly at temperatures above the molecular melting temperature (TD). This reduction in modulus is accelerated by alcohol, although the alcohol is not effective below TD.

In vivo and in vitro aging of collagen examined using an isometric melting technique.

1. In vivo and in vitro aging of tendon from rat tail, kangaroo tail and human wrist tendon was examined by the technique of isometric melting, in physiological saline. 2. For all these collagens, two mechanisms of structure stabilisation can be distinguished in the melting curves. One of these involves co-valent cross-linking as judged by its increasing stability to heat and acid pH, while the second appears to involve only secondary interactions. 3. The time rate of the first process is slow in vivo; rat tendon up to 2 years does not show it, but it is present in 6-year-old human tendon. However, its in vitro rate is markedly dependent upon the free oxygen content of the physiological saline. At an oxygen concentration of 300 nmol/ml, the in vitro aging rate is about 30 times the in vivo rate for rat tail tendon, and about 20 times for both kangaroo tail tendon and human wrist tendon. At a concentration of 60 nmol/ml (which is about the same as normal arteriovenous blood difference) in vitro aging proceeds close to the in vivo rate.