Best practice in nurse-led chemotherapy review: a position statement from the United Kingdom Oncology Nursing Society.

This position statement has been formulated by nurses from the United Kingdom Oncology Nursing Society (UKONS) to provide guidance on the provision of nurse-led chemotherapy review clinics for adult patients. For the purposes of this statement, a nurse-led chemotherapy clinic is defined as one that conducts formal review (in a consultation room) before the decision to proceed and prescribe the next cycle of chemotherapy. This statement does not address the toxicity checks that take place immediately prior to the administration of chemotherapy, although many of the same principles will apply to both settings.

Metal and oxalate contamination in a suburban watershed in the greater Toronto area: the benefits of combining acid leach and selective extraction procedures.

Environmentally available concentrations of Fe, Mn, Zn, Cu, Pb, Cr and Ni in soils and sediments from a small suburban catchment, obtained using an acid leach procedure, are compared to the Ontario Ministry of the Environment lowest effect level (LEL) and severe effect levels (SEL) and to Provincial sediment quality guidelines (PSQG's). These data are then compared to the bioavailability, potential bioavailability and non-bioavailability of the same metals, plus oxalate concentration, identified using a selective extraction procedure. This combination of techniques enhanced analytical interpretation with respect to metal mobility and potential metal contamination. Selective extraction highlighted the presence of oxalate as a potential contaminant, especially in poorly drained valley floor deposits (33,633 mg kg(-1) and 26,284 mg kg(-1)) and lakeshore sediments (27,095 mg kg(-1) and 13,729 mg kg(-1)). These levels are considerably in excess of those previously documented in a similar study from Rio de Janeiro, where contamination of urban sediment by sewage is a recognised environmental problem, and could possibly be used both as an indicator of similar contamination and the identification of those areas that warrant further investigation.

Quality indicators in breast cancer care.

To define a set of quality indicators that should be routinely measured and evaluated to confirm that the clinical outcome reaches the requested standards, Eusoma has organised a workshop during which twenty four experts from different disciplines have reviewed the international literature and selected the main process and outcome indicators available for quality assurance of breast cancer care. A review of the literature for evidence-based recommendations have been performed by the steering committee. The experts have identified the quality indicators also taking into account the usability and feasibility. For each of them it has been reported: definition, minimum and target standard, motivation for selection and level of evidence (graded according to AHRO). In overall 17 main quality indicators have been identified, respectively, 7 on diagnosis, 4 on surgery and loco-regional treatment, 2 on systemic treatment and 4 on staging, counselling, follow-up and rehabilitation. Breast Units in Europe are invited to comply with these indicators and monitor them during their periodic audit meetings.

Safe practice and nursing care of patients receiving oral anti-cancer medicines: a position statement from UKONS.

This position statement has been formulated by oncology nurses from the UK Oncology Nursing Society (UKONS) to provide guidance for nurses on safe practice with oral anti-cancer medicines. The ultimate aim is to ensure that patients are not only well informed and capable of managing their oral anti-cancer medicines, but also supported safely and effectively while they are receiving these treatments.

Storms in the tropics of Titan.

Methane clouds, lakes and most fluvial features on Saturn's moon Titan have been observed in the moist high latitudes, while the tropics have been nearly devoid of convective clouds and have shown an abundance of wind-carved surface features like dunes. The presence of small-scale channels and dry riverbeds near the equator observed by the Huygens probe at latitudes thought incapable of supporting convection (and thus strong rain) has been suggested to be due to geological seepage or other mechanisms not related to precipitation. Here we report the presence of bright, transient, tropospheric clouds in tropical latitudes. We find that the initial pulse of cloud activity generated planetary waves that instigated cloud activity at other latitudes across Titan that had been cloud-free for at least several years. These observations show that convective pulses at one latitude can trigger short-term convection at other latitudes, even those not generally considered capable of supporting convection, and may also explain the presence of methane-carved rivers and channels near the Huygens landing site.

No oceans on Titan from the absence of a near-infrared specular reflection.

With its substantial atmosphere of nitrogen, hydrocarbons and nitriles, Saturn's moon Titan is a unique planetary satellite. Photochemical processing of the gaseous constituents produces an extended haze that obscures the surface. Soon after the Voyager fly-bys in 1980 and 1981 photochemical models led to the conclusion that there should be enough liquid methane/ethane/nitrogen to cover the surface to a depth of several hundred metres. Recent Earth-based radar echoes imply that surface liquid may be present at a significant fraction of the locations sampled. Here we present ground-based observations (at near-infrared wavelengths) and calculations showing that there is no evidence thus far for surface liquid. Combined with the specular signatures from radar observations, we infer mechanisms that produce very flat solid surfaces, involving a substance that was liquid in the past but is not in liquid form at the locations we studied.

Middle-atmospheric Doppler lidar using an iodine-vapor edge filter.

We present both modeled capabilities of and experimental data from a Doppler lidar for the stratosphere and the lower mesosphere that uses the edge of a molecular iodine filter in a differential measurement to provide frequency discrimination. Modeled results show a capability for wind measurements to an altitude of 55 km with 1.5-km resolution in 30 min. Experimentally, wind-vector components from 18 to 45 km are measured every 20 min. The molecular-vapor filter provides great advantages with regard to system stability, operation in less-than-optimum weather conditions, and simplicity of data analysis.

Computer image sperm selection as a novel approach to subzonal insemination in the human.

Utilizing real-time computer image analysis, individual spermatozoa were selected using microaspiration. Selection criteria were based on potential hyperactivation motility characteristics; the amplitude of lateral head displacement > 7.5 microns, curvilinear velocity > 70 microns/s and linearity of < 30%. For this pilot study, 16 patients (eight in each group) were recruited. Using subzonal insemination (SUZI), up to five (mean = 4.4 +/- 0.3) spermatozoa selected using computer-image sperm selection (CISS) were micro-injected, or up to 15 (mean = 12.8 +/- 1.3 SD) unselected spermatozoa. In the group which utilized CISS, 28 out of 49 (57%) oocytes were fertilized compared with 13 out of 52 (25%) utilizing conventional SUZI (P < 0.04); polyspermy was 20% (n = 10) and 2% (n = 1) respectively. CISS with SUZI showed increased efficiency in achieving fertilization and is a novel approach to studying individual sperm function in a sperm egg bioassay where gamete ratios are close to unity.

The focus of hospitals on family care.

Health care professionals are recognizing the need to treat their patients not only as individuals, but as part of a social network--the family. In order for health care organizations to provide a total family care program and, therefore, a more efficient and effective health care delivery system, they must develop and implement strategies to identify and treat all of the patient's needs--psychological, biological, and familial. Coordination among individual departments and personnel is critical to ensuring that resources meet these needs. The trend toward total patient and family services will continue to be emphasized and refined by the leaders in the health care industry.

The relationship between tissue and arterial pH in hypercarbic rabbits.

Continuous tissue pH and intermittent central arterial pH were measured in six rabbits during 10-min exposures to a mixture of 10% CO2 and 90% O2. In control and recovery situations tissue pH was more acidic than arterial pH by a mean value of 0.07 pH units. During periods of rapidly increasing pCO2, the steady state relationship was inverted with tissue pH being more alkaline than arterial pH. After a second exposure to CO2, mean tissue pH values did not recover to baseline. It is concluded that in the rabbit during acute hypercarbia, the relationship of tissue to central pH is variable. The possible implications of these results in human fetuses during labor are discussed.