The porcine innate immune system: an update.

Over the last few years, we have seen an increasing interest and demand for pigs in biomedical research. Domestic pigs (Sus scrofa domesticus) are closely related to humans in terms of their anatomy, genetics, and physiology, and often are the model of choice for the assessment of novel vaccines and therapeutics in a preclinical stage. However, the pig as a model has much more to offer, and can serve as a model for many biomedical applications including aging research, medical imaging, and pharmaceutical studies to name a few. In this review, we will provide an overview of the innate immune system in pigs, describe its anatomical and physiological key features, and discuss the key players involved. In particular, we compare the porcine innate immune system to that of humans, and emphasize on the importance of the pig as model for human disease.

Osteoporosis education programs: changing knowledge and behaviors.

Osteoporosis is an age related metabolic disease that primarily affects women and causes bone demineralization that results in fractures. Early identification of risk factors for osteoporosis and development of prevention programs is needed to halt the increasing incidence of the disease. Public health nurses (PHNs), with their emphasis on primary, secondary, and tertiary prevention with individuals and families, are in a unique position to protect the health of these vulnerable populations who are at risk for osteoporosis. This article describes the implementation and program evaluation of three osteoporosis prevention educational programs that use three levels of intensity of design. Each design is based upon the learning needs of the targeted audience. The goals of each program were to increase knowledge of osteoporosis, increase health beliefs, and increase the frequency of osteoporosis preventing behaviors. Theoretical aspects from adult learning and the Health Belief Model (HBM) were used to develop the programs. For the program evaluation, participants completed evaluation instruments before and 3 weeks after participating in an osteoporosis health education program. Participants in all programs had significantly higher levels of knowledge after completing the programs; however, overall, there was no change in health beliefs or behaviors. Implications of these findings are discussed.

Codependency and related health variables.

Codependency is a controversial concept especially for feminist scholars who are concerned about pathologizing traditional female roles. This study's purpose was to determine: (1) the prevalence of codependency in a sample of older women who because of age may ascribe to traditional roles; (2) how the Hughes-Hammer/Martsolf theoretical model of codependency relates to other health variables; and (3) whether previous findings about the relationship between codependency and depression replicate. Survey design was used with a sample of 238 women (ages 65 to 91) attending a flu shot clinic. Subjects completed the Codependency Assessment Tool, Beck Depression Inventory, Quality of Life Scale, Perceived Health Report, Measurement of Patient Functional Abilities, and Illness Prevention Screening Behaviors Checklist. Of these women, 99% had low codependency scores. Statistically significant correlations existed between codependency and perceived health (p < .01), and functional ability (p < .01). Codependency was not significantly correlated with illness prevention behaviors and quality of life. Codependency and depression, as in previous studies, were significantly correlated (r = .446, p = .0001). Using analysis of variance, 3 codependency subscales had significant positive effect on depression: Low Self-Worth, Medical Problems, and Hiding Self. Further studies should examine the degree of ascribing to traditional female roles in women dealing with codependency issues.

Osteoporosis in older men: knowledge and health beliefs.

PURPOSE: The purpose of this theory-based descriptive study was to describe older men's (> or = 65 years of age) knowledge of osteoporosis, their health beliefs about osteoporosis (specifically their perceived susceptibility), their confidence to perform osteoporosis-prevention behaviors, and actual performance of osteoporosis-prevention behaviors. DESIGN: A descriptive design was used to determine men's knowledge and health beliefs of osteoporosis, confidence to perform osteoporosis prevention behaviors, and performance of osteoporosis prevention behaviors. SAMPLE: A community-based convenience sample of 138 men 65 years of age and older was obtained in Northeastern Ohio community centers where men were likely to gather. METHOD: Men completed a questionnaire that included the Osteoporosis Knowledge Test, Osteoporosis Health Belief Scale, Osteoporosis Self-Efficacy Scale (Kim, Horan & Gendler, 1991), and the Osteoporosis Preventing Behaviors Survey (Doheny & Sedlak, 1995). MAIN RESEARCH CLASSIFICATIONS: Osteoporosis, Men, Prevention, Health Beliefs, Orthopaedic Nursing. FINDINGS: Men had poor knowledge of osteoporosis, did not perceive themselves as susceptible to osteoporosis, and engaged in few osteoporosis preventing behaviors such as weight-bearing exercises and dietary calcium intake. CONCLUSION: Men need osteoporosis education and modification of lifestyle to include osteoporosis prevention behaviors. IMPLICATIONS FOR NURSING RESEARCH: Future research should include the development of osteoporosis awareness programs for men.

Fashion tips for women with osteoporosis.

Osteoporosis is a major nursing and health concern. Outcomes of this disease result in major body image changes including loss of height, curved spine, and protruding abdomen. Individuals with osteoporosis are not usually disabled but may perceive themselves as unattractive and experience social isolation due to ill fitting clothes that accentuate the physical changes. This article describes fashion tips on how to select clothes that are attractive, comfortable, and easy to wear.

Alcohol use in women 65 years of age and older.

The purpose of this study was to examine the relationships between depression, codependency, self-coherence, and alcohol use and health outcomes in women 65 years of age and older. The framework is Erikson's ego-development theory. A convenience sample of 238 women was obtained from women attending flu shot clinics. This cross-sectional field study used survey methodology. Measures included the Beck Depression Inventory, Codependency Assessment Tool, Self-Coherence Survey Form C, Alcohol Use Disorders Identification Test, Alcohol Use Questionnaire, Self-Rated Health Tool, Quality of Life Visual Analogue Scale, Functional Ability Scale, Illness Prevention Screening Behaviors Checklist, and Sociodemographic Data. Results indicate a low consumption and little variation in use of alcohol. There were no significant associations between alcohol consumption and the dependent variables. Depression was significantly related to all the health outcomes; codependency was significantly related to all health outcomes except perceived quality of life; and self-coherence was significantly related to all health outcomes except illness prevention behavior. These findings have important implications for those providing care for older women.

Differences in critical thinking of nontraditional and traditional nursing students.

This study is part of a larger study describing the differences in critical thinking between nontraditional and traditional beginning baccalaureate nursing students during the first clinical nursing course. Descriptive data analysis from student journals, interviews, and researcher observations revealed three major dimensions of reasoning to describe students' critical thinking: exploration of thoughts and feelings, demonstration of humility, and use of analogous experiences. Nontraditional beginning students do think critically and value the opportunity to share their subjective clinical experiences.

Peer review through clinical rounds. A collaborative critical thinking strategy.

Facilitating the development of critical thinking in beginning nursing students is challenging and exciting. Peer review through student-led clinical rounds can be an effective way to promote students' critical thinking in communicating assessment data and identifying client strengths and problems. Nineteen beginning baccalaureate nursing students participated in a peer review clinical round experience and were then asked to describe their critical thinking. Strengths of using the peer-led rounds include promotion of active student learning and encouragement of collaboration among peers.

Osteoporosis prevention in young women.

PURPOSE: To assess whether young women who participate in an osteoporosis prevention program based on the Health Belief (Rosenstock, 1966) and Self-Efficacy Models (Bandura, 1977) demonstrate higher levels of knowledge regarding osteoporosis prevention than young women who do not participate in such a program. DESIGN: A classic experimental design with one treatment group and one control group was used to test the efficacy of the osteoporosis prevention program. Pretest data on knowledge, health belief attitudes (7 subscales), and self-efficacy (2 subscales) were collected in the treatment and control groups. SAMPLE: A convenience sample of 31 young college women were randomly assigned to an experimental group or to a control group to receive an osteoporosis prevention program. METHOD: Subjects in the experimental and control groups completed the Osteoporosis Knowledge Test, the Osteoporosis Health Belief Scale, and the Osteoporosis Self-Efficacy Scale (Kim et al., 1991) at two times. The experimental group received an osteoporosis prevention program. MAIN RESEARCH CLASSIFICATIONS: Osteoporosis, Health Belief, Self-Efficacy, Women's Health. FINDINGS: Subjects in the experimental group had significantly higher knowledge and health belief scores after receiving the intervention than their pretest scores while subjects in the control group had no change in scores. CONCLUSION: The osteoporosis program was effective in increasing awareness of osteoporosis prevention in this group of young women. IMPLICATIONS FOR NURSING RESEARCH: The results may be useful for developing young women's awareness and knowledge of osteoporosis prevention. Future research could include developing osteoporosis prevention programs at an earlier age when girls are in grade school and junior high school. Teaching health promotion strategies for bone health is essential to all women across the life span.

Orthopaedic nursing research priorities: a replication and extension.

PURPOSE: This study identified current orthopaedic nursing research priorities that should be investigated to advance the practice of orthopaedic nursing. The study was accomplished by the National Association of Orthopaedic Nurses' (NAON) Research Committee via a national survey of selected NAON members. DESIGN: A descriptive design was used to determine research priorities. SAMPLE: The sample consisted of a random sample of 133 NAON members. The sample was stratified for either graduate degrees (> or = master's), other than a graduate degree (< or = bachelor's) (to insure representation from "frontline" practicing nurses), and registrants in the NAON Researcher Database and recipients of NAON Foundation or American Academy of Orthopaedic Surgeons (AAOS)/NAON grants. METHOD: A three round Delphi survey technique was used to build consensus by systematically generating, synthesizing, and analyzing opinions of a group of experts while maintaining confidentiality of the individuals. MAIN RESEARCH CLASSIFICATIONS: Nursing research priorities, Delphi method, Orthopaedic nursing. FINDINGS: The nine target research questions for orthopaedic nursing identified as high priority were grouped into the following categories: patient acuity, care delivery models, staffing issues, patient complications, pain management (in the elderly and those with altered mental status), and patient mobility. These research priority items are intended to direct the orthopaedic nurse researcher to study specific questions within these categories. CONCLUSION: Results reflect the dramatic changes occurring in orthopaedic nursing practice. Research priorities reveal the need for more research on pain and patient complications (e.g., deep vein thrombosis (DVT)) despite a preponderance of existing, published research on these topics. IMPLICATIONS FOR NURSING RESEARCH: This study identified target research questions for orthopaedic nursing. These questions may be used by orthopaedic nurses to develop nursing research proposals as well as collaborative research endeavors with other members of the orthopaedic health care team. An ongoing and wider dissemination of results of existing research to the NAON membership needs to be implemented.

Ethical issues and critical thinking: students' stories.

Through the stories told by these students it is evident that beginning students do think critically and act ethically during their first clinical nursing course. Ethical dilemmas involving students and staff, patients, faculty, and peers depict beginning students' development of values as they evolve into professionals. The conscientiousness and caring displayed by beginning students is apparent from students' shared perspectives. It is particularly encouraging that they seemed to focus more on values and cognitive aspects of patient care than on primarily technical psychomotor skills such as taking blood pressures and giving injections. Teaching beginning students is a challenge because the educator's role is twofold: Help students build a foundation for developing ongoing critical thinking abilities and help students develop an ethical view of patient care. Further exploration of critical thinking and ethical decision making should emphasize the mutual student-educator roles in facilitating self-awareness, through conscious awareness of their beliefs, values, feelings, and multiple perspectives. Because nursing emphasizes the human element and student nurses deal with human lives, educators play a vital role in facilitating the development of beginning students as critical thinkers and as ethical nurses. The most knowledgeable and most psychologically mature faculty are needed to teach beginning nursing students. Through ongoing reflection and critical thinking, nurse educators can help beginning students to identify and develop multiple perspectives on the ethics of nursing practice.

Neurotrophin-3- and norepinephrine-mediated adrenergic differentiation and the inhibitory action of desipramine and cocaine.

In the presence of neurotrophin-3 (NT-3), high-affinity norepinephrine (NE) uptake by quail neural crest cells was significantly increased as judged by in vitro colony assay of adrenergic differentiation. In the presence of the related neurotrophins nerve growth factor (NGF) or brain-derived neurotrophic (BDNF) factor, or of basic fibroblast growth factor (bFGF), there were no significant changes. When NE was added to the culture medium in addition to NT-3, more colonies contained dopamine-beta-hydroxylase (DBH)-immunoreactive cells, an enzyme that is characteristic for adrenergic cells. The NE-mediated increase in the portion of colonies that contained DBH-immunoreactive cells was prevented by the tricyclic antidepressant desipramine (DMI) and by cocaine, two types of drug that block cellular transport of NE. To further examine whether NE acts via uptake, colony assays were performed in the presence and absence of adrenergic antagonists and agonists. These would be expected to mimic the DMI and NE effects, respectively, if the mechanism of action involved activation of adrenergic autoreceptors. Neither class of drug showed a detectable effect within a wide range of concentrations. Immunocytochemistry using antibodies against beta 1 and beta 2 adrenergic receptors further supported the notion that DMI action and beta-receptor expression are not causally related. Ratio imaging was subsequently used in an attempt to elucidate the mechanism of NE action. Within a few minutes of addition of NE to the culture medium, there was an increase in intracellular free calcium in a subset of neural crest cells. Taken together, our data indicate that NT-3 is involved in the appearance of the NE transporter (NET) during embryonic development; internalized NE directly or indirectly increases adrenergic differentiation as measured by immunoreactivity of the adrenergic biosynthetic enzyme DBH; and norepinephrine uptake inhibitors have treatogenic potential.

Critical thinking of beginning baccalaureate nursing students during the first clinical nursing course.

The development of critical thinking is an essential component of baccalaureate nursing education and yet little is known about beginning nursing students' critical thinking abilities in making clinical decisions. The purpose of this study was to describe the critical thinking of seven beginning baccalaureate nursing students during their first clinical nursing course. Qualitative methodology using the case study approach was used to describe students' critical thinking from their perspectives. Sources of data for describing students' critical thinking included reflective journal writing, interviews, and the researcher's nonparticipatory lab observations. Paul's (1993) dimensions of reasoning were used as a framework to describe students' critical thinking. Four major themes revealed through the data analysis were: development of the professional self-perspective, development of a perfectionist perspective, development of a caring perspective, and development of a self-directed learning perspective. The descriptive nature of the study indicated that beginning students do indeed think critically. Opportunities for dialogue in a supportive environment are instrumental in facilitating students' critical thinking and growth as reflective practitioners.

Historical perspectives on orthopaedic nursing research in Orthopaedic Nursing from 1982 to 1995.

PURPOSE: To describe a systematic review of research studies published from 1982 through 1995 in Orthopaedic Nursing since its first issue in 1982. DESIGN: A descriptive design was used to systematically examine and classify the research studies published in Orthopaedic Nursing. SAMPLE: Forty-nine research studies made up the sample. METHOD: A descriptive historical research method was used to categorize the studies according to (1) topic, (2) research design, (3) sampling method, (4) sample size, (5) educational preparation of the author(s), and (6) funding status of the study. MAIN RESEARCH CLASSIFICATION: Nursing research Orthopaedic Nursing. FINDINGS: The number of research studies published in Orthopaedic Nursing was higher from 1990 to 1995. Most studies consisted of adult clients in acute care settings. There was increased attention to nursing interventions, psychosocial needs, and professional development (1990 to 1995). Pain was the most frequently addressed topic. Nonexperimental descriptive and retrospective designs were used most frequently. Nonprobability sampling was more common. Numbers of studies acknowledging funding increased from one study (1982 to 1989), to 10 studies (1990 to 1995). CONCLUSION: Overall, the number of research studies published in Orthopaedic Nursing has increased over the years and the studies have become more sophisticated. The clinical setting provides a wealth of topics for studies on nursing interventions and outcomes. IMPLICATIONS FOR NURSING RESEARCH: The final step of the research process, dissemination of research findings is integral to the success of the research process. As nursing continues to grow as a profession, the dissemination of research findings to the practicing clinician provides research-based information that can guide and improve clinical practice on a day-to-day basis. Nurses need to take advantage of the opportunities for conducting and using research.

Dressing up nursing diagnoses: a critical-thinking strategy.

Teaching nursing diagnoses to beginning students who have no clinical experiences challenges educators to use their creative energies in developing strategies that facilitate students' critical-thinking skills. Dressing Up Nursing Diagnoses is a fun and creative classroom teaching strategy you can use during the Halloween season to help beginning students formulate nursing diagnoses. Two nurse educators describe their successful experiences with this unique teaching strategy.

Multiple actions of stem cell factor in neural crest cell differentiation in vitro.

The neural crest is a transient tissue of the vertebrate embryo that gives rise to most primary sensory neurons and pigment cells in the adult organism, among other cell types and tissues. Many neural crest cells are pluripotent in the sense that their progeny can generate more than one phenotype. The presence of pluripotent neural crest cell-derived cells at sites of terminal differentiation suggests that location-specific cues from the embryonic environment, such as growth factors, are involved in directing their survival, proliferation, and cell type specification. We have therefore examined the influences of one pertinent growth factor, stem cell factor (SCF), on neural crest cell development by in vitro colony assay in a serum-free culture medium. SCF showed three major effects. (1) SCF is trophic for early neural crest cells, that is, either pluripotent cells and/or their more mature progeny. This effect occurs only if SCF is present throughout the culture period, and it is not observed when a neurotrophin is present in addition to SCF. (2) More colonies contain sensory neuron precursors in the presence of SCF. This effect is neutralized by NGF and neurotrophin-3 (NT-3), but not by brain-derived neurotrophic factor (BDNF). (3) The combination of SCF and any neurotrophin tested (NGF, BDNF, NT-3) is trophic for melanogenic cells, whereas SCF alone does not detectably affect melanogenesis. This suggests either that both types of factor are required for melanotrophic action or that melanogenic cells become dependent on neurotrophins after exposure to SCF. Our observation that SCF is required during the first half of the culture period only, and NGF during the second half only, indicates the latter possibility. Whereas coat color changes in the mouse mutants W (c-kit defect) and Steel (SCF defect) and several in vivo and in vitro studies by other investigators have shown previously that SCF is melanotrophic, they also indicated the requirement of an additional factor, or factors, in melanogenesis. Our data suggest that SCF affects neural crest cell development at multiple levels and that survival of melanogenic cells is mediated by a combination of SCF and a neurotropin, rather than by SCF alone.

Reducing orthopaedic hazards of the computer work environment.

The rate of repetitive strain injuries (RSI) in the workplace is rising at an alarming rate. People using computers and working at keyboards for long periods of time are particularly at risk. Prevention of orthopaedic injuries can make the work environment less stressful and more productive as well as help to avoid needless human suffering and costly medical and legal bills. Knowledge of the causes of RSI and preventive measures to reduce orthopaedic hazards of the computer work environment is important for orthopaedic nurses.