21st century nursing practice in Ghana: challenges and opportunities.

AIM: This article is intended to stimulate critical thinking and generate fruitful discussion on nursing practice in Ghana as experienced by the authors. Its rationale is to promote exchange of ideas and creative partnerships to ensure that right decisions are made in preparing competent, adaptable and resourceful nurses who can contribute to health for all in the 21st century. THE PROBLEM: The challenges of nursing education, practice and migration in Ghana seem grim. There is inadequate capacity of training institutions, low staff morale, poor distribution and serious workforce shortages. METHODS: Government reports and policy documents on nursing were sourced from official websites and reviewed and discussed in the context of the international scholarly published literature. OPPORTUNITIES: The authors note that despite the severe crises, a number of opportunities such as improved home-based training, international nursing education partnerships and welfare and human resource development could foster effective nurse retention and managed migration. CONCLUSIONS: To address the issues with nursing health service delivery and nursing shortages in Ghana requires all stakeholders to move beyond the traditional stereotypes and be flexible and forward-looking. Needed policy options include expansion of local nursing education and training capacity, collaborative training opportunities, improving the welfare and retention rates of current staff and international exchange of nurse resources that is mutually beneficial to both source and sink countries.

Ethics, culture and nursing practice in Ghana.

OBJECTIVE: This paper describes how nurses in Ghana approach ethical problems. BACKGROUND: The International Council of Nurses' (ICN) Code for Nurses (2006) that serves as the model for professional code of ethics worldwide also acknowledges respect for healthy cultural values. Using the ICN's Code and universal ethical principles as a benchmark, a survey was conducted in 2009 to ascertain how nurses in Ghana respond to ethical and cultural issues in their practice. METHODS: The study was qualitative with 200 participant nurses. Data were obtained through anonymous self-administered questionnaires. Descriptive statistics were used to analyze the data. FINDINGS: Nurses' approaches to ethical problems in Ghana do not always meet expectations of the ICN Code for Nurses. They are also informed by local ethical practices related to the institutional setting and cultural environment in the country. While some cultural values complemented the ICN's Code and universal ethical principles, others conflicted with them. NURSING IMPLICATIONS: These data can assist nurses to provide culturally competent solutions to ethical dilemmas in their practice. Dynamic communication between nurses and patients/clients, intentional study of local cultural beliefs, and the development of ethics education will improve the conformity between universal ethical standards and local cultural values.

Effects of delayed housing of broiler chicks and three different types of waterers on broiler performance.

The performance of broilers was examined under different days of placement (after hatching) and with three different types of waterers: 1) an automatic satellite waterer; 2) a broiler Plasson waterer; and 3) a regular Plasson waterer with a plastic ring in the trough of the waterer for 3 d. Male broiler chicks (2,106) from a commercial strain were randomly placed in 27 litter floor pens, with 9 pens per day of placement and waterer treatments. The broilers consumed feed and water ad libitum and mortality was recorded. The broilers were weighed at day of placement, at 7 and 49 d from day of placement and at 28 and 49 d from day of hatch. There was a difference in body weight (P < .05) among the broilers on the day of placement, with those on the day of hatch being heavier. There was no difference in body weights or feed conversion taken after the broilers were on feed for 7 and 49 d after placement. The broilers placed on the 3rd d after hatching had a higher (P < .05) mortality rate at 28 d of age than the other two groups. There was no difference in body weight, feed conversion, or mortality within the three different waterer treatments except for the broilers on the Plasson with the ring, which was higher in mortality percentage (P < .05) than the broilers on the broiler Plasson waterer. The broilers placed in the pens with the regular Plasson waterer did not get wet from climbing into the water during the first few days as did the broilers in the pens with the automatic satellite waterer or the Plasson waterer with the ring.

Effects of different floor types and levels of washing of waterers on broiler performance and bacteria count of drinking water.

The objective of the present experiment was to determine the effect of different flooring materials and washing of waterers on broiler performance. The floor treatments were 1) black, plastic-coated expanded metal, relatively rigid (B); 2) white plastic, semi-rigid, with rectangular openings (WR); 3) white plastic, semi-rigid, with square openings (WS); and 4) 3 cm of rice hull litter (C). One hanging waterer was placed in each pen. Wash treatments were 1) trough and bell washed every Monday, Wednesday, and Friday (AW); 2) wash trough only on Monday, Wednesday, and Friday (TW); and 3) the waterers were never washed after the 2nd wk (NW). Broilers reared on C has significantly lower BW than those broilers on B floors. Broilers reared on the B and WS floors had significantly higher breast blister scores and percentage of birds with blisters than broilers reared on C floors. Broilers reared on C had lower enlarged feather follicle scores than those reared on all raised floors and a lower percentage of enlarged feather follicles than those broilers reared on WS or WR floors. Broilers reared on WS+TW had significantly better feed conversion than WS+AW, B+TW, and B+AW treatments. Broilers reared on WR+TW treatment were significantly higher in breast blister score than broilers reared on WR+AW, C+TW, and C+AW treatments. Broilers reared on C+TW and C+AW treatments were significantly lower in breast blister score except for broilers reared on C+NW, WR+AW, and WS+AW treatments. Broilers reared on C+NW treatment were significantly lower in enlarged feather follicle score than those broilers reared on B+TW, WR+AW, and WS+NW treatments.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of sodium bicarbonate and potassium chloride drinking water supplementation. 1. Performance and exterior carcass quality of broilers grown under thermoneutral or cyclic heat-stress conditions.

Two broiler trials were conducted using two environmentally controlled chambers. From 4 to 8 wk of age in Trial 1, and from 5 to 8 wk of age in Trial 2, male broilers were grown under either constant environmental conditions [25 C, 50% relative humidity (RH)], or a daily cyclic heat stress period (4 h of 35 to 38 C, 40% RH). One of four water solutions was provided to each of 16 pens per chamber: 1) 5% NaHCO3: 2) .5% KCl; 3) .5% KCl and NaHCO3, or 4) an unsupplemented control of tap water. Seven-wk body weight, 8-wk weight, weight gain, water consumption, infected feather follicle score, prekill and carcass without giblets weight were all significantly (P less than .05) affected by environmental treatment in both trials. In Trial 1, a significant effect due to water treatment was detected for infected feather follicle score, with control broilers significantly less afflicted than broilers on the other three water treatments. In Trial 2, a significant (P less than .05) temperature treatment effect was detected for abdominal fat pad weight, where differences in fat pad weight were found among water treatments under constant conditions but not under cyclic environmental conditions. These differences in fat pad weight, when expressed as a percentage of carcass weight, were at a probability of .0814. Overall, no appreciable improvements were detected in the broiler production parameters measured under either environmental regimen for the water treatments tested.

Effects of sodium bicarbonate and potassium chloride drinking water supplementation. 2. Meat and carcass characteristics of broilers grown under thermoneutral and cyclic heat-stress conditions.

Two broiler trials were conducted to investigate the effect on post-mortem carcass and meat quality of NaHCO3 and KCl drinking water supplementation under thermoneutral and cyclic heat-stress climatic conditions. Water chill carcass weight change, water- and oven-cooked breast filled yields, and breast meat tenderness were measured. In Trial 1, neither environmental regimen, nor water treatments, nor their interaction was a significant (P less than .05) source of variation for the parameters measured. In Trial 2, environmental regimen was a highly significant (P less than .01) source of variability for chilled carcass weight change; the cyclic heat-stressed broiler carcasses gained more weight than the thermoneutral (control) broiler carcasses during ice-water chilling. Oven-cooked fillet yield was significantly (P less than .05) affected by environmental regimen; fillets from cyclic heat-stressed broilers had lower yields than thermoneutral (control) broiler fillets. Drinking water treatments were a significant (P less than .05) source of variation for breast meat tenderness in Trial 2. Broilers given .5% NaHCO3 from 5 to 8 wk of age had higher shear resistance values than broilers given a combination of .5% NaHCO3 and .5% KCl or tap water-fed controls. Breast meat shear values were negatively correlated (P less than .05) with 8-wk broiler body weight and 5- to 8-wk gain.

Oral rehydration therapy and broiler performance during summer growing conditions.

Two 8-wk broiler trials were conducted during summer growing conditions. Mild heat stress (30 C), as evidenced by panting, was induced by ventilation adjustments. From 4 to 8 wk of age, half of the pens were provided with a .10 strength, human oral rehydration therapy (ORT) solution containing .35 g sodium chloride, .25 g sodium bicarbonate, .15 g potassium chloride, and 4.0 g sucrose/L of drinking water. No significant (P less than .05) differences were found between treatments for 8-wk body weight. Mortality rate during the experiment period (4 to 8 wk) did not differ significantly between treatments in either trial, though it approached significance (P = .0558) in Trial 1 where mortality for broilers given ORT was 3.96% compared with 7.67% for control broilers. Feed efficiency was significantly (P less than .05) better in Trial 1 for ORT broilers, although no significant difference was found between treatments in Trial 2. Posttrial litter moisture measurements showed no significant differences (P greater than .05) between treatments in either trial. A crystalline deposit was observed in the internal filters of the bell-type waterers, which was probably caused by the sucrose (sugar) component of the ORT solution.

Lipofuscin in retinal pigment epithelium of rhesus monkey: lack of diminution with centrophenoxine treatment.

An experiment was performed to test the ability of Centrophenoxine to reduce the amount of lipofuscin (age pigment) in the retinal pigment epithelium (RPE) of aged rhesus monkeys. Centrophenoxine is reputed to have this action in neurons of lower mammals. Quantitative electron microscopic analysis was performed on sections from the perifovea of ten rhesus monkeys, all approximately 20 years of age. Four of the animals received 80 mg/kg Centrophenoxine (IM injection) daily for 12 weeks. No significant difference between the treated and control groups could be demonstrated statistically (Mann-Whitney U-test) either in the fraction of RPE cell cytoplasm occupied by lipofuscin granules or in the average size of the granules.

Structural periodicities observed in mammalian rod outer segments with Nomarski optics.

Structural periodicities have been observed in isolated rod outer segments of several mammalian species using differential interference contrast (Nomarski) optics. The spacing among the observed structural inhomogeneities is somewhat variable. If these measured spacings are corrected for shrinkage, estimated by comparing ROS widths in unfixed cells to those in light microscopic autoradiographs, the mean values correlate well with published rates of ROS renewal in rats and dogs.

Comparison of dwarf and normal broiler breeder hens.

Two strains of dwarf and two of normal broiler breeder hens were compared during the laying period for the following production parameters: egg number, hen-day and hen-housed egg production, mortality, feed consumption, egg weight, egg shell quality, hatchability, and fertility. Though the dwarf hens matured earlier, the number of eggs produced during the laying period did not differ (P less than .05) from that of the normal hens. The dwarf hens consumed 25.6% less feed per dozen eggs but produced smaller eggs. Mortality was higher for the dwarf hens during the laying period than for normal hens. The normal hens had an advantage over the dwarf hens in percent hatchability of all eggs set and percent fertility, but the percent hatchability of fertile eggs did not differ between the two genetic groups. No differences were found in egg shell quality of the two groups of chickens.

The effect of maternal age on broiler performance on litter and a raised perforated floor.

The effect of maternal age and floor type on the performance of broiler chicks was studied. Hatching eggs were collected and hatched from the same Cobb commercial strain of broiler breeder hens at 27, 42, and 52 weeks of age. Chicks from each group were reared separately or intermingled on commercial diets. Maternal age had a significant effect (P less than .05) on live body weights of broilers reared either separately or intermingled. Weight differences found at day-old between chicks from 42- and 52-week-old dams were overcome by the age of 44 days. Chicks from the 27-week-old dams were not as heavy and consumed less feed than those from other parentage groups. Broilers on the perforated floors were heavier than their floor counterparts. Overall performance, except for body weight, was not affected by floor type or rearing condition.

Birefringent periodicities in amphibian rod outer segments.

Birefringence variations, seen as regularly spaced altering light and dark rings (bands), have been observed along the length of unfixed, freshly isolated rod outer segments (ROS) of both Rana pipiens and Xenopus laevis. In our hands, the spatial frequency of the banding pattern is from 1.3-1.6u/band in Rana pipiens and 1.8-2.2u/band in Xenopus laevis ROS, both corresponding closely to determinations we made in the same animals of the quantity of new ROS disks added each day. To further probe this correlation, Xenopus laevis were maintained at 16 degrees C to lower the disk renewal rate. A similar correspondence was found, with the banding pattern and renewal rate both at 0.8-1.Ou/day. Further experiments involving Xenopus laevis placed on altered lighting cycles have suggested the existence of two normally superimposed periodicities. The more intense component is driven by the environmental light cycle, and thus may be regarded as diurnal. The less intense component is seen infrequently, suggesting lability, and apparently follows a 24-hour period in both constant light and darkness.

Freeze-fracture studies of photoreceptor membranes: new observations bearing upon the distribution of cholesterol.

We performed electron microscopy of replicas from freeze-fractured retinas exposed during or after fixation to the cholesterol-binding antibiotic, filipin. We observed characteristic filipin-induced perturbations throughout the disk and plasma membranes of retinal rod outer segments of various species. It is evident that a prolonged exposure to filipin in fixative enhances rather than reduces presumptive cholesterol detection in the vertebrate photoreceptor cell. In agreement with the pattern seen in our previous study (Andrews, L.D., and A. I. Cohen, 1979, J. Cell Biol., 81:215-228), filipin-binding in membranes exhibiting particle-free patches seemed largely confined to these patches. Favorably fractured photoreceptors exhibited marked filipin-binding in apical inner segment plasma membrane topologically confluent with and proximate to the outer segment plasma membrane, which was comparatively free of filipin binding. A possible boundary between these differing membrane domains was suggested in a number of replicas exhibiting lower filipin binding to the apical plasma membrane of the inner segment in the area surrounding the cilium. This area contains a structure (Andrews, L. D., 1982, Freeze-fracture studies of vertebrate photoreceptors, In Structure of the Eye, J. G. Hollyfield and E. Acosta Vidrio, editors, Elsevier/North-Holland, New York, 11-23) that resembles the active zones of the nerve terminals for the frog neuromuscular junction. These observations lead us to hypothesize that these structures may function to direct vesicle fusion to occur near them, in a domain of membrane more closely resembling outer than inner segment plasma membrane. The above evidence supports the views that (a) all disk membranes contain cholesterol, but the particle-free patches present in some disks trap cholesterol from contiguous particulate membrane regions; (b) contiguous inner and outer segment membranes may greatly differ in cholesterol content; and (c) the suggested higher cholesterol in the inner segment than in the outer segment plasma membrane may help direct newly inserted photopigment molecules to the outer segment.

The use of fly ash in diets of cage and floor broilers.

Three experiments were conducted to compare limestone to fly fly ash from a coal-fired generator station as a calcium source for broilers. In Experiment 1, 5 male and 5 female broiler chicks were placed in each of 32 cages. Sixteen cages of birds were fed a ration with limestone supplying 30% of the total calcium and 16 cages were fed a ration with 30% of the total calcium supplied by fly ash. The total calcium and phosphorus levels of the rations were 1.0% and .5% respectively. In this experiment no significant difference (P < .05) was found for 8-week body weight between diets where the added calcium was from limestone or fly ash. In Experiment 2 a group of 40 male and 40 female cage reared broilers and 40 male and 40 female floor reared broilers were fed a basal diet of limestone providing 33% of the total calcium. Three diets with increasing fly ash levels were fed to three cage groups of 40 male and 40 female broilers providing 33, 46, and 45% of the total calcium of .9, 1.1, and 1.8%, respectively. Broilers fed the highest fly ash level weighed significantly less (P < .05) at 8 weeks than the caged controls but did not differ from the other treatments. Bone breaking strength as measured by the Allo Kramer Shear Press was similar between the basal and low level fly ash group and increased with higher fly fly ash levels. Humerus and radius bone strength were greatest in floor broilers when compared with cage broilers. Tibia ash content of the floor-reared broilers and higher fly ash level of caged broilers were similar and greater than that of the basal cage group. Humerus and radius ash content were higher for the higher calcium groups. In Experiment 3 four groups of 40 male broilers in cages were fed limestone diets with graded levels of limestone for the calcium source. Another four groups of 40 caged male broilers were fed fly ash diets with equivalent graded levels of fly ash for the calcium source. Both limestone and fly ash diets provided .17, .34, .51, and .68% calcium of a total calcium content of .28, .45, .62 and .79%, respectively. The four limestone groups exhibited a definite linear improvement in both 3-week body weight and bone weight (tibia and femur combined) as the dietary calcium level was upgraded. The two low fly ash groups were similar in body and bone weight to their counterpart limestone groups, but further increases in the fly ash component did not improve body or bone weight. Bone ash values for both limestone and fly ash groups showed a similar improvement with each calcium increase, except the high value for the second level of fly ash.

Freeze-fracture evidence for the presence of cholesterol in particle-free patches of basal disks and the plasma membrane of retinal rod outer segments of mice and frogs.

The freeze-fracture technique was used to examine the membranes of the photoreceptors of mice and frogs. Particle-free patches were found in the plasma membrane and basal disk membranes of the outer segments of both mice and frogs housed at room temperature, but not in frogs kept in a cold room. These patches were shown not to be artifacts of cryoprotection or fixation, and they persisted when fresh isolated outer segments were frozen by an ultrarapid method. They were also found to persist in mouse rods when retinas were incubated and subsequently fixed at temperatures up to 80 degrees C. Cholesterol was implicated as a significant component of the patches by the observation that, in the outer segments, pits, induced by treatment with the sterol-specific polyene antibiotic filipin, were present in and confined to the particle-free patches. That these lesions are not inherently limited to particle-free membrane areas was evident in the apical plasma membrane of the photoreceptor inner segments, where particles and pits were intermixed. Treatment with saponin, a surface-active agent which specifically complexes cholesterol, resulted in the disappearance of the particle-free patches. Patches were found in basal disks of both mouse and frog rods but not in older disks nearer the pigment epithelium, which indicates that changes occur in the composition of disk membranes and/or in the molecular ordering of their protein and lipid components during the early phase of their transit from the base towards the apex of the outer segment.