Dhurrin increases but does not mitigate oxidative stress in droughted Sorghum bicolor.

MAIN CONCLUSION: Droughted sorghum had higher concentrations of ROS in both wildtype and dhurrin-lacking mutants. Dhurrin increased in wildtype genotypes with drought. Dhurrin does not appear to mitigate oxidative stress in sorghum. Sorghum bicolor is tolerant of high temperatures and prolonged droughts. During droughts, concentrations of dhurrin, a cyanogenic glucoside, increase posing a risk to livestock of hydrogen cyanide poisoning. Dhurrin can also be recycled without the release of hydrogen cyanide presenting the possibility that it may have functions other than defence. It has been hypothesised that dhurrin may be able to mitigate oxidative stress by scavenging reactive oxygen species (ROS) during biosynthesis and recycling. To test this, we compared the growth and chemical composition of S. bicolor in total cyanide deficient sorghum mutants (tcd1) with wild-type plants that were either well-watered or left unwatered for 2 weeks. Plants from the adult cyanide deficient class of mutant (acdc1) were also included. Foliar dhurrin increased in response to drought in all lines except tcd1 and acdc1, but not in the roots or leaf sheaths. Foliar ROS concentration increased in drought-stressed plants in all genotypes. Phenolic concentrations were also measured but no differences were detected. The total amounts of dhurrin, ROS and phenolics on a whole plant basis were lower in droughted plants due to their smaller biomass, but there were no significant genotypic differences. Up until treatments began at the 3-leaf stage, tcd1 mutants grew more slowly than the other genotypes but after that they had higher relative growth rates, even when droughted. The findings presented here do not support the hypothesis that the increase in dhurrin commonly seen in drought-stressed sorghum plays a role in reducing oxidative stress by scavenging ROS.

Seeking care for nonurgent medical conditions in the emergency department: through the eyes of the patient.

INTRODUCTION: The policy goal of shifting nonurgent visits from the emergency department to nonemergency health care settings is commonly devised, planned, and implemented without considering patients' perspectives. The purpose of this study was to gain an understanding of the context in which patients choose to seek health care in an emergency department. Human science provided the framework for this exploratory descriptive research study. METHODS: This study was conducted at an urban, university emergency department in Denver, Colo. Uninsured adult patients triaged as nonurgent who were being discharged home were eligible to participate. Eligible patients from 15 randomly selected shifts were asked to participate. Following their ED visit, open-ended interviews began with the question, "Can you tell me the story, or the chain of events, that led to your coming to the emergency department today?" Each interview was audiotaped. Transcripts were analyzed to identify common themes. Patients also rated their severity of illness from 1 (not severe) to 5 (life-threatening), and they rated their satisfaction with the health care they received from 1 (not satisfied) to 5 (extremely satisfied). RESULTS: The 30 study participants ranged in age from 17 to 60 years; 22 participants (73%) were women. Most patients (73%) rated their severity of illness as 3 or less and their satisfaction with the health care they received as 4 or more (83%). Five themes for seeking care were identified: (1) toughing it out, (2) symptoms overwhelming self-care measures, (3) calling a friend, (4) nowhere else to go, and (5) convenience. Despite the fact that the patients had nonurgent medical problems, their stories revealed that distress in their lives had influenced their need for emergency care. CONCLUSIONS: Access was prominent in the minds of uninsured patients seeking ED care for nonurgent medical diagnoses. Typically, patients did not perceive themselves as having an urgent problem, had been unsuccessful in gaining access to alternative non-ED health care settings, and found the emergency department to be a convenient and quality source of health care. The patients' stories relayed a context for ED visits that goes beyond medical diagnoses. This perspective has important implications for quality care delivery and for including patients in planning ways to access emergency health care.

Menopause: plight or passage?

Although the menopause has been discussed in medical, biological, and social science literature, the experience of menopause for women has been shrouded in myths and taboos. Separating myth from reality has been difficult for the American woman, who traditionally has not sought medical advice about the menopause on a routine basis. Health care professionals need to understand the influence of history, culture, taboos, and myths on the symptomatology and interpretation of the menopausal experience.

A theoretical model of the perimenopausal process.

The purpose of this qualitative investigation was to generate theory grounded in the responses of perimenopausal women about the process of menopause. A purposive sample of 12 perimenopausal women was interviewed to discover the menopausal process. Data were generated from interviews, two-month daily logs, and field notes. A substantive theory of Integrating a Changing Me identified the perimenopausal process, which included four categories: Tuning Into Me, My Body and Moods, which described the awareness of physical and emotional changes that initiated the beginnings of menopause; Facing a Paradox of Feelings, which reflected the thoughts, perceptions, and feelings experienced by perimenopausal women. Contrasting Impressions, which described the assimilation of information and the formulation of the woman's own personal meaning; and Making Adjustments, which included changes made by the women in response to this process. Implications for health care and education of perimenopausal women are discussed.

Optimal age for measles and mumps vaccination in Australia.

Trivalent measles-mumps-rubella vaccine has recently replaced measles-mumps vaccine in Australia and is recommended as a single dose at the age of 12 to 15 months, with the exception of Aboriginal children in central Australia who are vaccinated at 9 months. The timing of measles vaccination has been controversial not only in Australia but also in the United States, where measles outbreaks continue to occur. This study aimed to determine seroconversion rates for measles-mumps vaccine in children aged 12 to 18 months and to make a recommendation for the timing of vaccination based on seroconversion rates and attack rates. The parents of 425 children aged 12 to 18 months gave consent for their children to have serum collected at the time of measles-mumps vaccination and three months later. The mean age at vaccination of the children who had two serum samples for measles and mumps antibody estimations was 13.9 months (mode, 13.1). The seroconversion rate for measles was 95% (314/329) (95% confidence interval (CI), 92.5% to 97.3%) and for mumps 97% (309/320) (95% CI, 93.8% to 98.1%). There were no statistically significant differences in the rates of seroconversion for measles or mumps related to age in months at the time of vaccination or in post-vaccination measles antibody titres related to age at vaccination. Post-vaccination mumps antibody titres tended to be lower in older vaccinees. None of the children who presented for vaccination had serological evidence of prior measles infection but five had evidence suggestive of prior mumps. As the seroconversion rates for measles and mumps vaccines were very high in these children it was concluded that no advantage resulted from delaying vaccination until 15 months and that the current National Health and Medical Research Council recommendations for vaccination at age 12 to 15 months should remain.