Lessons from in vitro perifusion of pancreatic islets isolated from 80 human pancreases.

We report the average insulin response to acute glucose measured by in vitro perifusion of pancreatic islets isolated from 80 consecutive human organs. Different perifusion parameters were considered [basal release, stimulation index (SI), time to peak, incremental area under the curve delta-AUC alpha)], and the correlation among them was determined. SI positively correlated with delta-AUC alpha (p < 0.001, r = 0.80) while negatively with time to peak (p < 0.05, r = -0.23). We also evaluated several variables of the isolation procedure that might affect responsiveness to glucose by human islets. Sex and age of pancreas donors, cold ischemia time, duration of the digestion, collagenase concentration, and lot characteristics (collagenase, trypsin, clostripain, and proteases activity), and final islet yield were considered. Multivariate regression analysis showed only an independent association between SI and the concentration of collagenase (p = 0.01).

Alternative approaches to nursing practice: application of Peplau, Rogers, and Parse.

This article demonstrates three major nursing theories in practice. The uniqueness of each theory is clarified through the presentation of nursing formulations and practice implications. The discussion provides a metaperspective of how practice based in nursing theory is different from traditional practice and how nursing theory can guide practice.

The relentless drive to be ever thinner: a study using the phenomenological method.

The relentless drive to be thinner is an experience lived by many individuals in the present sociohistorical context. Since fundamental questions concerning the structure of this lived experience remain unanswered in the literature, theory-based approaches to nursing practice have yet to be conceptualized for these individuals. The investigator was unable to find even a single nursing study related to the target phenomenon. The present study addresses the foundational question: What is it like to live the experience of the relentless drive to be ever thinner? Retrospective written and verbal accounts from two women who had lived this experience were analyzed using the Giorgi modification of the phenomenological method. The central finding of this study was: The relentless drive to be ever thinner is a persistent struggle toward an imaged self lived through withdrawing-engaging. This theoretical proposition was found to be congruent with Parse's theory of nursing. The study findings suggest directions for innovative nursing practice and support Parse's theory as a useful perspective for the investigation of health experiences.

The expanded role nurse. A dissenting viewpoint.

This article presents a dissenting view of the expanded role nurse in light of contemporary nursing theory. Nursing has moved beyond the vision of expanded practice as conceptualized by provincial and federal nursing associations more than two decades ago. A body of scientific knowledge has emerged which distinguishes nursing practice as unique, and there is a trend away from practice based upon the medical model. The expanded role nurse represents a retreat to physician-dominated, medical model practice and runs counter to the goal of theory-based practice. It is suggested that the concept of the physician's assistant is an appropriate response to cutbacks in medical residents rather than the delegation of medical functions to nurses. If nursing is to survive into the 21st century, theory-based practice must be firmly established and expanded through research. It is proposed that the expanded nursing role as presented in the literature is incompatible with theory-based nursing practice and diminishes the hope for autonomous professionhood.