"I feel your pain": a research study addressing perianesthesia health care providers' knowledge and attitudes toward pain.

Patients' feedback about their perianesthesia experience at an acute care 609-bed teaching hospital in Washington, DC, indicated that pain management was an area in need of improvement. A nonexperimental descriptive study related to pain management was conducted in the perianesthesia areas to assess the knowledge and attitudes of health care providers. McCaffrey and Ferrell's 38-item self-report questionnaire was given to anesthesia providers, preoperative nurses, Phase I nurses, and Phase II nurses (N=138). Seventy-two participants responded, yielding a 52% response rate. Results showed a statistically significant difference between the scores of the anesthesia care providers and the preoperative area nurses and between the Phase I nurses and the preoperative nurses. No statistically significant differences were found between the anesthesia providers, and Phase I and Phase II nurses, indicating that at this hospital, nurses who provide postoperative care have similar knowledge and attitudes regarding pain as the anesthesia providers.

Dissection of melanogenesis with small molecules identifies prohibitin as a regulator.

Bioactive compounds can be used to selectively modulate gene function. We utilized a chemical genetic approach to dissect the mammalian pigmentation pathway and identify protein regulators. We screened a tagged library of 1170 small molecules in a cell-based assay and discovered a class of pigment-enhancing chemicals. From this class we characterized the small molecule melanogenin. Using melanogenin bound to an affinity matrix and amino acid sequencing, we identified the mitochondrial protein, prohibitin, as an intracellular binding target. Studies employing siRNA demonstrate that prohibitin is required for melanogenin to exert its propigmentary effects and reveal an unsuspected functional role for this protein in melanin induction. This represents a mechanism by which propigmentary signals are transduced and ultimately provides a potential target for the treatment of pigmentary disorders.

The violent adolescent: the urge to destroy versus the urge to feel alive.

The dynamics of adolescent violence are explored from theoretical and developmental perspectives applied to the review of psychoanalytic studies of violence and three cases: the case of Willie Bosket, presented in Fox Butterfield's All God's Children, an adolescent treated by one of the authors, and observation of staff dynamics in a juvenile detention facility. Studies indicate that violence is used to preserve a sense of existence and psychic equilibrium as well as to express rage and destroy unwanted projected parts of the self and dangerous intrusions into a fragile self-coherence. In the case studies, violent activity serves a number of psychic functions: it leads to high arousal states and the feeling of being alive thereby disavowing underlying feelings of deadness and depression, it serves to contain and discharge overwhelming chaotic and rageful feelings, and it enacts object ties and the unconscious fantasies of the parent. Staff dynamics in a treatment setting for juvenile offenders reflect the intrapsychic dynamics of the juvenile offender prone to acting out, projection, hypervigilance to signs of disrespect, and disavowal of unwanted affects including helplessness and vulnerability.

Stimulation of the cell cycle and maize transformation by disruption of the plant retinoblastoma pathway.

The genome of the Mastreviruses encodes a replication-associated protein (RepA) that interacts with members of the plant retinoblastoma-related protein family, which are putative cell cycle regulators. Expression of ZmRb1, a maize retinoblastoma-related gene, and RepA inhibited and stimulated, respectively, cell division in tobacco cell cultures. The effect of RepA was mitigated by over-expression of ZmRb1. RepA increased transformation frequency and callus growth rate of high type II maize germplasm. RepA-containing transgenic maize calli remained embryogenic, were readily regenerable, and produced fertile plants that transmitted transgene expression in a Mendelian fashion. In high type II, transformation frequency increased with the strength of the promoter driving RepA expression. When a construct in which RepA was expressed behind its native LIR promoter was used, primary transformation frequencies did not improve for two elite Pioneer maize inbreds. However, when LIR:RepA-containing transgenic embryos were used in subsequent rounds of transformation, frequencies were higher in the RepA+ embryos. These data demonstrate that RepA can stimulate cell division and callus growth in culture, and improve maize transformation.

Returning children home: clinical decision making in cases of child abuse and neglect.

Factors that influence the decision to remove children from their parents' care in cases of abuse and neglect were examined by reviewing hospital records of 185 children. Children with physical injuries were more likely to be placed in a foster home or in residential care if they were from poor families, while those with non-physical injuries were more likely to be removed if their families were more affluent. Implications for clinical decision making are considered.