A mixed methods pilot and feasibility open trial of internet-delivered cognitive behaviour therapy (iCanADAPT Advanced) for people with advanced cancer with depression and/or anxiety

PURPOSE

Evaluate the feasibility, acceptability and potential efficacy of a form of online therapy for clinical depression and/or anxiety in people living with advanced cancer.

METHODS

A single-arm open trial of a six-lesson clinician-supervised, internet-delivered cognitive behavioural therapy (iCBT) transdiagnostic intervention (iCanADAPT Advanced) was undertaken. Qualitative (semi-structured telephone interview conducted at 3-months) and quantitative data (questionnaires collected at pre-, post-, and 3-month follow-up) were analysed.

RESULTS

27 participants partook (26 women, 56% breast cancer, mean age 56yo; average number of mental health diagnoses 1.8, with majority (81%) meeting criteria for generalised anxiety disorder). Feasibility - Unanticipated numbers (48%) of participants had physical health deterioration (cancer progression or death). iCBT had high adherence overall (completion rates: 37% did 6 lessons; 70% did 4 lessons) but adherence was higher for those whose cancer remained stable (completion rates: 43% did 6 lessons; 85% did 4 lessons). Acceptability - the intervention was acceptable to the majority of participants, with high treatment satisfaction. Advisory data was achieved regarding future versions. Potential efficacy - regardless of physical health status, participants who completed the iCBT showed a significant decrease over time in anxiety and depression symptoms.

CONCLUSIONS

Online therapies may be useful in assisting those living with advanced cancer dealing with clinical depression and anxiety disorders. The specific modality of clinician supervised iCBT has significant potential to be a suitable modality of online therapy.

Double intussusception secondary to Meckel's diverticulum in a seventeen-year-old female: a case report

Meckel's diverticulum (MD) is the most common congenital malformation of the gastrointestinal tract. It rarely presents in adults and is usually asymptomatic. Attention to clinical history, examination and imaging studies are crucial for a successful diagnosis. A 17-year-old female presented with vomiting and acute peri-umbilical abdominal pain. Ultrasound examination showed an intussusception measuring 3.2cm in diameter and over 8cm in length. Exploratory laparoscopy showed two ileal intussusceptions. The first was reduced via laparoscopy; the second appeared suspicious for MD and ultimately required a mini-laparotomy for reduction and resection of the MD. Ultrasonography is a useful modality in the presence of perforation, occlusion, hemorrhage, neoplasia, or fistula and avoids exposure to radiation. Laparoscopic or laparoscopic-assisted mini-laparotomy is the route for the resection of MD. The choice depends on the clinical presentation and surgeon expertise. A careful history and physical examination are vital factors in diagnosis and treatment MD.

Depressive symptoms are related to boredom proneness in patients receiving hospital care, regardless of alcohol status, lifestyle, or social support

We examined the relationship between boredom proneness and psychological distress in patients receiving hospital care due either to excessive alcohol consumption or to gastrointestinal diseases. Sociodemographic data were collected together with boredom proneness subscales (internal/external lack of stimulation), psychological distress, physical activity, and social support. Boredom proneness due to a lack of external stimulation seemed to constitute a prominent personality trait in patients with alcohol consumption. But depressive symptoms were related only to boredom proneness due to a lack of internal stimulation in all patients, regardless of alcohol status, lifestyle, or social support. Potential implications for practice and future research are discussed.

Age-specific characteristics of neutrophilic dermatoses and neutrophilic diseases in children

BACKGROUND

Our suggested 'modern' concepts of 'neutrophilic dermatoses' (ND) and 'neutrophilic disease' were based on observations in adult patients and have not been studied in paediatric patients. Only a minority of ND occurs in children, and little is known about age-specific characteristics.

OBJECTIVES

To describe age-specific characteristics of ND in children and to study whether our suggested 'modern' classification of ND may be applied to children.

METHODS

We conducted a retrospective multicentre study in a French cohort of 27 paediatric patients diagnosed with pyoderma gangrenosum (PG) or Sweet's syndrome (SS).

RESULTS

Demographics and distribution of typical/atypical forms were similar in patients diagnosed with PG and SS. Atypical ND were more frequent in infants (90%), when compared to young children (60%) and adolescents (33%). Neutrophilic disease was observed in 17/27 patients and was most frequent in infants. Neutrophilic disease of the upper respiratory tract, as well as cardiac neutrophilic disease, was only observed in infants, whereas other locations were similarly found in infants, young children and adolescents. In infants and young children, ND were associated with a large spectrum of general diseases, whereas in adolescents associations were limited to inflammatory bowel disease and Behçet's disease.

CONCLUSIONS

Our study describes the concept of ND in paediatric patients and shows that they have some characteristics different from ND occurring in adults. ND occurring in infants can be associated with a large spectrum of general diseases. Occurrence of neutrophilic disease is frequent in children. Thus, ND occurring in young paediatric patients should incite clinicians to schedule complementary explorations in order to search for involvement of other organs and to rule out monogenetic autoinflammatory syndromes.

Ecoconception des caves : réduction de la consommation d'énergie et intégration paysagère du traitement des effuents de cave avec le dispositif de lit planté de roseaux sur support de zéolithe Zeofito®

Le traitement aérobie des effuents vinicoles est majoritairement utilisé dans les caves. Au-delà des impératifs de performance d'épuration, avec les orientations de développement durable, le traitement doit intégrer plusieurs orientations : faible consommation d'énergie, limitation des boues, valorisation paysagère et de la biodiversité, limitation des nuisances olfactives et sonores, et éventuellement la réutilisation des effuents traités pour l'irrigation. Les dispositifs classiques de phyto-épuration sur lit de sable, qui permettent de traiter des effuents avec une DCO généralement inférieure à 2 g/l, imposent le plus souvent un bassin de stockage aéré conséquent, consommateur d'énergie, source éventuelle de nuisance olfactive, visuelle et sonore. Le procédé Zeofito®, qui équipe maintenant une centaine de caves dans différentes régions italiennes, accentue grâce au support de zéolithe, les mécanismes d'adsorption et de biodégradation. Ainsi, il est possible de réaliser un traitement direct ou éventuellement avec un petit bassin de stockage d'égalisation/aération, correspondant à quelques jours de rejet. La réutilisation de l'eau pour le dispositif de refroidissement de la cave ou l'irrigation des vignes est facilitée comparativement aux dispositifs classiques. Parallèlement au principe et aux performances, l'objectif de la communication est de présenter des installations représentatives de la diversité des caves.

Solution-mediated crystallization of amorphous azithromycin

Water and water vapor are the bane of amorphous drug stability, both in storage and after administration. As is to be expected, crystallization of amorphous azithromycin did occur when exposed to water as dissolution medium. However, experimental results showed that, although solution-mediated phase transformation had occurred, it was not a rapid process for this drug. It is considered to be an advantageous characteristic of amorphous azithromycin and likely due to the high molecular mass (748.984 g/mol) and complex structure necessitating more energy for transformations to occur. A high apparent solubility is maintained for a considerable period of time, potentially rendering a higher percentage of this BCS Class II drug available for absorption when administered orally.

Quantification of the fungal fraction released from various preloaded fibrous filters during a simulated ventilation restart

This study aimed to demonstrate that particles, especially those associated with fungi, could be released from fibrous filters used in the air-handling unit (AHU) of heating, ventilation and air-conditioning (HVAC) systems during ventilation restarts. Quantification of the water retention capacity and SEM pictures of the filters was used to show the potential for fungal proliferation in unused or preloaded filters. Five fibrous filters with various particle collection efficiencies were studied: classes G4, M5, M6, F7, and combined F7 according to European standard EN779:2012. Filters were clogged with micronized rice particles containing the fungus Penicillium chrysogenum and then incubated for three weeks at 25°C and 90% relative humidity. The results indicated that the five clogged tested filters had various fungal growth capacities depending on their water retention capacity. Preloaded filters were subjected to a simulated ventilation restart in a controlled filtration device to quantify that the fraction of particles released was around 1% for the G4, 0.1% for the M5 and the M6, and 0.001% for the F7 and the combined F7 filter. The results indicate that the likelihood of fungal particle release by low efficiency filters is significantly higher than by high efficiency filters.

Behavior and Fate of Halloysite Nanotubes (HNTs) When Incinerating PA6/HNTs Nanocomposite

Nanoclay-based nanocomposites have been widely studied and produced since the late 1990s, and frequently end up in waste disposal plants. This work investigates the behavior of PA6/HNTs nanocomposites (nylon-6 incorporating halloysite nanotubes) during incineration. Incineration tests were performed at lab-scale using a specific tubular furnace modified in order to control the key incineration parameters within both the combustion and postcombustion zones. The combustion residues and combustion aerosol (particulate matter and gas phase) collected downstream of the incinerator furnace were characterized using various aerosol analysis techniques. Time tracking of the gas and particle-number concentrations revealed two-step char formation during combustion. HNTs transformed into other mineral structures which were found in both the aerosol and the residues. During combustion of the polymer, it appears that HNTs contribute to the formation of a cohesive char layer that protects the residual material.

New method using quantitative PCR to follow the tick blood meal and to assess the anti-feeding effect of topical acaricide against Rhipicephalus sanguineus on dogs

A 28-day study was conducted to assess the dynamic of blood feeding by Rhipicephalus sanguineus ticks on dogs treated or not with a novel topical combination of fipronil, amitraz and (S)-methoprene. Dogs were infested weekly through exposure to ticks in crates for 4h. Ticks were then counted in the crates at 2h and 4h post dog exposure. Ticks were also counted and removed from the dogs at 2h, 4h, 6h, 12h and 24h post tick exposure. The inhibition of blood feeding was assessed by both tick quantification and designing and performing a quantitative PCR (qPCR) to detect the canine hydroxymethylbilane synthase (HMBS) gene in ticks. The percentage of repellency sensu lato based on the ticks collected in crates at 2h varied from 4.7% at day 28 to 48.3% at day 7. The immediate mortality rate of the ticks expelled at 2h varied from 1.5% at day 21 to 31.7% at day 7. The efficacy calculation showed that the acaricidal combination started to kill ticks in as little as 2h. The average efficacy reached 90.0% at 12h post crate challenges and 100% at 24h post exposure in crates. The inclusion of an internal amplification control was used to ensure that no significant template-derived PCR inhibition (≤ 6.2%) affected the overall results. The reduction of blood feeding was significant at 4h (>80.0%) and >99.0% at 24h post tick exposure in the crate. The high repellency rate and the lethal efficacy of CERTIFECT(®) resulted in significantly fewer live attached ticks, consequently reducing blood intake and fluid exchanges.

Diffusion-weighted magnetic resonance imaging for detecting and assessing ileal inflammation in Crohn's disease

BACKGROUND

Whether diffusion-weighted imaging (DWI)-MRI is of value in detecting and assessing inflammation of ileal Crohn's disease (CD) remains poorly investigated.

AIM

To compare DWI-MR enterography (MRE) with conventional MRE in estimating inflammation in small bowel CD, to determine an apparent diffusion coefficient (ADC) threshold to differentiate active from non-active lesions and to assess inter-observer agreement.

METHODS

Thirty-one CD patients from the Clermont-Ferrand IBD unit with ileal involvement were consecutively and prospectively included between April and June 2011. All patients underwent DWI-MRI to detect the digestive segment with the most severe lesions, which was then used to calculate the ADC. Qualitative and quantitative results were compared with conventional MRE including MaRIA (Magnetic Resonance Index of Activity) score calculation and independent activity predictors (wall thickening, oedema, ulcers). Each examination was interpreted independently by two radiologists blinded for clinical assessment.

RESULTS

Seventeen patients (54.8%) had active CD as defined by the MaRIA score ≥7. DWI hyperintensity was highly correlated with disease activity evaluated using conventional MRE (P = 0.001). Qualitative analysis of DW sequences determined sensitivity, specificity, positive predictive value and negative predictive value as 100%, 92.9%, 94.4% and 100% respectively. Quantitative analysis using a cut-off of 1.6 × 10(-3) mm(2)/s for ADC yielded sensitivity and specificity values of, respectively, 82.4% and 100%. Inter-observer agreement was high with regard to DWI hyperintensity (κ = 0.69, accuracy rate = 85.7%) and ADC (correlation = 0.74, P < 0.001, and concordance = 0.71, P < 0.001).

CONCLUSION

DWI-MR enterography is a well-tolerated, non-time-consuming and accurate tool for detecting and assessing inflammation in small bowel Crohn's disease.

Evolution of microbial aerosol behaviour in heating, ventilating and air-conditioning systems--quantification of Staphylococcus epidermidis and Penicillium oxalicum viability

The aim of this study was to develop an experimental set-up and a methodology to uniformly contaminate several filter samples with high concentrations of cultivable bacteria and fungi. An experimental set-up allows contaminating simultaneously up to four filters for range of velocities representative of heating, ventilating and air-conditioning systems. The test aerosol was composed of a microbial consortium of one bacterium (Staphylococcus epidermidis) and one fungus (Penicillium oxalicum) and aerosol generation was performed in wet conditions. Firstly, the experimental set-up was validated in regards to homogeneity of the air flows. The bioaerosol was also characterized in terms of number and particle size distribution using two particle counters: optical particle counter Grimm 1.109 (optical diameters) and TSI APS 3321 (aerodynamic diameters). Moreover, stabilities of the number of particles generated were measured. Finally, concentrations of cultivable microorganisms were measured with BioSamplers (SKC) downstream of the four filters.

Evolution of microbial aerosol behaviour in heating, ventilating and air-conditioning systems--quantification of Staphylococcus epidermidis and Penicillium oxalicum viability

The aim of this study was to develop an experimental set-up and a methodology to uniformly contaminate several filter samples with high concentrations of cultivable bacteria and fungi. An experimental set-up allows contaminating simultaneously up to four filters for range of velocities representative of heating, ventilating and air-conditioning systems. The test aerosol was composed of a microbial consortium of one bacterium (Staphylococcus epidermidis) and one fungus (Penicillium oxalicum) and aerosol generation was performed in wet conditions. Firstly, the experimental set-up was validated in regards to homogeneity of the air flows. The bioaerosol was also characterized in terms of the number and particle size distribution using two particle counters: optical particle counter Grimm 1.109 (optical diameters) and TSI APS 3321 (aerodynamic diameters). Moreover, stabilities of the number of particles generated were measured. Finally, concentrations of cultivable microorganisms were measured with BioSamplers SKC downstream of the four filters.

Impact of the unfolded protein response on the pathogenicity of the necrotrophic fungus Alternaria brassicicola

The unfolded protein response (UPR) is an important stress signalling pathway involved in the cellular development and environmental adaptation of fungi. We investigated the importance of the UPR pathway in the pathogenicity of the plant necrotrophic fungus Alternaria brassicicola, which causes black spot disease on a wide range of Brassicaceae. We identified the AbHacA gene encoding the major UPR transcription regulator in A. brassicicola. Deletion of AbHacA prevented induction of the UPR in response to endoplasmic reticulum stress. Loss of UPR in mutants resulted in a complete loss of virulence and was also associated with a cell wall defect and a reduced capacity for secretion. In addition, our results showed that the UPR was triggered by treatment of mycelia with camalexin, i.e. the major Arabidopsis thaliana phytoalexin, and that strains lacking functional AbHacA exhibited increased in vitro susceptibility to antimicrobial plant metabolites. We hypothesize that the UPR plays a major role in fungal virulence by altering cell protection against host metabolites and by reducing the ability of the fungus to assimilate nutrients required for growth in the host environment. This study suggests that targeting the UPR pathway would be an effective plant disease control strategy.

Radiosensibilité intrinsèque et cassures double–brin de l'ADN dans les cellules humaines

Among the large spectrum of DNA damage induced by radiation, DNA double-strand breaks (DSBs) are considered, to date, as the key-lesions responsible for the cell killing. However, although it was always intuitive to radiobiologists, such a conclusion has only been reached after technical developments and conceptual advances and remains consensual rather than demonstrated formally. In this article, we have reviewed the results that have lead to the conclusion that the assessment of successful DSB repair can be the basis of reliable assays predictive of the clinical response to radiotherapy and some chemotherapeutic treatments. We have discussed a number of technical artifacts, the biases due to the extrapolation of data obtained in yeast and rodent model systems to the human situation and the variety of phenotypes observed in human cells and in particular: 1) the most recent techniques developed, based on immunofluorescence, which have revolutionized our understanding of the molecular events occurring early after irradiation but have also raised the crucial questions about the choice of techniques to assess DSB repair and their specificity for different steps of the repair process; 2) While the homologous recombination repair pathway is predominant in yeasts, its importance in human cells appears less obvious, and raises the problem that the existence of randomized repair events may produce many more errors in human cells than in small genome organisms; 3) the impairment of DSB repair is observed in a plethora of genetic diseases, leading to radiosensitivity, immunodeficiency and sometimes cancer-proneness, but the low frequency and the pleiotropism of such diseases makes difficult the development of a single predictive assay. Therefore, although complete DSB repair appears to be crucial for cell survival, further research is still needed to provide innovative techniques fro measuring repair which can be successfully transferred to the clinic and used to ensure the avoidance of deleterious side-effects to cancer therapies.

Evaluation of clinical teaching and professional development in a problem and community-based nursing module

In South Africa the main focus is on primary health care. This affects the education and training of nurses, and training schools must respond by developing appropriate teaching modules. A school of nursing developed, implemented and revised a problem- and community- based learning module over a period of three years (1996-1998). This student-centered module focuses on students’ needs, active participation, collaboration, accountability, self-assessment, self-study, life-long learning and appropriate skills. In the formal clinical teaching environment PBL was the main approach. However, this approach was also supported by a variety of strategies, for example group discussions and scenarios. The knowledge, attitudes and professional development skills acquired in the PBL approach were then applied informally in the community setting (CBE). The purpose of the study was to evaluate a first year clinical teaching module as part of an extensive programme. A quantitative research method, a descriptive design, and a variety of data collection techniques were used. Conclusions were that clinical teaching was effective within the problem- (PBL) and community-based (CBE) approaches; 78% of respondents were positive about the clinical learning environment; 61 % stated that expectations were met; 81% preferred group activities, and 67% indicated that they had developed professional skills. Facilitators agreed that clinical teaching met the requirements of PBL & CBE. The pass rate also improved.

Synchrotron radiation-based experimental determination of the optimal energy for cell radiotoxicity enhancement following photoelectric effect on stable iodinated compounds

This study was designed to experimentally evaluate the optimal X-ray energy for increasing the radiation energy absorbed in tumours loaded with iodinated compounds, using the photoelectric effect. SQ20B human cells were irradiated with synchrotron monochromatic beam tuned at 32.8, 33.5, 50 and 70 keV. Two cell treatments were compared to the control: cells suspended in 10 mg ml⁻¹ of iodine radiological contrast agent or cells pre-exposed with 10 μM of iodo-desoxyuridine (IUdR) for 48 h. Our radiobiological end point was clonogenic cell survival. Cells irradiated with both iodine compounds exhibited a radiation sensitisation enhancement. Moreover, it was energy dependent, with a maximum at 50 keV. At this energy, the sensitisation calculated at 10% survival was equal to 2.03 for cells suspended in iodinated contrast agent and 2.60 for IUdR. Cells pretreated with IUdR had higher sensitisation factors over the energy range than for those suspended in iodine contrast agent. Also, their survival curves presented no shoulder, suggesting complex lethal damages from Auger electrons. Our results confirm the existence of the 50 keV energy optimum for a binary therapeutic irradiation based on the presence of stable iodine in tumours and an external irradiation. Monochromatic synchrotron radiotherapy concept is hence proposed for increasing the differential effect between healthy and cancerous tissue irradiation.

Lack of cell death enhancement after irradiation with monochromatic synchrotron X rays at the K-shell edge of platinum incorporated in living SQ20B human cells as cis-diamminedichloroplatinum (II)

In this paper we describe the results of experiments using synchrotron radiation to trigger the Auger effect in living human cancer cells treated with a widely used chemotherapy drug: cis-diamminedichloroplatinum (II) (cisplatin). The experiments were carried out at the ID17 beamline of the European Synchrotron Radiation Facility, which produces a high-fluence monochromatic beam that is adjustable from 20 to 80 keV. Cisplatin was chosen as the carrier of platinum atoms in the cells because of its alkylating-like activity and the irradiation was done with monochromatic beams above and below the platinum K-shell edge (78.39 keV). Cell survival curves were comparable with those obtained for the same cells under conventional irradiation conditions. At a low dose of cisplatin (0.1 microM, 48 h), no difference was seen in survival when the cells were irradiated above and below the K-shell edge of platinum. Higher cisplatin concentrations were investigated to enhance the cellular platinum content. The results with 1 microM cisplatin for 12 h showed no difference when the cells were irradiated with beams above or below the platinum K-shell edge with the exception of the higher cell death resulting from drug toxicity. The intracellular content of platinum was significant, as measured macroscopically by inductively coupled plasma mass spectrometry. Its subcellular localization and particularly its presence in the cell nucleus were verified by microscopic synchrotron X-ray fluorescence. This was the first known attempt at K-shell edge photon activation of stable platinum in living cells with a platinum complex used for chemotherapy. Its evident toxicity in these cells leads us to put forth the hypothesis that cisplatin toxicity can mask the enhancement of cell death induced by the irradiation above the K-shell edge. However, K-shell edge photon activation of stable elements provides a powerful technique for the understanding of the biological effects of Auger processes. Further avenues of development are discussed.

[Retrospective study of hospitalizations for heart failure in elderly patients in a cardiology service of a general hospital center]

The results of a retrospective study of patients over 70 years of age admitted to the cardiology department of Meaux Hospital for cardiac failure in 1997 are reported. The cases of 143 patients were analysed with respect to two age groups: 70-79 years, and over 80 years of age. The principal aetiology of cardiac failure in all ages was ischaemic heart disease. Hypertensive heart disease was observed in younger patients and valvular heart disease in the more elderly. No significant gender differences were observed in those affected by this pathology or by left ventricular systolic or diastolic dysfunction between the younger and older patients, men having more systolic dysfunction than women. The main causal factor of decompensation in all ages was supraventricular arrhythmias. From the therapeutic point of view, the prescription of ACE inhibitors was relatively common but at low doses. Re-hospitalisation for cardiac failure was common and observed mainly in patients with low ejection fractions. The average hospital stay was 12.58 days. The hospital mortality was high: 15%. Two year survival was 41% with no difference between patients with systolic or diastolic dysfunction. Pluridisciplinary management should reduce the number of re-hospitalisation, improve the quality of life and, perhaps, improve survival.

The effect of the menstrual cycle on the pharmacokinetics of caffeine in normal, healthy eumenorrheic females

OBJECTIVE

Hormonal fluctuations of estrogen and progesterone in eumenorrheic women may be capable of altering the pharmacokinetics of certain agents. The objective of this study was to determine the effect of the luteal, ovulatory and follicular phases of the menstrual cycle on the pharmacokinetics of caffeine, a low clearance, flow-independent drug.

METHODS

Subjects were ten healthy, non-smoking, eumenorrheic females who were not pregnant and had not used oral contraceptives for a minimum of 3 months prior to the study. Blood samples were collected during one menstrual cycle for the determination of estradiol and progesterone concentrations during the follicular (days 2-6 post-onset of menses), ovulatory (days 13-16 post-onset of menses) and luteal (days 22-26 post-onset of menses) phases. Caffeine was administered over a single menstrual cycle during the follicular, ovulatory and luteal phases. Each subject was administered a single oral dose of caffeine (300 mg) in 100 ml of lemonade during each phase of the menstrual cycle. A venous catheter was used to collect blood samples at pre-dose and at the following time points: 0.25, 0.5, 0.75, 1, 1.5, 2, 4, 6, 8, 10, 12 and 24 h. Plasma caffeine concentrations were determined using a validated ultraviolet high-performance liquid chromatography method.

RESULTS

There were no significant (P < 0.05) differences in the pharmacokinetic parameters of caffeine across the menstrual cycle phases. The average area under the plasma concentration-time curve (AUCinf) was 93.01 mg 1(-1) x h and the absorption rate constant (ka) was 2.88 h(-1) during the ovulatory phase, 83.0 mg 1(-1) h and 2.06 h(-1), respectively, during the luteal phase and 84.7 mg 1(-1) x h and 1.84 h(-1), respectively, during the follicular phase.

CONCLUSIONS

These findings suggest that the menstrual cycle does not significantly alter the pharmacokinetics of caffeine.

A formative model for student nurse development and evaluation--Part 1--Developing the model

Preparing student nurses for the profession is a complex task for nurse educators; especially when dealing with the development of personal and interpersonal skills, qualities and values held in high esteem by the nursing profession and the community they serve. These researchers developed a model for formative evaluation of students by using the principles of inductive and deductive reasoning. This model was implemented in clinical practice situations and evaluated for its usefulness. It seems that the model enhanced the standards of nursing care because it had a positive effect on the behavior of students and they were better motivated; the model also improved interpersonal relationships and communication between practising nurses and students. The fact that students repeatedly use the model as a norm for self evaluation ensures that they are constantly reminded of the standards required of a professional nurse.

Bioavailability of two selegiline hydrochloride tablet products

The bioavailability of two selegiline HCl (CAS 14611-52-0) tablet products was compared in a single-blind, single-dose, randomised, two-way, cross-over study with 25 healthy volunteers. A test preparation of selegiline HCl (4 x 5 mg tablets) was compared to a reference preparation of selegiline HCl (4 x 5 mg tablets). The volunteers were randomised receiving each treatment once. Two clinic days were separated by a wash-out period of between 6 and 14 days. The variable AUC(0-infinity) was the primary characteristic of the extent of formation (bioavailability) of the selegiline metabolites, desmethylselegiline and methamphetamine. For desmethylselegiline the point estimate (90% confidence interval) of the "test/reference" mean ratio for the variable Cmax is 98.4% (91.2% to 106%), for AUC(0-infinity) 103% (97.6% to 109%), and for Cmax/ AUC(0-infinity) 95.6% (89.4% to 102%). For methamphetamine the point estimate (90% confidence interval) of the "test/reference" mean ratio for the variable Cmax is 101% (96.8% to 105%), for AUC(0-infinity) 102% (95.3% to 109%), and for Cmax/AUC(0-infinity) 99.0% (91.5% to 107%). The results of this study indicate that the test preparation is bioequivalent to the reference preparation with respect to both the rate and extent of formation of desmethylselegiline and methamphetamine.

Synthesis, biodistribution, and estrogen receptor scintigraphy of indium-111-diethylenetriaminepentaacetic acid-tamoxifen analogue

This study was aimed at developing a hydrophilic diethylenetriaminepentaacetic acid-tamoxifen (DTPA-Tam) analogue for use in imaging estrogen receptor positive (ER+) lesions. In rat uterine cytosol, the IC50 of DTPA-Tam conjugate was 1 microM and of tamoxifen, 2 microM. Biodistribution, autoradiography, and radionuclide imaging of 111In-DTPA-Tam in breast-tumor-bearing rats showed that tumor-to-tissue ratios increased steadily between 30 min and 48 h. The in vivo response of MCF-7 breast cancer xenografts to tamoxifen and DTPA-Tam in nude mice demonstrated that DTPA-Tam could reduce tumor growth rate. These results indicate that DTPA-Tam, a new hydrophilic ER+ ligand, might be useful in diagnosing ER+ lesions.

[Distance education retraining program: general nursing]

Distance- or distance contact education provides registered nurses with an ideal opportunity for professional growth. This method also fulfils a need to study without the problem of being absent from family, occupational and social responsibilities. It seemed that students are enthusiastic about their studies despite personal, financial and other difficulties. At the end of the course students claimed that their self-confidence improved and that they were better equipped to give high quality nursing care. Using the Spearman Correlation Coefficient there was substantial correlation between the metric results and the final course symbol for this group of students [alpha .05 (p.002)]. No correlation existed between the selection average of 1-9 and the different subjects as for example General Nursing and Ethos. If the decision is taken to present courses according to the distance contact education method, careful planning is essential. Some of the recommendations to assure the success include: * sound structuring of infrastructure and subject material * improvement of selecting procedures; and * the orientation of lectures to cope with the role of facilitator. The professional growth of students during their period of study proves to be worth the effort to present such a course.

Afstandskontakonderrig oorbruggingsprogram: Algemene verpleegkunde

Distance-or distance contact education provides registered nurses with an ideal opportunity for professional growth. This method also fulfils a need to study without the problem of being absent from family, occupational and social responsibilities. It seemed that students are enthusiastic about their studies despite personal, financial and other difficulties. At the end of the course students claimed that their self-confidence improved and that they were better equipped to give high quality nursing care. Using the Spearman Correlation Coefficient there was substantial correlation between the matric results and the final course symbol for this group of students [alpha .05 (p.002)]. No correlation existed between the selection average of 1-9 and the different subjects as for example General Nursing and Ethos.

Reaction To Novel Objects in a Troop of Guinea Baboons: Approach and Manipulation

Abstract

A troop of Guinea baboons living in an enclosure was exposed every day and for twelve consecutive days to a new object. The new object and the object(s) of the previous day(s) were presented simultaneously in the compound. The troop as a whole demonstrated excellent abilities to rapidly react to the new objects: 11 out of 12 new objects were discovered within a maximum of 3 min of their first presentation and were furthermore the first to be approached. An analysis conducted on data from age and sex subgroups showed the preponderant part played by juveniles and by some adult males in the discovery process and subsequent contacts with objects. The results are discussed within the conceptual frame of "cognitive mapping". In addition, the extent to which social factors (e.g. dominance) and perceptual and cognitive factors might determine the differential role of subgroups in the exploration and manipulation of objects is examined.