Standardised concentrations of morphine infusions for nurse/patient-controlled analgesia use in children.

Background: Standardizing concentrations of intravenous infusions enables pre-preparation and is effective in improving patient safety by avoiding large deviations from the prescribed concentration that can occur when infusions are made individually in wards and theatres. The use of pre-prepared morphine standardized concentration infusions for paediatric nurse/patient-controlled analgesia (N/PCA) has not been previously investigated. We aimed to establish, implement and evaluate standardized concentrations of morphine in pre-filled syringes (PFS) for use in paediatric N/PCA.

C-F Bond Activation of P(CF) by Ruthenium Dihydride Complexes: Isolation and Reactivity of the "Missing" Ru(PPh)H(halide) Complex, Ru(PPh)HF.

The major product of the reaction between Ru(IMe)(PPh)H (1; IMe = 1,3,4,5-tetramethylimidazol-2-ylidene) and P(CF) (PCF) is the five-coordinate complex Ru(IMe)(PF{CF})(CF)H (2), which is formed via a complex series of C-F/P-C bond cleavage and P-F bond formation steps. In contrast, hydrodefluorination of all six ortho C-F bonds in PCF occurs with Ru(PPh)H to afford Ru(PPh)HF (3). NaBAr abstracted the fluoride ligand in 3 to give [Ru({η-CH}PPh)(PPh)H][BAr], while Bpin reacted with 3 in CD to yield a mixture of [Ru({η-CD)(PPh)H] and Ru(PPh)H.

Identifying pre-hospital factors associated with outcome for major trauma patients in a regional trauma network: an exploratory study.

Background: Major trauma is often life threatening and the leading cause of death in the United Kingdom (UK) for adults aged less than 45 years old. This study aimed to identify pre-hospital factors associated with patient outcomes for major trauma within one Regional Trauma Network.

Method: Secondary analysis of pre-hospital audit data and patient outcome data from the Trauma Audit Research Network (TARN) was undertaken.

Training community matrons in basic cognitive behavioural therapy-based techniques for patients with COPD.

People with chronic obstructive pulmonary disease (COPD) experience anxiety and depression with a higher prevalence than the general population. Despite this, they are under-represented in mental health services on a national scale, but do regularly have contact with health-care professionals such as community matrons. We aimed to explore the process of CBT-based skills supervision and the practical implications for community matrons using CBT-based techniques with COPD clients as part of their standard practice.

Ni(I) and Ni(II) ring-expanded N-heterocyclic carbene complexes: C-H activation, indole elimination and catalytic hydrodehalogenation.

Reaction of the bulky 6-membered N-heterocyclic carbene 6-Mes with Ni(cod)(2) gives a C-H activated 6-Mes nickel(II) complex, but the novel three-coordinate Ni(I) species Ni(6-Mes)(PPh(3))Br if the reaction is performed in the presence of Ni(PPh(3))(2)Br(2). The Ni(I) complex is a precursor for the catalytic hydrodehalogenation of aryl halides.

Distinct subdomain organization and molecular composition of a tight junction with adherens junction features.

Most polarized epithelia constrain solute diffusion between luminal and interstitial compartments using tight junctions and generate mechanical strength using adherens junctions. These intercellular junctions are typically portrayed as incongruent macromolecular complexes with distinct protein components. Herein, we delineate the molecular composition and subdomain architecture of an intercellular junction between sensory and non-sensory cells of the inner ear.

Acting the part.

The implementation of two key policies highlighted the need to support nurses and midwives to challenge colleagues effectively. To overcome the difficulties this presented, an innovative training package using drama provided participants with practical tips and a safe environment to practise newly developed skills. The programme was well evaluated but further work needs to be undertaken to evaluate its impact upon practice.

Deafness in Claudin 11-null mice reveals the critical contribution of basal cell tight junctions to stria vascularis function.

Generation of a strong electrical potential in the cochlea is uniquely mammalian and may reflect recent evolutionary advances in cellular voltage-dependent amplifiers. This endocochlear potential is hypothesized to dramatically improve hearing sensitivity, a concept that is difficult to explore experimentally, because manipulating cochlear function frequently causes rapid degenerative changes early in development. Here, we examine the deafness phenotype in adult Claudin 11-null mice, which lack the basal cell tight junctions that give rise to the intrastrial compartment and find little evidence of cochlear pathology.

The use of phosphate enemas in the treatment of constipation.

Phosphate enemas are commonly used by community nurses in the treatment of constipation. This article reports on a literature review of evidence relating to their use. No evidence was found to support the use of these enemas conclusively, although a number of articles reported risks, contraindications, and complications.

An actin molecular treadmill and myosins maintain stereocilia functional architecture and self-renewal.

We have previously shown that the seemingly static paracrystalline actin core of hair cell stereocilia undergoes continuous turnover. Here, we used the same approach of transfecting hair cells with actin-green fluorescent protein (GFP) and espin-GFP to characterize the turnover process. Actin and espin are incorporated at the paracrystal tip and flow rearwards at the same rate.

A national audit of chronic constipation in the community.

This article presents the first available data on current national bowel-care standards. It involves 923 patients based at home or in residential/nursing homes. The baseline findings indicate problems of poorly controlled constipation, a high level of impaction and high use of rectal interventions.