In vitro and in vivo characterization of a novel naphthylamide ATP-sensitive K+ channel opener, A-151892.

1. Openers of ATP-sensitive K(+) channels are of interest in several therapeutic indications including overactive bladder and other lower urinary tract disorders. This study reports on the in vitro and in vivo characterization of a structurally novel naphthylamide N-[2-(2,2,2-trifluoro-1-hydroxy-1-trifluoromethyl-ethyl)-naphthalen-1-yl]-acetamide (A-151892), as an opener of the ATP-sensitive potassium channels.

Response formats and satisfaction surveys for elders.

Purpose: A factor common to the results of many satisfaction surveys of elders is a lack of response variability. Increasing response variability may be useful if satisfaction surveys of elders are to be productively used in the future. In this paper, we first examine elders' preferences between five response formats and then examine the response variability of these five commonly used formats.

Evaluation of a medical emergency team one year after implementation.

Aim: To evaluate the activity and impact of a Medical Emergency Team (MET) one year after implementation.

Setting And Population: A 700-bed District General Hospital (DGH) in Southeast England with approximately 53,500 adult admissions per annum. The population studied included all adult admissions receiving intervention by the MET during a 12-month period between 1 October 2000 and 30 September 2001.

Nursing homes with persistent high and low quality.

This article examines the concentration of low- and high-quality care within particular nursing facilities over time. The authors explore three different explanations for persistent low and high quality over time including the level of public reimbursement, the presence of bed constraint policies such as certificate-of-need and construction moratoria, and the role of consumer information. Using 1991 through 1999 data from the On-Line Survey, Certification, and Reporting system, the authors show that both low- and high-quality nursing home care is concentrated in certain facilities over time.

Consumer satisfaction in long-term care: state initiatives in nursing homes and assisted living facilities.

Purpose: We report the results of a survey of state initiatives that measure resident satisfaction in nursing homes and assisted living facilities, and we describe several model programs for legislators and public administrators contemplating the initiation of their own state programs.

Design And Methods: Data on state initiatives and programs were collected during March and April 2000 through a mailed questionnaire and follow-up telephone interviews and were current as of September 2002.

Results: Of the 50 states surveyed, 50 responses were received (response rate = 100%); 12 states (24%) reported the use of consumer satisfaction measures, and 7 (Florida, Iowa, Ohio, Oregon, Texas, Vermont, and Wisconsin) reported using resident satisfaction data within their consumer information systems for nursing homes or assisted living facilities.

Pre-printed 'do not attempt resuscitation' forms improve documentation?

Objective: Do not-attempt-resuscitate orders are fundamental for allowing patients to die peacefully without inappropriate resuscitation attempts. Once the decision has been made it is imperative to record this information accurately. However, during a related research projected we noted that documentation was poor and we thought that the introduction of a pre-printed Do Not Attempt Resuscitation (DNAR) form would improve the documentation process.

When the roof caves in.

Rescuing patients after structural collapse can be alien to emergency nurses but their ability to adapt should stand them well to provide good patient care in these unusual circumstances. Generally, they are held back until patients are released from the collapsed structures or specific requests for analgesia, anaesthesia or aggressive fluid resuscitation are made.

Avoidable cardiac arrest: lessons for an A&E department.

Deterioration to cardiac arrest is not always sudden and unexpected and on a significant number of occasions cardiac arrest could be prevented. This has important messages for the Accident and Emergency (A&E) department as the vast majority of emergency admissions originate via A&E.

Letter.

The change in emphasis from door-to-needle to call-to-needle times (Emergency Nurse, July - August 2003) represents a more difficult challenge for emergency nurses than before. At the heart of the change is the introduction of pre-hospital administered thrombolysis. This is to be welcomed but it is in its infancy and many patients will be excluded by the initial entry requirements for ambulance service treatment.

Strategic groups and outcomes in nursing facilities.

This article uses the Miles and Snow typology of strategies to examine nursing facilities' strategic responses to their changing environment and whether strategic responses are associated with facilities performance in quality outcomes. The author hypothesizes that prospector nursing facilities will have the highest quality outcomes, followed by defender, analyzer, and reactor facilities.

Providing outcomes information to nursing homes: can it improve quality of care?

Purpose: This study examined whether providing outcomes information to 120 nursing homes facilitated improvements in quality over a 12-month period, as compared with 1,171 facilities not receiving this information. The outcomes information provided consisted of a report mailed to administrators that examined six measures of care quality. These were the rates of physical restraint use, urethral catheterization, contractures, pressure ulcers, psychotropic medication use, and certification survey quality of care deficiencies.

Educating the families of nursing home residents: a pilot study using a computer-based system.

Objectives: To enhance family participation in nursing home care through a Web-based system of interactive video training and interactive communication with the facilities.

Design: In this pilot study, focus groups guided the design and development of a prototype computer system for family members of nursing home residents. Its usability and functionality was tested with family members of diverse age and ethnicity.

Searching for and selecting a nursing facility.

In this study, the authors present findings from 306 resident interviews matched with 306 family member interviews examining factors associated with both the search for and selection of a nursing facility. For many elders transitioning into a nursing facility, the facility becomes their home, and the average cost of residing in that home is high. As such, searching for and selection of a facility has important consequences.

Structure-activity relationship of a novel class of naphthyl amide KATP channel openers.

We have discovered a novel series of N-[2-(2,2,2-trifluoro-1-hydroxy-1-trifluoromethyl-ethyl)-naphthalen-1-yl] amides that are potent openers of K(ATP) channels and investigated structure-activity relationships (SAR) around the 1,2-disubstituted naphthyl core. A-151892, a prototype compound of this series, was found to be a potent and efficacious potassium channel opener in vitro in transfected Kir6.2/SUR2B cells and pig bladder strips.

Electrophysiological analysis of heterologously expressed Kv and SK/IK potassium channels.

This unit describes protocols to aid investigators in determining the electrophysiological and pharmacological profile of heterologously expressed voltage or calcium-activated potassium channels belonging to the Kv1.x and SK/IK gene families. Protocols for data acquisition as well as analysis are provided.

Effective relief of acute coronary syndrome.

Effective and early pain relief remains a clinical priority, presently no one agent offers the ideal solution to controlling the pain of ACS. The early use of opiates, betablockers and nitrates, as well as reassuring patients, both have vital roles to play in providing effective analgesia.

Maurotoxin: a potent inhibitor of intermediate conductance Ca2+-activated potassium channels.

Maurotoxin, a 34-amino acid toxin from Scorpio maurus scorpion venom, was examined for its ability to inhibit cloned human SK (SK1, SK2, and SK3), IK1, and Slo1 calcium-activated potassium (K(Ca)) channels. Maurotoxin was found to produce a potent inhibition of Ca(2+)-activated (86)Rb efflux (IC(50), 1.4 nM) and inwardly rectifying potassium currents (IC(50), 1 nM) in CHO cells stably expressing IK1.

Paediatric resuscitation: advanced life support.

The author describes the paediatric advanced life support algorithm and discusses specific aspects of paediatric resuscitation.

Nursing homes with persistent deficiency citations for physical restraint use.

Objectives: This paper examines the organizational and aggregate resident characteristics of nursing homes associated with persistent poor quality in the use of physical restraints. Deficiency citations for physical restraint use in two and three consecutive certification survey inspections are used as our measures of poor quality.

Materials And Methods: Nationally representative data from the 1996, 1997, 1998, and 1999 Online Survey, Certification, and Reporting system are used, first, to provide descriptive analyses.

Racial differences in end-of-life care for patients with AIDS.

This study examines the place of death for persons with AIDS, and the adequacy of the pain treatment that they received in their final months of life. Variations in the use of pain treatment during three months before death and place of death by patient's characteristics such as gender, race/ethnicity, mode of transmission, and geographical location are examined. We used merged AIDS surveillance data and paid Medicaid claims data for the period between 1991 and 1998 to examine the outcomes.

Health system costs of in-hospital cardiac arrest.

This paper reports on the health system resources used in the treatment of in-hospital cardiac arrests in a British district general hospital. The resources used in resuscitation attempts were recorded prospectively by observation of a convenience sample of 30 cardiac arrests. The post-resuscitation resource use by survivors was collected through a retrospective record review (n = 37) and by following survivor members in the prospective sample (n = 6).

The identification of risk factors for cardiac arrest and formulation of activation criteria to alert a medical emergency team.

Aim: (1) To identify risk factors for in-hospital cardiac arrest; (2) to formulate activation criteria to alert a clinical response culminating in attendance by a Medical Emergency Team (MET); (3) to evaluate the sensitivity and specificity of the scoring system.

Methods: Quasi-experimental design to determine prevalence of risk factors for cardiac arrest in the hospitalised population. Weighting of risk factors and formulation of activation criteria to alert a graded clinical response.

Incidence, location and reasons for avoidable in-hospital cardiac arrest in a district general hospital.

Aims: To determine the incidence of avoidable cardiac arrest among patients who had received resuscitation in a district general hospital. To establish how location and individual or system factors influence avoidable cardiac arrest in order to develop an evidence-based preventive strategy.

Methods: Expert panel review of case-notes from 139 consecutive adult in-hospital cardiac arrests over 1 year.