Low HbA1c and Increased Mortality Risk-is Frailty a Confounding Factor?

Diabetes mellitus is increasingly becoming an older person disease due to the increased survival and aging of the population. Previous studies which showed benefits of tight glycemic control and a linear relationship between HbA1c and mortality have largely included younger patients newly diagnosed with diabetes and with less comorbidities. Recent studies, which included older population with diabetes, have shown a U-shaped relationship of increased mortality associated with low HbA1c.

Reflecting on reflection: students' evaluation of their moving and handling education.

This paper discusses the value of introducing the component of reflection into a nursing programme for the teaching and learning of moving and handling. Twenty-five students who had just completed a Common Foundation Programme, of a Diploma in Higher Education (Nursing) course, were asked to evaluate the usefulness of reflection for moving and handling. Their qualitative evaluations suggest that the process of reflection may be instrumental in enabling students to adopt a more questioning approach towards practice through the sharing of different beliefs and values, and that reflection may be instrumental in facilitating a change in practice.

Development of an automated on-line analysis system using flow injection, ultrasound filtration and CCD detection.

The design and construction of an automated on-line analysis system is described with reference to applications in bioprocess control, clinical, and environmental analysis. The new system is built around three main elements: ultrasound filtration, a micro flow injection analysis (FIA) system, and direct readout spectrophotometry. The advantages of three on-line ultrasound filtration devices, developed for clarification of water, human blood and mammalian cell culture samples, are described.

The acute effects of combined static and dynamic stretch protocols on fifty-meter sprint performance in track-and-field athletes.

The purpose of this study was to investigate the effect of manipulating the static and dynamic stretch components associated with a traditional track-and-field warm-up. Eighteen experienced sprinters were randomly assigned in a repeated-measures, within-subject design study with 3 interventions: active dynamic stretch (ADS), static passive stretch combined with ADS (SADS), and static dynamic stretch combined with ADS (DADS). A standardized 800-m jogged warm-up was performed before each different stretch intervention, followed by two 50-m sprints.

Urinary elimination: Part 2--retention, incontinence and catheterization.

In part two of this article, the nursing role in relation to the assessment and management of urinary retention, urinary incontinence and catheterization are considered using recent literature and best practice statements. Retention of urine and incontinence have a major detrimental impact on a person's life and nurses have an important role to play in supporting patients. Catheterization is often necessary for acute retention of urine but is the last resort for incontinence.

Hexacyanoferrate(III) as a mediator in the determination of total iron in potable waters as iron(II)-1,10-phenanthroline at a single-use screen-printed carbon sensor device.

Hexacyanoferrate(III) was used as a mediator in the determination of total iron, as iron(II)-1,10-phenanthroline, at a screen-printed carbon sensor device. Pre-reduction of iron(III) at -0.2V versus Ag/AgCl (1M KCl) in the presence of hexacyanoferrate(II) and 1,10-phenanthroline (pH 3.

Disposable sensor for measurement of vitamin B(2) in nutritional premix, cereal, and milk powder.

Methodologies for the determination of vitamin B(2) in food matrixes and a premix using simple sample conditioning steps coupled with a convenient and cheap electrochemical sensing device are presented. Electrochemical analysis based on differential pulse voltammetry (DPV) coupled to carbon electrodes gave a well-defined reduction peak at -0.42 V versus a Ag/AgCl quasi-reference electrode.

Changes in gait kinematics and posture with the use of a front pack.

The objective of this study was to determine if posture during gait can be affected by position of the load. It was hypothesized that the front pack would result in postural changes in the gait cycle, compared to a similarly loaded backpack. Thirteen healthy adults, free of any injury, volunteered to participate in this study.

Establishing a culture for patient safety - the role of education.

This paper argues that the process of making significant moves towards a patient safety culture requires changes in healthcare education. Improvements in patient safety are a shared international priority as too many errors and other forms of unnecessary harm are currently occurring in the process of caring for and treating patients. A description of the patient safety agenda is given followed by a brief analysis of human factors theory and its use in other safety critical industries, most notably aviation.

The role of mentors in supporting pre-registration nursing students.

Students' practice experience is one of the most important aspects of their preparation for registration. There is currently considerable emphasis on improving this practice experience with adequate support and supervision. Mentors play a vital role in supporting, teaching and assessing students in practice.

Exploring consensus in practice with youth who are sexually abusive: findings from a Delphi study of practitioner views in the United Kingdom and the Republic of Ireland.

This article presents the findings of a study exploring current levels of consensus among practitioners in the United Kingdom (UK) and the Republic of Ireland (ROI) about good practice in relation to youth who are sexually abusive. A three-stage Delphi procedure was used to survey the views of 78 practitioners, experienced in this field, on a range of matters relating to preferred responses to this population. The exercise indicated high levels of agreement that youth who are sexually abusive should be seen as a group clinically distinct from adult sex offenders and that all of their developmental needs, and their problematic behavior, should be targeted in intervention.

Development of a new rapid measurement technique for fish embryo membrane permeability studies using impedance spectroscopy.

Information on fish embryo membrane permeability is vital in their cryopreservation. Whilst conventional volumetric measurement based assessment methods have been widely used in fish embryo membrane permeability studies, they are lengthy and reduce the capacity for multi-embryo measurement during an experimental run. A new rapid 'real-time' measurement technique is required to determine membrane permeability during cryoprotectant treatment.

The safety and dignity of patients and nurses during patient handling.

Since the implementation of the Moving and Handling Operations Regulations (Health and Safety Executive, 1992) there has been considerable effort to reduce back injury among nurses by developing patient handling policy that eliminates actual manual handling. Recently, however, there have been challenges to 'no manual handling' policies by patients as an issue of dignity and human rights. This article offers a literature-based discussion of patient handling in relation to safety and dignity for both patients and nurses.

Implementing solutions to prevent patient harm.

This article is the last in this series based on the Seven Steps to Patient Safety. Each article analyses one of the seven steps and offers a resource for healthcare staff to enhance knowledge, skills and attitudes relating to patient safety. This article identifies solutions and actions that healthcare staff can take to improve patient safety.

Modelling variations in corallite morphology of Galaxea fascicularis coral colonies with depth and light on coastal fringing reefs in the Wakatobi Marine National Park (S.E. Sulawesi, Indonesia).

Coastal environments in the tropics can suffer from high sedimentation and low light levels. Galaxea fascicularis is a hermatypic coral that is relatively resilient to stress from bleaching and from sedimentation. Corallite dimensions--width, height, corallite densities and inter-corallite distances--of Galaxea fascicularis colonies varied significantly with depth, and so with incident light at the Sampela reef in the Wakatobi Marine National Park, S.

Commentary on de Cock Buning: a United kingdom perspective.

de Cock Buning (1998) highlighted the existence of alternative and more favorable options available to xenotransplantation. Clearly, there is a need to emphasize a review of existing organ procurement programs worldwide. A tree interest in the welfare of animals encourages increased liaison between transplant communities throughout the world to discuss the experiences of various procurement programs.

Building a safety culture.

This is the first article in a series of seven based on the Seven Steps to Patient Safety (National Patient Safety Agency (NPSA) 2004a). It is aimed at enhancing nurses' and midwives' knowledge about patient safety, including strategies and tools that are available to improve the quality of health care. This article outlines the patient safety agenda and emphasises the importance of creating an open and fair culture in the NHS.

Promoting organ donation and transplantation among South Asians in the United Kingdom: the role of social networks in the South Asian community.

The percentage of South Asians on the kidney transplant waiting list in the United Kingdom is 3 times their percentage in the general population. Obviously, organ donation and transplantation among South Asians in the United Kingdom needs improvement. In recent years, ethnically targeted campaigns in the mass media have specifically attempted to attract donors from the South Asian communities.

Novel tissue remodelling roles for human recombinant erythropoietin.

rHuEPO (recombinant human erythropoietin) is a haemopoietic growth factor and a primary regulator of erythropoiesis that is used for the treatment of chronic anaemia associated with RA (rheumatoid arthritis). Erythropoietin also appears to modulate a broad array of cellular processes, including progenitor stem-cell development, cellular integrity, angiogenesis and oxidative damage. These diverse activities suggest the exciting possibility of multiple roles for rHuEPO therapy in a variety of disorders other than RA, including cerebral ischaemia, myocardial infarction, chronic congestive heart failure and cancer.

Study on fish embryo responses to the treatment of cryoprotective chemicals using impedance spectroscopy.

Investigations using electrical impedance spectroscopy to measure the responses of fish embryos to the cryoprotective chemicals, methanol and dimethyl sulphoxide (DMSO), were carried out. Zebrafish (Danio rerio) embryos were used as a model to study the newly proposed technique. The normalised permittivity and conductivity changes of the embryos were measured continuously over a 20-min period in a customised embryo-holding chamber.

The effect of external medium composition on membrane water permeability of zebrafish (Danio rerio) embryos.

The effect of external medium composition on chorion and plasma membrane permeability of zebrafish (Danio rerio) embryos was investigated in this study. Initially, survival of embryos spawned into varying strengths (10-40%) of Hank's solution (HBSS) was assessed. Development and hatching rates for embryos spawned into 30% and 40% HBSS were significantly lower than those obtained with embryos spawned into system water.

Dwelling with Alison: a reflection on expertise.

Reflection is always purposeful toward realising expert practice. Yet how might expertise be recognised? Using a narrative approach, Benner, Tanner and Chesta (Expertise in nursing practice. Springer Publishing, New York, 1996) explicated a model of expertise that offers the practitioner a useful framework to reflect on their expertise which I do using my own narrative of dwelling with Alison, given that expert practice must be the concern of every practitioner.

Aseptic technique: evidence-based approach for patient safety.

The fact that there is a relationship between the standards of aseptic technique performance and the rise in hospital infection rates has been suggested by the Department of Heath's (DoH's, 2004) 'Winning Ways' document. This literature review considers how the aseptic technique is performed in the UK, and examines the nature of ritualistic and evidence-based practice underpinning this skill-based procedure. The findings have identified an emerging glove culture and continuing poor hand-hygiene practices.

Studies on membrane permeability of zebrafish (Danio rerio) oocytes in the presence of different cryoprotectants.

Investigation into fish oocyte membrane permeability is essential for developing successful protocols for their cryopreservation. The aim of the present work was to study the permeability of the zebrafish (Danio rerio) oocyte membrane to water and cryoprotectants before cryopreservation protocol design. The study was conducted on stage III and stage V zebrafish oocytes.

Reflection on the relationship between technology and caring.

Being attached to a piece of medical technology may cause patients physical and emotional distress. Critical care nurses need to empathize and respond to the patient's experience on being attached to all forms of medical equipment. The use of sedation must be carefully considered in response to agitation.