Calculating nursing turnover in NSW

A study of nursing staff turnover is being carried out by the Nursing Research Team from the Riverina-Murray Institute of Higher Education for the New South Wales College of Nursing and the New South Wales Department of Health. The general aim of the study is to provide information about the annual rate of loss of registered nurses from public hospitals and licensed private hospitals in NSW. This paper provides background details about the project and recent attempts to understand the problem of nursing staff turnover. Brief mention is made of Australian and overseas literature and recent calls for methodological and conceptual precision in calculation nursing turnover. Reference is made to 'Nursing Turnover Indices' and other statistical descriptors used to guide this research.

Relationship of lung function to radiographic reading (ILO) in patients with asbestos related lung disease

The 1980 International Labour Office (ILO) classification of posteroanterior chest radiographs was used to obtain the scores for profusion of small opacities and pleural abnormalities of 172 men with confirmed or suspected disease of the lungs due to asbestos. After allowance had been made for age, stature, and smoking habit the quantitative score for area of diffuse pleural thickening seen in profile on both lateral chest walls contributed to reductions in inspiratory capacity, expiratory reserve volume, and forced expiratory flow rates. Occlusion of one or both costophrenic angles in the presence of diffuse thickening was associated with further reduction in inspiratory capacity. Profusion of small opacities was associated with a reduction in transfer factor. Diffuse pleural thickening and occlusion of costophrenic angles were associated with relatively low values for the forced expiratory flow rates (MEF50FVC) and FEV1/FVC, whereas small opacities were associated with relatively high values. Thus overall increased, normal, or reduced values of MEF50FVC and FEV1/FVC might occur, depending on the distribution of the radiographic abnormalities. The findings contribute to the validation of the ILO pleural scores; those for diffuse pleural thickening and occlusion of costophrenic angles should be used jointly with the scores for profusion of parenchymal small opacities in interpreting the lung function of persons exposed to asbestos.

Lung function impairment as a guide to exercise limitation in work-related lung disorders

The hypothesis that exercise limitation of respiratory origin can be predicted accurately from the lung function impairment has been tested using maximal oxygen uptake (VO2max) as the dependent variable in a multiple regression analysis. The subjects were 157 men who met objective criteria for exercise being limited by respiratory impairment. VO2max (mean value, 1.38 L min-1) was described by FEV1 and single-breath lung transfer factor (diffusing capacity) for carbon monoxide (TL') singly or in combination, but the accuracy was poor (at best, standard error of the estimate, 0.36 L min-1; r2, 29.1%). FEV1 could be replaced by FVC and FEV1/FVC. Description of VO2max was improved by also including in the equation the variables age, fat-free mass, and submaximal exercise ventilation (VE). Transfer factor did not then contribute significantly. VO2max as percent of predicted (mean value of 60%) was described by %FVC or %FEV1, but the accuracy was poor (SEE, 16.0%; r2, 14%). Prediction was improved somewhat by the alternative use of inspiratory vital capacity and FEV1/FVC. Transfer factor did not contribute additional information; however, inclusion of VE materially improved the accuracy (SEE, 12.9%; r2, 44%). Among a subgroup of 35 men whose lung disease was due to asbestos, %TL' or transfer factor measured using a multibreath estimate of residual volume (%TLCO) made a small contribution to the explained variance, e.g.: %VO2max = 0.44% FEV1 -0.78 VE + 0.16% TLCO + 52.3 SEE 7.27%. This equation also described the %VO2max of all subjects (SEE, 13%).(ABSTRACT TRUNCATED AT 250 WORDS)

Diuresis and natriuresis during continuous dopamine-1 receptor stimulation

Stimulation of renal dopamine-1 (DA1) receptors for 3 hours produces an increase in renal plasma flow and sustained natriuresis. The present study was designed to assess the response of renal hemodynamic and tubular function to long-term DA1 receptor stimulation. Fenoldopam, a selective DA1 receptor agonist, was infused intravenously for 24 hours in 10 normal male subjects in metabolic balance at 150 mEq sodium and 60 mEq potassium intake in a single-blind, vehicle-controlled protocol. During DA1 receptor activation, urine flow rate and fractional excretion of sodium increased for the first 5 hours, 16.9 +/- 0.9 ml/min compared with a vehicle control value of 12.4 +/- 0.5 ml/min (p less than 0.001) and 2.0 +/- 0.1% compared with a vehicle control value of 1.1 +/- 0.1% (p less than 0.005), respectively. Urinary sodium excretion rose at 5 hours, 0.27 +/- 0.02 mEq/min compared with a vehicle control value of 0.14 +/- 0.01 mEq/min (p less than 0.01). Renal plasma flow increased during fenoldopam at 5 hours, 505 +/- 47 ml/min compared with a vehicle control value of 397 +/- 25 ml/min (p less than 0.01), and was sustained for 24 hours, 523 +/- 40 ml/min compared with 432 +/- 31 ml/min (p less than 0.05). The distal sodium load increased and the percentage of distal sodium reabsorption decreased during fenoldopam. Glomerular filtration rate, blood pressure, heart rate, plasma aldosterone concentration, plasma renin activity, and fractional excretion of potassium were unchanged. Selective DA1 receptor activation produced sustained 5-hour diuresis and 11-hour natriuresis without kaliuresis or a systemic hemodynamic effect.(ABSTRACT TRUNCATED AT 250 WORDS)

Separation of spontaneously differentiating and cell cycle-specific populations of HL-60 cells

The human leukemia cell line HL-60 consists predominantly of abnormal promyelocytes. When grown in RPMI-1640 and 10% FCS between 5 and 10% of these cells spontaneously differentiate into more mature myeloid cells, becoming smaller in size and developing the ability to generate superoxide. Centrifugal elutriation was used to separate these G0 cells from the bulk of the cycling G1, S and G2M cells. These isolated differentiating cells are shown to be similar in size, DNA content, RNA content and NBT positivity not only to granulocyte induced HL-60 cells but also to human peripheral blood granulocytes. This methodology allows the study of differentiative vs proliferative processes through the quick one-step generation of homogeneous subpopulations of G0, G1, S and G2M cells.

Clearance of proteoglycan from joint cavities

The rate of loss from the synovial cavity of proteoglycan subunit, a major constituent of cartilage, has been measured in rabbits with and without experimental arthritis. The effect of aggregation between proteoglycan and hyaluronic acid upon the rate of elimination has also been investigated. The results indicate that proteoglycan subunit has a clearance half life of around 12 hours in normal joints and that this rate is not significantly altered in the presence of an active synovitis. Neither injection of proteoglycan as an aggregate, nor in a form incapable of aggregation, had any significant effect on clearance rates. These data indicate that loss of proteoglycan from the joint is not retarded by its ability to aggregate with hyaluronic acid in the synovial fluid and, together with measurements of synovial fluid proteoglycan, may enable rates of cartilage breakdown in vivo to be calculated.

'Methicillin-resistant' Staphylococcus aureus in a regional neonatology unit

In December 1985 a neonate was transferred to a Yorkshire Regional Neonatology Unit (RNU) from a neighbouring hospital and was subsequently found to be colonized with a 'methicillin-resistant' strain of Staphylococcus aureus (MRSA). Spread of the MRSA was controlled by routine cross-infection methods. The RNU was not closed to new admissions, the economic cost of control measures was small and no neonatal death was attributable to MRSA infection. Eradication of the MRSA from the RNU was associated with a decline in frequency of coagulase-negative staphylococci (CNS) from blood cultures, but the overall frequency of positive blood cultures did not decline and there was a rise in frequency of isolation of Gram-negative bacterial species. The decline in frequency of CNS isolates from blood cultures may have resulted from a reduction in the level of cross-colonization of neonates with antibiotic-resistant CNS strains and also increased usage of erythromycin and vancomycin.

In vivo studies of articular tissue damage mediated by catabolin/interleukin 1

A partially purified porcine synovial catabolin interleukin 1 (CF) preparation was injected intra-articularly into rabbit stifle (knee) joints. Radiolabelled CF was rapidly cleared from the joint (0.4 h). Repeated injections of CF caused a marked loss of articular cartilage glycosaminoglycan (GAG) and a great increase in synovial fluid GAG. 35SO4 uptake was inhibited. Time course experiments after a single injection produced similar loss of GAG from knee cartilages, which was maximal three days after injection. The above changes were significantly less with heat inactivated preparations. Loss of articular cartilage metachromasia was found histologically, and an acute synovitis occurred together with lymphocytic foci and plasma cell infiltration.

Glutamine synthetase genes are regulated by ammonia provided externally or by symbiotic nitrogen fixation

Glutamine synthetase is the key enzyme in the assimilation by plants of reduced nitrogen provided from either the soil or fixed symbiotically in association with Rhizobium. We have isolated a number of cDNA clones for soybean glutamine synthetase (GS) from a nodule-cDNA library, using RNA from polysomes immunoprecipitated by GS antibodies. Transcripts corresponding to two clones differing in their 3' non-translated sequences were present in both root and nodule tissue; however, the concentration in the nodules was several times higher. The relative concentrations of these sequences in both tissues is about 9:1. Availability of ammonium ions [provided as NH(4)NO(3) or (NH(4))(2)SO(4)] enhanced the expression of both sequences in root tissue within 2 h, reaching a level similar to that in nodules by 8 h, while KNO(3) had no effect during this period. When nitrogen fixation was prevented by replacing nitrogen with argon in the root environment or when the nodules were formed by a Fix mutant of Bradyrhizobium japonicum, the amounts of GS mRNA did not increase over that in roots. These experiments, together with the time course of increase in GS mRNA transcripts, suggest that the genes encoding cytosolic GS are directly induced by the available ammonia.

Bovine coronavirus hemagglutinin protein

Treatment of purified bovine coronavirus (Mebus strain) with pronase destroyed the integrity of virion surface glycoproteins gp140, gp120, gp100, reduced the amount of gp26 and destroyed the hemagglutinating activity of the virus. Bromelain, on the other hand, destroyed the integrity of gp120, gp100 and gp26 but failed to remove gp140 and failed to destroy viral hemagglutinating activity. These experiments suggest that gp140 is the virion hemagglutinin. Immunoblotting studies using monospecific antiserum demonstrate that gp140 is a disulfide-linked dimeric structure reducible to monomers of 65 kDa.

Antigenic relationships among proteins of bovine coronavirus, human respiratory coronavirus OC43, and mouse hepatitis coronavirus A59

Antisera prepared against each of three single and one pair of major structural proteins of the bovine coronavirus (Mebus strain) were used in immunoblotting studies to measure cross-reactivity with the structural proteins of the human coronavirus OC43 and the mouse hepatitis coronavirus A59. We conclude that the bovine coronavirus is comprised of four major structural proteins, gp190 (normally present as 120- and 100-kilodalton subunits), gp140, pp52, and gp26. The human coronavirus OC43 has an antigenically homologous counterpart of similar molecular mass to each of these proteins. The mouse hepatitis coronavirus A59 has an antigenically homologous counterpart to only three of these proteins: gp190, pp52 and gp26. There is no counterpart in the mouse virus to the 140-kilodalton glycoprotein, the apparent hemagglutinin of the bovine coronavirus.

The pathophysiology of neurofibromatosis. II. Angiosarcoma as a complication

A patient with Von Recklinghausen neurofibromatosis and an angiosarcoma (which developed subsequent to two separate neurofibrosarcomas ) is described, and the association of neurofibromatosis and angiosarcoma is reviewed. The data showed that angiosarcoma is not coincidental with neurofibromatosis, and there is a need to focus investigative efforts on the vascular aspects of this disease.

Bovine coronavirus structural proteins

The tissue culture-adapted strain (Mebus) of bovine coronavirus was grown in the presence of isotopically labeled amino acids, glucosamine, or orthophosphate for the purpose of analyzing the virion structural proteins. Five species of polypeptides were identified when purified virions were solubilized in urea and sodium dodecyl sulfate and resolved by polyacrylamide gel electrophoresis. Four species were glycosylated and had apparent molecular weights of 140,000, 120,000, 100,000, and 26,000. The glycoproteins were susceptible to proteolytic cleavage and enzymatic iodination when intact virions were studied and are thus at least partially external to the virion envelope. The 140,000-molecular-weight glycoprotein is apparently a dimer of 65,000-molecular-weight glycopolypeptides held together by disulfide linkages. Species 5 was phosphorylated and had an apparent molecular weight of 52,000. In the intact virion, it was unaffected by protease and was not enzymatically iodinated. It is therefore apparently an internal protein.