Violence and aggression in the emergency department: factors impinging on nursing research

This paper examines issues involved in the debate regarding the role of research in nursing. The authors take the example of violence and aggression in the emergency field to discuss methodological, philosophical, professional, logistical, power differentials and leadership theory that influence and explain the process of conducting research surrounding violence and aggression experienced by nurses working in emergency departments. The paper examines the importance of research and discusses practical issues that impinge or frustrate clinical nursing staff who wish to conduct original research.

Identification of senescence and death in Emiliania huxleyi and Thalassiosira pseudonana: Cell staining chlorophyll alterations and dimethylsulfoniopropionate (DMSP) metabolism

We measured membrane permeability, hydrolytic enzyme, and caspase-like activities using fluorescent cell stains to document changes caused by nutrient exhaustion in the coccolithophore Emiliania huxleyi and the diatom Thalassiosira pseudonana, during batch-culture nutrient limitation. We related these changes to cell death, pigment alteration, and concentrations of dimethylsulfide (DMS) and dimethylsulfoniopropionate (DMSP) to assess the transformation of these compounds as cell physiological condition changes. E. huxleyi persisted for 1 month in stationary phase; in contrast, T. pseudonana cells rapidly declined within 10 d of nutrient depletion. T. pseudonana progressively lost membrane integrity and the ability to metabolize 5-chloromethylfluorescein diacetate (CMFDA; hydrolytic activity), whereas E. huxleyi developed two distinct CMFDA populations and retained membrane integrity (SYTOX Green). Caspase-like activity appeared higher in E. huxleyi than in T. pseudonana during the post-growth phase, despite a lack of apparent mortality and cell lysis. Photosynthetic pigment degradation and transformation occurred in both species after growth; chlorophyll a (Chl a) degradation was characterized by an increase in the ratio of methoxy Chl a : Chl a in T. pseudonana but not in E. huxleyi, and the increase in this ratio preceded loss of membrane integrity. Total DMSP declined in T. pseudonana during cell death and DMS increased. In contrast, and in the absence of cell death, total DMSP and DMS increased in E. huxleyi. Our data show a novel chlorophyll alteration product associated with T. pseudonana death, suggesting a promising approach to discriminate nonviable cells in nature.

Birth, life and death of a cyclonic eddy in the Southern Ocean

The ACC is a climatically relevant frontal structure of global importance that regularly develops instabilities which grow into meanders that eventually evolve into long-lived cyclonic eddies. These eddies exhibit sustain primary productivity that can last several months fuelled by local resupply of nutrients. During April-May 2015 we conducted an intensive field experiment in the Southern Ocean (SMILES) where we sampled and tracked an ACC meander as it developed into an eddy and later vanished some 90 days later. The meander and later eddy physical characteristics were observed with a combination of high resolution hydrography, ADCP and turbulence observations in addition to surface and depth resolved biogeochemical observations of nutrients and phytoplankton. The life and death of the eddy was subsequently tracked through ARGO, BIO-ARGO and remote sensing.

The consequences of child-parent violence reflected in a life story

A process of social transformation allied with ongoing changes to the family has made possible the existence of a relatively little-known phenomenon: that of child-parent violence, which is raised as one of the most commonly experienced forms of violence in the family environment. Based on the study of this phenomenon, in our research we have used the qualitative technique of a life story, making use of a field diary in which we have taken notes on our daily work in the therapeutic context, for the purposes of mitigating the effects of such a process. The following research objectives were set: establishing the connection existing between family education style and the use of violence by the minor; and evaluating the extent to which family therapy mitigates the use of violence by the minor. The family education model, together with other dimensions, results in situations of child-parent violence occurring repeatedly, with continuing negative reinforcement from both parties in order to maintain a recurrent cycle of conduct, from which it is difficult to «escape» other than through a process of ongoing psychological therapy.

Demographic and temporal trends in out of hospital sudden cardiac death in belfast

Objective: To determine the epidemiology of out of hospital sudden cardiac death (OHSCD) in Belfast from 1 August 2003 to 31 July 2004.

Design: Prospective examination of out of hospital cardiac arrests by using the Utstein style and necropsy reports. World Health Organization criteria were applied to determine the number of sudden cardiac deaths.

Results: Of 300 OHSCDs, 197 (66%) in men, mean age (SD) 68 (14) years, 234 (78%) occurred at home. The emergency medical services (EMS) attended 279 (93%). Rhythm on EMS arrival was ventricular fibrillation (VF) in 75 (27%). The call to response interval (CRI) was mean (SD) 8 (3) minutes. Among patients attended by the EMS, 9.7% were resuscitated and 7.2% survived to leave hospital alive. The CRI for survivors was mean (SD) 5 (2) minutes and for non-survivors, 8 (3) minutes (p < 0.001). Ninety one (30%) OHSCDs were witnessed; of these 91 patients 48 (53%) had VF on EMS arrival. The survival rate for witnessed VF arrests was 20 of 48 (41.7%): all 20 survivors had VF as the presenting rhythm and CRI ? 7 minutes. The European age standardised incidence for OHSCD was 122/100 000 (95% confidence interval 111 to 133) for men and 41/100 000 (95% confidence interval 36 to 46) for women.

Conclusion: Despite a 37% reduction in heart attack mortality in Ireland over the past 20 years, the incidence of OHSCD in Belfast has not fallen. In this study, 78% of OHSCDs occurred at home.

Hepatocyte growth factor (HGF) protects c-met-expressing Burkitt''s lymphoma cell lines from apoptotic death induced by DNA damaging agents

The relative sensitivity of neoplastic cells to DNA damaging agents is a key factor in cancer therapy. In this paper, we show that pretreatment of Burkitt's lymphoma cell lines expressing the c-met protooncogene with hepatocyte growth factor (HGF) protects them from death induced by DNA damaging agents commonly used in tumour therapy. This protection was observed in assays based on morphological assessment of apoptotic cells and DNA fragmentation assays. The protection was dose- and time-dependent — maximal protection requiring pre-incubation with 100 ng/ml HGF for 48 h. Western blotting analysis and flow cytometric studies revealed that HGF inhibited doxorubicin- and etoposide-induced decreases in the levels of the anti-apoptotic proteins Bcl-XL, and to a lesser extent Bcl-2, without inducing changes in the pro-apoptotic Bax protein. Overall, these studies suggest that the accumulation of HGF within the microenvironment of neoplastic cells may contribute to the development of a chemoresistant phenotype.