title: The effects of hypertonic fluid administration on the gene expression of inflammatory mediators in circulating leucocytes in patients with septic shock: a preliminary study

authors: van Haren, Frank MP

subjects: hypertonic fluid administration

abstract: Objective:
This study was designed to investigate the effect of hypertonic fluid administration on inflammatory mediator gene expression in patients with septic shock. 
Design and setting:
Prospective, randomized, controlled, double-blind clinical study in a 15-bed mixed intensive care unit in a tertiary referral teaching hospital. 
Interventions:
Twenty-four patients, who met standard criteria for septic shock, were randomized to receive a bolus of hypertonic fluid (HT, 250 ml 6% HES/7.2% NaCl) or isotonic fluid (IT, 500 ml 6% HES/0.9% NaCl) administered over 15 minutes. Randomization and study fluid administration was within 24 hours of ICU admission for all patients. This trial is registered with ANZCTR.org.au as ACTRN12607000259448. 
Results: 
Blood samples were taken immediately before and 4, 8, 12, and 24 hours after fluid administration. Real-time reverse transcriptase polymerase chain reaction (RT rtPCR) was used to quantify mRNA expression of different inflammatory mediators in peripheral leukocytes. In the HT group, compared with the IT group, levels of gene expression of MMP9 and L-selectin were significantly suppressed (p = 0.0002 and p = 0.007, respectively), and CD11b gene expression tended to be elevated (p = NS). No differences were found in the other mediators examined. 
Conclusions: 
In septic shock patients, hypertonic fluid administration compared with isotonic fluid may modulate expression of genes that are implicated in leukocyte-endothelial interaction and capillary leakage. 
The study was performed at the Intensive Care Department, Waikato Hospital, and at the Molecular Genetics Laboratory, University of Waikato, Hamilton, New Zealand. 
Trial registration: 
Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12607000259448

text: The effects of hypertonic fluid administration on the gene expression of inflammatory mediators in circulating leucocytes in patients with septic shock: a preliminary study Objective:
This study was designed to investigate the effect of hypertonic fluid administration on inflammatory mediator gene expression in patients with septic shock. 
Design and setting:
Prospective, randomized, controlled, double-blind clinical study in a 15-bed mixed intensive care unit in a tertiary referral teaching hospital. 
Interventions:
Twenty-four patients, who met standard criteria for septic shock, were randomized to receive a bolus of hypertonic fluid (HT, 250 ml 6% HES/7.2% NaCl) or isotonic fluid (IT, 500 ml 6% HES/0.9% NaCl) administered over 15 minutes. Randomization and study fluid administration was within 24 hours of ICU admission for all patients. This trial is registered with ANZCTR.org.au as ACTRN12607000259448. 
Results: 
Blood samples were taken immediately before and 4, 8, 12, and 24 hours after fluid administration. Real-time reverse transcriptase polymerase chain reaction (RT rtPCR) was used to quantify mRNA expression of different inflammatory mediators in peripheral leukocytes. In the HT group, compared with the IT group, levels of gene expression of MMP9 and L-selectin were significantly suppressed (p = 0.0002 and p = 0.007, respectively), and CD11b gene expression tended to be elevated (p = NS). No differences were found in the other mediators examined. 
Conclusions: 
In septic shock patients, hypertonic fluid administration compared with isotonic fluid may modulate expression of genes that are implicated in leukocyte-endothelial interaction and capillary leakage. 
The study was performed at the Intensive Care Department, Waikato Hospital, and at the Molecular Genetics Laboratory, University of Waikato, Hamilton, New Zealand. 
Trial registration: 
Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12607000259448

year: 2011

title: Chinese immigrants in New Zealand early childhood settings: Perspectives and experiences

authors: Guo, Karen

subjects: immigrant

abstract: This article discusses the perspectives and experiences of Chinese immigrant parents in New Zealand early childhood settings. The findings suggest that the parents’ behaviour is aimed at raising children with an understanding of both New Zealand and Chinese culture. A key feature of this bicultural development, however, is a disconnect between activities at home and at childcare. The research highlights conflicts involved in forming a cross-cultural community of practice in which immigrants’ funds of knowledge interact with those of early childhood centres.

text: Chinese immigrants in New Zealand early childhood settings: Perspectives and experiences This article discusses the perspectives and experiences of Chinese immigrant parents in New Zealand early childhood settings. The findings suggest that the parents’ behaviour is aimed at raising children with an understanding of both New Zealand and Chinese culture. A key feature of this bicultural development, however, is a disconnect between activities at home and at childcare. The research highlights conflicts involved in forming a cross-cultural community of practice in which immigrants’ funds of knowledge interact with those of early childhood centres.

year: 2012

title: A humanistic approach to addressing the needs of Maori homeless people with mental health concerns

authors: Johnson, Diana

subjects: Maori

abstract: Homelessness is a human tragedy that is often associated with mental illness. Maori people are overrepresented in the homeless population and among people experiencing mental illness in New Zealand. Little is known about the mental health experiences of Maori homeless people or the efforts of practitioners who render assistance. The authors explore the experiences of six Maori homeless people and six mental health professionals. Findings highlight the importance of a humanistic and culturally informed approach to addressing the needs of homeless people and restoring their wellness and dignity.

text: A humanistic approach to addressing the needs of Maori homeless people with mental health concerns Homelessness is a human tragedy that is often associated with mental illness. Maori people are overrepresented in the homeless population and among people experiencing mental illness in New Zealand. Little is known about the mental health experiences of Maori homeless people or the efforts of practitioners who render assistance. The authors explore the experiences of six Maori homeless people and six mental health professionals. Findings highlight the importance of a humanistic and culturally informed approach to addressing the needs of homeless people and restoring their wellness and dignity.

year: 2013