In summary, this study did show a significant relationship between the nurse counselor's therapeutic counseling skills as determined on the Barrett-Lennard Relationship Inventory and the Nursing Communication Content Evaluation form. This indicates congruence between self-evaluation and client evaluation of the nurse counselor's functioning. In addition, the seven counselors demonstrated high scores in level of regard and unconditionality of regard. The lowest scores were in the areas of congruence, empathetic understanding, and willingness to be known. Levels of education and experience were not contributing factors.

Adult↗

PubMedDate not supplied

Changing trends in acute peptic ulcer surgery in a district surgical unit.

Despite changes in management and the advances in therapeutics, surgeons are still required to treat the complications of peptic ulceration. A retrospective review of all open surgical interventions for complications of peptic ulcer disease between January 1983 and December 1993 was carried out. There were no exclusion criteria. Open gastric surgery accounted for 3% of all inpatient surgical procedures and 13% of all the major operations. There were 341 adult and 132 paediatric procedures performed in the 11 year period. Acute gastric procedures accounted for 34% of major gastric surgery in this district unit. 76 perforated ulcers and 39 bleeding ulcers required surgery. 38% of the patients were over 70 years. The perioperative mortality was 13.9% (4% for those under 70 years). The overall morbidity rate was 71% and procedure-related morbidity rate was 17%. Acute gastric surgery has a very high inpatient morbidity and is associated with a significant mortality particularly in elderly patients.

Acute Disease↗

PubMedDate not supplied

Computerized hospital on-line resources allocation link (CHORAL): a mechanism to monitor and establish policy for hospital ambulance diversions.

Ongoing monitoring of the availability of hospital critical care resources is necessary to assure patients in the emergency medical services (EMS) system reach appropriate care. In this densely populated area Multnomah County, Oregon, ambulances have been diverted by radio from several hospitals before finding one that would accept the patient. Dispatch centers and base-stations had no reliable method to monitor the availability of hospital resources. Data were not available for use in establishing policy. In response, this community developed an on-line, computerized system known as Computerized Hospital On-Line Resources Allocation Link (CHORAL) that visually displays the resource status of all hospitals to the 911 center, base station, and participating hospitals. A change of status requires simple keystrokes for entry into the computer which in turn transmitted automatically to all other CHORAL computers. Six patient care resources are monitored: Adult Ward (AW); Computerized Axial Tomography Scan (CT); Critical Care (CC); Labor and Delivery (LD); Pediatric (PEDS); and Psychiatric Secure Beds (PSB). Paramedics use protocol to determine if a particular patient fits one of these categories. Availability is relayed to paramedics by the 911 center and the base-station. During the first three months of system operation, there were 337 diversions representing 4,527 hours among 10 of the 12 participating hospitals. The most common resource resulting in diversion was PSB, which was unavailable for 2,195 hours (48.5%). Unavailability of CT resulted in the lowest number of diversions (1.3%, 60.3 hours).(ABSTRACT TRUNCATED AT 250 WORDS)

Ambulances↗

PubMedDate not supplied

Possible roles for corticosterone and critical size in the fledging of nestling pied flycatchers.

Our study was designed to see whether corticosterone (B) rises abruptly in the blood of nestling pied flycatchers (Ficedula hypoleuca) at the time they fledge, as reported recently for kestrels, and if so, why. We measured the growth and blood levels of B and selected nutrients of nestlings in broods of five, seven, and nine chicks during 1998 and 1999. In half of the broods, we clipped selected wing and tail feathers of both parents with the intention of making it more difficult for them to provide their chicks with food. We collected blood samples when the chicks were six to 10 d old (period of rapid growth) and 15 d of age or older (0-5 d before fledging). B increased substantially several days before the chicks left the nest and then declined somewhat. We found no differences in rates of growth or blood levels of B, nutrients, and hematocrit as a function of either brood size or parental handicapping. Nestlings within a day of fledging appear to have been food deprived in 1998; their glucose was significantly reduced, and B, free fatty acids, and glycerol were significantly elevated compared to levels in chicks 1-4 d younger. Such changes did not occur in 1999. Blood levels of B were significantly correlated with brood size near the day of fledging, but not earlier, in both years of the study. It was possible to predict the day on which chicks would leave the nest, using their wing length when 12 d old. These results suggest that high blood levels of B associated with food restriction and sibling competition induce chicks to fledge, provided they have reached a critical size, and that the importance of fasting, sibling competition, and B may vary from year to year.

Animals↗

PubMedDate not supplied

Nursing overseas: bitter paradise.

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Cultural Characteristics↗

PubMedDate not supplied

Comparison of hemodialysis (HD) and renal transplantation (RT) from one center.

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Adolescent↗