Comparison of newly hired nursing graduates in their first hospital staff nurse positions and newly hired experienced nurses employed in the same hospitals revealed that the two groups were indistinguishable with respect to turnover patterns and rates, job hunting behavior, and job satisfaction levels. Type of basic nursing education did not alter results. Differences between the two groups were in the opposite direction from that expected based on the literature which emphasizes problems associated with role transition among new graduates. These findings imply that the process of job acclimation is fundamentally the same for the two groups. Implications for hospital and nursing administrators are discussed.

Employment↗

PubMedDate not supplied

Fatigue in HIV-infected men receiving investigational interleukin-2.

BACKGROUND: Although fatigue is an almost universal clinical complaint of people with human immunodeficiency virus (HIV) infection, little has been done to study systematically the etiology, frequency, severity, response to, or management of HIV-related fatigue. In addition, HIV-related treatments may contribute to fatigue. OBJECTIVES: To describe the extent and severity of perceived fatigue in a cohort of HIV-infected men (N= 50) who, as participants in a randomized clinical trial, were randomized to receive or not to receive investigational interleukin-2 (IL-2). METHOD: A modified Piper Fatigue Scale was used to measure fatigue at baseline, at the end of 5 days of IL-2 therapy, 1 week later at home, and 1 month later for three consecutive cycles of IL-2 therapy. RESULTS: Against a variable background of baseline fatigue in all subjects, those receiving IL-2 reported a significant increase in their level of fatigue after receiving IL-2. Fatigue levels remained elevated 1 week later but returned to baseline by 1 month. Fatigue was related to the dose of IL-2 but not to the reported amount or quality of sleep. CONCLUSIONS: Against a background of fatigue related to HIV infection and its multiple manifestations and treatments, therapy with IL-2 dramatically increases the experience of fatigue. Although this increase is transient and tends to return to baseline by 1 month, during that month the patient's life function and quality may be severely affected.

Adult↗

PubMedDate not supplied

Family aggregation of high density lipoprotein cholesterol. Collaborative lipid research clinics program family study.

High density lipoprotein cholesterol data on a population-based random sample of 858 white and 72 black probands and their 3935 white and 205 black relatives were collected from nine North American clinics using a common protocol and standardized methodology. Familial associations were examined within clinics for whites and pooled across clinics for blacks. The influence of covariates and varying family size on correlations was examined using several sets of transformed and adjusted values and a variety of weighting schemes. Parent-offspring and sibling correlations were significant in most cases, but spouse correlations were not, suggesting a stronger influence of shared genes than shared environment on high density lipoprotein cholesterol. Adjustment for covariates tended to weaken the correlations, but the effect of variable family size was imperceptible. Although pairs involving pediatric offspring or siblings tended to show higher correlation than their adult counterparts, the differences were not significant. All correlations except father-daughter and brother-brother were homogeneous across clinics in whites. There was no asymmetry in parent-child correlations by the sex of the offspring, but the pooled mother-child correlation was significantly higher than father-child values, suggesting a possible maternal influence on high density lipoprotein cholesterol. No heterogeneity in correlations in high density lipoprotein cholesterol was detected between blacks and whites except for mother-son pairs.

Adolescent↗

PubMedDate not supplied

Brain atrophy in 18 patients with Down syndrome: a CT study.

Individuals with Down syndrome develop neuropathologic and in some cases clinical evidence of Alzheimer disease after age 40. We compared CT scans of 18 Down syndrome subjects, 26-70 years old (seven of whom satisfied criteria for dementia), with 175 screened normal volunteer control subjects for evidence of cortical and subcortical atrophy. CT scans were analyzed as a function of age and cognitive status. The suprasellar cistern ratio, presumed to measure mesial temporal-lobe atrophy (or hypoplasia), was correlated with severity of cognitive impairment, even when age effects were removed. The suprasellar cistern ratio predicted dementia status with an accuracy of greater than 75%. Brain measurements on CT scans showed a distinct pattern of increased abnormality with age in patients with Down syndrome; this differed clearly from that seen in controls.

Adult↗

PubMedDate not supplied

Comparison of two intravenous sedation techniques for percutaneous radio frequency trigeminal rhizotomy. A pilot study.

Conscious sedation, as used in dentistry and oral surgery, has been used satisfactorily to manage patients undergoing the intense pain encountered in radio frequency trigeminal rhizotomy for tic douloureux. The pain produced by this procedure cannot be blocked by local anesthesia. General anesthesia cannot be used because of the need for sensory testing in an awake, cooperative patient. Conscious sedation using alphaprodine, hydroxyzine, methohexital, and intensive behavioral modification was compared with a neuroleptic intravenous sedation technique using droperidol, fentanyl, and thiopental. Patients managed with conscious sedation were found to be more amnestic for the pain of surgery, a difference that persisted six months later.

Aged↗

PubMedDate not supplied

Abortion attitudes and performance among male and female obstetrician-gynecologists.

Recently trained female obstetrician-gynecologists in active practice have more favorable attitudes toward abortion than do recently trained male ob-gyns, and the former also are more likely to provide abortions. However, since female providers perform fewer abortions than do male providers, women's contribution to the overall volume of abortions performed is no higher than expected. In a multivariate analysis, abortion attitudes proved to be the strongest predictor of whether or not a physician provides abortions, but practice-related variables are stronger predictors of the number of abortions performed. Factors related to policy issues, such as state funding of abortions for poor women and hospital policies with respect to abortion provision, had statistically significant effects on physicians' abortion performance.

Abortion, Induced↗

PubMedDate not supplied

Declines in nonwhite and white neonatal mortality in Mississippi, 1975-80.

Linked birth and death records provided the population for an investigation of declines in nonwhite and white neonatal mortality rates (NMR) in Mississippi between 1975 and 1980. The effect of changes in the characteristics of women giving birth and in perinatal care on declining NMRs was analyzed. A decomposition of the difference in the 1975-76 and 1979-80 NMRs was performed to determine whether declines in NMRs were due to shifts in population characteristics or in characteristic-specific rates. Between 1975 and 1980, the NMR declined significantly by 1 death per 1,000 live births per year among nonwhites and by 0.8 per 1,000 among whites. Increases in the number of prenatal visits during the study period were associated with part of this decline, especially for nonwhites. The effect of rising use of prenatal care on NMRs was not, however, a result of shifts in the birth weight distribution. The decrease in NMRs was also associated with declining birth weight-specific rates; 75 percent of the decrease in rates was noted among low birth weight infants. Shifts in the distribution of birth weight and in maternal characteristics had little effect on declining NMRs. A strong commitment of the Mississippi State Board of Health to provide prenatal care to indigent women may be responsible for the large increases in use of prenatal care among Mississippi women. The decline in NMRs among low birth weight infants is likely linked to greater availability of specialized care for the sick neonate, although survival of these infants increased across the State, even where specialized care was not available.

Adolescent↗

PubMedDate not supplied

Determinants of staff nurses' perceptions of autonomy within different clinical contexts.

Studies of nurses and other health professionals indicate that autonomy is an important determinant of job satisfaction and turnover. This study analyzed selected characteristics of hospital nursing units to identify those features of the work setting that influence staff nurses' perceptions of autonomy: comparisons among nurses who work in different clinical areas were made. Data were collected by interviewing 789 nonsupervisory registered nurses who were employed full time at one large university-affiliated hospital. Personal and job-related information was obtained for each nurse. Structural features of units, such as workload, were gathered from head nurse reports and hospital records. Findings indicated that nurses' perceptions of autonomy are influenced by both personal characteristics of the nurse and structural features of the units. The nurse's sense of personal efficacy and the relationship she has with her head nurse are two important determinants of autonomy across all units. Workload, primary nursing, and staffing patterns are influential factors in predicting autonomy for nurses who work in critical care areas. Implications of these findings for nursing administrators are discussed.

Efficiency↗

PubMedDate not supplied

The effect of the intensive care nursing role on job satisfaction and turnover.

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Critical Care↗