The importance of being integrated.
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Biomedical subjects
Publications and source records attributed to J King.
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Previous studies of pollen and mold dispersal have not correlated meteorological phenomena with clinical exacerbations of asthma, allergic rhinitis, and sinusitis. We utilized the resources of 11 New England Society of Allergy (NESA) pollen collectors, a certified palynologist, over a dozen weather stations for meteorological data, and 10 emergency rooms to explore the effects of the strong "El Niño" of 1997-1998 on our region during the 1998 pollen season. There was a marked increase in the number of clinical exacerbations of asthma, allergic rhinitis, and sinusitis in April, May, and June of 1998. Several emergency rooms reported a greater increase in visits for sinusitis as compared to asthma. In addition, maximum mold counts occurred two to three months earlier than in 1997. Maximum pollen counts were also higher than in 1997, and occurred two to four weeks earlier for most tree pollen types.
Leaders and vendors candidly explore new opportunities for industry standards, work-force training, and patient-focused care.
Over the past three years, families, school staff, and healthcare personnel in our state have benefited from an innovative service delivery system designed to demonstrate that we can improve the lives of children with TBI. Project ACCESS has used hospital-based pediatric brain injury Community Transition Coordinators to identify, coordinate care, educate, support, and generally improve the lives of thousands of children with TBI. The project also uncovered a host of barriers that adversely affect the future of many of North Carolina's most vulnerable children. We hope that this article helps delineate the challenges faced by our state's healthcare and educational systems, and contributes to the adoption of a statewide model system of care for children with brain injury.
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The complementary feeding national programme (PNAC) delivers 2 kg-month of dried full-fat cow's milk (LP) to 0-1 year old infants. The purpose of this work was to design, produce and evaluate nutrient stability and shelf life of a modified LP milk formula (LPM), which seems nutritionally more adequate for infants and is of similar cost than LP, to be included into the PNAC. LPM has the following attributes: P% 12.0 (LP 21.8%): casein/whey proteins ratio: 40 to 50/60 to 50 (LP 80/20); more digestible fats; essential fatty acids: > or = 4% of total calories; vitamins and minerals which cover 100% daily requirements for 0 to 6 months old infants; protein and energy can be modulated between 1.5 and 2.25 g/100 ml and 50-75 kcal/100 ml respectively. Forty tons of LPM were produced in accordance with our specifications for a field study. Quality controls on the product showed the production feasibility of such a formula at a lower price than LP. To determine shelf life, periodical analysis of peroxides, available lysine, ascorbic acid and linoleic acid were carried out in LPM stored for 1 year at 20 degrees C and 37 degrees C. It was found that LPM has an optimum shelf life of 7 months when packed in the same material that is now being in use for LP.(ABSTRACT TRUNCATED AT 250 WORDS)
Collaboration between nurses in clinical and educational settings has been advocated as a means of ensuring nursing research is both practice oriented and scientifically valid. This paper describes a model, jointly developed by colleagues from the Nursing Departments of Alfred Hospital and La Trobe University, to foster collaborative research and steer research projects generated by clinical nurses from conceptualisation to publication.
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To assess empirically the radiologic appearance of fractures among victims of child abuse, the charts and radiographs of 189 battered children exhibiting fractures (n = 429 total fractures) were studied. Approximately one-half of the patients had a single fracture. Bones most commonly fractured were the humerus, femur, and tibia; transverse fractures were the most common type. Of long bone fractures, the middle third (50%) and distal third (41%) locations were most prominent. Age, race, and gender were not associated with any particular long bone fracture type. Skull fractures were the only type more likely to be present in children aged less than 1 year than in older children (p less than 0.05, one-tailed). In the past, emphasis has been placed on corner fractures, fractures at different stages of healing, and injuries at several sites. Our results suggest that fresh single diaphyseal fractures are more common.
A woman who underwent mastectomy for left breast carcinoma has been followed-up yearly with bone scintigraphy using Tc-99m diphosphonate compounds for nine years. In the bone images of the initial three years (first, second, and third years postmastectomy), radiotracer accumulation in the right renal upper collecting system had been interpreted as obstructive uropathy. Then the patient underwent initial (third year postmastectomy) and repeat (fifth year postmastectomy) intravenous contrast pyelography (IVP), which revealed an extrarenal pelvis with no significant interval changes. The fourth and fifth bone scintigraphs and the subsequent four consecutive bone scintigraphs showed the same pattern radiotracer retention in the right renal collecting system. Thus, while interpretation of an accumulation of radiotracer in the upper renal collecting systems on a single bone scintigraphy may provide difficulty in making a differential diagnosis between obstructive uropathy and extrarenal pelvis, IVP is important for definitive diagnosis. Alternatively, a review of the previous consecutive bone studies, if available, may also aid in this differentiation, since obstructive uropathy may manifest as progressive renal dysfunction, while extrarenal pelvis may have the same pattern of radiotracer accumulation in the collecting system persistently.
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The normal physiology of the vagina, the six most common causes of vaginal discharge, current accepted methods of treatment, and specific nurse practitioner implications are reviewed.
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