Biomedical subjects
Publications and source records attributed to R Shearer.
Luck permeates every aspect of human behaviour. Thus, luck is an aspect of nursing care and client belief of which the nurse should be aware. Beliefs about luck will influence client compliance with recommendations for actions as well as influence actions the client selects in relation to health. Beliefs about luck will also influence actions the nurse may take when responding to clients.
Contrary to the manner in which a great many people seem to regard sleep, sleep is not a waste of time. Inadequate sleep, let alone chronic sleep deprivation and actual sleep disorders, leads to diminished quality of work and loss of productivity. As far as caregivers are concerned, inadequate sleep can affect dangerously their ability to function in critical situations. On the other hand, adequate sleep is needed if one is to function at one's potential best and sufficient sleep is also an effective hedge against the encroachment of job stresses. For one who is occasionally unable to get sufficient sleep, there are steps to be taken to improve the ability to rest. A good night's sleep invariably precedes a good day's work.
Getting in the news usually needs to be a planned event with intentional actions and strategies. In most cases, news from the nursing program needs to be an administrative or faculty goal with a strategy for how this will occur. There must be a commitment to ensure that timely information is provided so that a news item can actually become reality. Most importantly, when newspapers and the media are provided with this information in a news release it must be written in a style that piques the interest of the editor and causes it to be selected as news (Perloff, 1997). If time is taken to interact with reporters and to understand how the media works, it can provide support to achieve the goals and outcomes of a nursing program.
In an amazingly short time, electronic mail (e-mail) has become one of the most powerful and useful communication mediums in the health care workplace. However, while e-mail has added new dimensions to the communication system, which are advantageous, a concomitant effect is e-mail overload. By implementing e-mail management technique, strategies information overload can be controlled and effective productivity promoted.
When used effectively, voice mail is an indispensable and powerful tool for the busy health services manager. On the other hand, misused or abused, voice mail can handicap the manager and cause frustration to all individuals involved in the communication interaction. By following guidelines for effective use of voice mail, the manager can maximize this important communication modality and enhance business finesse.
Several reports have suggested that one or both of the trinucleotide repeat polymorphisms in the human androgen receptor (hAR) gene, (CAG)n coding for polyglutamine and (GGC)n coding for polyglycine, may be associated with prostate cancer risk; but no study has investigated their association with disease progression. We present here a study of both hAR trinucleotide repeat polymorphisms not only as they relate to the initial diagnosis but also as they are associated with disease progression after therapy. Lymphocyte DNA samples from 178 British Caucasian prostate cancer patients and 195 control individuals were genotyped by PCR for the (CAG)n and (GGC)n polymorphisms in hAR. Univariate Cox proportional hazard analysis indicated that stage, grade and GGC repeat length were individually significant factors associated with disease-free survival (DFS) and overall survival (OS). The relative risk (RR) of relapse for men with more than 16 GGC repeats was 1.74 (95% CI 1. 08-2.79) and of dying from any cause, 1.98 (1.13-3.45). Adjusting for stage and grade, GGC effects remained but were not significant (RR(DFS)= 1.60, p = 0.052; RR(OS)= 1.65, p = 0.088). The greatest effects were in stage T1-T2 (RR(DFS)= 3.56, 95% CI 1.13-11.21) and grade 1 (RR(DFS)= 6.47, 95% CI 0.57-72.8) tumours. No differences between patient and control allele distributions were found by odds-ratio analysis, nor were trends with stage or grade evident in the proportion of short CAG alleles. Non-significant trends with stage and grade were found in the proportion of short GGC alleles. The (GGC)n polymorphism in this population is a significant predictor of disease outcome. Since the (GGC)(n) effect is strongest in early-stage tumours, this marker may help forecast aggressive behaviour and could be used to identify those patients meriting more radical treatment.
As more and more clients with acquired immunodeficiency syndrome (AIDS) are encountered in health care agencies, it is important that the health care professional be well informed with current facts and information on treatment. Supportive care by the health professional is essential to assist the client in maintaining maximum quality of life and a sense of self-esteem and self-efficacy. It is important for the professional to be aware not only of the supportive care needed by clients but also of the safeguards necessary in such a high-risk profession.
For many clients in home care with chronic illness the real work of getting well involves learning to adjust to chronic illness and to disability. Learning to adjust to disability by maximizing the abilities and qualities that are present can mean overcoming otherwise very significant problems while still maintaining a high quality of life. Home care providers play an important role in helping clients and their families optimize functioning to do the real work of getting "well."
It is important to identify signs of clinical depression such as pessimism, refusal to eat, diminished concern about personal appearance, and reluctance to make decisions. Medical referral for clinical depression is imperative because there are medications and other interventions that can effectively alleviate the feelings of sadness and despair that accompany clinical depression. One must determine if loneliness is a symptom of depression or an emotional state that can be changed by one's own efforts. Whether the lonely person is the health care giver or a health care receiver, the ability to use creative strategies for coping with loneliness can turn loneliness into a more comfortable experience.
The authors describe the dynamics of the "super nurse" syndrome and provide nurse managers experiencing this syndrome with strategies to assist them. The article discusses the roles of nurse educators, hospital development staff, mentors, and social support networks. The authors hope to prevent the "super nurse" syndrome from affecting new graduates, through proper education of nurse educators, mentors, and nurse managers who assist the new graduates in problem solving and adjusting to being a "real nurse."
The authors describe the dynamics of change, barriers and resistance to change, and provide techniques for assisting staff cope with change. The nurse manager should provide support during change, intervene when change is a surprise, help staff find challenge in change, encourage staff to have courage and stamina while coping with change, and foster teamwork. Using these techniques enables the manager and staff to view change as a challenge and an opportunity rather than a threat.
The authors provide strategies for nurse managers to reward with dignity, thus giving praise that matters. These strategies include treating employees with respect, focusing on the positive, designing recognition systems, expressing confidence in employees, providing opportunity for participative management, and promoting career development and advancement. Job satisfaction and personal worth of employees can be increased with use of these techniques.
This article offers a variety of methods for the nurse manager to incorporate humor into the workplace. Humor is defined in the article, and the benefits of humor are described. These benefits include reducing stress and aggression, building relationships, enhancing problem solving, improving negotiating, personal survival, physical healing, and emotional healing. Humor can be used to reduce stress in the nurse manager's personal life as well as in the work environment.
Electronic mail is a powerful and useful communication medium in the health care workplace. Unfortunately, managing E-mail overload can present a problem for the nurse manager. Intentional strategies must be developed to handle this situation in order to maintain efficient use of managerial time. The objective of this article is to provide such strategies for the nurse manager.
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Prostate cancer shows evidence of familial aggregation, particularly at young ages at diagnosis, but the inherited basis of familial prostate cancer is poorly understood. Smith et al. recently found evidence of linkage to markers on 1q, at a locus designated "HPC1," in 91 families with multiple cases of early-onset prostate cancer. Using both parametric and nonparametric methods, we attempted to confirm this finding, in 60 affected related pairs and in 76 families with three or more cases of prostate cancer, but we found no significant evidence of linkage. The estimated proportion of linked families, under a standard autosomal dominant model, was 4%, with an upper 95% confidence limit of 31%. We conclude that the HPC1 locus is responsible for only a minority of familial prostate cancer cases and that it is likely to be most important in families with at least four cases of the disease.
Change seems to be the one constant in health care. This article examines how employees react to change and provides guidelines to help them and managers overcome barriers to change. These guidelines include providing support during change, using appropriate interventions, helping staff find the challenge in change, helping them find the stamina for change, and fostering teamwork.