Biomedical subjects
Publications and source records attributed to R Shearer.
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.
Explore the source record for details and available documents.
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.
Humor has the potential to be positive or negative, character building or destructive. Many suggest that a sense of humor is necessary for good health, whether of an individual or an organization. This article presents ways in which managers can foster a "laughing with" (instead of "laughing at") attitude as a means of managing stress, enhancing teamwork, and maintaining employee satisfaction in the face of adversity.
Job satisfaction affects employee morale, which in turn affects employee productivity. Therefore, managers need to learn about contributing factors and use the factors within their power to improve job satisfaction. Extrinsic rewards, such as a high salary and good work benefits, are important, but studies show that how a job makes an employee feel is the greatest determinant of job satisfaction. Managers can influence the emotional effect of work on an employee through, among other strategies, recognizing the employee's efforts, providing opportunities for the employee to participate in decision making, and allowing the employee to grow professionally.
An investigation for serious illness can be terrifying for the client. While diagnostic procedures are a high priority, a supportive interpersonal approach for the fear the client is experiencing is also a significant aspect of client care. The nurse is in the ideal position to provide such support and have a significant impact on the client's psychological state.
Positive bedside manners are essential when caring for patients. Positive bedside manners should be utilized wherever patients and their significant others are encountered. Putting your best foot forward is the first step in establishing a therapeutic relationship. Attention to one's professional image is important if the client is to see the licensed practical/vocational nurse as someone that can be trusted. Next is actively communicating interest and concern. It is also important to communicate empathy and respect through words and actions. The LP/VN must practice attending skills in order for the patient to experience the physical and psychological presence of the nurse. Communicating availability and following up on requests promote the establishment of trust. It is important for the nurse to avoid defensiveness, maintain a professional manner, answer questions honestly, demonstrate integrity, maintain a positive attitude and practice intentional encouragement. All the characteristics will demonstrate a positive bedside manner and will communicate caring and concern to clients and their significant others.
Explore the source record for details and available documents.
There is evidence that predisposition to cancer has a genetic component. Genetic models have suggested that there is at least one highly penetrant gene predisposing to this disease. The oncogene MXI1 on chromosome band 10q24-25 is mutated in a proportion of prostate tumours and loss of heterozygosity occurs at this site, suggesting the location of a tumour suppressor in this region. To investigate the possibility that MXI1 may be involved in inherited susceptibility to prostate cancer, we have sequenced the HLH and ZIP regions of the gene in 38 families with either three cases of prostate cancer or two affected siblings both diagnosed below the age of 67 years. These are the areas within which mutations have been described in some sporadic prostate cancers. No mutations were found in these two important coding regions and we therefore conclude that MXI1 does not make a major contribution to prostate cancer susceptibility.
Giving encouragement is not generally stated as a high priority role of health care supervisors. Traditionally, technical skills and productivity on the job were aspects that received the supervisor's primary focus. However, there is a growing appreciation that encouragement is a transformational leadership technique that is related to productivity on the job and to quality work. Use of encouragement is a leadership technique that fits in today's people-oriented work climate.
"I'm not the only one working here! Why do I have to do everything nobody else wants to do? I get all the skut work around here. I'm really sick of it." What do you do when a co-worker complains? Complainers always seek out people who will listen. The listener must either agree, which makes the listener a complainer, or disagree, which often leads to an argument.
Explore the source record for details and available documents.
Illnesses can rob persons of their dignity and pride. Nowhere has this been more apparent than with people who suffer from Acquired Immunodeficiency Syndrome (AIDS). Because AIDS is a progressive and debilitating disease whose fatal outcome seems hopeless, it is often hard for the sufferer to maintain a sense of human worth. Add to that a prevailing public prejudice that keeps the individual at an arm's length from the support of the community, and a grim picture is given. However, unknown to lay persons and professionals alike, this bleak picture is no longer so grim. With the advent of drug combination therapy treatments (taking several commonly prescribed anti-HIV drugs at the same time), new hope has been given. The purpose of this paper is to describe for the licensed practical/vocational nurse the different and various drugs used for therapy and their effects on the AIDS population. Particular emphasis is placed on the modern combination therapy programs that are being utilized. Current knowledge of AIDS treatment can enable the licensed practical/vocational nurse to increase a client's feelings of hope, self worth, and dignity.
OBJECTIVES: The objective of this study was to evaluate efficacy, safety, and dose-response profiles of four dosing schemes of flutamide over 24 weeks. METHODS: Patients were randomized to receive one of the following five treatment regimens for a period of 24 weeks: placebo capsule, flutamide capsules 125 mg twice daily, 250 mg once daily, 250 mg twice daily, and 250 mg three times daily. Patients were then evaluated at baseline (0 weeks) and at 4, 6, 12, 18, and 24 weeks after the start of treatment, and 8 weeks after the end of treatment (32 weeks). Evaluation of efficacy was performed by noting changes in urine flow rate, residual urine volume, symptom score, prostate volume, and prostate-specific antigen level. A total of 372 patients were enrolled into the study at 32 centers (14 centers in the United States and 18 international centers). RESULTS: Baseline peak urinary flow rate and percent change from baseline in maximum flow rate showed a dose-related increase at 4 and 6 weeks; this increase was significant in the 250 mg three times daily group. At later time points, no significant differences between the flutamide and placebo groups were observed, largely because of the decreasing number of evaluable patients. At 4 and 6 weeks, 25% of patients in the 250 mg three times daily group had more than 3 cc/s increase in uroflow compared to about 10% of placebo patients (P < 0.05). All flutamide-treated groups had a significant decrease in prostate volume from baseline to the last treatment visit compared to placebo and this reduction was dose related (in comparison to placebo: P < 0.05 for 125 mg twice daily and P < 0.001 for all other treatment arms). Median decrease for the flutamide-treated groups ranged from 6% to 23% at 12 weeks and from 14% to 29% at 24 weeks. All treatment groups showed a subsequent increase in prostate volume after treatment was stopped. Furthermore, there was a significant reduction in residual urine volume at 24 weeks only in the 250 mg three times daily group. It increased following cessation of therapy. Urinary symptoms at 6, 12, 18, and 24 weeks did not show any significant difference between placebo and any flutamide dose group. The most common adverse events were nipple and breast tenderness (42% to 52%), diarrhea (29% to 34%), and gynecomastia (14% to 19%). Each of these adverse events had a significantly higher incidence in all flutamide dose groups compared with placebo, but none appeared to occur in a dose-related fashion. Sixteen percent of patients in the placebo group and 25% to 39% of patients in flutamide groups were discontinued due to diarrhea (12% to 17%) or nipple and breast tenderness (4% to 8%). A total of 1% to 3% of patients in various treatment arms discontinued due to deranged liver enzymes (1% for placebo); and 1% to 4% due to impotence (1% for placebo). CONCLUSIONS: Flutamide reduced the prostate volume in a dose-related fashion and resulted in an increase in peak flow rate at 4 weeks (3% for 250 mg three times daily, P value < 0.05), but the early positive effects did not maintain statistical significance due to an increasing number of dropouts due to adverse events. Effect on postvoid residual volume was observed only at the highest dose and at 24 weeks (median reduction, 23 mL, P < 0.05). Despite volume reduction and early improvement in peak flow rate, there were no significant differences in urinary symptoms among the placebo and flutamide groups. Higher incidences of diarrhea, breast tenderness, and gynecomastia, however, were the main limiting factors in this study and until these problems are overcome, the role of flutamide in the management of benign prostatic hyperplasia remains investigational.