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PubMed1996

[Analysis of professional applications of training given to general nursing care staff in continuing education].

At a time when any leaders, either political or socioeconomical speak about "productivity, professional qualification, high-technology, research, etc.", it seemed to us that it was essential, as far as Public Health is concerned, to analyse through a medium-sized hospital the vocational training given to nurses working in general care. What does the nursing staff think about it? What about the "educational quality"? What are the consequences and effects of this training on a professional and human ground? Our hypothesis of research is to invalidate or to confirm those elements (different from those found in literature) can be more helpful to put into pratice the training on a professional ground. Those elements are: a number of training attended by nurses (from 6 to 12 in 5 years) ans which take the educational principles into account, that is why we have decided to condiser what presently exist, that is to say: the hospital and its plan, the current training, the nursing staff concerned and alle the possible means to succeed. Like this the problem was formulated and we could search a review for elements which sustain our analysis. The results of our research, which was based on a methodological way, prove that there is not only a great variety of applications of those teachings on a professional ground but also no application of the teachings on a professional ground. From this study and apart from the educational quality, we can note that the training subjects must be in connection with the hospital development, society and the medical profession. Anyway, the trainings are short, theoretical, do not fit in with the professional ground and do no consider the knowledge people acquired from other trainings. Our conclusion tend to confirme that the vocational training is necessary as well as its application from which the nursing staff can gain a lot.

Adult↗
PubMed2006

[Orthodontics for mentally handicapped patients].

The mentally handicapped exhibit a 3 times higher incidence of malocclusions and related functional problems than the general population. In contrast there is little available literature relating to the orthodontic treatment of handicapped patients. Based on published articles on orthodontic treatment of disabled patients the following recommendations can be given. First of all for each patient a 'problem list' should be drawn up, based on the diagnosis. In this list the orthodontic problems are formulated. Additionally, the list makes clear who is responsible for providing services related to orthodontic care, such as oral hygiene and transportation of the patient to the orthodontist. When deciding whether or not orthodontic treatment should be administered to a patient with a mental handicap the same functional and aesthetic considerations as with any other orthodontic case must be taken into account. Furthermore, the severity of the handicap and possible associated psychosocial and medical limitations as well as the extent to which it will be possible to treat the patient have to be considered. Contraindications are a severe mental handicap, inability to remain still in the dental chair, insufficient co-operation of parents/carers, open bite resulting from abnormal oral function, and a mild malocclusion. The orthodontic treatment should aim for an acceptable result, and not for orthodontic perfection.

Dental Care for Persons with Disabilities↗
PubMed1976

Dysuria in women.

Only 46% of 84 women with dysuria were found to have significant bacteriuria while 8% had gonorrhea, 1% had herpes progenitalis and 17% had monilia and Trichomonas vaginitis. The remainder were considered to have the urethral syndrome. Neither pyuria, microscopic bacteriuria, nor any single subjective or objective datum definitively predicted cystitis at the initial visit. Therefore, we advise formulating the problem as "dysuria" at the initial evaluation even though one treats with an antimicrobial. The initial workup should include a routine urinalysis, gram stain of the urinary sediment, urine culture, an examination of the urethra and labia as well as a urethral culture. Complete pelvic examination is useful in documenting gonorrhea, herpes progenitalis or vaginitis. If the pelvic examination is deferred and the initial urine culture is negative, reevaluation of the dysuria should include a pelvic examination.

Bacteriuria↗
PubMedDate not supplied

[The stem cells of animal tissues].

A brief historical review of concepts on stem cells is given with a stress made on the role of Russian scientists A. A. Maksimov and A. A. Zavarzin who have formulated key problems in biology of stem cells and cell renewal. Principal stages in current studies of stem cells are considered. An outline is given of traditional and recent trends in the investigations: comparative studies of tissue systems with stem cells; molecular genetic mechanisms of the self-maintainance and the differentiation of stem cells; stem cells as a subject of gene engineering.

Animals↗
PubMed1990

Coming of age in the era of AIDS: puberty, sexuality, and contraception.

The existing discrepancies between adolescent and societal constructions of teenage sexuality in America are further exacerbated by AIDS. Male and female teenagers receive different and often conflicting messages about sexuality from diverse sources; their parents' lack of frankness about sexual intercourse contrasts sharply with the media's emphasis on sex and with highly rationalistic discussions about sexuality in schools, complicating adolescents' decisions about entering and continuing sexual relationships. Survey research indicates that not all teenagers engaging in sexual intercourse reduce risks of HIV infection as much as they might. While AIDS has prompted many teenagers to change their sexual behavior, serious questions remain about adolescents' conceptions of the dangers of unprotected sex.

Acquired Immunodeficiency Syndrome↗
PubMed1988

A model of time-limited treatment for the older patient.

In conclusion, brief treatment can be offered to a majority of patients when focused around current difficulties in the life structure, as opposed to past unconscious dynamic conflicts relived in the transference. Some aspects of the life structure, of course, are also unconscious, namely, those having to do with attempted solutions to core personality conflicts and those reflecting modes of ego functioning. We have utilized Loevinger's model of stages of ego development to understand the latter aspect. Personality and cognitive operations are the portals through which life-cycle tasks are experienced and interpreted. In order to formulate the problems of the life structure and of accomplishment of life tasks, the clinician must understand the major dynamic issues as they present themselves within the particular stage of ego development. In our example, Mr. S.'s sense of defect and injury was processed within a fairly "high level" of development which enabled him to undertake the therapeutic task with considerable autonomy and initiative, compatible with his view of himself and optimal interaction with others. Presentation of a therapeutic task or focus which fits the dynamic issues and the developmental stage in a manner which is readily comprehensible and relevant to the patient is the major task of the therapist in brief treatment. In this model, the patient uses the therapy to work on a life task and life structure in a goal-oriented manner jointly constructed with the therapist. This reality orientation and focus on aspects of the person closest to awareness make the model applicable to a broad spectrum of patients and to a time-limited setting in which the work can be done in different phases over time.

Adaptation, Psychological↗
PubMed1987

Pharmacist participation in the management of incidents involving hazardous materials.

The role of the pharmacist as a hazardous materials consultant is described. Pharmacists in a university-affiliated teaching hospital are contacted by either emergency medical services or the emergency department to assist in the management of incidents involving toxic hazardous materials. These incidents can range from major chemical spills or leaks to long-term exposures involving generalized, nonspecific symptoms. An advanced pharmacy resident in emergency medicine is the primary pharmacy contact for hazardous materials consults. The services provided by the clinical pharmacist include identification of the hazardous materials involved, initiation of special precautions for rescue-squad and hospital-based personnel, clinical assessment of the toxicologic problem, and formulation of therapeutic recommendations. Teaching programs have been developed for pharmacy, nursing, and medical students, hospital employees, and emergency-response agencies. Pharmacy participation in the management of hazardous materials incidents has been well received by emergency department physicians and nurses, as well as by rescue personnel. During the period between January 1 and July 1, 1986, the pharmacy was consulted on 66 hazardous materials incidents. Since pharmacists have traditionally been used as information resources for clinical toxicology questions, it follows that their participation can extend into the field of environmental toxicology, specifically involving hazardous materials. The pharmacist's input as a hazardous materials consultant in our institution has been well received, and we believe that pharmacy departments can play an important role in the management of incidents involving hazardous materials.

Consultants↗
PubMed1987

Two-sample rank tests for detecting changes that occur in a small proportion of the treated population.

In the course of studying a biological phenomenon thought to be a precursor to chromosome breakage, researchers have found that treatments sometimes produce a higher proportion of "outliers" than do controls. Our examples pertain to smokers and patients undergoing chemotherapy, although the statistical methods developed here would apply to subjects exposed to any other health hazard. We formulate the problem in a nonparametric setting. Locally most powerful rank tests are obtained for mixture alternatives. In one instance, the approximate scores test has the simple form of counting the number of treatment responses above a combined sample percentile. Our test statistics are compared to the Wilcoxon and normal scores tests using empirical power studies and asymptotic efficiencies.

Biometry↗
PubMed1979

[Biochemical mechanisms for the effect of alcohol on the brain].

This paper reviews and discusses basic knowledge of biochemical mechanisms of action of ethanol upon the central nervous system, the emphasis being on effects upon cerebral membrane structures and processes as well as mechanisms of chemical synaptic transmission. Results of detailed studies into material and steric changes in membranes, ion-dependent adenosine triphosphatases, variations in ion balance, effects upon cyclic nucleotides, influences on special transmitter systems, and mechanisms of formation of morphine-analogous condensation products are presented. In addition, open questions are derived and formulated in problem complexes.

Acetaldehyde↗
PubMed1985

Topical retinoic acid therapy for disorders of the outer eye.

Topical all trans retinoic acid (tretinoin) 0.1 per cent has been used to treat eight patients with squamous metaplasia and keratinisation of the conjunctiva. In four patients the changes followed Stevens-Johnson syndrome, one patient had chronic atopic kerato conjunctivitis, one had persistent epithelial erosions following sarcoid related kerato conjunctivitis sicca complicated by preservative induced epithelial toxicity, one had a recurrent Bowen like epithelial dysplasia and one had an unclassifiable primary ocular surface disorder. Improvement in symptoms and signs were noted in all patients but local irritation developed in some and the optimum dosage remains to be determined. Problems of formulation and stability of the preparation need to be solved before topical retinoid therapy can be more widely used.

Administration, Topical↗
PubMed1979

Bismuth toxicity in man II. Review of bismuth blood and urine levels in patients after administration of therapeutic bismuth formulations in relation to the problem of bismuth toxicity in man.

A survey of the leterature on bismuth toxicity in man in relation to blood level data, has revealed the necessity of distinguishing between lipid soluble and water soluble organic complexes of bismuth on the one hand and the simple inorganic salts of bismuth on the other hand. A characteristic feature of the former, illustrated by the water soluble bismuth complex triglycollamate, is the high bismuth levels (due to absorption of the complex as such) and the nephrotoxic properties of the compound in man. Bismuth absorption after administration of the simple inorganic salts of bismuth is postulated to occur in the form of ionic bismuth as such, low bismuth levels being characteristic features of such compounds. Bismuth blood and urine levels obtained from patients after administration of a new anti-ulcer drug (Bicitropeptide) in a well controlled clinical trial are discussed and suggest that that this bismuth containing drug behaves pharmacologically in a manner similar to the inorganic bismuth salts in man, low bismuth blood levels and the absence of toxic side effects being conspicuous features of the drug. Based on these considerations, it is proposed that the pharmacologically active bismuth compounds be divided into four different groups depending on structure, stability and solubility. The question as to what constitutes a "toxic bismuth blood level" can only be discussed in relation to the new proposed sub-division of bismuth compounds and is only meaningful if the term is defined to relate only to ionic bismuth (presumably bound to a large extent to blood proteins). Based on information gleaned from the literature and blood level values reported in the clinical trial referred to, it is suggested that bismuth blood level values below 50 micrograms/ml are highly unlikely to be associated with meaningful toxicity in man. Finally, attention is drawn to the reversibility of bismuth toxicity in man as reported by many authors irrespective of the type of bismuth compound concerned.

Animals↗
PubMed1984

[Problems in the classification and formulation of diagnoses of diseases of the peripheral nervous system].

The author reports on the classification of peripheral nervous system diseases approved at the expanded plenary meeting of the All-Union Task Commission on Peripheral Nervous System Diseases (Kiev, June 16-17, 1983) and recommended (pending the publishing of methodological recommendations) to be introduced into health service practical work. Approximated models of the diagnostic wording for this pathology are presented.

Humans↗
PubMed1984

Exact significance testing to establish treatment equivalence with ordered categorical data.

This communication concerns the problem of establishing the therapeutic equivalence of two treatments that are being compared on the basis of ordered categorical data. The problem is formulated as a significance test in which the null hypothesis specifies a treatment difference. An efficient numerical algorithm for computing the exact significance level is provided, along with a simple method for obtaining the asymptotic significance level. Both methods are applied to a clinical trial of a new agent versus an active control. Guidelines for when to use the exact procedure and when to rely on asymptotic theory are provided.

Biometry↗
PubMed1978

A method for plotting the optimum positions of an array of cortical electrical phosphenes.

The cortical visual prosthesis provides one approach to the substitution of vision in blind people. Usable visual information is provided in the form of phosphenes, and in order to make use of the prosthesis the positions of the phosphenes in visual space must first be determined. Such phosphene maps have to be constructed from observations of the angle and distance between various pairs of phosphenes. Because of the variation in repeated observations of the same phosphene pair, some method is needed to provide the 'best' fitting map to the observations. By formulating the problem as one involving the minimization of a function of many variables, an algorithm is constructed which determines a two-dimensional co-ordinate for each phosphene by minimizing one of two criteria indicating the fit of the map to the observations. The minimization algorithm employed is, essentially, a 'steepest descent' procedure, and initial co-ordinate values are provided by a triangulation method.

Blindness↗
PubMed1993

[The neglected preschool child].

Neglect is seen as a chronically insufficient quantitative or qualitative response towards a child's physical needs. Neglected children often demonstrate considerable developmental delay, manifested through deficits in their mental, motor, linguistic and/or social skills. Neglect can carry profound consequences for the children who are the victims. Some of the children suffer diverse types of long term sequelae. They display personality disorders, sleep disturbances, suicidal tendencies or attempts, and they are runaways. The problem of neglect is associated with several factors; it is a multi-factorial phenomenon. The importance of intervening with these children's families in order to improve the overall health of the children is an essential element in the role of the school nurse. The author developed an approach towards families with neglected children based upon the Calgary Family Assessment Model (1984) and the model for care of disadvantaged families designed by Thibaudeau and Reidy (1982). The author recommends that nurses, working with negligent families, look for the positive attributes of family members. Too often, health professionals only look for the negative. It is important that nurses accept the values of each family. The attitude of the nurse should be one of respect and confidence, not one of judging or working against the family value system. The importance of team work can not be overemphasized. It is difficult for a nurse to be alone in front of passive families who do not recognize their own negligence. They need a team able to understand the problems and formulate new strategies. A discouraged professional person leads to the risk of multiplying the forms of negligence.

Child Abuse↗
PubMed1994

Problem-solving for better health.

An outline is given of an approach to the health-for-all goals which involves optimizing resource use, prioritizing people's well-being, achieving excellence and a measurable impact at all levels of care, and solving health problems in a broad developmental context.

Attitude to Health↗