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Establishing the role of the clinical nurse specialist in postanesthesia care.

The postanesthesia clinical nurse specialist (CNS) is a relatively new and developed role, one that is needed and that can be justified in the specialty of postanesthesia care nursing. This article describes a model with components of expert practitioner, educator, researcher, consultant, and liaison. The sub-role of change agent pervades all other roles of the postanesthesia CNS. Establishment of the role is examined using change theory. Fitting this specialty CNS into the organization is briefly examined through systems theory. Integrating the role into the system requires role making, role taking, and steps to reduce the stress associated with establishing a new role. Communication with involved subsystems, such as postanesthesia staff nurses, management, anesthesia staff, and physicians, is vital to the success of the role. Through education and interaction, significance of the role can be demonstrated to establish the postanesthesia CNS as a vital partner in postanesthesia nursing practice.

Consultants↗

[Modern morpho-functional concepts in cephalic arterial distribution].

The present paper provides a general morphofunctional study of the oro-maxillary-facial cephalic arterial area that shows some particular hemodynamic characteristics. The internal maxillary artery supplies a very large territory, with numerous and wide anastomoses. In order to understand the hemodynamic characteristics of this artery, we analyzed some older theories, such as: Ludwig von Bertalanffy's General Systems Theory, Walter Zimmermann's Telome Theory, and some general rheological principles also.

Carotid Artery, External↗

[The comparative study on parent-adolescent communication between the model student family and the delinquent adolescent family].

This research is based on the communication system theory which considers the family as a communication system or a communication network and which understand interpersonal relations among family members through a communication. This research is intended to define the difference of Parent-Adolescent Child communication between the model student family and the delinquent adolescent family, and also found the factors affecting parent-adolescent child communication. This aims to clarify wether a delinquent behavior is associated with family members' relations caused by dysfunctional communication between parents and their child, moreover explorate their problem to find the method of nursing intervention for prevention and treatment for delinquency. Subjects are 190 families (570 persons: father, mother, adolescent child) of model high school students and 87 families (261 persons) of delinquent adolescents. The employed tool is Olson et al's Parent-Adolescent Communication Scale (PAC, 20 items). The followings are the results derived through hypotheses verification. First, Comparison of two groups showed a significant difference in Parent-Adolescent Communication (t = 2.77, p less than 0.1). In the communication of delinquent group showed lower response than the model group. And also communication of the model group was more opened and positive (t = 2.41, p less than .05), and showed fewer problems (t = 2.06, p less than .05), the delinquent group had more problems. 2ndary, the delinquent group showed significantly more disagreement in response to variable of PAC than the model group. As analyzing of factors affects the Parents-Adolescent Communication, the best method to protect juvenile from delinquency are consistent open-hearted, congruent communication with mutual concern and warm mind between parents and child. And even though the all family don't hardly send together their time for their job, parents have to arrange many times to hold communication with children and to listen attentively to and respond to them, and so to increase their satisfaction for their parents. In conclusion, it seems that delinquent behavior is the outcome caused by dysfunctional communication between the parents and the child because of severe generation gap at adolescence period when the child needs communication with their parents. Therefore, it seems that the delinquent adolescent is the scape-goat of the family. Finally, it seems that more effective method to solve juvenile delinquents increasing day by day, is the family therapy that all family members participate than the individual therapy.

Adolescent↗

Formulations of self and family systems.

The observations of systemic family therapy and self psychology fit together conceptually because both rest upon systems theory. Underlying assumptions common to both fields of inquiry are reviewed. The concept of the self and its parts is examined, with discussion of its systems properties featuring stability and change. Parallels are noted between healthy self-functioning and healthy family functioning; self-formation processes and family developmental processes; and sense of self and family paradigm. It is suggested that there are isomorphic patterns in these formulations that allow us to switch back and forth easily between the individual and the family. Two clinical case examples are also included.

Adolescent↗

The systems, holograms and theory of micro-acupuncture.

Although acupuncture has been practiced for more than 5,000 years, micro-acupuncture is a recent concept. In the mid-1950s, Nogier discovered that the ear may be utilized as a diagnostic and therapeutic system for the entire body. He explored the topology of acupoints on the ear, observing that it is reiterative of the anatomy. Micro-acupuncture extends these principles to other parts of the body, for example, the foot, hand, nose, and even the orbit of the eye. The development, systems, theory, clinical uses and holograms of micro-acupuncture are reviewed. It is suggested that the holographic paradigm may even have implications for the evolution of a new scientific, social and personal consciousness.

Acupuncture Therapy↗

A theory of alternative designs for biochemical control systems.

Any theory of alternative designs must include (a) an appropriate language for describing alternatives, (b) methods of analysis for relating system behavior to changes in design elements, and (c) methods for critically comparing the behavior of alternatives. Over the past two decades we have been reasonably successful in developing a theory of alternative designs that meets these basic requirements. The language for describing alternatives is provided by the S-system of differential equations discussed elsewhere in this volume. The methods of analysis consist of adaptations of conventional methods from control theory and newly developed algorithms specific for S-systems. The methods for making critical comparisons perhaps are less familiar and will be treated in some detail. Several applications of this theory to alternative designs for biochemical control are reviewed.

Animals↗

Alcohol dependence and depression: advance practice nurse interventions.

PURPOSE: To identify alcohol dependence, depression, and their comorbidity as common health problems in the United States. To emphasize advance practice nurse (APN) interventions including screening, treatment, and outcome evaluations for individuals and their families suffering with alcohol dependence and depression. DATA SOURCES: Scientific literature on alcohol dependence, depression, and their comorbidity as well as general systems theory. CONCLUSIONS: APNs have the opportunity to successfully intervene with individuals and their family with alcohol dependence, depression, and their comorbidity. These complex health conditions need to be screened for, treated, and evaluated to ensure positive outcomes for the individual and their family system. IMPLICATIONS FOR PRACTICE: APNs are in an excellent position to intervene at every contact with the individual and family with alcohol dependence and depression. Interventions aimed at the individual and family system are detailed in order to assist the individual and family to optimal health.

Adaptation, Psychological↗

A method for cross-sector priority setting. Gaps and hypotheses in malaria research: Tanzania.

This study proposes a new priority setting method for identifying critical information gaps in a multisector system. The method uses graph-theoretical concepts and principles of systems theory in characterizing the underlying information structure of the system. Its application is illustrated in the context of malaria control in Tanzania, drawing on the findings of a workshop held in October 2003 in Dar es Salaam. The workshop identified two critical pathways, EVHA and EVHPA, which warrant better understanding. The first suggests that the malaria research should generate information on the effects of environmental changes (E) on vector ecology (V) and then on the effects of V on human health (H) and then on the effects of H on agriculture (A). Interpreted likewise, the second pathway additionally points to the need for information on the effects of socioeconomic conditions (P) on A.

Health Priorities↗

On-chip microdialysis system with flow-through sensing components.

Microdialysis probes have been used for diabetes treatment as continuous monitoring system coupled to a glucose sensor. An on-chip microdialysis system with in-line sensing electrodes is demonstrated. As a first step towards greater biosensor integration with this miniaturized microdialysis system, a stacked system with in-line sensing electrodes was developed. Impedance electrodes sputtered within the microchannels were used to determine fluid electrical resistance from a dialyzed phosphate buffered saline (PBS) solution, which characterizes solution conductivity as a function of PBS concentration. The permeability of the membrane to the salt ions was obtained as 0.246+/-0.028 microm/s (15 nm pores). Subsequently, experiments measuring PBS dialysis in the time-domain at 64.4% recovery were conducted. The PBS concentration of the reservoir was changed in both a step response and sinusoidally with an 800 s period. The subsequently measured impedance indicates that the system is able to continuously track concentration changes in the reservoir with a 210 s system response delay. Most of this delay is due to the dead volume within the tubing between the syringe pumps and the microsystem. In addition, the predicted response was modeled using linear systems theory and matches the experimental measurements (r=0.98). This system is expected to have the proper sensitivity to track physiologically relevant concentration changes of biomolecules such as glucose (which has a physiological maximum change rate of approximately 4 mg/dl min with a periodicity of 1h or greater) with minimal lag time and amplitude reduction.

Electrochemistry↗

[Psychotherapy for schizophrenia].

Based on different theoretical concepts, psychotherapeutic methods in the treatment of schizophrenia reach from clinical pragmatism, psychoanalysis, learning theory, cognition and communication psychology to concepts of systems-theory. Both the German (DGPPN) and the American (APA) practice guidelines for the treatment of schizophrenic patients don't separate psychotherapy, social and rehabilitation measures strictly. So a specific psychotherapy for psychotic patients seems to be missing. A better relationship between patient and expert is fundamental for building up a ??? therapeutic liaison. For that purpose, the disease concepts of both sides must be carefully explained and integrated ("Basic psychotherapy").

Guidelines as Topic↗

The impact of managed health care in the United States on women with breast cancer and the providers who treat them.

This article describes how the increasing shift to managed care has impacted the treatment of women with breast cancer, from the perspectives of patients and providers. A descriptive exploratory pilot study was undertaken in a comprehensive cancer center in an urban northeastern city of the United States. The use of General Systems Theory is used to describe how the health care system has adapted to recent insurance changes. Qualitative interviews with patients,physicians, nurses, and business office staff reveal that the type of insurance did not affect treatment decisions. Findings from this pilot study, however, reveal that the increasing shift to managed care has resulted in a change in roles for nurses, fragmentation of care, and intangible costs to the patients.

Attitude of Health Personnel↗

Ecological factors associated with adolescent sexual activity.

Bronfenbrenner's (1979) ecological systems theory was used as an organizing framework for the research on teenage sexual activity. Per Bronfenbrenner's theory, the literature is discussed according to macrolevel (system-wide), mesolevel (immediate social environment), and microlevel (individual) factors that are associated with adolescent sexual involvement. Following the review, implications for social work are explored.

Adolescent↗

Controlling blood glucose: insights from an engineering control systems perspective.

In order to discern areas of potential improvement in various aspects of glycaemic control for patients with insulin dependent (type 1) diabetes mellitus, blood glucose control is analysed in the light of general engineering feedback control systems theory. This approach is based on models of the system being controlled, using appropriate control strategies. The models presently used for glycaemic control are analysed from this perspective, revealing certain limitations that they impose on the control strategies that use them. Current type 1 diabetes regimens are evaluated for the ease with which they may be analysed mathematically, suggesting areas where improvements in control may be effected by simplifying calculation of appropriate insulin quantities. A new model of undergraded insulin action, derived from established insulin action profiles, along with a control strategy which flexibly extends the basal/bolus regimen using patient-specific parameters, is proposed. This may provide the information needed to enable prediction of expected glycaemia several hours into the future, thereby enabling earlier corrective action to be taken should it fail outside the target range, and in turn potentially reduce the degree and frequency of both hyperglycaemia and hypoglycaemia.

Blood Glucose↗

Neuro-ontological interpretation of spiritual experiences.

The prevailing neuroscientific paradigm considers information processing within the central nervous system as occurring through hierarchically organized and interconnected neural networks. The hierarchy of neural networks doesn't end at the neuroaxonal level; it incorporates subcellular mechanisms as well. When the size of the hierarchical components reaches the nanometer range and the number of elements exceeds that of the neuroaxonal system, an interface emerges for a possible transition between neurochemical and quantum physical events. "Signal nonlocality", accessed by means of quantum entanglement is an essential feature of the quantum physical domain. The presented interface may imply that some manifestations of altered states of consciousness, unconscious/conscious shifts have quantum origin with significant psychosomatic implications. Healing methods based on altered states of consciousness and common in spiritual or shamanic traditions escape neuroscientific explanations based on classical cognition denoted here as "perceptual-cognitive-symbolic" (characteristic of ordinary states of consciousness). Another channel of information processing, called "direct-intuitive-nonlocal" (characteristic of non-ordinary states of consciousness) is required to be introduced for interpretation. The first one is capable of modeling via symbolism and is more culturally bound due to its psycholinguistic features. The second channel lacks the symbolic mediation, therefore it has more transcultural similarity and practically ineffable for the first one, though culture specific transliteration may occur. Different traditional healing rituals pursue the same end: to destroy "profane" sensibility. The ritual use of hallucinogens, the monotonous drumming, the repeated refrains, the fatigue, the fasting, the dancing and so forth, create a sensory condition which is wide open to the so-called "supernatural". According to contemporary anthropological views, the breakdown of ordinary sensibility/cognition is not the ultimate goal, but the way to accomplish healing, that is psychointegration in the widest sense. From the perspective of system theory, integration needs information to be brought into the system. According to the presented model, when the coping capability of the "perceptual-cognitive-symbolic" processing is exhausted in a stressful, unmanageable situation, or its influence is eliminated by the use of hallucinogens or in case of transcendental meditation, a frame shift occurs, and the "spiritual universe" opens up through the "direct-intuitive-nonlocal" channel. There is little chance either for a psychointegrative effect, or for a meaningful "opening" without ritual context, and with the recreational use of mind altering strategies. .

Cognition↗

Family interactions and sex education in the home.

Despite the tremendous growth of family systems theory in recent years, sex education within a family systems context has received little attention. This study examined patterns of interaction within the family and the possible relationship of these patterns to the amount of sex education occurring in the home. Ninety-six adolescents (ages 13-14, 43% male, 90% Caucasian) and the parents of 63 of them (61 mothers and 45 fathers) completed three questionnaires: (1) FACES-II, a measure which categorizes family interactions as Balanced, Midrange or Extreme based on the two dimensions of cohesiveness and adaptability; (2) the Parent-Adolescent Communication Scale; and (3) the Home Discussion Questionnaire, a measure of the amount of discussion about 17 sex education topics. Adolescents who reported open communication and satisfaction with family interactions reported significantly more sex education in the home. Although mothers' reports of sex education were not related to their perceptions of family communication or interactions, fathers who reported the healthiest family interactions also reported the most involvement in the sex education of their adolescent.

Adolescent↗

[Studies on theory and models of systemic conservation of animal and poultry genetic resources. I. Theory analysis of systemic conservation of animal and poultry genetic resources].

The concept and fundamentals of Systemic Conservation of Animal and Poultry Genetics Resources (SCAPGR) and mathematical models of genetic structure with conservation population were proposed. The SCAPGR regarded all genes of a given species in definite time and space as conservation object and live animal preservation combining with modern biotechnology as basic method. The SCAPGR might systematically conserve genes controlling the characters of a given species as well as regional varieties. In a no overlapping generation population with selection, mutation migration and random drift under consideration, two mathematical models presented in this paper might describe change of frequencies of multiple alleles at a locus and population mean of metrical characters resp.

Animals↗

Coordination of the EMS system: an organizational theory approach.

Emergency medical services (EMS) systems include autonomous organizations with high degrees of interdependence. The need to coordinate system participants has long been recognized but seldom achieved. This can be explained by organizational theory--specifically, the study of the relationships among organizations. Existing models identify the total system's functions, but fail to explain roles and relationships among the system's participants. Coordination among organizations is more difficult than coordination within an organization because of lack of an authority structure. The EMS system can be described as "a functionally interdependent system," consisting of multiple autonomous organizations with high degrees of interdependence in their technical functions. Communities have five potential management approaches, varying according to their aggressiveness. These are laissez-faire, where even voluntary coordination efforts are not tried; voluntary cooperation efforts, such as coordinating councils; external planning agencies without regulatory control; "framework organizations" with regulatory control over the system participants; and bureaucratization, placing the system participants within a single organizational hierarchy. The "multicratic organization" is a model for management of multiorganizational systems. A "system lead agency" plans joint activities and manages relationships among system participants in the way that the management of a uniorganization integrates departments. A lead agency is usually a unit of government or organized pursuant to government action, but a managed care organization can also fill this role. In extreme application of the model, the system is viewed as a framework and temporary modules are attached. Their interests are limited, as needed, to optimize the entire system. The lead agency sets policies affecting relationships of modules and policies crossing organizational boundaries.

Decision Making, Organizational↗