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PubMed1991

Foundations of nursing's perspectives on health education.

Nursing is one of the many diverse disciplines on which health education draws for theoretical perspectives, research, and practice tools. It brings more than a 130 year heritage of practice with individuals, groups, institutions, and communities toward the goals of restoring, promoting, and maintaining health. Nursing's more recent history of theory development and research, in which relationships are examined between persons, their environment and health, is especially germane to the art and science of health education. In nursing, health education is one of a large repertoire of intervention actions nurses take to support healing, caring, and health with individuals, families, groups, organizations, and communities. The theoretical foundations of these actions characterize the nursing domain and guide research and practice. In this paper, several theoretical frameworks from nursing and health education are examined to bring their perspectives more clearly into focus for the mutual advance of both fields.

Health Education↗
PubMed1991

Mayo Foundation Electronic Results Inquiry, the HL7 connection.

Rapid access to patient information is critical for care in both inpatient and outpatient settings. Ancillary systems (Lab, Microbiology, Electrocardiogram (ECG), Echocardiography, etc.) contain test result information. Mayo Foundation is piloting an Electronic Results Inquiry System (ERIS), using the Phamis Lastword database, that aggregates some of this information into a central location. The results may then be accessed by workstations or forwarded to surgical, critical care, and transplant information systems. All communications messages, except for the workstation interface, will be based on the Health Level 7 (HL7) specification, version 2.1. The specification has benefitted Mayo by shortening interface design effort and providing common messages between various computer systems. At this time, HL7 is the most practical solution for these interfaces[1]. HL7 gives all parties involved in the interfaces a "blueprint" to begin design. Unlike a formal blueprint, the specification is flexible and handles most of the needs encountered to date. The areas in which the specification was lacking were reported to the HL7 working group. These areas have been addressed by the working group to allow completion of the interfaces described here. This paper describes the HL7 interfaces to ERIS, with the ECG result and client query interfaces emphasized.

Clinical Laboratory Information Systems↗
PubMed1991

Theodor Kocher and the Scientific Foundation of Wound Ballistics.

The systemic and rational approach used by Kocher, coupled with his interest in research of wound ballistics for more than 40 years, resulted in a clear elucidation of the principles that form the basic scientific foundation of modern wound ballistics. The validity of his work has been proved repeatedly on the battlefields of the world for more than a century. Presently, more than ever before, the sound scientific precepts revealed by Kocher are essential to keep technologic investigation within the framework of good judgment.

Firearms↗
PubMed1990

Dealing with geographic variations in the use of hospitals. The experience of the Maine Medical Assessment Foundation Orthopaedic Study Group.

Orthopaedists and other physicians in Maine organized the Maine Medical Assessment Foundation to deal with the problem of variations in the rates of hospitalization for orthopaedic conditions. Five musculoskeletal injuries and five orthopaedic procedures were selected for study. The variation in decision-making by orthopaedists was least for fractures of the ankle and fractures of the hip and was greatest for fractures of the forearm, derangement of the knee, and lumbosacral sprain. The rates in an area tended to be consistently high or low for the same treatments. The major reasons for the variations appeared to be related to lack of agreement about optimum treatment. Feedback of data to physicians on variations in patterns of practice reduced the variations.

Ankle Injuries↗
PubMed1990

Philosophical foundations of nursing practice.

This chapter examined how nursing has conceived itself historically and how this conception has changed. It is our contention, along with some of the authors discussed, that this issue is of paramount importance in structuring how a nurse responds to a moral dilemma and which obligations have primary or greater weighting. The empirical studies contained or referred to in Holfing et al. and Murphy substantiate that these conceptions do make a determinative difference in how nurses make ethical decisions. How nursing is viewed and its role relationships defined has been variously referred to as model, role conception, or philosophy of nursing. The significant point is that this forms the philosophical foundation of nursing and has profound ethical implications. The now dominant philosophy is that of client advocacy. However, as the articles indicate, ambiguity about just what advocacy entails and misgivings about the direction nursing has taken by those within and outside of nursing do exist. The next chapter presents still more conceptions of client advocacy and problems associated with it.

Ethics, Nursing↗
PubMed1990

[The clinico-morphologic foundation of the modern pathogenetically oriented surgery of hydrophthalmos simplex].

On materials of 45 biopsies dissected at the time of antiglaucomatous operations and 10 eyes of newborns, a detailed morphologic analysis of the state of the drainage apparatus of the in norm and at relatively early stages of hydrophthalmos simplex is presented, and considering results of clinical investigations (105 eyes, of them 45 eyes mentioned) a foundation of modern surgery of congenital glaucoma is given. It is shown that the basis of congenital pathology of retinocorneal angle is disturbance of anatomotopographic relationships of its structures as well as expressed trabeculodysgenesis and dysgenesis of scleral sinus. The paper describes three main variants of combinations of pathologic changes in the drainage apparatus, characterized by a common gonioscopic picture and reflecting the degree of severity of congenital pathology (3 degrees of goniodysgenesis). It is noted that the presence of a coarse congenital pathology of trabecular plexus in hydrophthalmus, incompatible with the possibility of its functioning, and at the same time a satisfactory enough state of the "scleral sinus-emissary" link allow to consider the basic element of surgical reconstruction of anterior outflow passage to be trabeculotomy from outside. Indications in the choice of adequate surgical intervention and its volume are shown (the degree of goniodysgenesis and the state of functional preservation of scleral sinus and emissaries). The approved, within 15 years, system of operations in case of hydrophthalmos simplex and their results are presented.

Biopsy↗
PubMed1990

Cancer risk among children of atomic bomb survivors. A review of RERF epidemiologic studies. Radiation Effects Research Foundation.

This article summarizes recent epidemiologic studies of cancer risk among the children of atomic bomb survivors conducted at the Radiation Effects Research Foundation. These children include two groups: (1) the in utero-exposed children (ie, those born to mothers who had been pregnant at the time of the bombings of Hiroshima and Nagasaki) and (2) the F1 population, which was conceived after the atomic-bombings and born to parents of whom one or both were atomic bomb survivors. Although from 1950 to 1984 only 18 cancer cases were identified among the in utero sample, cancer risk did appear to significantly increase as maternal uterine dose increased. However, since the observed cases are too few in number to allow a site-specific review, the increased cancer risk cannot be definitively attributed to atomic bomb radiation, as yet. For those members of the F1 population who were less than 20 years old between 1946 and 1982, cancer risk did not appear to increase significantly as parental gonadal dose increased. Follow-up of this population will continue to determine if the patterns of adult-onset cancer are altered.

Abnormalities, Radiation-Induced↗
PubMed1990

Cancer risk among atomic bomb survivors. The RERF Life Span Study. Radiation Effects Research Foundation.

This article summarizes the risk of cancer among the survivors of the atomic bombing of Hiroshima and Nagasaki. We focus primarily on the risk of death from cancer among individuals in the Life Span Study sample of the Radiation Effects Research Foundation from 1950 through 1985 based on recently revised dosimetry procedures. We report the risk of cancer other than leukemia among the atomic bomb survivors. We note that the number of excess deaths of radiation-induced malignant tumors other than leukemia increases with age. Survivors who were exposed in the first or second decade of life have just entered the cancer-prone age and have so far exhibited a high relative risk in association with radiation dose. Whether the elevated risk will continue or will fall with time is not yet clear, although some evidence suggests that the risk may be declining. It is important to continue long-term follow-up of this cohort to document the changes with time since exposure and to provide direct rather than projected risks over the lifetime of an exposed individual.

Acute Disease↗
PubMed1989

Texas Medical Foundation strives for quality medical care.

Since implementation of Medicare's prospective payment system, the emphasis of medical peer review organization (PRO) activities is quality health care in the appropriate setting. The Texas Medical Foundation's dedication to quality health care is evident in its quality review, in its information to the medical community, and in its challenges for physicians to utilize contemporary techniques in medical practices. TMF is committed to the integrity of the medical profession and to its role as a physician-directed means of assuring efficient and quality inpatient services. TMF hopes that physicians will view the PRO for what it is: an advocate of excellence in the medical community.

Humans↗
PubMed1989

[100 years of medical practice in the mountain region of Ticino. I. Development of a health policy following the foundation of the canton].

This essay covers the milestones of health care development in the canton Ticino from its foundation in 1803 reviewing the first attempts for legislation in the medical field to the endorsement of a cantonal health-care amendment covering the fields of health insurance (mandatory or private), the financial basis of insurance carriers, the remuneration of medical acts and global strategies for health care delivery (up to the remotest mountain areas).

Delivery of Health Care↗
PubMed1989

[The oral hygiene, dental health and prosthetic care of old age home pensioners and geriatric patients. A study at the Adullam Foundation in Basel].

To determine the current state of oral hygiene, dental health and prosthetic appliances among residents of nursing homes and geriatric hospitals, 100 nursing home residents and 53 hospital patients with an average age of 82 were interviewed and examined in the Adullam Foundation in Basle. Only about 30% of those questioned expressed problems related to chewing, and only about 15% were dissatisfied with their dentures. Hardly any material other than toothbrush and toothpaste was used for dental hygiene. Only 38% of the nursing home residents and as few as 15% of the hospital patients brushed their teeth three times daily. A good 46% of the nursing home residents still possessed at least one original tooth. The incidence of plaque was categorized as high. In more than 86% of the cases, flaws were determined in removable prosthetics. Dental treatment was considered immediately necessary in 2% of the cases and necessary in 41%. In order to improve oral hygiene and dental care among aged nursing home residents in Switzerland, a list of suggestions has been compiled.

Aged↗
PubMed1989

A cross-reference table between the Protein Data Bank of macromolecular structures and the National Biomedical Research Foundation-Protein Identification Resource amino acid sequence data bank.

The National Biomedical Research Foundation-Protein Identification Resource (NBRF-PIR) and the Protein Data Bank at Brookhaven National Laboratory (PDB) both contain protein sequences. We have prepared a cross-reference index of the sequences in these data banks, and compared the data. Of the 270 cases of sequences of the same protein appearing in both data bases, for only 31% are the sequences identical. This is often the result of a difference in the state of maturation of the proteins rather than experimental error. Nevertheless is useful to be aware that the sequence information in these two data archives should not be regarded as redundant.

Amino Acid Sequence↗
PubMed1978

Coronary artery surgery in Australia, 1974-1976. A report by the National Heart Foundation of Australia.

This is a report of the total Australian experience in coronary artery bypass graft surgery over a two year period from October 1, 1974, to September 30, 1976. It provides data on the results up to discharge from hospital. There were 2349 patients undergoing operation in 9 units in all mainland States. Each of the nine participating units reported preoperative data on age, sex, symptoms, previous history, indications for surgery and special investigations including results of X-ray examination, electrocardiography (ECG), ventricular and coronary angiograms and left ventricular end diastolic pressure as well as details of surgery which was carried out, and patient status at the time of discharge. The data were collated and analysed at National Heart Foundation headquarters in Canberra.

Adult↗
PubMed1985

The role of non-prosthetic surgery in the treatment of rheumatoid arthritis by fusions and auto-arthroplasties. Current practice at the Rheumatism Foundation Hospital, Heinola.

After the introduction of modern artificial joints the classical operation methods, such as osteotomies, arthrodeses and auto-arthroplasties, have been forced aside little by little. Irrespective of the late complications following replacement surgery, the patients today expect a movable, painless endoprosthesis, which at it best seems to benefit the patient. The question arises whether the classical methods still have a role in the surgical treatment of rheumatoid arthritis. The reply is "yes", they do have a fair share of rheumatoid surgery, indeed. They still compete with the modern endoprosthetic surgery for the place of the primary operation in many cases. To give instances, tarsal reconstruction by subtaloid arthrodesis is superior to other methods and arthrodesis of the wrist is often only reasonable way to get a strong, painless key joint to the hand. Even the shoulder arthrodesis may successfully compete with an endoprosthesis. Also classical auto-arthroplasties such as resection arthroplasties of the metacarpophalangeal and elbow joints are serious rivals of respective endoprostheses. The practice of Rheumatism Foundation Hospital (RFH) in the golden mean between the endoprosthesis enthusiasts and their opponents will be described in this article. The practice varies greatly from clinic to clinic and is progressing--and regressing--all the time.

Ankle Joint↗
PubMed1985

Robinson-Patman update: De Modena v. Kaiser Foundation Health Plan.

The findings in a case dealing with price differentials for drugs purchased for members of a health maintenance organization (HMO) are presented. In the case of De Modena v. Kaiser Foundation Health Plan, community pharmacists in California and Oregon claimed that sales of drugs purchased at special prices by Kaiser-Permanente Medical Care Program for its members constituted price discrimination as interpreted by the United States Supreme Court decision in Abbott Laboratories et al. v. Portland Retail Druggists Association, Inc. A United States Court of Appeals ruled in favor of Kaiser, holding that the HMO was purchasing drugs for its "own use" and thus qualified for exemption from the provisions of the Robinson-Patman Antidiscrimination Act. The implications of this decision are discussed in light of corporate restructuring and diversification of services by hospitals. Evaluation of the overall health-care mission of a health-care organization rather than strict application of the Portland decision may be used to identify permissible uses of drugs purchased at special prices by these organizations.

California↗
PubMed1985

Trends in hip dysplasia control: analysis of radiographs submitted to the Orthopedic Foundation for Animals, 1974 to 1984.

From 1974 through 1984, the Orthopedic Foundation for Animals evaluated 143,218 radiographic submissions representing 151 breeds of dogs. All breeds from which there were 35 or more evaluations had some frequency of dysplasia. Seventy breeds, each with over 100 submissions, were tabulated and ranked according to frequency of hip dysplasia. Frequency of dysplasia varied from 0.6% in the Borzoi to 46.9% in the Saint Bernard. These data were compared with data obtained earlier (1966 to 1973) on evaluations in 38 breeds for changes in frequency. There was significant (P less than 0.05) reduction in frequency of dysplasia in 27 breeds, a significant (P less than 0.05) increase in frequency in only 1 breed (German Shorthaired Pointer), and no significant change in frequency in 10 breeds. The median significant decrease was 22.4%, and the range was from 3.1% in the Chesapeake Bay Retriever to 48.7% in the Keeshond. The reduction in frequency of hip dysplasia demonstrated the value of a control program. There were 5 breeds with a significant (P less than 0.05) decrease in frequency of dysplasia that had over 5,000 evaluations from 1974 to 1984. The decreases in frequency were independent of changes in American Kennel Club registrations for these breeds (a dramatic decline in registrations for the German Shepherd Dog and Old English Sheepdog, and a dramatic increase for the Rottweiler, Golden Retriever, and Labrador Retriever). Frequency regressed linearly in the German Shepherd Dog and Old English Sheepdog, but regressed nonlinearly in the other 3 breeds. The percentage reduction in frequency from the base frequency (1966 to 1973) for these breeds was 17.5% for the German Shepherd Dog, 23.1% for the Old English Sheepdog, 9.1% for the Rottweiler, 10.1% for the Golden Retriever, and 6.8% for the Labrador Retriever.

Age Factors↗
PubMed1966

A statistical review of malignant testicular tumours based on the experience of the Ontario Cancer Foundation Clinics, 1938-1961.

For the 827 patients with malignant testicular tumours registered at the Ontario Cancer Foundation's regional clinics in the period 1938-1961, the probability of surviving for five years after treatment was 59.8%; for the 731 patients who received all or part of their initial treatment at the clinics or were not treated anywhere, five-year survival probability was 62.7%. Most deaths from testicular cancer took place in the first two years after treatment, and 90% of recorded recurrences were diagnosed before the third anniversary. Survival rates were strongly influenced by histological type and extent of disease, and to some degree by age. Survival did not seem to be closely correlated with delay after first symptom, site or size of primary lesion, ectopia, surgical treatment of the abdominal nodes, site or dosage of radiation, or chemotherapy. The survival rates in this series of cases compare favourably with those of other large series.

Adolescent↗