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PubMed2004

Spirituality: the basis for nurses' ethics.

A social crisis in both the labor and ecological systems constitutes a problem that requires the formulation of a new ethics for humanity. The social crisis is a result of the organizational model used by modern societies in the production of wealth and its unequal distribution. This intense inequality in wealth distribution contributes to a schism between populations. On one side an opulent and privileged society exists, and on the other a poor and downtrodden humanity. This crisis in the labor system stems from automated production methods, which devalue man's work and exclude him from contemporary society. The ecological crisis emerges from the dominance with which men have subjugated the Earth and its resources. Man has not acknowledged Earth's permutations and, therefore, has not taken the necessary caution of such changeability nor respected its effects. Such crises affect all populations and cry out for attention. Contemporary societies demand solutions to these questions. Nursing is a part and parcel of this yearning. In this setting, the nurse should be able to offer collaboration and solidarity with a project of creating a world ethos based on a minimum consensus amongst humans. Understanding and believing that spirituality is invaluable in this process, the authors of this work aim at addressing it as an essential dimension for nurses' ethics.

Ethics, Nursing↗
PubMed2004

Emerging role of EGFR-targeted therapies and radiation in head and neck cancer.

The treatment of head and neck cancer has been at the forefront of novel therapeutic paradigms. The introduction of drugs that interact with selective biologic pathways in the cancer cell has generated considerable attention recently. A wide variety of new compounds that attempt to target growth-signaling pathways have been introduced into the clinic. A majority of studies in the clinic have focused on epidermal growth factor receptor (EGFR) antagonists, but future studies will likely build upon or complement this strategy with agents that target angiogenic or cell-cycle pathways. EGFR activation promotes a multitude of important signaling pathways associated with cancer development and progression, and importantly, resistance to radiation. Since radiation therapy plays an integral role in managing head and neck squamous cell cancer (HNSCC), inhibiting the EGFR pathway might improve our efforts at cancer cure. The challenge now is to understand when the application of these EGFR inhibitors is relevant to an individual patient and how or when these drugs should be combined with radiation or chemotherapy. Are there molecular markers available to determine who will respond to EGFR inhibitors and who should be treated with alternative approaches? What are the mechanisms behind intrinsic or acquired resistance to targeted agents, and how do we prevent this problem? We need to formulate integrated laboratory/clinical research programs that address these important issues.

Antibodies, Monoclonal↗
PubMed2005

Transdermal androgens: pharmacology and applicability to hypogonadal elderly men.

Transdermal testosterone (T) gels have proven to be an efficacious means of delivering T to hypogonadal men. Patches, gels and creams have been used in T transdermal formulations. Patches suffered from problems either with adherence or skin irritability while gels have a potential problem of transferability from patients to partner or other family member. At present, gels have been well received by clinicians and users. There is no evidence that transdermal preparations are not suitable for treatment of older hypogonadal men; the rapid off time of both patches and gels may argue allow that transdermal preparations may be a preferential treatment modality for older men with a potential higher risk of developing androgen-responsive prostate cancer.

Administration, Cutaneous↗
PubMed2005

[The role of Wacława Moszyński in the development of the Polish School of Machine and Mechanism Theory].

The end of the 19th and the first half of the 20th centuries saw the emergence and intensive development of many disciplines in the technical sciences, and the laying of a groundwork for those disciplines in their current form. In Poland, a country deprived of independent statehood until 1918, this was additionally a period when native research centres and scientific schools came into being, and when Polish-language specialist literatures emerged as well. Many of the eminent personages whose activities contributed to those trends have already been described in biographical notes and articles. There are still, however, not enough studies dealing with the substance of their scientific and professional achievements. One of the personages in question was Wacława Moszyński, professor of the Warsaw Technical University, a pioneer of machine construction and mechanism theory, author of the first academic textbook in the field to be published in Poland. The current article discusses Moszyński's contribution to the development of mechanism and machine theory. The first part of the article gives an outline of the history of the discipline until 1945, presents the context of the after-war activities of the author, and evaluates his influence on the development of machine and mechanism theory in Poland; it also carries a short biography of Moszyński. The rest of the article is devoted to Moszyński's scientific achievements, and describes his approach to matters of structure, kinematics and dynamics, with special focus on those of his formulations and solution to problems that appear particularly innovative and original. The article also points out those proposals by Moszyński which made him a precursor of other disciplines, such as vibroacoustics, biomechanics and ergonomics. The paper also presents the role of Moszyński's work as a foundation for the development of the Warsaw research-and-teching centre in the field. The achievements and methods of the Warsaw school combined with the those of other centres in Poland, which based on the earlier Lwów tradition, thus leading to very significant research and educational accomplishments.

Engineering↗
PubMed2005

[Pharmacological treatment of hypercholesterolaemia in primary prevention. The use of the different sources of information].

In the first two articles of this series devoted to Evidence-Based Medicine, we have shown how to translate a clinical problem in a well formulated question and how to derive search terms from the PICO. In this article, we describe in more detail the different sources of information and how to use them. The strategy will be illustrated by answering the question whether it should be recommended to treat hypercholesterolaemia in a young woman without cardiovascular risk factors. In a following article, we will show how to adapt a search strategy to a specific question or PICO.

Adult↗
PubMed2006

[Evidence-based management of temporomandibular dysfunction. Think before you begin!].

Nowadays, dentists are expected to base their treatment decisions on the strongest available evidence. This so-called evidence-based approach has four steps: the formulation of a clinical problem, the search for evidence, the evaluation of the evidence, and the treatment of the patient. As part of this approach, the strongest evidence comes from systematic reviews, which are free of any author-related bias. Since working according to the principles of evidence-based dentistry is time consuming, dental schools should assist general practitioners through producing sufficient numbers of high-quality systematic reviews. The ever-increasing emancipation of patients stresses the need of adopting the principles of evidence-based dentistry. 'Think twice' should be the motto.

Dentistry↗
PubMed2006

[Protection against electromagnetic fields reports effects exerted on the environment].

This paper presents basic information about reports on the effects exterted on the environment. These reports are elaborated to meet the needs of administrative procedures concerning the evaluation of effects exerted on the environment and provide the basis on which decisions are made whether environmental determinants allow for issuing permission for taking up a given enterprise. The author discusses only a small part of a wider problem of the report formulation. Such issues as waste management, protection against noise, conservation of historical monuments and Natura 2000 areas are not raised.

Electromagnetic Fields↗
PubMed2006

Prevalence and occurrence of stress urinary incontinence in elite women athletes.

OBJECTIVE: 1) To assess the prevalence of stress urinary incontinence (SUI) and urge urinary incontinence (UTI) in elite women athletes versus the general female population, and 2) to analyze the conditions of occurrence of urine loss in search of etiological clues in elite athletes. DECISION: An anonymous self-questionnaire was collected transversally from women aged 18 to 35 years. The exposed group was composed of elite female athletes; the non-exposed group was made up of women in the same age range accepting to answer the questionnaire. RESULTS: A total of 157 answers from elite athletes and 426 from control subjects were available for analysis. Urinary incontinence prevalence was 28% for athletes and 9.8% for control subjects (p = .001). There was no significant difference in the relative prevalence of SUI between the athletes and control subjects. Athletes reported urine loss more frequently during the second part of the training session (p < 0.0003), and the second part of competition (p < 0.05). Urinary incontinence prevalence was 9.87% in physically-active control subjects versus 9.84% in sedentary control subjects (NS). Even a small quantity of urine loss was felt to be embarrassing. Most incontinent women did not dare to speak of their condition to anybody. CONCLUSIONS: There is a very high prevalence of urinary incontinence in women athletes. Detailed studies of the patho-physiology of this problem are necessary to formulate preventive recommendations.

Adolescent↗
PubMedDate not supplied

[Vinogradskiĭ and modern microbiology].

The 150th anniversary of the birth of Sergei N. Winogradsky is a special date for general microbiology. Apart from the discovery of chemosynthesis, the development of the elective method, the application of the direct method, and formulation of microbial ecology problems, Winogradsky, in his pioneering studies, addressed fundamental aspects of the naturalistic Weltanschauung from the position of a microbiologist who studies the role of microorganisms in nature. These problems are still important today. Expanding knowledge throws light on them from different angles of view and highlights them with varying degrees of completeness, but the problems remain beyond time. It may be useful for contemporary microbiologists to realize the extent to which they would recognize their own work in the system of questions and answers stated a hundred years ago.

Adaptation, Physiological↗
PubMed1991

A computational model for the overall pattern of ocular dominance.

In layer IV of the primary visual cortex, in both the macaque monkey and the cat, geniculocortical terminals representing the two eyes are segregated into alternating zones known as ocular dominance bands. Viewed tangentially, in the monkey these bands take the form of a series of branching parallel stripes that run roughly perpendicular to the border of striate cortex. In the cat, the overall ocular dominance pattern consists of irregularly branching, beaded bands that exhibit no predominant orientation. If the striking differences in the appearance of these two patterns reflect important differences in the basic rules governing cortical ocular dominance, then this poses a problem for attempts to formulate general principles of visual cortical organization. However, it has been suggested that the differences in the appearance of the ocular dominance patterns in these two species could result simply from known differences in the boundary conditions of their geniculocortical pathways. This article describes the formulation and testing of a single computational model that accurately predicts the quite dissimilar ocular dominance patterns in cats and monkeys. This model also generalizes to predict the different ocular dominance patterns observed in young and old three-eyed frogs, supporting the notion that the overall pattern of ocular dominance is governed by a common set of rules. The significance of these results is discussed in terms of previous models, which have focused largely on local processes underlying the development of ocular dominance segregation. Although the present model is not a developmental one, it does shed some light on potential mechanisms for establishing retinotopy in striate cortex and on possible developmental relationships between the geniculostriate pathway and intrinsic modularity of the striate cortex.

Animals↗
PubMedDate not supplied

[The nurse's role in a child psychiatric unit of St. Sophia Children's Hospital, Athens, Greece].

The role of the nurse in a child psychiatric unit is defined by the systems: a. Nurse-child b. Nurse-child-family c. Nurses-children d. Nurses-disciplinary team (a). In these systems the nurse: assesses the child, identifies the problems, sets the goals, provides care, educates the child. (b). Reinforces the parents' role, intervenes to help the relationships in the family. (c). Facilitates the team interactions and also the healthy behaviour in the peer group team, provides secure relationships. The nurse also functions as a reinforcement which leads to maturity. (d). The nurse is an equal member in the therapeutic team, is the link for communication and the main source for information. He participates in the organization and management of the team. Many nurses are specialized in psychiatric and child psychiatric nursing. All nurses believe in the continuing education and they attend various seminars. Through the activities in the unit the nurses have an update information on the subject of their work. Supervisions with educational character have been established for the nursing team. The nurse works on the base of the "special nurse-child" relationship and has the full responsibility of the child. The special nurse fulfills the nursing history. Systematic observation and evaluation are performed by the special nurse: he identifies the problems, sets the goals, formulates a programme, writes down and evaluates the results which means that he works with the implementation of the nursing process.

Child↗
PubMed1990

[A new topical preparation for the treatment of burns. I. Technical aspects of preparation].

In the present paper some problems connected with the formulation of a topical preparation of the hydro-ointment type intended for the treatment of deep dermal burns were examined. Sixteen ointment bases containing hydroxypropyl-methylcellulose, hydroxyethylcellulose, Carbopol 934 and Pluronic F-127 as gel-forming substances were evaluated. The local anaesthetic agents carbizocaine and lidocaine served as active ingredients. Suitability of ointment bases was evaluated on the basis of their liberating capability for drugs, rheological properties and washability. The results show that an increase in the concentration of the gel-forming substance in the ointment resulted in a decrease in carbizocaine liberation. A decrease in the released amount of drugs occurred also after an addition of a humectant additive to the ointment base. The local anaesthetic agents under study decreased the viscosity of ointment bases. The highest coefficient of washability was found in the Carbopol ointment base. From the viewpoint of administration, the base with 1% Carbopol, or a combined base with 2% Methocel and 0.5% Carbopol proved to be most suitable.

Anesthetics, Local↗
PubMed1990

[Treatment planning for patients with periodontal disease].

The planning and execution of dental treatment in patients suffering from (severe) periodontal disease has to be carried out thoroughly and systematically. Based on a proper diagnosis and prognosis (problem analysis), a temporary treatment plan (problem solution) will be formulated. The initial (periodontal) treatment is concluded with a reevaluation. After this new diagnosis, and if necessary adjustment of the original goal of the treatment plan, a definite treatment plan can be effected. Also in this plan, the therapy must be carried out in separate phases with evaluations in between. Primarily, the periodontal therapy must be finalized, after which the definite restorative-prosthetic treatment can be carried out. A good cooperation between the dentist, dental hygienist and patient is of prime importance to achieve a permanent result. The principles of periodontal treatment planning are discussed in this contribution.

Humans↗
PubMed1989

[Goal related observation of motor behavior in psychiatry].

The goals to be attained by the patients frequently are determined by the various professions in psychiatry solely before the background of their various specialities. The new observation tool--LOVIPT--is aimed at enabling an integrative approach to be taken, leading from purposive observation of problem behaviour to the formulation of therapy goals. The potential range of objectives is worded in such a way that they can be taken over by other disciplines as well. Development and scientific validation are described in some detail.

Arousal↗
PubMed1983

Behaviour therapy in phobic and obsessional disorders.

Behaviour therapy consisting of specific exposure in vivo is reviewed in terms of its clinical usefulness for the treatment of agoraphobia, obsessive compulsive neurosis and related conditions. A combined behavioural and psychological formulation of individual target problems is advocated. These can be rated in terms of discomfort, disability, and physiological indices of anxiety. Although discomfort and disability have been found to correlate, their relationship with anxiety measures is questioned. Variables affecting the outcome of exposure are reviewed, including: duration--best results with prolonged, frequent sessions over a short period; arousal--experience of high anxiety not essential; adjunctive cognitive therapy--considered to add nothing to effectiveness during exposure treatment. The author goes on to argue that simple response prevention is effective in reducing ritualising activities in obsessive compulsive neurosis, without effecting concomitant anxiety. Whereas anxiety responds independently to exposure therapy, and hence that the anxiety reduction model of obsessive compulsive neurosis is inadequate. The putative anti-obsessional properties of clomipramine are questioned, and the utility of imipramine in agoraphobia is disputed.

Agoraphobia↗
PubMedDate not supplied

Methadone maintenance: past, present, and future.

Since first developed by Dole and Nyswander, there have been significant changes in the clinical use of methadone, based on evaluation of the initial programs and a better understanding of the psychology and pharmacology of addictive behavior. Treatment has evolved from Dole's original concept that methadone "blockaded" the euphoric effect of heroin to current usage which reflects a greater appreciation of methadone's ability to prevent the development of withdrawal symptoms and to moderate intense affective states. The successes and limitations of methadone maintenance are best appreciated in comparison with alternative treatment modalities including therapeutic communities and detoxification. Program administrators face unique pressures because of the need to resolve the often contradictory goals of patients, staff, community groups, law enforcement officials, government regulators and funding agents. The evolution of effective treatment models has been greatly impaired by these pressures. Clinicians must become more effective leaders in helping to resolve these problems and to help formulate more rational drug abuse treatment policy.

Attitude↗