SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
OBJECTIVE: To explore how and what Australian and American registered nurses working in critical care and high-dependency units initially learn about the life-sustaining medical devices they use as well as the consequences of device use both for patients and staff. DESIGN: Cross-sectional survey with a mailed questionnaire. SETTING: Large midwestern American tertiary care center and two large South Australian tertiary care centers. SUBJECTS: Thirty-two American registered nurses who worked in critical care and 127 Australian registered nurses who worked in critical care, coronary care, and high-dependency units. RESULTS: The most frequently identified initial method of learning both for Australian and American registered nurses was trial and error (taught self). A significantly larger proportion of American nurses initially learned to use a life-sustaining device by watching a video or slide tape, whereas a significantly larger proportion of Australian nurses received instruction in nursing school. At least 90% of Australian and American nurses indicated they initially had learned the same four facts about the device: its purpose, its function, how to respond to the alarms, and how to operate it. A significantly larger proportion of Australian nurses indicated that they had learned about the potential hazards for patients than did their American colleagues. The potential consequences of using any medical device were nurse stress and patient harm. The two reasons most frequently cited by Australian and American nurses for stress were fear of harming the patient and being unsure how to use the device. Of the Australian and American nurses combined, 12.3% indicated they had used a medical device that had harmed a patient. CONCLUSIONS: Australian and American registered nurses were more similar than dissimilar in terms of how and what they learned about the life-sustaining devices they use in direct patient care, in experiencing stress when using medical devices, and in having used a device that caused patient harm. Differences in how they learn may be a reflection of marketing and inservice support by manufacturers and basic and highest levels of nurse education. The latter may also account for differences in what Australian and American nurses learned. The results emphasize that nurses must be knowledgeable about the devices they use on behalf of patients. More knowledge about the devices they use in direct patient care might decrease nurse stress.
Explore the source record for details and available documents.
BACKGROUND: African-American adults are more likely than white adults to desire the continuation of life-sustaining medical treatment (LSMT) at the end of life. No studies have examined racial differences in parental end-of-life decisions for neonates. OBJECTIVE: To collect preliminary data to determine whether differences exist in the choices made by parents of African-American and white infants when a physician has recommended withholding or withdrawing LSMT from their infant to develop hypotheses for future work. DESIGN/METHODS: A retrospective chart review of African-American and white infants who died in an urban neonatal intensive care unit (NICU) over a two-year period. Charts were abstracted for demographics, cause of death, and documentation of meetings where the physician recommended withholding or withdrawing LSMT. RESULTS: Thirty-eight infant charts met study criteria (58% African-American, 42% white). Documentation of physician recommendations to limit LSMT was present in 61% of charts. Approached families of white infants agreed to limit LSMT 80% of the time compared to 62% of the families of African-American infants. CONCLUSIONS: In this pilot study, parents of African-American and white infants appeared to make different end-of-life choices for their children. A larger study is needed to confirm these findings and further explore contributing factors such as mistrust, religiosity, and perceived discrimination.
Explore the source record for details and available documents.
For years, many of the nation's Indian tribes struggled to provide high-quality healthcare for their members. But that's all changing as the tribes parlay gambling revenues into new clinics, nursing homes and a variety of health programs.
Explore the source record for details and available documents.
Previous estimates of life expectancy in the United States have not corrected for biases in population and mortality data, and no study has examined life expectancy in U.S. Asian/Pacific Islander and American Indian populations. We used information on population undercounts by race/ethnicity in the census and on misclassification of race/ethnicity on death certificates to calculate life expectancy for black, white, American Indian, and Asian men and women in the United States in 1990. Correction for undercount and misclassification had little effect on life expectancy estimates for whites, but it substantially decreased estimates for American Indians and Asians. Asian men had life expectancies of 82.0 years and Asian women 85.8 years--the highest life expectancies reported for any population in the world and beyond the limit predicted by some current theories.
"This article examines the immigration and settlement patterns [in the United States] of immigrants from Latin America. It places Latin American immigration in historical perspective in order to understand the components of the contemporary flow. Settlement is examined through a series of attitudinal and behavioral variables with the goal of assessing the levels of attachment of Latin American immigrants to life in the United States. In addition to data from the Immigration and Naturalization Service and the Census Bureau, it reports previously unpublished findings from the National Latino Immigrant Survey and the Latino National Political Survey."
The United States has an extensive statistical system that generates hundreds of indicators of the health and economic status of its population components. Yet, there is no consensus about how different indicators should be weighted and interpreted to judge the absolute and relative progress of black Americans. Neither a "melting pot" nor a "polarization" model adequately describes the conflicting areas of gain, pervasive stagnation, and substantial loss in racial equality of life.
The life expectancy of African Americans has been substantially lower than that of white Americans for as long as records are available. The life expectancy of all Americans has been lower than that of all Canadians since the beginning of the 20th century. Until the 1970s this disparity was the result of the low life expectancy of African Americans. Since then, the life expectancy of white Americans has not improved as much as that of all Canadians. This article discusses two issues: racial disparities in the United States, and the difference in life expectancy between all Canadians and white Americans. Each country's political culture and institutions have shaped these differences, especially national health insurance in Canada and its absence in the United States. The American welfare state has contributed to and explains these differences.
This paper examines healthy life expectancy by gender and education for whites and African Americans in the United States at three dates: 1970, 1980 and 1990. There are large racial and educational differences in healthy life expectancy at each date and differences by education in healthy life expectancy are even larger than differences in total life expectancy. Large racial differences exist in healthy life expectancy at lower levels of education. Educational differences in healthy life expectancy have been increasing over time because of widening differentials in both mortality and morbidity. In the last decade, a compression of morbidity has begun among those of higher educational status; those of lower status are still experiencing expansion of morbidity.
The influx of around thirty million European immigrants into the United States in the relatively short time of a little more than a hundred years (1815-1920's) created a great challenge for the American people in their efforts to build a strong society. The newly arrived immigrants had the challenge of assimilating into a new culture and the native Americans found the supremacy of the Anglo-Saxon culture, upon which they hoped to build the ideal society, challenged by the various cultures of the immigrants. To see how both the native Americans and the immigrants faced this problem, three theories, the total assimilation theory, the melting pot theory, and the multi-cultural theory or cultural pluralism are investigated. My own reasons for thinking that the American society has not and will not become a melting pot and what I think is the best way for a heterogeneous society to strive to become an ideal society are presented in the conclusion.
There has been much speculation recently in both the popular and professional literature about the status of the American family. Accounts of family life in the United States are generally pessimistic, focusing on high divorce rates and other indicators of instability. This paper briefly examines the development of research on the family. The state of the contemporary American family is then discussed, pointing especially to indicators both of the family's stability and the family's ill health. Finally, some speculations are presented about future directions for research in the field.
Explore the source record for details and available documents.
Explore the source record for details and available documents.