Nursing at the crossroads

Crossroads is the term used to describe nursing's decisional grid in the post health care reform era. Four avenues of practice are laid out. Nursing's decision about clinical pathways will contribute to the future of professional nursing and help shape health care delivery.     

Penicillin at the beginning

Many deaths among hospital survivors of acute myocardial infarction are due to sustained ventricular tachycardia and ventricular fibrillation. This has prompted the evaluation of prophylactic antiarrhythmic drugs and devices. Although it is widely agreed that antiarrhythmic treatment is useful, it is not certain which therapy provides optimal results. Increasing recognition of the efficacy of amiodarone has prompted the design of several trials of the drug. This paper focuses on primary prophylactic antiarrythmic therapy in the post-infarction setting and particularly on recent amiodarone trials.     

Resuscitation at the roadside

This article summarizes what to do in the event of an emergency outside the dental surgery. It gives a simple and easy to follow guide to preserving life at the roadside when only minimal equipment is available. The fundamental principles of resuscitation will enable the practitioner to save a life in a situation when it is easy to forget the basic techniques in sheer panic. The training of the dental practitioner is an advantage in these uncommon but difficult situations when literally seconds count.     

Medicine at the fringes

Until the new Act is in operation, and assuming it has strong and clear sections covering competence, the Medical Council of New Zealand is left with the need to manage unorthodoxy as a form of misconduct unless there is a mental health problem. Charges of misconduct unless there is a mental health problem. Charges of misconduct may arise of there is: harm to patients inadequate information and consent including false representation of the theoretical base of diagnostic method or management, or the training of the doctor, short cuts in the standard methods of diagnosis with the use of unproven and unrecognised methods, treatment programmes that are inappropriate, unjustified, unproven or unsupported by a substantial body of opinion, or that omit consideration if orthodox methods. exploitation in terms of securing patients, financial gain and inadequate aftercare.     

School psychology at the University of Texas at Austin.

Describes the development of a university school psychology (SP) program, which began in 1962 as a component of a counseling psychology program. In 1965, the author became director of the SP program. Objectives were to have a leadership role in the field of SP, facilitate both school- and non-school-based career opportunities for nontraditionally educated and trained school psychologists, contribute to the upgrading of doctoral SP, and push for more extensive institutionalization of doctoral SP in public schools. The curriculum has come to encompass more eclectic theoretical foundations. Three reasons are noted for why the program has been successful: its attraction of outstanding students and preparation of graduates for leadership roles, departmental support and breadth, and financial support from the National Institute of Mental Health. (23 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neurosurgery at the State University of New York at Buffalo

We treated five patients with auricular deformities (microtia in microform and group IIB or III constricted ears) using the following procedure: nearly all of the contralateral conchal cartilage was resected, grafted, and sutured to supplement a cartilaginous deficit and to keep the supporting frame of conchal cartilage expanded by the double banner flap method. After this, a soft tissue deficit was reconstructed by our newly developed method of covering the defect with a triangular flap superior to the auricle by making a skin incision and a rhomboid flap anterior to the auricle. So far, we have obtained satisfactory results using this one-stage procedure.     

Allergy to Ficus benjamina: at the workplace and at home

In four patients, two women aged 40 and 42 years and two men aged 49 and 37 years, type I allergy to Ficus benjamina was established. Two patients had been sensitized by contact with these pot plants at their homes. The other two patients were plant growers. F. benjamina is a non-flowering, currently very popular pot plant to be found in both private houses and public buildings. The symptoms comprise itching and swelling of the eyelids, tears, running nose, wheezing and dyspnoea. In one plant grower contact urticaria progressing to dermatitis of the hand was the main symptom. Only one patient had a clear-cut atopy. Both plant growers showed a cross-allergy to other Ficus species. Two patients had a cross-allergy to latex and the associated cluster of tropical fruit (banana, kiwi, avocado, and chestnut). Removal of the ficus plants from the homes and change to another crop or to another occupation completely resolved the complaints of these patients.     

Cracks at the ferrite-austenite interface

Bulk specimenss for three point tests are produced from explosion clad austenite-ferrite material by electron beam welding bulk austenite and bulk ferrite to the respective surfaces. By milling, spark-erosion and fatigue cracks are introduced at and parallel to the interface in these specimens. At −30°C the crack extension force is the same for interfacial and bulk cracks in the ferrite. At room temperature the crack extension force for interfacial cracks is half of that for bulk ones, for suinterfacial cracks it lies between the two extremes.     

Coaching at the top.

Presents a systems-oriented approach to the leadership development of top-level executives. A structured program is described that is designed to have a positive impact at the organizational level through focused work with the individual client. Leadership effectiveness is seen as strongly influenced by the individual's past, personal life, and work environment. Comprehensive information gathered from the client's work life and personal life increases understanding of behaviors that influence performance, and thereby fosters change. Development is perceived from a holistic point of view, with benefits to the organization accruing through increased effectiveness in any areas of the client's life. A case example (of a 40-yr-old male) is given to illustrate how this approach is put into effect. (PsycINFO Database Record (c) 2010 APA, all rights reserved)