Noninvasive pacing: what you should know

Noninvasive pacing is a valuable therapy in emergency cardiac care. The more experience clinicians have with the noninvasive pacing procedure, the greater their confidence and the easier the job becomes. Effective troubleshooting during pacing becomes less problematic with increased experience with the therapy. Noninvasive pacing allows rapid initiation of emergency pacing and "buys time" to stabilize the patient and plan further care.     

Introduction to the special section on what every psychologist should know about assessment.

The article notes discrepancies between typical practices in the development and utilization of psychological tests and current knowledge about assessment noted by the authors in this special section. Reasons for this failure of innovation diffusion are considered. The need to make routine use of the assessment knowledge presented in this series of articles is noted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient-focused care: what managers should know

This study investigated varieties and incidence of abnormal physiological conditions in acute schizophrenic patients on emergency. Laboratory data obtained prior to treatment from patients, admitted on an emergency basis during an 18-month period, were evaluated retrospectively, as well as demographics and clinical characteristics. Of 259 male acute schizophrenic patients (ICD-10: F2), 6.9% revealed dehydration, a third had hypokalemia and leukocytosis, and two thirds showed elevated serum muscle enzymes. These percentages were statistically significant compared with those of outpatients. In addition, the former three of these conditions in the F2 group were as frequent as those in alcohol and/or psychoactive substance abusers (ICD-10: F1) on emergency admission, although elevated serum muscle enzymes in the F2 group was less frequent than that in the F1 group. In order to prevent these abnormal physiological conditions from worsening and becoming life-threatening, one fourth of the F2 group [dehydration, 6.9%, severe hypokalemia (< 3.0 mEq/l), 2.3%, and markedly elevated serum muscle enzymes (creatine phosphokinase > 1000 IU/l), 16.5%] required medical management such as fluid therapy and various types of monitoring. In cases of a behavioral emergency, laboratory screening and monitoring of urinary output were essential. Due to their lack of cooperation, case history, physical examination, and initial vital signs did not contribute to detection of their medical condition.     

What every perioperative nurse should know about customers

Adult mosquitoes were collected from 3 areas in northern Thailand with different availabilities of rice fields for larval habitats by using blacklight, truck, and pig-baited traps. Culex tritaeniorhynchus Giles and Culex gelidus Theobald were dominant in all samples. Significant study-area differences were found in light and truck trap collections for Cx. tritaeniorhynchus and Cx. gelidus, but not for Culex vishnui Theobald + Culex pseudovishnui Colless. In pig-baited sample area differences were significant only for Cx. gelidus. Adults of Culex fuscocephala Theobald were relatively rare, comprising only 0.6-7.9% of the total mosquitoes collected. When compared with the results from previous studies in the Chiangmai area, we conclude that Cx. fuscocephala has become a minor species and that changes in the mosquito fauna have occurred in northern Thailand.     

Child abuse and dentistry: what you should know

Dentistry must become more aware of its moral, legal and ethical responsibilities in recognizing and reporting child abuse and neglect. All dental professionals must be aware of the seriousness of the problems of child maltreatment, and understand that children do not just get hurt in abuse and neglect, they often die as a direct result of their maltreatment. It has been said that victims of child abuse and neglect fall into only two categories--those who lived through it, and those who did not.     

Acne. What every pediatrician should know about treatment

Acne is one of the most common and easily treated diseases of adolescents. Scarring can be prevented in most cases with early and vigorous treatment. But such treatment requires patience, skill, and a commitment to good counseling.     

Seven abdominal assessment signs every emergency nurse should know

BACKGROUND: Open or laparoscopic surgery for gastroesophageal reflux disease gives longterm freedom from symptoms in 83-100% of cases but has a certain percentage of complications. This study was undertaken to evaluate the early and late complication rates after primary or repeat antireflux operations. STUDY DESIGN: The records of all patients who underwent surgery for gastroesophageal reflux disease during a 32-year period at a university teaching hospital were reviewed retrospectively. Records for 793 adults (448 men and 345 women) aged 16-85 years (mean, 51) were retrieved for calculation of complication rates and statistical analysis. RESULTS: A total of 827 operations were performed: 793 primary and 41 for recurrent disease (2 patients were each reoperated on twice). There were 49 laparoscopic operations. Only two patients died (mortality, 0.3%), both after open operation. Morbidity was 24% after open surgery and 14% after laparoscopic operation. The total (early and late) complication rate was higher after reoperations than that after open or laparoscopic procedures. The overall complication rate in the open operations was similar in the first and the third decade of the study, namely, 24.6% and 26.1%, respectively. CONCLUSIONS: Surgical treatment of gastroesophageal reflux disease carries very low mortality when performed in a specialized unit. The main causes of morbidity after open operation are infectious complications. The incidence of complications is substantially lower after laparoscopic surgery than after open operation. Reoperation is seldom required, but it carries higher morbidity than the primary operations.     

Psychiatric medication: what the occupational health nurse should know

1. Occupational health nurses need a general knowledge of psychiatric medications to work effectively with clients and their off site health providers. 2. Acquiring an understanding of the major classes of medications--anti-psychotic, anti-anxiety, anti-depressant, and antimanic--is important. 3. It is helpful to understand under what conditions and with which conditions psychotropic medications are helpful.     

Counseling for physical activity: what primary-care physicians should know

In Connecticut, 22.1% of the adult population report no physical activity other than activities of daily living. Primary care physicians can play a vital role in the flight against a sedentary lifestyle. As outlined in Healthy People 2000 and the Surgeon General's Report on Physical Activity and Health, the primary-care physician's role in the assessment and advising of physical activity is critical. The primary-care physicians that responded to the Connecticut survey appear to be doing an excellent job in delivering this important message. Recommendations made by the primary-care physician can be a great source of motivation for the patient. The primary-care physician's initial goal should be to get the patient active on a daily basis and than progress to more health-based fitness goals. The patient needs to receive instruction on goal setting, safe exercise tips, and adherence strategies. The primary-care physician's low-cost intervention of advising physical activity can help prevent medical problems in the future. The most current recommendation on physical activity states that, "All U.S. adults should accumulate 30 minutes or more of continuous or intermittent amounts of moderate-intensity physical activity on most, preferably all, days of the week." This latest recommendation offers primary-care physicians a broader range of activities to suggest to their patients. An overwhelming number of research studies indicate that physical activity is a powerful weapon in combating a host of lifestyle-related health problems.     

Kennedy/Kassebaum: what physicians should know about this new law

Pretreatment of milk with either sodium or calcium polystyrene sulfonate resins is useful in limiting potassium dietary intake in children with renal failure. We therefore studied the in vitro effects of Kayexalate and Calcium Sorbisterit on potassium, sodium and calcium concentrations in 3 standard formulas and in human milk. It is concluded that wide variations in the final potassium, sodium and calcium concentrations can be observed according to the resin but also to the formula.     

Clostridium difficile and older adults: what primary care providers should know

Clostridium difficile poses particular risk for older adults, who are subject to more serious symptoms than younger patients. Antibiotic exposure and other risk factors are associated with the pathogenesis of C. difficile-associated disease. Treatment goals include prescribing anti-C. difficile activity agents (when indicated), attending to volume status and prescribing oral rehydration therapy as needed, avoiding the use of antiperistaltic drugs, discontinuing any offending antibiotics, avoiding the indiscriminate use of broad-spectrum antibiotics, providing supportive therapy, following infection control protocols, and eliminating environmental contaminants.     

Test construction in the 1990s: Recent approaches every psychologist should know.

The article summarizes the current state of the art in test construction and contrasts it with previous conceptual models, some of which are wrong or misleading. In particular, new methodologies for item selection and review are presented as well as current thinking on the specification of technical characteristics of tests. (PsycINFO Database Record (c) 2010 APA, all rights reserved)