The politics of nursing. Interview by Ian McMillan

Using the retrograde axonal marker transport it was shown that in dog nucleus accumbens medial and lateral segments receive similar projections. Cortical ones receive projections from mesocortical (prelimbic, infralimbic, orbital, insular and cingular) cortical fields, whereas subcortical receive projections from ventral tegmental field and basal nucleus of amygdala. The differences between projections of nucleus accumbens studied are that apart from the above-mentioned common afferents medial segment receives projections from allocortical (entorhinal, periamygdalar) fields and subicular portion of hippocampal formation while lateral segment receives projections from all dopaminergic portions of substantia nigra.     

Improving nursing practice with staff education: the challenges of dysphagia

The 15 million Americans who experience some degree of dysphagia risk choking, airway obstruction, aspiration-related pulmonary disease, and/or death. These complications increase mortality, morbidity, length of hospitalization, and healthcare costs, but may be preventable through nursing intervention. Fifty-four nursing care workers (NCWs) from medical/surgical units in two acute care hospitals were assigned by convenience to two experimental groups and a control group. Experimental groups A and B participated in an educational program on dysphagia designed to increase their knowledge of dysphagia, knowledge attention, and the number of dysphagic patients identified and referred. Group B received deliberate reinforcement of program content over a 1-month period. The educational intervention had a significant effect on knowledge level and knowledge retention, immediately and at 1-month posttest in both experimental groups. NCWs applied what they learned to clinical practice as evidenced by an increase in the number of patients identified as being at risk for or experiencing dysphagia. Reinforcement of program content did not affect the outcomes. The study has implications for staff educators and nursing personnel who care for persons at risk for dysphagia.     

Challenges and benefits of ethical small-community practice.

Ethical dilemmas and boundary challenges are parts of daily life for psychologists who live and practice within small communities. Although rural psychologists are most readily identified as “small-community psychologists,” there are a number of other settings that can be considered small communities—colleges, communities of color/ethnicity/culture, lesbian/gay/bisexual/transgender (LGBT), military, faith-based, feminist, criminal justice and corrections, suburban, disability, deaf/hearing impaired, chemical dependency, school districts, sport psychology, graduate training programs, and therapists who see other therapists as clients. Psychologists in these small communities strive to balance a traditional individualist perspective with a need to participate in and contribute to the overall wellness of the community in which they live and work. The 3 invited commentaries provide additional depth through their perspectives on rural, LGBT, and Latina/o community practice. Their insights model thoughtful and contemporary practice that challenges, enriches, and educates the larger field of ethical psychological practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Anthroposophical medicine: a nursing perspective. Interview by Joanna Trevelyan

Despite its popularity on mainland Europe, particularly in Germany and Switzerland, anthroposophical medicine remains relatively unknown in the UK. Joanna Trevelyan takes a closer look at this truly holistic form of medicine, and asks Frances Bay, one of the founders of the Anthroposophical Nurses Association in Great Britain, what it can offer nurses.     

Funding nursing education: the Medicare dilemma. Interview by Cheryl Slagle King

A total of 110 patients of symptomatic otomycosis was investigated, prospectively. Aural swabs were collected on 1st, 7th and 14th day and examined by direct microscopy and culture for fungi. Of these, 80 patients found to be having pure fungal infection, were taken up for mycological and therapeutic study. Fungi belonging to genus Aspergillus were isolated in 76 (95.0%) patients of which Aspergillus niger was the commonest isolate in 46 (57.5%), followed by A. flavus in 27 (33.7%), A. fumigatus in 3 (3.7%), Candida species in 3 (3.7%) and Mucor in 1 (1.2%). The patients were of all age groups but majority were between 21 and 30 years and the male-female ratio was equal. Of the total of 40 male patients, twenty-one were Sikhs using turban. Before developing the symptoms, forty five patients used oil, mixture of oil and garlic juice, antibiotics, steroids, antiseptics or wax solvent as ear drops. Only two patients were diabetic. No patient had fungal infection elsewhere in the body. The patients were called for regular follow-up for three weeks. In forty cases mercurochrome was applied as the antifungal agent after cleaning the external auditory canal, in twenty-three clotrimazole and in rest of the seventeen patients miconazole was used. On 7th day, only 11 (13.7%) patients grew different fungi in culture. They became symptom-free on 14th day and no fungal material could be seen on otoscopy, direct microscopy or culture. Mercurochrome was found to be most effective in these patients.     

Spirituality and practice. Stories, barriers and opportunities. Interview by Laurence A. Savett

What are "spiritual matters?" Are "spiritual matters" the same as "religious matters?" What is spiritual inquiry? Are such questions appropriate for those of us in the caring professions, other than clergy, to consider? If we accept that role, how far should we go? When should we call for help? Whom should we call? We convened a gathering of a hospital chaplain, a social worker, a hospice nurse and a physician to discuss many of the dimensions of spirituality and then to apply their personal and professional paradigms of care to a discussion of an actual case. This article is a record of that conversation. It is actually several articles in one, for it deals with their own views of the meaning of spirituality, the degree to which their spirituality has impact on their practice, what they see as the merit of spiritual matters in the caring professions, barriers to collaboration among their professions and to addressing these issues with patients, and boundaries beyond which one should not go. One way to read this conversation is to include yourself; that is, to reflect on the points the participants make and the ways in which you might integrate their insights into your personal practice. We hope that you find this task worthwhile and that it provokes further thought and discussion. The discussion began with participant introductions.     

Methodological challenges encountered in summarizing evidence-based practice.

This paper details the challenges encountered by authors summarizing evidence from a primary study to describe a treatment's effectiveness using an effect size (ES) estimate. Dilemmas that are encountered, including how to calculate and interpret the pertinent standardized mean difference ES for results from studies of various research designs, are described. Recommendations are offered to authors of primary studies and to those conducting summaries of primary studies. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Addressing key challenges in evidence-based practice in psychology.

With its promise of enhancing the effectiveness of services, evidence-based practice in psychology (EBPP) appears to offer much to psychologists, patients, and policymakers. The purpose of this article is to examine some of the key challenges facing psychologists who wish to provide evidence-based treatment services, including how research evidence is used in EBPP, whether the results of the treatment research literature can be generalized to typical clinical practice, and how effective evidence-based treatments are in clinical practice. On the basis of recent evidence-based initiatives and treatment research, there is a solid scientific basis for EBPP, although much more research is necessary on the treatment of relatively mild, but common, clinical conditions and on the transporting of evidence-based treatments into clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The new nursing scientist. Interview by Tonny van de Pasch]

Till nowadays the diagnosis of biliary and pancreatic ducts disorders remains to be rather difficult. Cholangioscopy is the only method, that gives an opportunity of visual evaluation of the ducts. The results of 234 retrograde peroral pancreatico-cholangioscopies (RPCS) in 149 patients are analysed. 2 systems of the "Olympus" endoscopes, including both "mother" and "daughter" apparatus with uncontrolled (model PF-24, external diameter 2.4 mm) and controlled distal tip (model CHF B 20, external diameter 4.5 mm) were used for the tests. Endoscopic papillosphincterotomy has been performed in 87 of the patients, who were later on tested with RPCS (147 tests). 38 RPCS have been performed in 29 patients after transduodenal papillosphincterotomy. 47 cholangioscopic procedures have been undertaken in 31 patients after various types of biliodigestive anastomoses. In 2 cases RPCS has been performed after the balloon dilatation of the major duodenal papilla. The signs of catarrhal cholangitis have been observed in 27% of the cases. Purulent cholangitis was present in 13.4% of the patients. Cholangitis was detected in 19.5% of the cases in long-term follow up after endoscopic papillosphincterotomy; in 88.2% of such cases catarrhal inflammation of duct's mucosa was observed. It is stated that after endoscopic surgery cholangitis is observed 2.5 times less frequently, than after relevant transduodenal procedure.     

Clinical electives: the challenges and benefits of student choice

Traditionally, students have not had the opportunity to exercise choice over the specialty and location of their clinical placements. This is now changing but it requires the wholehearted commitment of students, their lecturers and all those in the institutions concerned. The innovation has to sit coherently within the largely externally prescribed curricula approved by the National Boards, the professional arm of conjoint validation processes. The challenges are many, but the benefits can be immeasurable. This article describes the experiences of one university in managing and planning these initiatives and examines students' responses to them. Significant questions are raised about developments for the future.