The preferable future for nursing

As a part-time work-based degree with students registered from all parts of the United Kingdom, and potentially from abroad, the Bachelor of Science (BSc) in Medical illustration does not have assessment in the conventional form as used by full-time courses undertaken in a university. It incorporates the expertise of medical illustrators actually working in the profession. The unique nature of the Institute of Medical Illustrators (IMI) and Glasgow Caledonian University (GCU) BSc has required the development of an assessment system that satisfies the quality assurance demands of both the awarding and professional body. This paper details the system devised to meet the needs of the provision and to ensure consistent assessment.     

The future of nursing homes.

Suggests that the significant changes in the age demography of the US are reflected in the growth of nursing home care. The most recent change has involved the aging of the oldest portion of the aged population, the group that is most likely to need skilled nursing home care. The need for skilled nursing facilities to develop rehabilitation programs is emphasized. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The future of tropical medicine in Europe. Opportunities for intersectoral cooperation

The author provides a brief history of tropical medicine and describes how it has evolved since its creation at the end of the 19th century. The author proposes a working definition of tropical diseases, including their geographical distribution and their socioeconomic conditions prevailing in these regions. Currently tropical medicine is in danger of fragmenting into a number of subspecialties or being absorbed into the subspecialties of other medical sectors. The broad interdisciplinary nature of tropical medicine may be its weakness, but also its particular strength. The effective interplay between four major areas of work makes it different from other specialties. These are biomedical sciences, medical care, epidemiology and the social sciences. This intersectoral approach should also lead to stronger synergisms between scientists in Europe and institutions in the South.     

The use of benevolent power in nursing care

In response to estrogen the rat cervical epithelium undergoes squamous metaplastic changes, progressing from a resting state through a proliferating, secretory stage and finally to a cornified stage before sloughing or being reabsorbed. The transition from a secretory to a cornified epithelium is preceded by a dramatic reduction in the expression of the cellular retinol binding protein (CRBP). The associations among retinoids (retinol and retinoic acid), CRBP expression, and estrogen-induced keratinocyte differentiation were explored in cultured cervical epithelial cells. Retinoids supported proliferation of cervical epithelial cells expressing basal keratins. Alone, estrogen had no effect on proliferation and enhanced expression of keratins characteristic of stratified cervical epithelial cells. When added together, estrogen prevented retinoid effects on proliferation, whereas retinoids prevented the estrogen-enhanced expression of differentiation-associated cytokeratins. When CRBP expression was repressed by elevating intracellular cyclic AMP levels, the ability of retinol, but not retinoic acid, to block estrogen-induced changes in keratin expression was severely compromised. These results support a critical role for CRBP in cervical cell responsiveness to circulating retinoids (primarily retinol). We hypothesize that retinol inhibits estrogen-induced keratinization of the cervical epithelium, and the drop in CRBP level results in transient vitamin A deficiency within cervical epithelial cells, permitting the orderly transition from the secretory to the cornified stage.     

The overprotection of neurosurgeons jeopardizes future neurosurgical care

In some areas of the world the next generation of neuro-surgeons is fa facing a serious problem. The training of an inappropriately large number of neurosurgeons will lead to underemployment/unemployment, which will have a direct impact on the quality of neurosurgical care. The following statistical data relate to local phenomena but reflect dilemmas to be considered by the international neurosurgical community since they exist in many countries.     

The challenges of a care information system reflecting holistic nursing care

In this article two recent developments in the German health care system are outlined. On one side, an increasing economic pressure and legal changes on the German health care system lead to growing computerization in German hospitals. On the other side, a shift from functional to holistic nursing is observed. The question is raised if within the paradigm of holistic nursing computer support is an adequate way to organize and design work. The newly developed German care information system, PIK (Pflegedienst im Krankenhaus--Nursing service in hospital), serves as an example for a program that is structured according to the nursing process. On the grounds of this exemplification it is argued that within the concept of "technology as an option" not only is the design of a program important but also its basic work organization and design. The authors come to the conclusion that computer support of holistic nursing is possible. However, it is shown that some aspects of nursing (for example, intuitive knowledge, which has been identified as an integral part of expert nursing) cannot be formalized and thus cannot be supported by computer systems.     

Philosophy of nursing: future directions

At a time when psychiatric nurses in Australia face the changes brought about by the transfer of nursing education to the universities, it is timely to reconsider the knowledge base of the profession, not from the perspective of any one theoretical position, but by reflecting on a fundamental division in the way nursing is thought about. Many nurse theorists argue for a shift away from conceptions of nursing based on medicine and science. The alternative, idealism, brings with it a new set of problems, particularly the tendency to react against the perceived dominance of the medical profession instead of positing a philosophy of nursing that reflects a more considered response. The argument developed here begins by aligning medicine and related conceptions of nursing with materialism. This leads to a consideration of the relevance of philosophical positions on the nature of body and mind, that is then linked to the assumptions of medicine and nurse theorists. Introduction of the concepts of holism and interactionist dualism follows. The implications of these concepts for psychiatric nursing are drawn out by using conceptions of the objective and rational. Finally, it is argued that interactionist dualism enables psychiatric nurses to be sensitive to the experiences of patients while still acknowledging the importance of objective knowledge.