The relevancy of tenure in medical schools

PURPOSE: To determine whether the traditional teaching of placing the caudal border of the spinal field at the S2-S3 interspace in children receiving craniospinal irradiation (CSI) is appropriate. METHODS AND MATERIALS: Twenty-three children had magnetic resonance imaging (MRI) of the spine with gadolinium prior to craniospinal irradiation at one institution. Thecal sac termination using MRI was determined by drawing a perpendicular line from the point of convergence of dural margins to the corresponding vertebral body. RESULTS: Location of thecal sac termination varied from mid-S1 to low S3 vertebral body, with the most frequent site at the upper S2 vertebral level. Only 2 of 23 (8.7%) children had thecal sac terminations below the S2-S3 interspace. For the nine patients with neuraxis disease, none had thecal sac terminations below the S2-S3 interspace. In seven of the nine patients who had neuraxis seeding at initial presentation, MRI of the spine after CSI was performed and showed that thecal sac termination was lower after radiation therapy in two children, higher in one, and the same in four. CONCLUSIONS: In 2 of 23 children (8.7%), placement of the inferior border at the bottom of the S2 vertebral body would have missed the entire thecal sac. Treatment to the entire neuraxis with adequate coverage of distal spinal theca can be achieved by using MRI. Individualized spinal fields using the MRI may help minimize radiation scatter to the gonads while adequately covering the target volume.     

Historic and future health promotion contexts for nursing

Lumbar artery aneurysms are uncommon lesions that usually present as pseudoaneurysms secondary to vessel injury. Despite their small size and retroperitoneal location, these lesions are potentially lethal once they rupture. This report describes a ruptured lumbar artery aneurysm which was successfully treated in a minimally invasive fashion. The diagnosis was suggested by computed tomography scan and confirmed with angiography. Successful treatment consisted of placing intravascular metallic coils into the lumbar artery. The literature contains only seven previous reports of ruptured lumbar artery aneurysms and these were managed either operatively or via an endovascular approach. Based upon the outcome of all reported cases, we believe that coil embolization of lumbar artery aneurysms following diagnostic angiography is an appropriate and effective mean of treating these lesions.     

Health promotion ideology and nursing education

Nursing has been concerned primarily with the visible aspects of health promotion and has shown little regard for what is invisible. Yet the hidden ideology powerfully shapes current approaches to health promotion. This paper examines and makes visible the ideology of individual responsibility which is embedded in individualistic health promotion, the primary orientation to health promotion. Ways in which this ideology is perpetuated within nursing curricula are described. Concrete strategies are proposed that may be considered by nurse educators as they seek to prepare students in health promotion, with particular emphasis on strategies that highlight its ideological underpinnings.     

Infertility education in baccalaureate schools of nursing

The increasing number of couples who enter the current health care system for assistance with fertility needs warrants an examination of the ways nurse educators are preparing nurse generalists to meet those needs. A survey was conducted of baccalaureate nursing programs to determine what, if any, information was being presented on infertility. Analysis of data with a 50% return rate indicated most schools of nursing in this sample are in fact including some information on infertility in their curricula. What is interesting to note is only slightly more than half of respondents included information on the emotional and psychosocial issues of infertility, despite the fact that the greatest cost of infertility is the emotional one. One of the major concerns of infertile couples is health care providers, including nurses, do not seem to understand what they are experiencing. How do nurses obtain such understanding if they are not prepared in their educational program to do so?     

Faculty mentoring and administrative support in schools of nursing

This study investigated the relationship between senior nursing faculty mentoring activities and support for faculty mentoring provided by nursing program administrators. Eighty nurse administrators and 389 senior nursing faculty from NLN-accredited MSN programs completed questionnaires. Twenty-five percent of the faculty sample reported that they did not mentor junior faculty in their present work setting, while 75% reported being engaged in mentoring activities which focused on career and personal development. Mentoring activities reported by senior nursing faculty were not significantly related to the three levels of administrative support: (1) formal support, (2) conceptual support, and (3) no support. The majority of institutions expressed support for the concept of mentoring and nurse administrators used informal mechanisms to support faculty mentoring. Significant differences were found between the three different levels of support and two supportive activities used by nurse administrators to facilitate mentoring relationships: (1) to arrange gatherings, and (2) to provide funding for joint projects.     

A longitudinal analysis of organizational fairness: An examination of reactions to tenure and promotion decisions.

Most organizational justice research takes a cross-sectional approach to examining the relationship between perceived fairness and individuals' attitudes. This study examines the effect of procedural and distributive justice over time. It is suggested that individuals acquire more information and experience with procedures and outcomes over time. These changes in information and experience affect the influence of procedural and distributive justice on organizational attitudes. Faculty perceptions of tenure and promotion decisions were assessed 3 times (preallocation, short-term postallocation, long-term postallocation) over a 2-year period. Results generally supported the hypotheses. Procedural justice was most influential prior to and soon after outcome decisions were made. Distributive justice was most influential 1 year later. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychologists in medical schools—professional issues for the future: How are rank and tenure associated with productivity and satisfaction?

The authors surveyed a random sample of 293 psychologists employed as faculty members in medical schools to evaluate professional activities, academic productivity, and work satisfaction. A relatively high response rate (62%) was obtained. Medical school psychologists devoted significant amounts of time to clinical service (30%) and research (34%). Overall satisfaction was relatively high, and participants expressed substantial enthusiasm regarding the future of psychology in medical schools. When differences were examined by tenure track and academic rank, psychologists on the tenure track and full professors displayed the highest levels of productivity and satisfaction. This pattern continued when medical school psychologists ranked their satisfaction in relation to physician colleagues and faculty in university departments of psychology. Results are discussed within the context of the rapidly evolving health care delivery system and the future of psychologists in medical schools. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The teaching of diagnostic methodology in nursing schools]

The results of examining patients with parasagittal meningiomas were first compared by angiography and intraoperative ultrasound diagnosis. The significance of each method was defined. A correlation was found between the data obtained by the two techniques and the functional status of the upper sagittal sinus by taking into account each angiographic phase. It is concluded that intraoperative ultrasound diagnosis is of highly informative significance and it should be obligatorily used while removing parasagittal meningiomas in order to maintain the anatomic integrity of the upper sagittal sinus.     

Organizational effectiveness: toward an integrated model for schools of nursing

This study of the caregiving arrangements of 214 disabled elderly people in a large northeastern city found that the recipients of care were severely disabled, particularly in instrumental activities of daily living, yet had limited sources of informal care and used formal services minimally. The authors discuss the need to use a structural adaptation approach and to develop social services that are culturally sensitive and acceptable to both elders and their caregivers.     

The contribution of health promotion to community children''s nursing

In the past, a pre-electroconvulsive therapy (ECT) psychiatric evaluation focused on the question, "Does the patient have an ECT-responsive condition?" Technological advances, a broadening experience base with psychiatric patients with concomitant severe medical illness, and advances in ECT technique have led to the need for a more extensive pre-ECT assessment of the patient's psychiatric and medical status, including concomitant medications. A specific "ECT consultation" has evolved that builds on the basic components of the standard psychiatric consultation and extends to recommendations designed to maximize the safety and efficacy of ECT for each individual patient. This article briefly reviews the key components of the ECT consultation and provides an extensive update on important considerations in the use of combined ECT and psychotropic medications.     

Experiences of ethnic minority faculty employed in predominantly white schools of nursing

This qualitative study describes the bicultural experience of ten ethnic minority faculty employed in predominately white baccalaureate and higher degree nursing programs in the Southeastern section of the United States. Seven themes emerged from the data: (a) appraising, (b) proving, (c) fitting-in, (d) defending, (e) distancing, (f) being invisible, and (g) mentoring to describe their experience. Results also provided support for the authors' generated Bicultural Systems Model which evaluates why and to what extent a particular transaction or series of transactions between the person and the environment is perceived as stressful. The general perception among participants was that they were not fully accepted in the academic setting of predominately white nursing programs. As a result, some faculty were expending energy trying to convince others of their legitimacy; while others were choosing to distance themselves from the academic setting and white colleagues. This study indicates a need for dialogue between white and ethnic minority faculty to facilitate adoption of strategies that reduce the negative effects of the bicultural phenomenon.     

Hispanics and worksite health promotion: review of the past, demands for the future

During the last 15 years, reports, books, and published papers have demonstrated the positive health benefits of comprehensive health promotion and disease prevention interventions at the worksite. Although the progress made in worksite health promotion should not be understated, experts agree that it is time to step forward and address the new demands of the changing labor force. One area of intervention that needs to be more aggressively addressed is that of minority populations. Because work force projections show the high participation rate that Hispanics will have in the future labor force, the Hispanic population should be one of the targets of worksite health promotion. This paper reviews how employee health promotion programs have addressed Hispanic workers in the past and establishes directions for the future.     

Community action for health promotion: a review of methods and outcomes 1990-1995

Five repeated cross-sectional serological surveys of 790 dairy cattle in 4 dairy herds between December 1985 and February 1987 provided an opportunity to study the changes in the seroprevalence of Haemophilus somnus across the 5 surveys and with respect to some demographic and disease variables. The demographic variables included were age (heifers or cows) and farm, representing two groups of herds (two herds in each group, located in the Central and Northern Valleys of California). The serological status of cattle as either negative or positive against H. somnus, Campylobacter fetus and Leptospira hardjo were determined with enzyme linked-immunosorbent assays. Logistic regression analysis was used to compute maximum likelihood estimates of adjusted odds ratios and their respective 95% confidence intervals. The baseline risk of being H. somnus seropositive in the cattle observed at first sampling did not vary significantly during the study period after adjustment for the effects of covariates. Only at first sampling were cows about twice as likely to be H. somnus seropositive than heifers. At samplings 1 and 3, but not at 2 and 5, being in the herds of the Central Valley appeared protective. In contrast, at sampling 4 the cattle in herds in the Central Valley were about 7 times more likely to be H. somnus seropositive. C. fetus-positive cattle were about 3 times more likely to be H. somnus seropositive at sampling 1 only. The relationship between H. somnus status and L. hardjo was not significant during the study period.     

A review of the teaching of psychology in high schools.

Presents an overview of course and teacher characteristics, available teaching materials, the role of the American Psychological Association in this area, and existing research that assesses the effects of such courses on students. (2? p ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Study of immunization promotion against influenza in nursing homes and long term care facilities in Quebec

This study measured the rate of influenza immunization in nursing homes and long-term care facilities, and evaluated the effectiveness of a promotion program in reaching the national objective of 95% coverage. At the end of 1993, data were provided by 55 of the 79 nursing homes in the region of Montérégie, Quebec. The mean reported immunization rate was 78%, minimum 19% and maximum 100%. In 70% of cases, non-vaccination was due to patient refusal. In 1994, an intervention was carried out in a random sample of 28 nursing homes. Directors, chiefs of nursing and consulting physicians were informed of the coverage achieved in their institution in relation to the national objective. In addition, presentations were given to the nursing personnel and residents. These presentations were made by post-graduate medical students in 22 of the 28 nursing homes in the experimental group. No increase in the mean immunization rate was observed, indicating that it will be more difficult than expected to reach the desired level of coverage.