Nurse anesthesia educational programs, 1991-1997.
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Biomedical subjects
Publications and source records attributed to B J Horton.
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OBJECTIVE: To investigate wool organophosphorus concentrations resulting from a range of farm pesticide application methods. DESIGN: Random sampling of wool for pesticide residues and on-farm interviews to determine associated treatments. PROCEDURE: Tasmanian fleece wool lots were sampled at random and tested for organophosphorus residues. The grower was identified and the pesticide treatments applied to the sheep were ascertained by on-farm interview. RESULTS: The residue concentrations showed a large variation that was not accounted for by differences in treatments by growers. Organophosphorus concentrations were proportional to the number of treatments applied, and inversely related to the time between pesticide application and the subsequent shearing, and were significantly influenced by the method of application. After allowing for the time of application, plunge dipping resulted in pesticide residue concentrations 2 to 2.5 times greater than shower dipping, using spray races or hand jetting, and the use of these methods caused larger residues than the use of jetting races. CONCLUSIONS: We recommend that plunge or shower dipping should not be used more than 7 weeks after shearing, nor at higher concentration than the standard dose rate used for lice control, whereas jetting may be satisfactory for up to 7 months after shearing, provided only one application is administered.
This information was originally presented during the AANA Annual Meeting in August 1996. Accreditors and educators are urged to plan for the future and maintain quality education by anticipating changes in the work and educational environments. Successful adaptation to change will be critical to the future of education and accreditation. A number of factors serving as catalysts to change are described.
Program directors from 90 accredited nurse anesthesia programs in the United States and Puerto Rico were surveyed concerning multicultural issues. This article summarizes the identified needs of clients and student nurse anesthetists from culturally diverse backgrounds. Noteworthy findings include the perception that clients were more disadvantaged than students because of differences in socioeconomic status; the fact that about half of the programs provided students with instruction on cultural differences; and the observation that specific units of instruction within courses were the most frequent way of giving instruction in this subject area.
Closures of nurse anesthesia educational programs and a resulting shortage of nurse anesthetists were the focus of a study by the National Commission on Nurse Anesthesia Education. This study occurred simultaneously with the implementation of an accreditation requirement for the submission of Annual Reports by the Council on Accreditation of Nurse Anesthesia Educational Programs (COA). Both groups recognized a need for routine collection of information about educational programs and the result was a cooperative effort between the AANA Education and Research Department and the COA to establish a computer database for public purposes. This article reviews the need for information, describes the Annual Report, and explains the functions and creation of the database.
Although millions of anesthetics are administered by Certified Registered Nurse Anesthetists (CRNAs) every year, all CRNAs are not trained in the actual administration of regional anesthesia. Some individuals believe that all students should receive this instruction while enrolled in nurse anesthesia education programs. This belief has resulted in the Council on Accreditation of Nurse Anesthesia Educational Programs being encouraged to adopt an accreditation requirement for the administration of regional anesthesia by students. Clinical experience in administration would supplement experience in managing regional anesthetics and didactic instruction that students do receive. This study identified the current practices in nurse anesthesia programs related to the administration of regional anesthesia by students and reasons for supporting or opposing an accreditation requirement.
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Causes of preweaning mortality were examined on a large intensive piggery. Diagnosis was made using comprehensive clinical histories combined with post-mortem data. Two thousand four hundred and twenty-six piglets were born in 238 litters. Pre-parturient and parturient losses were 2.9% and 5.4% of the total numbers of piglets born. Birth to weaning mortality was 11.3%. Among piglets born alive, overlaying was the most frequent cause of death (2.1%), followed by deaths due to diarrhoea (1.7%), anaemia (1.2%), savaging (1.1%) and losses of small weak piglets (0.9%). Most deaths, including stillbirths, were associated with below average birth weight, and two-thirds of all deaths of liveborn pigs occurred within 4 days of birth. Increased litter size resulted in decreased birth weights, an increased percentage of stillborn piglets and mummified foetuses, but duration of parturition was not affected. Stillborn piglets were born late in the litter and after a longer interval between pigs born (interpig interval). Over 70% of deaths due to overlay were in previously healthy piglets, but some were associated with illness of the sow (18%) or both sow and piglet (3%). Savaging was confined mainly to first parity sows and was responsible for 20% of all deaths in these litters. Sixty-two per cent of all piglets with a birth weight of less than 800g were stillborn or died before weaning compared with 18.7% mortality for all piglets. Anaemia in piglets was considered to be due to umbilical haemorrhage. Anaemic piglets had a 36% mortality to weaning compared with 10% for non-anaemic piglets.(ABSTRACT TRUNCATED AT 250 WORDS)
Polioencephalomalacia (PEM) induced in sheep was compared with the disease found in naturally occurring cases. Blood biochemical indicators measured were pyruvate, lactate, glucose, erythrocyte transketolase (TK) and stimulation of TK by addition of thiamine pyrophosphate (TPP effect). Faeces and rumen contents were assayed for thiaminase activity. The effect of treating affected sheep with thiamine was also noted. It was found that amprolium treatment could induce thrombocytopenia, but once the sheep became accustomed to amprolium in the diet they seemed to be resistant to this effect. In sheep receiving amprolium significant weight losses preceded the onset of clinical signs. Further weight loss continued throughout the recovery period despite removal of amprolium from the diet and treatment with thiamine. Blood glucose was variable, and was elevated only when marked clinical signs were present. Pyruvate and lactate levels showed marked variation throughout the trial. TK values were depressed and TPP effects increased well before the onset of clinical signs, although some naturally occurring cases had normal levels. Faecal thiaminase activity was negligible in all the sheep on the amprolium trial but most field cases had a high level. High faecal thiaminase was observed in about 5% of clinically normal animals from affected flocks. Depression of erythrocyte TK activity coupled with the presence of faecal thiaminase appeared to be the most reliable diagnostic biochemical parameters for PEM. Treatment of PEM affected sheep with thiamine rapidly brought the biochemical status of the animals to normal. However where advanced brain lesions were present the damage was permanent and such sheep treated with thiamine remained partially decorticate.
We have carried out a survey to determine the prevalence of carriers of pyruvate kinase deficiency haemolytic anaemia in Basenjis in Victoria. Of 186 dogs tested, 20 were found to be carriers for pyruvate kinase deficiency, a prevalence similar to that reported overseas. Of the 20 carriers found, 17 were born in Australia and were traced directly to 1 of the 3 imported carriers. Despite the relatively high frequency of carriers, no mating of 2 carriers has yet been detected and no dogs with haemolytic anaemia have been observed. The inheritance of the pyruvate kinase deficiency has been traced through up to 5 generations of dogs in Australia and is consistent with co-dominance for pyruvate kinase activity and with an autosomal recessive gene for haemolytic anemia.
Several laboratory tests that are currently used for the diagnosis of lead poisoning in man were evaluated for the detection of lead poisoning in sheep given 3 or 10 mg Pb/kg body weight/day for 7 weeks. Urinary porphyrins and basophilic stippling of erythrocytes were not sensitive indicators of lead poisoning in sheep, while urinary lead and urinary delta-aminolevulinic acid concentrations were too variable to have diagnostic value. However, erythrocyte delta-aminolevulinic acid dehydratase was strongly inhibited by exposure to relatively low doses of lead, while blood lead concentrations gave an indication of the level of exposure to lead poisoning.
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The relative rates of sterol synthesis in the liver, ileum, and lung of the guinea pig have been studied by measuring the incorporation by tissue slices of 14C-labeled acetate into digitonin-precipitable sterols. The liver showed maximum incorporation of acetate at pH 6.5, the ileum at pH 7.5, and the lung at pH 6.0. The incorporation of acetate approached the maximum rate at a concentration of 10 mM with the liver and lung and 5 mM with the ileum. Using these conditions of assay, sterol synthesis was measured in the liver, ileum, and lung of four groups of guinea pigs killed at 6-hourly intervals. Depending on the time of day, the rate of sterol synthesis in the ileum was from 6 to 14 times that in the liver, while in the lung the rate was up to 3 times that shown by the liver, Additional studies showed that all regions of the small intestine synthesized sterol at a higher rate than the liver, with the highest rate of synthesis occurring in the ileum. The rates observed in the adrenal, testis, muscle, adipose tissue, and skin indicated that these tissues are not quantitatively important sites of sterol synthesis in the guinea pig.
Male and female guinea pigs maintained under controlled lighting and fed ad libitum exhibit a diurnal fluctuation in feed intake. This is characterised by periods of increased eating activity at the beginning and end of the light period and in the middle of the dark period. However, the feed consumption for the light and dark periods is similar. If the normal lighting cycle is retarded by 6 h, the guinea pigs adjust their diurnal rhythm of eating in the new cycle within 8 days. Similar findings in female rabbits have previously been reported from this laboratory.
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