Friends of nursing: a strategy for transforming the community-nursing relationship.
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Biomedical subjects
Publications and source records attributed to D D Walker.
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Return to work is considered to be a criterion of a good outcome after a myocardial infarction or coronary revascularisation procedure. In general, return to work is not necessarily correlated with cardiac state; a variety of psychological, social and economic factors influence whether or not the individual will return to gainful employment. Psychological variables to be considered include the reactions of patient and family, their understanding of the illness, the personality and behavioural characteristics of the patient, expectations of the results of treatment and attitudes towards disability. These will be influenced by aspects of the job itself or the working environment as perceived by the patient. Physicians' attitudes are strong factors in influencing the final decision on whether or not the patient goes back to work. Employers and fellow employees, by their attitudes to the illness, will also influence the decisions. It follows that assessment and management of psychological problems must be part of total patient care after a coronary event if the optimal number of patients are to return to work, confidence of their ability to cope with its demands. Though the actual way in which assessment is made and appropriate treatment undertaken may vary considerably, a study of available knowledge enables general guidelines on these aspects to be given.
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The Barbash strain of spotted fever group rickettsia was reexamined in this study by the microimmunofluorescence test with mouse antisera and with monoclonal antibodies. Protein immunoblotting was performed for comparison of purified antigens of R. rickettsii, R. sibirica, R. conorii and Barbash strain. Comparison of Barbash strain, R. rickettsii (Sheila Smith strain), R. conorii (Malish 7 strain), and R. sibirica (strains 232, 246 and Jinghe-74) of the spotted fever group in the microimmunofluorescence test of Philip et al. revealed that Barbash strain has antigens that yield homologous titers with the R. conorii strains and differ from R. sibirica and R. rickettsii. Monoclonal antibodies specific for R. conorii react at identical titres with the Barbash strain, and a monoclonal antibody specific for R. sibirica does not react with the Barbash strain. Likewise, T-cell hybridomas reactive with R. conorii but not R. sibirica yield a strong response when stimulated by Barbash strain antigens. Western immunoblotting with the same polyclonal and monoclonal antibodies confirmed the presence of specific protein antigens of R. conorii and different protein antigenic composition of R. sibirica when compared with Barbash strain. Thus, Barbash strain is a strain of R. conorii.
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The complexities of today's nursing unit, and especially the ICU, require greater interunit cooperation than ever before. As the complexity of the ICU structure increases, so does the potential for interunit conflict and organizational strain.
Men engaged in breaking or reinstating road surfaces are exposed to vibration from mechanical tools. In view of the lack of epidemiological information on vibration white finger in such a population, a survey was carried out to identify the prevalence of symptoms of white finger in a sample of men using these tools in the gas industry and to compare the prevalence with that found in a control group not occupationally exposed to vibration. Altogether 905 men (97%) in the gas industry and 552 men (92%) in the control group were interviewed, using a questionnaire from which the presence or absence of white finger symptoms from all causes was noted. The prevalence of white finger was 9.6% in the group exposed to vibration at work compared with 9.5% in the control group. The prevalence in the former group when adjusted for age differences between the survey and control populations was 12.2%, but this difference did not reach statistical significance. In case the approach of comparing prevalences of white finger from all causes might have obscured any contributory effect of vibration, the prevalence of white finger was examined in relation to the number of years vibrating tools had been used, this being the only measure of exposure to vibration available. No direct association was found between the prevalence of symptoms and number of years vibrating tools had been used. In view of this and the absence of a significant excess of white finger symptoms in the group using vibratory tools, the authors conclude that vibration white finger is not a special problem in the gas industry. Nevertheless, experimental tests carried out on the different types of roadbreakers used in the industry and on different road surfaces indicate that the vibration levels exceed the standards advocated in the draft international standard DIS 5349 (1979) at the lower end of the frequency spectrum. That no particular problem has been found may be due to the relatively short exposures to vibration experienced by the operators or the fact that they are able to grip the tools lightly, or even, possibly, that the standards suggested in DIS 5349 do not accurately reflect the risk of vibration white finger when they are exceeded at the lower end of the frequency spectrum for vibrating tools such as roadbreakers.
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To overcome the problem of amplifier 'blocking time' due to stimulus artifact, a fast-recovery electrode amplifier is developed. The design of this amplifier and its application to a clinical EMG unit is discussed.
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When two potentials having large amplitude differences are simultaneously recorded, the large amplitude potential contaminates the small amplitude response. The small, early potentials generated by this contamination resemble far-field potentials. Although scalp-recorded SEP was contaminated by waves similar to the peripheral potential, peak latencies and wave form were not identical. Experiments simulating the recording situation verified the presence of "cross-talk." Capacitive coupling would shift peaks and alter the wave forms. Other possible mechanisms for the cross-talk and methods of minimizing it are offered. One should be cautious interpreting the results when potentials of large amplitude differences are simultaneously recorded.
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Nursing administrators urgently need objective, tested information on which to base crucial decisions regarding quality and cost in all areas of nursing service. Such information can be obtained only through research, but the scarcity of credentialed nurse-researchers limits the possibility of meeting this need. As an alternative approach, a consortium of nine nursing service agencies was established to prepare nurses to study their concerns. This article describes the consortium's background and function.