In regard to Sanchez-Nieto et al. IJROBP 2001;49:487-499.
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Humans↗
Biomedical subjects
R MacKay
Publications and source records attributed to R MacKay.
[Doxycycline induced photoonycholysis].
A case of phototoxic onycholysis secondary to treatment with doxycycline is presented. Tetracyclines are known to provoke photosensitivity reactions in some individuals exposed to sunlight. The typical photo-toxic manifestation is erythema, but cases with onycholysis have also been reported in the past. With travel to regions with sunny climates it will be important to be aware of the risk of developing onycholysis following the use of tetracyclines and to avoid the most potential phototoxic derivates, especially doxycycline.
Adult↗
Recruiting and retaining competent clinical nurses. The Clinical Promotion Project Victoria General Hospital, Halifax, Nova Scotia.
A career advancement program for nurses has been developed and implemented at the Victoria General Hospital, Halifax, as part of a manpower planning strategy for recruitment and retention of clinical nurses. A competency based performance appraisal system was developed and implemented as part of the program. This system identifies four levels of clinical expertise. Progression through each level indicates that a nurse has achieved a certain level of skill, knowledge and abilities. Demonstrated competence in one level is a prerequisite to promotion to the next level of practice. Implementation of this system provides clinical career opportunities for nurses in direct patient care. This article will provide the nurse administrator with an insight into the development and implementation of a clinical career advancement program. Future articles will described the research evaluation of the Clinical Performance Appraisal System and clinical nurses' reactions to the new system.
Career Mobility↗
Effect of prostaglandin on early surgical mortality in obstructive lesions of the systemic circulation.
To examine the effect of preoperative prostaglandin infusion on surgical mortality the records of all patients aged less than or equal to 28 days operated between January 1979 and December 1981 for obstructive lesions of the systemic circulation were reviewed. Forty patients had coarctation of the aorta, five interrupted aortic arch, and seven critical aortic stenosis. Fourteen patients received intravenous prostaglandin before operation. Among preoperative variables low cardiac output was identified as a possible risk factor for hospital death, whereas the presence of a raised blood urea concentration was possibly significantly associated with hospital mortality only in patients not treated with prostaglandin. The preoperative administration of prostaglandin had a strongly favourable influence: 11 out of 38 (29.0%) patients who did not receive prostaglandin died compared with none of 14 treated with prostaglandin. The two groups were otherwise comparable with respect to the incidence of coagulopathy, urgency of operation, associated anomalies, and other medical treatment. Mean age at operation was younger and mean admission blood urea concentration higher in the group treated with prostaglandin, whereas the incidence of preoperative low cardiac output was probably higher. It is concluded that short term preoperative infusion of prostaglandin in associated with a significant reduction in early surgical mortality in this high risk group of infants.
Alprostadil↗
Reflections on reflections.
Most cochlea models consider the system as a pair of channels separated by a flexible membrane (basilar membrane). In the part of the wave where the stiffness of the membrane dominates, traveling waves are set up. Because of varying propagation conditions the speed of propagation diminishes most rapidly when the wave approaches the region where the basilar membrane shows resonance for the frequency under consideration. It might be expected that such a rapid change of propagation velocity gives rise to reflection. In this paper a one-dimensional model is considered in such a way that resonance properties stand out clearly. The results show that even when extremely little damping occurs (damping factor less than 10(-3)) virtually no reflection is evident. under conditions of low damping the nature of the response is such that it is incompatible with inner hair cell or nerve fiber responses from the cochlea: some kind of "sharpening mechanism" should be present. Limitations of the model considered should be studied further to verify the conclusions in more general cases. Despite these limitations the present model serves to illustrate typical physical phenomena, like reflection and energy dissipation, quite well.
Basilar Membrane↗
Developing a hospital nursing research program.
Including nursing research as a stream in the nursing career structure in Western Australia paved the way for development of the Nursing Research Department at Sir Charles Gairdner Hospital. Over the last two years a program of research activities has been introduced to assist nurses to evaluate their practice, to critique the research and apply its results in patient care.
Clinical Competence↗
Evaluating the competence of clinical nurses from beginning to advanced practitioner.
Frequently, clinically competent nurses leave direct patient care for non-clinical positions or other careers to achieve greater professional advancement and recognition. The drain of clinical nursing expertise away from the patient prompted the development and evaluation of a clinical promotion program to appraise and recognize clinical nursing competence. At the beginning of the evaluation period, 205 nurses were appraised for clinical competence and categorized as: Level 1--a beginning practitioner or a nurse returning to service; Level 2--a skilled clinical practitioner; and Level 3--an advanced clinical practitioner. Nurses volunteered information related to demographic characteristics, education, clinical experience, and attitudes to their work and work environment. Reassessments were completed after one year. Evaluation of the program employed a longitudinal comparative design. The major finding shows significant shift in clinical nurses' competence over time with a greater percentage of nurses at higher levels of ability. Further evaluation of the program is in process.
Adult↗
Persistent Carer. Interview by Jo Carlowe.
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Aged↗