Rules and regulations governing nursing education

The purpose of this article is to report on a national survey of the 51 state boards of examiners in the United States that govern and regulate nursing education. Data were gathered from the written rules and regulations of each of the state agencies, and content analysis was performed focusing on the following categories: qualifications (State board members, program directors, faculty, and preceptors); roles and responsibilities (state board members, faculty, preceptors, and clinical agencies); and process and content of the nursing education curriculum and program. Findings of the study indicate specific problem areas in the regulating of basic nursing education programs. The following were among the major issues identified: (1) educational qualifications for board membership are virtually nonexistent, (2) in many situations different requirements exist for various types of programs, and (3) there is great disparity from state to state regarding both the content deemed as necessary in nursing education and in the mandated process of that education. The investigators noted that several patterns lend credence to a need for a national plan regarding the state regulation of basic nursing education.

Preparing acute care nurse practitioners at the University of Connecticut

To meet the pressing demands for enhanced quality of patient care in a time of shrinking resources, a cooperative effort between the School of Nursing and the University Hospital (John Dempsey) Department of Nursing was initiated to educate nurses for a new role. Acute care nurse practitioners are master's prepared nurses in advanced practice who are capable of case management. Major functions include creating an initial data base, ordering diagnostic tests, therapeutics interventions, and medications, and monitoring their results in collaboration with attending physicians. Results show promise for unprecedented interdisciplinary patient management and nurse-to-nurse cooperation.

Transforming growth factor-alpha (TGF-alpha) in a semisolid dosage form: preservative and vehicle selection

The selection of an ideal semisolid vehicle for growth factors presents a challenge. Some antimicrobial agents are known to delay wound healing. The objective of this investigation was to identify appropriate preservatives and vehicles for TGF-alpha. Criteria for acceptance are noninterference with the mitogenic activity of TGF-alpha as well as adequate product preservation. Vehicles considered were o/w creams, ointments, and a gel. Combinations of six preservatives were tested. Selection was determined using both microbial preservative challenge and TGF-alpha mitogenic assay. In the former, 10 species of microorganisms were inoculated into formulation samples. At selected time intervals, it was determined whether colonies decreased, increased, or remained constant. In the mitogenic assay, samples of either preservatives or formulation prototypes were introduced to TGF-alpha-stimulated fibroblast cell cultures. Mitogenesis was determined by measuring 3H-dThd uptake into newly synthesized DNA. As preservatives, sorbic acid and quaternium-15 appear to satisfy both selection criteria. A thermosetting gel appears most promising as vehicle.

Percutaneous transluminal coronary angioplasty in totally occluded arteries

Out of 321 consecutive cases of Percutaneous Transluminal Coronary Angioplasty (PTCA), 28 (8.7%) patients underwent PTCA for nonacute total occlusion with no visible antegrade flow. All patients had evidence of reversible ischaemia in the territory of totally occluded artery. Overall initial success rate was 66% and was mainly related to the duration of the occlusion (85% for occlusion of 1 month or less, 70% for 1-6 months, and nil for more than 6 months duration). In 21 (75%) cases where collateral circulation to the occluded vessel could be demonstrated before PTCA, was not visible after successful PTCA. Failure was mainly due to inability to cross the lesion with the guide wire (8 out of 10 failures). Emergency Coronary Artery Bypass Graft (CABG) surgery was required in 2 cases where dissection of nontarget vessels occurred during manipulation of the guide wire. Acute reocclusion occurred in 2 cases, both were redilated successfully. There was no death. Although the primary success rate is lower than that associated with conventional stenotic lesions, with improvement in the hardware-balloon catheters and guide wires, coronary angioplasty can be performed successfully in majority of the patients with total coronary occlusion.

The clinical teaching partnership

Nursing educators have struggled to find the optimal solution for students' clinical learning. The authors discuss a potential avenue to address this problem. Through the combined efforts of a hospital-based clinical nurse specialist and a university-based faculty member, the authors promoted effective learning for their students. Their combined strengths resulted in a positive experience for students, staff, and the instructors.

Nurses' views on sexuality. Why, what, and how to change

What practicing professional nurses believe about the sexual functioning of their patients has a direct influence on the patients' psychological well being. A preliminary investigation identifying some of nurses' beliefs demonstrated their attitudes and knowledge about the effects of chronic disease on sexuality. Staff development educators can assist nursing staff to change attitudes and improve knowledge through an educational program outlined in this article.

Organizational structure: blueprint for action

"Organizational structure is the way a group is formed and the way it functions." The authors describe the successful revision of the structure of one school. Its change process and outcome can serve as a blueprint for action for other schools that are changing or considering changing their organizational structure.

Magnetic resonance imaging--the evaluation of choice in residual shunt after congenital heart disease surgery?

Accurate anatomic diagnosis presents a dilemma in patients with residual shunt after corrective surgery for congenital heart disease. We describe a patient who, after atrial septal defect repair, developed dyspnea and central cyanosis despite normal pulmonary arterial pressures and right heart chamber size. A role for early MRI is suggested.

Circulating antibodies against human colonic extract enriched with a 40 kDa protein in patients with ulcerative colitis

We have previously described a 40 kDa colonic protein(s) which is specifically recognised by tissue-bound immunoglobulin G obtained from the colon of patients with ulcerative colitis. We now report the presence of circulating antibodies against this antigen using an enzyme-linked immunosorbent assay with a highly enriched preparation of the 40 kDa protein from normal colon extracts. Serum was collected from 79 patients with ulcerative colitis, 36 with Crohn's disease, 16 with specific diarrhoeal syndromes, and from 19 normal subjects. Twenty nine of 79 patients with ulcerative colitis, 21 of 36 with Crohn's disease, and all patients with diarrhoea were symptomatic during the collection of sera. The difference in optical density values between patients with symptomatic ulcerative colitis and each of the other groups, including patients with ulcerative colitis in remission, was highly significant (p less than 0.01). Seventy nine per cent of patients with symptomatic ulcerative colitis had optical density values above the means for all other groups. Fifty five per cent of sera from patients with symptomatic ulcerative colitis had optical densities beyond two SDs of the values for all other groups and only two of 71 sera from non-ulcerative colitis patients (one Crohn's disease and one normal subject) had values in this range. These results show the presence of anti-colon antibodies against the 40 kDa protein(s) in the sera of many patients with symptomatic ulcerative colitis.

Theoretical aids for the determination of colorimetric curves of binary powder mixtures

Colorimetric assessment of powder mixtures or pigmented specimens can be made by determining CIE color coordinates from sample spectral reflectance curves. The diffuse reflectance spectra of five particulate systems having different hues are determined using modified particle model theory for wavelengths of 400 (20) 700 nm. Six binary powder mixtures are prepared from these particulate systems. The reflectance spectra of binary powder mixtures are then predicted assuming the contribution of each component to be equal to the product of its reflectance and the total surface area of particles. The theoretically predicted diffuse reflectance spectral curves agree well with experimentally measured ones. The evaluation of the theoretical technique is made by determining the color difference between the measured and predicted color coordinates. The color difference calculated for all the samples is <2 CIELAB units. The study establishes a theoretical aid to predict diffuse reflectance spectra of powder mixtures from the fundamental morphological and optical properties of particulate matter.

Induced optical anisotropy in heterodispersed systems

Magnetically induced extinction and birefringence of systems containing a mixture of ultramicroscopic particles with different optical and magnetic properties have been theoretically investigated. It is shown that the effects may exhibit an extremum and an inversion in sign with increasing applied field strength if the system contains diamagnetic as well as ferromagnetic particles. The field strengths at which the effects exhibit the extremum and the inversion in sign are found to depend on the relative number distribution of the two types of particles and on the wavelength of the incident radiation. Experimental results from systems containing particles of bentonite and chromium ferrite in different proportions are also discussed.

Estimation of particle size distribution parameters with forward-scattering techniques

A polydisperse sample can be statistically represented by a log-normal distribution having two parameters, viz., geometrical standard deviation sigma(g) and modal size parameter X(m). In an earlier paper a method to determine sigma(g) from the shift in the angular position of the maximum in Itheta(2) vs theta plot was discussed. The present paper describes a method of determining the other parameter X(m) from the polarization measurement in the forward direction. This can be achieved by comparing the angular position of maxima in P (degree of polarization) vs theta with that of the similar curve of a single particle. Certain experimental results are also discussed. This method is expected to be useful in routine particle size analysis.