The Magnetic pull. The U.S. health care infrastructure now boasts more than 100 magnet facilities--and counting

Discover the major attributes of the facilities that earn Magnet status from the American Nurses Credentialing Center.     

Atopy in patients with bronchiectasis: more than coincidence

Bronchiectasis is common in developing countries, but its precise underlying mechanism can be detected in only about 40% of the cases. The studies reporting the frequency of atopy and its relation to radiological findings and lung function in bronchiectasis are limited in number, and the results are controversial. The present study was designed to investigate the relationship between atopy and bronchiectasis by means of high resolution computed tomography (HRCT) and pulmonary function tests. Skin prick test, HRCT and pulmonary function tests, including spirometric values of forced expiratory volume in one second (FEV1), FEV1/FVC (forced vital capacity) ratio were performed in 121 bronchiectatic patients of unknown etiology and in 68 healthy controls. Atopy and HRCT scores for the severity of atopy and extent of bronchiectasis respectively were determined for each patient. The rate of atopy (48.8% vs 11.8%) and mean atopy score (14.3 +/- 10.1 mm vs 5.5 +/- 2.1 mm) were significantly higher in patients with bronchiectasis than those in controls. Atopic patients had significantly worse spirometric values and more extended bronchiectasis than non-atopics. There is a significant correlation between atopy and HRCT scores (r = 0.54, p < 0.001), indicating that the more severe atopy is the more extended bronchiectasis. In conclusion, we suggest that the rate of atopy is higher in bronchiectatic patients than that in healthy controls. Bronchiectatic patients with atopy have lower spirometric values and higher HRCT scores. Atopy might be considered as a deteriorating and/or a causative or contributing factor for development of bronchiectasis.     

Promoting breast health among women in the U.S. Virgin Islands: a focused study of the needs of Caribbean women.

Breast cancer is the number one cause of cancer death among women in the United States Virgin Islands. Consequently, the Bureau of Health has identified breast cancer as a priority health concern. Within the medical community, increasing emphasis is being placed on the importance of hereditary, familial, environmental, and behavioral risk factors to breast cancer control. Little research has been conducted regarding these factors, however, to explore their influence on breast cancer detection and breast cancer risk management. This report highlights the outcomes of a study undertaken to explore the associations between breast cancer risk, risk assessment, risk communication, screening, and receptivity to the management of breast cancer risk among women from the United States Virgin Islands. Results of this study suggest a need within the territory to expand the systems that are responsible for monitoring and reporting breast cancer trends; forums to discuss concerns of women relative to breast health; forums to discuss communication with health-care providers; and, research efforts that address breast cancer detection and control among women in the United States Virgin Islands.     

Coping with stroke: psychological and social dimensions in U.S. patients

Stroke is the third-leading cause of death in the world, affecting 3 million women and 2.5 million men annually. The success of rehabilitation efforts for stroke patients is often measured in terms of physical functioning. However, the literature suggests that the effects of stroke and subsequent adaptation include psychological and social dimensions as well. The purpose of this study was to investigate how patients in the United States perceived their stroke experiences by examining their coping strategies and hopes for recovery. In addition, factors that inspired hope during recovery were identified. Sixty participants with a diagnosis of embolic or ischemic stroke were interviewed during their initial hospitalization. Tape-recorded interviews were coded and categories of data identified. Findings suggested that stroke patients experience a range of physical symptoms and emotions surrounding their stroke experience, and that stroke often interfered with daily functioning. Coping strategies included maintaining a positive attitude and asserting independence, as much as possible, during the acute stroke experience. Many patients expressed general hopes for recovery while some admitted fear of getting worse. Hopefulness was often inspired by interaction with family and spiritual beliefs and practices. The findings will hopefully enhance nurses' understanding of patients' perceptions of the stroke experience and increase their ability to provide interventions that will aid in promoting effective coping strategies.     

Differences in triage thresholds for patients presenting with possible acute coronary syndromes: more than meets the eye.

BACKGROUND: Many studies have shown differences in cardiac care by racial/ethnic groups without accounting for institutional factors at the location of care. OBJECTIVE: Exploratory analysis of the effect of hospital funding status (public vs private) on emergency department (ED) triage decision making for patients with symptoms suggestive of acute coronary syndromes (ACSs) and on the likelihood of ED discharge for patients with confirmed ACS. STUDY DESIGN AND SETTING: Secondary analysis of data from a randomized controlled trial of 10,659 ED patients with possible ACS in five urban academic public and five private hospitals. The main outcome measures were the sensitivity and specificity of hospital admission for the presence of ACS at public and private hospitals and the adjusted odds of a patient with ACS not being hospitalized at public versus private hospitals. RESULTS: Of 10,659 ED patients, 1,856 had confirmed ACS. For patients with suspected ACS, triage decisions at private hospitals were considerably more sensitive (99 vs 96%; p<.001) but less specific (30 vs 48%; p<.001) than at public hospitals. The difference between hospital types persisted after adjustment for multiple patient-level and hospital-level characteristics. CONCLUSION: Significant differences in triage for patients with suspected ACS exist between public and private hospital EDs, even after adjustment for multiple patient demographic, clinical, and institutional factors. Further studies are needed to clarify the causes of the differences.     

Measurement of preference for information in U.S. and Korean cardiac catheterization patients

Seeking information is a common coping strategy of patients facing a stressful event. Persons differ, however, in how much information they want to help them in their coping process. Research-based practice related to patients' preferences for information is hampered by the lack of reliable, valid, and clinically useful instruments to measure preference for information. Furthermore, it is imperative that researchers and clinicians understand preference for information in different cultures to reflect the diversity of the needs of patients in clinical practice. This study was designed to determine the reliability and validity of three measures of preference for information-the Miller Behavioral Style Scale (MBSS), the Krantz Health Opinion Survey-Information Subscale (KHOS-I), and the Preference for Information Scale-in 106 U.S. and Korean cardiac catheterization subjects. The MBSS and the KHOS-I were found to have fair-to-excellent reliability and fair-to-moderate convergent validity. The lack of a correlation of either of these two instruments with the Preference for Information Scale does not support convergent validity for that instrument.