Increasing importance of viruses in acute otitis media

Acute otitis media is generally considered a simple bacterial infection that can be effectively treated with antibiotics. However, despite the extensive use of broad-spectrum antibiotics, poor clinical response to treatment of acute otitis media is common in children. Numerous studies ranging from animal experiments to extensive clinical studies have clearly demonstrated that respiratory viruses play a crucial role in the aetiology and pathogenesis of acute otitis media. Viral infection of the upper respiratory tract initiates the whole cascade of events that finally leads to the development of acute otitis media as a complication. Respiratory viruses induce a release of inflammatory mediators in the nasopharynx, increase bacterial colonization and adherence, and have a suppressive effect on the host's immune defense. Recent data indicate that at least some types of viruses actively invade the middle ear. Viruses also seem to enhance the inflammatory process in the middle ear and impair the outcome of the disease. Vaccines against the major viruses predisposing to acute otitis media hold a great promise for the prevention of this disease. Major advances in the management of acute otitis media will require further research into the mechanisms of viral infection, viral-bacterial interaction and the host inflammatory response during viral infection.     

The importance of fastidiousness in nursing

There has been a lot of criticism of nurses recently. Some would say that one of the biggest problems today is that nurses are not as disciplined or don't pay sufficient attention to detail. One hundred years ago in the BJN, there was an article questioning just how fussy and careful nurses were about small details such as dress and cleanliness.     

Increasing importance of the elderly in a trauma system

The objectives of the study were to determine age- and sex-related trends in hospitalization after injuries. Statewide hospitalization data from 1980-1999 were evaluated annually by sex and age (0-39, 40-64, 65-99), incidence, mean length of stay (LOS), and disposition. Males 0-39 represented 39.6% of admissions in 1980, but only 20.7% in 1999; females >or=65 are now most frequent. These trends partly reflect population changes, but rates of hospitalization for young men have also declined. For age < 65, LOS has gradually decreased since 1980; for age >or=65, LOS decreased after 1990. However, most elderly patients were formerly discharged home, whereas now most are discharged to skilled nursing facilities (SNF). The proportion of younger patients hospitalized in trauma centers increased significantly, but over age 65 this proportion remained stable. Major changes have occurred in populations served by trauma systems. Preventing injuries in the elderly is increasingly important. Accurate evaluation of cost-effectiveness in the elderly must include outcomes from SNF.     

Increasing nursing students' spiritual sensitivity

Since the 1960s, the nursing profession has experienced a resurgence of interest in spirituality. Even though nursing theories and the holistic perspective acknowledge the nurse's responsibility to attend to the spiritual needs of patients, little attention has been given to the development of spiritual sensitivity in nursing students. The authors articulate teaching strategies used in a community health practicum course that have been effective in promoting and increasing spiritual sensitivity in baccalaureate nursing students who come from varied religious traditions. Specific recommendations for integrating spirituality into the nursing curriculum are offered.     

Increasing nursing research capacity in the workplace

BACKGROUND: Engaging nurses in research remains extremely difficult. AIM: This action-research project aimed to increase nursing research capacity in one hospital trust. METHOD AND INITIAL RESULTS: A survey established levels of research knowledge, activity and experience among nurses. The response was low but participants expressed considerable interest. Two roadshows were organised. We then ran a series of four workshops, and the location of the second workshop was changed to increase staff involvement. By the fourth week, uptake was slow but sure and three or four valuable contacts had been made. DISCUSSION: Lack of understanding and accessibility of research emerged as key concerns. The initiatives described can help to support and develop nurses' capacity and demystify research. CONCLUSION: This initiative has highlighted the tensions between service demand, nursing capacity and nurses' research confidence and capabilities. It is important to remain flexible, proactive, creative and enthusiastic in supporting nurses to develop skills.     

Education for genetics and nursing practice

Genetic factors influence the risk for disease, selection of treatments, and overall health of persons throughout the life span. Nurses in critical care practice participate in assessing genetic risks for disease, implementing treatments, educating people about genetic aspects of health and disease, supporting the client's abilities to cope with the information, and assisting the individual and family to make health-related decisions involving genetic information. Opportunities for critical care nurses to become knowledgeable about genetic aspects of critical care nursing exist through academic courses, continuing education, and summer institutes. Recently, new guidelines for the genetic education of nurses have been developed. However, genetic education opportunities are not available to all nurses throughout the United States. Genetic nursing education programs based on guidelines for integration of genetic knowledge into professional nursing practice are needed.     

Legal and ethical issues in cancer genetics nursing

OBJECTIVES: This article will set forth major interests at stake for patients considering predictive genetic testing, some legal bases for protecting patients, and general ethical principles that can guide cancer genetic nurses in their practice. DATA SOURCES: Review of health, ethical, and legal literature CONCLUSION: There are many potential interests at stake for patients considering genetic testing for susceptibility to cancer and a number of legal protections for patients against genetic discrimination. Nurses and physicians who offer genetic testing should be aware of applicable laws in their states, and remain cognizant of evolving ethical principles that can guide the practice IMPLICATIONS FOR NURSING PRACTICE: Ethical and legal questions surrounding genetic testing linger--particularly for nurses and physicians whose primary concern is the best interests of the patient.     

The importance of transcultural nursing in cancer care

All patients around the time of cancer diagnosis are emotionally vulnerable. This sense of anxiety is further heightened for patients who are not fully integrated into the society in which they are receiving care because of the cultural shock and language barriers they may face. This article explores the author's experience of caring for a patient from China who was studying in the UK and was admitted with acute promyelocytic leukaemia. The patient had a limited grasp of English and was used to very different cultural norms. Bridging the cultural gap as outlined by Narayanasamy in the ACCESS model (2002) enabled the author to provide the important holistic nursing care that could be easily overlooked in these situations. There is a need for nurses to actively seek to understand cultural differences and take the opportunity to experience transcultural nursing.     

多元文化在临床护理工作中的重要性

随着社会经济和文化的发展,护理工作被赋予多元化内容。根据多元文化的特征,护理工作需不断的从各方面完善,开展和实施多元文化护理。护理工作在多元文化的渗透下会日趋广泛,以利于病人的治疗和康复。