Live a legacy or live a lie: a choice

This article is about the result of a choice to Live a Legacy or Live a Lie. The choice led to the development and implementation of a clinical practice model (CPM) designed to create a healthy, healing integrated practice culture. The focus is on the foundation of the model that is a unique ongoing process called the Core Belief Review. The purpose of the review is to uncover those things that matter most for both those who give and receive care. The ongoing open communication process provides insights and truths about reality and a sense of direction related to the nature of the work necessary to create and sustain the best places to give and receive care. The results of the review feedback from 2500 providers and recipients of care are correlated to the actions taken to address the complexities of the point-of-care reality and the clinical outcomes reached as a result of collaboration and lessons learned within an International Consortium.     

Caring for a patient with a urostomy in a community setting

Around 7500 people in the UK have a urostomy. A urostomy is normally performed if a person has bladder cancer, congenital bladder abnormalities. Many people who have a urostomy have long term conditions and may require the help and support of community nurses. This article examines common complications of urostomy including stomal complications, urinary tract infections and dermal complications. Although stoma complications are common and can affect quality of life, many people with a stoma tend not to seek help. Community nurses can provide care and support to optimize stoma management and enable the person with a urostomy to enjoy the best possible quality of life.     

FXTAS: a bad RNA and a hope for a cure

Background: Fragile X-associated tremor/ataxia syndrome (FXTAS) is a newly identified neurodegenerative disorder due to intermediate expansion of trinucleotide CGG repeats (55 - 200 repeats) in the 5' untranslated region (UTR) of the Fragile X mental retardation 1 (FMR1) gene. FXTAS is now considered to be one of the most common inherited neurodegenerative disorders in males. Objective: To examine the future of potential therapies for this late-onset disease. Methods: Examination of relevent literature. Results/conclusions: Accumulating evidence indicates that overproduced riboCGG repeats in the 5' UTR of FMR1 mRNA are toxic. Recently, proteins that bind specifically to rCGG repeats were identified. Progress in understanding the molecular pathogenesis of FXTAS, plus the availability of different animal models are discussed.     

社区发烧、咳嗽初诊病例讨论

目的：1．根据循证医学指南知识诊治社区肺炎病人；2．根据指征安排病人门诊或住院；3．了解下呼吸道感染病人的药物选择；4．评估头孢菌素在下呼吸道感染病人治疗中的作用；5．正确诊断出现并发症的下呼吸道感染病人；6．合理使用抗生素，避免滥用抗生素和产生抗药性；     

The meaning of being a mother of a child with a heart disease: a phenomenological study

The objective of this study is to understand what it means to a mother to have a child with a heart disease. In order to do so, a phenomenological approach was used. The study was carried out with mothers of children with congenital cyanotic cardiopathy at the Infant Cardiology Center of a public hospital in Campo Grande, State of Mato Grosso do Sul. Ten open interviews were made based on the following guiding question: What does it mean to you to have a child with a heart disease? The comprehensive analysis of the reported speeches made possible the construction of three categories: "Discovering the disease: being up against the unknown"; "Living together with cardiopathy: being with the child in the disease", and "Believing in a stronger force: the necessary support". The impact of the disease on the mother begins the moment the child is born. Desperation, guilt and insecurity are mentioned as present feelings. It is in God, however, that such mothers look for the necessary support to follow this new path--a path of pain and faith.