Political Action Handbook for Nurses

Book Review in this Article
Mason, Diana J. and Talbott, Susan W. (Eds.) (1985). Menlo Park, CA: Addison-Wesley Publishing Co.     

丘脑血管病的神经心理学研究

本文报告了18例经CT扫描诊断为单侧丘脑血管病患者,于发病2～4周内进行失语症及记忆测验:结构、运用及计算等检查。2/3患者有失语,约半数出现近记忆、计算及摆方块障碍,约1/3患者出现手指失认、左右失认等Gertmano's综合征表现。讨论了丘脑性失语的特点,认为这是一种独立失语类型。指出丘脑语言优势多为左侧,右侧亦存有语言功能,少数人可为优势侧。丘脑病变导致的近记忆、计数、结构等心理学障碍与言语障碍程度及演变不呈平行关系。本研究为中风患者临床诊断和康复治疗标准提供客观依据。     

Outcome After Trans-tibial Amputation for Vascular Disease

All 112 patients (55 females and 57 males) with a primary unilateral trans-tibial amputation for vascular disease performed in one year at all five hospitals in Malmöhus county, Sweden were examined at 6 months according to the prosthetic function and prospectively followed-up 8 years after the amputation for survival, and prosthetic fitting. The prosthetic function was re-examined among the survivors 8 years postoperatively. At 6 months 50% were fitted with a prosthesis and later (up to 8 years) a further 13%, in total 32 females and 39 males. The mortality at 6 months was 33%, at 2 years 47% and at 8 years 92%. Age at amputation (p = 0.015), to be amputated on the left leg (p = 0.0004), to be able to walk alone outdoors before the amputation (p = 0.007) and not using a wheelchair (p = 0.02) were all found to be statistically significant predictors for receiving a prosthesis. Predictors for good function with the prosthesis 6 months postoperatively was male sex (23 of 57 vs 8 of 55 females) (p = 0.006) and greater ability to walk alone outdoors before the amputation (p = 0.01). There was no significant age difference in this comparison. The finding that it is more favourable to be amputated on the left leg merits further study.     

Vascular Disease of the Spleen

A wide range of vascular disorders can affect the spleen. Although clinical presentation is often nonspecific, early diagnosis and treatment are mandatory in most conditions. Noninvasive imaging techniques are well suited to meet these objectives. Familiarity with normal macroscopic and microscopic vascular anatomy is a prerequisite to understand the pathophysiology of vascular disorders of the spleen. This article deals with diseases of the splenic vasculature (aneurysms, arteriovenous fistula, splenic vein thrombosis, collateral circulation in portal hypertension) as well as vascular disorders affecting the splenic parenchyma (splenic infarct, Gamna-Gandy bodies). Primary vascular tumors and tumor-like conditions of the spleen will be discussed very briefly.     

Preparing Nurses for the Global Pandemic of Chronic Obstructive Pulmonary Disease

PURPOSE: To raise awareness of the global pandemic of chronic obstructive pulmonary disease (COPD), its multiple underlying causes, and how to fight it, with particular attention to needs in nursing education. METHODS: Integrative review of the literature. FINDINGS: The main underlying causes of COPD are both individual and environmental factors, and the disease usually results from an interaction between these two factors. The prevalence of COPD is highest in countries where cigarette smoking has been, or still is, very common, and it is lowest in countries where smoking is less common, or total tobacco consumption per person is low. COPD is to some extent a preventable disease especially by preventing exposure to tobacco smoke and to occupational dusts and chemicals including vapours, irritants, fumes, and indoor and outdoor air pollution. The main implication for nurses and nursing curricula is to expand the focus from the individual to include population-based intervention programmes. CONCLUSIONS: Addressing the underlying causes of COPD and providing appropriate interventions are within the scope of nursing practice and responsibility. Changes in nursing education are needed for nurses to be able to address the COPD pandemic.