Resolving epistemological pluralism: a personal account of the research process

In this paper, the author seeks to address issues of personal and professional development that may occur during the research process Whilst research reports now abound in the nursing literature, this personal aspect is often neglected As we seek to encourage research awareness within the profession, many student and qualified nurses now produce a small research project, and this often concentrates on measurable outcomes By examining her own perceived learning in resolving epistemological pluralism whilst undertaking such a project as a tutor student, the author has attempted to resolve the problem of ignoring the personal Indeed, she believes that increased self-awareness can only enhance nursing professionalism     

Tissue-type plasminogen activator: a historical perspective and personal account.

Over the past two decades tissue-type plasminogen activator (t-PA), the main physiological plasminogen activator, has been developed as a fibrin-specific thrombolytic agent for the treatment of various thromboembolic diseases. Milestones in this development include: first purification of human t-PA from uterine tissue, elucidation of the interactions regulating physiological fibrinolysis, thus providing a molecular basis for the concept of fibrin-specific plasminogen activation, first animal models of thrombosis and pilot studies in patients supporting the therapeutic potential of t-PA, cloning and expression of recombinant t-PA providing sufficient amounts for large scale clinical use, and demonstration of its therapeutic benefit in large multicenter clinical trials, mainly in patients with acute myocardial infarction (AMI), but also in patients with massive pulmonary embolism, ischemic stroke, deep vein thrombosis and peripheral arterial occlusion. Genetically modified variants of t-PA have been developed for bolus administration in patients with AMI.     

Pharmaceutical care in community pharmacy: practice and research in the Netherlands

OBJECTIVE: To describe the pharmaceutical care activities and research in community pharmacy in the Netherlands. FINDINGS: Pharmaceutical care is well advanced in Dutch pharmacy practice. This is largely due to the fact that clinical pharmacy was already an integrated part of community pharmacy practice by the end of the 1980s. Activities of the International Pharmaceutical Federation (FIP), some wholesale companies, and influential individuals in the Netherlands stimulated universities and the Royal Society for the Advancement of Pharmacy to advance the implementation of pharmaceutical care. DISCUSSION: Not all pharmacies in the Netherlands provide pharmaceutical care at the same level, although medication surveillance (concurrent and prospective medication analysis) is part of everyday practice. Implementation of quality assurance systems in community pharmacy practice could be helpful in assuring high levels of care. Similar to those in other countries, Dutch pharmacists are torn between the wish to provide pharmaceutical care and economic considerations, although the financial status of most pharmacies is still (very) healthy. New entrants into the market, such as supermarket and pharmacy chains, seem to put little emphasis on care provision. CONCLUSIONS: Pharmaceutical care has been implemented in many Dutch community pharmacies, but not everywhere to the same extent. Due to excellent automated medication surveillance; structured, high-quality medication counseling; and the fact that patients usually visit the same pharmacy, Dutch patients are well protected against many drug-related problems.     

Major incident: a front line,on-scene personal account by a nurse observer

As a newly appointed junior staff nurse in a city Accident & Emergency (A & E) department, the author took part in an orientation programme which included joining a paramedic crew for a 12-hour shift as a nurse observer. During this shift the crew and observer were involved in a major incident, when a coach carrying a party of pensioners overturned into a water-filled culvert, with a loss of 13 lives. This paper offers a personal reflection on the holistic application of multidisciplinary teamwork, so often rehearsed but, thankfully, rarely required.Over I year later these reflections may serve as a respectful reminder of the deceased, and through that, an appreciation of the arduous tasks faced by emergency workers both front-line and within the A & E department. Also discussed is the need for access and the opportunity for counselling if required, thereby possibly averting the development of Post Traumatic Stress Disorder, or at least recognising its early stages and beginning to work with it.     

Jon Van Rood: pioneer at the crossroad of human leukocyte antigens and transplantation

Jon Van Rood (born in 1926) has made major contributions to the fields of transfusion medicine as well as organ and stem cell transplantation. His group was the first to start unraveling the complexity of the human leukocyte antigen (HLA) system through collaborative studies that used panels of sera and leukocyte samples. Furthermore, using HLA typing, he introduced the first HLA-matched platelet transfusions and developed routine leukocyte depletion as a means to prevent HLA alloimmunization. Van Rood has also been active in the fields of kidney transplantation (Eurotransplant) and stem cell transplantation (Europdonor). He combined scientific laboratory research with application to clinical medicine. He retired from his university position in 1991 but remains active in the field.     

Elements of transcultural and translinguistic research: a personal experience.

Prior to undertaking the exploration of phenomena in a research study with people from different cultures, certain elements must be addressed in order to bridge cultural and linguistic differences. In this article, the authors explore some of these elements, with specific reference to personal experiences in a research study done in Italy, the results of which will not be presented here. Elements discussed include: transcultural/translinguistic literature review, protection of human subjects, translinguistics, maintaining necessary and appropriate contact with persons at the research site, presentation of research to participants, structuring interviews, and post-session amenities.     

Levels of care in the intensive care unit: a research program.

A multidisciplinary research program on levels of care was conducted in 15 adult intensive care units in North America, Europe, and Australia. The program addressed advance directives for cardiopulmonary resuscitation, provision of advanced life support, and clinicians' discomfort with evolving treatment plans. The results indicated that the factors that determined the establishment of directives for advance life support differed from the factors that informed a decision to limit or withdraw support after admission to an intensive care unit. In addition, clinicians' prognoses were imprecise and often an underestimation of the probability of short-term survival. Finally, some degree of discomfort was common in care providers in the intensive care unit, most often because they thought interventions were excessive and not compatible with an acceptable future quality of life. The provision of advanced life support mandates explicit decision making about how life-support measures should be used.     

Politics and palliative care: the Netherlands

Dion Smyth's review of the internet for palliative nursing.     

The challenge facing critical care nurses in the UK: a personal perspective.

Wide-reaching professional, organisational and technological changes within healthcare have impacted on the role of the critical care nurse over the past decade. The major challenge to critical care nurses is to remain focused on providing quality care, optimistic about what can be achieved and realistic given the finite resources available. Suggestions as to how the future of critical care nursing may look are raised. Strategies to ensure that best practice and innovation continues within critical care are discussed, ensuring that patient and family needs remain a priority.     

Holistic self care: strategies for initiating a personal assessment.

To be fully present for clients, occupational health nurses must assume responsibility for meeting their own self care needs. To promote holistic health care, occupational health nurses must assess personal values, priorities, and responsibilities. This can be accomplished by completing a personal assessment focusing on current use of holistic modalities. To implement a plan for holistic self care, nurses can write goals, set intentions, be open to holistic modalities, begin with small changes, recognize feelings, pay attention to breathing and self talk, simplify their lives, build support systems, and apply self care at work.