Interdisciplinary patient teaching plans: design and implementation

Interdisciplinary teaching plans are standardized teaching plans that provide guidance for preparation and actual delivery of patient education. The development of interdisciplinary teaching plans serves to better actualize the ANA and NAON standards of practice, to provide for an interdisciplinary approach to patient teaching as recommended by JCAHO, and to create an efficient patient teaching documentation system. Teaching plans create a mechanism that allows individual disciplines to document patient responses to teaching, and the plans provide written information for the patient that promotes self-care management. This article discusses problem identification, the development process, the content model, teaching plan development, and the implementation process of interdisciplinary teaching plans in one large university medical center.     

Female sexual behavior: fluctuations during the menstrual cycle

This longitudinal prospective study was designed to examine the influence of menstrual cycle phase on female sexuality. Sixty-nine normally cycling women monitored their sexual behavior including both heterosexual and autosexual activities and their basal body temperature daily over two or three consecutive menstrual cycles. Temperature charts were used to ascertain five cycle phases (menstrual, postmenstrual, ovulatory, luteal and premenstrual) and data were analyzed using analyses of variance with repeated measures. The results supported a significant cyclic fluctuation in sexual behavior with both female-initiated and male-initiated sexual activities peaking in the ovulatory phase. Moreover, the findings indicated that women experienced increased sexual arousal and sexual pleasure as they progressed from the menses to the premenstruum. These data suggest that human sexual behavior may be influenced by hormonal fluctuations and cognitive factors associated with the menstrual cycle.     

Intravenous digital subtraction arteriography in the evaluation of vascular grafts

Between 1982 and 1986 intravenous digital subtraction arteriography was used to evaluate vascular grafts in 97 patients (54 males, 43 females). Indications included recurrent symptoms, absent or diminished pulses, a drop in Doppler pressure measurements, and clinical uncertainty with respect to graft patency. Problems identified included graft stenosis, stenosis of the anastomosis or its distal vessels, false aneurysm, arteriovenous fistula and emboli. Forty-eight operations were carried out following intravenous digital subtraction arteriography, and radiographic findings were verified surgically. Twice, intravenous digital subtraction arteriography did not show significant graft findings which were discovered at surgery. Thus intravenous digital subtraction arteriography showed a sensitivity of 95.8% and specificity of 100%. Complications following intravenous digital subtraction arteriography were: two patients developed urticaria, and one superficial thrombophlebitis. There were no cases of pulmonary edema or death. In conclusion intravenous digital subtraction arteriography is very useful in the diagnosis of graft-related problems if done on a selective basis looking at graft and anastomosis site only, intravenous digital subtraction arteriography is done on an outpatient basis, has high sensitivity and specificity, good patient acceptance, is safe, fast and is less expensive than conventional arteriography.     

Tri-iodothyronine inhibition of thyrotrophin-releasing hormone-induced growth hormone release from the chicken adenohypophysis in vitro

Tri-iodothyronine (T3) had no effect on the basal level of GH release from chicken hemipituitary glands perifused in vitro. The GH response to TRH was, however, markedly suppressed following exposure to T3. Suppression of TRH-stimulated GH secretion was observed after a 2-h preincubation with T3, and was induced, in a dose-related way, by 0.01-10 mumol T3/l. Exposure to T3 also reduced the effectiveness of TRh, at concentrations of 0.001-10 micrograms/ml, to stimulate GH release. These results demonstrate that, in addition to a hypothalamic site of action, T3 is likely to suppress GH secretion in vivo by direct effects on pituitary GH release.     

The nasopharynx and adenoid in children with glue ear compared with normal controls

This study was designed to demonstrate whether any differences could be detected in the nasopharyngeal soft tissue size and postnasal space airway in children with glue ear compared with controls. Lateral cephalometric radiographs of 34 children with bilateral glue ear confirmed by paracentesis were compared with those of normal children matched for age and sex. There was no difference in the measurement of adenoid depth between the 2 groups. However, it was found that the palatal airway size was significantly smaller in children with bilateral glue ear than in normal children. Reduction in the palatal airway to 4 mm or less is found in most cases with bilateral glue ear, but only in 15% of normal controls.     

Parathyroid hormone messenger ribonucleic acid in the rat hypothalamus

Polyadenylated RNA, extracted from rat hypothalami, cross-hybridized with a RNA probe complementary in sequence to rat PTH (rPTH) messenger RNA (mRNA). Amplification of complementary DNA (cDNA) by the polymerase chain reaction also demonstrated the presence of rPTH mRNA in the rat hypothalamus and parathyroid gland. rPTH mRNA was localized by in situ hybridization in the paraventricular and supraoptic nuclei of the rat hypothalamus. These results demonstrate the expression of the PTH gene in the central nervous system of the rat in areas which suggest roles for PTH in neuroendocrine function.