Dependent ‐care by battered women: Protecting their children

The phenomenon of battered women's dependent‐care (Orem, 1991), that is, their efforts to prevent hazards to the life, health, and well‐being of their children, was examined. Open‐ended, semi‐structured interviews were conducted with mothers (N = 50) at battered women's shelters in a metropolitan area in the Midwest. The women demonstrated deliberate, creative, and diverse dependent‐care. Caring action and timing provided the basis for patterns of dependent‐care. Health care providers need to recognize these caring actions and consider their value from the perspective of battered women.     

The process of embarking on a weight control program

The purpose of this study was to describe the process of embarking on a weight control program, to understand more about the decision to seek treatment for obesity, a chronic health problem. Obese women were interviewed using field methods. The grounded theory approach was utilized to analyze the data. Loss and isolation were predominant themes and stages through which women progressed before entering treatment. The entering of treatment was viewed as a way of adapting to sex role norms, or what was expected of women by society. Body image concerns‐the loss of attractiveness—was an overriding theme. Physical health played a minor role in this decision to seek treatment for obesity. This investigation generated hypotheses for further study related to the importance of body image versus physical health as a motivator for weight control.     

Diagnosis of acute surgical abdomen – The best diagnostic tool to reach a final diagnosiscin

ObjectiveTo evaluate the best diagnostic tool (clinical, radiological, laboratory, or endoscopy) used to reach a final diagnosis of four most common presentations of acute abdomen to the surgical unit in the Limerick University Hospital, Limerick, Ireland.MethodsData was analyzed retrospectively of prospective collected data of all patients who had been admitted at a single academic institution from July 2011 till September 2011. Radiology, operating theatre and histopathology, haematology and endoscopy databases were searched from the Hospital Inpatient Enquiry (HIPE) department for patients who had presented with acute abdominal pain. Patients' charts were searched manually and final diagnosis of each patient was recorded.ResultsOut of 30 confirmed final diagnosis of appendicitis or appendicular mass, 9/30 (30.0%) were diagnosed with radiological (either on ultrasonography or CT scan). The remaining 21 cases (70.0%) were diagnosed clinically. Majority cases of diverticulitis 16/22 (72.7%) was diagnosed radiologically compared to only 6/22 (27.3%) of those confirmed by endoscopy. All diagnosis of gallstone-related diseases (cholecytitis, biliary colic, or cholelithiasis and/or choledocholithiasis) and bowel obstruction were confirmed by radiological investigation.ConclusionsAppendicitis can be accurately diagnosed clinically based on history and clinical examination alone. Diagnosis of diverticular disease, gallstone disease, and bowel obstruction further requires radiology intervention to confirm the provisional diagnosis.     

Nursing implications of alcohol withdrawal in the postoperative orthopaedic patient

Early assessment and identification of patients experiencing alcohol withdrawal (AWD) in the postoperative period can be crucial to the outcomes for the orthopaedic patient. Accurate and swift identification of patients experiencing AWD can impact mortality, morbidity and length of stay in the postoperative period. This article follows a case study involving a postoperative right Total Knee Arthroplasty patient, outlines the current perceptions on pathophysiology and offers guidelines for prevention and interventions. The purpose is to increase the nurse’s knowledge and understanding of AWD and related safety issues in the hospitalised postoperative orthopaedic patient.     

Preoperative albumin as a predictor of one-year mortality in patients with fractured neck of femur

A simple measure to determine one-year mortality following hip fractures has its benefits. Where there is controversy over implant selection, such a scoring system can facilitate the decision-making process. We undertook a retrospective analysis of one-year postoperative mortality of our hip fracture patients and established their admission serum albumin levels to see if there was any correlation between this and one-year mortality. Our results showed one-year mortality was significantly higher (p=0.0049) for those patients with a serum albumin of <35g/dl. Of the patients with low albumin, we found that there was no statistical significance between one-year mortality and source of admission (p=0.0789). Prefracture serum albumin can be used as a simple predictor of one-year mortality in patients presenting with a fractured neck of femur, thereby aiding operative planning and implant selection with a view to likely survival and possible need for revision.     

肝癌门静脉癌栓的介入治疗

肝癌合并门静脉癌栓(PVTT)的治疗仍是医学难题,既往一直被视为手术禁忌,近年随着介入医学的进步,发展了多种微创治疗方法,取得了可喜的疗效,使肝癌并PVTT由不可治变为部分可治,展现了介入方法治疗肝癌并PVTT的乐观前景.本文就当前针对门静脉癌栓的介入治疗方法,技术要点及各种介入治疗方法的初步疗效进行了综述.为进一步的临床规范化综合治疗肝癌并门静脉癌栓提供参考.