Menstrual Perceptions and Preparation Among Female Adolescents

Seventy-four 8th- and 10th-grade students attending a private girls' school in Hawaii were queried about their perceptions of and preparation for menstruation using a questionnaire administered in a health education class. Eighty percent had already started menstruating. The most frequently cited perceptions by the respondents referred to both the inconveniences and the normalcy of menstruation. Many were first informed about menstruation by their mothers and stated that they also first informed their mothers when they started menstruating. Surprise, fear, and embarrassment were common initial reactions, while strong negative or positive emotions were more rare. Only 35% wanted boys and girls together during class discussion, but 89% stated that boys needed to be informed about menstruation. The most frequent reasons cited for noncoed settings were the girls' concern about their comfort in openly discussing menstruation. Thirty-eight percent thought parents should inform other siblings when they started menstruation, although almost half gave specific conditions the parents should consider. The majority thought the fifth to sixth grades were the best times to introduce menstruation content.     

The key informant technique

BACKGROUND AND OBJECTIVE: This article considers the role of the key informant techniqueas a qualitative research method and examines the potentialcontribution of the approach to health care research. METHOD: The principles underlying the technique and the advantages anddisadvantages are considered, illustrated with examples froma range of social science studies. RESULTS AND CONCLUSION: An example of the author's own use of key informants in a studyof the professional relationship between general practitionersand specialists is described. Keywords. Key informants, qualitative methods, professional relationships.     

Invasive ventilation in the emergency department: Part 2: Implications for patient safety

The use of mechanical ventilation in the Emergency Department requires adequate resources in order to maintain patient safety and avoid potential risks. Moreover, developments in technology require increased knowledge of mechanical ventilation techniques to address the complexity of decision-making involved. Organisational issues and system factors have the potential to negatively impact on the ability of the emergency service to provide optimum care to patients receiving mechanical ventilation. These issues include staffing and skill-mix, demand on emergency services, role-delineation, scope of practice, and current mechanisms for monitoring of quality and safety. Furthermore, in response to advances in ventilator technology, current education programs for both nursing and medical staff require review to ensure that they provide comprehensive information about the types of ventilation techniques now available and the relative risks and benefits associated with their application.This article is the second in a two-part series and explores the educational and organisational factors that impact upon safety and quality of care delivered to patients receiving mechanical ventilation in the emergency department. Recommendations for future policy development, curriculum review and reporting mechanisms to support further research in the application of mechanical ventilation in the emergency department are made.     

Lobar and segmentai atrophy of the liver

Lobar atrophy of the liver has been recognized as a complication of hepatic and biliary disease for many years. Previously regarded as rare and clinically unimportant, it is now accepted as reasonably common and clinically significant in many patients. Atrophy of liver lobes and, now, also segments, is much more frequently diagnosed because of the routine use of ultrasound and computed tomography scanning in the assessment of hepatobiliary disease, together with its recognition on angiograms and at laparoscopy.

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Resumen La atrofía lobar del hígado ha sido reconocida como una complicación de la enfermedad hepática y biliar desde hace muchos años. Previamente considerada como rara y de escasa importancia clínica, ahora es aceptada como una entidad relativamente común y de significación clínica en muchos pacientes. La atrofía de los lóbulos hepáticos, y ahora también de los segmentos, se diagnostica con mayor frecuencia en virtud del uso rutinario del ultrasonido y de la tomografía computadorizada en la valoración de la enfermedad hepatobiliar, así como de su reconocimiento en angiogramas y en laparoscopia.

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Résumé On a longtemps considéré l'atrophie d'un lobe du foie comme une complication de la maladie hépatique et biliaire. Considérée d'abord comme rare et sans importance, elle est actuellement reconnue comme assez fréquente et cliniquement importante chez bien des patients. On diagnostique l'atrophie des lobes du foie et à ce jour également celle des segments beaucoup plus souvent gráce à la pratique systématique d'échographie et de tomodensitométrie dans l'évaluation de la maladie hépatobiliaire, jointe à son identification en angiographie et par laparoscopie.

     

Time related bias in longitudinal studies using dual photon absorptiometry.

Examining the bone mineral density (BMD's) slope of patients regularly followed in our department, we observed recently that the group of patients who had their last BMD during the last 6 months of 1989, had a different slope than patients who had their last BMD during the following 6 months. In order to investigate if a small time-related bias of measurement, unsuspected by the former quality control investigations, could exist, we performed the following analyses. A regression equation between BMD and time was calculated and a slope was obtained for 95 women who had been followed for at least 3 yr and had had at least 3 BMD measurements during that time. The women were divided in 3 groups according to when the last BMD measurement had been performed (July-December 1989, January-June 1990 or July-December 1990). The slopes of the 3 groups of patients were compared. For each value of BMD of every patient, a predicted BMD (BMDp) was calculated using the regression equation and the relative difference (RD) between BMDp and BMD was calculated and analysed in relation to time. There was a significant difference (p < 0.05) between the slopes of patients in relation to the time when the last BMD had been measured. Significant fluctuations (p < 0.001) in RD were observed in relation to time. These RD variations suggested the existence of a time-related error. The presence of this error is also substantiated by the fact that a parallelism existed between the curve of the RD variations and the curve of the mean values of BMD of all patients referred to our department, calculated per period of 4 months. Although the fluctuation of the latter curve was not statistically significant.(ABSTRACT TRUNCATED AT 250 WORDS)     

The telephone survey: a methodological strategy for obtaining information

Studies have shown that students and the general population have little knowledge about nursing schools and the nursing profession. This study investigates the extent to which a sample of the population of Brazil is aware of the existence of nursing schools, and how they have obtained this information. Data were collected by telephone interviews. The sample consisted of 326 subjects whose telephone numbers were taken from the telephone book. Analysis showed that 73% of the subjects were aware of the existence of two nursing schools in the city; however, 65.03% did not know the names of these schools. Direct communication with friends and family, as well as indirect communication by television and advertising, were the sources of information mentioned by those questioned.     

Accelerating effects of epidermal growth factor on skin lesions of pemphigus vulgaris: a double-blind, randomized, controlled trial

BACKGROUND: Pemphigus vulgaris (PV) is a severe blistering disease involving the skin and mucous membranes. The most common causes of death in these patients are adverse effects of drugs, and infection. Skin lesions are one of the important sources of infection. Thus, any local treatment that could reduce healing time of lesions and consequently reduce the total dosage of drugs needed to treat is favourable. OBJECTIVE: To evaluate the efficacy of epidermal growth factor (EGF) in reducing healing time of lesions in patients with pemphigus vulgaris. METHODS: In this randomized, double-blind, within-patient, left/right, controlled trial, 20 hospitalized patients with pathologial and immunohistologial (direct and indirect immunoflourecence) proven pemphigus vulgaris (PV) were chosen. In addition, all patients had at least one appropriate pemphigus lesion on each side of the body that had not healed after 2-week systemic therapy and sterile saline washing. EGF (10 microg/g) in 0.1% silver sulfadiazine cream vs. 0.1% silver sulfadiazine cream alone was applied randomly on one side of the body. RESULTS: Kaplan-Meier survival analysis suggested that median time to heal with application of EGF plus silver sulfadiazine cream was 9 days, in comparison with 15 days for silver sulfadiazine cream alone (log-rank test, P=0.0003). No intervention-related adverse effect was observed during the study. CONCLUSIONS: EGF can significantly reduce healing time of skin lesions in patients with pemphigus vulgaris, at least when this cream base is applied (Cochrane skin group identifier: CSG20).