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We compared health-related control perceptions in 115 HIV+ gay/ bisexual British men who were or were not members of an AIDS support group. Participants completed the Multidimensional Health Locus of Control Scale (MHLC). Compared to those who were not members of a support group, HIV+ men who belonged to a support group reported higher frequencies of perceptions that both oneself and powerful others (health professionals) are major determinants of one's health. Support group members also reported a lower frequency of perceptions that chance factors greatly influence one's health.

The national prevalence of elder abuse is unknown, and estimates vary from study to study. Currently, 1.2 to 2 million older Americans are believed to be victims of elder abuse each year. Researchers and clinicians concur that elder abuse is underreported, is a serious problem, rarely occurs as an isolated event, persists over extended periods, and requires coordinated intervention.

Purpose: To prevent hemorrhagic cystitis, mesna is typically injected intravenously (i.v.) at the time of an ifosfamide dose and 4 and 8 h later. To simplify outpatient ifosfamide therapy, we gave the second and third mesna doses orally., Methods: The mesna doses (400 or 600 mg/m2) were 40% (w/w) of each ifosfamide dose (1.0 or 1.5 g/m2), which was given daily for 5 days. We evaluated urinary mesna excretion and plasma concentrations in ten patients from the beginning of mesna infusion until the time of the second oral dose. The first oral dose was administered at hour 2 in the last six patients to allow time for absorption of mesna., Results: The rate and amount of mesna excretion was less variable over time and among patients after oral than after i.v. administration. No macrohematuria was observed in these ten patients nor in an additional 50 patients given oral mesna at hours 2 and 8 during at least two cycles of ifosfamide therapy., Conclusion: These pharmacokinetic and clinical efficacy data support the use of a combined regimen of i.v. and oral mesna to simplify outpatient ifosfamide administration.

The introduction of university based nurse education in Australia has nursing students spending more time in the classroom and less time in clinical settings. This decrease in clinical exposure may result in reduced opportunities for students to develop pertinent patient assessment and management skills. This is particularly true of skills required for effective wound assessment and management. Computerised databases offer an innovative method of teaching or refining these skills in a cost and time-effective manner without risk to patients or students. Such technology can also provide important grounding in data identification, hypothesis testing, problem solving and clinical decision making skills. This paper explores the underlying pedagogical principles of database use and describes the development of the prototype closed database, DECUBITUS. The prototype database included the following data fields; physical assessment, clinical diagnosis, risk assessment, wound assessment and treatment modality. The introduction of more sophisticated databases will permit the storage of visual images of actual wounds thus providing an additional dimension to the teaching of wound assessment and management.

Developments in Information Technology are requiring nurses to not only access complex information but also manipulate it within an information rich environment to benefit patient care. Within such an environment, the role played by the Internet and more specifically, the World Wide Web (WWW or web), will become increasingly important to health care providers. Nurse academics within the School of Nursing, Monash University, have adopted an innovative and integrated approach to Internet technologies as part of information processing and inquiry in nursing. This approach is aimed at enhancing the teaching/learning process by lending additional richness to the learning environment. Initial feedback from this project supports the assumption that information technology has an important, and increasingly prominent, role to play within nursing education and clinical practice. Although very much at an embryonic stage, the project has been well received by students and staff alike. This descriptive paper will attempt to highlight some of the benefits of the project for nurse academics and students, provide an overview of Internet and WWW applications and suggest some practical applications of these technologies in nurse education.

Background and Purpose: The purposes of this study were to describe physical therapists' knowledge regarding battered women and to determine whether physical therapists recognize these patients in clinical settings., Subjects and Methods: Two hundred questionnaires were distributed to outpatient physical therapists in northern California. One hundred fifty-one usable questionnaires (76%) were returned., Results: Although 43% of the respondents reported treating a patient they identified or strongly suspected as having been battered, only two respondents (1%) reported they routinely asked patients about physical abuse. Less than 50% of the respondents correctly identified that battering injuries are more likely to occur in a central pattern (ie, head, neck, chest, abdomen)., Discussion and Conclusion: The results of this survey suggest that physical therapists have treated patients who are battered. Many physical therapists, however, may not be fully educated to detect the signs of abuse. This study is the first step in initiating physical therapy research in domestic violence identification and education.

A retrospective study of tinnitus sufferers who had committed suicide was undertaken. A questionnaire was compiled, and circulated world-wide. Adequate information was obtained on 28 suicides. An association between suicide and left-sided tinnitus reported previously, was not conclusively replicated. In fact, no particular tinnitus parameter, or associated audiological symptom was over-represented in the suicide series. Demographically, tinnitus suicide victims were characterized by being male, elderly, and socially isolated. There was a high prevalence of psychiatric morbidity, in particular depression (70%). A suicide attempt within the year preceding suicide occurred in five individuals.

This article discusses the perinatal health issue of abuse directed at pregnant women by their intimate partners. The incidence, prevalence, and severity of intimate violence during pregnancy are presented, as is a discussion of the possible health disruptions that can occur as a result of violence and abuse. Nursing interventions for abused pregnant women are presented within a framework of advocacy and empowerment. Strategies for primary prevention are outlined, and methods of secondary and tertiary intervention are discussed. The article concludes with a discussion of culturally relevant practice for abused women.

This study assesses the prevalence of psychological disturbance among a consecutive series of 120 neuro-otology outpatients, using a structured interview conducted by a clinical psychologist. 42% of all patients were found to be in need of, and were offered, psychological help (27% of those with hearing loss, 45% of those with tinnitus and 64% of those with dizziness). 86% of those offered psychological help accepted it. Current psychological distress was associated with the number of symptoms complained of and past psychiatric history. Patients completed the General Health Questionnaire which was found to have a sensitivity rate of 82% and a specificity rate of 87% in this setting. Physicians were also asked to rate patients' psychological state; close agreement was found between these ratings and those of a psychologist. The contribution of psychological assessment of neuro-otology patients is discussed.

Methoxamine and phenylephrine (PE), postsynaptic alpha adrenergic agonists stimulated the accumulation of cyclic AMP in spinal cord tissue slices. Naphazoline, oxymetazoline and clonidine, previously shown to have greater efficacy at presynaptic alpha receptors did not alter accumulation and, in fact, blocked the PE response. The PE-stimulation was completely inhibited by postsynaptic alpha antagonists, incompletely by agents which bl ock presynaptic alpha receptors, and slightly by the beta blocker propranolol. Pe-stimulated accumulation was potentiated by phosphodiesterase inhibition (RO 20-1724). In contrast to previous reports on the requirement of the copresence of adenosine for alpha receptor stimulated accumulation of cyclic AMP in neuronal tissue, the PE-stimulation in spinal cord slices was unchanged by adenosine receptor blockade (theophylline), hydrolysis of endogenous adenosine (adenosine deaminase), inhibition of adenosine deaminase (EHNA) or blockade of adenosine uptake (dipyridamole). Added adenosine increased basal accumulation and produced a marked potentiation of the PE response. From this data it is evident that, in spinal cord tissue slices, there occurs a postsynaptic alpha adrenergic receptor linked to cyclic AMP accumulation which does not require the presence of other neurohumoral agents for activation.

This paper describes the processes involved in goal planning, a means of structuring and evaluating a rehabilitation programme which is individually designed for a particular patient. The goal planning procedure involves a multi-disciplinary effort with the patient as an integral member of the team. Goals, which are identified from a strengths-needs list compiled by the team for a patient, are broken down into specific steps which should be easy to achieve by a given target date. The patient's strengths are used to help achieve the goals. Each step should be written in clear and objective terms and the use of vague goals such as 'the patient should make better use of a hearing aid', should be avoided. Goal planning does not dictate which therapy should be used but it does provide a framework for implementing any therapy that the team decide is appropriate. An example of a goal plan used in an audiological rehabilitation clinic is given.

The use of a cochlear implant (CI) to restore some acoustical input to patients with complete acquired hearing loss may be expected to result in changes in their psychological functioning. CI programmes should therefore include a careful psychological screening of all candidates and subsequent psychological assessments of patients who receive implants. Procedures used in the psychological assessment of CI candidates and patients outlined in the literature, as well as those used in the Royal Ear Hospital (REH) programme, are discussed. It is concluded that standard psychological tests of personality and intellectual functioning are of limited value in the screening of CI candidates and the postoperative evaluation of patients. It is proposed that more useful information be obtained by an analysis of the possible functional value of the implant to each individual candidate and by assessment of actual postoperative changes in the patient's behaviour. Unless an implant leads to improvements in the patient's psychosocial functioning, the device is unlikely to be used. Examples of this approach in assessing the REH candidates and patients are given.