Comparison of mammography, sonography, and magnetic resonance imaging in the detection of silicone-gel breast implant rupture.

Silicone-gel breast implant rupture is difficult to diagnose preoperatively. A variety of radiological methods have been used for diagnosis. This study prospectively compares film-screen mammography, high-resolution sonography, and magnetic resonance imaging in the diagnosis of implant rupture using predetermined diagnostic criteria.

Infusing research into practice to promote quality care.

This article describes the Iowa Model of Research in Practice, a heuristic model used at the University of Iowa Hospitals and Clinics for infusing research into practice to improve the quality of care. The components of the model are presented with examples. The impact of the model on patient, staff, and fiscal outcomes is delineated.

Geropsychiatric nursing consultation: a valuable resource in rural long-term care.

Psychiatric and geropsychiatric nurse specialists have the potential to positively influence the day-to-day care provided in rural nursing homes by acting as teachers, resource persons, facilitators, and role models to long-term care (LTC) personnel. The combined approach of training LTC nurses to train their own staff while supporting the application of learning with consultee-focused nursing consultation proved to be an effective and time-efficient method of improving the geropsychiatric nursing care provided in rural nursing homes.

Ways to promote successful training.

With today's financial cutbacks, long-term care facilities are looking for low-cost ways to help nurses meet licensing requirements. In-house training can be one economical way, but getting employees involved is another challenge.

Use of substitute decision makers by the mentally ill rural elderly: an issue of concern for mental health nurses.

In 1986, the Abbe Center for Community Mental Health implemented a nurse-led elderly outreach program (EOP) designed to identify and treat elderly rural residents in need of mental health care. Because some EOP clients evidenced a lack of or limited decision-making capacity, a record review was conducted to answer the following questions: Do any of the clients have a legal substitute decision maker? What are the forms of substitute decision making? Is there a familial relationship between the elderly client and the substitute decision maker? Is there evidence that any of the named legal substitute decision makers have abused the elder? Almost half the clients who had a substitute decision maker used a power of attorney. Adult children were the most frequent family members named as substitute decision makers.

Mental health of rural elderly: a research agenda for nursing.

Only recently have the health sciences, including nursing, begun to focus on the dynamics of mental health and aging. Reports on rural initiatives, are beginning to appear; these developments have occurred without the benefit of context and direction, however, especially in terms of how these issues apply in rural areas. The article reviews selected issues in the interface of aging and mental health in rural areas.

Nasogastric and nasointestinal feeding tube placement: an integrative review of research.

The authors present a review of the research on various methods for determining placement of nasogastric and nasointestinal feeding tubes. They also discuss research on associated risk factors, complications specific to critical care patient populations, and techniques for postpyloric placement. They present research consensus, recommendations for practice, and implementation strategies.

A nursing challenge: Assessment and management of agitation in Alzheimer's patients.

1. Agitation in patients with Alzheimer's disease is a pervasive problem. The behaviors associated with agitation may have detrimental effects on the patient, health care providers, and other patients.

Essential clinical experience for subspecialty development in geropsychiatric nursing.

1. Subspecialization in geropsychiatric nursing builds on the specialist preparation obtained in graduate level psychiatric/mental health or gerontologic nursing education. 2.

Geropsychiatric nursing: a clinical knowledge base in community and institutional settings.

1. The term clinical knowledge base refers to the foundations and areas of knowledge that are integral to an independent and interdependent clinical discipline. 2.

Evaluation of a geriatric mental health training program for nursing personnel in rural long-term care facilities.

Although mental illness among elderly living in nursing homes is a substantial and growing concern, the behavioral problems associated with mental illness or threats to mental health are not well understood, tolerated, or effectively managed by nursing home staff. As a result, resident care and quality of life, and staff morale often suffer. The need for geriatric mental health training in long-term care settings has become increasingly apparent.

Alzheimer's special care units.

An overview of Alzheimer's special care units is provided, including the several models that have been used to guide their development. Philosophy and programming, physical and social environments, staff selection and training, admission and discharge criteria, family programming, and quality and cost features are described. Evaluation and research of special units and interventions for residents with Alzheimer's, their family members and staff caregivers are discussed.

Alzheimer's residents' cognitive and functional measures: special and traditional care unit comparison.

The aim of this field experiment was to compare the effects of a special care unit (SCU) on residents with Alzheimer's disease (AD) who lived on the SCU and on traditional (integrated) nursing home units. Twenty-two subjects, 13 on the SCU and 9 on traditional integrated units were compared. Repeated measures ANOVA was used to assess differences between the two groups and within the groups over two bimonthly pretests and two bimonthly posttests.

Case report 824: Tuberculosis presenting as a soft tissue forearm mass in a patient with a negative tuberculin skin test.

Tuberculosis presenting as a soft tissue mass is rare. The diagnosis should be considered in patients with radiographic findings of massive soft tissue swelling and cortical bone destruction. Such patients may present with few clinical findings and have no evidence of prior exposure to tuberculosis or history of immunosuppression.

Emotional responses of family members during a critical care hospitalization.

Background: The needs and satisfaction levels of family members of critically ill patients have received much attention in the literature. The feelings of family members, however, have not been thoroughly investigated. To develop appropriate nursing interventions to assist family members in coping with a critical care hospitalization, accurate information about their emotional response to the situation is needed.

A nursing perspective on SCUs.

Much of what is in the literature regarding nursing of AD patients and their families is anecdotal, has not been validated by systematic research, and is atheoretical. The majority of nursing research in AD has focused on patient characteristics and problem behaviors or on the needs and experiences of family care givers rather than on characteristics of SCUs. Research should continue in these areas, along with testing nursing interventions to maintain the optimal cognitive, physical, social, and emotional function of residents with AD in institutional settings.

Langerhans cell histiocytosis of bone: MR imaging.

Magnetic resonance (MR) images of 12 pathologically proven lesions of Langerhans cell histiocytosis (LCH) of bone were reviewed retrospectively. MR identified all lesions, three of which were not identified on plain radiographs. In all cases, MR showed greater abnormality than did plain radiographs.

Displacement analysis of the temporomandibular condyle from magnetic resonance images.

A technique was developed to investigate the condylar displacement of the human temporomandibular joint. Condylar displacement was analyzed from magnetic resonance images of the joint. Fourteen static images were obtained during incremental jaw closure.

Managing the care of patients with irreversible dementia during hospitalization for comorbidities.

Caring for the patient with AD hospitalized with comorbidities is a nursing challenge. By educating staff, using the PLST model, working with families, and implementing patient-focused care, positive outcomes are not only possible but probable. It is important for staff to work with caregivers in all aspects of care of the patient incorporating the patient's personal and medical historical knowledge into the care plan.

Behavioral responses of family members during critical illness.

This articles describes the behavioral responses of adult family members to critical illness and how these responses change over the course of the hospitalization. A convenience sample of 52 family members of patients in intensive units completed the Iowa ICU Family Scale, a self-report tool measuring sleep, eating, activity, family role, and support behaviors. Scales were completed by family members each day during the first week and then weekly throughout the patient's ICU stay.

An administrator's dilemma: keeping the innovative mental health and aging programs alive after the grant funds end.

Too often innovative and successful mental health and aging programs terminate when external funding sources end. This article describes one such project that has survived and even flourished well beyond the grant period. The original program is set forth, and changes in both the type of services offered and in the clientele are reviewed.

Catastrophic reactions and other behaviors of Alzheimer's residents: special unit compared with traditional units.

Using a quasi-experimental pretest/posttest design, the effects of a Special Care Unit (SCU) on the incidence of catastrophic reactions and other behaviors of nursing home residents with Alzheimer's disease (AD) were examined. Findings indicate significantly fewer catastrophic reactions and other selected behavior changes occurred during the posttest period for subjects in the experimental group compared with the subjects in the control group. Implications for psychiatric consultation/liaison nurses (PCLNs) working with this vulnerable population are discussed.