Searching the web: toward maximizing relevance.

Searching for information on the Web is paradoxically easy but frustrating. There is an increasingly vast amount of high-quality information available on the Internet, but finding it can seem like groping through the world's largest haystack for the proverbial needle. This review discusses some of the most basic and important methods and techniques, (table 1) applicable to almost any search using almost any search engine, whose thoughtful application ensures that the information found is both high-quality and relevant.

Evidenced-based nursing resources.

Evidence-based medicine and, more generally, evidence-based practice (EBP), is the integration of the best available patient care evidence and clinical expertise-guided by and sensitized to patient values-into a patient-oriented decision-making process. It is increasingly clear that all health professions neither equally value nor draw upon the same pool of evidence. Although there are areas of overlap between evidence-based nursing and medicine, for example, there are important differences as well.

The Health Assessment Longitudinal File imperative: foundation for improving the health of the force.

A smaller active duty force and an increased operational tempo have made the Reserve components (RC) essential elements in the accomplishment of the mission of the U.S. Army.

Pain management of older adults after discharge from outpatient surgery.

Older adults manage their pain at home after outpatient surgery. Yet the experience and management of postoperative pain outside the hospital is largely unknown. The purpose of this study was to examine older adults' experiences of postoperative pain and their methods of pain management after discharge from outpatient surgery.

Waiting for lung transplantation: family experiences of relocation.

The waiting period for pediatric lung transplantation begins when it is determined that a child's only choice, other than transplantation, is death within 1 year. Children who are on the waiting list must always be within beeper range of the transplant center. Six parents who temporarily relocated with their children to be closer to the transplant center shared their perceptions of the experience.

A phenomenological framework for psychiatric nursing research.

This article describes a framework developed to support phenomenological research within the context of psychiatric nursing. Phenomenology involves the construction of social reality from the perspectives of those living within a situation. This research approach is of value to psychiatric nurses because of the essence of their practice and the unique nature of their clients' realities.

Nurse practitioner knowledge of complementary alternative health care: foundation for practice.

Aim: With the increasing use of complementary alternative treatments by the general public in the United States of America (USA), it is critical that nurse practitioners have the most up-to-date information about the use and safety of these modalities. A strong knowledge base is crucial in delivering competent and culturally sensitive care, yet the level and source of nurse practitioner knowledge in this area is largely unknown. The purpose of this study was to investigate the level and source of nurse practitioner knowledge of complementary alternative health care practices, as well as their referral practices involving these treatments.

Provider-patient roles in chronic disease management.

Health care provider-patient role relationships can influence patient satisfaction, adherence to treatment, and health outcomes positively. Existing models of role relationships reflect one of three approaches to clinical management--paternalism, consumerism, or shared decision making. These models may or may not reflect the reality of chronic disease management in clinical practice.

Parents call for concerned and collaborative care.

Parents' perceptions and expectations of health care providers within the context of the pediatric lung transplant experience were investigated using a phenomenological approach. Fifteen parents of 12 children were interviewed. Two theme clusters, concerned care and collaborative care, were formulated.

Taking the "ouch" out of injections for children. Using distraction to decrease pain.

Purpose: This research compared the effect of two forms of distraction on injection pain in a convenience sample of preschool children.

Design: A quasi-experimental study of 105 children (53 girls and 52 boys) ages 4 to 6 years needing DPT immunizations. Data were collected at three sites: two school-based immunization clinics and one public health center with a walk-in immunization program.

Pediatric lung transplantation: families' need for understanding.

Fifteen parents of 12 children who had undergone lung transplantation described their relationships with others, such as members of their extended family, coworkers, and friends prior to, during, and following the transplantation. We conducted a content analysis to formulate a narrative description of the parents' relationships with others. The parents described their relationships in terms of the support they received from them.

Making the transition: pediatric lung transplantation.

Introduction: Little information exists regarding how parents whose children have undergone lung transplantation perceive the meaning of their return home to face the reality of the posttransplant experience.

Method: A naturalistic approach was selected to investigate the meaning of the experience from the perspective of the parents. Fifteen parents of 12 children were interviewed.

Laparoscopic splenectomy for splenic sequestration crisis.

Medical and surgical advances have improved the treatment of splenic sequestration crisis in pediatric patients with sickle cell disease (SCD). Rapid enlargement of the spleen can result from sickled blood cels being trapped in the spleen, which can be life threatening. The laparoscopic splenectomy procedure using the lateral approach has been adapted successfully for the pediatric patient since 1993.

Update of the health care management needs of infants with sickle cell disease.

This article describes the characteristics, clinical manifestations, and health care management of infants with sickle cell disease. Also discussed are parent education issues and stressors related to coping with the health care management needs of infants with sickle cell disease. Special emphasis is given to literature focused on the concept of anticipatory grief often experienced by parents of chronically ill children.

Crisis intervention strategies when caring for families of children with cancer.

A diagnosis of childhood cancer is an unexpected life event that often precipitates a situational crisis for all family members. Required cancer treatments and other ongoing stressors for both child and family will significantly disrupt the family's equilibrium and well-being. An increasingly important role of the pediatric oncology nurse is to facilitate crisis intervention strategies that help families adjust to the psychosocial stresses associated with childhood cancer, yet many nurses have little or no training in crisis theory and/or crisis intervention strategies.

Diabetic ketoacidosis: implications for the medical-surgical nurse.

Diabetic ketoacidosis (DKA) is an acute complication associated with type 1 diabetes mellitus. DKA accounts for a significant portion of annual health care expenditures and is considered a medical emergency. Previously treated in the ICU, DKA is now treated on general medical-surgical nursing units.

The new varicella vaccine: efficacy, safety, and administration.

Since the FDA has given approval for the manufacture of a varicella vaccine (Varivax), nurses are beginning to administer the vaccine to children. Over 11,000 healthy and immunocompromised children have been immunized since 1979. Varivax has been found to be 95% to 100% effective in conferring immunity for at least 10 years, and it appears to be a safe vaccine.