Assessment of regional differences in myocardial blood flow using T2-weighted 3D BOLD imaging.

The feasibility of detecting regional differences in myocardial blood flow based on the blood oxygen level-dependent (BOLD) effect was evaluated in vivo in dogs (N = 9) using a 3D T2-prepared segmented gradient-echo sequence at 1.5 T. Regional differences in myocardial blood flow were created by administering adenosine through a catheter placed in the left circumflex coronary artery (LCX). The difference in the R2 (1/T2) relaxation rate between the left ventricular myocardial region supplied by the LCX and regions supplied by the left anterior descending coronary artery (LAD) or septal artery during adenosine administration was correlated to the corresponding regional myocardial blood flow difference determined using fluorescent microspheres. A correlation coefficient of 0.80 was found between the MR BOLD measurements and the myocardial flow assessment. Our results show that the sequence used in this study allows fast 3D BOLD imaging of the heart, and is a promising technique for detecting regional myocardial perfusion differences.

A description of the gastroenterology nurse endoscopist role in the United States.

The use of nurse endoscopists in the specialty of gastroenterology has gained recent support in the United States. While studies using nurse endoscopists have documented positive patient outcomes, including cost effectiveness, public access to cancer screening, and patient satisfaction, research regarding the training and experiences of nurse endoscopists is almost nonexistent. This article presents findings from an exploratory, descriptive study of 17 gastroenterology nurse endoscopists in the United States. Study subjects describe their role as nurse endoscopists, their experiences, and their opinions about basic job and curriculum requirements for further development. These findings support the viability and future expansion of this advanced practice role in gastroenterology nursing.

Colonic cleansing, fluid absorption, and discomfort following tap water and soapsuds enemas.

Tap water and soapsuds are common enema solutions, but little is known about their effectiveness. Consequently, nurses have no guidance when choosing the best enema for a given patient. In this study, liver transplant patients were given either a tap water or soapsuds enema preoperatively. Amount of enema instilled into the colon and output were measured. Soapsuds enemas produced significantly greater output than tap water and were equally well tolerated. Most subjects who received tap water enemas retained more fluid than was eliminated. Based on these findings, nurses should use caution when giving repeated enemas to patients sensitive to large fluid loads.

Self-transcendence and family caregivers of adults with dementia.

Research has documented that caring for a family member with dementia is stressful and burdensome. However, difficult life experiences such as fear, loss, and grief may help persons move beyond a concern for self toward a larger perspective and concern for others. Both positive and negative experiences can promote positive movement toward growth and development. This movement has been described as self-transcendence, or the ability to look beyond the self and present difficulties, to extend concern to others, and to find personal meaning and wholeness in the context of life-changing events. The family caregiving experience with its inherent difficulties might provide the impetus for such a movement toward self-transcendence. The purpose of this article is to examine the concept of self-transcendence, explore its linkages to the caregiving experience, and suggest potential strategies to assist family caregivers to achieve self-transcendence.

Professional, ethical, and legal implications for spiritual care in nursing.

PURPOSE: To highlight nurses' professional and ethical responsibility to consistently provide spiritual care. The legal issue of nurse-client privilege in relation to spiritual care is also discussed. Spiritual care is consistent with the model of holistic care. Yet spiritual care often remains a neglected focus of current nursing practice. CONCLUSIONS: Spirituality, as an important aspect of wellness, is indispensable in nursing care. Nurses are obligated to take an active role in meeting the spiritual needs of patients.

Qualitative research: exploring new frontiers.

Qualitative research is an excellent strategy for exploring new areas of study. It is particularly appropriate for the field of gastroenterology nursing, a developing nursing specialty. In this article, the authors provide an introduction to qualitative research through a comparison of quantitative and qualitative perspectives, exploration of qualitative research designs, and discussion of qualitative analysis. Examples of qualitative research are used to illustrate the rich, vivid, and practical information gained using four different mehtodological approaches. Qualitative research topics appropriate for gastroenterology nurse researchers are suggested.

Shared ideology in Alcoholics Anonymous: a grounded theory approach.

This article uses grounded theory to explore the shared ideology espoused in Alcoholics Anonymous, specifically the nature and role of shared ideology in increasing the efficacy of the recovery process, and the features of the group's tenets and meetings that help facilitate members' indoctrination. Findings support Kassel and Wagner's (1993) contention of shared ideology's major role in the change process of the group, and Antze's (1976) categorizations of the AA ideology and alcoholics' characteristics. Antze's (1979) finding that AA ideology removes the concept of drinking from the voluntary sphere was also supported. The group was found to be a context in which members could change their assumptive worlds through reinterpreting life events, as Frank and Frank (1991) contended. Little support was found for Alexander and Rollins's (1984) comparison of AA to religious cults. The findings underscore the importance of human interaction as persuasion and reinforcement for AA ideology.

Advanced practice nursing: merging the clinical nurse specialist and nurse practitioner roles.

Advanced practice nursing has taken a preeminent role in the recent reform of health care by fostering a perception of leadership, accountability, and responsibility in areas involving access to care, quality of care, and the cost of care. Despite this opportunity for recognition and advancement in the current healthcare system, variations in educational preparation, public confusion about the various roles and titles within advanced practice nursing, and differing professional certifications plague the opportunity for an elevated status of advanced practice nursing. In this article, the author addresses the issues related to merging the clinical nurse specialist and nurse practitioner roles. A review of the historical development of advanced practice nursing along with current practice issues and future needs is also presented.

Society of Gastroenterology Nurses and Associates, Inc. (SGNA) Endoscopic Disinfectant Survey results compared with control group.

Disinfectant surveys from responding members of the American Society of Postanesthesia Nurses were divided into two groups based on whether or not they considered themselves to be exposed to disinfectants in their work environment. Their survey responses were then compared with those obtained previously from members of the Society of Gastroenterology Nurses and Associates, Inc., who were regularly exposed to 2% alkaline glutaraldehyde in the work setting. There were significant differences among the groups in the percentage of respondents who reported having headaches, eye irritations, respiratory problems, shortness of breath, rashes, memory loss, mood swings, and fatigue. These findings support the association of these complaints with 2% alkaline glutaraldehyde exposure. In contrast, there were no significant differences among the groups in the percentage of respondents who reported having asthma, rhinitis, chest pain, nausea, diarrhea, muscle/joint pain, visual disturbances, or dermatitis.

Enema administration techniques used by experienced registered nurses.

The enema has evolved through trial and error, not scientific investigation. Because little scientific base exists, the authors began their study of enemas by examining current nursing practice. They asked 24 experienced registered nurses to describe how they give enemas, and if they had seen any complications. Interviews were audiotaped, transcribed, and analyzed using qualitative analysis software. The authors found that the nurses emphasized patient cooperation, preparation, and comfort; had observed few complications, and had difficulty describing quantitative aspects of enemas (e.g., amount of solution given, speed of administration).

Alveolar bone loss in two children with short-bowel syndrome receiving total parenteral nutrition.

Two preschool children who were receiving total parenteral nutrition (TPN) for short-bowel syndrome (SBS) were noted to have radiographic evidence of alveolar bone loss in their primary dentition. Tooth mobility, gingival recession, and premature tooth loss were clinical findings in these children. Both had a 2-year history of recurrent infections and fluctuating serum electrolytes prior to identification of their dental problems.