What are the reasons for nurses using complementary therapy in practice?

The increasing popularity of complementary therapies has generated many surveys to establish how many nurses are involved in its use. This paper explores reasons why nurses are using complementary therapy in orthodox nursing practice to determine the catalysts influencing its use. The following areas are addressed: definitions, terminology and historical aspects of complementary medicine relationship with orthodox medicine, examining dominance, conflict, partnerships and socialization rise in popularity nurse involvement and implications to the profession methodology and findings conclusion. Information about nurses practising complementary therapies was obtained from the King's Fund London and from hospitals within the researcher's local area. Questionnaires for the pilot study were self administered locally, while those for the main study were sent through the postal system.

Restricting the time of injury in fatal inflicted head injuries.

OBJECTIVE: To determine the normal clinical progression of fatal head injuries in children. Such information can then be used to estimate the time of injury in cases with obscure histories and will thus aid investigations of nonaccidental trauma. METHOD: A retrospective chart review design was used. One hundred and thirty eight accidental fatalities involving head injury were identified and 95 of these were used as the study group. Details of the cases were reviewed and cases in which a child either had a Glasgow Coma Scale (GCS) of 14-15 or was described as having a "lucid interval" or as being "conscious" were further studied. RESULTS: One "lucid interval" case was identified. This case involved an epidural hematoma. Three other cases that partially met the criteria for a lucid interval were also identified; one of these cases did not meet the criteria for inclusion in the study group. Review of head CTs revealed that brain swelling could be detected as early as 1 hour and 17 minutes post injury. CONCLUSIONS: The children studied were in obvious serious medical condition from the time of injury until death. If a history purports a lucid interval in a fatal head injury case that does not involve an epidural hematoma, that history is likely false and the injury is likely inflicted. The time of most fatal head injury events can be restricted to the time period after the last confirmed period of wellness for the child. In addition, the presence of brain swelling on a head CT scan is not helpful in restricting the time of injury.

Legal considerations in cases of child abuse.

Child abuse is a common pediatric problem that can be recognized and treated appropriately by all primary care physicians who care for children. One of the necessary skills in this process involves being prepared to interface with the legal system. The physician is mandated to report suspected child abuse according to his or her state laws. He or she must be aware of the legal recourses for child protection in cases when the child remains at risk. When interacting with the child, a number of legal considerations can guide the physician in obtaining information with history, physical examination, and specimen collection. Finally, the physician may be called to testify. An understanding of how to prepare for court and how to conduct oneself in court is the final necessary skill for the primary care physician who sees children. This article provides the primary care physician with a practical understanding of the legal considerations in child abuse.

Deaths from falls in children: how far is fatal?

The outcome of injury was determined in 317 children who were brought to a children's trauma center with a history from the caretaker that the child had fallen. Cases in which the clinicians' judgment was that an incorrect history had been given were included along with cases in which the history was not questioned. Seven deaths occurred in 100 children who fell 4 feet or less. One death occurred in 117 children who fell 10 feet to 45 feet. The 7 children who died in short falls all had other factors in their cases which suggested false histories. When children incur fatal injuries in falls of less than 4 feet, the history is incorrect. Long falls with an outdoor component are likely to be reliable data points for studies of children's injuribility.

Preparation for court testimony in child abuse cases.

Medical expert testimony in child abuse cases is a socially essential task if children are to be protected from abuse. Accomplishing this task in an excellent way is an important challenge requiring attention to its ethical, legal, and administrative aspects as well as to technical medical considerations. As the field of child protection matures as a medical specialty, expertise in child abuse becomes increasingly definable; it is now sufficiently definable to allow courts to begin to separate those physicians who are specialists in the field from those who are not.

Optical properties of new oxide glasses with potential for long-wavelength optical fibers.

The optical transparency and refractive index were measured over a wide wavelength range from the UV into the infrared for five glasses of potential use for long-wavelength optical fibers. The glasses contain 30-50 mole % Ge0(2) with the addition of Bi(2)O(3), Tl(2)O, PbO, and Sb(2)O(3). Indices were measured with a computerized refractometer to an accuracy of +/-3 x 10(-5) and were fitted within this accuracy to a three-term Sellmeier formula. This formula was then used to obtain interpolated index values, the dispersion, Abbé number, wave-length for zero material dispersion lambda(0), and slope of material dispersion vs wavelength (dM/dlambda) at lambda(0) The temperature coefficients of the refractive index were also measured over a wide wavelength range, and the glasses were characterized by density, thermal expansion, glass transition, and crystallization temperatures. Raman and Brillouin spectra were also recorded on one of these glasses and the latter used to determine the elastic constants. The refractive indices ranged from n(D) = 1.93948 to n(D) = 2.28553, with Abbé numbers between 22.7 and 10.5. Values of lambda(0) were in the range from 2.08 to 2.81 microm combined with -dM/dlambda values from 54.8 to 85.0 psec/nm . km . microm, significantly lower than that of fused silica (101 psec/nm . km . microm). These glasses show promise for waveguide fibers for the 3-4-microm region if ultrahigh purity specimens can be prepared.

Partial trisomy 20p derived from a t(18;20) translocation.

Two sibs show a strikingly concordant syndrome of congenital anomalies and G-banding reveals that each has partial trisomy 20p resulting from a t(18;20) translocation. They resemble other cases of partial trisomy 20p in some respects but also differ in some ways. Their normal sib, mother, and half-aunt are balanced heterozygotes for the t(18;20) translocation. The segregation of the balanced translocation in this family is associated with an extremely poor reproductive record. The segregation pattern closely parallels that of a t(13;20) translocation in a family described by Carrel et al. (1971) and Francke (1972). The similarity of segregation patterns is predictable on the basis of probable pachytene configurations, but the dissimilarity of phenotypes between families is not readily explained.

Childhood pelvic osteomyelitis presenting as a "cold" lesion on bone scan: case report.

A case of occult pelvic osteomyelitis is presented. The involved portions of the left pubis and left ischium presented as "cold" areas on the original bone scan with 99mTc-diphosphonate. The presumed mechanism for this unusual finding in osteomyelitis is compression of the microcirculation to bone by subperiosteal and intraosseous pus.

Origin of a small metacentric chromosome: familial and cytogenic evidence.

A family is described in which the mother has an 18p- chromosome, one normal 18, and a probable i(18p). One of the daughters of this woman inherited the 18p- chromosome, and her phenotype resembles that of other 18p- cases. The other daughter inherited the presumed i(18p) chromosome, and her phenotype resembles that of some cases with extra, small metacentric chromosomes. The clinical, chromosomal, and familial evidence suggest that these abnormal chromosomes originated in the occurrence of one transverse break of the centromere and subsequent misdivision of a chromosome 18 in an earlier generation of this family. According to this interpretation, the mother is trisomic for 18p, one daughter is monosomic and the other daughter is tetrasomic for this chromosomal region.