Spatial relationship between ambulatory surgery centers and colorectal cancer mortality within Pennsylvania, United States.

OBJECTIVES: The objective of this study was to evaluate the spatial relationship between colorectal cancer (CRC) mortality and ambulatory surgery center (ASC) density in Pennsylvania's 67 counties. STUDY DESIGN: This was an ecological study. METHODS: Age-adjusted CRC mortality rates were linked to ASC densities per 1,000 people. The data set was analyzed using global, local, and regional Moran's I, to test for randomness in CRC mortality and ASC density. RESULTS: CRC mortality rates (median: 15.30 per 100,000 of the US 2000 standard million population) exhibited hot spots in rural Pennsylvania counties. ASC densities (median: 0.35 providers/km2 per 1,000 people) showed hot spots in urban southeastern Pennsylvania and cold spots in northern Pennsylvania. CONCLUSIONS: CRC mortality rates tended to cluster in rural northern Pennsylvania counties; ASC density tended to cluster in urban southeastern counties, indicating a spatial disparity between needed and provided healthcare resources. There is a need for public health and health system changes to increase the availability of CRC services to rural communities.

Metal-assisted electrochemical etching of silicon.

In this paper the metal-assisted electrochemical etching of silicon is introduced. By electrochemical measurement and sequent simulation, it is revealed that the potential of the valence band maximum at the silicon/metal interface is more negative than that of the silicon/electrolyte interface. Accordingly, holes injected from the back contact are driven preferentially to the silicon/metal interface. Consequently, silicon below metal is electrochemically etched much faster than a naked silicon surface without metal coverage. Metals such as Ag and Cu have been utilized to catalyze the electrochemical etching. Feature sizes as small as 30 nm can be achieved by metal-assisted electrochemical etching. Meanwhile, the metal-assisted electrochemical etching method enables convenient control over the etching direction of non-(100) substrates, and facilitates the fabrication of orientation-modulated silicon nanostructures.

Contributing to the ICNP: validating the term 'informal settlement'.

AIM: The specific aims of this study were to propose a definition of the term informal settlement, validate the term informal settlement, and submit a term and definition for international utilization to the International Council of Nurses (ICN) for consideration for inclusion in the International Classification of Nursing Practice (ICNP). BACKGROUND: South Africa was one of four African countries (Botswana, South Africa, Swaziland and Zimbabwe) funded by the WK Kellogg Foundation to participate in the ICNP project. South Africa had two research groups. One of the research groups identified the term informal settlement to define. METHODS: This was a qualitative study where a philosophical perspective was used to explore, explain and describe nursing practice. The combined method proposed by the ICN was utilized to define and validate the term informal settlement. FINDINGS: Validation and literature review provided sufficient support for the defined characteristics and the term was finally defined and submitted to ICN on 12 April 2001 as informal settlement is a type of residential development with the specific characteristics--temporary residential structures, erected with limited or no formal infrastructure, densely populated, no secure tenure for occupants, no property demarcations, often associated with overcrowding/limited or no privacy, and low standard of living, being situated in high risk areas with an increased risk for disease and disasters. CONCLUSION: The ICNP Evaluation Committee recommended inclusion in the ICNP with minor changes in February 2003.

Contributing to the ICNP: validating the term cultural diversity.

AIM: The specific aims of this study were to: Propose a definition of the term cultural diversity; Validate the term cultural diversity; and Submit a term and definition for international utilisation to the International Council of Nurses (ICN) for consideration for inclusion in the ICNP. BACKGROUND: South Africa was one of four African countries (Botswana, South Africa, Swaziland, and Zimbabwe) funded by the WK Kellogg Foundation to participate in the ICNP project. South Africa had 2 research groups. One of the research groups identified the term cultural diversity to define. METHOD: This was a qualitative study where a philosophical perspective was used to explore, explain and describe nursing practice. The combined method proposed by the International Council of Nurses (ICN) was utilised to define and validate the term cultural diversity. FINDINGS: Validation and literature review provided sufficient support for the defined characteristics and the term was finally defined and submitted to ICN in November 2002 as: CULTURAL DIVERSITY is a type of CULTURE with the specific characteristics: co-existence of different groups, e.g. ethnic, religious, linguistic and other groups each with their own values and belief systems, traditions and different lifestyles. CONCLUSION: The research group was informed in December 2003 of the ICNP Evaluation Committee recommendation that the term cultural diversity will be included in the ICNP.

Enabling legislation in diagnosis and prescribing of medicine by nurses/health practitioners.

The South African health system has undergone major changes over the last 5-10 years. These rapid changes have not only significantly increased the visibility of the nurse practitioner in South Africa, but are also posing challenges to the profession and health care services that need to be addressed. In its Health Policies the Government has indicated that the nursing/midwifery profession, as the biggest group of health care professionals, should be the practitioners to provide primary health care services to the communities. But to do this, they require enabling legislation. The "permit system" has been in place for non-pharmacists and institutions other than hospitals and pharmacies to acquire, possess, use and supply medication for a number of years. This system has been fraught with problems mainly due to a lack of clarity on exactly how the system works and the system had been abused. The purpose of this article is to explore the current situation with the aim to analyze the legal framework that exists within which the primary health care services, and specifically the diagnosing and prescribing of medication, could be performed. The conclusion is made that health legislation has not kept up with the rapid changes in service delivery and are not adequate to empower the nurse to deliver health services. Some recommendations are made for the way forward.

[X-rays taken by nurses]. / Neem van x-strale deur verpleegspersoneel.

Medical technology makes use of ionising radiation in many ways to diagnose and treat disease. One of these is X-rays. In rural areas there are hospitals where the services of a radiographer are not available and nurses take over this task. No formal training is available for these nurses in order to equip them with the necessary knowledge and skills to take X-rays. This article looks into the nature of this phenomenon.

[Cost estimation of an intensive care unit]. / Kosteberaming van 'n chirurgiese intensiewe eenheid.

The cost of health services has increased tremendously due to advances in technology, and the cost of intensive care units forms an important part of total hospital costs. A survey done over a 3-month period of all human and material resources utilised in a surgical intensive care unit showed that the average cost amounted to R1 298 per patient per day.

Rolipram in major depressive disorder: results of a double-blind comparative study with imipramine.

Rolipram improves signal transmission in central noradrenergic neurones at a pre- and postsynaptic level, and is thus a novel approach in antidepressant therapy. In order to prove efficacy, tolerance, and safety, several controlled studies are underway. Results of a randomized double-blind comparative trial versus imipramine involving 64 in-patients with Major Depressive Disorder (DSM III) in six independent centers will be presented and discussed. The chosen biometric model provided evidence that towards the end of the study imipramine was superior to Rolipram. The particular clinical relevance of this difference is discussed. As regards tolerance, nausea emerged as the typical side-effect of Rolipram, whereas imipramine precipitated mainly anticholinergic side-effects.

[Preliminary physiological and psychological results under various electroclimatic conditions (author's transl)]. / Physiologische und psychologische Erstresultate unter verschiedenen elektroklimatischen Bedingungen.

Before the start of a research project which was to stretch over a period of several years, characteristics of the control space were to be defined. Therefore the influence of spherics and 50 Hz-alternating fields in the unscreened control space were studied.--Pupils (Foster children) were the test subjects. Each test subject was subjected to the conditions of the control space as well as the testing space.--Two classes of parameters were studied. Blood sugar, blood pressure and pulse rate were recorded as physiological dimensions. Short-term memory, powers of concentration as well as the subjective well-being were the psychological parameters.--As to the parameters examined, no significant difference between testing and control space conditions was recorded. In order to examine whether the climatic factors of the control space have an antagonistic effect on the variables in question, their influence was studied separately in two further investigations. In order to clarify this problem, spherics-impulses in the 10 Khz range were given in screened space ("Vorversuch 2"/preliminary experiment 2), then--in, "Vorversuch 3"/preliminary experiment 3 - a 50 Hz-alternating field was applied. For each of the climatic factors under examination the influence on each single parameter was negative. The assumption of an antagonistic effect which would hinder the definition of standard spatial conditions was thereby shown to be incorrect.