A model for enhancing worldwide personal health and wellness.

Individuals must increasingly take control of managing their own health affairs. This requires access to quality information that is not easily obtained from traditional social institutions. NetWellness is an electronic consumer health information service that provides a model for reaching the goal of enhancing personal health and quality of life. [1] We present a vision of consumer health information delivery in the 21st century, and a model for reaching that vision. Our experience to date, progressing through a five-phase model, is aimed at providing the best health information possible to the widest population possible.

Conscious sedation in cardiovascular procedures.

CS is commonly used in conjunction with CV procedures. Although CS provides a means to manage patient anxiety and discomfort, it also poses risks for the CV patient. The RN in the CV procedure lab plays a key role in the management of patients receiving CS. By formulating an individualized CS plan that integrates procedure risks, underlying disease processes, and medication effects, the RN minimizes patient risks and optimizes symptom management.

Approaching equity in consumer health information delivery: NetWellness.

The growing public interest in health and wellness information stems from many sources, including social changes related to consumers' rights and women's health movements, and economic changes brought about by the managed health care revolution. Public, hospital, and medical center libraries have been ill-equipped to meet the increasing need for consumer-oriented materials, even though a few notable programs have been established. The "Information Superhighway" could be an effective tool for sharing health information if access to telecomputing equipment and training were available to those with an information need. The University of Cincinnati Medical Center, with its libraries in the leading role, is delivering NetWellness, an electronic consumer health library service, to residents of 29 counties in three midwestern states. Users connect directly through the Internet, through regional Free-Nets, and by visiting one of 43 public access sites where networked workstations have been installed. The continued success of the project depends on developing partnerships, providing quality content and maintaining fair access.

An electronic consumer health library: NetWellness.

NetWellness is a community-based, consumer-defined grant program supporting the delivery of electronic health information to rural residents of southern Ohio and urban and suburban communities in the Greater Cincinnati tri-state region. NetWellness is a collaboratively developed and publicly and privately funded demonstration project. Information is delivered via ISDN, standard dial, dedicated network connections, and the Internet. TriState Online (Greater Cincinnati's Free-Net) and other southern Ohio Free-Nets are key access points in the larger project communities. The other access points are more than forty workstations distributed at public sites throughout the project's primary geographical area. Design strengths and limitations, training initiatives, technical issues, and the project's impact on medical librarianship are examined in this paper. Also discussed are ways of determining community needs and interest, building political alliances, finding and developing funding sources, and overcoming technical obstacles. NetWellness's Internet address is: http:@www.netwellness.org.

The bundling of actin with polyethylene glycol 8000 in the presence and absence of gelsolin.

Actin filament and bundle formation occur in the cytosol under conditions of very high total macromolecular concentration. In this study we have utilized the inert molecule polyethylene glycol 8000 (PEG) as a means of simulating crowded conditions in vitro. Column-purified Ca-actin was polymerized in the absence and presence of gelsolin (to regulate mean filament lengths between 50 and 5000 mers) and PEG (2-8%) using various concentrations of KCl and/or 2 mM divalent cations. Bundling was characterized by the scattered light intensity and mean diffusion coefficients obtained from dynamic light scattering, as well as by fluorescence and phase-contrast microscopy. The minimum concentration of KCl required for bundling decreases both with increasing concentration of PEG at a fixed mean filament length, and with decreasing filament length at a fixed concentration of PEG. In the absence of divalent cation, bundling is reversible on dilution, as determined by intensity levels, diffusion coefficients, and microscopy. However, with either 2 mM Mg2+ or Ca2+ added, bundling is irreversible under conditions of higher PEG concentrations or longer filaments, indicating that osmotic pressure effects cannot fully explain actin bundling with PEG. Weaker divalent cation-binding sites on actin as well as disulfide bonds appear to be involved in the irreversible bundling.

Is it a contact hour, a continuing education recognition point, or a continuing education unit?

Based on the content of this article, the reader should be able to: (1) differentiate between a contact hour, a continuing education recognition point, and a continuing education unit; (2) identify states that require mandatory continuing education for relicensure; and (3) define certification.

Succinylcholine: "good guy, bad guy".

Based on the content of this article, the reader should be able to (1) identify the action of succinylcholine; (2) list drugs that potentiate the effects of succinylcholine; (3) identify the conditions that potentiate the effects of succinylcholine; (4) name conditions in which succinylcholine is contraindicated; (5) state the laboratory test for determining various genotypes of plasma cholinesterase; and (6) identify the classic clinical tests for determining return of muscle tone.

The patient with post-transurethral resection of the prostate syndrome.

Based on the content of the article, the reader should be able to: (1) list signs and symptoms of transurethral resection of the prostate syndrome as it relates to the case study, (2) identify clinical manifestations that relate to different serum sodium levels, (3) identify the cause of the patient's temporary blindness, and (4) differentiate results between the use of hypotonic versus isotonic irrigating solutions.

New radioimmunoadsorbent method for detection of hepatitis B surface antigen.

A radioimmunoadsorbent assay for the detection of hepatitis B surface antigen (HBsAG) is described. The method uses small DEAE-cellulose columns to adsorb HBsAg from serum or plasma samples, and it uses 125 I-labeled antibody to HBsAg to detect the adsorbed antigen. A single 2-h incubation at 45 degrees C is used in the procedure. The sensitivity of the method was determined with the Bureau of Biologics HBsAg reference panels and was shown to be equivalent to other third-generation test methods. The specificity of the method was evaluated by testing specimens from blood donors, dialysis patients, and hospital staff in parallel with commercial radioimmunoassay kits for HBsAg. In the tests performed on 2,868 blood donor specimens, 6 positive specimens were identified by both the radioimmunoadsorbent method and the commercial radioimmunoassay kits. These positive specimens were confirmed by a counterimmunoelectrophoresis procedure. One nonconfirmable, repeatably positive specimen was observed with the radioimmunoadsorbent method. In testing 1,250 specimens from dialysis patients and hospital staff, 120 confirmable positive specimens were identified by both the radioimmunoadsorbent method and a commercial test. Overall, the false positive rate for the radioimmunoadsorbent method was found to be less than 1%.