Insights from inside: the duties and activities of nurses at the psychiatric clinic Münsterlingen (CH). A qualitative study.

In the German-speaking countries: Austria, Germany and Switzerland, which have a joint annual conference in psychiatric nursing, the process of academization of nursing has led to a discussion about which adaptations to make in psychiatric nursing in order to develop a profile, which is practicable in the future. Therefore, it was necessary to describe the current duties and activities of psychiatric nurses. With this, the knowledge and abilities of the nurses were to be made more explicit and their identity was to be strengthened. Data were generated by using participant observation and group discussions with the involved nurses to validate the observations and the emerging categories of activities. Participant observation took place in a psychiatric clinic in Switzerland over a period of 11 months on 14 psychiatric wards with different specializations. Data analysis followed a qualitative content analysis. Findings show that by means of descriptions of nursing situations the duties and activities of the nurses can be summarized into 12 categories. Many of the described activities can be found in psychiatric nursing textbooks. This concurrence suggests that there is something like a basic framework of psychiatric nursing. In addition, the findings illustrate how wide the variety of tasks are and how challenging psychiatric nursing is.

Direct determination of the energy required to operate a single molecule switch.

Using a noncontact atomic-force and scanning-tunneling microscope in ultrahigh vacuum, we have measured the switching energy of a single molecule switch based on the rotation of a di-butyl-phenyl leg in a Cu-tetra-3,5 di-tertiary-butyl-phenyl porphyrin. The mechanics and intramolecular conformation of the switched leg is controlled by the tip apex of the noncontact atomic-force microscope. The comparison between experimental and calculated force curves shows that the rotation of the leg requires an energy less than 100 x 10(-21) J, which is 4 orders of magnitude lower than state-of-the-art transistors.

Impact of teaching interventions on nurse compliance with hand disinfection.

The impact of teaching interventions and the availability of additional dispensers for alcoholic hand disinfection was measured during three study periods. A nursing care system of relevant nursing interventions was found to be a useful tool for the assessment of compliance with hand hygiene requirements if combined with an analysis of hand disinfectant use. This study shows that compliance with hand disinfection can be improved through targeted teaching and supportive structural improvements, and that this positive impact may persist even after targeted teaching activities have ended.

Factor V Leiden mutation in postthrombotic and non-postthrombotic venous ulcers.

OBJECTIVE: To determine the prevalence of the factor V Leiden mutation in patients with postthrombotic and non-postthrombotic venous ulcers. DESIGN: Case-control study. SETTING: Department of Dermatology, University Hospital of Zurich, Zurich, Switzerland. PARTICIPANTS: Seventy-three consecutive outpatients and inpatients with venous ulcers and 45 age- and sex-matched control subjects (matched to the 42 patients with postthrombotic syndrome). MAIN OUTCOME MEASURES: Frequency of postthrombotic and non-postthrombotic findings in patients with venous ulcers. Prevalence of the factor V Leiden mutation in these different subgroups. RESULTS: Postthrombotic syndrome was identified as the cause of 42 (58%; 95% confidence interval [CI], 45%-69%) of 73 venous ulcers, and the remainder were caused by primary valvular insufficiency. In postthrombotic ulcers, the prevalence of the factor V Leiden mutation was 38% (95% CI, 24%-54%) (16/42), which corresponds to an odds ratio of 13.2 (95% CI, 2.8-62.3; P<.001). In non-postthrombotic venous ulcers, the prevalence was 16% (95% CI, 5%-34%) (5/31), which corresponds to an odds ratio of 3.2 (95% CI, 1.0-10.0; P =.07). CONCLUSIONS: The factor V Leiden mutation is highly prevalent in patients with postthrombotic venous ulcers. Even patients with non-postthrombotic venous ulcers show a moderately elevated prevalence of the factor V Leiden mutation. Some of the latter might be misclassified because of near-to-perfect revascularization after asymptomatic deep venous thrombosis. However, as long as the therapeutic consequences of the factor V Leiden mutation are not established, systematic screening cannot be recommended in patients with venous ulcers.

Evaluation of 'round cells' in semen analysis: a comparative study.

The aims of this review are to evaluate the morphological differences between 'round cells' of spermatogenic and non-spermatogenic origin in semen. The latter group includes inflammatory cells like neutrophils, lymphocytes, and macrophages, and epithelial cells. A comparison was made between non-spermatogenic cells in semen samples and inflammatory cells in blood smears, using various staining procedures commonly used in routine andrology laboratories. The result presented in this review confirmed previously published data. In blood smears as well as in semen samples, only neutrophil leukocytes (both eosinophilic and basophilic) showed a positive reaction when exposed to the peroxidase stain. Lymphocytes, macrophages and other 'round cells' such as epithelial cells and spermatogenesis cells remained negative. It could be concluded that the neutrophil polymorphonuclear leukocytes were the only 'round cells' showing a positive reaction in the semen samples. The presence of specifically stained neutrophils in semen was considered to be compatible with an infection and/or a subsequent inflammatory reaction in the male genital tract. The potential influence of inflammatory cells in the sperm samples on infertility/subfertility is discussed. However, the question of determining if morphologically abnormal, degenerated spermatids are still capable of fertilizing an oocyte in vitro is not addressed in this review.

Sled-type motion on the nanometer scale: determination of dissipation and cohesive energies of c60.

The tribological properties of C(60) on the mesoscopic scale were investigated with a scanning force microscope, which allowed simultaneous measurements of normal and lateral forces under ultrahigh-vacuum conditions. Islands of C(60), deposited on NaCl(001), could be moved by the action of the probing tip in a controlled way. Different modes of motion, such as translation and rotation, were observed. An extremely small dissipation energy of about 0.25 millielectron volt per molecule and a cohesive energy of 1.5 electron volts were determined in these nanometer-scale experiments. The corresponding shear strength of 0.05 to 0.1 megapascal was smaller by one order of magnitude than typical values of boundary lubricants. For C(60) on graphite, disruption of the islands was observed and collective motion of the islands could not be achieved. These results could find use in the field of nanotechnology; for example, C(60) islands could be developed into a sled-type transport system on the nanometer scale.

The significance of morphine concentrations in the cerebrospinal fluid in morphine caused deaths.

Morphine analysis was performed using a variety of immunoassay methods in blood, urine and the cisternal cerebrospinal fluid (CSF) from 23 patients dying opiate-related deaths. Of these, 16 were a result of intravenous morphine or heroin use. The blood and CSF morphine concentrations were determined using both fluorescence polarization immunoassay (FPIA) and radioimmunoassay (RIA), while urine was analyzed by enzyme multiplied immunoassay technique (EMIT). Urine morphine concentrations were greater than 0.300 microgram/mL in all but one case. Blood and CSF morphine concentrations were found to be poorly correlated, and it was concluded that one should not be used to predict the other. Following intravenous administration, CSF morphine concentrations of greater than 0.02 microgram/mL were however found to be consistent with death from morphine related respiratory depression. As intrathecal or epidural administration of morphine can greatly influence the CSF concentration without inducing respiratory depression, the site of collection of the CSF must be known, as must the route of administration in order to properly interpret CSF morphine concentrations.

A case of nonneuroleptic malignant syndrome.

Neuroleptic malignant syndrome is a diagnosis that has been reported with increasing frequency in recent years. We report the case of a patient who was not treated with a neuroleptic but in whom a syndrome identical to neuroleptic malignant syndrome developed. The case highlights the overuse of and the confusion about the diagnosis of the syndrome.

[The Berne Härz-As (Ace of Hearts) Project: goals, study plan and initial results]. / Das Berner Härz-As-Projekt: Ziele, Untersuchungsplan und erste Ergebnisse.

The Berne Härz-As (Ace of Heart) project is a randomized trial in changing cardiovascular risk factors, morbidity and subjective health. It further investigates to what extent psychosocial and somatic factors account for these health indicators in the course of at least 4 years. A pilot study conducted in two companies (N = 620) indicates that the project is feasible and acceptable to both management and employees and that the intervention goals are justified.

[Vasospastic syndrome in a young women with migraine, Raynaud's disease, cerebral ischemia and myocardial infarction]. / Vasospastisches Syndrom bei junger Frau mit Migräne, Raynaud-Syndrom, Hirninfarkt und Herzinfarkt.

The case is described of a 32-year-old female patient who has suffered since puberty from acute migraine attacks and Raynaud syndrome of both hands. In June 1981 acute posterior cerebral ischemia occurred. 11/2 years later the patient was hospitalized for acute myocardial infarction with normal and patent coronary arteries. Thereafter, the patient was treated with nifedipin and anticoagulation, and no other vascular complications have since occurred. The authors suggest that the patient is suffering from a diffuse vasospastic disorder leading to migraine attacks, Raynaud syndrome, cerebrovascular ischemia and myocardial infarction, in view of the fact that the patient has no other known risk factors for early vascular complications.