Stress management: a program designed to facilitate coping.

1. Continual exposure to work-related stressors compounds nurses' workloads, increases their stress levels, and places increased demands on their abilities to adapt. 2. Nurses need to learn and routinely use coping measures to prevent exhaustion and burnout. 3. An in-house stress management program can help nurses learn to cope with constant exposure to work-related stressors, halt the cyclic process of stress, prevent burnout, and decrease turnover.

Stress management: a program designed to facilitate coping.

Continual exposure to work-related stressors compounds nurses' workloads, increases their stress levels, and places increased demands on their abilities to adapt. Nurses need to learn and routinely use coping measures to prevent exhaustion and burnout. This article describes the assessment, plan, implementation, and evaluation of an in-house stress management continuing education program to aid staff members in halting the cyclic process of stress.

Continuing education in gerontological nursing.

Programs are needed to evaluate staff because more elderly with multiple health-care problems are being hospitalized. Current formal training programs do not always have gerontology content based on up-to-date standards. Stimulation exercises give healthy young and middle-aged health-care workers an idea of challenges confronting the elderly with loss of mobility, vision, hearing, or paralysis. A survey of staff nurses indicated that most had difficulty differentiating physical and psychosocial changes attributed to the normal aging process from pathological manifestation. Awareness of the biological, developmental, and psychosocial theories of aging provide health-care workers a greater understanding of rationale for a specific treatment program.

Correlation of altered penile ultrastructure with clinical arterial evaluation.

We investigated the ultrastructural changes in the penile erectile tissue from 32 consecutive patients who underwent penile prosthesis implantation. Because most of the patients had undergone papaverine injection with or without duplex ultrasonography, we compared these results with the electron microscopic findings. In patients with a good arterial response and full erection after papaverine injection the ultrastructural findings were similar to those reported in normal men. In patients with moderate arterial disease a distinct increase in mitochondria with aggregation and cytoplasmic vacuolization in smooth muscle cells was noted. These findings could be interpreted as an active cellular attempt to respond to the altered environmental and nutritive situation. In patients with severe arterial insufficiency the cellular structure was markedly altered, the number of intracavernous smooth muscle cells was reduced and the density of the connective tissue separating individual cells was increased. These changes in the smooth muscle cells consisted of contour irregularity with fragmentation and loss of the basal lamina. The cytoplasm was largely devoid of contractile elements. The nuclei tended to be pleomorphic with unevenly distributed chromatin. The endothelium was also altered significantly in this group. A careful clinical evaluation of penile arterial function should be performed in all patients undergoing penile arterial or venous corrective surgery. If doubt remains, a penile biopsy may be indicated.

Effects of omega-3 fish oils on lipid metabolism, glycemic control, and blood pressure in type II diabetic patients.

We investigated the effects of omega-3 fish oil (FO) supplementation on lipid metabolism, glycemic control, and blood pressure (BP) in patients with type II diabetes mellitus. In 22 diabetic patients without overt hyperlipidemia, serum triglyceride, total cholesterol, high density lipoprotein (HDL)-cholesterol, HDL2-cholesterol, HDL3-cholesterol, and apolipoprotein A-I (apo A-I) levels did not change during omega-3 FO supplementation for 8 weeks. The mean serum apo B concentration increased significantly [baseline, 2.56 +/- 0.11 (+/- SEM) mmol/L; 4 weeks, 2.82 +/- 0.13 mmol/L; 8 weeks, 2.80 +/- 0.13 mmol/L; P less than 0.01]. The mean plasma postheparin lipoprotein lipase activity increased transiently during the fourth week (baseline, 168 +/- 17 U/mL; 4 weeks, 182 +/- 18 U/mL; P less than 0.05), whereas postheparin hepatic triglyceride lipase activity did not change. Glycemic control worsened transiently during the fourth week, (baseline, 7.7 +/- 0.4%; 4 weeks, 8.4 +/- 0.3%; P less than 0.05). Both systolic and diastolic BP decreased significantly throughout the study (systolic BP: baseline, 142 +/- 5 mm Hg; 8 weeks, 128 +/- 5 mm Hg; diastolic BP: baseline, 88 +/- 4 mm Hg; 8 weeks, 80 +/- 3 mm Hg; P less than 0.01). These findings suggest that in type II diabetics without overt hyperlipidemia, omega-3 FO supplementation does not improve either the glycemic control or serum lipids, and it is associated with a potentially detrimental rise in serum apo B concentrations. Until more information is available, use of such supplementation should be discouraged.