A survey of registered nurses who graduated in 1986 (n=50) and 1991 (n-58) revealed these opinions: insurance companies increasingly control patient care; workload and paperwork have increased; and there are fewer jobs and less job security. A significant number reported decreased job satisfaction. (SK)

The effects of long-term hospitalizations can be severe, especially among older adults. In Manitoba, between fiscal years 1991/1992 and 1999/2000, 40 per cent of acute care hospital days were used by the 5 per cent of patients who had long stays, defined as stays of more than 30 days. These proportions were remarkably stable, despite major changes…

Context: Referral bias reflecting the preferential hospital transfer of patients with intracerebral hemorrhage (ICH) has been demonstrated as the major contributing factor for an observed high nonrisk-adjusted in-hospital crude acute stroke mortality rate at a rural academic medical center. Purpose: This study was done to assess the impact of a…

Medical errors and patient safety have gained increasing attention throughout all areas of medical care. Understanding patient safety in rural settings is crucial for improving care in rural communities. To describe a system to decrease medical errors and improve care in rural and frontier primary care offices. Applied Strategies for Improving…

Ethical problems encountered by mental health practitioners working with deaf clients are often complex and involve issues not fully addressed in professional codes of ethics. A principles-based ethical reasoning process can assist in resolving many of these ethical concerns. Principles such as beneficence, nonmaleficence, autonomy, fairness,…

Most of us who have clinical practices firmly contend that the treatments we provide cause beneficial changes in the lives of our patients. Indeed, our clinical experience engenders strong convictions to the point of believing that withholding treatment creates ethical violations. Intellectually, however, we must recognize that the value of…

The purpose of this article is to identify and describe four essential skills for effective supervision of family therapy trainees in primary care medical settings. The supervision skills described include: (1) Understand medical culture; (2) Locate the trainee in the treatment system; (3) Investigate the biological/health issues; and (4) Be…

Because "Roe v. Wade" left ill-defined or derivative just who could be a medical caregiver for pregnant women, courts struggled in the post-Roe medico-legal environment to decide just who could be a medical advisor in this newly recognized zone of privacy. The courts also were challenged to balance individual privacy rights, state…

The unique experience of HIV/AIDS among rural women in the United States was explored using qualitative interviews with 7 women who are HIV positive. Based on these interviews, eight themes emerged. These included (a) daily powerful emotions, (b) emotional and physical abandonment, (c) romantic betrayal, (d) medical treatment issues, (e) loss and…

The Medical Home series follows fictional parents Amita and Samir and their premature daughter, Anjali. In Part Two, Amita and Samir bring Anjali home from the hospital, contact the care coordinator who will be responsible for Anjali's care, and go to their first appointment with the pediatrician. Emphasis is placed on the manner in which the…

In 1997, The University of Texas Health Science Center at San Antonio established the Regional Academic Health Center (RAHC) for the Lower Rio Grande Valley in south Texas. Through medical education programs, research facilities, and partnerships with health-care providers, the RAHC aims to improve the health status and access to health services…

Staff carers in pediatric skilled nursing facilities (PSNF) deal directly with dying residents, and are on the forefront of communication with families. These providers have expressed misunderstandings regarding the meaning of resuscitation status and redirection of care. This descriptive study evaluated perceptions and understanding of end of…

In this article, the author examines how activist media by Native AIDS organizers promoted anticolonial analyses of AIDS, gender, and sexuality as a contribution to scholarship on Native responses to AIDS. His discussion centers on the organizers who created media as authorities on and in their media. In contrast to recent accounts that popularize…

Direct family caregivers of population-based adolescents with intellectual disabilities in Taiwan were surveyed regarding their perceptions of the use of prescribed medication and its relationship with health-related behaviors, medical care and preventive health utilization of people with intellectual disabilities. Cross-sectional data on 1419…

Aside from the fear, isolation, or the loss of a loved one that violence imposes on many Americans, the financial burden placed on taxpayers through medical costs is significant. This fact sheet provides statistical information on the monetary impact of treating the "typical" gunshot victim in the United States. Data are provided on cost…