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Explores collaborative learning and determines what is needed to expand a small organization devoted to peer education. Aspect which is a link between collaborative inquiry and organization development; Ways for lowering the barriers to peer counseling; Themes surrounding the community women's inquiry.

Presents advice on how nurses can detect signs of professional sexual misconduct and intervene effectively. What sexual misconduct is; Why it occurs; Documentation of publications which deal with the topic. INSETS: What to do if your patient makes sexual advances.;Preventing sexual misconduct.;Are you at risk for professional sexual misconduct?.;Disciplining offenders.

Presents advice on how to accept a chemically-dependent nurse at work after his rehabilitation. Incidence of drug use or alcohol problems among nurses; Advantages in allowing a nurse back to work; Policies to protect patients and support the nurse; Disclosure of information about a nurse's chemical dependency. INSETS: What you can do.;Recovering nurses back at work: A study..

Discusses guidelines for nurses to handle a chemically dependent colleague. Report of American Nurses Association; Response of nondependent nurses; Effect of chemical dependency; How and when to report; Handling of a case; Policies of American Hospital Association; Focus on patient's health and safety. INSETS: Warning signs of chemical dependency.;Where to turn for help..

OBJECTIVE To characterize hypertension management in an academic family medicine clinic. DESIGN Cross-sectional chart review. SETTING Academic family medicine clinic in Edmonton, Alta. PARTICIPANTS A total of 210 patients with 1 or more visits for hypertension during the previous 3 years. MAIN OUTCOME MEASURES Patient characteristics, current antihypertensive therapies, most recent blood pressure measurements, and compelling indications according to the 2006 Canadian Hypertension Education Program recommendations. RESULTS A total of 185 subjects (88%) were prescribed antihypertensive medications, and 89 (42%) had controlled hypertension. Younger subjects, people with diabetes, and people not receiving antihypertensive medication therapy appeared less likely to have controlled hypertension. There were 76 subjects (36%) prescribed 1 antihypertensive medication, 65 subjects (31%) prescribed 2 antihypertensive medications, and 44 (21%) prescribed 3 or more antihypertensive mediations. Antiotensin-converting enzyme inhibitors were prescribed for 51% of the subjects, diuretics for 47%, β-blockers for 27%, calcium channel blockers for 23%, angiotensin receptor blockers for 20%, and α-blockers for 1%. CONCLUSION Hypertension treatment and control rates in this academic family medicine clinic appear to be better than those in the general population. Following the principles of a continuous quality improvement process, this information will serve as an important foundation for identifying areas to improve hypertension management in the clinic. [ABSTRACT FROM AUTHOR]

BACKGROUND: Integrative medicine is an individualized, patient-centered approach to health, combining a whole-person model with evidence-based medicine. Interventions based in integrative medicine theory have not been tested as cardiovascular risk-reduction strategies. Our objective was to determine whether personalized health planning (PHP), an intervention based on the theories and principles underlying integrative medicine, reduces 10-year risk of coronary heart disease (CHD). METHODS: We conducted a randomized, controlled trial among 154 outpatients age 45 or over, with 1 or more known cardiovascular risk factors. Subjects were enrolled from primary care practices near an academic medical center, and the intervention was delivered at a university Center for Integrative Medicine. Following a health risk assessment, each subject in the intervention arm worked with a health coach and a medical provider to construct a personalized health plan. The plan identified specific health behaviors important for each subject to modify; the choice of behaviors was driven both by cardiovascular risk reduction and the interests of each individual subject. The coach then assisted each subject in implementing her/his health plan. Techniques used in implementation included mindfulness meditation, relaxation training, stress management, motivational techniques, and health education and coaching. Subjects randomized to the comparison group received usual care (UC) without access to the intervention. Our primary outcome measure was 10-year risk of CHD, as measured by a standard Framingham risk score, and assessed at baseline, 5, and 10 months. Differences between arms were assessed by linear mixed effects modeling, with time and study arm as independent variables. RESULTS: Baseline 10-year risk of CHD was 11.1% for subjects randomized to UC (n=77), and 9.3% for subjects randomized to PHP (n=77). Over 10 months of the intervention, CHD risk decreased to 9.8% for UC subjects and 7.8% for intervention subjects. Based on a linear mixed-effects model, there was a statistically significant difference in the rate of risk improvement between the 2 arms (P=.04). In secondary analyses, subjects In the PHP arm were found to have increased days of exercise per week compared with UC (3.7 vs 2.4. P=.002), and subjects who were overweight on entry into the study had greater weight loss in the PHP arm compared with UC (P=.06). CONCLUSIONS: A multidimensional intervention based on integrative medicine principles reduced risk of CHD, possibly by increasing exercise and improving weight loss. [ABSTRACT FROM AUTHOR]

A new hemoglobin variant, designated hemoglobin-St Luke's. was detected by routine starch-gel electrophoresis in four members of a Maltese family. The carriers of this abnormality are clinically and hematologically normal. Structural analyses showed the replacement of prolyl residue in position 95 (G2) of the alpha chain by an arginyl residue. The relative amount of hemoglobin-St Luke's present in the red cell hemolysates of its cagier is approximately 10 %, compared to about 23 % for hemoglobin-G Georgia and 15% for hemoglobin Rampa (the other two variant in which prolyl residue α95 (G2) is replaced). Sedimentation velocity studies of hemoglobin. St Luke's in NaCl solutions of increasing concentration up to 2 M indicate that the oxy derivative is extensively dissociated into dimers in 0.1 M NaCl at neutral pH; whereas under the same conditions, the deoxygenated molecule retains a tetrameric structure. In the deoxy state, appreciable tetramer formation occurs even in 2 M NaCl. In addition, association-dissociation in oxyor cyanferrihemoglobin St Luke's is troth pH and temperature dependent. [ABSTRACT FROM AUTHOR]