Search

A key distinction needs to be made between formal and informal risk profiling. It is usually assumed that formal risk profiling, based on statistical data, provides an optimal means of prediction and thus of detecting high-risk individuals or situations. However, it must be recognized that formal profiles are based extensively on informal profiles - those built upon the experience and working cultures of security-related officials. Formal profiles are thus prone to the same errors and tend to produce self-fulfilling prophecies, resulting in both errors of fact and discriminatory consequences for false-positive cases. All profiles, however, are fraught with problems, perhaps the most obvious and significant being that the targets of interdiction readily become aware of them and modify their operations to incorporate activities and/or individuals that do not fit existing profiles. Consequently, totally risk-based security, ironically, may become less effective than alternatives such as randomly assigned focused interdictions.

29, Issue No. 10, pp. 71-72, 74-75 (2004). Reprinted with permission. From the Miami Valley Hospital, Dayton, Ohio (Dr O'Malley); the Geriatric Care Consultants and Indiana Wesleyan University (Dr Trimble); and the Miami Valley Hospital Intensive Care Unit, Dayton, Ohio (Ms Melissa). Corresponding author; Patricia O'Malley, PhD, RN, CCRN, CNS, Miami Valley Hospital, One Wyoming St, Dayton, OH 45409.

The vast majority of research on drug dealers focuses on men, while most studies on women in the drug economy focus on subordinated drug users. We know very little about attributes or skills required for successful drug dealing may apply primarily to male dealers, while allegedly female attributes regarded by men as handicapping women may be irrelevant or even valuable resources. This in-depth, observational study of successful women drug dealers in Melbourne indicates that skills and orientations associated with familial relations play a key part in the most sensitive aspects of such business. Conversely, ruthlessness and violence are comparatively peripheral, even though the women demonstrated that these were well within their repertoires of action.

I am a clinical nurse specialist in a busy family practice with many elderly patients experiencing osteoarthritis. During an evaluation for the management of long-term pain, a patient stated that he would not use a sports cream since he had heard on the news that someone had died as a result of use. What are the risks and toxicity associated with the use of these pain-relieving products?

I am a clinical nurse specialist in a busy trauma center. Increasingly, we are using ketamine for procedures and pain management in adults. I thought ketamine was appropriate only for pediatric patients. Why has ketamine emerged again for adults? Also, we have seen a few cases of ketamine abuse over the past 3 months. Is ketamine abuse becoming more prevalent?

Pediatric palliative care is an approach to delivering comprehensive, symptom-based, compassionate care to children with chronic complex conditions (CCC) and/or life-threatening conditions which treats the patient and his/her family as the unit of care (family-centered in approach). Palliative care is focused on providing a systematic approach to enhancing quality of life, minimizing suffering, optimizing function, and providing opportunities for personal and spiritual growth (Friebert 2009). Palliative care is concerned with the physical, psychosocial, and spiritual care of children with a life-limiting or life-threatening illness. The goal of palliative medicine is to provide the best possible quality of life by providing holistic care at every stage of the illness and, as such, this care is not reserved only for the imminently dying patient.

Objective The purpose of this study was to assess the incidence of pain in inpatient and outpatient populations experiencing invasive procedures. Background Nursing staff consulted the clinical nurse specialist regarding a patient they assessed who was not medicated appropriately and experienced significant procedural pain. As a result, a Procedural Pain Task Force was created to research the incidence of procedural pain and create evidence-based practice protocols. Methods A convenience sample of 358 patients undergoing diagnostic or therapeutic invasive procedures (surgery excluded) was studied. Variables for analysis included demographic data, procedure type, medication, and perceived pain before, during, and after the procedures. Results Patients who were not premedicated had lower mean pain scores (mean, 1.81) than patients who did receive medication before a potentially painful procedure (mean, 3.64). Age was negatively correlated with perceived pain; thus, the greater the patient age, the lower the pain score. Sex, premedication, and type of procedure were positively correlated with perceived pain scores. Sixty-three subjects reporting pain scores of 5 or greater during a procedure were further evaluated. Conclusions Results were used to develop procedural pain guidelines and a physician order set as well as a medication reference grid to assist clinicians in the management of procedural pain. Furthermore, nurses were empowered by the revised guidelines to advocate for relief of pain based on the nursing assessment.

Outcomes of pharmacological therapy are more than an accurate assessment and appropriate choice of an agent. Patient outcomes are the result of complex interactions of factors known and unknown. This study explores 10 of many factors that clinical nurse specialists should consider before writing the prescription and monitoring responses to therapy.