Risk assessment of thyroid follicular cell tumors.

Thyroid follicular cell tumors arise in rodents from mutations, perturbations of thyroid and pituitary hormone status with increased stimulation of thyroid cell growth by thyroid-stimulating hormone (TSH), or a combination of the two. The only known human thyroid carcinogen is ionizing radiation. It is not known for certain whether chemicals that affect thyroid cell growth lead to human thyroid cancer. The U.S. Environmental Protection Agency applies the following science policy positions: 1) chemically induced rodent thyroid tumors are presumed to be relevant to humans; 2) when interspecies information is lacking, the default is to assume comparable carcinogenic sensitivity in rodents and humans; 3) adverse rodent noncancer thyroid effects due to chemically induced thyroid-pituitary disruption are presumed to be relevant to humans; 4) linear dose-response considerations are applied to thyroid cancer induced by chemical substances that either do not disrupt thyroid functioning or lack mode of action information; 5) nonlinear thyroid cancer dose-response considerations are applied to chemicals that reduce thyroid hormone levels, increase TSH and thyroid cell division, and are judged to lack mutagenic activity; and 6) nonlinear considerations may be applied in thyroid cancer dose-response assessments on a case-by-case basis for chemicals that disrupt thyroid-pituitary functioning and demonstrate some mutagenic activity. Required data for risk assessment purposes is mode of action information on mutagenicity, increases in follicular cell growth (cell size and number) and thyroid gland weight, thyroid-pituitary hormones, site of action, correlations between doses producing thyroid effects and cancer, and reversibility of effects when dosing ceases.

Nursing research in HIV/AIDS home care, Part 2: Results and implications.

This study categorized the problems of clients with human immunodeficiency syndrome/acquired immune deficiency syndrome (HIV/AIDS), identified on admission to home care, into nursing diagnoses. The study followed a descriptive retrospective record review of adult men and women (n = 244) admitted to a certified home health care agency in New York City. When all problems were clustered into nursing diagnoses, the principle diagnosis in more than 70% of the sample were impaired home maintenance, high risk for ineffective individual coping, altered nutrition:less than body requirements, feeding self-care deficit, and fatigue. The results indicate that the home healthcare needs of persons with HIV/AIDS are multifaceted in nature and extend beyond the signs and symptoms of advancing disease. Nursing diagnoses serve as a basis for capturing all data that contribute to client problems and are the focus of planning nursing care in the home.

Nursing research in HIV/AIDS home care, Part 1: Importance and methods.

One of the primary goals of nursing research is to develop a systematic body of knowledge to guide nursing practice. In the community setting, an extremely useful method of research is the exploratory field study, which can be used to discover important variables that may exist in real-life situations. This study reflects an analysis of the problems that were identified in persons living with human immunodeficiency virus/acquired immune deficiency syndrome in New York City who were referred for home care services. Part I presents an overview of nursing research methods, focusing on an actual field study in human immunodeficiency virus/acquired immune deficiency syndrome home care; Part II describes the results and implications for nursing.

Home healthcare needs of adults living with HIV disease/AIDS in New York City.

The authors' primary purpose was to identify home healthcare needs of adults (N = 244) living with HIV disease/AIDS. The study followed a retrospective chart review of a stratified random sample of cases discharged during 1991 from a certified home health agency (CHHA) in New York City. Frequently observed signs and symptoms included dyspnea, weakness, fatigue/lethargy, pain, ataxia, cough, skin lesions, and memory deficit. Additional problems identified included inadequate nutrition, issues related to compliance with prescribed medications, inadequate in-home support systems, inadequate facilities/utilities in the home, financial concerns and lifestyles that included drug/alcohol abuse and tobacco use. The results suggest that the health care needs of people living with HIV disease/AIDS in the home care setting are multifaceted and extend beyond the clinical manifestations of HIV disease.

Human immunodeficiency virus and mental health: meeting the needs of health professionals.

Psychiatric-mental health nurses are taking a leadership role in the human immunodeficiency virus epidemic. This article details activities, developed through federally-supported acquired immune deficiency syndrome (AIDS) projects, which are designed to meet the mental health needs of health professionals who work intensively with people with AIDS.