Are we ready for a name change for schizophrenia? A survey of multiple stakeholders.

About one in 100 people worldwide are diagnosed with schizophrenia. Many people advocate for a name change for the condition, pointing to the stigma and discrimination associated with the term "schizophrenia", as well as to how the name poorly characterizes features of the illness. The purpose of this project was to collect opinions from a broad, diverse sample of stakeholders about possible name changes for schizophrenia. The project represented a partnership between researchers, clinicians, and those with lived experience with psychosis. The group developed a survey to assess opinions about the need for change in the name schizophrenia as well as potential alternate names. We accumulated 1190 responses from a broad array of community stakeholders, including those with lived experience of mental illness, family members, clinicians, researchers, government officials, and the general public. Findings indicated that the majority of respondents (74.1%) favored a name change for schizophrenia. Most (71.4%) found the name stigmatizing. Of the proposed alternate names, those with the most support included "Altered Perception Syndrome", "Psychosis Spectrum Syndrome", and "Neuro-Emotional Integration Disorder". Survey findings provide strong support for renaming schizophrenia. Most expressed hope that a name change will reduce stigma and discrimination.

Delirium in the orthopaedic patient.

Published incidence of delirium in orthopaedic patients ranges from 5.1% to 61%. Delirium may present before or after the patient undergoes the surgical procedure and has demonstrated increased risk, including mortality. Yet, delirium goes unrecognized by both physicians and nurses. This article focuses on the literature on delirium in the orthopaedic patient, including incidence, how to identify those patients at risk, patient outcomes, nonpharmacological and pharmacological interventions, and provides an example of how one tertiary care hospital implemented a prevention and management program of delirium in orthopaedic patients.

Leptin and body fat in type 2 diabetes and monodrug therapy.

To better understand the relations among leptin, insulin, and body fat during the metabolic progression to diabetes and during drug monotherapy, metabolic parameters were examined in subjects classified as 1) type 2 diabetes; 2) impaired fasting glucose or mild diabetes mellitus; 3) nondiabetic, matched for body mass index (BMI); and 4) nonobese, nondiabetic. Diabetic subjects were also studied during no pharmacological treatment, after 3 months of randomization to metformin or glyburide, and after 3 months of cross-over to the opposite drug. Log leptin correlated more with percent body fat (slope, 0.042; confidence interval, 0.036-0.047; r(2) = 0.826; P < 0.0001) than with total fat mass, percent truncal or nontruncal fat, or BMI. When normalized to percent fat, leptin did not differ by gender. Leptin normalized to percent fat was 35% less in untreated diabetes than that in BMI-matched controls (P < 0.001). Leptin normalized to percent fat was increased by 25% (P < 0.01) as a result of glyburide therapy compared with pretreatment values, but was unchanged by therapy with metformin. Across a spectrum of subjects with diabetes, impaired fasting glucose/mild diabetes, or BMI-matched nondiabetic controls, normalized leptin significantly correlated with glucose-induced insulin release, but not with insulin sensitivity. Our data suggest that plasma leptin is reduced in untreated type 2 diabetes probably as a consequence of reduced insulin secretion and that circulating leptin concentrations are differentially affected by monodrug therapy.

The parish nurse coordinator: a bridge to spiritual health care leadership for the future.

Parish nursing has emerged as a specialized professional nursing practice in the past 10 years. Nursing literature addressing the functions of the parish nurse role in a faith community or congregation has become more prevalent in recent years. However, there is very little literature that examines the role of the parish nurse (PN) in a program leadership position. The purpose of this qualitative descriptive study is to describe the role and functions of the parish nurse coordinator (PNC) charged with leadership of a group of PNs networked together as a P N program. Specifically, this article highlights the demographics of PNCs across the United States, what they value most about being a PNC, and the challenges they experience in this leadership role. Findings are examined in light of their potential for contributing to the growth and development of nursing leadership that incorporates the spiritual dimension.