ABSTRACT
Just as there exist many forces driving the need for change on many fronts in health care, there are corresponding forces, some equally strong, that resist the change. The article presents a model for nurse executives to help them understand the predominant forces of change. The article also emphasizes the importance of organizational politics in the change process.
Subject(s)
Nursing Service, Hospital/trends , Humans , Models, Nursing , Nurse Administrators , Nursing Service, Hospital/organization & administration , Organizational InnovationABSTRACT
The experience of a new breast screening unit is reported. In the first 12 months there was a 72.1% response rate with 9890 women being screened. After the initial screen 598 (5.8%) were referred to the Assessment clinic. Following repeated mammography and clinical examination 166 patients were referred for a surgical opinion; 105 (1.06% of the total screened) were considered to be possibly malignant; 61 further patients with clinical and mammographically benign disease were kept under review by a single surgeon; 101 patients had excision biopsies; 28 of 32 palpable breast lumps and 36 of 69 non-palpable lesions proved to be malignant.
Subject(s)
Breast Neoplasms/prevention & control , Mammography , Mass Screening , Medical Audit , Biopsy , Breast Neoplasms/pathology , Female , Humans , Middle Aged , Patient Compliance , Referral and ConsultationABSTRACT
In 1979, widespread distribution of chicken and egg food products and grease contaminated with polychlorinated biphenyl (PCBs) occurred across the United States and as far away as Canada and Japan. The contamination was traced to an accidental leakage of PCBs from a transformer stored in a hog slaughtering plant in Montana. Breast milk analyses showed the PCB absorption had occurred among egg consumers. The episode illustrates the need for heightened vigilance over the fate of PCBs still in use.
Subject(s)
Abattoirs , Food Contamination/analysis , Polychlorinated Biphenyls/analysis , Animals , Chickens , Eggs/analysis , Female , Humans , Milk, Human/analysis , United StatesABSTRACT
Cases of plague continue to occur in various parts of the world, including the western United States, where plague is endemic among the wild rodent population. In 1980, a case of plague acquired in New Mexico and hospitalized in Nebraska illustrated the problem of plague occurring in persons traveling from the state in which they become infected to another state. Nine cases of plague in travelers were identified among the 166 cases of plague reported in the United States from 1950 to 1980. Physicians should be aware of natural plague foci in the western United States and should obtain a travel history from patients with an illness clinically compatible with plague.
Subject(s)
Plague/epidemiology , Adolescent , Female , Humans , Lymph Nodes/microbiology , New Mexico , Plague/diagnosis , Travel , Yersinia pestis/isolation & purificationSubject(s)
Head and Neck Neoplasms/immunology , Immunity, Cellular , Humans , Rosette Formation , Skin TestsSubject(s)
Carrier State , Disabled Persons , Hepatitis B , Female , Hepatitis B/transmission , Humans , Male , MontanaABSTRACT
A 62-year-old black female with Kaposi's sarcoma associated with multiple myeloma is reported. The co-existence of the two entities in the same patient appears more than coincidental. The case is the first woman and only the fifth described with Kaposi's sarcoma associated with multiple myeloma.
