Registered nurses' experiences with an evidence-based home care pathway for myocardial infarction clients.

OBJECTIVES: To obtain home health nurses' comments on an evidence-based care pathway for post myocardial infarction. DESIGN: A qualitative design was used. SETTING: Culturally diverse, lower income area of a large city. PARTICIPANTS: All home health nurses from one nursing agency who participated in a comparative study on the impact of the evidence-based care pathway. RESULTS: The largest number of comments made by the nurses were related to the beneficial impact of the pathway on the provision of quality nursing care and on increased job satisfaction. The home health nurses reported that the pathway increased clients' knowledge of medications and diet. In addition, they commented that they were able to use the pathway effectively because of the training they received from the inpatient cardiac nurses. CONCLUSIONS: This qualitative study demonstrates the benefits of investing in the implementation of best practice guidelines by home health nurses. However, nursing associations, such as the Canadian Community Health Nurses Initiatives Group, will need to continue to champion for additional funds to support the additional expenses incurred.

Neuroprosthesis consumers' forum: consumer priorities for research directions.

The purpose of this forum was to discuss with consumers having spinal cord injury what their research priorities would be for the field of functional electrical stimulation (FES) and to explore the impact of technology in the lives of people with disabilities. Both FES users and nonusers were included on the panel. The format for the discussion was primarily question and answer, with each participant giving his or her personal response to the moderator's question. Consumer research priorities depended on the individual and his or her personal priorities, preferences, background, history, and level of injury. Common themes that emerged were independence, ease of movement, ease of control, and spontaneity. From the consumers' perspective, the focus of research to restore function ought to be based on the needs and desires of the consumer, not just on the scientifically intriguing aspects of a particular technology.

Model-based development of neuroprostheses for restoring proximal arm function.

Neuroprostheses with the use of functional neuromuscular stimulation (FNS) have the potential to restore elbow and shoulder function lost to paralysis because of spinal cord injury (SCI). The human shoulder is highly flexible and thus provides a large range of motion to the arm and hand, although at the expense of precarious stability of the articulations. The complexity of the shoulder has prevented widespread use of FNS at this joint. However, musculoskeletal modeling of the elbow and shoulder has the potential to significantly speed the development of neuroprostheses by allowing many mechanical issues to be resolved in simulation prior to implementation in human subjects. This paper describes our rationale for the use of musculoskeletal modeling, the model we are using, and several practical applications of the model to study the potential use of shoulder and elbow muscle FNS to restore function following cervical SCI.

Heart failure from diastolic dysfunction.

Heart failure from diastolic dysfunction is a clinical syndrome similar to, but distinct from, failure from systolic dysfunction. Because the standard cardiac diagnostic tools may not be helpful, the advance practice nurse and physician collaborate on the diagnosis. Interventions are aimed toward improving diastolic filling and reducing hemodynamic compromise for these patients.

Arthrographic observations of the equine distal interphalangeal joint (Articulationes interphalangeae distalis manus) and navicular bursa (Bursa podotrochlearis).

Twenty cadaver limbs of adult horses were examined by arthrographic examination of the distal interphalangeal joint. The joint capsule and space is described. Comparison is made with existing descriptions.