From sea to shining sea: making collaborative rural research work.

Rural researchers collaborate on many levels to collect and analyze data, develop research reports and disseminate findings. While this collaboration is critical, there is a dearth of literature about research team collaboration within all stages of the research process. The purpose of this article is to discuss the research experience of 10 rural researchers scattered across Canada who participated in the study, Health Research: Accessible, Applicable and Useable for Rural Communities and Practitioners. Using focused ethnography, one aim of this study was to discover how research is utilized in rural and remote settings. The necessity of establishing networks to collect and manage data, and jointly analyze 72 qualitative transcripts from different geographical sites led to innovations and unexpected lessons learned. The research design provided significant opportunities to mentor undergraduate, masters and doctoral nursing students and to enhance the development of newly graduated doctoral nurses. These opportunities are crucial in the development of new researchers and in creating ongoing interest in rural health research. In this article, we discuss how the research process evolved, the mentoring process used, the barriers identified related to collaboration across vast distances, and the strategies employed to enhance the study's trustworthiness. We also consider the advantages and challenges of using Elluminate, a web application, as an interactive forum for this qualitative health research.

Assessment and management of galactorrhea.

Galactorrhea, inappropriate lactation, is a relatively common clinical sign encountered by primary health care providers. However, this physical sign is not synonymous with life-threatening breast or intracranial malignancy; rather, it may be physiologic, drug-induced or idiopathic. Given the 20 percent prevalence of pituitary adenomas in women with galactorrhea, the primary health care provider must rule out, in every case, intracranial causes for galactorrhea. This article reviews relevant physiopathology and develops an assessment and diagnostic protocol, which includes indications for urgent referral. It concludes with summaries of treatment modalities, outlining the role of the primary care provider throughout the diagnostic and treatment processes.

Illiteracy: implications for nursing education.

Possession of an internally consistent body of knowledge from which principles and practice can be derived is the pre-eminent characteristic of professional groups. Active, enquiring minds are required as nursing struggles to develop such a base. Yet, recent evidence, such as the 1992 report of the Economic Council of Canada, suggests a pervasive decline in basic language competencies. The illiteracy of candidates entering professional schools of nursing is creating problems for students, faculty and the profession, with ramifications for public safety and professional growth. This article describes problems and proposes action that can, and must, be taken to remedy the situation.

A screening method for mucopolysaccharidoses with increased urinary excretion of sulfated N-acetylhexosamines.

Patients with mucopolysaccharidosis have been reported to excrete elevated amounts of sulfated N-acetylhexosamines in their urine. Based on this finding, a new and simple colorimetric screening test for these disorders is presented. Chromatography of whole urine on Dowex AG 1-X8, from each of 23 normal controls, 5 patients with mucopolysaccharidosis and one patient with multiple sulfatase deficiency, was used to separate the sulfated hexosamines. The fractions eluted with 2M NaCl were analyzed according to the method of Reissig. Patients with Sanfilippo syndrome, type A, Sanfilippo syndrome, type D, Maroteaux-Lamy syndrome, Morquio syndrome, type A, and multiple sulfatase deficiency were clearly distinguished from normal controls. The procedure appeared most sensitive for Sanfilippo syndrome, type D, and multiple sulfatase deficiency, each of which involves deficient activity of N-acetylglucosamine 6-sulfate sulfatase.