Nursing leaders predict top trends for 2000.

Nursing Management's Editorial Advisory Board predicts the top 10 trends that will impact nurse leaders in 2000. Use them to lead in the new millennium.

The hospital nurse's role in managed care.

This article describes the staff nurse's role in managed care and can be used by nurse managers in the education process. An obstetric case study demonstrates the potential of increasing patient-care quality while reducing health care cost.

Contract leveraging: a strategy for provider groups in managed care.

Using one's leverage in health care negotiation does not mean intimidating, threatening, or even demanding a certain percentage of the premium. Leveraging is not a game of who wins and who loses; rather, it is a negotiation technique. The authors explain how to best use the abilities and proficiencies of a provider group to negotiate contracts with MCOs.

Case management as a mindset.

Melanie Richards was a $3.5 million baby who provided the motivation for developing the case management model used by Friendly Hills HealthCare Network. Born five years ago with gastroschisis, Melanie was transferred from Friendly Hills Regional Medical Center to a tertiary care hospital, where she spent 11 1/2 months in the neonatal intensive care unit. No discharge plans were ever made, and it wasn't until Friendly Hills HealthCare Network started to manage Melanie's care that anyone imagined that this infant could go home, should go home, and would thrive at home. Case management saved Melanie's life, saved money in the long run, and is credited with changing the entire method Friendly Hills HealthCare Network uses for complicated cases.

Direct nursing care given to patients in a subacute rehabilitation center.

Direct nursing care observations were performed in a 57-bed head trauma subacute rehabilitation center on four day shifts, three evening shifts, and three night shifts. The type of nursing care and level of personnel providing this care are described. Although nursing assistants give the majority of direct care, the RN still provides most of the psychosocial care that is crucial for these patients and their families.

Measuring the requirements for nursing care in the acute head trauma patient.

A measuring tool to assess the requirements for nursing care, define patient care goals, and document progress was developed in a 57-bed head trauma sub-acute rehabilitation center. The process of tool development and reliability testing is described.

Inhibition of brain monoamine oxidase by 1,2,4-trisubstituted 5-imidazolones.

Nine 1-(3,4-dimethoxyphenethyl)-2-methyl-4-(substituted benzylidene)-5- imidazolones were evaluated for their ability to inhibit the activity of rat brain monoamine oxidase during oxidative deamination of tyramine, 5-hydroxytryptamine (serotonin), and kynuramine. All substituted imidazolones inhibited monoamine oxidase activity. A concentration-dependent inhibition of monoamine oxidase was observed using kynuramine as the substrate and the degree of enzyme inhibition was also evaluated on the basis of their I50 values. Preincubation of imidazolones with the enzyme preparations for varying lengths of time prior to the addition of substrate in no way altered their degree of inhibition and thus exhibited a reversible nature of inhibition. A kinetic study carried out with 1-(3,4-dimethoxy-phenethyl)-2-methyl-4-(4- nitrobenzylidene )-5- i midazolone revealed a competitive nature of inhibition of rat brain monoamine oxidase.

Central nervous system depressant, analgesic and monoamine oxidase inhibitory properties of substituted piperidines.

Eight 1-(arylaminothiocarbonyl)-4-hydroxy-4-phenyl piperidines were evaluated for their central nervous system depressant, analgesic, and monoamine oxidase inhibitory properties. The central nervous system depressant property of these substituted piperidines was reflected by their ability to potentiate pentobarbital-induced sleep in mice ranging from 18.3 to 58.5 minutes. The analgesic activity possessed by these substituted piperidines, with the exception of one compound, was shown by their ability to provide 16.7 to 50 percent protection against tail pinch response in mice. All substituted piperidines (1 mM) inhibited in vitro activity of rat brain monoamine oxidase with the degree of inhibition ranging from 17.2 to 18.3 percent.