Symptom consultation in lay networks in an elderly population.

Although lay referrals are known to be important as factors affecting the use of professional services, less is known about how individuals use lay consultation in evaluating symptoms. The amount and type of advice given by persons in the social network is especially important with respect to self care of symptoms that never reach the attention of professional caregivers. This article provides information on how often and from whom elderly citizens seek and receive consultation, such as family and friends, when they experience common symptoms. Findings suggest that female relatives are important sources of advice but that neither gender nor living arrangements are closely related to the tendency to seek lay advice for common symptoms. Subjects who consulted lay advisers about arthritic symptoms also were more likely to seek professional consultation.

Common patterns of person-environment interaction in persons with rheumatoid arthritis.

This study's purpose was to identify and describe common patterns of person-environment interaction in persons with rheumatoid arthritis. Newman's propositions about pattern provided the theoretical foundation, and a combination of quantitative and qualitative techniques were used to recognize pattern. Sixty-six adults diagnosed with rheumatoid arthritis completed questionnaires that assessed characteristic ways of functioning. Iterative cluster analysis of the data identified five distinct groups of individuals with similar response profiles. Content analysis of each group's characteristics produced a core theme representing the nature of the common pattern. The finding of multiple, distinct common patterns of person-environment interaction within the population of persons with RA is consistent with findings in other populations. Further study of the common patterns, in relation to health outcomes, has potential for increasing knowledge about the sources of different health experiences among persons with the same chronic illness.

A framework for care during the stroke experience.

This article describes a model we developed to guide the selection and design of nursing activities that will facilitate the health of persons with stroke and their families. Care in the context of stroke has been structured by the medical model's focus on functional ability. As a result, nursing is viewed as ancillary to other professions; yet, studies of the stroke experience from the patient's view suggest that distinctive nursing interventions are needed. Current models of illness do not sufficiently address the nature of stroke and thus cannot serve as a framework for nursing care. Our model conceptualizes stroke as a progressive, holistic experience with physiological, psychological, and social dimensions. It was developed from a synthesis of research articles identified through searches of CINAHL, MEDLINE, and PSYCHLIT (1980-1999) indexes using the terms "stroke," "stress," "coping," "chronic illness," and "transitions and growth" and from our clinical experiences. Our research established that the stroke experience involves the deterioration of the whole person and the development of a new person through discovery and resynthesis. Each of these processes progressively dominates the experience and together they form a three-phase model. This model of the stroke experience suggests that nursing care should focus initially on limiting deterioration and then concentrate on facilitating growth. Selection of specific interventions requires an understanding of the uniqueness of each stroke experience, as well as the commonalities, among these experiences.

New stereoselective route to the epoxyquinol core of manumycin-type natural products. Synthesis of enantiopure (+)-bromoxone, (-)-LL-C10037 alpha, and (+)-KT 8110.

A practical route is decribed for the preparation of the C(7)N core of manumycin-type compounds. Starting from p-benzoquinone, optically pure compounds in both forms can be prepared via enzymatic resolution of a derived diacetoxy conduritol. A diepoxy aminoinositol is accessible which can function for formation of enantiopure epoxyquinones and quinols. Examples are given for acylation reactions of this amine with several acyl derivatives. With this approach (-)-LL-C10037alpha and quinones such as (+)-KT-8110 with 5R,6S-configuration can be synthesized through oxidation. In addition a short route to (+)-bromoxone is described. Most steps include simple epoxide formation and cleavage reactions which all can be carried out in a high stereoselective manner.