bluuebunny/crossref_metadata_2025 huggingface dataset:
The P–T record of synchronous magmatism, metamorphism and deformation at Petrel Cove, southern Adelaide Fold Belt
Authors: Alias G. , Sandiford M. , Hand M. , Worley B.
Published: March 2003

Porphyroblastic schists in the thermal aureole of the Victor Harbor Granite at Petrel Cove, in the southern Adelaide Fold Belt, South Australia, preserve a record of sequential cordierite, andalusite, staurolite, fibrolite, chlorite and muscovite growth (along with biotite+plagioclase+quartz+ilmenite) during progressive deformation. A P–T pseudo‐section appropriate to biotite‐saturated assemblages in KFMASH shows that the sequence of mineral reactions records increasing pressure of at least 1 kbar (from c. 3 to c. 4 kbar) during cooling from around 580 °C. Heating at pressures below c. 3 kbar is inferred for growth of early formed cordierite porphyroblasts, and is attributed in part to the thermal effects of granite emplacement, while the pressure increase is attributed to tectonic burial accruing from ongoing deformation. The ‘anticlockwise’P–T path is consistent with convergent deformation being focussed as a consequence of heating, as to be expected for a lithospheric rheology that is strongly temperature dependent.
Near‐isothermal decompression within a clockwise P–T evolution recorded in migmatitic mafic granulites from Clavering Ø, NE Greenland: implications for the evolution of the Caledonides
Authors: Jones K. A. , Escher J. C.
Published: March 2003

The high grade rocks (metapelites and metabasites) of Clavering Ø represent the easternmost exposures of granulites in the Palaeozoic Caledonian Orogen of East Greenland. Mafic granulites which occur as sheet‐like bodies and lenses within metapelitic migmatites and orthogneiss complexes have experienced migmatisation and mineral equilibria which define a clockwise P–T path incorporating a near‐isothermal decompression segment. Textures demonstrate the existence of early garnet‐clinopyroxene‐melt assemblages which equilibrated at >8–11 kbar and 850–915 °C. Subsequently, decompression melting led to formation of orthopyroxene‐plagioclase‐melt assemblages at conditions below >8–11 kbar. Continued syn‐deformational decompression is indicated by a combination of both static and syn‐deformational recrystallization textures which generated finer grained orthopyroxene‐plagioclase assemblages. P–T constraints indicate these assemblages equilibrated at c. 5.0–6.5 kbar at 850–915 °C. These data are consistent with the rocks undergoing a stage of rapid tectonic‐induced exhumation involving some 3.0–4.5 kbar (c.10–12 km) uplift as part of a clockwise P–T path in a collisional setting.
Melt‐producing and melt‐consuming reactions in the Achankovil cordierite gneisses, South India
Authors: Cenki B. , Kriegsman L. M. , Braun I.
Published: March 2003

Migmatitic cordierite gneisses within the Achankovil Zone (AZ) of southern Pan‐African India record melt‐producing and subsequent melt‐consuming mineral reactions. Early mineral assemblages Bt‐Sil‐Qtz and Bt‐Sil‐Spl, deduced from inclusion textures in garnet prophyroblasts, break down via successive dehydration melting reactions to high‐Tphase assemblages (e.g. Grt‐Crd‐Liq, Opx‐Liq, Spl‐Crd‐Liq). Later back reactions between the restite and thein situcrystallizing melt resulted in thin cordierite coronas separating garnet from the leucosome, and partial resorption of garnet to Opx‐Crd or Crd‐Bt‐Qtz symplectites. Leucosomes generally display a moderate (low‐strain gneisses) to strong (high‐strain gneisses) depletion of alkali feldspar attributed to mineral‐melt back reactions partly controlled by the degree of melt segregation.

Using a KFMASH partial petrogenetic grid that includes a melt phase, and qualitative pseudosections for microdomains of high and low Al/Si ratios, the successive phase assemblages and reaction textures are interpreted in terms of a clockwiseP–Tpath culminating at about 6–7 kbar and 900–950 °C. ThisP–Tpath is consistent with, but more detailed than published results, which suggests that taking a melt phase into account is not only a valid, but also a useful approach. ComparingP–Tdata and lithological and isotopic data for the AZ with adjacent East Gondwana fragments, suggests the presence of a coherent metasedimentary unit exposed from southern Madagascar via South India (AZ) and Sri Lanka (Wanni Complex) to the Lützow–Holm Bay in Eastern Antarctica.
Raman spectra of carbonaceous material in metasediments: a new geothermometer
Authors: Beyssac O. , Goffé B. , Chopin C. , Rouzaud J. N.
Published: March 2003

Metasedimentary rocks generally contain carbonaceous material (CM) deriving from the evolution of organic matter originally present in the host sedimentary rock. During metamorphic processes, this organic matter is progressively transformed into graphite s.s. and the degree of organisation of CM is known as a reliable indicator of metamorphic grade. In this study, the degree of organisation of CM was systematically characterised by Raman microspectroscopy across several Mesozoic and Cenozoic reference metamorphic belts. This degree of organisation, including within‐sample heterogeneity, was quantified by the relative area of the defect band (R2 ratio). The results from the Schistes Lustrés (Western Alps) and Sanbagawa (Japan) cross‐sections show that (1) even through simple visual inspection, changes in the CM Raman spectrum appear sensitive to variations of metamorphic grade, (2) there is an excellent agreement between the R2 values calculated for the two sections when considering samples with an equivalent metamorphic grade, and (3) the evolution of the R2 ratio with metamorphic grade is controlled by temperature (T). Along the Tinos cross‐section (Greece), which is characterised by a strong gradient of greenschist facies overprint on eclogite facies rocks, the R2 ratio is nearly constant. Consequently, the degree of organisation of CM is not affected by the retrogression and records peak metamorphic conditions. More generally, analysis of 54 samples representative of high‐temperature, low‐pressure to high‐pressure, low‐temperature metamorphic gradients shows that there is a linear correlation between the R2 ratio and the peak temperature [T(°C) = −445 R2 + 641], whatever the metamorphic gradient and, probably, the organic precursor. The Raman spectrum of CM can therefore be used as a geothermometer of the maximum temperature conditions reached during regional metamorphism. Temperature can be estimated to ± 50 °C in the range 330–650 °C. A few technical indications are given for optimal application.
Metamorphic history of high‐pressure granulites in Payer Land, Greenland Caledonides
Authors: Elvevold S. , Thrane K. , Gilotti J. A.
Published: March 2003

A high‐P granulite facies gneiss complex occurs in north‐west Payer Land (74°28′−74°47′N) in the central part of the East Greenland Caledonian (Ordovician–Devonian) orogen. High‐P metamorphism of the Payer Land gneiss complex resulted in formation of the assemblages Grt + Cpx + Amp + Qtz + Ru ± Pl in mafic rocks, and Grt + Ol + Cpx + Opx + Spl in rare ultramafic pods. Associated metapelites experienced anatexis in the kyanite stability field. Peak metamorphic assemblages formed around 800–850 °C at pressures of c. 1.4–1.7 GPa, corresponding to crustal depths of c. 50 km. Mafic granulites contain abundant reaction textures, including the replacement of garnet by symplectites of Opx + Spl + Pl, indicating that the high‐P event was followed by decompression while the granulites remained at elevated temperatures.

 Charnockitic gneisses from Payer Land show evidence of late Archean (c. 2.8–2.4 Ga) crustal growth and subsequent Palaeoproterozoic (c. 1.85 Ga) metamorphism. The gneiss complex experienced intense reworking during the Caledonian continental collision. On the basis of Caledonian monazite ages recorded from the high‐P anatectic metapelites, the clockwise P–T evolution and formation of the high‐P granulite facies assemblages is related to Caledonian crustal thickening, which resulted in formation of eclogites approximately 300 km north of Payer Land. The Payer Land granulites comprise a metamorphic core complex, which is separated from the overlying low‐grade supracrustal rocks (the Neoproterozoic Eleonore Bay Supergroup) by a late Caledonian extensional fault zone, the Payer Land Detachment. The steep, nearly isothermal, unloading P–T path recorded by the granulites can be explained by erosional and tectonic unroofing along the Payer Land Detachment.
Metamorphism of the deepest exposed arc rocks in the Cretaceous to Paleogene Cascades belt, Washington: evidence for large‐scale vertical motion in a continental arc
Authors: Valley P. M. , Whitney D. L. , Paterson S. R. , Miller R. B. , Alsleben H.
Published: March 2003

The Swakane Gneiss and the overlying Napeequa Complex in the North Cascade range, Washington, were metamorphosed and deformed during development of a Cretaceous‐Paleogene continental arc, and are among the structurally deepest exposed rocks within the Cordilleran arcs of North America. Peak metamorphic conditions in both the Swakane Gneiss and Napeequa Complex were c. 640–750 °C, 9–12 kbar. Clockwise paths and widespread evidence for high‐P metamorphism in meta‐supracrustal rocks (burial to >40 km) document major vertical tectonic motion during arc construction and unroofing.

These and other moderately high‐pressure rocks in the North Cascades‐Coast Mountains experienced a dramatically different tectonometamorphic history than metamorphic rocks within other Cordilleran arcs. The exhumed arc complexes of the Sierra Nevada and Peninsular Ranges are dominated by relatively low‐P metamorphic and plutonic rocks (typically <6 kbar). There is no evidence that the northern Cordillera was thickened to a greater degree than these other belts, suggesting that the greater magnitude of vertical motion in the Cascades may have been related to exhumation mechanisms: Eocene extension in the northern Cordillera vs. erosional unroofing in the central and southern Cordillera.
ACID‐BASE IN RENAL FAILURE: Acid‐Base Balance in Dialysis Patients
Authors: Gennari F. John
Published: March 2003

Acid‐base balance in dialysis patients is achieved by a unique interaction between the patient and the particular mode of renal replacement therapy. The prevailing serum HCO3− in these patients is determined not only by endogenous acid production but also by the nature of the dialysis prescription and, in particular, by the bicarbonate (or lactate) concentration of the bath solution. Despite the technical advances in dialysis therapy, pre‐dialysis serum HCO3− remains lower than normal in most patients receiving hemodialysis and in many patients receiving peritoneal dialysis. A central question is whether even a mild degree of acidosis increases morbidity and mortality in patients with end‐stage renal disease. This article reviews the nature of the acid‐base equilibrium achieved in patients receiving hemodialysis or peritoneal dialysis, addresses the question of whether correction of acidosis is beneficial, and reviews the techniques for increasing serum HCO3− in these patients. Based on the information available, it is clear that the patient with a serum HCO3− less than 19 mEq/L should be assessed to determine the cause of the low value and steps undertaken to correct the acidosis. Whether patients with steady‐state values between 19 and 24 mEq/L require specific attention remains an issue for further investigation.
Hemodialyzer Membranes and Configurations: A Historical Perspective
Authors: Clark William R.
Published: March 2003

The principle of hemodialysis (HD) was first described over a century ago while the first human HD treatment was performed in 1923 with collodion tubes. Since that time, a variety of different hemodialyzer configurations and membranes have been used. The purpose of this article is to provide a historical review of these various configurations and membranes. The rotating drum, coil, parallel flow, and hollow fiber artificial kidneys are discussed. Emphasis is placed on the factors that have influenced the shaping of the contemporary HD market.
Increasing the Proportion of Diabetics with AV Fistulas
Authors: Konner Klaus
Published: March 2003

Worldwide, older diabetic patients represent the most rapidly growing group of patients treated for end‐stage renal disease (ESRD). Preexisting arterial as well as venous problems have led to a pessimistic view on the creation of vascular access in this population. During 1993–98 I created all primary arteriovenous (AV) accesses for a total of 181 patients with diabetes mellitus (DM) ESRD and 567 patients with ESRD due to all other causes (non‐DM). The following approach led to good outcomes for both groups whether assessed by time to first intervention or time to failure: careful preoperative investigations for selection of adequate location for initial AV fistula through ultrasonographic techniques; timely surgical AV fistula creation; preference of large‐diameter, “healthy” arteries and veins, frequently requiring use of the elbow region; absolute priority for use of native vessels (i.e., avoidance of initial polytetrafluoroethylene [PTFE]); meticulous surgical technique and creativity; and continuous surveillance by the nephrologist and staff allowing elective revisions and avoidance of thrombosis. With this approach AV fistulas rather than PTFE grafts can be created in most diabetic and nondiabetic patients.
Fellows' Forum in Dialysis edited by Mark A. Perazella: A Case of Uremia‐Associated Pleural Effusion in a Peritoneal Dialysis Patient
Authors: Krishnan Mahesh , Choi Micheal
Published: March 2003

The development of pleural effusions in ESRD patients is a relatively common occurrence. Uremia, currently a rare cause of effusion, can lead to the development of hemorrhagic pleural fluid collections in patients who are underdialyzed. Uremic pleural effusions should be considered when common etiologies of effusions such as volume overload, congestive heart failure (CHF), infection, and malignancy have been excluded. Uremia‐associated serosal injury allows transudation of fluid into the pleural space, and defective platelet function contributes to the hemorrhagic nature of the effusion. Although uremic effusions may occur less frequently in peritoneal dialysis patients, we present a patient who developed this complication due to a peritoneal dialysis regimen that was inadequate by current Dialysis Outcomes Quality Initiative guidelines. The pleural effusion resolved with an intensified dialysis regimen in the absence of a change in the underlying volume status.
Cardiac Biomarkers in the New Millennium
Authors: Herzog Charles A. , Apple Fred S.
Published: March 2003

Cardiac disease is the major cause of death in patients with end‐stage renal disease (ESRD), accounting for about 45% of all deaths. In dialysis patients about 20% of cardiac deaths are attributed to acute myocardial infarction (AMI). The survival of dialysis patients after AMI is poor, with nearly three‐quarters of patients dead at 2 years after AMI. The definition of AMI is based on symptoms, electrocardiography, and cardiac biomarkers. In the non‐ESRD population, it has been recognized that sensitive markers of myocardial injury (cardiac troponin I and troponin T) define a group of patients who are increased risk for adverse cardiac outcomes and who are more likely to benefit from treatment. Elevated cardiac troponin levels in nonhospitalized ESRD patients without other evidence of ongoing myocardial ischemia may also prospectively identify a subgroup of ESRD patients at increased risk for death. This editorial is an overview of cardiac biomarkers (specifically troponin I and troponin T) in the management of acute coronary syndromes in ESRD patients. A potential role of cardiac troponin testing for risk stratification in the outpatient dialysis unit is also presented.
Catheter Thrombosis
Authors: Beathard Gerald A.
Published: March 2003

Catheter malfunction due to poor flow is a common problem. When it occurs early, the cause is generally technical. Late occurrences are most often related to thrombus formation. Several types of thrombus may be seen, differing by location and supposed mechanism of formation. The most common offender, however, is the fibrin sheath thrombus. Prevention of catheter malfunction is an endeavor that continues to beg many questions. Catheter malfunction should be treated early to avoid inadequate dialysis. In the past, urokinase was a highly valuable aid to the nephrologist in managing this problem. Since this agent became unavailable a suitable alternative has not emerged. Recombinant tissue plasminogen activator (tPA) seems to be the most likely candidate for this role; however, it is not currently available in a packaging form that is optimal for this purpose. Currently, catheter exchange appears to be the best available alternative for this problem, which cannot yet be resolved by simpler means.
Editorial Focus: Dialysis Quality and Outcomes: Quality Outcomes and Obstacles to Their Achievement in End‐Stage Renal Disease
Authors: Fishbane Steven , Goldman Richard
Published: March 2003

Much effort has gone into improving the quality of care in end‐stage renal disease (ESRD) in recent years. In particular, the National Kidney Foundation's Kidney Disease Outcomes Quality Initiative (KDOQI) serves as a positive example. However, there are certain barriers to quality of care that may hinder such efforts. In this article we discuss obstacles to quality of care in ESRD and present potential solutions.
Isothermic Dialysis for Hypotension‐Prone Patients
Authors: Maggiore Quirino
Published: March 2003

Standard hemodialysis (dialysate temperature ≥37°C) induces an increase in body temperature capable of eliciting circulatory adjustments dictated by the maintenance of thermal homeostasis. These adjustments oppose, and can overcome, those elicited by the hypovolemia caused by the ultrafiltration process, and thus predispose patients to develop hypotensive crises during the treatment. Hemodynamic studies in hypotension‐prone patients treated with standard hemodialysis showed that during the hypotensive crisis the peripheral vascular resistances decrease, while the stroke volume decreases proportionally more than the blood volume, suggesting cardiac underfilling due to blood volume redistribution. On the other hand, removal of the body heat surplus by cool dialysis helped the same patients to sustain their peripheral vasoconstriction and cardiac filling. To prevent the increase in body temperature, dialysate temperature should be regulated in such a way as to remove through the dialyzer the heat surplus accumulated in the body as a result of the ultrafiltration process. The amount of heat removal should be tailored to each patient because there are wide interindividual and intraindividual variations in baseline body temperature and ultrafiltration requirements. This can be accomplished by the use of a device that can adjust the dialysate temperature automatically in order to keep the body temperature of the patient unchanged (isothermic hemodialysis). Isothermic hemodialysis reduced from 50% to 25% the incidence of treatments complicated by episodes of symptomatic hypotension in a large randomized clinical trial involving 95 high‐risk patients. The thermoregulated treatment results in better patient tolerance because the cold stress inherent in this procedure is lower than that inflicted by the use of a fixed low temperature as was done in the past. Overall, the available evidence supports the Gotch hypothesis that the increase in body temperature during hemodialysis is due to the ultrafiltration process eliciting peripheral vasoconstriction and heat accumulation in the body. Heat accumulation brings into play the thermal homeostatic mechanisms endangering cardiovascular tolerance to ultrafiltration.
Imaging in the dialysis patient: Dialysis Bone Disease
Authors: Adams Judith Elizabeth
Published: March 2003

The bone disease associated with end‐stage renal failure (ESRD) and treatment are complex and multifactorial, and has changed in both clinical and imaging features over the past three decades. Whereas previously features of vitamin D deficiency (rickets/osteomalacia) and intense, and prolonged, secondary hyperparathyroidism (bone resorption, osteosclerosis, metastatic calcification) predominated, these features are now rarely evident radiologically. This has occurred through the better understanding of vitamin D metabolism and improvements in therapeutic management. However, metastatic calcification in soft tissues and ‘‘adynamic’’ bone continue to be problematic. New complications have developed as a consequence of treatment (dialysis and transplantation), including amyloid deposition, noninfective sponyloarthropathy, osteonecrosis, and osteopenia/osteoporosis). Radiographs remain the most widely used imaging technique in examining for skeletal disease in patients with ESRD on maintenance dialysis. Occasionally, more sophisticated imaging (CT, MRI, nuclear medicine scanning) are helpful (parathyroid tumor localization, differentiation between infection and amyloid deposition). Developments in quantitative methods to assess bone density enable the effects of ESRD and treatment to be studied and monitored. Technical developments in computed tomography (rapid, multislice scanning) allow quantitation and monitoring of metastatic cardiac calcification in patients on hemodialysis, which has relevance to prognosis.
A Dialysis Case Presentation and Discussion Edited by Roger A. Rodby: Peritoneal Dialysis Catheter Replacement: “Save the Patient and Not the Catheter”
Authors: Piraino Beth
Published: March 2003

A 63‐year‐old man on ambulatory peritoneal dialysis (APD) developed peritonitis with Enterococcus faecalis, treated with 2 g intraperitoneal (IP) vancomycin, with rapid clearing of the effluent white blood cells, but persistence of positive cultures. Vancomycin was redosed on day 8 (2 g IP), and then weekly. Gentamicin 140 mg IP loading dose, followed by 40 mg IP once a day was added after cultures were still positive at 2 weeks. The two drugs were continued for six additional weeks. Although the patient was asymptomatic, the effluent cultures continued to grow E. faecalis and the catheter was replaced 2 months after the onset of peritonitis. There was no evidence of either tunnel infection or intra‐abdominal abscess. Refractory peritonitis is defined as continuation of peritonitis after 5 days of appropriate therapy. This patient had persistently positive cultures but quickly became asymptomatic and signs of inflammation resolved readily. The most likely etiology appears to have been colonization of the slime layer of the intra‐abdominal portion of the catheter with the organism. The vancomycin dosing schedule may have played a role in the persistently positive cultures. A recent pharmacokinetic study suggested that patients on APD require 35 mg/kg IP of vancomycin as a loading dose, followed by 15 mg/kg IP once a day, given in a long day exchange. Simultaneous placement and removal as a single procedure was successful in this patient and can be done safely in patients whose effluent white blood cell count (WBC) is less than 100/mm3. Most patients can then be subsequently managed by doing supine dialysis (using a cycler) with decreased exchange volumes and a dry abdomen until healing occurs (usually 1–2 weeks). In this way hemodialysis can be avoided. By minimizing the effect on the patient's lifestyle, the patient is more likely to agree to a catheter exchange.
HRAS1 Proto‐Oncogene Polymorphism and Prostate Cancer
Authors: Farmer Deborah A. , Platz Elizabeth A. , Febbo Phillip G. , Stampfer Meir J. , Kantoff Philip W. , Giovannucci Edward
Published: March 2003

Objectives: Rare HRAS1 variable number tandem repeats (VNTR) have been associated with increased risks for a variety of cancers. We investigated the relationship of this polymorphism with the risk of prostate cancer among 240 cases and 481 control subjects in the Health Professionals Follow‐up Study.

Materials and Methods: The HRAS1 VNTR region of leukocyte DNA was polymerase chain reaction amplified, and fragment lengths were determined by automated fluorescence detection and computer analysis. We estimated the odds ratios (OR) of prostate cancer for rare HRAS1 VNTR from logistic regression models. Four common HRAS1 VNTR alleles were identified about which there was a distribution of rare 28‐nucleotide repeat units. There was no difference (p = 0.4) in the prevalence of rare alleles between cases (25.8%) and control subjects (23.7%). Compared to common alleles, the OR for prostate cancer was 1.13 (95% confidence interval 0.87–1.45) for rare alleles.

Conclusions: This study suggests that rare HRAS1 VNTRs may not be important in the etiology of prostate cancer.
Intergenerational Concepts of Adolescent Sexuality: Implications for Community‐Based Reproductive Health Care with Haitian Immigrants
Authors: DeSantis Lydia , Thomas Janice T , Sinnett Katharine
Published: March 2003

Intergenerational conflict occurs when immigrant parents hold different values from those of their more rapidly acculturating offspring. These conflicts frequently involve disparate views related to sex roles and reproduction. A community‐based study of 19 immigrant Haitian parent‐adolescent pairs in South Florida compared their attitudes and values about sexuality and reproduction. Data were obtained through focused, open‐ended interviews. Content analysis procedures at the level of words and phrases facilitated the categorization of responses. Data revealed considerable differences between parents and adolescents about the sources and types of information learned about reproduction and contraception, when such information is learned, and expectations regarding premarital sexual intercourse. Both parents and adolescents lacked accurate biomedical information about contraception, placed responsibility for contraceptive use primarily on the female partner, considered reproduction a natural rather than a medical event, and believed parents have the major responsibility for educating children about reproduction and contraception. Implications for culturally‐appropriate health care center on increasing the role of the public health nurse in health education, minimizing intergenerational and intercultural conflict, and engaging the Haitian immigrant community in the promotion of reproductive health.
Social Support Provided by Public Health Nurses and the Coping of First‐Time Mothers with Child Care
Authors: Tarkka Marja‐Terttu , Paunonen Marita , Laippala Pekka
Published: March 2003

The purpose of this study was to look at the factors related to the first‐time mother's coping with child care when her child is 3 months old. This study is part of an extensive longitudinal project in which the development of mothering skills of first‐time mothers was followed up for 8 months postpartum. The data were collected with a questionnaire between March and September 1995, in a sample of 271 first‐time mothers. The mothers filled in the questionnaire when their babies were 3 months old. Coping with child care was assessed using Spearman correlation coefficient and stepwise regression analysis. Positive correlation was found between the mother's competence, attachment to the child, health, depression, relationship with the spouse, sense of isolation and role restriction, and the mother's coping with child care. The strongest correlation existed between the mother's competence and her coping. Positive correlation was also found between the child's mood, demandingness and acceptability, and the mother's coping with child care, with the child's demandingness having the strongest correlation. Positive correlation was again found between social support–the average functional support the mother received from her own social network, plus affect, affirmation, and aid from the public health nurses–and the mother's coping with child care. The predictors included in the multivariate method were the mother's competence, health, depression, and attachment to her child; the child's mood and ease or difficulty of care; and the affect and affirmation from the public health nurse. The results show that the first‐time mother's coping with child care, when the child is 3 months old, is affected by the characteristics of both mother and child, as well as by the social support received from their social network and from the public health nurses at the child welfare clinic.
A Comparison of Urban Versus Rural Experiences of Nurses Volunteering to Promote Health in Churches
Authors: Chase‐Ziolek Mary , Striepe Jan
Published: March 2003

Recent years have seen a resurgence of the health and healing role of the church. Nurses have been involved in this movement through the development of health ministry and parish nursing with a growing number of nurses volunteering their services to congregations. This program evaluation research study compares two programs (one in an urban environment and the other in a rural environment) that use nurses who volunteer in congregations to promote health and well‐being. The study found that the two programs differed significantly with regards to the location where nurses provided care. The urban nurses provided most service at the church, while the rural nurses provided service through home visits and phone calls as well as at the church. The groups were also significantly different in the ethnicity, education, work status, and age of the nurses. Further differences were also found in the type of services the nurses provided; for example, the rural nurses were more involved in case management and practical assistance than their urban peers. The two groups were similar in the program support they valued and in their appreciation of the opportunity to integrate their faith and their nursing practice.
Community Health Nursing Practice and the Roy Adaptation Model
Authors: Dixon Elizabeth L.
Published: March 2003

In the current health care environment in the United States, the work performed by community health nurses is increasingly being recognized and valued by society at large. An increased societal emphasis on health promotion and disease prevention has generated many opportunities for community health nurses (CHNs) to stretch their practices from individually‐oriented type practice models to more encompassing population‐focused type practices. Addressing this trend, the Roy Adaptation Model of nursing has been reconceptualized and expanded to offer a framework for the systematic delivery of nursing care to aggregates in community settings. The purpose of this paper is to describe the current health promotion movement in the United States and discuss the impact of this movement on the practice of community health nursing. In recognition of the importance of theory‐based nursing practice and the opportunities that CHNs will have in the health promotion movement, the use of the a specific conceptual model, the reconceptualized Roy Adaptation Model, will be presented as a theoretical framework for community health nursing practice. The nursing process according to Roy is applied to community health nursing and specific attention is paid to the performance of community assessments within the newly defined adaptive modes that relate to collectives: the physical, group identity, role function, and interdependence modes. To date, few references appear in the literature which link the Roy Adaptation Model to community health nursing.
Health and Quality of Life Within Colonias Settlements Along the United States and Mexico Border
Authors: Davidhizar Ruth , Bechtel Gregory A.
Published: March 2003

The Colonias settlements along the United States–Mexican border are reflective of third‐world communities. Although most of the residents are U.S. citizens, they lack the basic educational and work opportunities found in most parts of the country. Because of the limited infrastructure, diseases controlled in most parts of the world are epidemic within these communities. Using the Giger and Davidhizar Transcultural Assessment Model, public health nurses can be instrumental in coordinating services in partnership with community members to enhance health and social service programs.
Developing a Caregiving Tradition in Opposition to One's Past: Lessons from a Longitudinal Study of Teenage Mothers
Authors: SmithBattle Lee
Published: March 2003

Although teenage mothering has been exhaustively studied, the cross‐sectional designs and the deficit‐finding focus of empirical‐rational studies have exaggerated the negative consequences of an early pregnancy and have obscured how teenage mothering is often a rite of passage to adulthood, particularly in the absence of middle‐class resources and aspirations. In examining the experiences of young mothers, an 8‐year longitudinal study sought to understand how teenage mothers extend and develop family caregiving traditions. The original sample included 16 families and 39 subjects. Multiple individual and family interviews were conducted once the teen's first‐born infant reached 8 to 10 months of age, and then 4 and 8 years later. Data from all three study periods were analyzed using the interpretive method. The following analysis provides an in‐depth account of how young mothers with an oppressive past strive to become the parents they want to be. In addition, the teen mother's difficulties and struggles of creating a more positive maternal legacy and the role that positive and negative examples of parenting play in fostering or hindering the development of a new caregiving tradition are described. Study findings have implications for how clinical practice and social policy can better assist mothers to become the mothers they want to be.
Use of a Western Theoretical Model to Investigate the Relationships Among Characteristics of Pregnant Women, Utilization, and Satisfaction with Prenatal Care Services in St. Petersburg, Russia
Authors: Ivanov L. Louise
Published: March 2003

Few studies of utilization and satisfaction with prenatal care services have been conducted internationally. In this study, utilization and satisfaction with prenatal care services in St. Petersburg, Russia were examined using Aday and Andersen's (1974) A Framework for the Study of Access to Medical Care. This study was conducted under the auspices of the European Region, World Health Organization (WHO) Healthy Cities Project, which promotes a community‐based intersectoral approach to meeting health needs. The convenience sample included 397 women with uncomplicated pregnancies and normal deliveries, representing an 86% response rate. Multiple regression and path analysis found significant predictors of prenatal care utilization and satisfaction. They were different, however, from those posited in the theoretical model. This indicates that Aday and Andersen's health care services model is specific to the U. S. health care system, where it originated. The Russian health care system has been and remains different from that of the United States. If the reformed Russian health care system takes on aspects of the U. S. health care system, the utility of Aday and Andersen's theoretical model may change.
A Student‐Directed Community Project to Support Sexually Abused Women Veterans Suffering from Post‐Traumatic Stress Disorder
Authors: Wing Donna Marie , Oertle Jayne R , Cabioc Autumn R , Evans Carlissa M , Smith Dana J , Stangeby Belinda L
Published: March 2003

While awareness of post‐traumatic stress disorder (PTSD) and sexual abuse continues to grow, it has only been during the past few years that the military has realized the prevalence and impact of sexual abuse inflicted upon women while on active military duty. Though Veteran Administration (VA) agencies throughout the United States have given concerted attention to this problem, published resources specific to PTSD and military sexual abuse have been limited.

In this article the authors present the results of a 2 ½‐year endeavor to address the problem of PTSD and military sexual abuse at the Tulsa VA Outpatient Clinic. The project started with a research study and the subsequent initiation of a PTSD women veterans support group, and culminated in the development of resource manuals for both professional staff and women veterans.
The Challenge of Choosing a Pediculicide
Authors: Hensel Paula
Published: March 2003

Head lice is the most frequently occurring communicable disease, except for the common cold, among children in the United States. The impact on a family facing the challenge of head lice is tremendous, ranging from emotional to financial distress. Challenges also face the health care provider and school personnel. Many over‐the‐counter preparations and prescription products are available to combat head lice. With the alleged advent of pediculicide‐resistant head lice, many other products and applications not necessarily intended to treat head lice are being recommended. The purpose of this article is to outline the products and procedures currently being utilized and to provide a starting point for treating head lice.
Definition and Identification of Child Abuse by Finnish Public Health Nurses
Authors: Paavilainen Eija , Tarkka Marja‐Terttu
Published: March 2003

Abstract The purpose of this study was to determine how public health nurses in Finland defined child abuse and how they assessed their capability to identify child abuse in the family. Public health nurses described child abuse as consisting of physical and emotional abuse. They described physical abuse as consisting of two categories, direct physical abuse towards children and other acts causing children physical harm. Emotional abuse included neglect, teasing the child, frightening the child, rejecting the child in the family, and forcing the child to assume an adult role.

The nurses divided the identification of child abuse into two categories: tools for identifying child abuse and markers indicating child abuse. The tools for identifying abuse included knowledge acquisition and interactive skills, intuition, and the capacity of the nurse to handle problematic situations. Public health nurses identified child abuse in the child's behavior and appearance and in family behaviors.

Public health nurses seem to be aware of child abuse, but further research is needed if they need more‐specific skills regarding how to apply their theoretical knowledge to nursing practice to provide nursing care for abused children and their families.
Do We Really Help? Perspectives of Abused Women
Authors: Lutenbacher Melanie , Cohen Alison , Mitzel Julia
Published: March 2003

Abstract  Findings are presented from focus group data collected during a larger study describing factors that inhibit, support, and sustain women's abilities to leave and stay out of abusive relationships. A subset (n = 24) of the larger study sample (N = 40) participated in one of four focus groups. Participants had left or were currently in abusive intimate relationships. Women reported diverse experiences and were in various stages of abusive relationships. Ages ranged from 21 to 51; 67% were Caucasian, and 20% African American. Most women (71%) had at least a high school education and were employed (60%), but 83% reported annual incomes less than $20,000. NVIVO software facilitated content analysis of transcriptions. After initial synthesis of data, 20 women participated in one of two confirmatory focus groups. Four primary themes emerged from the content analysis: (1) Living an Unnatural Experience included maladaptive physical and emotional responses to chronic violence; (2) The Experience of Telling included multiple intrapersonal, interpersonal, and societal barriers to disclosure; (3) The Experience of Leaving included descriptions of acute and long‐term experiences and difficulties; and (4) Reducing Barriers included participant ideas on ways to reduce barriers to assistance. Recommendations are made to improve community interventions and programs that will facilitate the choices and enhance the successes of women who have experienced domestic violence.
Stress and Coping in High‐Risk Mothers: Difficult Life Circumstances, Psychiatric‐Mental Health Symptoms, Education, and Experiences in Their Families of Origin
Authors: LeCuyer‐Maus Elizabeth A
Published: March 2003

Abstract  A pilot study was conducted to test methods and measures used to assess factors related to stress and coping in high‐risk mothers and their effect on parenting. Twenty mothers with 12‐month‐old toddlers were recruited from a WIC population; they came into an observational laboratory where they were interviewed about stressors in their lives and their symptoms of stress and were videotaped interacting with their children. Maternal difficult life circumstances, psychiatric‐mental health symptoms, education, maternal experiences in their families of origin, and parenting stress explained 74% of the variance in maternal sensitive‐responsiveness with their toddlers in the laboratory setting. The findings support the methods of the study. Clinical implications and implications for future research to assist in the development of interventions for this population are discussed. Increased attention to screening for maternal psychiatric‐mental health symptoms and for negative experiences in mothers' families of origin may provide important opportunities for intervention with these mothers.
Colocalization of Alopecia Areata and Vitiligo
Authors: Adams Brian B. , Lucky Anne W.
Published: March 2003

Abstract: We report an 18‐year‐old woman who had a 4‐month history of colocalization of alopecia areata and vitiligo, principally on the occipital portion of the scalp.
Extensive Mongolian Spots with Involvement of the Scalp
Authors: Leung Alexander K. C. , Kao C. pion , F.R.C.P.C.
Published: March 2003

Abstract: A Chinese infant boy had extensive Mongolian spots in the occipital, gluteal, sacrococcygeal, and lumbar areas. The occurrence of a Mongolian spot in the scalp area has not been previously reported. Awareness of such an occurrence is important so that a false accusation of child abuse is not made.
Proceedings of the 1998 Meeting of the Society for Pediatric Dermatology
Authors: Duarte Ana M. , GARZON MARIA C.
Published: March 2003

The Society for Pediatric Dermatology held its annual meeting in Cambridge, Massachusetts, on July 23–26, 1998. Selected summaries of presentations at the meeting follow.
Dystrophic Epidermolysis Bullosa Associated with Eosinophilic Infiltrate and Elevated Serum IgE
Authors: Grunwald Marcelo H. , Amichai Boaz , Avinoach Ilana , Kedar Tamar , Bergman Reuven
Published: March 2003

An infiltrate of eosinophils is rarely seen in epidermolysis bullosa. We describe a child with dystrophic epidermolysis bullosa associated with a marked eosinophilic tissue infiltrate and elevated serum IgE.
Multiple Eccrine Spiradenomas in Zosteriform Distribution in a Child
Authors: Gupta Somesh , Jain Vijay Kumar , Singh Uma , Gupta Sanjeev
Published: March 2003

Abstract: A 9‐year‐old boy presented with asymptomatic papulonodular lesions on the left half of the chin of 3‐years duration. On examination he had small papular lesions on the left chin varying in size from 1 to 5 mm. An additional lesion on the margin of the lip was 14 mm in diameter. The overlying skin was normal. Lesions were firm, nontender, and fixed to the skin. Histopathologic examination of the biopsy specimen revealed characteristic features of eccrine spiradenoma. A literature search produced reports of 10 cases of linear/zosteriform spiradenoma. Of these, five were in children or adolescents. We report this patient because of the rare occurrence of this presentation.
Scleroderma‐like Indurations Involving Fascias: An Abortive Form of Congenital Fascial Dystrophy (Stiff Skin Syndrome)
Authors: Jablonska Stefania , Blaszczyk Maria
Published: March 2003

Abstract: Four patients are described with stone‐hard indurations of the skin and subcutaneous tissue, predominantly on the buttocks and thighs, in the areas of the thickest fascia lata and glutealis. All cases were sporadic, started in early infancy, were only slightly or not progressive, and showed no visceral involvement or immunologic abnormalities. In all, the hallmark of the disease was strikingly enlarged fascia. In one patient, typical features developed progressively for 9 years, and in two patients the changes remained abortive, limited to some areas, and not symmetrical. The fourth patient showed some similarity to profound morphea with no cutaneous involvement. Recognition of atypical or abortive cases of congenital fascial dystrophy, which is probably a variant of heterogeneous stiff skin syndrome involving exclusively fascia, is of practical importance, since no therapy is required. However, intensive rehabilitation should start in early infancy and continue throughout life. The genetic defect of molecular organization of collagen in the fascia results in formation of giant amianthoid‐like collagen fibrils.
Telangiectasia Macularis Eruptiva Perstans
Authors: Gibbs Neil F. , Friedlander Sheila Fallon , Harpster Elaine F.
Published: March 2003

Abstract: Telangiectasia macularis eruptiva perstans (TMEP) is a form of mastocytosis. It is an uncommon condition, particularly in children. The disorder is characterized by telangiectatic macules and generally has a good prognosis, with little tendency to urticate or cause constitutional symptoms. We report a girl who presented at age 2 with a 6‐month history of erythematous macules on her arms and legs. The lesions were larger and possessed a more angular configuration than classic telangiectases. They slowly spread to her torso and face; there were no associated constitutional symptoms. Histopathologic examination showed dilated capillaries and increased numbers of mast cells, consistent with TMEP. Mastocytosis should be considered in patients presenting with telangiectatic lesions that are atypical in appearance, distribution, or onset.
Benign Anteromedial Plantar Nodules of Childhood: A Distinct Form of Plantar Fibromatosis
Authors: Jacob Carolyn I. , Kumm Randal C.
Published: March 2003

Abstract: Plantar fibromatosis is a benign but sometimes locally aggressive proliferation of fibrous tissue that usually arises in adolescence or early adulthood. Pediatric presentation with asymptomatic, bilateral nodules on the anteromedial heel pad may be cause for cosmetic concern, but is otherwise harmless. Awareness and clinical diagnosis of benign anteromedial plantar nodules of childhood will prevent unnecessary and possibly unsuccessful surgery. We present a case of anteromedial plantar nodules and a brief review of the literature. We propose the term “benign anteromedial plantar nodules of childhood” to describe and define this clinically distinctive form of plantar fibromatosis.
Generalized Eruptive Histiocytoma: A Pediatric Case
Authors: Wee Seong Ho , Kim Hee Sung , Chang Sung‐Nam , Kim Dong‐Kun , Park Wook‐Hwa
Published: March 2003

Abstract: Generalized eruptive histiocytoma (GEH) is a rare, benign, papular, self‐healing histiocytosis characterized by recurrent crops of small, firm, tan to reddish papules that appear in a symmetrical fashion on the face, trunk and arms, affecting mainly adults. Approximately 31 cases have been described, of which 8 were in children. A new concept unifying the confusing potpourri of non‐Langerhans cell histiocytosis has recently been described in which GEH has been considered to represent an early undifferentiated stage of various histiocytic disorders. We describe a 9‐year‐old boy who had all the features of GEH and emphasize the importance of clinical, histologic, immunohistochemical, and ultrastructural examination in the diagnosis of histiocytic disorders. On the basis of the increasing numbers of similar reported cases showing overlap in clinical and histologic features and in accordance with the new unifying concept of non‐Langerhans cell histiocytosis, we presume that this group of disorders may represent a continuous spectrum of a single disease rather than a collection of separate disorders.