This paper examines connections between concepts of space and extension on the one hand and immaterial spirits on the other, specifically the immanentist concept of spirits as present in rerum natura. Those holding an immanentist concept, such as Thomas Aquinas, typically understood spirits non-dimensionally as present by essence and power; and that concept was historically linked to holenmeris...

The most important challenge at the forefront of the national agenda is the need for health care reform. Major concerns of the current system are cost and access to care. This article discusses numerous congressional proposals and strategies for addressing these concerns. ET nurses are in a unique position to influence health care delivery. The Wound Ostomy and Continence Nurses Society has imp...

PURPOSE To compare ostomy-related costs and incidence of peristomal skin complications (PSCs) for ceramide-infused ostomy skin barriers and control skin barriers. DESIGN The ADVOCATE trial is a multi-centered randomized controlled trial, and double-blinded international study with an adaptive design. SUBJECTS AND SETTING The sample comprised 153 adults from 25 sites from the United States, ...

Wound ostomy continence (WOC) programs are essential in any healthcare organization, including home care agencies, to provide comprehensive, high-quality care. Advanced practice nurses (APNs) with assessment, diagnostic, and coordination skills are well suited to manage the complex patients being cared for by home care agencies. A number of research studies have assessed the credibility and val...

Y our patient presents with a history of ovarian carcinoma, 2 years post pelvic exenteration, chemotherapy, and pelvic radiation therapy. She has a colostomy and an ileal conduit. She now is experiencing extremely high output from her colostomy, symptoms of dehydration, frequent leakage and skin irritation, and a short wear time of 24 to 48 hours for her colostomy pouching system. After her phy...

Anastomotic leakage is an unfortunate complication of colorectal surgery. This distressing situation can cause severe morbidity and significantly affects the patient's quality of life. Additional interventions may cause further morbidity and mortality. Parenteral nutrition and temporary diverting ostomy are the standard treatments of anastomotic leaks. However, technological developments in min...

A 58-year old male with a history of small bowel resection and ileostomy presented with severe dehydration and high ostomy output. Laboratory investigation indicated hypochloremia, hypokalemia, hyponatremia, metabolic alkalosis, chloride-rich diarrhea, acute renal failure, and low urinary chloride excretion. Due to striking similarities to congenital chloridorrhea (CCD) reported in neonates, we...