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Biomedical subjects

B L Walker

Publications and source records attributed to B L Walker.

At least 19 recordsLinked to original sources

Treatments to promote colonic hydration: enteral fluid therapy versus intravenous fluid therapy and magnesium sulphate.

Although large intestine impactions are commonly treated with i.v. fluids combined with the osmotic laxative MgSO4, enteral fluids are less expensive and also appear to be efficacious for impactions. Therefore, this study was conducted to compare the systemic and gastrointestinal effects of enteral fluids with the changes produced by i.v. fluids combined with MgSO4. Four horses with a fistula in the right dorsal colon alternately received both treatments in 2 periods one week apart. Sixty litres of fluids were administered continuously (10 l/h) through a venous catheter or a nasogastric tube. Magnesium sulphate (1 g/kg bwt) was administered via nasogastric tube before i.v. fluid therapy. Two horses had mild abdominal discomfort at the end of enteral fluid therapy. Pollakiuria, hypostenuria, increased bodyweight, increased faecal and ingesta hydration, and decreased PCV, plasma protein and plasma magnesium were produced by both treatments. Abdominal distention and more pronounced changes in bodyweight and ingesta hydration were seen with enteral fluids. Intravenous fluids plus MgSO4 produced hypocalcaemia and more pronounced changes in plasma protein. These results indicate that enteral fluid therapy is more effective in promoting ingesta hydration and produces less pronounced systemic effects than i.v. fluid therapy plus MgSO4.

Animals↗

Iron metabolism in mammalian cells.

Most living things require iron to exist. Iron has many functions within cells but is rarely found unbound because of its propensity to catalyze the formation of toxic free radicals. Thus the regulation of iron requirements by cells and the acquisition and uptake of iron into tissues in multicellular organisms is tightly regulated. In humans, understanding iron transport and utility has recently been advanced by a "great conjunction" of molecular genetics in simple organisms, identifying genes involved in genetic diseases of metal metabolism and by the application of traditional cell physiology approaches. We are now able to approach a rudimentary understanding of the "iron cycle" within mammals. In the future, this information will be applied toward modulating the outcome of therapies designed to overcome diseases involving metals.

Animals↗

Around my table.

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Child↗

Lues and lupus: syphilis mimicking systemic lupus erythematosus (SLE).

Malar rash and photosensitivity are common findings in systemic lupus erythematosus (SLE). However, a number of inflammatory, dermatologic, infectious or drug-induced conditions may mimic cutaneous findings of SLE. These typically include seborrheic dermatitis, contact dermatitis, rosacea, polymorphous light eruption, syphilis and dermatomyositis sine myositis. Herein we describe a patient with fever, malar rash, alopecia, photosensitivity, arthralgias and lymphadenopathy who was subsequently diagnosed with secondary syphilis. In this case report we review clinical and histopathological findings in the differential diagnosis of malar rash and photosensitivity and discuss the overlapping features of syphilis and SLE.

Adult↗

Does emotional expression make a difference in reactions to breast cancer?

PURPOSE/OBJECTIVES: To examine the feasibility of using an emotional expression intervention with patients with cancer and test the hypothesis that emotional expression improves psychosocial adjustment. DESIGN: Sequentially randomized pretest/post-test design with repeated measures. SETTING: Two radiation therapy (RT) facilities. SAMPLE: Women completing RT for stage I or II breast cancer, who spoke and read English, were independent in self-care, and provided written consent. Subjects (N = 44) were middle-aged (mean = 53.6 years), Caucasian, married, and well educated. METHODS: Following a baseline interview, subjects were sequentially randomized to an attentional control group, a single dose, or a three-dose emotional expression writing group. Interventions were administered at the time of completion of RT. Follow-up telephone interviews were completed at 1, 4-6, 16, and 28 weeks post-RT. MAIN RESEARCH VARIABLES: Positive and negative affect, intrusiveness of thoughts, use of avoidant coping, side effect severity, trait negative affectivity, content of written essay, and themes derived from content analysis. FINDINGS: A high level of acceptance and completion of emotional expression existed, but no effect of the intervention on psychosocial adjustment was evident. Process measures in the three-dose group changed as expected. No relationship existed between content changes and outcome measures. CONCLUSIONS: Emotional expression is feasible for patients with cancer, but the efficacy of the intervention in improving mood and decreasing cognitive intrusion and avoidance was not supported. Emotional expression processes were consistent with those seen in other samples and may influence outcomes that were not addressed in this study. IMPLICATIONS FOR NURSING PRACTICE: More extensive testing is needed, including additional outcome variables. Essays reveal concerns around communication, recurrence, and health behavior changes that should be considered in practice.

Adult↗

Preventing falls.

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Accidental Falls↗

Planning and conducting a multi-institutional project on fatigue.

PURPOSE/OBJECTIVES: To describe the process used in proposal development and study implementation for a complex multisite project on cancer treatment-related fatigue (CRF), identify strategies used to manage the project, and provide recommendations for teams planning multisite research. DATA SOURCES: Information derived from project team meeting records, correspondence, proposals, and personal recollection. DATA SYNTHESIS: The project was built on preexisting relationships among the three site investigators who then built a team including faculty, research coordinators, staff nurses, and students. Study sites had a range of organizational models, and the proposal was designed to capitalize on the organizational and resource strengths of each setting. Three team members drawn from outside oncology nursing provided expertise in measurement and experience with fatigue in other populations. Planning meetings were critical to the success of the project. Conference calls, fax technology, and electronic mail were used for communication. Flexibility was important in managing crises and shifting responsibility for specific components of the work. The team documented and evaluated the process used for multisite research, completed a major instrumentation study, and developed a cognitive-behavioral intervention for CRF. CONCLUSIONS: Accomplishments during the one-year planning grant exceeded initial expectations. The process of conducting multisite research is complex, especially when the starting point is a planning grant with specific research protocols to be developed and implemented over one year. Explicit planning for decision-making processes to be used throughout the project, acknowledging the differences among the study settings and planning the protocols to capitalize upon those differences, and recruiting a strong research team that included a member with planning grant and team-building expertise were essential elements for success. IMPLICATIONS FOR NURSING PRACTICE: Specific recommendations for others planning multisite research are related to team-building, team membership, communication, behavioral norms, role flexibility, resources, feedback, problem management, and shared recognition.

Communication↗

Concerns, affect, and cognitive disruption following completion of radiation treatment for localized breast or prostate cancer.

PURPOSE/OBJECTIVES: To describe concerns, cognitive disruption, and affect following the completion of radiation treatment (RT) for localized breast or prostate cancer. DESIGN: Cross-sectional, descriptive. SETTING: Two RT centers associated with a university hospital. SAMPLE: Patients who completed RT for prostate (n = 9) or breast cancer (n = 11). The mean age of the sample is 64 years. Ninety percent are Caucasian, 80% are married, 50% are of Latter-day Saint faith, and 50% are retired. All had early stage disease, with a mean of 20 months post-RT. METHODS: One-time interview using qualitative methods and the Life Orientation Test, Revised Impact of Events Scale, state scale of the Positive and Negative Affect Schedule, satisfaction items of the Sarason Social Support Questionnaire, and Side Effect Severity Checklist. MAIN RESEARCH VARIABLES: Frequency of intrusive thoughts or avoidant behavior, positive and negative affect, dispositional optimism, satisfaction with social support, severity of side effects, and themes extracted from semistructured interviews. FINDINGS: Most subjects had unexpected intrusive thoughts about cancer; more than one-third avoided reminders of cancer. The level of positive affect was high, as was optimism. The level of negative affect was low. Subjects' satisfaction level with social support was high. Fatigue was the most frequently reported continuing side effect. Relative optimism, acceptance, vigilance, and trust of healthcare providers were major themes. Avoidance, comparison, maintaining normalcy, and information seeking were common coping strategies. CONCLUSIONS: Subjects perceived themselves to be doing well. Fatigue was the most common long-term side effect. Subjects continued to seek information. Symptom vigilance and interpretation were important, as were having a positive outlook and maintaining normalcy. IMPLICATIONS FOR NURSING PRACTICE: Nurses must acknowledge the potential for concerns about symptoms and continuing side effects and what they mean for the patient. Clinicians need to provide accurate information about common post-treatment experiences. Clinicians also must remember that subjects have vivid recollections of both positive and negative interactions with healthcare providers.

Adaptation, Psychological↗

Computer analysis of qualitative data: a comparison of three packages.

This article describes and compares three computer programs designed to assist in the analysis of narrative text. Ethnograph, GATOR, and Martin were compared in the context of a qualitative study of women and their husbands following mastectomy in order to (a) describe the fit between research purpose and program capabilities and (b) explore the influence, if any, of particular program features on research methods or analysis. The comparison suggests that methodological assistance provided by the programs involves differences in approach sufficient to make prior consideration of the fit between program capabilities and research purposes, methods, and style an important research decision. Descriptions of the programs and their application provide guidelines for comparison of these and other computer programs.

Evaluation Studies as Topic↗

The short-term effects of a fire safety education program for the elderly.

The high risk of fire death and injury among elderly people is well documented. To be effective, fire safety education must reach older adults in the settings in which they reside: nursing homes and other long-term care institutions, board and care homes, and independent living facilities including the person's own home. Training must also be targeted at the people who are responsible for fire safety. In the case of the nursing home or board and care home, the responsible people are the staff and owners. In the case of the majority of older adults who live independently in their homes, it is either the individual or family members. These programs must also be comprehensive. A fire safety education curriculum was developed by a group of experts in a variety of related fields including fire safety, gerontology, health care industry, developmental disabilities, research, and instructional design. Older adults were included in each planning session. Based on that curriculum, workshops and workshop materials were developed for each of the three target populations: staff of health care facilities, staff and owners of board and care homes, and elderly people living independently in their homes. Materials included both print and audiovisuals. A pilot test of each workshop was conducted to test the short-term effects of the programs. Results indicated significant gains in knowledge for all groups and a significant improvement in positive attitudes toward fire safety for most participants. Measures of effects of the programs on intentions to change fire safety practices indicated a potential for change. Results also showed that the measured traits, knowledge of fire safety and attitudes toward fire safety, were relatively stable.

Aged↗

Soft tissue myofibroblastomas.

Five well-circumscribed solitary soft tissue tumors composed of myofibroblasts are described and termed myofibroblastomas. By light microscopy these lesions are characterized by short, intersecting, or crisscrossing fascicles of spindle cells, sometimes associated with foci of necrosis and/or mitotic activity with less than three mitoses per 10 high power fields. Myofibroblastomas show well-defined myofibroblastic differentiation ultrastructurally with peripheral myofilaments and vimentin, actin, and desmin immunocytochemistry positivity. The five tumors described occurred in patients of various age groups, including one congenital, and in a variety of soft tissue locations. It is important to recognize this benign soft tissue neoplasm to avoid confusion with other soft tissue tumors and to separate this lesion from other myofibromatosis. This study elucidates the spectrum of light microscopic, ultrastructural, and immunocytochemistry findings of soft tissue myofibroblastomas and establishes this soft tissue tumor as a specific clinico-pathologic entity.

Actins↗

The fate of free autogenous fascial grafts in the rabbit.

Fascial grafts were taken from 34 New Zealand rabbits and implanted above and below the cranial periosteum in the same animal. They were placed as four-layered folded grafts and as single-layered grafts. When harvested from 6 to 14 months after transplantation, the multi-layered grafts and the single-layered grafts on bone had maintained their bulk but consisted histologically of only a retained collagen matrix with no viable cellular structure. The one-layered grafts on periosteum, however, retained their cellular make-up with normal vascularity and normal cellular structure when harvested at approximately the same intervals.

Animals↗

Fats in nutrition.

Investigation of the relationship of diet to blood lipids and atherosclerosis has dominated the field of lipid nutritional biochemistry for the past 25 years. Although this subject has consumed considerable time, effort, and research funds, it has also proved beneficial to other areas of lipid biochemistry by attracting qualified people to the field and by initiating development of sophisticated methodology and instrumentation required for progress in those areas. The development of capillary gas-liquid chromatography and high-performance liquid chromatography, together with more extensive computer control and processing of data, should accelerate progress in all areas of lipid biochemistry. In the next 25 years, I expect to see extensive investigation of dietary hydrogenated fats and their constituent isomeric fatty acids. Specificity of deposition in animal tissues, effects on blood lipids and coronary heart disease, and their relationship to polyunsaturated fatty acids and prostaglandins are among the topics likely to receive attention. The prostaglandins, prostacyclins, thromboxanes, and leukotrienes will continue to receive attention in the near future, and the role of diet in modulating the concentrations of these compounds in blood and other body tissues is a promising area of active research. The discovery of abnormalities in polyunsaturated fatty acid metabolism in pathological conditions in man has renewed interest in these dietary components. Association of neurological abnormalities with lack of linolenic acid metabolites should stimulate further investigation of the role of the n-3 series acids in central nervous system function.

Animals↗

Cholesteryl ester hydrolase activity in adrenal homogenates from normal and essential fatty acid-deficient female rats.

Cholesteryl ester hydrolase was assayed in adrenal homogenates from mature female rats fed a control (corn oil-containing) or essential fatty acid (EFA)-deficient diet. Cholesteryl ester of 16:0, 18:0, 18:1, 18:2(n-6), 20:4(n-6) and 22:4(n-6) were used as substrates. In control rats, the unsaturated esters were hydrolyzed more rapidly than the saturated esters and cholesteryl arachidonate was the preferred substrate of the six investigated; cholesteryl oleate elicited the highest activity in the deficient group. Polyunsaturated esters were hydrolyzed at a significantly lower rate by homogenates from EFA-deficient rats than by those from control animals. The esters of 18:1, 18:2(n-6) and 20:4(n-6) were hydrolyzed more extensively in relation to their concentrations in adrenal tissue than were cholesteryl esters of 16:0, 18:0 and 22:4(n-6). This difference was more pronounced in control than in EFA-deficient rats. No simple relationship of adrenal cholesteryl ester hydrolase activity to ester fatty acid structure or to nutritional essentiality was evident.

Adrenal Glands↗