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C Holland

Publications and source records attributed to C Holland.

97 records · Page 6Linked to original sources
PubMedDate not supplied

Paving the road to maximum productivity.

"Job security" is an oxymoron in today's environment of downsizing, mergers, and acquisitions. Workers find themselves living by new rules in the workplace that they may not understand. How do we cope? It is the leader's charge to take advantage of this chaos and create conditions under which his or her people can understand the need for change and come together with a shared purpose to effect that change. The clinical laboratory at Arkansas Children's Hospital has taken advantage of this chaos to down-size and to redesign how the work gets done to pave the road to maximum productivity. After initial hourly cutbacks, the workers accepted the cold, hard fact that they would never get their old world back. They set goals to proactively shape their new world through reorganizing, flexing staff with workload, creating a rapid response laboratory, exploiting information technology, and outsourcing. Today the laboratory is a lean, productive machine that accepts change as a way of life. We have learned to adapt, trust, and support each other as we have journeyed together over the rough roads. We are looking forward to paving a new fork in the road to the future.

Adaptation, Psychological↗
PubMedDate not supplied

Development and psychometric evaluation of the Caregiver Reciprocity Scale II.

Caregiver reciprocity is the collective affective and behavioral expression of exchanges given and received between a caregiver and care receiver, and among family members. This psychometric investigation was designed to further examine the reliability and validity of the revised Caregiver Reciprocity Scale II (CRS II). Items were rewritten to reflect valued exchanges and balance among the entire family network, including spouses. An alpha of .83 for Warmth and Regard; .73 for Intrinsic Rewards of Giving; .83 for Love and Affection; and .75 for Balance Within Family Caregiving indicated acceptable internal consistency. The study, conducted with 176 spouse or adult children caregivers, provides additional support for the conceptual model of the four-factor solution. Construct validity was supported by the standardized factor loadings and goodness-of-fit indices obtained from confirmatory factor analysis. The results of the analysis of the measurement model, taken as a whole, demonstrate that the CRS II has adequate psychometric properties. Model parsimony was supported by an AGFI of .87, combined with an adjusted chi-square between 1.0 to 3.0. All but two item loadings were greater than .50. This, combined with the fact that all standardized loadings were twice the standardized errors and t-values were greater than 2.0, contributes to concluding that convergent validity was strong. Discriminant validity, evaluated by variance extracted estimates, and confidence interval (+/- two standard errors) around the correlation estimate between factors, was adequate. This study provided evidence to support the reliability and validity of the CRS II.

Adult↗
PubMedDate not supplied

Increased cardiac allograft rejection in female heart transplant recipients.

To assess differences between male and female recipients after heart transplantation, we retrospectively reviewed 140 consecutive heart transplant recipients (119 males and 21 females) with regard to sex and characteristics before and after transplantation. Before transplantation, fewer female recipients had heart failure on the basis of coronary artery disease (14% versus 56%, p = 0.001), and more females required inotropic agents (71% versus 38%, p = 0.007). Although average follow-up (for females 430 +/- 73 days, range 12 to 1097 days; for males 412 +/- 27 days, range 1 day to 1103 days, mean +/- standard error of the mean), mortality (one female and nine males), and proportion of recipients with infectious complications (48% females and 52% males) did not differ between the groups, female recipients manifested a higher incidence of rejection during the first 4 months (2.39 +/- 0.27 episodes versus 1.67 +/- 0.11 episodes, p = 0.010) and during follow-up (3.24 +/- 0.44 episodes versus 2.20 +/- 0.21 episodes, p = 0.012). Although it was possible to discontinue maintenance dosages of corticosteroids in 65% of males, corticosteroid discontinuation was possible in only 17% of females (p less than 0.001). Furthermore, in a stepwise logistic regression analysis that included age, crossmatch (no female recipients with positive results, three males with positive results), cause of heart failure, and hemodynamic status before transplantation, females were more likely to experience a rejection episode than males (p less than 0.001). Although female recipients experience rejection episodes more than their male counterparts after heart transplantation and are more likely to require maintenance corticosteroid therapy, survival and the incidence of infectious complications are not different.

Antibodies, Monoclonal↗