How to improve your shift report.
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Communication↗
Biomedical subjects
C Mosher
Publications and source records attributed to C Mosher.
Combining optical and atomic force microscopy for life sciences research.
The atomic force microscope (AFM), a three-dimensional imaging tool that can measure structures from the atomic level to micron scale, has been combined with an inverted optical microscope capable of confocal imaging. The robust design of this microscope, termed the BioScope, enables the operator to use fluorescent markers on a wide variety of biological specimens to determine internal structure to 200 nm resolution and determine surface morphology of the same sample to 20 nm resolution while imaging under physiological conditions. In this report we demonstrate the capabilities of the BioScope by examining living Xenopus retinal glial (XR1) cells, Drosophila polytene chromosomes and colloidal gold-labeled plasmid DNA.
Animals↗
Pressure ulcer risk assessment--simple or complex?
A descriptive comparison study was carried out to determine whether there was a difference between a staff nurse's single-item pressure ulcer risk assessment and a risk assessment using the Braden Scale. Seventy-two medical patients participated in the study. Statistical analysis of the data indicated nurses were accurate in predicting pressure ulcer risk with a simple YES/NO answer. The mean Braden Score for those patients indicated at risk by the nurse was 14.45, and 20.24 for those assessed to be not at risk. This study indicates that nurses' good judgement is as reliable as more complicated tools in determining pressure ulcer risk. Further studies comparing risk assessment tools are recommended.
Aged↗
Upgrading practice with critical pathways.
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Documentation↗
Intense immunosuppression in chronic progressive multiple sclerosis: the Kaiser study.
The value of a short course of intensive immunosuppression with cyclophosphamide in stabilising chronic progressive multiple sclerosis (MS) was examined in a randomised single-blinded, placebo-controlled clinical trial. Forty two patients, from the Kaiser Permanente Medical Care Program, Northern California, were studied. Twenty two patients received a short course of cyclophosphamide in an outpatient neurology clinic until their leucocyte counts fell below 4000/mm3, and 20 patients received folic acid. Level of disability, impairment of functional systems, and performance of social roles were assessed before randomisation and reassessed 12, 18, and 24 months after therapy. In both the cyclophosphamide and folic acid groups, the mean level of disability increased from the baseline examination to the 12 month follow up examination (the primary endpoint) by 0.5 on Kurtzke's Expanded Disability Status Scale, indicating similar disease progression in the two groups. Although immunosuppression therapy can be safely administered to MS patients in an outpatient clinic, evidence of substantial benefits was not found.
Adult↗
Three-dimensional display techniques in radiation therapy treatment planning.
Good radiation treatment planning requires that the target volume be treated with a high and uniform dose of radiation while irradiating normal tissue as little as possible. Even if the merits of a given treatment plan are judged only on the appearance of isodose lines in one or a few planes it can sometimes be difficult for the experienced radiation oncologist to select the best of several alternative plans. If consideration is given to the entire spatial distribution of dose, however, the problem becomes far more difficult because of the enormous amount of data that must be evaluated. We believe that the lack of suitable methods to display these data has greatly contributed to the slow incorporation of 3D considerations into routine radiation treatment planning. In the past few years there have been great advances in both the theory of how to produce effective 3D displays and in the display hardware itself. In this paper we survey some of the methods used at the University of North Carolina, and show specific examples of how these displays can be used in radiation therapy treatment planning.
Computer Graphics↗
Documenting for patient-focused care.
Hospitals across the country are rethinking the way health care is delivered. With a shift from inpatient to outpatient care, there is an effort to deliver quality, "patient-focused care" in the hospital setting. Multidisciplines have embarked in cross-training to provide immediate services at the bedside. The premise of "nursing" documentation is no longer feasible in multicaregiver environments. One hospital's adaptation to documentation methods to meet the needs of a patient-focused system is described.
Forms and Records Control↗
The POP Program: the patient education advantage.
In 1992, a preoperative education program was developed for total joint replacement patients in a small community hospital. The goals of the program were to increase educational opportunities for the joint replacement patients, prepare patients for hospitalization, plan for discharge needs, and increase efficiency of the orthopaedic program. Since 1992, approximately 600 patients have attended the education program. Outcomes have included positive responses from patients regarding their preparedness for surgery, increased participation in their plan of care, coordinated discharge planning, decreased length of stay, and progression across the continuum of care. A multidisciplinary approach to preparing patients for surgery allows for a comprehensive and efficient education program. Marketing of successful programs can enhance an institution's competitive advantage and help ensure the hospital's viability in the current health care arena.
Arthroplasty, Replacement↗