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C S Roberts

Publications and source records attributed to C S Roberts.

98 records · Page 6Linked to original sources
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Role socialization of graduating student nurses: impact of a nursing practicum on professional role conception.

This study examined graduating student nurse role conception changes that occurred during a concentrated clinical preceptorial. A Nursing Role Conceptions Questionnaire was administered to nursing students before (n = 44) and immediately after (n = 41) a 4-week Nursing Practicum; to the students' staff nurse clinical teaching associates (n = 34); and to nursing program faculty (n = 18). Respondent perceptions of ideal nursing behaviors and actual nursing behaviors within three major nursing roles (professional, service, and bureaucratic) were identified and differences between ideal and actual scores (role discrepancy) were calculated. Findings showed that student role orientation in selected areas changed from a faculty role orientation to a staff nurse role orientation over the 4-week period. The Practicum seemed to effectively facilitate role socialization of graduating student nurses into the work setting, easing the necessary transition from education to practice.

Education, Nursing↗
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Medulloscopy for sepsis or nonunion: Early clinical experience with the tibia and femur.

We report the clinical use of "medulloscopy" for the visualization and irrigation of sepsis or nonunion of the tibia and femur in 7 cases. Included were 2 cases of aseptic femoral nonunion, 1 infected femoral nonunion with chronic osteomyelitis, 2 cases of healed tibia fracture with chronic osteomyelitis, 1 aseptic nonunion of the tibia, and 1 case of tibial osteomyelitis secondary to intravenous drug use. Visualization of the nonunion site or pathologic lesion was achieved in 86% of cases (6 of 7) and additional diagnostic information was obtained by medulloscopy in 86% of cases (6 of 7). A representative case is presented. Medulloscopy appears to be clinically useful for the treatment of sepsis or nonunion of the tibia and femur when access to the intramedullary canal is necessary.

Adult↗
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When does the lung die? I. Histochemical evidence of pulmonary viability after "death".

An inadequate number of lung donors for transplantation results in the death of many potential lung recipients awaiting a transplant. Canine experiments in our laboratory have shown effective gas exchange in lungs transplanted from cadaver donors (lungs retrieved after circulatory arrest). The time course of pulmonary cell death after circulatory arrest is unknown. To address this question, we used trypan blue dye exclusion to quantitate lung cell death at postmortem intervals in rats. One hundred ninety Sprague-Dawley rats were killed and separated into four groups: (1) control (n = 10); (2) nonventilated group (n = 60); (3) oxygen-ventilated group (n = 80); and (4) nitrogen-ventilated group (n = 40). At intervals after the animals' deaths, trypan blue was infused into the pulmonary artery followed by fixative, and the left lung was excised. Histologic sections were prepared for each rat lung, and the percentage of nonviable cells was quantified with light microscopy. Control lungs retrieved immediately after death showed little or no uptake of trypan blue dye. In nonventilated rats, 36%, 52%, and 77% of cells were nonviable in lungs retrieved 2, 4, and 12 hours after death, respectively. These results were similar to 34%, 58%, and 71% nonviability at the same intervals in nitrogen-ventilated cadaver rat lungs. Oxygen-ventilated cadaver rats, however, had significantly fewer nonviable lung cells at each time interval: 13%, 10%, and 26%, respectively (p < 0.01). Thus, postmortem mechanical ventilation with oxygen appears to delay lung death in the rat after circulatory arrest. Nonventilated and nitrogen-ventilated cadaver lungs had a similar severity and progression of ischemic injury.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMedDate not supplied

When does the lung die? II. Ultrastructural evidence of pulmonary viability after "death".

Lung transplantation as a therapy for end-stage lung disease is limited by the paucity of suitable donors. If lungs could be retrieved from circulation-arrested cadavers (that is, after death), then more donors for lung transplantation might be available. This study was undertaken to determine the time course of ultrastructural deterioration of cellular organelles in pulmonary tissue after circulatory arrest and death and to determine the effect, if any, of postmortem ventilation on the development of these ultrastructural changes. Sprague-Dawley rats were sacrificed and then separated into three groups: (1) controls, from which the right lung was immediately harvested (n = 4); (2) ventilated group, in which mechanical ventilation with 100% oxygen was started after death (n = 15); and (3) nonventilated group (n = 15). In the ventilated and nonventilated groups, the right lung was harvested at 2, 4, or 8 hours after death. Portions of the lung from each rat were examined by electron microscopy, and each specimen was assigned a semiquantitative injury score that was based on nuclear chromatin clumping, mitochondrial degeneration, intracellular edema, and cellular membrane integrity. The lung in all four controls was normal. At 4 and 8 hours postmortem, ultrastructural damage was significantly attenuated in rats with oxygen ventilation compared with those in the nonventilated group. The degree of ultrastructural damage observed in the oxygen ventilation group at 2 and 4 hours postmortem was not significantly different from that of normal controls. Thus, mechanical ventilation with oxygen after death appears to preserve lung ultrastructure and may delay cell death. This study supports the hypothesis that lung transplantation from cadaver donors may be feasible.

Animals↗