Biomedical subjects

D Brooks

Publications and source records attributed to D Brooks.

151 records · Page 9Linked to original sources

PubMedDate not supplied

Clinical practice guidelines for suctioning the airway of the intubated and nonintubated patient.

OBJECTIVE: To provide physicians, physiotherapists, nurses and respiratory therapists with guidelines for the application of airway suctioning. DESIGN: This clinical practice guideline was developed using the model by Browman and colleagues. A working group of representatives from four professional colleges (nurses, physicians and surgeons, physiotherapists and respiratory therapists) and research experts was formed to conduct a systematic review, develop evidence-based recommendations and generate clinical practice guidelines. MEDLINE (1966 to 1998), CINAHL (1982 to 1997) and EMBASE (1974 to 1996) as well as the reference lists of identified articles were searched. Inclusion of articles was determined by at least two group members, and studies were classified according to type. Randomized, controlled; randomized; and nonrandomized crossover and comparative cohort trials were grouped by type of intervention and population for use in the development of recommendations. Other observational and animal studies dealing with adverse effects of suctioning were included in the review but were not used in the development of recommendations. Input on the evidence-based recommendations was sought and incorporated from members of all four professions and from experts on content and methodology. SETTING: Any setting (hospital or home) where suctioning is performed. POPULATION: Intubated and nonintubated adults, infants and children. RESULTS AND CONCLUSIONS: An attempt was made to develop recommendations in each of the subcategories of suctioning techniques addressed by at least one study. In some subcategories, definite recommendations were made (13 in adults, and three in children and infants); in other subcategories, insufficient evidence precluded recommendations. The recommendations addressed the following aspects of suctioning: preoxygenation, hyperinflation, insufflation, hyperoxygenation, hyperventilation, saline instillation, adaptor use, medication use, open and closed systems, and various types of catheters.

Adult↗

PubMedDate not supplied

The effect of circumferential taping on flexor tendon pulley failure in rock climbers.

The purpose of this study was to determine whether circumferential taping of the base of the finger increases the A2 pulley's load to failure in a model simulating a rock climber's grip. Nine pairs of fresh-frozen cadaveric hands, 20 to 47 years of age, were rigidly mounted in a specialized jig that maintained the finger in the climber's "crimp" position. Two of the four fingers of each hand were reinforced over the A2 pulley with three wraps of cloth adhesive tape. The flexor digitorum profundus and superficialis tendons were distracted until pulley or tendon failure. Overall, A2 pulley strength was greater in male specimens than in female specimens, and the A2 pulley of the small finger was the weakest tested. The A2 pulley failed simultaneously with the A3 and A4 pulleys in 55% of the tests. In the remaining trials, a single pulley failed initially followed by the remainder of the sheath. Of the 72 fingers studied, complete data were available for comparison of 22 pairs of fingers. No statistically significant difference in load to A2 pulley failure was noted between the taped and untaped finger pairs. Based on our findings we do not support taping the base of the fingers as a prophylactic measure against flexor tendon sheath injury in the climbing athlete.

Adult↗

PubMedDate not supplied

Analysis of vocal fold function in the miniswine model.

Correlation of the vocal fold vibratory pattern with the postoperative surgical wound should demonstrate to the laryngologist the critical depth of injury at which the functional voice would be adversely affected. An animal model was selected to study these changes. Twelve adult miniswine were operated on in this prospective study. The right true vocal fold was surgically altered; the left true vocal fold was the control. An interval of 6 weeks was allowed for healing, and then changes in vocal fold function were studied by stroboscopy, photography, voice recording, and electroglottography. Laryngectomy provided tissue for histopathological correlation. The results showed that injury at the junction of the lamina propria and vocalis muscle consistently caused significant vibratory dysfunction resulting in poor phonation.

Animals↗

PubMedDate not supplied

American Cancer Society guidelines for the early detection of cancer: update of early detection guidelines for prostate, colorectal, and endometrial cancers. Also: update 2001--testing for early lung cancer detection.

Updates to the American Cancer Society (ACS) guidelines regarding screening for the early detection of prostate, colorectal, and endometrial cancers, based on the recommendations of recent ACS workshops, are presented. Additionally, the authors review the "cancer-related check-up," clinical encounters that provide case-finding and health counseling opportunities. Finally, the ACS is issuing an updated narrative related to testing for early lung cancer detection for clinicians and individuals at high risk of lung cancer in light of emerging data on new imaging technologies. Although it is likely that current screening protocols will be supplanted in the future by newer, more effective technologies, the establishment of an organized and systematic approach to early cancer detection would lead to greater utilization of existing technology and greater progress in cancer control.

Colorectal Neoplasms↗

PubMedDate not supplied

Pulmonary rehabilitation programs in Canada: national survey.

OBJECTIVE: To characterize pulmonary rehabilitation (PR) programs in terms of their type, size, duration, patient population, content and staffing. DESIGN: Surveys were sent to members of the Rehabilitation Committee of the Canadian Thoracic Society, as well as any program identified by members of the Canadian Physiotherapy Cardio-Respiratory Society, by provincial lung associations or by the respondents. PARTICIPANTS: Of 51 surveys sent, responses were received from 44 facilities (86% response rate). In-patient or out-patient pulmonary rehabilitation programs were offered by 36 facilities. RESULTS: Most programs (97%) admitted out-patients, and 22% had an in-patient capability. Out-patient programs enrolled 13 patients (median 11; range five to 48) at a given time for a duration of 8.3 weeks (range two to 26). In-patient programs enrolled nine patients at a given time (range two to 26) for 4.6 weeks (range one to eight). Programs included patients with chronic obstructive pulmonary disorder (100%), restrictive disease (93%), asthma (82%), adults with cystic fibrosis (46%), patients pre- or postlung transplantation (45%) and patients receiving mechanical ventilatory support (18%). Breathing retraining, education and upper extremity training were incorporated in more than 90% of all programs. Only one-third of programs offered smoking cessation as part of the rehabilitation. Education sessions on medications and inhaler usage were included in most programs, but sexuality was addressed in only half the programs. CONCLUSIONS: This first comprehensive national survey of PR programs in Canada shows that there are similarities in the format, content and staffing of PR programs. Programs are only able to service a small percentage of patients with chronic respiratory conditions.

Adult↗

PubMedDate not supplied

Terminally ill patients' expectations of nurses.

This exploratory study was undertaken to discover what nursing behaviours terminally ill patients desire. To rank patients' attitudes and judgements a Q-sort consisting of 70 cards was used. The statements covered three categories: physical and psycho-emotional care of patients and psycho-emotional care of significant other/s. "I would like the nurse to help me remain at home for as long as possible" was the most favoured statement and the least favoured was: "I would like the nurse to talk to me about death and dying." The overall theme was that responsive rather than directive nursing behaviours were desired. Analysis identified five Factors from which a model of responsive nursing care was developed. Interpretation of the Factors indicated patients desired responsive nursing care that enabled them and their families to bring their own resources to the dying process, rather than having imposed upon them care which nurses deemed appropriate.

Humans↗

PubMedDate not supplied

Race and child welfare services: past research and future directions.

A review of child welfare research suggests that children of color and their families experience poorer outcomes and receive fewer services than their Caucasian counterparts. The relationship between race and the outcomes of child welfare services is confounded, however, by the relationships among race and other contributors to poor child welfare outcomes. Child welfare researchers should take explicit account of race and ethnicity in designing and carrying out their studies. Service approaches intended to meet the special needs of children of color and their families should be developed and rigorously evaluated.

Black or African American↗