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Biomedical subjects

D C Harper

Publications and source records attributed to D C Harper.

At least 55 records · Page 3Linked to original sources

Self indentified personality patterns of children with facial or orthopedic disfigurement.

This study compared personality characteristics of children with cleft lip and palate to another group of children with different observable physical impairment (orthopedic disability) and speech difficulties. It was hypothesized that different types of observable physical stigmata may result in different personality adaptations. Forty-five children from each of two groups (25 males and 20 females) were matched for sex, age, and intelligence. They were compared using the Missouri Children's Picture Series, a non-verbal personality test, on the following dimensions: Conformity, Masculinity/Femininity, Maturity, Agression, Inhibition, Activity Level Sleep Disturbance and Somatization. The results indicate that males with cleft lip and palate are significantly higher on Maturity and Inhibition while Orthopedically Disabled males are higher on Agression, Activity Level, and Somatization. Cleft lip and palate females are significantly higher on Maturity and Inhibition while Orthopedically Disabled females are higher on Masculinity. The results indicate differential personality adaptations in the two different types of observable physical impairments. Results are discussed in terms of their relationship to selected psychosocial variables.

Aggression↗

Personality characteristics of physically impaired adolescents.

Investigated MMPI profile differences between disabled and nondisabled (normals). Comparison of mean raw scores on the MMPI was made by t-tests. A preliminary analysis that compared adolescents with congenital versus traumatic impairment yielded only one significant finding: Scale O (Si) (p is less than .05) for females with congenital impairment. Subsequently, after the congenital and traumatic groups for each sex were combined, t-tests were computed on mean raw scores of the MMPI for each scale between the disabled and nondisabled adolescent groups. The profile patterns of the disabled groups for both sexes were similar; however, the male disabled adolescents had significantly higher scores on Scales 1, 2, 5, 8 and 9, while the disabled female adolescents had significantly higher scores on Scales F, 1, 6, 7, 8 and 9. Inspection of the profiles revealed minimal sex differences among the disabled groups. It was suggested that the common factor of moderate to severe chronic physical impairment may serve to reduce normative sex differences in personality development at least as reflected by the MMPI.

Adaptation, Psychological↗

Personality profiles of physically impaired adolescents.

Investigated MMPI profiles between two groups of adolescents with dissimilar disabilities (cleft lip/palate, orthopedic) who displayed observable physical impairment. The findings support the contention that type of disability has differential effects on adolescent personality characteristics. However, the profile elevations are consistent with previous reports of behavioral inhibition in both disability groups. Adolescents with impairments of the cleft lip/palate display greater self-concern and ruminative self-doubt over interpersonal interactions. The orthopedically impaired group exhibit an isolative and passive orientation to interpersonal interactions, as well as more generalized feelings of alienation.

Adolescent↗

Lack of control as a determinant of perceived physical symptoms.

Two experiments were conducted to investigate the role of lack of control in determining the extent to which individuals report experiencing physical symptoms. In Experiment 1, subjects who had little control over a noise burst subsequently reported a higher incidence of physical symptoms than did subjects who could control the noise burst. Unfortunately, degree of failure may have been confounded with degree of control in Experiment 1. Thus, Experiment 2 was designed to determine if differential perceptions of control would produce differences in reported symptoms when degree of success was held constant. Greater symptoms were again reported by subjects in the no-control condition. Experiments 1 and 2 also explored questions concerning the mechanism underlying the effects of lack of control on reported physical symptoms. Both experiments failed to find evidence that subjects reported symptoms for ego-preserving reasons. Other data suggested that the symptoms reported by subjects were not related to their past experience with physical symptoms, nor were symptoms reported as a function of perceived or actual physiological arousal.

Affect↗

Perceived maternal child-rearing behavior among disabled and non-disabled adolescents.

The purposes of this study were (a) to contrast the reported perceptions of maternal rearing using the Child's Report of Parental Behavior Inventory of 70 disabled (cerebral palsied) and 70 non-disabled adolescents of similar sex, age, intelligence, and socioeconomic status and (b) to evaluate the impact of severity of physical impairment within the disabled group. Analyses of variance were completed using group (disabled/controls) as one dimension and sex as the within-groups source. Partial correlations were used to assess the relationship between severity of incapacitation and perceived maternal behavior. Of the 18 main effects, two were significant, suggesting that the non-disabled perceived their mothers as more possessive and intrusive than did the disabled. Males perceived their mothers as significantly more lax in discipline and allowing more autonomy than did females. Severity of disability was only modestly related to perceived maternal behavior. With this sample of disabled adolescents it was suggested that a physically handicapping condition and its severity may be of more limited influence in the maternal rearing process than assumed.

Adolescent↗

Evidence for a renal alpha-adrenergic receptor inhibiting renin release.

The mechanism by which clonidine suppresses renin release was investigated in conscious rats. This suppression was studied by means of selected autonomic interventions in conjunction with changes in sodium balance. Serum renin activity and direct arterial pressure were monitored. Clonidine administration suppressed basal (by 68-85%), diuretic-induced (by 89%), and sympathetic nervous system-mediated (by 75-100%) renin release. Cholinergic, ganglionic, and peripheral sympathetic neuronal blockade did not prevent this inhibitory effect of clonidine. These results indicate a peripheral site of action for suppression of renin release by clonidine. The alpha-adrenergic blocking drug phentolamine prevented clonidine suppression of renin release in sodium-depleted rats and was partially effective in normal rats. Phentolamine blocked the decrease in renin caused by clonidine in ganglion-blocked rats. Clozapine, a new neuroleptic agent with alpha-adrenergic blocking activity, or phenoxybenzamine blocked the effect of clonidine on renin release in both sodium-depleted and normal rats. After ganglionic blockade in sodium-depleted rats, clonidine caused a significantly greater suppression of renin release than did an equipressor dose of methoxamine. These data, combined with hemodynamic correlates, suggest that clonidine inhibits renin release by activation of an intrarenal alpha-adrenergic receptor.

Adrenergic alpha-Antagonists↗

Grief in adults with mental retardation: preliminary findings.

Structured direct interviews of 43 adults with mental retardation were conducted to evaluate how they express grief and deal with loss. In addition, 100 providers, social workers, and clergy were surveyed to assess their views of how adults with mental retardation cope and respond during a grief situation. Adults with moderate to severe mental retardation display grief responses similar to all adults: a mixture of sadness, anger, anxiety, confusion, and pain. Individuals continue to experience emotional turmoil 1 year beyond the initial death and personal loss. Caregivers and professionals were mixed on how long a grief reaction continues before it can be viewed as dysfunctional. Intense behaviors, such as self-injury, were noted by respondents in 10-15% of grief reactions. Ability to "feel" or display emotional behavior during grief is not contingent only on a conceptual level. Common reactions include a depressive response (crying, fatigue, sleep disruption, loss of appetite) of moderate intensity. Adults with significant mental retardation verbalized an understanding of the irreversibility of death, and their responses reflect personal beliefs as well. An unknown group of these adults may have been exhibiting a depressive disorder.

Adult↗

An economic paradigm for nurse practitioner program development.

In 1987 a collaborative nurse practitioner program was developed and implemented by George Mason University, a public institution, and The George Washington University, a private institution. Three economic factors affecting decisions related to the development of the collaborative program are discussed: (1) optimal use of resources, (2) consumer and institutional utility, and (3) demand for the program. Optimal use of resources was based on collaboration in the areas of faculty and administrative resources and existing curriculum, thereby reducing the cost burden at each institution. From the perspective of consumer and institutional utility, the program was structured financially to enhance the well-being of students and both institutions. Finally, the consumer demand for the program was addressed by maintaining the higher proportion of credits at the lower-cost institution, thus enabling more students to afford the program. The success of the institutions in addressing the economic factors noted above can serve as a paradigm for program development in other universities and graduate programs.

Costs and Cost Analysis↗

Partnership for a nurse practitioner-directed student health primary care center.

Since 1991, the George Mason University Student Health Center (SHC) has been a primary health care center directed by College of Nursing and Health Science (CNHS) nurse practitioner (NP) faculty. This model was planned and implemented through a partnership between the CNHS and Student Services. From September 1991 until the present, the number of student visits has more than doubled, and the offered services have tripled without a comparable increase in budget and with minimal expansion of space. The student population now has access to comprehensive quality primary care services on-site at a relatively small investment per student. The focus of care goes beyond simply managing current health care needs by emphasizing prevention of future health problems, wellness, and quality of life. In addition, negotiations with surrounding specialists have resulted in a prompt and cost-effective referral system as needed by conditions exceeding the capabilities of the SHC providers. Responses to student surveys regarding the quality, availability, and cost of care, as well as the process involved in receiving that care, indicate the highest level of satisfaction among students using these services. The CNHS has a fertile, convenient faculty practice site as well as several clinical placements for NP as well as undergraduate students. This NP faculty-directed SHC offers a cost-effective, consumer-responsive alternative for delivering primary care services to the members of the university community.

Ambulatory Care Facilities↗

Effects of distraction on children's pain and distress during medical procedures: a meta-analysis.

BACKGROUND: It is difficult to determine the usefulness of distraction to decrease children's distress behavior and pain during medical procedures because many studies use very small samples and report inconsistent findings. OBJECTIVES: To investigate the mean effect sizes across studies for the effects of distraction on young children's distress behavior and self-reported pain during medical procedures. METHOD: Hunter and Schmidt's (1990) procedures were used to analyze 16 studies (total n = 491) on children's distress behavior and 10 studies (total n = 535) on children's pain. RESULTS: For distress behavior, the mean effect size was 0.33 (+/-0.17), with 74% of the variance accounted for by sampling and measurement error. For pain, the mean effect size was 0.62 (+/-0.42) with 35% of the variance accounted for. Analysis of studies on pain that limited the sample to children 7 years of age or younger (total n = 286) increased the amount of explained variance to 60%. CONCLUSIONS: Distraction had a positive effect on children's distress behavior across the populations represented in this study. The effect of distraction on children's self-reported pain is influenced by moderator variables. Controlling for age and type of painful procedure significantly increased the amount of explained variance, but there are other unidentified moderators at work.

Adolescent↗

Improving health care communication for persons with mental retardation.

There has been little effort directed at training health care professionals in behaviors and attitudes that are effective in communicating with persons with mental retardation. Such training would be beneficial not only to assist those with congenital cognitive deficits but for those with acquired central nervous system conditions as well, for example, dementia. Persons with mental retardation are living in community settings in greater numbers and increasingly participating in vocational, residential, and health care programs. Yet, most health care professionals are not routinely offered an opportunity to gain experience interacting with people who have limited ability to express and understand health care information. An education program was focused on health care professionals' use of basic communication skills when providing health information to an adult who is mentally retarded. A self-study instructional text and a 20-minute companion video provided methods of communicating with a patient with mental retardation in medical and dental care settings. Resident physicians, medical students, nurses, and nursing assistants improved their communication skills, knew more about mental retardation, and were more proactive in health care interviews following training. Health care training needs to incorporate educational opportunities focusing on skills to assist special populations. Brief, structured, and interactive skill training in communication offered early in the health care professional's career has positive benefits for the recipient and the provider.

Adult↗

Organizing for power.

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American Nurses' Association↗

Taking aim at interdisciplinary education for continuous improvement in health care.

Over the last 30 years, nursing faculty have achieved varying levels of success in their efforts to engage in interdisciplinary education. To sharpen the focus, the Institute for Healthcare Improvement sponsored a national demonstration project in which nursing faculty from four universities participated.

Education, Nursing, Baccalaureate↗