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Biomedical subjects

D L Wells

Publications and source records attributed to D L Wells.

43 records · Page 3Linked to original sources
PubMedDate not supplied

Swine influenza virus infections. Transmission from ill pigs to humans at a Wisconsin agricultural fair and subsequent probable person-to-person transmission.

In September 1988, a previously healthy 32-year-old pregnant woman was hospitalized for pneumonia and died 8 days later. The only pathogen detected was an influenza virus antigenically related to the swine influenza virus (SIV). Four days before illness onset, the patient visited a county fair swine exhibition where there was widespread influenzalike illness among the swine. To detect other persons who were possibly infected by contact with the ill swine, we measured serum SIV hemagglutination-inhibition antibody titer in 25 swine exhibitors who were 9 to 19 years old. Nineteen (76%) had SIV hemagglutination-inhibition titers of 20 or greater. Antibody was undetectable in serum samples from 25 swine exhibitors from a neighboring county. Additional studies suggest that one to three health care personnel who had contact with the patient developed influenzalike illnesses with laboratory evidence of SIV infection. An outbreak of apparent SIV infection in swine resulted in multiple human infections, and, although no recognized community outbreak resulted, there was evidence of virus transmission from the patient to health care personnel.

Adolescent↗
PubMedDate not supplied

Use of a content methodology process to enhance feeding abilities threatened by ideational apraxia in people with Alzheimer's-type dementia.

Self-feeding behavior is often the first of a chain of self-maintenance skills to deteriorate in people with Alzheimer's-type dementia and is a major determinant of institutionalization. Moreover, nurses working in geriatric settings report the feeding of patients as a most difficult management problem. Of the various features of Alzheimer's-type dementia that can affect a person's ability to feed him- or herself, ideational apraxia can explain the loss of ability to conceptualize, plan, and execute the complex sequence of motor actions involving the use of tools or objects necessary for feeding. In this article, a systematic process is used to review the research literature to develop substantive content for nurses caring for people with feeding problems related to ideational apraxia. Ideational apraxia is a condition in which an individual is unable to plan movement related to an object because he or she has lost the perception of the object's purpose. The specific abilities necessary for feeding that are threatened by ideational apraxia are identified. A tool to assess these abilities is described, and nursing interventions aimed at enhancing or preserving existing abilities, preventing excess disability, or compensating for lost abilities are presented.

Aged↗
PubMedDate not supplied

An integrated model of discharge planning for acutely-ill elderly patients.

Prior research has demonstrated that current discharge-related practices present resource-related and ethical problems for all those involved. The purpose of this 9-month qualitative study was to develop a more resource efficient and compassionate discharge planning model for acutely-ill, elderly patients. The focus group interviewing method was used to elicit 99 participants' perceptions of an ideal approach to discharge planning. Focus group participants included professionals from acute-care hospitals and community organizations. Telephone interviews were also completed with 25 patients and 6 family members. Themes identified in the analysis revealed that an ideal approach to discharge planning would incorporate seven elements. According to participants, the approach is ideal because it potentially addresses both resource utilization and ethical issues. Program evaluation of the model is underway in order to determine its effectiveness.

Acute Disease↗
PubMedDate not supplied

Process evaluation of an integrated model of discharge planning.

In this study, a new, empirically-derived model of discharge planning for acutely-ill elderly was evaluated to determine (a) whether it could be implemented in a hospital setting, and (b) what facilitated or challenged the implementation. The process evaluation involved four case studies conducted on three in-patient units of two acute-care hospitals. Data were analyzed using explanation-building and case comparison methods. Three main study results emerged: (a) The integrated model had the potential to be implemented in a hospital setting when certain conditions were in place, (b) use of the integrated approach to discharge planning contributed to patient satisfaction, and (c) the materials developed as part of the discharge planning protocol required only minor formatting modifications in order to be rendered user-friendly. In this article, recommendations are made that will facilitate the model's implementation and utilization in other clinical settings and ongoing and future process evaluations.

Acute Disease↗