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Biomedical subjects

D Lewis

Publications and source records attributed to D Lewis.

At least 433 records · Page 24Linked to original sources
PubMedDate not supplied

The determination of 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid (THCCOOH) in meconium.

The determination of 11-nor-delta 9-tetrahydrocannabinol-9-carboxylic acid (THCCOOH), the major urinary metabolite of delta 9-tetrahydrocannabinol (THC), in meconium is extremely difficult because of the high concentration of lipids in the specimen and the low concentration of drug present. A simple, robust, analytical procedure for the screening and confirmation of THCCOOH in meconium is presented. To our knowledge, the procedure is the first published method for the successful confirmation of THCCOOH in meconium and is used routinely in our laboratory for the purpose of detecting marijuana use during pregnancy.

Dronabinol↗
PubMedDate not supplied

Occult neonatal seizures.

Forty-one infants with neonatal seizures frequent enough to be captured by randomly recorded routine EEG examinations were studied to determine how often their electrographic seizures were occult (subclinical) and to examine the effects of seizure duration and mental status on their clinical visibility. Seizures were the result of diverse etiologies and most infants had received one or more antiepileptic drug prior to the EEG recordings. The majority of electrographic seizures were occult: only 84 of 393 (21%) were accompanied by distinctive clinical seizure activity; the remaining 79% were occult. There was no significant difference between the duration of EEG seizures with distinctive clinical signs and those without. There was no significant difference in the proportion of occult seizures in neonates with preserved consciousness compared with lethargic or comatose infants. We conclude that unaided visual inspection of infants seriously underestimates true seizure frequency. Long-term EEG monitoring may be necessary in many infants to determine their real seizure frequency and to judge the adequacy of antiepileptic drug treatment.

Anticonvulsants↗
PubMedDate not supplied

Computer-based approaches to patient education: a review of the literature.

All articles indexed in MEDLINE or CINAHL, related to the use of computer technology in patient education, and published in peer-reviewed journals between 1971 and 1998 were selected for review. Sixty-six articles, including 21 research-based reports, were identified. Forty-five percent of the studies were related to the management of chronic disease. Thirteen studies described an improvement in knowledge scores or clinical outcomes when computer-based patient education was compared with traditional instruction. Additional articles examined patients' computer experience, socioeconomic status, race, and gender and found no significant differences when compared with program outcomes. Sixteen of the 21 research-based studies had effect sizes greater than 0.5, indicating a significant change in the described outcome when the study subjects participated in computer-based patient education. The findings from this review support computer-based education as an effective strategy for transfer of knowledge and skill development for patients. The limited number of research studies (N = 21) points to the need for additional research. Recommendations for new studies include cost-benefit analysis and the impact of these new technologies on health outcomes over time.

Computer-Assisted Instruction↗
PubMedDate not supplied

Current computer use by diabetes educators.

PURPOSE: The purpose of this study was to ascertain diabetes educators' current use of computer technologies. METHODS: The study population consisted of 279 randomly selected certified diabetes educators, all of whom were members of the American Association of Diabetes Educators. Participants were asked to complete the Attitudes Toward Patient Education Technology instrument. RESULTS: Descriptive findings showed that most educators (89.6%) have access to computers and use them primarily for word processing (43%). Nearly 30% of participants had never accessed the Internet, and no significant difference was noted when this variable was categorized by age. In addition, age and gender were not significant predictors of computer use, although age was significantly related to computer ownership. Patient access and organizational issues were the primary barriers to computer use in patient education. CONCLUSIONS: These findings provide further understanding of diabetes educators' computer use and integration of computer technology in the patient education process.

Allied Health Personnel↗
PubMedDate not supplied

Computer-based patient education: use by diabetes educators.

The purpose of this descriptive study was to identify the concerns and characteristics that distinguish diabetes educators who use computers for patient education from those who do not. Three hundred certified diabetes educators who were current members of the American Association of Diabetes Educators were surveyed using the Stages of Concern Questionnaire and a demographic questionnaire compiled by the author. Results indicated that diabetes educators are interested in computer-based patient education as an educational strategy, even though most diabetes educators are not currently using the computer for patient education. Primary barriers to using computers were identified as lack of computer availability for patients and limited financial resources. Because computers are becoming more pervasive in disseminating information about diabetes and new educational software is being developed for patients, diabetes educators need to learn more about this educational methodology for teaching their patients about diabetes.

Adult↗
PubMedDate not supplied

The Internet as a resource for healthcare information.

The Internet provides an additional means for healthcare providers to reach their patients. As more and more healthcare providers and patients get on-line and learn to use the Internet, the value of being on-line will increase. The Internet and other healthcare computing technologies will challenge us to look to the future for new ways to create partnerships with our patients. On-line skills and technological literacy will not replace more traditional approaches to patient care, but they most likely will change the model of how care is provided. Technology is an adjunct that will serve us well if it is incorporated as part of a multidimensional patient care environment. Above all, we will need to continue to foster good interpersonal relationships with patients to encourage ongoing dialogues about information obtained from all resources.

Diabetes Mellitus, Type 1↗
PubMedDate not supplied

Primary malignant lymphoma of the parotid gland report of three cases.

AIMS AND BACKGROUND: To document the clinicopathologic features and treatment modalities of primary malignant parotid gland lymphoma, based on three cases diagnosed and treated at Oldchurch Hospital, Romford, UK. METHODS: Three patients, two with stage II and one with stage IV disease, received primary treatment consisting of chemotherapy following surgical biopsy. RESULTS: All three patients obtained rapid complete remission during their scheduled chemotherapy. One patient is alive without evidence of disease 12 months from the end of treatment. One patient, a frail, elderly gentleman, died due to massive pneumonia while in complete remission for two months. The third patient, who developed local recurrences in both parotid glands without transformation of his low-grade histology, achieved a second complete remission following chemo- and radiotherapy. All side effects were of a mild nature. CONCLUSION: Malignant lymphoma of the parotid gland is a chemo- and radiosensitive disease.

Aged↗
PubMedDate not supplied

Equilibrium and kinetic studies of calcium transport and ATPase activity in sarcoplasmic reticulum.

A number of equilibrium and kinetic measurements are presented to characterize the partial reactions of the ATPase and transport cycle in sarcoplasmic reticulum vesicles. The cycle begins with calcium and nucleotide binding on sites available on the outer surface of the vesicles. A phosphorylated enzyme intermediate is then formed, and the calcium sites are subjected to a change in their orientation and their affinity for calcium. It is shown that steps involved in calcium release on the inner side of the vesicles are rate limiting for the cycle, and are followed by hydrolytic cleavage of the intermediate with release of inorganic phosphate and recycling of the enzyme.

Animals↗
PubMedDate not supplied

Comparison of on- and off-axis photorefraction with cycloplegic retinoscopy in infants.

We have compared the performance of an off-axis (knife-edge) photorefractor with that of an on-axis (isotropic) system. Normal infants and children between the ages of 8 and 208 weeks were photographed with each camera both with and without cycloplegia. Refractive errors were estimated for each technique based on equations derived from ray-tracing. These refractions were compared to the results of retinoscopy under cycloplegia. Sensitivity and specificity of the two photorefraction systems were evaluated as a function of the magnitude of meridional hyperopia defined by retinoscopy. We also examined the effect of varying the photorefraction screening criterion. Thirteen percent of the infants in the screening sample presented with +3.50 diopters or more of meridional hyperopia. Using this level of ametropia as a referral criterion, the sensitivity and specificity of the off-axis system for infants without cycloplegia were 83% and 72%, respectively. For the on-axis system, sensitivity and specificity values were 85% and 53%. The use of cycloplegics did not significantly improve the performance of either system, but rather their use degraded the specificity of the on-axis system in the presence of moderate refractive errors. The results of the present study indicate that both on- and off-axis systems are effective in identifying highly ametropic infants, but that the off-axis system results in significantly fewer false positives. Moreover, the off-axis system has the advantages of an inherently greater dynamic range for a fixed camera design, and also more easily interpreted photographs.

Child, Preschool↗
PubMedDate not supplied

Clinical supervision for nurse lecturers.

This article builds on a previous one which discussed the use of de Bono's thinking tool, 'six thinking hats' in the clinical, managerial, educational and research areas of nursing (Lewis 1995). This article explores clinical supervision and describes how the six thinking hats may be used as a reflective tool in the supervision of nurse lecturers who teach counselling skills.

Clinical Competence↗
PubMedDate not supplied

A survey of therapeutic touch practitioners.

Therapeutic touch is the name of a specific nursing technique that was devised by Dr Dolores Krieger, an American nurse, in the early 1970s. This article provides a brief overview of therapeutic touch, and describes the responses received to a survey exploring the views and experiences of its practitioners in Britain.

Humans↗