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Biomedical subjects

D Oakley

Publications and source records attributed to D Oakley.

At least 37 records · Page 2Linked to original sources

Community health nurses and family planning services for men.

Current concerns about sexually transmitted diseases (STDs) and acquired immunodeficiency syndrome (AIDS), as well as unintended pregnancy, have drawn increasing attention to reproductive health services for men. This report presents information about responses by 844 community health nurses (CHNs) to a self-administered mailed questionnaire that included questions about the extent of the nurses' involvement in delivering or administering family planning services to men, their knowledge and attitudes about men and family planning, and their preparation for working with men. Our sample included CHNs in practice in five states and a sample of CHNs belonging to a national organization of public health nursing, in order to gain information about CHNs in practice in the field and CHNs more likely to be in an educational or administrative position and thus able to influence or to set policy. Two thirds of the nurses surveyed work with men in their reproductive years but only 17.8% delivered or administered family planning services to men (23% of the state sample and 12.5% of the organization sample). Deficits in knowledge about male birth control methods were identified; for example, only 32% knew the use-effectiveness rate of the condom. However, 90% of the CHNs knew the condom has to be put on before any genital contact is made. The CHNs' attitudes were positive; more than 90% said they felt men had equal responsibility with their partners in preventing unwanted pregnancies, using contraception, and contraceptive decision making. Yet, only 9.6% of the CHNs felt men have as much knowledge about contraception as women do. Seventy percent of the nurses felt tha sex education in schools was directed more to female students than to male students. More than 90% said they believed that family planning providers have a responsibility to provide services to men; but two thirds felt that nurses are not as well prepared to work with male as with female clients. Increased educational preparation may improve CHNs' knowledge about men and family planning and enable them to feel professionally prepared to deliver and administer the services they feel are necessary for male as well as female clients. There are 101,430 CHNs in the United States, working in public health departments or other service agencies in almost every community across the country. These CHNs are a major resource for the family planning field.

Community Health Nursing↗

Integrating nursing theory, practice and research through collaborative research.

The advancement of professional nursing requires integration of theory, practice and research. One realistic mechanism to achieve this integration is collaborative nursing research. A collaborative experience between clinical nurse specialists and faculty researchers is described and evaluated. The collaborative research project focused on contraceptive nursing care and self-care conceptualized within Orem's theory. A major finding was that while job titles and settings of the participants differed markedly, role components were not disparate; rather, they were compatible and complementary. The collaborative project strengthened both the theory base for a primary care nursing practice and the practice base for faculty research and theory development efforts.

Clinical Nursing Research↗

Tracker--an ambulatory recorder for ST-segment monitoring?

If ST-segment shifts are markers for ischaemic heart disease, they must be recorded accurately so that reliable diagnoses may be made. It is important to establish whether ST segments are distorted when recorded with ambulatory recorders. The Tracker/Replay II system (Reynolds Medical Ltd) is a machine widely used in Europe, yet little has been published assessing its performance when recording ST segments. We have therefore investigated the Tracker/Replay II system using electrocardiograms from patients with ischaemic heart disease and synthesized test signals to see if it could accurately reproduce ST-segment levels. We found that when recording QRS complexes at the upper limit of normal (2 mV and 110 ms), significant (0.14 mV) artefactual ST-segment changes were produced. The distortion was less for narrower or smaller complexes.

Ambulatory Care↗

Acute coronary occlusion during percutaneous transluminal coronary angioplasty.

Two hundred and forty percutaneous transluminal coronary angioplasty procedures were performed in three centres over a two year period. Acute occlusion of the vessel undergoing angioplasty was seen on 20 (8%) occasions. The cause of occlusion was determined angiographically and in some cases confirmed at the time of emergency open heart surgery. The mechanism of coronary occlusion was arterial dissection in six cases, persisting coronary arterial spasm in seven, and coronary thrombosis in four. In three patients the mechanism could not be determined. Immediate reintroduction of a balloon dilatation catheter was attempted in 10 patients and resulted in restoration of adequate coronary flow in six. The remaining 14 patients underwent open heart surgery as an emergency procedure.

Acute Disease↗

Autoshaping in the rat: Effects of omission on the form of the response.

Two experiments were conducted to investigate the effect of an omission contingency on behavior related to and characterizing autoshaped lever contacts in the rat. In Experiment I an omission contingency imposed on autoshaped lever contacts forceful enough to produce a press (.078N) resulted in a significant decrease in lever presses, but had no effect on frequency of lever touches (contacts of insufficient force to produce a press) or rate of food tray entry during lever presentation. In contrast, rats which received a similar number of lever-food pairings, but whose behavior had no programmed consequences (yoked control subjects), showed an increase in lever press rate, a significant decrease in rate of food tray entry, and no change in rate of lever-touches. In Experiment II, the effect of a similar omission contingency on the topography of lever contact responses was investigated. Prior to omission training subjects contacted the lever primarily by pawing it. Following omission training this behavior was suppressed, with a subsequent increase in lever contacts characterized as nosing. Yoked control subjects showed no significant changes in lever contact topography. The results indicate that (1) an omission contingency does not simply eliminate wholesale those topographies which incur the contingency but produces subtle adaptive changes in lever contact topography; and (2) the nature of the autoshaped response in the rat does not appear to be rigid enough to depend solely upon the nature of the unconditioned stimulus or the conditioned stimulus, but can also be determined by the relationships existing between the animal's behavior and these stimuli.

Journal Article↗

Surgical treatment of endomyocardial fibrosis with preservation of mitral valve.

A 48-year-old Kenyan African, who presented with a history of coronary and cerebral embolism, was found to have endomyocardial fibrosis of the left ventricle. It proved possible to remove all diseased tissue at operation, and at the same time to preserve the mitral valve. It is important to inspect the mitral valve from both the atrial and ventricular aspects so that the valve can be spared, if it is not involved in the disease process. The choice of transatrial of transventricular surgical approach for the removal of pathological tissue may depend on whether or not the mitral valve requires replacement.

Endomyocardial Fibrosis↗

Praecordial surface mapping after exercise in evaluation of propranolol for angina pectoris.

The effect of propranolol on ST depression in the praecordial 16 lead electrocardiogram was observed in 52 patients before and after treatment, both at rest and after exercise. In a further 20 patients exercise tests repeated on separate days two months apart showed that the technique gave reproducible results. A variable relation between symptomatic relief and praecordial exercise-induced ST segment depression was noted. Use of a single fixed-position chest lead (V5) was shown to be less accurate. The relief of symptoms alone is probably an inadequate guide to the success of medical treatment, which should control not only angina but also the manifestations of ischaemia on the praecordial electrocardiogram.

Angina Pectoris↗