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Biomedical subjects

E Ross

Publications and source records attributed to E Ross.

177 records · Page 10Linked to original sources
PubMedDate not supplied

A prospective survey for central line skin-site colonization by the pathogen Malassezia furfur among hospitalized adults receiving total parenteral nutrition.

BACKGROUND: Over 50 case reports suggest that Malassezia furfur is an emerging systemic pathogen in neonates who receive IV lipid emulsions. Because isolation of this fungus requires special culture techniques, which are not routinely used, the authors of many case reports of M. furfur infections in adults question whether infections caused by this organism are being underdiagnosed in older patients. METHODS: Catheter insertion site colonization rates in adults receiving total parenteral nutrition (TPN) were prospectively evaluated in 149 hospitalized patients with 928 cultures handled specifically for M. furfur detection. Positive control samples consisted of M. furfur cultures in neonates and in adults, who had not been enrolled in the study, and of a separate positive culture obtained from a skin site inoculated with M. furfur. RESULTS: M. furfur was not cultured from any of the 928 study samples (95% confidence interval [CI] -0.4% to +0.4%). CONCLUSIONS: These results suggest that M. furfur is less of a threat to hospitalized adults receiving TPN than has been otherwise postulated. These data do not support the inclusion of special cultures for M. furfur in routine skin-site surveillance programs among hospitalized adults receiving TPN.

Adult↗
PubMedDate not supplied

Multistrategy health education program to increase mammography use among women ages 65 and older.

Mammography use decreases with age although the risk of breast cancer increases with age. Medicare now provides biennial coverage for screening mammography. This study was designed to simulate the Medicare condition by subsidizing mammography among women in eight retirement communities in the metropolitan Philadelphia area. The study also measured the impact of health education interventions and the presence of a mobile mammography van on increased use of mammography. Retirement communities were assigned randomly to the control (cost subsidy alone) or experimental group (cost subsidy, mammography van, and tailored health education interventions). A total of 412 women ages 65 and older who had not had mammograms in the previous year were surveyed at baseline and 3 months later. Analytic techniques reflected the cluster nature of the randomization. Women in the experimental group were significantly more likely than the control group women to have obtained mammograms. Forty-five percent of the experimental group women compared with 12 percent of the control group women subsequently had mammograms in the 3 months after the baseline interview (P less than .001). Logistic regression analysis for mammography use indicated an odds ratio of 6.1 associated with being in the experimental group. For women in the experimental group, a separate logistic regression for mammography use showed an odds ratio of 7.8 associated with attendance at the educational presentation. The results suggest that Medicare coverage alone will not increase mammography use sufficiently to achieve year 2000 objectives. However, the addition of access enhancing and health education interventions boosts utilization dramatically.

Aged↗
PubMedDate not supplied

Developing a plan to evaluate the use of nursing conceptual frameworks.

Five hospitals in the Metropolitan Toronto area have introduced a nursing conceptual framework as the basis of practice in their agencies. A research team representing the hospitals and the University of Toronto has developed a comprehensive plan to evaluate the impact of using a nursing framework on nursing practice. This paper describes the selection of variables to be studied and the ways selected to measure them. A series of papers will follow describing the establishment of psychometric properties of the instruments and the results of the pre-test phase. Although this paper describes a process that began some time in the past, the authors have kept current the literature on the subject and the most current references are included in this paper.

Humans↗
PubMedDate not supplied

Implementation of nursing conceptual models: observations of a multi-site research team.

The general acceptance by nursing of the nursing process as the methodology of practice enabled nurses to have a common grounding for practice, research and theory development in the 1970s. It has become clear, however, that the nursing process is just that--a process. What is sorely needed is the nursing content for that process and consequently in the past 10 years nursing theorists have further developed their particular conceptual models (CM). Three major teaching hospitals in Toronto have instituted a conceptual model (CM) of nursing as a basis of nursing practice. Mount Sinai Hospital has adopted Roy's adaptation model; Sunnybrook Medical Centre, Kings's goal attainment model; and Toronto General Hospital, Orem's self-care deficit theory model. All of these hospitals are affiliated through a series of cross appointments with the Faculty of Nursing at the University of Toronto. Two community hospitals, Mississauga and Scarborough General, have also adopted Orem's model and are related to the University through educational, community and interest groups. A group of researchers from these hospitals and the University of Toronto have proposed a collaborative project to determine what impact using a conceptual model will make on nursing practice. Discussions among the participants of this research group indicate that there are observations associated with instituting conceptual models that can be identified early in the process of implementation. These observations may be of assistance to others contemplating the implementation of conceptually based practice in their institution.

Attitude of Health Personnel↗
PubMedDate not supplied

Chronic airflow limitation.

Chronic airflow limitation (CAL) is a problem which causes much disability and the necessity for long-term care. This article discusses the clinical and psychosocial assessment of the patient with CAL as it relates to the goals of management: to optimize airflow; to minimize respiratory failure; to facilitate adaptation to chronic illness; and to develop appropriate coping skills.

Adaptation, Psychological↗
PubMedDate not supplied

The effect of a comprehensive breast screening program on self-reported mammography use by primary care physicians and women in a health maintenance organization.

BACKGROUND: Mammography use is increasing in the United States, but most women older than 50 years still are not being screened regularly. A multicomponent program, with components for women and physicians, was conducted to increase screening among women aged 50 to 74 years in an independent practice association (IPA)-model health maintenance organization (HMO). METHODS: The participating women and physicians were surveyed in four waves to evaluate the program. We report on changes in mammography practices by both women and physicians between 1988 (preintervention year) and 1992 (postintervention year). Bivariate and multivariate analyses were calculated. RESULTS: The proportion of responding HMO physicians who recommended annual mammograms for women aged 50 to 74 years increased by 16 percent from 1988 to 1992 compared with an increase of 10 percent for control group physicians (nonsignificant). There was a 30 percent increase from 1988 to 1992 in the proportion of HMO women respondents who reported having had a mammogram in the past year compared with a 19 percent increase among control group women. The difference between these differences was highly significant. The intervention had the strongest effect on women with incomes of less than $30,000. CONCLUSIONS: A multicomponent program in an IPA-model HMO resulted in significant increases in the proportion of HMO women who had mammograms. Similar approaches should be tested in other settings.

Adult↗
PubMedDate not supplied

[Pathology of the cecal appendix in our country. An analysis of 936 surgical specimens of appendectomy].

Analysis was made of 436 specimens of appendectomy in the Caracas University Hospital during the year 1.990. Ages of the patients ranged between 9 months and 79 years (average age: 21 years). 236 were males and 200 females. The pathology found most frequently was the acute inflammatory processes, followed by secondary reactive changes to other entities, many of which were unspecified (e.g. pelvic inflammatory disease) and other specific (such as infestation by parasites) less frequently were found tumoral processes such as mucocele, carcinoid tumor and those which involved another portion of the digestive apparatus and which secondarily affect the appendix.

Acute Disease↗
PubMedDate not supplied

The chief of nursing practice: a model for nursing leadership.

The role and structure of the Canadian Health Care System and its facilities are changing rapidly. Regionalization, decentralization, and flattening of hierarchical structures have occurred in governments and institutions. Traditional management roles, including the Vice President/Director of Nursing have been eliminated. There is a need to create a new model of nursing leadership if nurses are to continue to provide quality patient care. This article describes the initiative at Women's College Hospital to meet the expressed needs of nurses by developing a unique nursing role. The development of the chief of nursing practice role is defined within the context of the changing environment and Kanter's theory of empowerment. The position of the chief of nursing practice is a role model for nursing leadership and one that is pivotal for the professional identity of nursing, and for the provision of high quality patient care.

Canada↗
PubMedDate not supplied

Preoperative radiation therapy and chemotherapy for adenocarcinoma of the pancreas.

Since preoperative radiation therapy combined with chemotherapy (CTRT) was first performed in 1986 for patients with pancreatic adenocarcinoma, there have been several reported experiences with varying drugs and radiotherapy regimens. We describe those experiences and contrast them to a series of patients treated at our institution with resectional surgery before CTRT. Finally, the current role of preoperative CTRT in the therapy of pancreatic adenocarcinoma is proposed.

Adenocarcinoma↗