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Biomedical subjects

H Ellis

Publications and source records attributed to H Ellis.

At least 37 records · Page 2Linked to original sources

Teaching roles in critical care--the mentor and preceptor.

Mentorship and preceptorship have been terms used indiscriminately throughout the literature. The English National Board has used the term 'mentor' in all educational material and the term has slipped into current usage. Despite this, very little preparation and thought has been given to the role. Confusion has arisen as the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) Post Registration Education and Practice Project (PREPP 1990) proposals have outlined the need for a preceptor to support new practitioners to move confidently into a period of primary practice. This paper discusses the development of the mentor role and provides a definition of classical and formal mentoring. The preceptor role is viewed as one of the elements that enable the full development of mentorship. As a functional role, preceptorship can be clearly defined and utilised to support new staff into new areas of clinical practice. It crystallises the teaching, assessing and evaluative element of clinical nurse education and provides a firm foundation for the development of mentorship within the nursing profession.

Critical Care

The pathological effects of glove and condom dusting powders.

Dusting powders are used on latex gloves and condoms. They help to release these products from their moulds during manufacture and facilitate processing and donning. Dusting powders are also used on contraceptive diaphragms, sanitary napkins and in toiletries. There are numerous dusting powders in current use around the world. At present a consensus exists about the best dusting powder to use on surgical gloves, based on data about the safety of these agents in humans, as well as their manufacturing qualities. No such consensus exists for the use of dusting powders in other situations. However, there is uncertainty about whether dusting powders used in situations other than on surgical gloves are responsible for harmful effects. This study uses intraperitoneal injections in rats to examine the pathological effects of dusting powders that are in current use on surgical gloves and condoms. We suggest that dusting powders may be a source of morbidity when used in situations other than on surgical gloves and confirm the findings of previous investigators that the dusting powders we tested differ in their ability to produce pathological effects.

Aluminum Silicates

An AIDS-related knowledge, attitudes, beliefs, and practices survey among schoolchildren in Barbados.

A knowledge, attitudes, beliefs, and practices (KABP) survey was performed among Barbadian secondary schoolchildren 11-16 years old in January 1990. The survey sought to assess the children's knowledge of AIDS and human immunodeficiency virus (HIV) transmission; their attitudes toward people with HIV/AIDS; their sexual practices; and changes needed in education programs seeking to reduce childhood HIV transmission. A pretested self-administered questionnaire was used. The survey sample was derived by selecting every eleventh student on the rosters of all the secondary schools in Barbados. All of the survey respondents completed the questionnaire on the same day, having been assembled examination-style for that purpose. The results showed high levels of correct knowledge about the principal routes of HIV transmission. However, a considerable proportion of the respondents harbored incorrect beliefs regarding mosquito transmission and dangers to blood donors, and many showed uncertainty or incorrect knowledge regarding possible HIV transmission by biting, spitting, or use of public toilets. About a third of the children (51.4% of the boys and 18.7% of the girls) said they had experienced sexual intercourse, though only 20% reported being sexually active in the year preceding the survey. Three-quarters of the sexually experienced group said they knew how to use condoms, but only a third said there was any time when they had used protection during sexual intercourse. Overall, the results indicate that education efforts prior to the survey had been effective, but that reinforcement of such efforts as well as their extension into the primary schools is warranted. Further research directed at helping these efforts to encourage more meaningful changes in sexual behavior is also needed.

Acquired Immunodeficiency Syndrome

Healing of abdominal incisional hernia in infant rats.

Incisional hernia following major laparotomy in adult humans occurs in 5 per cent of cases. Spontaneous healing of such hernias does not occur. We have devised a model for producing abdominal wall incisional hernia in the rat by dividing the linea alba subcutaneously through a small transverse skin incision. In adult rats (n = 17), an incisional hernia formed and progressively increased in size over 32 weeks. In 3-week-old infant rats (n = 17), all developed herniation immediately. In eight rats, these hernias progressively increased. In three, the hernias were healed at the third week, but recurred at the fourth, eighth and 12th weeks, respectively. In the remaining six animals, the hernias healed spontaneously at 3 weeks and remained healed. A similar observation of spontaneous healing of incisional hernias in children has been reported in one clinical paper. This animal model provides a useful means of studying the clinical difference between adult and infant with respect to incisional hernia.

Age Factors

Newborns' preferential tracking of face-like stimuli and its subsequent decline.

Goren, Sarty, and Wu (1975) claimed that newborn infants will follow a slowly moving schematic face stimulus with their head and eyes further than they will follow scrambled faces or blank stimuli. Despite the far-reaching theoretical importance of this finding, it has remained controversial and been largely ignored. In Experiment 1 we replicate the basic findings of the study. In Experiment 2 we attempt a second replication in a different maternity hospital, and extend the original findings with evidence suggesting that both the particular configuration of features, and some aspects of the features themselves, are important for preferential tracking in the first hour of life. In Experiment 3 we use a different technique to trace the preferential tracking of faces over the first five months of life. The preferential tracking of faces declines during the second month. The possible causes and consequences of this observation are discussed.

Attention

An investigation of the role of diet and burn injury on wound healing.

Forty-four rats underwent standard laparotomies and were randomly allocated to four groups according to injury (control or burned) and diet (maintenance or protein depleted). Wound healing was assessed tensiometrically on the 14th postoperative day. The energy intakes of the four groups were comparable. Both injury by burning and protein depletion caused significant weight loss. The peak force applied to the laparotomy wounds was unaltered by burning, but protein depletion caused a significant reduction in wound strength. It is concluded that any impairment in wound healing in burned patients is more likely to result from inadequate feeding rather than the injury itself or any resultant weight loss.

Animals

A comparison of polypropylene mesh and expanded polytetrafluoroethylene patch for the repair of contaminated abdominal wall defects--an experimental study.

Abdominal wall defects created in Sprague-Dawley rats were repaired with either polypropylene mesh (PPM) or expanded polytetrafluoroethylene patch (PTFE). Tensiometric studies of abdominal wall strength showed that PPM and expanded PTFE provided a strong repair in uninfected wounds. Wounds reconstructed with expanded PTFE and contaminated with Staphylococcus aureus had a weak interface between the patch and the abdominal wall fascia. The strength of the interface was inadequate because collagen ingrowth in the material was inhibited. In contrast, the wound strength of PPM was unaffected by the presence of bacterial contamination.

Abdominal Muscles

The role of plasminogen activator in adhesion prevention.

The reduction in peritoneal plasminogen activator activity (believed to be the pathogenic mechanism of adhesion formation) and its replacement with recombinant tissue plasminogen activator (rt-PA) have been investigated in the prevention of initial (primary) and recurrent adhesion production. Other, potentially harmful, effects of intra-abdominal rt-PA application have also been examined. This included effects on wound and colonic healing and hemostasis. The prevention of adhesion formation was studied in primary and recurrent adhesion formation using a rabbit model. Primary adhesions formed in one of 14 occasions (7 per cent) with rt-PA compared with 12 of 15 occasions (80 per cent) with placebo (chi-square equals 15.542, p less than 0.001). Recurrent adhesions formed on two of 27 occasions (7 per cent) with rt-PA compared with 22 of 28 occasions with placebo (79 per cent) and 12 of 12 occasions with control rabbits (100 per cent, chi-square equals 40.588, p less than 0.0001). The application of rt-PA to abdominal wounds in the rabbit failed to show any reduction in wound strength at four, seven and ten days. Colonic anastomotic healing was unaltered by rt-PA at three, five and seven days. There was no difference seen in hemorrhagic events between control, placebo or rt-PA rabbits at any stage. The use of rt-PA is an exciting development in the field of adhesion prevention; it is an effective inhibitor of adhesion formation and intra-abdominal administration appears safe in a rabbit model.

Anastomosis, Surgical

Salvage mastectomy after failed breast-conserving therapy for carcinoma of the breast.

The indications, technique and complications of salvage mastectomy in 25 patients with local recurrence after breast-conserving therapy for carcinoma of the breast have been reviewed. Two patients required myocutaneous flaps to repair the defect, and six patients (24%) suffered wound infection or breakdown. Subsequent local relapse occurred in a total of five patients, two of whom died with uncontrolled chest wall skin nodules.

Axilla

An investigation of the anabolic activity of somatropin in normal and burned rats.

A 'blind', cross-over study was performed in 10 control and 12 burned rats which were assigned to receive either biosynthetic human growth hormone (somatropin) or placebo for 5 days each in random order. There was a significant rise in urinary nitrogen excretion and rapid weight loss in the burned rats, which also had significantly lower plasma somatomedin levels than control rats. Somatropin administration resulted in a significant increase in somatomedin levels in control rats only. There was no significant difference in weight or nitrogen balance between somatropin or placebo-treated rats. It is concluded that rats with normal pituitary function are insensitive to the anabolic effects of somatropin and that burn injury abolishes the normal somatomedin response to somatropin.

Animals