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Biomedical subjects

J Adam

Publications and source records attributed to J Adam.

119 records · Page 7Linked to original sources
PubMedDate not supplied

Time-sensitive clinical management: a case study of acute asthma care.

This paper emerged from a study of change in a major teaching hospital subsequent to the introduction of casemix-based funding--a management tool designed to support the development of industrial practices in hospital management. A clinical unit had been advised to become more financially efficient. The unit staff redefined the task as becoming more clinically effective, as well as more efficient. One of the important themes to emerge was the importance of time. The resultant changes in the provision of care reflected a sophisticated approach to time.

Acute Disease↗
PubMedDate not supplied

Statistical bias in cross-sequential studies of aging.

In an earlier published study (Botwinick & Arenberg, 1976) it was argued that cross-sequential designs used in studies of aging and intelligence bias results in favor of a larger main effects F ratio for cohort than for time of measurement. As a consequence, purely ontogenetic influences are likely to be misinterpreted as generational. The present paper gives conclusive proof of the statistical bias inherent in these designs. In addition it shows that, for any given number of measurement occasions, the degree of bias increases with the number of different cohorts tested. An explanation of the statistical problem in intuitive terms is also provided.

Aging↗
PubMedDate not supplied

Caring for the 'new' family in palliative care.

A knowledge of societal changes within the family and bereavement theories increases the nurse's understanding of the loved ones' needs in palliative care. The encouragement of self-awareness and reflective practice facilitates staff to support the new family or patient's partner effectively.

Adaptation, Psychological↗
PubMedDate not supplied

Discharge planning of terminally ill patients home from an acute hospital.

This exploratory descriptive study was designed to explore how well carers perceived they were being prepared by hospital staff to care for a terminally ill relative at home. In particular the study focused on the information and practical advice and support they received in hospital and how much this facilitated them in caring at home following the patient's discharge from hospital. The study used a convenience sample of 12 patients and carers referred to a specialist palliative care service in an acute teaching hospital. The data were collected using semi-structured interviews. Qualitative analysis identified an overarching theme and related categories on coping with caring at home. The findings are supported by Folkman's (1997) model of stress and coping and corroborated by other research on carers' needs (Davies et al, 1994; Fakhoury et al, 1997). Interventions that may enable health professionals to facilitate carers to cope more effectively in caring at home and recommendations for further study are discussed.

Acute Disease↗
PubMedDate not supplied

Prediction of the left ventricular ejection fraction response to doxorubicin using a multiple linear regression model.

The aim of this study was to develop a model for predicting clinically significant deterioration in the left ventricular ejection fraction due to chronic doxorubicin administration. Twenty-six patients were monitored during their courses of doxorubicin chemotherapy with serial gated equilibrium radionuclide angiography. Multiple linear regression analysis was used to derived the best combination of clinical and radionuclide angiographic predictors of resting left ventricular ejection fraction at any point during the course of chemotherapy. The final model consisted of five variables: left ventricular ejection fraction at the previous monitoring point; cumulative dose of doxorubicin achieved at the previous monitoring point; increment in dose from the previous monitoring point; age of the patient; and time to peak left ventricular emptying at the previous monitoring point. The cumulative dose, the ejection fraction at the previous monitoring point and the final model, respectively, explained 11%, 33% and 53% of the variability in ejection fraction determinations during the 26 patient courses. The final model also forecast a potentially very low resting left ventricular ejection fraction (less than 35%) at the cumulative doses of doxorubicin which provoked serious clinical cardiotoxicity in two patients. A multivariate model is a useful aid in timing discontinuation of doxorubicin prior to the development of a clinically significant deterioration in left ventricular ejection fraction.

Computer Simulation↗