A nurse managed center's client satisfaction survey.
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Adolescent↗
Biomedical subjects
J Ashley
Publications and source records attributed to J Ashley.
Comparison of epidural and intravenous opioid analgesia after elective caesarean section.
Patient acceptance is a particularly relevant method of assessing currently employed epidural and intravenous techniques of opioid analgesia after elective caesarean section. We have prospectively studied 71 such patients, randomised postoperatively to receive epidural morphine, intravenous morphine or intravenous pethidine. When compared with either intravenous opioid, epidural morphine provided twofold better average or excellent analgesia with 30% less drowsiness but with about 50% more pruritus. In spite of this troublesome complication, more patients (83% vs 74%) preferred epidural to intravenous opioid analgesia.
Analgesia, Epidural↗
The effectiveness of an intervention to promote successful performance on NCLEX-RN for baccalaureate students at risk for failure.
This study evaluated the effectiveness of an intervention designed to enhance the performance of high-risk baccalaureate students on the National Council Licensure Examination for Registered Nurses (NCLEX-RN). Thirty senior nursing students met risk criteria drawn from the NCLEX-RN prediction literature: a nursing grade point average (GPA) of 2.40 or below, a ranking on the Mosby Assesstest at or below the 20th percentile, and/or a diagnosed learning disability. Fourteen students in this nonrandomized, posttest-only study received the intervention. Sixteen students served as a control group. The groups were equivalent on 12 academic variables prior to treatment. Concepts of test-wiseness and test-coaching served as the basis for the intervention. The NCLEX-RN passing rate for the group participating in the intervention was 92.9% compared to 50% for the control group. The findings of this study provide preliminary evidence that a long-term intervention can assist high-risk students in passing the NCLEX-RN.
Adult↗
Phosphorylation of tyrosine enhances its electron transfer capability: a model of redox modulation as oncogene expression?
The influence of tyrosine and o-phosphotyrosine on the transfer of electrons to nitrobluetetrazolium (NBT) was studied. Tyrosine phosphate was found to strongly promote the transfer of electrons from ferrous iron to NBT, while tyrosine was inhibitory. The enhancement of NBT reduction by tyrosine phosphate was blocked by superoxide dismutase (SOD). The results suggest a role for phosphorylated tyrosine residues to promote intracellular redox reactions. We suggest that the role of tyrosine protein kinases in cell proliferation and transformation may be to regulate electron transport in as yet undefined cellular systems. Consistent with a unique role for phosphotyrosine, the other commonly occurring phosphoamino acids, o-phosphoserine and o-phosphothreonine were not effective electron transfer agents.
Electron Transport↗
Rising frequency of ulcer perforation in elderly people in the United Kingdom.
Peptic ulcer admission rates were known to be declining in England and Wales in younger men and women at least until 1977, but rates in elderly men were stable and rates in older women were increasing. Analysis of the most recently available data shows that these trends have continued in England and Wales and similar trends are seen in the elderly populations in Scotland. Reasons for the increasing susceptibility of elderly people, particularly older women, to peptic ulceration are not clear. However, altered smoking habits seem unlikely to explain the change, whereas increased use of non-steroidal anti-inflammatory drugs may account for part of it.
Adolescent↗
Neglect: what part of abuse?
Neglect and its consequences are important to study. At this time, there is little consensus on what it is specifically, but it is being reported with greater frequency and state agencies are concerned with the alarming number of incidents being called to the attention of their protective service staff. The purpose of this paper has been to describe some of the definitional and assessment problems related to elder neglect for the purpose of outlining a decision making aid that can guide individuals in their assessment of suspected neglect cases. While researchers continue to refine their understanding of the phenomenon of neglect, it is crucial that systematic guidelines be available which can assist in the evaluation of suspected neglect events. The clinical area may not be able to wait for the perfect definition of neglect. In the meantime, the health and safety of elders demands a process for consideration of the phenomenon.
Aged↗
Geriatric nursing in acute settings.
In conclusion, it is important to reiterate the interdependent nature of the functional health patterns as they relate to the geriatric patient in the acute care setting. Further, the combination of the primary nursing model with the functional health pattern approach that leads to subsequent nursing diagnoses provides a comprehensive care approach, which is so important for the elderly patient. As elders live longer, become frailer, and are subject to increasingly frequent hospitalizations, it will become more and more important to provide care in a manner that decreases fragmentation, increases individualization, and makes provisions for comprehensive and wholistic continuing care.
Activities of Daily Living↗
From team nursing to individual care.
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Humans↗
Management: showing the colours.
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Color↗
Acute intravenous and sustained oral treatment with the beta1 agonist prenalterol in patients with chronic severe cardiac failure.
Prenalterol, a beta1 agonist, was given in a single blind acute intravenous study to seven patients with cardiac failure (New York Heart Association class II and III). It was then given in a double blind crossover study of sustained oral prenalterol to six of them. As a result of dose titration studies the oral dose of prenalterol given was 100 mg twice a day in all patients. Erect bicycle sprint tests were performed to exercise tolerance before and after treatment had been started. Cardiac function was assessed at rest and during graded supine bicycle exercise by determining haemodynamic indices using a Swan-Ganz catheter and radionuclide left ventricular ejection fractions. In the intravenous study cardiac function was assessed at rest and during exercise after a control infusion of dextrose and after an infusion of 5 mg prenalterol. In the oral crossover study a placebo or prenalterol were given for two periods of two weeks; at the end of each period exercise tolerance was measured and cardiac function assessed at rest and during exercise. Throughout the study period there was no change in symptoms, medication, or exercise tolerance. Intravenous prenalterol significantly improved cardiac function; left ventricular ejection fraction and cardiac index increased and left ventricular filling pressure fell both at rest and during exercise. Sustained oral treatment with prenalterol, however, did not improve resting left ventricular filling pressure or left ventricular ejection fraction at rest or during exercise but did increase heart rate at rest, and mean blood pressure and peripheral vascular resistance at rest and during exercise; in fact, during exercise left ventricular filling pressure was significantly increased while cardiac index and stroke volume index were decreased by prenalterol. Sustained oral treatment with prenalterol did not have the beneficial effects on cardiac function produced by intravenous treatment and in fact had deleterious effect on the measured indices of cardiac function during exercise.
Administration, Oral↗
Macrocephaly and minor congenital anomalies in children with learning problems.
To determine whether existing data which indicate a significant prevalence of abnormal head circumference and minor congenital anomalies in referred learning disabled populations could be replicated in a nonreferred population, 75 children enrolled in learning disabilities resource programs in an elementary school district were compared with a matched group of 73 children. Macrocephaly (occipitofrontal head circumference of 2 or more SD above the mean) was noted significantly more often in resource than in control children (12 versus 3) (p less than 0.05). Macrocephalic resource children had significantly lower achievement scores than either normocephalic resource or control children (p less than 0.05). There were no significant differences between resource and control children for mean number of anomalies per child, frequency of individual anomalies per group, or evidence of recurring anomaly patterns in the resource children. The macrocephalic resource children revealed the same prevalence of anomalies as normocephalic resource and control children, with no evidence of recurring anomaly patterns. Resource children with four or more anomalies did not differ from those with three or fewer anomalies on any psychometric parameters. Clinical, familial, radiological, and psychometric investigation of several macrocephalic resource children indicated similar patterns of learning deficits and documented evidence of familial macrocephaly but did not show any recognizable CNS abnormalities. This study confirms a significant prevalence of macrocephaly in children with learning problems. It indicates the need for further research into the prevalance and patterns of learning deficits in children with familial macrocephaly. The results add to recent concerns about the psychoeducational criteria of specific learning disabilities.(ABSTRACT TRUNCATED AT 250 WORDS)
Abnormalities, Multiple↗
Plasma fractionation methods and T-cell subsets in haemophilia.
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Acquired Immunodeficiency Syndrome↗
Effect of total parenteral nutrition on marrow recovery during induction therapy for acute nonlymphocytic leukemia in childhood.
Ten well-nourished children with acute nonlymphocytic leukemia (ANLL) were randomly assigned to groups that received (a) total parenteral nutrition (TPN) throughout the period of induction therapy or (b) standard nutritional support. Body mass and skin hypersensitivity reactions were better maintained in experimental patients. Patients on TPN had higher total white blood counts, absolute granulocyte counts, and platelet counts than did control patients during the course. No difference was apparent in the frequency of febrile episodes, or other aspects of the patients' courses. This preliminary report suggests that intensive nutritional support may accelerate the recovery of normal marrow function during induction therapy for ANLL.
Acute Disease↗
Long-term nutritional assessment of patients with esophageal atresia and/or tracheoesophageal fistula.
Fifty-three patients operated for esophageal atresia and/or tracheoesophageal fistula at the Childrens Hospital of Los Angeles returned for long-term nutritional assessment. The ages ranged from 11 months to 31 years of age with a mean age of 9 years 11 months. Nineteen percent of the patients were below the third percentile in height for their age, thus exhibiting evidence of chronic malnutrition. No significant differences could be demonstrated between patients with a birth weight above or below 2500 g or above or below 5 years of age. Patients over 13 years of age demonstrated considerably less evidence of chronic malnutrition (p less than .06), thus exhibiting a "catch-up" growth phenomenon. Associated anomalies and illnesses were frequently seen in patients with the most significant abnormal nutritional-assessment parameters. Nutritional assessment should be part of long-term management and follow-up of all patients with esophageal atresia or other congenital surgical anomalies.
Adolescent↗
Report on confidential enquiries into maternal deaths in England and Wales 1976-1978.
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Abortion, Induced↗
Cellular phenotypes of normal and leukemic hemopoietic cells determined by analysis with selected antibody combinations.
Individual leukemic cells and the corresponding rare normal cell types in nonleukemic bone marrow were analyzed with various combinations of antisera (labeled with different fluorochromes: TRITC and FITC). Double staining for membrane Ia-like molecules (TRITC) and nuclear terminal transferase (FITC) was a very useful combination that distinguished common non-T, non-B ALL (Ia+,TdT+) and thymic ALL (Ia-,TdT+) from the rare cases of B ALL (Ia+,TdT-) and from AML (frequently Ia+, TdT-; in some cases Ia-, TdT-). Additional antisera (such as anti-ALL, anti-HuTLA, anti-immunoglobulin reagents, etc.) confirmed the diagnosis and further characterized the leukemic blasts. Ia+,TdT+ cells could be observed in low numbers in normal and nonleukemic regenerating marrow and were probably normal precursor cells; this reagent combinations was, therefore, not useful for monitoring residual non-T, non-B ALL blasts in treated patients. Other marker combinations detecting pre-B ALL blasts (double staining for cytoplasmic IgM and nuclear TdT) and Thy-ALL blasts (HuTLA+,TdT+) were, however, virtually leukemia specific in the bone marrow and could be used to effectively monitor residual leukemic cells throughout the disease. These combined single-cell assays are not only economical and informative but are also important for assessing the heterogeneity of leukemia and for standardizing new mouse or rat monoclonal antibodies for diagnosis.
Animals↗
Sexual adjustment after lower extremity amputation.
Sexual adjustment following lower extremity amputation was evaluated by interviewing 60 adults with recent amputations, 39 men and 21 women, after they had become independent in ambulation with a prosthesis. Among the men, 77% reported a substantial decrease in the frequency of sexual intercourse following amputation, while only 38% of the women reported a decrease. The decreased frequency was greater for nonmarried men than for married men, greater for men with above-knee amputations than for men with below-knee amputations, and greater for male amputee patients in whom phantom phenomena persisted compared to those in whom phantom phenomena no longer existed. The decreased frequency of intercourse for male amputee patients was unrelated to the patient's age, education, and etiology of amputation. There was no significant change in other aspects of sexual activity, including oral-genital relations, masturbation, homosexuality, and extramarital relations.
Adolescent↗