The value of the parental interview in a perinatal mortality survey.
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Adult↗
Biomedical subjects
J Edwards
Publications and source records attributed to J Edwards.
Personality disorders in recent-onset bipolar disorder.
The frequency and types of DSM-III personality disorders (PDs) were investigated in a sample of 26 recent-onset bipolar-disordered (BD) patients. Results showed that 62% of BD patients had PDs according to the Structured Interview for DSM-III Personality Disorders (SIDP). The most frequently diagnosed PDs were the histrionic, borderline, passive-aggressive, and antisocial categories. A comparison between the BD patients and a sample of 35 recent-onset schizophrenic patients showed significant differences for two PDs. Schizotypal PD was more frequently diagnosed in the schizophrenic group, while the BD group had a higher frequency of histrionic PD.
Bipolar Disorder↗
Concordance between two personality disorder instruments with psychiatric inpatients.
Eighty-two psychiatric inpatients received axis II diagnoses on the Millon Clinical Multiaxial Inventory (MCMI-1)--a self-report instrument--and the Structured Interview for DSM-III Personality (SIDP). Those two instruments were then compared in terms of personality disorder categories and trait-scores (dimensions). Essentially, with the exception of the borderline category, concordance between the two instruments was poor on all scales. Bayesian statistics confirmed the obtained results. The adequacy of the MCMI-I as an index of DSM-III personality disorders is questioned.
Adult↗
Impact of interdisciplinary education in underserved areas: health professions collaboration in Tennessee.
A community-based interdisciplinary health professions education project, involving the Colleges of Medicine, Nursing and Public and Allied Health, was implemented at the undergraduate level at East Tennessee State University from 1990 to the present. The outcomes of this project and the extension of the project into graduate health profession programs are described. Committed leadership, effective communication, and genuine community involvement are identified as essential to the success of community-based, interdisciplinary health professions training programs.
Communication↗
Delayed hemolytic transfusion reaction caused by a primary immune response.
Delayed hemolytic transfusion reactions usually occur as a result of a secondary immune response with maximal hemolysis occurring seven days posttransfusion. We report a delayed hemolytic transfusion reaction in which hemoglobinuria, anemia, and reticulocytosis developed four weeks after transfusion. The incriminated antibody, anti-C, was first detected eight weeks posttransfusion using enzyme-treated red blood cells. We conclude, that in all likelihood, this hemolytic transfusion reaction was due to a primary immune response, this case illustrates the importance of sequential testing in cases of suspected transfusion reactions.
Adult↗
Enrichment and identification of fetal trophoblast cells from first trimester maternal cervical lavage and uterine blood specimens.
First trimester prenatal diagnosis of fetal aneuploidies is an active area of research despite years of disappointing data employing maternal peripheral blood samples. To remedy this situation we have investigated other first trimester maternal specimens attempting to find a consistent fetal cell source. Using our previously established positive enrichment procedure along with a commercially available depletion method, fetal trophoblast cells were identified employing immunocytochemistry using an antibody cocktail or by using mRNA in-situ hybridization employing a cocktail of trophoblast specific probes. Fetal origin of positively identified cells was verified using interphase fluorescent in-situ hybridization (FISH) for X and Y-chromosomes. Artificial model systems were established that indicated yields of trophoblast cells and allowed the enrichment procedure to be optimized for minimal losses from maternal specimens. We demonstrate herein that blood drawn from maternal vessels near the placental implantation site to be the most consistent source of fetal cells from any first trimester maternal specimen described to date. In addition, a high yield of multinucleated syncytiotrophoblast cells was obtained using a cell depletion strategy to enrich the target cells. The safety of the procedure or even the clinical utility of blood drawn from maternal vessels near the placental implantation site is yet to be demonstrated.
Cell Separation↗
Hospital admissions for asthma in preschool children: relationship to major roads in Birmingham, United Kingdom.
This study examined the relationship between residence near major roads, traffic flow, and risk of hospital admission for asthma in children younger than 5 y of age living in Birmingham, United Kingdom. Area of residence and traffic flow patterns were compared for children admitted to the hospital for asthma, children admitted for nonrespiratory reasons, and a random sample of children from the community. Children admitted with an asthma diagnosis were significantly more likely to live in an area with high traffic flow (> 24,000 vehicles/24 h) located along the nearest segment of main road than were children admitted for nonrespiratory reasons (p < .02) or children from the community (p < .002). A significant linear trend was observed for traffic flow (p < .006) for children living less than 500 m from a main road but not for those living farther away. Children admitted for nonrespiratory reasons were more likely to be admitted than children in the community sample if they lived within 200 m of a main road (p < .02), irrespective of traffic flow.
Asthma↗
Complications common to ventricular assist device support are rare with 90 days of DeBakey VAD support in calves.
The DeBakey VAD is a miniaturized, electromagnetically driven axial flow pump intended for long-term ventricular assist. Safety and performance data from six calves implanted with the complete DeBakey VAD system are reported elsewhere; here we describe complications and necropsy findings for these same six animals, all of which survived 90 days. The study was conducted according to a uniform protocol, which included anticoagulation and antibiotic prophylaxis. Clinical complications tracked included bleeding, cardiovascular abnormalities (e.g., arrhythmias, tachycardia unrelated to pain, bradycardia), hemolysis, hepatic dysfunction, renal dysfunction, thromboembolism (neurologic or peripheral), or infection. Each adverse event was retrospectively categorized with regard to severity (mild, moderate, severe) and relationship to device. Clinical findings were confirmed by necropsy. There was no evidence of systemic infection, thromboembolism, hemolysis, or renal or hepatic dysfunction in these six animals during the study period. A single adverse event was noted in each of two of the calves. Both events were considered mild according to the predefined criteria. Bleeding related to the surgical implantation procedure and requiring reoperation occurred in one animal. The other animal had evidence of a superficial infection at the exit site of the cables on the left lateral thoracic wall; the infection did not extend into the thoracic cavity. Chronic, healed small renal infarct scars were present in several animals. Mild valvular endocardiosis was observed in two calves and mild fibroelastosis was present in the endocardium at the site of the inflow cannula in three calves; however, these lesions were not considered clinically significant. No other gross or histologic abnormalities were noted at necropsy. In conclusion, calves implanted with the complete DeBakey VAD for 90 days demonstrated few complications and had no significant necropsy findings. Complications common to ventricular assist device (VAD) support (i.e., hemolysis, infection, bleeding, thromboembolism) were rare during long-term support (90 days) with the DeBakey VAD.
Animals↗
The ontogeny of phonological categories and the primacy of lexical learning in linguistic development.
In this paper, we draw on recent developments in several areas of cognitive science that suggest that the lexicon is at the core of grammatical generalizations at several different levels of representation. Evidence comes from many sources, including recent studies on language processing in adults and on language acquisition in children. Phonological behavior is influenced very early by pattern frequency in the lexicon of the ambient language, and we propose that phonological acquisition might provide the initial bootstrapping into grammatical generalization in general. The phonological categories over which pattern frequencies are calculated, however, are neither transparently available in the audiovisual signal nor deterministically fixed by the physiological and perceptual capacities of the species. Therefore, we need several age-appropriate models of how the lexicon can influence a child's interactions with the ambient language over the course of phonological acquisition.
Child↗
"Open" nursing stations on psychiatric wards.
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Hospital Design and Construction↗
The interplay between prosodic structure and coarticulation.
In this paper we draw on a linguistic model of prosodic structure and a task-dynamic model of speech gestures to account for the interplay of coarticulation and stress in English. We reinterpret results from two experiments in which articulator movements were recorded for utterances varying in pitch accept placement. In the first experiment, jaw kinematics were studied in post-nuclear unaccented and nuclear accented [pap] syllables. The kinematic patterns suggested that gestures in syllables with greater stress (nuclear accented) show less coarticulatory overlap. By contrast, the vowel's low jaw target is undershot in unaccented syllables. Two hypotheses are possible. Either the jaw is lower in stressed syllables so more energy can radiate from the mouth ("sonority expansion") or the jaw is lower to help distinguish the low vowel from other vowels ("hyperarticulation"). Another experiment differentiates the two hypotheses by examining tongue point positions in [put] preceding a [th]. In the more stressed syllables, the tongue dorsum retracts more, likely to make a more distinct back vowel. Also, the amount of assimilation of the alveolar stop to the following dental is reduced. Both results suggest hyperarticulation rather than sonority expansion. Thus, it seems that coarticulation is reduced in stressed syllables, because stressed syllables are hyperarticulated.
Female↗
Use of Exu-Dry in the management of a variety of exuding wounds.
Exu-Dry is a relatively new product that is designed to manage a variety of exuding wounds. It is a one-piece, multilayer, highly absorbent, non-adherent wound dressing. It is unique in construction, and incorporates a non-adherent wound contact layer which, it is suggested, makes dressing changes less painful and traumatic. This article explores the use of Exu-Dry in wounds, including heavily exuding wounds, burns, pressure ulcers, skin grafts, donor sites and fungating wounds.
Bandages↗
Asthma and rhinitis related to laboratory rats: use of a purified rat urinary allergen to study exposure in laboratories and the human immune response.
Using the major rat allergen as a model has made it possible to study both natural exposure and the human immune response to an important laboratory animal. The close correlation between positive skin tests to whole rat urine and IgE antibody to the major urinary allergen in this and previous studies supports the use of this protein as a model rat allergen. Measurements of airborne rat allergen confirm that the maximum levels are higher than those reported with pollen or mite allergens. However, it is possible that exposure to rat allergens is comparable to levels of exposure to cat salivary allergens in houses with cats. The clear implication is that the high levels of exposure are responsible for the fact that a large proportion of exposed individuals develop IgG antibodies. Our results suggest that the prevalence of IgG antibodies (not individual levels) in a group of workers would be a good guide to exposure. This leaves unresolved why some of the individuals who develop IgG ab also develop IgE ab and become at risk for developing asthmatic responses. Only part of this risk is related to atopy. A striking feature of all the studies on animal allergy is the close association between IgE ab and asthma. It appears clear that it is those immune responses that include IgE ab that are a risk factor for asthma. It is not sensible for anyone to remain consistently sick with asthma and continue working with laboratory animals because there are well documented examples of occupational asthma that has not resolved after ceasing exposure.(ABSTRACT TRUNCATED AT 250 WORDS)
Allergens↗
An evaluation of the effectiveness of osteopathic treatment on symptoms associated with myalgic encephalomyelitis. A preliminary report.
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Adolescent↗
Feeding back surveillance data to prevent hospital-acquired infections.
We describe the Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance system. Elements of the system critical for successful reduction of nosocomial infection rates include voluntary participation and confidentiality; standard definitions and protocols; identification of populations at high risk; site-specific, risk- adjusted infection rates comparable across institutions; adequate numbers of trained infection control professionals; dissemination of data to health-care providers; and a link between monitored rates and prevention efforts.
Centers for Disease Control and Prevention, U.S.↗
Reduction of peak pressure on the forefoot with a rigid rocker-bottom postoperative shoe.
An ideal postoperative shoe should be comfortable to wear and protect the foot during recovery from surgery or injury. Protection is assumed to be related to peak pressure and force-time integral under the foot. This study compared a commonly used postoperative shoe with a new postoperative shoe that incorporates a rigid sole with an 11 degrees rocker bottom. The new postoperative shoe significantly reduced peak pressures on the forefoot by 20%. The amount of pressure and force-time integral reduction is compared with other values found in the literature for various shoe modifications. Indications for rocker-bottom shoes are also explored.
Biomechanical Phenomena↗
Integrating services in community child care.
Many changes in education and practice are taking place which will affect paediatric nurses working in the community. The authors argue that instead of fighting over professional boundaries and defending traditional territories, nurses involved in community child care must learn to integrate their services. They urge nurses to make the most of opportunities being presented to them to develop a high-quality professional service.
Child↗
Intra-articular and soft tissue injections by nurses: preparation for expanded practice.
Administration of intra-articular and soft tissue injections for rheumatic disease represents an expansion of the nurse's role. To achieve the benefits of improved care for patients, and enhanced practice and job satisfaction for practitioners, preparation for the role must be rigorous and systematic. Here the authors describe a course designed to meet these criteria. They set out the content and outcomes of the course and consider some of the ethical and legal issues surrounding such role expansion.
Attitude of Health Personnel↗