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Biomedical subjects

J H Davis

Publications and source records attributed to J H Davis.

231 records · Page 13Linked to original sources
PubMedDate not supplied

Total parenteral nutrition (TPN) at home: prototype high-tech home care nursing.

Current economic and demographic trends in the United States indicate the demand for complex treatments, such as infusion therapies at home, will continue to escalate. In light of the increasingly acute and autonomous nature of home health practice, examination of home care nursing process affecting patient care outcomes is crucial. This study explored the cognitive, technical, and interpersonal components included in total parenteral nutrition (TPN) home care nursing. The purpose of this study was to evaluate psychometrically the Schmele Instrument to Measure the Process of Nursing Practice in Home Health (SIMP-H) so that it may be used to examine high-tech home care nursing process. Home visits must be observed to identify the specific cognitive, technical, and interpersonal components included in high-tech home care nursing that are important for patient care outcomes. This study captured high-tech home care nursing process on videotape, which provided a medium for evaluating interobserver reliability for the SIMP-H. Results revealed an interobserver reliability coefficient of .72.

Aged↗
PubMedDate not supplied

Immunosuppressive therapy: a potential alternative to bone marrow transplantation as initial therapy for acquired severe aplastic anemia in childhood?

PURPOSE: Currently bone marrow transplantation (BMT) with an HLA-identical sibling donor is recommended as optimal therapy for children with acquired severe aplastic anemia (SAA). Immunosuppressive therapy (IST) has become a very successful initial therapy for SAA in children lacking a related bone marrow donor. We wished to evaluate whether current IST regimens may be as efficacious as BMT. PATIENTS AND METHODS: A retrospective review identified children treated for SAA over a 12-year period. Children with a related donor received a BMT. Children lacking a donor were treated with IST followed by a "rescue" BMT if IST was ineffective. IST consisted of anti-thymocyte globulin and steroid +/- cyclosporine A. Transfusion independence and survival rates were compared between the two groups. RESULTS: Twenty-seven children were identified. Nine received a related BMT; seven of these survive and are transfusion independent (median follow-up 54 months). Sixteen of 18 patients who received IST are transfusion-independent survivors, including three of four patients who received a rescue BMT (median follow-up 33.5 months). Actuarial survival is 75% (95% CI = 45%, 105%) and 92% (95% CI = 78%, 107%) for the BMT and IST groups, respectively (p = 0.15). Severe toxicity was not experienced by any patient as a result of IST. CONCLUSIONS: Equivalent rates of transfusion independence and survival were experienced by patients receiving BMT and IST. We propose that a prospective trial be undertaken to evaluate IST as initial therapy in all children with SAA, to be followed by BMT if there is inadequate response.

Adolescent↗
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Diamond-blackfan anemia and cyclosporine therapy revisited.

A girl with Diamond-Blackfan anemia diagnosed in infancy started cyclosporine A (CSA) therapy at 9 years and 8 months of age after experiencing unacceptable side effects while receiving prednisone. Since then, she has been followed-up for more than 4 years. She exhibited a dramatic response to CSA, with weaning and then cessation of steroid therapy after 5 months. She has remained transfusion-independent. Attempts to discontinue CSA therapy have been unsuccessful. Relapse of the anemia has occurred in the context of viral infections with missed CSA doses. The major clinical problem during treatment has been recurrent oral aphthous ulceration, which responds to topical therapy. She is currently maintained on CSA 100 mg twice daily with a hemoglobin of 10.2 g/dL and a reticulocyte count of 1.6%. A trial of CSA therapy should be considered in patients with Diamond-Blackfan anemia in whom steroid therapy has failed before a transfusion program is instituted or alternative donor stem cell transplantation is entertained.

Adrenal Cortex Hormones↗
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Pet care during preadolescence: developmental considerations.

This exploratory study investigated pet care in relation to psychosocial development during preadolescence. A group of male and female preadolescents (n = 22) at appropriate grade level for age completed a dog care responsibility inventory. The results revealed that preadolescents in general do not routinely care for pets. Mothers appear to assume most pet care tasks.

Animals↗
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Nitrate removal effectiveness of a riparian buffer along a small agricultural stream in western Oregon.

The Willamette Valley of Oregon has extensive areas of poorly drained, commercial grass seed lands. Little is know about the ability of riparian areas in these settings to reduce nitrate in water draining from grass seed fields. We established two study sites with similar soils and hydrology but contrasting riparian vegetation along an intermittent stream that drains perennial ryegrass (Lolium perenne L.) fields in the Willamette Valley of western Oregon. We installed a series of nested piezometers along three transects at each site to examine NO3-N in shallow ground water in grass seed fields and riparian areas. Results showed that a noncultivated riparian zone comprised of grasses and herbaceous vegetation significantly reduced NO3-N concentrations of shallow ground water moving from grass seed fields. Darcy's law-based estimates of shallow ground water flow through riparian zone A/E horizons revealed that this water flowpath could account for only a very small percentage of the streamflow. Even though there is great potential for NO3-N to be reduced as water moves through the noncultivated riparian zone with grass-herbaceous vegetation, the potential was not fully realized because only a small proportion of the stream flow interacts with riparian zone soils. Consequently, effective NO3-N water quality management in poorly drained landscapes similar to the study watershed is primarily dependent on implementation of sound agricultural practices within grass seed fields and is less influenced by riparian zone vegetation. Wise fertilizer application rates and timing are key management tools to reduce export of NO3-N in stream waters.

Agriculture↗
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Continuing education electronic bulletin board system: provider readiness and interest.

This study explored the feasibility of establishing a computer-based, statewide electronic bulletin system (BBS) for continuing education for nurses in Florida. An anonymous survey addressing the feasibility of instituting such a BBS was mailed to a random stratified sample of 225 continuing education providers approved by the Florida Board of Nursing. The survey explored information services used and desired by providers, availability of resources to use a BBS, fees providers would be willing to pay, and the degree of interest in participating in a BBS. The findings of this preliminary study suggest that although support for a BBS featuring continuing education for nurses may be emerging in Florida, two major impediments to the establishment of such a system currently exist: start up and maintenance costs, and the nursing profession's lack of preparedness.

Advertising↗
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Unifying the strategies of primary health care and nursing education.

Nurses prepared to work co-operatively with the world's peoples in achieving "Health for All" have a vital role in primary health care. At the University of Illinois, Nursing in Primary Health Care is offered through the Collaborative Baccalaureate Project, a basic instructional system which can be adapted to different educational settings. It is presented here as an example of an original approach for effective delivery of primary health care content.

Curriculum↗
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An innovative preceptor program for intravenous home care nursing.

The demands of intravenous home care nursing require a comprehensive orientation of newly hired staff. This article describes a model preceptor development program to promote collaboration in the orientation experience. Nurses are selected by their managers to attend a 3-day training program. An evaluation questionnaire is given to participants at the end of the program. Results indicate that at the conclusion of the program, the attendees feel prepared to assess learning needs, to plan instructional activities, and to evaluate learning outcomes of their future preceptees. This program can easily be adapted for use by other home care agencies providing IV nursing.

Adult↗