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Biomedical subjects

J Richman

Publications and source records attributed to J Richman.

At least 37 records · Page 2Linked to original sources
PubMed1993

Pulmonary function during and after total hip replacement. Findings in patients who have insertion of a femoral component with and without cement.

Eleven patients who had a femoral component inserted with cement and twenty-three who had a femoral component inserted without cement were studied prospectively for changes in the pulmonary shunt associated with total hip replacement. The levels of oxygen in the arterial blood and the platelet counts were measured preoperatively and each morning for three days after the arthroplasty. Levels of oxygen in the arterial blood were determined intraoperatively, once before and once after the femoral component was inserted. Intraoperative shunt values increased 28 per cent when a femoral component was inserted with cement (p < 0.05), but they did not change when cement was not used. The average postoperative shunt values were higher than the average preoperative shunt values for both groups of patients, but only the values on the second postoperative day after a procedure with cement were significantly higher (p < 0.05). The ability of the patient to tolerate an increase in pulmonary shunt should be assessed when the femoral component is to be cemented during total hip replacement.

Aged↗
PubMed1992

A rational approach to rational suicide.

Suicide is a reaction to internal and external sources of stress and the impact of life events. In the elderly these situations are prevalent in many who are not suicidal and instead choose life. They represent what may be called rational nonsuicide. They are far more frequent than rational suicide. Nevertheless, considerably more is written about rational suicide than its alternative. The reasons for this phenomenon are reviewed, and suggestions are made for a rational approach to the affirmation of life rather than its rejection, even to the very end.

Age Factors↗
PubMed1992

Case consultation: Mary Catherine.

A case of the attempted suicide of a 66-year-old female is presented. Comment based on the chapters in this volume is presented. Specific topics of demographics, psychiatric-psychological, object relations, the attempt, and concluding comments provide an idiographic illustration of suicidal behavior in an older adult.

Aged↗
PubMed1990

Results of a program to reduce admissions for adult asthma.

STUDY OBJECTIVE: To determine the effect of an outpatient program designed to reduce readmissions for asthma exacerbations among adults with asthma. DESIGN: Randomized patient selection with crossover. SETTING: Bellevue Hospital, New York City, New York. PATIENTS: We identified 104 adult asthmatics who had previously required multiple hospitalizations for asthma attacks. Forty-seven patients were randomly assigned to an intensive outpatient treatment clinic and 57 patients continued to receive their previous outpatient care. Nineteen patients from this latter group were then crossed to the intensive outpatient therapy clinic. INTERVENTIONS: Attenders of the intensive outpatient treatment program were treated with a vigorous medical regimen and educational program. Emphasis was placed on teaching patients aggressive self-management strategies in case of marked asthma exacerbation. MEASUREMENTS AND MAIN RESULTS: The main measurement used to determine efficacy of the study program was readmission rate and hospital days used. Prospective comparison of treated compared with untreated patients indicated that program enrollment resulted in a threefold reduction in readmission rate and a twofold reduction in hospital day use rate (P less than 0.004 and P less than 0.02, respectively). Using retrospective data with patients serving as their own controls, we found a threefold reduction in readmission rate and in hospital day use (P less than 0.003) during a 32-month follow-up period. A similar magnitude of reduction in hospital utilization was found when patients were crossed over to the intensive treatment group (P less than 0.004). CONCLUSIONS: By using a vigorous medical regimen and intensive educational program, we were able to decrease hospital use among a group of adult asthmatics who had previously required repeated readmissions for acute asthma exacerbations.

Adult↗
PubMed1990

Comparison of ofloxacin, gentamicin, and tobramycin concentrations in tears and in vitro MICs for 90% of test organisms.

Concentrations of three anti-infective agents in tear film were monitored after one topical application in rabbits. Ofloxacin concentrations exceeded the MIC for 90% of the organisms tested (MIC90) (gram-negative and gram-positive organisms) for 240 min. Tobramycin concentrations exceeded the MIC90 for 10 min. Gentamicin concentrations exceeded the MIC90 for 20 min for gram-positive organisms and 120 min for gram-negative organisms.

Animals↗
PubMed1990

Irlen lenses: a critical appraisal.

The purpose of this paper is to assess the credibility of the Irlen lenses, Irlen's hypotheses, and the scotopic sensitivity syndrome. The analysis includes a review of 13 pro and con research papers. Of special interest is the dichotomy which developed between researchers who were Irlen participants and the professional and scientific community who required less disputable evidence. Even the former, however, failed to find scientific support for Irlen's concept of dysfunction in the discharge rate of the retinal receptor cells. Furthermore, in the absence of any evidence that it is a separate and distinct entity, it appears that the scotopic sensitivity syndrome is, in fact, a symptom complex which results primarily from various refractive, binocular, and accommodative disorders. Some of the papers which support Irlen's hypotheses provide reason to believe that there is a strong placebo effect.

Dyslexia↗
PubMed1989

Gender differences in the perception and utilization of social support: theoretical perspectives and an empirical test.

The authors contend that women are the more supportive, nurturing and affectively-connected sex. They argue that these gender differences result from socialization experiences which may be modified by social and occupational roles. Theoretical perspectives and research addressing this proposition are reviewed. Empirical data on support-eliciting and support-providing behaviors in a cohort of medical students are then provided to test their thesis. The data suggest that women have developed a greater sensitivity to the needs of themselves and others, leading to a greater capacity to provide support and a greater dependence upon social support for psychological well-being. Personality and developmental factors that may account for these differences are examined. The implications of these findings for gender differences in mental health are discussed.

Adult↗
PubMed1989

Parental adjustment to intrapartum and delivery room loss. The role of a hospital-based support program.

Perinatal loss prompts a unique bereavement for parents and their families that is unlike the mourning process experienced at the death of other loved ones. The Support Center For Perinatal and Childhood Death has developed a comprehensive program to provide support, counseling, and information to families who experience miscarriage, stillbirth, fetal anomalies, and therapeutic abortion for genetic or congenital abnormalities. The impact of perinatal loss is felt not only in the real loss of the wished-for child but also in the loss of self-esteem, the role of parent, and the loss of confidence in the ability to produce a healthy child. The emotional experience of miscarriage or stillbirth creates an atmosphere of despair and confusion for families anticipating a joyous event. The presence of a support counselor and medical caregivers at this time can help parents to navigate the crisis surrounding the loss in ways that promote a healthy grieving process and avert pathologic adaptations. Prenatal, intrapartum, and postpartum counseling opportunities are afforded to families as the situation and parental needs dictate. Services also are extended to other family members, with particular attention to surviving siblings who might be vulnerable to the consequences of unresolved or unacknowledged grief. Grief is experienced as a long-term process, which frequently emerges fully after discharge from the hospital and lasts well beyond the interest and stamina of supportive family members and friends. Support groups, which meet the specific needs of families who experience perinatal loss, contemplate subsequent pregnancy, or face the prenatal decision to terminate a genetically or congenitally compromised pregnancy, have been run successfully for a period of several years. Beyond the experience of intrapartum loss in the delivery room, the experience comes full circle for families who enter the delivery room again with a subsequent child. The expressed need for support in acknowledging the rekindled memories of prior loss at this poignant time are matched only by parents' needs to find reassuring ways of differentiating healthy newborns from the memory of those who died. It is often at the time of the subsequent birth that the memory of the lost child can take its proper place in the family. Stein expresses the essence of grief work and resolve: Mourning is not just feeling sad. It is the specific psychological process by which human beings become able to give up some of the feelings they have invested in a person who no longer exists, and extend their love to the living. Mourning is hard, emotional work.(ABSTRACT TRUNCATED AT 400 WORDS)

Adaptation, Psychological↗
PubMed1987

Quality assurance: is it professional insurance?

Quality assurance (QA) is being hailed as a 'new frontier' of nursing. Its diffusion into nursing theory and practice in the United Kingdom is outlined. QA is not an alien import; favourable preconditions already existed. The systems-reasoning of the nursing process, which sprawned a plethora of models, each geared to the 'orderly' progression of stages, objectives and process, is resonant with the values and measurement techniques of QA. A major limitation of QA is that it downplays the organizational complexity of hospitals. Although QA is projected as being in the service of clients, its major impetus is concerned with professional self-defence, as regards other professions, the state and litigious clients. Further, QA enlisted by nursing strongly reproduces the ethos and logic of the dominant medical model; patients are 'objectified' as the technical products of production. The 'medical gaze' is now being joined with the 'nursing gaze'.

Consumer Behavior↗