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Biomedical subjects

J T Shepherd

Publications and source records attributed to J T Shepherd.

172 records · Page 10Linked to original sources
PubMedDate not supplied

Occupational therapists in the school setting: working with students with complex health care needs.

OBJECTIVE: This study investigated one aspect of the role of school-based occupational therapists working with students with complex health care needs during the school day. METHOD: One hundred seventy-two occupational therapists working in school systems were surveyed with regard to their involvement with children with complex health care needs, particularly specific complex health care procedures performed, knowledge of policies, training in the administration of health-related procedures, and perceived levels of competency. RESULTS: Sixty-eight (61%) of the therapists reported having children with complex health care needs on their caseload; of these, 65% reported involvement in seizure monitoring and 24% reported performing gastrostomy feedings. Most respondents reported an awareness of policies regarding administration of medication, gastrostomy feeding, and seizure monitoring in their school system. Respondents' main role with this population included activities in positioning, environmental modification, and staff instruction. CONCLUSION: The major role of occupational therapists working in school systems involved providing direct intervention with the student and not conducting or instructing others in health-related procedures. Therapists also served as a resource on health-related issues for school personnel.

Adolescent↗
PubMedDate not supplied

Raynaud's phenomenon.

Much has been learned about the complexity of the local, humoral and nervous factors regulating the normal behavior of the skin blood vessels, and many studies have addressed how this knowledge might relate to the causation of primary Raynaud's disease. Despite this, the mechanism(s) responsible for the attacks of digital vasospasm remain an enigma. A key question is whether these attacks represent an exaggeration of the normal mechanisms causing constriction of the digital vessels with local cooling, or are due to a specific abnormality. In this article it is suggested that multiple factors are responsible, including the possibility of co-transmitters released with norepinephrine from the sympathetic nerves, increased activation of beta 2-adrenoceptors on the nerve endings, a shift in the balance of alpha 1 and alpha 2 adrenoceptors on the vascular smooth muscle and in endothelium-derived relaxing and contracting factors, and altered interactions of the endothelium with the blood elements including the effects of increased platelet serotonin.

Cold Temperature↗
PubMedDate not supplied

Initial and delayed circulatory responses to orthostatic stress in normal humans and in subjects with orthostatic intolerance.

Gravitational stresses, which are common daily event for humans, result in a diminution in central blood volume, due to displacement of blood to the lower parts of the body. They demand complex adjustments in the cardiovascular system to offset the decrease in cardiac filling pressure. Such changes are necessary to sustain arterial blood pressure at an appropriate level so that there is adequate perfusion of vital organs, especially the brain. These adjustments must compensate for both the initial and sustained orthostatic stress. The rapid short-term adaptations are mediated primarily by the cardiovascular reflexes with humoral agents reinforcing these reflexes during severe and prolonged orthostatic stress. Understanding these complex reflex adjustments in normal humans is necessary in order to appreciate subjects with orthostatic intolerance.

Atrial Natriuretic Factor↗