Biomedical subjects
Publications and source records attributed to J Williams.
Adult neurological scales do not always assess conscious levels in head-injured children accurately. A new scale, the Pinderfield scale, has been introduced into the Major Injuries Unit in Birmingham and has found a favourable reception with nurses.
Specialist centres provide excellent treatment and expert care, but the best interests of children may not be served if they must always attend a hospital far from home. Systems of shared care have been developed to offer care nearer the family home whenever possible. Parent-held shared care records were introduced at a paediatric haematology/oncology centre in response to issues raised by parents and professionals concerning the management of shared care. These were set up to facilitate communication, teamwork and family involvement. Consultation took place within the multidisciplinary team to ensure that the design of the records met the needs of each group. During a multidisciplinary study day the records were introduced to professionals from shared care hospitals. Before formally incorporating these records into regular clinical practice they were piloted with a group of families. The records have become an accepted part of the service provided for family and professional partners in shared care. Formal evaluation of this innovation is currently taking place.
Traditionally, the pulmonary system has not been considered the limiting factor in determining maximal oxygen uptake (VO2max) in healthy individuals since arterial oxygen-haemoglobin saturation is thought to remain high during intense exercise. However, there appears to be a major exception to this rule. Recent evidence suggests that arterial hypoxaemia results during heavy exercise in well trained individuals with a high VO2max. Further, the degree of arterial desaturation is inversely related to VO2max. This exercise-induced hypoxaemia does not appear to be due to hypoventilation although athletes who have limited hyperventilation seem to exhibit the lowest arterial oxygen-haemoglobin saturation. A significant venoarterial shunt has been ruled out as a primary cause of the hypoxaemia based on both experimental and theoretical considerations. Therefore, it appears that the exercise-induced hypoxaemia seen in highly trained athletes during heavy exercise is primarily due to diffusion limitations and ventillation-perfusion inequality. It is postulated that incomplete diffusion in the healthy lung may be due to a rapid red blood cell transit time through the pulmonary capillary. In summary, recent findings suggest that the limits of the human pulmonary system may be reached or even exceeded during intense exercise in some individuals. In light of these findings the role of the pulmonary system as a limiting factor during maximal exercise in the highly trained endurance athlete warrants further investigation.
Explore the source record for details and available documents.
The authors describe the principles and functioning of a 7-week course of interdisciplinary treatment for small groups of patients with cognitive and behavioral difficulties resulting from brain damage. The programme is intended for patients with less severe physical disability. It outlines a programme of individual, practically oriented workshops and of more theoretical group sessions working on cognitive and communications handicaps. The work is based on conceptual explanations, coping strategies and training techniques. The neurological and neuropsychological consequences of four subjects accepted on such a programme are presented, as well as some of the principles of treatment used for these patients. The efficacy of such programmes is discussed, given the classical post-traumatic picture of brain-injured patients. The programme consists of 1 week of evaluation and 6 weeks of therapeutic sessions.
Explore the source record for details and available documents.
As we approach the 21st century, the workforce in the United States is becoming more culturally diverse. This is evident in many of our hospitals across the nation. Preceptors, who are trained as role models, communicators, and teachers, are poorly prepared to deal with the cultural diversity of nurses and their clients. The Texas Medical Center Collaborative Preceptor Program uses several methods to explore cultural differences and increase preceptors' sensitivity to people from other cultures. The course assists preceptors in identifying potential conflicts of value systems and cultural differences and enables them to identify methods of facilitating cultural adjustment. Preceptors are given the opportunity to identify their own cultural values and communication techniques and to experience cultural differences firsthand. The class includes lecture/discussion, gaming, role-play, and video. Experiential learning is used to identify cultural differences without being culturally offensive or stereotypical.
Rapid changes in the health care environment have challenged educators to find more efficient methods of developing nurses. These demands are leading to the use of collaborative approaches to education. Nurse educators have also found that they have to rely on preceptors for orientation of new employees. The Texas Medical Center Collaborative Preceptor Program was developed in 1989 to prepare nursing preceptors for all nine participating institutions. The goals of the program were to increase efficient use of instructor time, standardize preceptor preparation in the Texas Medical Center, and offer more programs and prepare more nurses per year than each individual institution could do alone. There were many unexpected benefits as well, and future plans for collaboration are already being formulated.
An 18-month-old, neutered male beagle presented with acute abdominal signs and a suppurative infection of the urogenital tract. Chromosomal sex was female (78, XX), gonadal sex was male (testicles), and phenotypic sex was ambiguous, with evidence of both male and female duct systems. The internal and external genitalia consisted of epididymides, an underdeveloped uterus with an immature spermatic cord, communication between the uterus or cranial vagina and the membranous urethra, a urethrographically male urethra, a hypoplastic os penis, and a hypoplastic penis with hypospadia. Based on these findings and the familial history of a similarly affected litter mate, the dog was diagnosed as having the XX male syndrome with pyovagina and uterine stump pyometra. Radiographic and ultrasonographic investigations are described, and abnormalities of chromosomal sex, gonadal sex, and phenotypic sex are discussed.
Explore the source record for details and available documents.
Bone marrow cells explanted after the host animal has been exposed to chemicals can be assayed in vitro for cytogenetic damage. Cells were grown in medium for two cell cycles in the presence of 5-bromodeoxyuridine and then analyzed for the frequency of sister chromatid exchanges and cell replication kinetics. The patterns for induction of these endpoints as assayed in vitro were very similar to those observed if the assay was performed totally in vivo. Several chemicals were tested in this system and shown to be positive; hycanthone, ethidium bromide, 4-fluoro-3-nitro-phenyl azide, mitomycin-C, 2-aminoanthracene, benzo(a)pyrene, and cyclophosphamide. Dehydroemetine, known as a nonmutagenic drug, was negative in this assay. Since this assay incorporates host metabolism, is rapid, and has a wide dynamic range, it may be useful to perform to determine the potential of chemicals to induce genetic damage.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
The need for change was identified when an increase occurred in peritoneal catheter exit site infection rate of those patients who had newly inserted peritoneal dialysis catheters. A decision was taken to improve this situation by reviewing the prevailing procedure. A literature search of the recommended care of peritoneal dialysis catheter exit sites was carried out; a new procedure was written in accordance with the research recommendations, as a result of the new procedure of care the exit site infections rate dropped dramatically.
This is the second publication on the results of studies of the whiskered auklet breeding biology on Buldir Island. In 1993, according to the time of chick hatching the egg-laying period began in late April-early May. The single egg was incubated by both parents, which relieved each other once a day, usually at early night. Among the chicks under observation, the first hatched on June 11; the median of hatching was on June 17. After hatching, the egg shell usually remained in the nest. The chick was continuously brooded by one of parents for the first several days but since the age of 7-9 days, it stayed in the nest by itself during the daytime. Each parent fed the chick once a day, at early night, although occasional feedings were recorded also during daytime and at dawn. A newly hatched chick was covered by typical embryonal (natal) down. The remiges, rectrices, their coverts, and large feathers on pteryla humeralis had a mesoptile stage during their growth (the second down generation). The juvenile plumage consisted of semiplumes of types I and II and contour feathers of type I and, possibly, type II. In fledglings, the ornamental feathers were underdeveloped: the crest was absent and facial plumes only began growing. By reaching 100 g, the chicks left their nests at the age of about 37 days. A longer nesting period than in other Aethia auklets appears to be related to a low feeding rate due to the nocturnal activity in the colony.
How many times have you heard from a third-party payer, "we don't have the claim"? Is it only the health insurance industry that has problems receiving its mail and electronic transmissions? Rather than spend time beating up on the payers, the author provides constructive and proactive approaches to help identify why claims fall into a black hole and how to avoid pitfalls.
This article is meant to serve as a general overview of the ADA and the regulatory areas that have the greatest implications for audiologists and speech-language pathologists. If you would like more detailed information, copies of the regulations and technical assistance are available from federal agencies (See Table 1) and through federally funded ADA technical assistance grants (See Professional Practices Perspective). Now it's time for a retest on the quiz.