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Biomedical subjects

K Heller

Publications and source records attributed to K Heller.

At least 73 records · Page 4Linked to original sources
PubMed1990

Surgical techniques in short bowel syndrome.

An operation according to Bianchi in a 2-year-old girl is described and indications as well as technical procedure are discussed. The girl was born with a gastroschisis. There was a jejunal perforation 10 cm below the ligament of Treitz caused by a volvulus. Only 20 cm of the jejunum remained. Moreover, only the left part of the colon was present. Total parenteral nutrition for 2 years was necessary. The principle of the operation is based on a longitudinal division of the remaining bowel and a creation of two separate bowel tubes out of the divided bowel halves, thus effecting an isoperistaltic serial connection by means of two anastomoses. This is technically possible since each half of the bowel wall has its own blood supply. The vessels originating from the mesenterium branch off before they reach the bowel wall so that the mesenteric dissection line can be anastomosed longitudinally with the antimesenteric border. This results in doubling of the bowel length, narrowing of the preoperatively dilated bowel diameter, closer contact of bowel contents with the mucosa, prolonged transit time and a Bacteroides colonization which is reduced by more effective peristalsis. Indications, time of operation and our own experiences are discussed and three cases are described. All children are alive and show marked improvement in nutrition.

Anastomosis, Surgical↗
PubMed1990

Attributional style in aggressive adolescent boys.

Past research suggests that aggressive children misattribute hostile intentions to peers during ambiguous provocative interactions. This study sought to extend the analysis of attributional differences between aggressive and nonaggressive boys to a sample of court-involved adolescents and their perceptions of interactions involving both peers and adults. Three groups of youngsters (nonoffenders, nonaggressive offenders, and aggressive offenders) participated in a structured interview and provided causal attributions for interpersonal problems commonly faced by teenagers. Results indicated that offenders were more likely than nonoffenders to attribute blame to others in ambiguous problem situations. Among offenders, external, person-centered blame attributions were significantly related to aggressiveness. This relationship was found only in ambiguous situations, and the correlation between such person-centered attributions and aggressiveness was higher in adult-oriented interactions than in peer-oriented ones. Overall, the results suggest that aggressiveness among offenders is associated with an attributional style that is characterized by the tendency to attribute blame for problems in ambiguous interactions to global, dispositional characteristics of others.

Adolescent↗
PubMed1990

Facets of support related to well-being: quantitative social isolation and perceived family support in a sample of elderly women.

The purpose of this study was to examine the independent and interactive relationships of measures of network embeddedness and perceived social support with mental and physical health measures from responses of a sample of 271 community-dwelling elderly women. Quantitative social isolation was measured as the co-occurrence of low network embeddedness with family and with friends. There was a threshold effect such that quantitatively isolated participants had poorer psychological well-being and functional health than did nonisolated participants. This effect was independent of perceived support levels. The pattern was different for perceived social support. Elderly women with low perceived family support had poorer psychological well-being regardless of perceived support from friends or network embeddedness. Implications are discussed for several unanswered questions in the social support literature, including possible interventions for the quantitatively isolated and for those with low levels of perceived support.

Aged↗
PubMed1990

A measure of relational competence for community-dwelling elderly.

A measure of relational competence was developed to assess the skills necessary for peer friendship development among the elderly. Participants were required to respond to a series of social problem vignettes that were constructed to tap empathy, assertion, and role-taking skills. Validation data were collected as part of a larger project designed to establish indigenous, elderly peer-support telephone dyads among low-income, community-dwelling elderly women. Results indicated that the measure of relational competence was related to initial friendship formation, telephone conversational skills, and rated social competence as determined by judges' ratings of 2 telephone conversations between participants and staff members. The research illustrates the usefulness of moving away from trait conceptions of social competence to a more focused consideration of particular task demands and the skills needed to solve age-linked social problems.

Activities of Daily Living↗
PubMed1990

[Effect and correlation of various risk factors in the development of retinopathy of prematurity. A retrospective study of 338 premature infants].

The statistical significance of ophthalmological and pediatric findings in the development of retinopathy of prematurity (ROP) was evaluated in a retrospective study of 338 premature infants. Short gestation time, frequent hypoxia, and low birthweight were strongly correlated with advanced stages of ROP. The influence of Vitamin E treatment, duration of oxygen therapy, and need for transfusions was less significant. Neither multiple births nor the infant's sex had any influence on the development of ROP. Cryotherapy appears to reduce ROP, but the number of cases in the present study was too small to permit statistical analysis.

Birth Weight↗
PubMed1989

Ethical dilemmas in community intervention.

Ethics code books provide only general guidelines and are inadequate in resolving explicit ethical dilemmas that frequently occur in community intervention. Ethical choices often reflect personal values as well as professional role proscriptions and are difficult to resolve for a number of reasons. It often is not clear to whom the interventionist should be accountable, or what the long-range impact may be of specific programs that seem to have short-term benefit. Value clashes can occur between consultants and consultees, even when both groups believe that they represent the best interests of vulnerable client groups. Since personal values are important determinants of ethical choices, whenever possible, they should be communicated openly so community groups can understand the interventionist's values before community projects begin. It also is important to share ethical dilemmas with professional colleagues in order to provide community psychologists with constructive feedback from their professional peers, and to help others anticipate similar value conflicts in their own work. These points are illustrated by discussion of the vignettes presented by O'Neill (1989) and by additional examples drawn from my own experience.

Adolescent↗
PubMed1989

[Short bowl syndrome and quality of life in childhood].

From 1985 to 1988, six patients suffered from short gut syndrome due to congenital malformations. The children were aged 4-24 months at the time of the operation in which the gut was doubled in length by a Bianchi procedure. It is necessary to interview the parents about their own and the child's psychological and physical stress during the pre- and postoperative periods. Collective reactions were found which must be considered for indication and time of operation.

Adaptation, Psychological↗