Biomedical subjects

Kathleen Benjamin

Publications and source records attributed to Kathleen Benjamin.

6 recordsLinked to original sources

PubMed2006

Patient choice: an influencing factor on policy-related research to decrease bedrail use as physical restraint.

BACKGROUND: This paper shows patients' enactment of choice in mixed methods, multidisciplinary study on the use of bedrails as restraints. APPROACH: Under the pressure of the implementation of impending legislation, patients from a Canadian elderly care rehabilitation unit were recruited to be part of this study and assigned to either a study or control group. Study group patients were exposed to a new facility policy on restraints in which bedrails were not to be used on a patient's bed except under specified conditions. Patients in the control group continued to have bedrails on a routine basis according to the facility's old policy. Following group assignments, patients could choose to crossover to either the control or study group based on their opinions about bedrails. FINDINGS: After patients crossed over into either the study or control group, findings for the new groups differed significantly. Participants in the rails-up group had lower admission Functional Independence Measure scores (p = .001) and higher admission Cumulative Illness Rating scores (p = .000) compared to those in the rails-down group. CONCLUSIONS: Patients have specific concerns related to the use of bedrails that might affect implementing bedrail minimization policies. Additionally, the authors conclude that patients' input into research design may increase patients' support of the protocol and help maintain study integrity.

Aged↗

PubMed2006

Broadening the patient safety agenda to include home care services.

Caring for an individual in the home is inherently complex. The physical environment, family dynamics and the cognitive abilities of the client and family members are only a few of the factors to be considered in delivering services. Although targeted initiatives have been established to reduce preventable injuries and deaths in the hospital sector, there has not been a corresponding level of research or patient safety initiatives in other healthcare delivery sectors. A coordinated and collaborative approach to generate new knowledge pertaining to safety in home care in Canada has therefore been undertaken by the Canadian Patient Safety Institute (CPSI), VON Canada, and Capital Health (Edmonton). Actions included the development of a background paper (Lang and Edwards 2006) that informed an invitational roundtable discussion, where key safety issues in home care were identified and priority actions discussed. Over 40 individuals from across Canada participated, reflecting various disciplinary and organizational affiliations in the delivery of home care services. This paper describes key findings from the background paper, outcomes from the ensuing roundtable discussions and implications for practice, research and policy.

Canada↗

PubMed2005

Part 1. Injuries to the brachial plexus: mechanisms of injury and identification of risk factors.

Upper-arm weakness (paresis) or paralysis indicates peripheral-nerve damage to the brachial plexus, a network of lower cervical and upper thoracic spinal nerves supplying the arm, forearm, and hand. Physical findings reflect muscle paralysis from spinal nerve roots. The mechanism of injury includes maternal, obstetric, and infant factors that apply traction on or compression to the anatomically vulnerable brachial plexus. Nerve regeneration can occur if nerve tissue components are preserved. Recovery is affected by multiple factors, including the type and site of injury, intervention timing, and developmental factors. The majority of injuries recover in days or months; however, residual deficits can persist. Part 1 of 2 of this article provides an overview of the neurophysiology of peripheral-nerve damage and nerve regeneration. The multifactorial etiology of brachial plexus injuries will be reviewed. Photographs and on-line video clips will enhance the description of the brachial plexus injury classifications and illustrate mechanisms of shoulder dystocia and obstetric relief maneuvers. A systematic approach to the physical examination will be explored in Part 2. Serial evaluation of motor function recovery is essential and is accomplished by appropriate referrals and follow-up. Part 2 will also describe treatment options and discuss anticipatory parent guidance.

Birth Injuries↗

PubMed2005

Part 2. Distinguishing physical characteristics and management of brachial plexus injuries.

Brachial plexus injuries (BPI) are usually readily apparent at or shortly after birth. Failure of caregivers to recognize and appropriately treat BPI may contribute to the risk of life-long neuromuscular dysfunction for the infant and represents a serious medical-legal liability for the delivery provider. This article is the second in a series on BPI and provides a standard classification and a systematic guide to physical examination of the infant with suspected BPI. Conditions that mimic BPI are discussed along with diagnostic studies used to confirm this disorder. The natural history and predictors of outcome are presented along with a sample treatment protocol. Pictures and video clips are provided to enhance the reader's understanding of the consequences of this injury and the potential for improvement with surgical treatment. Useful Internet resources for parents, focused discharge planning, and guidelines for appropriate monitoring and follow-up are provided. Advantages of early referral and management by a multidisciplinary team at a brachial plexus specialty center are discussed.

Birth Injuries↗

PubMed2005

Attitudinal, perceptual, and normative beliefs influencing the exercise decisions of community-dwelling physically frail seniors.

For seniors, an inactive lifestyle can result in declines in mental and physical functioning, loss of independence, and poorer quality of life. This cross-sectional descriptive study examined theory-of-planned-behavior, health-status, and sociodemographic predictors on exercise intention and behavior among 109 older and physically frail adults. Significant predictors of being a high versus a low active were a strong intention to continue exercising, positive indirect attitudes about exercise, and having been advised by a doctor to exercise. Findings indicate that a strong intention to continue exercising differentiates between those who report low levels and those who report high levels of physical activity. The results also highlight the salience of physician's advice for seniors to exercise.

Aged↗

PubMed2002

Scrotal and inguinal masses in the newborn period.

Scrotal or inguinal masses may represent inguinal hernias, hydroceles, or testicular torsion and are common findings in the newborn period. The clinician is challenged to differentiate between normal, abnormal, atypical, and pathologic findings and to seek urgent surgical consultation when compromised bowel, testis, or ovary is suspected. This issue of Focus on the Physical offers a review of the embryologic development of the processus vaginalis and testicular attachments to enhance the clinician's understanding of the development of these conditions. Systematic advanced physical assessment techniques will be provided along with pictures of common clinical findings. A brief discussion of the diagnostic studies that aid in differentiation of scrotal and inguinal masses and the clinical implications of each of these conditions will be discussed.

Diagnosis, Differential↗