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Biomedical subjects

L Simpson

Publications and source records attributed to L Simpson.

230 records · Page 13Linked to original sources
PubMedDate not supplied

A central role for adenosine in the hypotension elicited by hypoxia in anesthetized rats.

Brief inhalation of an oxygen-deficient (5%) gas mixture evoked a rapidly developing, profound hypotension in anesthetized rats. Recovery upon reoxygenation was also rapid. A potential involvement of adenosine in the genesis of this hypotension was evaluated with various peripherally administered adenosine antagonists. Caffeine (10 mg/kg), which readily crosses the blood-brain barrier, significantly attenuated the hypoxia-evoked hypotension. 8-p-Sulphophenyltheophylline and xanthine amine congener, which do not readily penetrate the blood-brain barrier, had little effect on the magnitude of the hypotension. The data suggests that hypoxia-elicited hypotension in anesthetized rats results from the activation of central adenosine receptors.

Adenosine↗
PubMedDate not supplied

Relationship between peripheral intravenous catheter Dwell time and the development of phlebitis and infiltration.

The purpose of this study was to evaluate whether lengthening the dwell time of peripheral i.v. catheters from 72 hours to 144 hours resulted in increased rates of phlebitis and/or infiltration. The study was conducted in medical/surgical units at a 110-bed teaching hospital with an i.v. team. Kaplan-Meier estimates of the success and failure and conditional failure probabilities were calculated for phlebitis and infiltration scores. Log rank tests were used to test for an association between the covariates and the time until failure. Drug irritation was the most significant predictor of phlebitis and infiltration rates in this study. The total difference in the estimated failure rates for the catheter lasting 6 days versus a new catheter inserted for another 3 days is 1.3%. Because the conditional failure probability estimates for days 4, 5, and 6 are slightly higher than for days 1, 2, and 3, consideration may be given to extending the dwell time of a peripheral i.v. catheter beyond 72 hours under certain circumstances.

Adult↗
PubMedDate not supplied

Pediatric environmental health: perceptions from a survey questionnaire.

To expand the base of knowledge regarding perceptions about potential environmental threats to children's health, a survey was conducted in the Northwest United States. Samples of Head Start parents, PTA presidents, public health officials, school nurses, naturopathic physicians, family practitioners, and pediatricians were mailed a questionnaire inquiring into the nature and degree of concerns about pediatric environmental health. The response rate was 24%. Trends in the data showed disparities in perceptions regarding levels of concern and exposure concerns between respondent categories. Disparities also existed regarding information resources used for children's environmental health. Recognizing differences in perceptions of children's environmental health, as demonstrated in these results, may be useful for risk communication and resource allocation, especially in the context of the wide variety of health belief models. Such knowledge may help clarity situations with environmental health risk concerns, including clinical, public health, and educational circumstances.

Adult↗
PubMedDate not supplied

Annual report on access to and utilization of health care for children and youth in the United States--2000.

OBJECTIVE: This report provides an update on insurance coverage, use of health care services, and health expenditures for children and youth in the United States. In addition, the report provides information on variation in hospitalizations for children from a new 22-state hospital discharge data source. METHODS: The data on insurance coverage, utilization, and expenditures come from the Medical Expenditure Panel Survey. The data on hospitalizations come from the Database for Pediatric Studies, which is part of the Healthcare Cost and Utilization Project. Both data sets have been prepared by the Agency for Healthcare Research and Quality. RESULTS: Few changes in insurance coverage occurred between 1996 and 1998. About two thirds of American children are covered by private insurance and 19% by public sources; the remaining 15% are uninsured. Of the 71.5% of children who have at least 1 doctor's office visit, the average number of visits was 3.9, but this ranged from 2.7 among the uninsured to 4.2 for those with private insurance. Slightly more than half of children had a prescription, and these averaged 5.4 prescriptions. The majority of children (85%) incur medical expenditures, averaging $1019 for children with any expenditure. Private health insurance was by far the largest payer of medical care expenses for children, even more so than among the general population. However, nearly 21% of expenditures for children's health care were paid out of pocket by children's families. The data also show substantial differences in average length of hospitalization across states, ranging from 2.7 to 4.0 days, and rates of hospital admission through the emergency department, which vary across states from 9% to 23%. Injuries are a major reason for hospitalization, accounting for 1 in 6 hospital stays among 10- to 14-year-olds. In the 10-17 age group, 1 in 7 hospital stays are due to mental disorders. Among 15- to 17-year-olds, more than one third of all hospital stays are related to childbirth and pregnancy. CONCLUSION: Children's use of health care services varies considerably by what type of health insurance coverage they have. Expenditures for children entail a substantial out-of-pocket component, which may be quite large for children with major health problems and which may represent a significant burden on lower-income families. Substantial variation in hospitalization exits across states.

Adolescent↗
PubMedDate not supplied

Stress incontinence in younger women: prevention and treatment.

Urinary stress incontinence is prevalent in older people, but it has also been found to affect fit nulliparous women. Building pelvic floor muscles with pelvic muscle exercises helps to treat stress incontinence in women, but if exercises are begun at an early age, it is also effective in reducing the incidence of stress incontinence later in life.

Adolescent↗
PubMedDate not supplied

Indwelling urethral catheters.

Lesley Simpson discusses the risks associated with indwelling urethral catheters and identifies how nurses can reduce them with proactive management.

Aged↗
PubMedDate not supplied

Prenatal care needs assessment comparing service use and outcomes in Fresno, CA.

The authors performed a prenatal care needs assessment for Fresno County, CA, using data from a sample of 11,878 birth certificates for the county for 1989. Birth records, patterns of prenatal care utilization, and low birth weight outcomes in the county were compared with those in a random sample of 11,826 certificates derived from births in the remainder of the State. Bivariate techniques were used in calculating care utilization rates. Multivariate logistic regression analysis was used in associating rates of prenatal care visits and gestational month of initiation of prenatal care with low weight birth outcomes. County women entered prenatal care as early as women in the remainder of the State, but did not return as often for prenatal care visits. Their rate of return for followup visits was 29.9 percent, compared with 24.8 percent for women in all other counties (P < 0.001). County women with the lowest rates of visits had 1.4 to 1.9 times the risk of having a low weight birth than other county women with higher rates of visits, and a significantly higher risk than for women of all other counties. An intensive visit schedule for high-risk care was provided 28.9 percent of county women, compared with 33.0 percent of women in all other counties (P < 0.001). County women who received a high-risk intensive visit schedule were 2.5 times more likely to have a low weight birth than county women who did not receive the schedule. For all other women in the State, the comparable risk was 2.1 times. Improvements in the number and content of prenatal care visits were shown to have a high likelihood of substantially improving birth weight outcomes for pregnancies among Fresno County women.

Adolescent↗
PubMedDate not supplied

Outcomes of enhanced prenatal services for Medicaid-eligible women in public and private settings.

OBJECTIVE: With changes in Medicaid, more low-income women are receiving prenatal care in private practice settings. The authors sought to determine whether private settings can provide the enhanced prenatal support services for low-income women that have been offered for decades in public settings. METHODS: The authors analyzed birth outcomes of Medicaid-eligible women receiving care from public and private providers certified to deliver enhanced prenatal care services, which included assessments of nutritional, psychosocial, and health educational risks and individualized counseling along with clinical care. Birth outcomes were compared by type of provider setting using multivariate logistic regression models to adjust for differences in risks and use of care. RESULTS: Among settings certified to deliver enhanced perinatal support services, private physicians' offices had the best risk-adjusted birth outcomes and public health department clinics the worst, while public hospital clinics had outcomes no different from private physicians' offices. Adjusted for prenatal care use, outcomes were still better for women seen in private physicians' offices than for women seen in public health department clinics, community clinics, or private hospital clinics. CONCLUSIONS: The findings suggest that given a certification process, private providers can provide enhanced support services as effectively as providers in public practice settings.

Ambulatory Care Facilities↗