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Biomedical subjects

M Allen

Publications and source records attributed to M Allen.

At least 325 records · Page 18Linked to original sources
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The nature of advanced practice nursing.

In attempting to define "advanced practice," we argue that nursing as such is teleological or goal-directed with those goals being defined by the patient or client in interaction with the nurse. In helping the patient meet identified goals, the nurse requires 2 kinds of knowledge-general and particular. General includes theory (know what/why), pattern recognition (know what), and practical knowledge (know how). Particular (know who) is personal knowledge about the patient. The advanced practice nurse, by virtue of graduate education, is able to move beyond the familiar and experientially learned. He or she makes a deliberate attempt to situate self in a dialectic between general and particular knowledge in such a way that the interplay opens possibilities. Knowing when a particular action would be most helpful is defined as practical wisdom. We argue that a highly developed sense of practical wisdom is the hallmark of advanced practice.

Education, Nursing, Graduate↗
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Augmentation mammoplasty: a complex choice.

Augmentation mammoplasty is a surgical procedure with known risks and complications. Despite this, millions of women have opted to undergo the procedure. With the recent publicity surrounding this procedure, and the current concern about long-term side effects, the rationale behind women's choice has been questioned. Often, health care professionals are less than empathetic when a women complains about experiencing complications. This attitude seems to "blame the victim." We examine the complex psychological and sociological factors behind a woman's decision to have her breasts enlarged artificially. It is our hope that the information presented herein will contribute to a better understanding and more compassionate care of women who have breast augmentation surgery.

Attitude of Health Personnel↗
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Prescribing exercise for cardiac patients: knowledge, practices, and needs of family physicians and specialists.

PURPOSE: To determine the following about prescribing exercise for cardiac patients: physicians' present and needed knowledge; their present practices; barriers that hinder them; and perceived need for and content of a protocol for prescribing exercise. METHODS: (1) Questionnaire mailed to 371 family physicians (FPs), 31 internists, and 25 cardiologists; and (2) four focus groups consisting of 25 FPs, 1 internist, and 3 cardiologists. RESULTS: Questionnaire response rate was 45% (n = 192). Because responses were similar and the group was small, internists and cardiologists were combined as "specialists." Generally, questionnaire data agreed with focus group data, with the latter providing more detail. Family physicians perceived they know little about prescribing a specific exercise program while specialists perceived they know little about motivating patients to begin an exercise program. The method most frequently used by both physician groups to increase exercise is providing general advice. The main barriers to prescribing exercise were inadequate knowledge (FPs only), patient education materials, and community resources. Both groups rated highly the need for a protocol for prescribing exercise and indicated it should: (1) include identification of patient's stage of change; (2) include indications and contraindications for exercise; (3) provide guidelines for developing a specific exercise prescription; (4) contain patient education materials, and (5) be simple and short. CONCLUSIONS: Family physicians perceive they know little about prescribing a specific exercise program for cardiac patients while specialists perceive they know little about motivating patients. Physicians rate highly the need for a protocol to help them prescribe exercise for cardiac patients.

Adult↗
PubMedDate not supplied

Endoscopic documentation of unintentional perforation of the dividing membrane during amnioreduction for twin-twin transfusion syndrome.

OBJECTIVE: The purpose of this report is to document endoscopically the occurrence of unintentional piercing of the dividing membrane in a monochorionic twin pregnancy with twin-twin transfusion syndrome (TTTS). MATERIALS AND METHODS: The dividing membrane was visualized endoscopically during laser therapy in a patient with TTTS who had previously undergone therapeutic amniocentesis. The donor twin had no visible bladder, but the amniotic fluid volume had normalized after amniocentesis. RESULTS: The suspected membrane perforation was identified endoscopically during laser surgery. Five areas of vascular communications were identified and photocoagulated. CONCLUSIONS: Sonographic evidence of normalization of the amniotic fluid volumes after therapeutic amniocentesis with persistent nonvisualization of the bladder of the donor twin should not be interpreted as a sign of improvement of TTTS, but rather as indirect evidence of unintentional perforation of the dividing membrane. This complication can be confirmed endoscopically.

Adult↗
PubMedDate not supplied

Fine needle aspiration cytology of mammary pseudoangiomatous stromal hyperplasia. A case report.

BACKGROUND: Pseudoangiomatous stromal hyperplasia (PASH) is an unusual benign breast lesion that may occasionally present as a palpable mass. CASE: This report describes the fine needle aspiration cytology (FNAC) features of a case of mammary PASH that presented as a palpable mass. This is the second description of the FNAC features of this lesion and the first reported case in which a diagnosis of phyllodes tumor was considered. The aspirate was cellular and contained cohesive groups of cells in which there was a dual population of epithelial and myoepithelial cells. Occasional cellular stromal fragments were present, as were typical, bipolar, bare nuclei. Admixed with the bare nuclei were large numbers of plump, spindle-shaped cells, some with intact cytoplasm. Histologic examination of the excised mass showed features typical of PASH. CONCLUSION: Mammary PASH may present as a palpable mass and is likely to be encountered in FNAC specimens. This diagnosis should be considered when one is confronted with an aspirate containing cohesive epithelial groups, cellular stromal fragments and large numbers of single, spindle-shaped cells. These features on FNAC may result in consideration of a phyllodes tumor. The single, spindle-shaped cells may be a characteristic cytologic feature of PASH.

Adult↗
PubMedDate not supplied

Comparison of registered nurses' and nursing assistants' choices of intervention for aggressive behaviors.

This article extends the work conducted by Fagan-Pryor, Femea, and Haber (1994), in which factor analyses were used to examine the congruence between aggressive behavior and type of intervention warranted (verbal, chemical, or physical), as rated by nursing personnel. The purpose of this study was to determine if 88 registered nurses (RNs) and 84 nursing assistants (NAs) would choose similar interventions for 84 aggressive behaviors. The three scales used (labeled Precursor, Defensive, and Acting Out) obtained Cronbach alpha internal consistency reliabilities ranging from .79 to .96. Analyses of variance indicated that RNs and NAs agreed on a set of precursor behaviors for which they would use therapeutic verbal intervention. RN and NA responses differed significantly only in prescribing the use of physical intervention for behaviors on the Defensive and Acting Out scales. In both situations, RNs selected fewer behaviors that required physical intervention than did NAs. Implications for clinical practice are presented.

Aggression↗
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Stigma and blindness.

Moral disapproval, denigration, and avoidance are part of the stigma toward persons with blindness, as well as other chronic diseases. This stigma can affect adjustment, leading to decreased social and self-acceptance. Health-care professionals share the value and beliefs of society, and by their actions may contribute to the discrediting of the individual. Strategies can be used to increase awareness of the attitudes that health-care professionals hold, as well as assisting blind persons to manage their stigma.

Blindness↗