Biomedical subjects
M Bowen
Publications and source records attributed to M Bowen.
Understanding people in groups.
The leader is the key to a successful group. A leader must communicate acceptance, warmth, and concern for others, because these human qualities are also related to effective group work. In addition to positive facilitation, however, the leader must be able to handle behaviors that disrupt accomplishment of the group's goals. By controlling the group, the leader can maintain a sense of security, which contributes to positive group functioning.
Let's talk about it. Communication in the OR.
1. Clear communication in the operating room promotes efficiency, reduces the chance of patient injury, and provides the support necessary for the staff to respond to high stress levels. 2. Stress, cultural or language barriers, differing education levels, and stereotyping are barriers to effective communication. 3. Positive communication techniques that are useful in the operating room include those that build rapport, provide support, communicate information, and promote problem solving.
Manipulators don't last in the operating room.
Certain characteristics of the operating room are not conductive to successful manipulation. Given these characteristics, individuals who relate to others in a manipulative style are less likely to be found the operating room, but instead will choose a setting where there is more opportunity to meet needs in a manipulative manner. Nevertheless, it is important for the manager to be aware of manipulative behavior and to respond appropriately when it does occur. A manager who can handle manipulation can ensure that manipulators do not last long in the operating room.
Tinnitus reaction questionnaire: psychometric properties of a measure of distress associated with tinnitus.
The development of the Tinnitus Reaction Questionnaire (TRQ), a scale designed to assess the psychological distress associated with tinnitus, is described. Psychometric analyses of the TRQ are examined with a total of 156 subjects in three separate samples. The results indicate very good test-retest reliability (r = .88) and internal consistency (Cronbach's alpha = .96). Factor analysis yielded four factors that were interpreted as General Distress, Interference, Severity, and Avoidance. Moderate to high correlations were found between the TRQ and clinician ratings (r = .67) and self-report measures of anxiety and depression (r = .58-.87), but a low correlation was found with neuroticism (r = .27). It is concluded that the TRQ provides a useful index of distress related to tinnitus for subject selection and clinical assessment and has potential as a measure of change in coping ability.
Helping the new nurse adjust to the OR environment.
1. The concept of culture shock can be applied to nurses who enter specialized areas of health care, where professionals with unique patterns of behavior and thinking are encountered. 2. The phenomena of communication, space, social organization, time, and environmental control can be used in assessing the OR environment and in easing the transition of new nurses. 3. Staff orientation periods need to include not only the transmission of technical information but also an understanding of the adjustments that must be made in terms of culture shock.
Intimidation and the nurse manager.
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Dry chemistry thin film immunoassay.
The authors report the development of a novel thin film multilayer immunoassay technology. The technology is applied to therapeutic drug monitoring and thyroid hormone testing in serum or plasma and can be extended to assays of other low molecular weight analytes. The assay detection range spans five orders of magnitude, from 1 x 10(-3) to 1 x 10(-8) M. The assay element comprises of multilayer coated chip, containing the active reagents in an agarose matrix and a plastic module serving both as a holder and a spreader. The assays are in the fluorescent competitive immunoassay format of the ligand displacement mode and are performed on an automated instrument with random access capability. The assays are fast and reliable and gave very good agreement when compared to reference methods.
Tension reduction in the operating room.
Muscle relaxation, altering stressful thought patterns, verbalization to supportive team members, time management, and humor are all effective tension relievers. Whereas muscle relaxation, altering thought patterns, and time management may be effective individual techniques, verbalization and humor are techniques that involve others and maximize the use of support from others. However, in every situation, personality, culture, background, and levels of stress affect reactions to tension and color the reactions of others to strategies used to reduce tension. Thus, in all cases, the situation must be carefully assessed, and timing, discretion, and selectivity are of vital importance if the strategy is to be used effectively. In addition to the nurse's knowledge of tension reduction strategies that can be used in the operating room, optimal function can be promoted by a total lifestyle that attends to coping directly with tension. Adequate periods of planned relaxation and exercise, planned time off, proper nutrition, and diet must also be part of a holistic approach to help prevent and reduce disabling tension.
The difficult doctor.
Nurses in the operating room may find themselves in interpersonal conflict with difficult doctors. It is important to remember that the relationship may be influenced by patterns of thinking and behavior learned in childhood, in one's culture, and through the professional socialization and education process. The nurse may be able to improve communication by assessing the difficult doctor's interaction, using approaches that will elicit cooperation, timing approaches strategically, avoiding approaches that will precipitate defensiveness, and using direct approaches.
Using confrontation in the OR.
Whereas some managers choose to avoid confrontation because it is likely to sound punitive or provoke self-defensive or aggressive responses, others use it extensively, believing that confrontation holds people accountable for their behaviors. The final decision on how much, when, and with whom to use confrontation must be based on a deliberate evaluation of the situation and the best judgment of the manager.
The OR nurse manager. Blending an autocratic and democratic approach to lead effectively.
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Pseudopsychopathic syndrome in hydrocephalus: a case report and review.
A 24-year-old man with a head injury developed a communicating hydrocephalus and underwent ventriculoperitoneal shunting. A revision was required, and the patient emerged from coma with severe behavior outbursts, which persisted for more than 1 year. Computed tomographic scans indicated a recurrence of low-pressure communicating hydrocephalus and a shunt revision was performed. The patient's severe behavior outbursts immediately decreased dramatically. The improvement continued long term and extended beyond the acute rehabilitation program.
Change: how to prepare for loss.
Adjusting to change is one of the most integral and yet most difficult tasks of the human experience. A variety of factors affect individual reaction to change, including unresolved childhood experiences with change, the degree to which change was anticipated, and simultaneous changes. Adjusting to change is an inevitable part of a health-care setting where change often appears to be the order of the day. The manager's ability to respond to change, to successfully separate from significant relationships and objects, and to reinvest in new relationships and objects is of vital importance to personal mental health and future job success. The manager also plays a key role in helping employees adjust to change by assisting them in planning for change, verbalizing feelings about the change, using support and coping strategies, avoiding hostile reactions, and focusing on the future.
Anxiety in the operating room: the manager's dilemma.
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Networking in the operating room.
Although managerial networking in the operating room takes on different dimensions than elsewhere in the nursing arena, networking is nevertheless an important concept for the OR manager. The manager's network can assist in achieving both personal and surgical department goals. This article has identified key aspects of developing a network and has outlined the benefits of networking in the operating room, including facilitating the exchange of information, interpersonal support, and establishing contacts. In addition, the OR manager's potential role as mentor and mentee in a professional network has been identified.
Posterior subluxation of the glenohumeral joint.
Twenty-four patients who had posterior subluxation of the glenohumeral joint were assigned to one of two groups on the basis of the severity of the symptoms. The sixteen patients in Group I, who had less severe symptoms, were treated with a physical therapy program that was based on exercises to strengthen muscles. The eleven patients in Group II (three of whom had no success with physical therapy when they were originally in Group I) had a posterior capsulorrhaphy, with or without a bone block. According to an over-all rating, Group I had a rate of success of 63 per cent, and Group II had a rate of success of 91 per cent. The patients who had more severe ligamentous laxity were not more likely to fail either of the treatment programs. Although voluntary subluxation may be a subtle but important indicator of underlying emotional difficulties, it appears that, in the patient who is emotionally stable, the ability to voluntarily subluxate the shoulder posteriorly is not associated with a negative prognosis for either non-surgical or surgical treatment. Patients who have moderately disabling posterior subluxation of the shoulder should be treated with an intensive program that is designed to strengthen muscles. Patients who have symptoms that are severely disabling or who have had no success with non-operative treatment should be treated with posterior capsulorrhaphy. When the posterior aspect of the glenoid is severely deficient and when the posterior portion of the capsule or the infraspinatus tendon is attenuated, a bone block should augment the reconstruction.
Bone morphometrics and tetracycline marking patterns in young growing American alligators (Alligator mississippiensis).
Nine young American alligators (Alligator mississippiensis) were injected at monthly intervals with tetracycline to determine the bone apposition rate and the resorption patterns over a 3-mo period. The periosteal apposition rate increased progressively over the 3-mo period from 2.99 microns/day to 5.94 microns/day. Endosteal apposition rate was much slower with incomplete tetracycline lines being observed on the endosteum. This suggests that most modeling-resorptive activities occur on the endosteal envelope.