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Biomedical subjects

M Gray

Publications and source records attributed to M Gray.

229 records · Page 13Linked to original sources

Continence for women: evaluation of AWHONN's third research utilization project. Association of Women's Health Obstetric and Neonatal Nurses.

OBJECTIVE: To develop an evidence-based protocol for initial evaluation and treatment of urinary incontinence and to design procedures that would facilitate the protocol's implementation into clinical practice. DESIGN: Descriptive report of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) Continence for Women Project. SETTING: Twenty-one public, private, and other women's health sites. PARTICIPANTS: Women in ambulatory care settings (N = 1,474) provided demographic statistics. METHODS: The protocol was developed, sites were selected, site coordinator training was provided, data collection was facilitated by project-specific teleforms, and the overall process was evaluated by the science team. MAIN OUTCOME MEASURES: Site representation, patient representation, site coordinator feedback on the training program, and site coordinator experience during project implementation. RESULTS: The process yielded a representative mix of site and patient diversity appropriate for testing of the protocol. Site coordinators felt well-prepared to implement the protocol and experienced increased professional satisfaction because of therapeutic benefits achieved for patients and positive collaboration with physicians. CONCLUSIONS: The Continence for Women Project demonstrated the potential for developing and testing evidence-based protocols for clinical practice when the resources of an organization such as AWHONN and the research community are combined.

Adult↗

Continence for women: a test of AWHONN's evidence-based protocol in clinical practice. Association of Women's Health Obstetric and Neonatal Nurses.

OBJECTIVE: To test the effectiveness of an evidence-based protocol for urinary incontinence in increasing identification of women with the condition and improving their outcomes. DESIGN: Prospective formative evaluation study. SETTING: Twenty-one public, private, and other women's health care sites. PARTICIPANTS: Women in ambulatory care settings (N = 1,474) provided descriptive statistics. Clinical outcomes were tested in 132 cases for whom pre- and posttreatment data were available. INTERVENTIONS: Standardized screening and baseline follow-up forms were used to minimize time burden on clinicians; bladder and pelvic floor muscle training materials were provided to clinicians for distribution. MAIN OUTCOME MEASURES: Self-reported frequency, volume, and quality of life related to incontinence and cost of self-management were used to assess protocol effectiveness. RESULTS: Frequency of incontinence episodes, estimated volume lost per episode, and the cost of self-management decreased. Quality of life improved, as reflected in decreased bother attributed to incontinence and in the number of women avoiding activities such as shopping, exercising, or travel because of incontinence. CONCLUSIONS: This simple program of pelvic floor muscle and bladder training, as it has been systematically implemented in a variety of ambulatory women's health care settings, has benefited women's continence status. The results of this project strongly support widespread application.

Adult↗

Are ball pits the playground for potentially harmful bacteria?

Ball pits, enclosed play areas with padded floors and pits of small plastic balls, have become popular features for children at fast food restaurants. This pilot study sought to identify and confirm bacterial organisms that place children at a potential health risk in three play pits within fast food restaurants. Data for this descriptive study were randomly collected from restaurants offering play pits with multicolored, round, hollow, plastic balls within urban communities of the Tidewater region of Virginia. Specimens were collected from entrances into the ball pits as well as various areas of the bottom lining to incur a representative sample. Results indicated an increased level of normal flora as well as nonhuman flora, demonstrating that bacteria are present within the ball pits. The results question the safety of these play pits for both health care providers and parents. Nurses play a vital role in public awareness through health education. Disinfection protocol and proper handwashing are the keys to making ball pit play areas safe for children.

Bacterial Infections↗

Mechanisms of lidocaine kinetics in the isolated perfused rat liver. I. Effects of continuous infusion.

The mechanisms of time-related reduction in lidocaine clearance were studied using a "one-pass" perfused rat liver system. Lidocaine was infused continuously for a period up to 150 min (concentration ranged from 9.6 to 278 microM). The time required for lidocaine to achieve steady state in the effluent ranged from 20 to 90 min. Analysis of material balance suggested that capacity-limited tissue binding was partially responsible for determining the time to steady state. The characteristic rise of monoethylglycinexylidide to a maximum within 5 min and decline to a stable level during constant lidocaine infusion suggested that the deethylation pathway may be partly deactivated. This observation could be the major determinant for the time-dependent effects of lidocaine elimination. Saturation of metabolism, mainly hydroxylation, and product inhibition by monoethylglycinexylidide did not reduce the extraction of lidocaine significantly. The dose-related reduction in lidocaine elimination is believed to have little contribution to the time effects of lidocaine.

Animals↗

Atraumatic urethral catheterization of children.

Urethral catheterization is often perceived by the child and parents as an invasive and painful procedure. However, with adequate preparation of the child and skill on the part of the nurse, the discomfort and anxiety associated with catheter insertion can be dramatically reduced or avoided. Preparation of the child must be tailored to the child's developmental level as well as the parents' needs. Discomfort is minimized if the nurse chooses an appropriate size and type of catheter, and prepares the urethra with local anesthetic. Special strategies are necessary for children who have been sexually abused, children with myelodysplasia, those who have undergone urological surgery, and boys with epispadias or classic exstrophy.

Adolescent↗