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Biomedical subjects

M Halm

Publications and source records attributed to M Halm.

At least 19 recordsLinked to original sources
PubMed1999

Women and cardiac rehabilitation: referral and compliance patterns.

Heart disease is the primary killer among American women. Differences in referral for cardiac rehabilitation, as well as compliance rates, have been reported between male and female cardiac patients. This study explored the use of Phase I and Phase II cardiac rehabilitation programs by male and female patients. In particular, the study aimed to investigate the relationship between eligibility and subsequent referral to Phase II cardiac rehabilitation in both men and women, as well as their compliance rates in completing Phase II. In addition, for those patients who never started a Phase II program, their reasons for nonparticipation were explored. Structured patient interviews and chart audits were used to explore cardiac rehabilitation eligibility criteria, referral and completion rates. The sample consisted of 87 patients (46 women and 41 men) who were admitted with a medical diagnosis of angina, myocardial infarction, coronary artery bypass grafting, or valve replacement surgery. Men had higher eligibility rates for Phase I, whereas women had higher eligibility rates for Phase II; more men received a referral for Phase II from their physician than women did. Men had a higher completion rate with Phase II compared with women. For those patients who chose not to start a Phase II program, the most common reasons cited included transportation problems, insurance issues, and having exercise equipment at home. Although women are being referred for cardiac rehabilitation, fewer complete the programs. Continued education is essential to teach women the importance of cardiac rehabilitation to overall recovery and adaptation to an acute cardiac event. In addition, cardiac rehabilitation programs must be structured to meet the unique needs of women and thereby remove obstacles that have prevented higher participation rates by women in the past.

Adult↗
PubMed1998

Women and coronary disease: relationship between descriptors of signs and symptoms and diagnostic and treatment course.

BACKGROUND: Heart disease is the No. 1 killer among women in the United States. Differences in the clinical features of coronary heart disease among men and women have been reported, along with various approaches to the diagnostic workup and therapeutic interventions. PURPOSE: To explore the relationship between descriptors of signs and symptoms of coronary heart disease and follow-up care and to investigate any differences between male and female patients. METHODS: Structured interviews with patients and chart audits were used to assess initial signs and symptoms, associated cardiac-related signs and symptoms, and the diagnostic tests and interventions used for treatment. The sample consisted of 98 patients (51 women and 47 men) who were admitted with a medical diagnosis of myocardial infarction. RESULTS: Chest pain was the most common sign or symptom reported by both men and women. The 4 most common associated signs and symptoms were identical in men and women: fatigue, rest pain, shortness of breath, and weakness. However, significantly more women than men reported loss of appetite, paroxysmal nocturnal dyspnea, and back pain. Women were also less likely than men to have angiography and to receive i.v. nitroglycerin, heparin, and thrombolytic agents as part of acute management of myocardial infarction. CONCLUSION: Chest pain remains the initial symptom of acute myocardial infarction in both men and women. However, women may experience some different associated signs and symptoms than do men. Despite these similarities, men still are more likely than women to have angiography and to receive a number of therapies.

Adult↗
PubMed1996

Restructuring the clinical nurse specialist position to a unit-based role.

Role restructuring can be the key to maximizing efficiency, productivity, and operational effectiveness. The clinical nurse specialist role was restructured from a divisional project focus to a unit-based design to enhance the care of specific patient populations. The authors describe the process used to make this change, the outcomes achieved, and the lessons learned.

Efficiency, Organizational↗
PubMed1995

The antimicrobial activity of lactic acid bacteria from fermented maize (kenkey) and their interactions during fermentation.

A total of 241 lactic acid bacteria belonging to Lactobacillus plantarum, Pediococcus pentosaceus, Lactobacillus fermentum/reuteri and Lactobacillus brevis from various processing stages of maize dough fermentation were investigated. Results indicated that each processing stage has its own microenvironment with strong antimicrobial activity. About half of the Lact. plantarum and practically all of the Lact. fermentum/reuteri investigated were shown to inhibit other Gram-positive and Gram-negative bacteria, explaining the elimination of these organisms during the initial processing stages. Further, widespread microbial interactions amounting to 85% to 18% of all combinations tested were demonstrated amongst lactic acid bacteria within the various processing stages, i.e. raw material, steeping, 0 h and 48 h of fermentation, explaining the microbial succession taking place amongst lactic acid bacteria during fermentation. The antimicrobial effect was explained by the combined effect of acids, compounds sensitive to proteolytic enzymes and other compounds with antimicrobial activity with the acid production being the most important factor. The pattern of antimicrobial factors was not species-specific and the safety and storage stability of fermented maize seem to depend on a mixed population of lactic acid bacteria with different types of antimicrobial characteristics. This means that introduction of pure cultures as starters may impose a risk to the product.

Anti-Bacterial Agents↗
PubMed1995

Perceived changes in adult family members' roles and responsibilities during critical illness.

An exploratory design was used to study the effects of critical care hospitalization on family roles and responsibilities of adult family members and how these effects changed over time. A convenience sample of 52 subjects from pediatric, neonatal, surgical, medical, and cardiovascular intensive care units was used. Data were collected using an open-ended question contained in the Iowa ICU Family Scale (IIFS). Using qualitative techniques, seven themes were identified: (a) Pulling together, (b) Fragmentation of families, (c) Increased dependence, (d) Increased independence, (e) Increased responsibilities, (f) Change in routine, and (g) Change in feelings. These findings indicate that nurses need to implement family-centered interventions such as role supplementation programs or identification of support systems to decrease role strain and role overload in families during a crisis.

Adolescent↗
PubMed1994

Significance of yeasts and moulds occurring in maize dough fermentation for 'kenkey' production.

Yeasts and moulds associated with the fermentation of maize dough during the processing of the West African traditional food 'kenkey' were investigated. A mixed flora comprising Candida, Saccharomyces, Trichosporon, Kluyveromyces and Debaryomyces species were isolated from raw maize, during steeping and early phases of fermentation. After 24-48 h of fermentation, Candida krusei and Saccharomyces cerevisiae dominated reaching counts exceeding 10(6) cfu/g. This succession of yeast populations and the significant multiplication of C. krusei and S. cerevisiae were observed in all cases for both the fermentation and the production sites investigated. Penicillium, Aspergillus and Fusarium species, including potential mycotoxin producers, were isolated from raw maize. Initial high counts of 10(5) cfu/g for moulds were reduced to less than 10(2)cfu/g within 24 h of fermentation. High levels of aflatoxins were observed in raw maize, and they were not affected during the fermentations.

Aflatoxins↗
PubMed1994

Epidural analgesia for effective pain control.

Over the past decade, awareness of the harmful effects of postoperative pain has increased. These effects seem to be intensified in critically ill patients. Epidural analgesia has been shown to improve pulmonary function in the critically ill, including a reduction in frequency of intubation and tracheostomies and decreased length of mechanical ventilatory support. In addition, the heightened metabolic-stress response associated with pain may be averted, thereby reducing problems with fluid retention that may further compromise pulmonary status. As a result, epidural analgesia can lead to: shortened length of stay in the ICU overall decreased mortality rate improvement in quality of life As a pain-control method, epidural analgesia is gaining popularity in a variety of ICU patient populations. Therefore, critical care nurses need to update their knowledge base and nursing practice to provide safe and effective nursing care. State nurse practice acts and agency policies dictate the amount and type of involvement nurses have in caring for patients receiving epidural pain therapy. Potential life-threatening problems with epidural analgesia are rare. Many side effects can be controlled or prevented with appropriate patient selection and nursing management.

Analgesia, Epidural↗
PubMed1994

Emotional responses of family members during a critical care hospitalization.

BACKGROUND: The needs and satisfaction levels of family members of critically ill patients have received much attention in the literature. The feelings of family members, however, have not been thoroughly investigated. To develop appropriate nursing interventions to assist family members in coping with a critical care hospitalization, accurate information about their emotional response to the situation is needed. OBJECTIVE: To examine emotional responses of family members and their descriptions of supportive behaviors of others during a critical care hospitalization. METHODS: An exploratory design was used to study 52 subjects with critically ill family members in the pediatric, neonatal, medical, surgical and cardiovascular intensive care units in a large tertiary care hospital. The subjects kept daily logs of their feelings and the supportive behaviors of others. Thematic analysis was used to identify major themes. RESULTS: Analysis revealed a broad range of powerful emotions throughout the intensive care unit stay. Negative and positive emotions such as despair and joy were sometimes identified by subjects within a 24-hour period. Although fear, worry, anger and exhaustion were dominant themes during the first 24 hours and when the family received bad news about the patient, there was no pattern of emotional response evident as the stay progressed. Some differences between subjects drawn from the medical and neonatal intensive care units were evident. CONCLUSIONS: The findings suggest that family members of critically ill patients experience deep emotional turmoil throughout the intensive care unit stay. Specific nursing interventions to promote adaptive coping are needed throughout the experience.

Adolescent↗
PubMed1993

Microbiological and aromatic characteristics of fermented maize doughs for kenkey production in Ghana.

A very uniform microflora was demonstrated in 15 samples of fermented maize dough from different larger commercial production sites. At the advanced stage of fermentation, more than 96% of the bacteria present were morphologically and biochemically uniform, obligatively heterofermentative lactobacilli occurring in concentrations about 10(9) cfu/g. Yeast occurred in levels of about 10(6) cfu/g, dominated by Candida and Saccharomyces spp. Studies on microbial successions indicated a selection towards a micropopulation dominated by lactic acid bacteria. The Gram-negative bacteria, catalase-positive Gram-positive bacteria and moulds underwent three to four decimal reductions during the early phase of the process. The aroma components detected were dominated by lactic acid, acetic, butyric and propionic acids. Volatile aroma components demonstrated by gas chromatography and mass spectrometry were characteristic for lactic acid bacteria with acetoin and related products as typical examples.

Bacteria↗
PubMed1981

[Subclavian steal syndrome; results of operative treatment (author's transl)].

36 patients-average age 56 years--suffering from subclavian steal syndrome underwent surgery. No postoperative mortality. In a percentage of 84 the results obtained were satisfactory. In the 4 years period after the operation 7 patients died, 28 patients could now be followed up. Only in 2 cases the bypass became occluded in the intermediate time.

Angiography↗
PubMed1980

[Vein-bypass or endarterectomy in femoropopliteal reconstruction (author's transl)].

The authors report on 124 femoropopliteal arterial reconstructions in 112 patients. 6 years after surgery 23.6 percent of bypasses and 67.0 per cent of endarterectomised arteries were obstructed but 65.5 percent of patients with bypass procedures and 64.2 percent of the patients with endarterectomy were free from complaints.

Endarterectomy↗
PubMed1979

[Surgical management of reno-vascular hypertony (author's transl)].

Only in 2/3 out of a total of 33 patients suffering from renal artery stenosis surgery was indicated. Thrombendarterectomy and saphenous patch are the method of choice for reconstructive procedures. In 87% of successful reconstructions the functional result was satisfactory. The follow-up gave evidence of change to the worse due to the progress of the underlying disease.

Adult↗