Biomedical subjects
Publications and source records attributed to M L Bell.
Community health nurse managers require tested orientation methods to fit new employees into the rapidly changing conditions of professional practice, increase nursing productivity, and reduce turnover. The clinical competencies for community health nursing provide a workable framework for applying orientation principles to the special demands of community health nursing.
Nurse managers in community health can streamline the orientation of new employees by building planning and evaluation on a list of nursing skills that meet requirements for beginning practice. A model list of skills required in public health nursing and home health care can guide individual agencies in tailoring orientation programs to their respective needs, streamlining the process, reducing overall costs, and producing long-term benefits for nurse managers and nursing staff.
This study determined the relationship between the components of the cognitive map and the diploma nursing student's successful academic completion of the first semester. This ex post facto study applied the Modified Hill Cognitive Style Model (MHCSM) instrument; the final grade, the dependent variable, was intercorrelated with the instrument's 28 mapping elements. Data analysis indicated three positively correlated predictors: a preference for finding meaning from written words, for independent problem-solving, and for a logical deductive approach in decision-making. Four negatively correlated predictors included a preference for finding meaning from the spoken word, for finding meaning from sight, for problem-solving with peers, and for categorical reasoning. Implications applicable to nursing education are included.
The purpose of this study was to identify the anxiety profile of undergraduate nursing students when learning a complex psychomotor skill, and to determine the effect of preclinical skill evaluation on student anxiety and performance when applying the skill in a patient situation. Findings support preclinical skill evaluation as an effective strategy for reducing anxiety related to initial transfer of skill learning from a laboratory to a clinical setting and enhancing self-confidence.
Many sources of error exist in industrial hygiene measurements. Errors may be systematic or random. Eliminating or controlling systematic and random error during measurement, analysis, and data interpretation is a matter of aggressive quality control/quality assurance and appropriate statistical treatment of data. The occupational health care professional should be aware of error sources in industrial hygiene measurements and be on the lookout for flawed exposure estimates.
Cost-containment strategies initiated in the early 1980s caused a major shift in site of care delivery for persons needing nursing care. Where once the majority of clients were cared for in the acute-care setting until they were self-sufficient, now most are discharged to the home environment still requiring acute-care nursing interventions as well as community health nursing skills. This rapid shift in practice sites has placed severe strain on community health nursing agencies. Not only are more nurses required to fill the increased demand for services, but the demand comes at a time when we are experiencing a severe nursing shortage. This has forced many agencies to hire acute care nurses who have little or no community health nursing experience. These nurses come to community health nursing expecting to use the same set of skills and knowledge base used in their acute-care practice; however, the skill levels and concepts required for community health nursing are quite different from the acute care setting. Educational preparation has not kept pace with this shift in practice. Consequently, many nurses are not adequately prepared to enter community health nursing. Preparation must include theoretical and experiential components that focus on assessment skills (of the community and individual), decision making, case management, health systems management, teaching, and leadership. Collaborative efforts between community health organizations and educational institutions would seem to be one solution that would ensure adequately prepared nurses for community health nursing. The establishment and maintenance of strong staff-development programs within community health nursing agencies are also required.
A new commercial enzyme immunoassay kit for quantification of creatine kinase-MB (CK-MB) isoenzyme was compared with its electrophoretic determination with respect to efficacy in diagnosis of acute myocardial infarction. Enzygnost CK-MB (Behring Diagnostics) is a solid-phase "sandwich"-type enzyme immunoassay with antibodies to the B-subunit coated on plastic tubes and peroxidase-conjugated antibodies to the M-subunit added after incubation with sample. This kit is designed to measure only CK-MB and not CK-MM, CK-BB, adenylate kinase, or atypical CK molecules. The linear-regression equation comparing the two methods was: Enzygnost = 0.98 . electrophoresis - 0.72, with a correlation coefficient of r = 0.967 (n = 143). For 51 patients admitted for diagnosis of possible acute myocardial infarction, the Enzygnost kit achieved 100% sensitivity, specificity, and efficiency in predicting the correct diagnosis. Corresponding values for the electrophoretic assay were: 95.5% sensitivity, 93.1% specificity, and 94.1% efficiency. We conclude that this kit method provides an excellent alternative to electrophoresis.
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A novel method of affinity chromatography on insolubilized collagen-binding fragments of fibronectin was utilized to isolate a random-coil collagenous protein from culture media of mouse teratocarcinoma-derived endodermal cells. These cells also produced another collagenous protein, which did not bind to fibronectin but could be isolated by differential salt precipitation. The affinity-purified collagen differs from its conventionally isolated counterpart in that it is not triple-helical in structure, its polypeptides are not disulfide-crosslinked and it has affinity for fibronectin in its native state. Both collagens resemble previously characterized type IV basement-membrane collagens with respect to their amino acid composition, cyanogen bromide peptides, chain size, immunological reactivity and tissue localization. The random-coil collagen is directly active in promoting the attachment of some lines of cells, but for attachment of the endodermal cells addition of fibronectin is required. This suggests that the presence of nonhelical, fibronectin-binding collagen may have biological significance in the interaction of cells with the extracellular matrix.
Scalp reduction applies the principle of staged excision to the alopecic area in male pattern baldness. Two to rarely five excisions are performed as outpatient office procedures under local anesthesia. The reduction greatly enhances the results obtainable by supplementary hair transplantation and may reduce or eliminate the need for it. A personal series of 30 patients is presented. Technique and expected results are illustrated. Complications and limitations of the method are discussed. Wider consideration of scalp reduction in the treatment of patients seeking hair restoration is encouraged.
The affinity of fibronectin for collagen was exploited in biospecific affinity chromatography of collagen. Matrices with excellent capacity and stability were obtained by coupling collagen-binding fragments of fibronectin to Sepharose. Collagen-binding tryptic (30,000 daltons) and chymotryptic (45,000 daltons) fragments, lacking the binding sites of intact fibronectin for various other substances, were coupled to Sepharose and used to chromatograph gelatin and type I collagen. Gelatin was rapidly and quantitatively bound to these matrices at 4 degrees C and 37 degrees C, while binding of type I collagen took place more slowly and was temperature dependent. The collagen did not bind at 4 degrees C but bound quantitatively at 37 degrees C if preincubated at this temperature. These results suggest that a temperature-dependent perturbation of the triple helical structure of the collagen uncovers the binding site for fibronectin, allowing the collagen to bind to the insolubilized collagen-binding fibronectin fragments. Enzyme affinity assays showed that the conformational change in the fibronectin-binding region of collagen was irreversible. Affinity chromatography on collagen-binding fragments of fibronectin could provide a method for the study of structure and function of collagens and may prove useful for the isolation of minor collagens.
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Management by objectives, a system for stimulating growth and measuring performance in an organization, is explained, and its advantages for nursing management discussed. The author shows how to implement the system and how to make it succeed. Two examples of MBO in nursing are given: staff evaluation and patient care planning.
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Explore the source record for details and available documents.