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Biomedical subjects

M Nolan

Publications and source records attributed to M Nolan.

At least 73 records · Page 4Linked to original sources
PubMed1994

Choice and control for the disabled mother.

One-to-one maternity care is most appropriate to the disabled woman's needs. The midwife should find out about the sources of help available to the disabled mother--lay sources of support and information should be tapped as well as professional expertise. Vaginal delivery should not be ruled out and is possible in the majority of cases. While tiredness is a problem for any new mother, midwives should guard against 'taking over' too much responsibility from the disabled mother in the mistaken belief that they are 'helping'.

Persons with Disabilities↗
PubMed1994

Maternity care for the visually impaired.

Midwives should not express doubts about a blind woman's ability to cope but try to boost the woman's confidence and encourage her to build on her skills. The mother needs to understand that as her abdomen enlarges and her centre of gravity shifts, she may find it more difficult to assess her own body space and her relationship to other objects. Blind women appreciate continuity of care from a small number of known professionals and may prefer a home birth or domino scheme. For those who go to hospital, help with negotiating busy waiting areas, pulling up chairs and getting into bed is likely to be welcomed. The support of another blind mother is invaluable as experiences can be shared.

Adaptation, Psychological↗
PubMed1993

Action research and quality of care: a mechanism for agreeing basic values as a precursor to change.

This paper describes the trend apparent in nursing and other practice disciplines towards more participative and collaborative methods of enquiry as exemplified by action research. In so doing it notes the conceptual similarities between action research, change theory and quality initiatives. Particular attention is focused on the need to establish the basic values which provide the impetus and direction for subsequent activity. The difficulties this may pose are illustrated by reference to the application in two continuing care hospital wards for elderly patients of a checklist operationalizing a typology of care. A mechanism to facilitate and make explicit the values underpinning care in any given environment is suggested.

Aged↗
PubMed1993

Audit: an exploration of some tensions and paradoxical expectations.

There can be very few nurses, at the moment, whose daily activity is not in some way influenced by the notion of audit and related concepts. Yet despite an impressive growth in the literature relating to audit, conceptual clarity on a number of key issues remains elusive. This paper suggests that there are major tensions inherent in much of the current thinking about audit. In outlining the arguments supporting our position, we term these tensions primary and secondary. The potential effects of ignoring such tensions are illustrated by reference to the development of day hospital care for older people in the United Kingdom. This is used to highlight a number of paradoxical expectations and deleterious consequences for day hospital services which have arisen from a failure adequately to address a number of fundamental questions. The lessons to be drawn are then applied to audit in general, with particular reference to services for individuals with on-going health care needs.

Attitude of Health Personnel↗
PubMed1993

Rust out and therapeutic reciprocity: concepts to advance the nursing care of older people.

This paper considers the issue of the quality of nursing care for frail elderly patients in continuing-care environments. The continued failure to raise the standards of such care is explored and potential explanations sought. It is argued that the application of models of nursing do not represent the best solution and that there is a need for a fundamental re-appraisal of sources of job satisfaction for nurses working with such patients. Using the results of an evaluation of a respite care service two concepts, 'rust out' and 'therapeutic reciprocity', are identified as offering the basis for future research, education and practice developments in this field.

Aged↗
PubMed1993

Service evaluation: time to open both eyes.

This paper draws attention to issues raised by the present emphasis on service evaluation. It highlights in particular the limitation of many current models and argues the need to adopt a broad approach which takes account of the potentially disparate views of differing interest groups. The central tenets of a pluralistic model are presented and the benefits of such an approach are illustrated by reference to a recent evaluation of a respite care scheme for elderly people and their carers.

Clinical Competence↗
PubMed1992

Mid-range theory building and the nursing theory-practice gap: a respite care case study.

Nursing, with its historical roots in practice, has tended to have an uneasy relationship with theory. Whilst the benefits of theory to nursing have been propounded by many commentators, it remains that theory all too rarely informs nursing practice. This paper argues for the development and utilization of mid-range theories as representing a solution to this problem. The advantages of such an approach are illustrated by the application, testing and refinement of Chenitz's theory of relocation to a hospital-based respite care scheme for the frail elderly.

Adaptation, Psychological↗
PubMed1992

Acoustic evaluation of earmoulds in situ: a comparison of impression and earmould materials.

Laboratory research has been carried out on the accuracy of both ear impression and earmould materials. The present work was undertaken to assess such materials in vivo. An objective clinical method of earmould evaluation was developed, based on estimation of the attenuation in the acoustic feedback path. The method was used to assess the acoustic performance of earmoulds made from three earmould materials of different texture, when prepared from two different impression materials. It was shown that the choice of impression material made a significant difference to earmould performance. For greatest accuracy, addition cured silicone impression materials are recommended.

Adolescent↗
PubMed1991

Antenatal prediction of mother-infant difficulties.

A prospective study of 143 "low risk" pregnant women expecting their first baby was conducted in Newcastle, Australia. The study was designed to examine the contribution of a woman's perception of her own childhood experiences, her trait anxiety level, socioeconomic status, and social support network to difficulties in her relationship with her baby during the baby's first year. The women were initially interviewed during pregnancy and followed up 3 and 12 months postpartum. Follow-up measures included the Dimensions of Perinatal Adjustment, the Neonatal Perception Inventory, the Ainsworth Strange Situation, and information from hospital records, family doctors, and baby health centre sisters. Women who perceived their social network as less supportive during pregnancy were likely to see their one-year-old babies (p less than .05) as more difficult. The other antenatal measures were not significantly predictive of outcome.

Adolescent↗
PubMed1991

Factors influencing the efficacy of light cured materials for earmoulds.

This work was undertaken to investigate two systems for producing light-cured earmoulds, in order to evaluate the factors which influence the efficacy of such procedures. It was shown that there were variations in light intensity in the light boxes, and that the depth and age of gel in which curing takes place was important. Degree of cure of the materials was assessed by hardness measurements for hard materials and resistance to tearing for hard materials. Light-cured technology has great potential for the rapid production of earmoulds.

Equipment Design↗
PubMed1990

A reappraisal of the Malaise Inventory.

In recent years Rutter's Malaise Inventory has been used increasingly to measure levels of stress among those who care for people with dependency needs. Although there has been an element of dispute in the literature about the unidimensional nature of the scale, later work (Bebbington and Quine 1987) tends to suggest that Malaise Inventory scores can be used as a single internally consistent measure of stress. In this study consideration is given to the results of a national sample survey of 527 members of the Association of Carers (now Carers: National Association) which suggests the existence of two valid dimensions to the Malaise Inventory across a wider range of carer groups. Implications for future development and administration of the scale as a measure of stress are discussed.

Chronic Disease↗
PubMed1989

In vitro considerations in the production of dimensionally accurate earmoulds. II. The earmould material.

In the first part of this work, the accuracy of impression materials was studied. In the present paper, the dimensional accuracy of a range of hard and soft polymeric earmould materials was studied and found to be a function of choice of material, processing equipment, curing cycle, time after processing, and choice and storage time of impression material. It was noted that generally speaking the overall shrinkage of a two-stage specimen is approximately equal to the sum of the impression shrinkage plus processing shrinkage. Clinical trials are now being conducted to assess the real ear performance of earmoulds as a function of material accuracy and flexibility.

Acrylates↗
PubMed1989

The effects of sterilization on the accuracy of silicone ear impression materials.

The dimensional stability of a range of elastomeric impression materials has been assessed to study the effect of storage in sterilizing solutions. Experiments were carried out on audiological silicones of condensation and addition types. Further, a number of dental-based materials comprising a polysulphide, a polyether, a condensation and an addition silicone, were also investigated for comparison. The results indicate that the addition silicones had the greatest dimensional stability over a range of storage conditions, which included aqueous glutaraldehyde and hypochlorite solutions.

Ear, External↗
PubMed1986

Practical considerations in the fabrication of earmoulds for young babies.

The practicalities of fabricating earmoulds for young babies (under the age of 3 months) have been investigated. The results indicate that earmoulds can be satisfactorily fabricated provided there are changes in approach in the fabrication procedure. This applies in both the ear impression taking and in the format of the final earmould.

Acoustics↗
PubMed1985

Silicone materials for ear impressions.

Comparative properties have been determined for some commonly used ear impression materials (condensation reaction silicones) and some recently developed dental products (addition reaction silicones). Experiments have included measurement of dimensional stability, weight change on storage, viscosity, syringing characteristics, the energy required to tear the material and the stress relaxation characteristics. The major finding is that of the superb dimensional stability of the addition-cured silicones, which show no significant shrinkage over time. This is in contrast to a linear shrinkage of the order of 0.5% over a 48-hour period for the condensation silicones.

Dental Impression Materials↗