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Biomedical subjects

M S Nelson

Publications and source records attributed to M S Nelson.

At least 19 recordsLinked to original sources
PubMed2001

When the visit to the emergency department is medically nonurgent: provider ideologies and patient advice.

It is estimated that more than half of pediatric hospital emergency department (ED) visits are medically nonurgent. Anecdotal impressions suggest that ED providers castigate medically nonurgent visits, yet studies on such visits are scarce. This study explored the perspectives of 26 providers working in the EDs of two urban hospitals regarding medically nonurgent pediatric ED visits and advising parents or guardians on appropriate ED use. Three provider ideologies regarding the appropriateness of medically nonurgent ED use were identified and found to be linked to particular communication strategies that providers employed with ED users: restrictive, pragmatic, and all-inclusive. The analysis resulted in the development of a typology of provider ideological orientations toward ED use, distinguished according to different orientations toward professional dominance.

Attitude of Health Personnel↗
PubMed2001

Mental health consultations in the preschool daycare center.

This article explores some of the challenges to children's emotional and social development inherent in the all-day childcare programs for children aged 3 to 5 years. The psychoanalytically oriented child development community has offered ongoing assistance, information, and support to teachers, parents, and children in preschools and preschool daycare sites in a number of communities across the country. The process and results of a long-term preschool daycare consultation are presented.

Child Day Care Centers↗
PubMed1997

HIV diagnosis rituals and identity narratives.

Using the constitutive view of health communication as a framework, this essay explores the construction of HIV diagnoses in narratives about physician/patient interactions. Narrative analysis reveals the life-changing impact of HIV diagnosis and the incongruence of the routine ways in which most diagnoses are handled. It also highlights the importance of HIV-positive communities in the construction of HIV-positive identities. These analyses suggest a review of how all diagnoses are delivered, and a need for further exploration of the role of supportive communities in construction of identity.

Adult↗
PubMed1996

Validation of probe EFD52 (D17S26) for forensic DNA analysis.

Validation studies that meet TWGDAM (The Working Group on DNA Analysis Methods) and CAC (California Association of Criminalists) guidelines for RFLP (restriction fragment length polymorphism) analysis were performed with the DNA probe EFD52 (D17S26). These studies demonstrate that the probe EFD52 is suitable for forensic casework. No unexpected DNA banding patterns were obtained from controlled studies examining various tissues, sample consistency over many gels, mixtures of body fluids, various substrates, various contaminants and non-human DNA sources. Of all the animal DNAs tested, only one higher primate yielded a single band to EFD52 hybridization. The sensitivity of EFD52 was shown to be comparable to that of other forensic probes. Population frequency distribution tables were prepared from over 4000 alleles and two-locus studies were conducted on nine forensically useful probes. Black, White, Hispanic and Lumbee Indian populations were found to be in Hardy-Weinberg and linkage equilibrium. Comparisons between victim blood standards and epithelial fractions of mixed strains from sexual assault cases were used to demonstrate the robustness of the EFD52 probe in forensic casework.

Asian People↗
PubMed1995

Patient education for diabetic patients. An integral part of quality health care.

The diabetic patient is at high risk for developing long-term medical complications including serious foot problems with potential loss of limb. With today's growing awareness of the importance of curtailing overall health care costs, the importance of comprehensive diabetic patient education programs is academic. It is demonstrated that a multidisciplinary approach to diabetic care management, with foot care assessment encompassing early preventive measures, can serve as a model for other Veterans Affairs Medical Centers to follow. Foot screenings can individualize specific foot problems and provide an understanding of risk factors to prevent complications. Patients with diabetes or peripheral vascular disease and, especially those individuals at risk of foot ulceration, are referred to the appropriate clinic for ongoing management to prevent amputation. Patient education is considered most effective when it is encouraged throughout a diabetic patient's medical care, and it becomes a part of lifestyle habits.

Diabetic Foot↗
PubMed1994

Albuterol.

Explore the source record for details and available documents.

Adult↗
PubMed1993

Clinical skills training of U.S. medical students.

BACKGROUND: Although there is general agreement that the teaching of clinical procedures needs vast improvement, little appears to have been done to achieve this goal, particularly with regard to medical students. METHOD: In the summer and fall of 1992, 60 U.S. medical schools participated in a telephone survey about how they taught clinical procedures to medical students. The schools were in 30 states and the District of Columbia; 36 were public and 24 were private. The schools were asked to describe what procedures were taught, how, and over what duration of time, with a focus on whether students were taught procedures prior to their clinical rotations. RESULTS: More than three-fourths of the schools (47 of 60) offered nothing other than an introduction to phlebotomy. Only four schools offered more extensive courses (40-50 hours) that covered a variety of topics. CONCLUSION: Few schools had adopted any formal method for training students to perform clinical procedures. In light of this problem, the authors describe a solution that has proven popular at the Stanford University School of Medicine--an elective course in surgical skills developed in 1988-89 and continuing to the present. Although the content of this particular course focuses on surgical procedures, important topics from other disciplines could easily be added or substituted. The course incorporates techniques that have previously been shown to be successful, such as the use of plastic models and cadavers. It also enables students to learn by performing procedures on each other, and to benefit from continuity of supervision by being taught by one faculty member.

Clinical Clerkship↗
PubMed1993

Critical pathways in the emergency department.

The actual development of the CP is an easy undertaking that an experienced emergency nurse can accomplish. The important points to remember are as follows: (1) include all disciplines that provide patient care in the development of the CP, (2) use realistic time frames (i.e., those currently found to be true in the emergency department, not those that are perceived to be ideal), (3) thoroughly educate the staff about the value of the CP in the emergency department, and, finally, (4) make sure that staff members know how to document variances. CPs in the emergency department give physicians and nurses common ground on which to negotiate patient care management more efficiently and effectively. They are a logical way to bring case management into the acute care setting. With the cost of ED visits continually rising, patient acuity levels increasing, and resources declining, expedient, coordinated, multidisciplinary action is crucial in giving total quality care to each patient.

Clinical Protocols↗
PubMed1992

What we say and what we do: self-reported teaching behavior versus performances in written simulations among medical school faculty.

Much of the research in medical education is performed through the use of self-reporting questionnaires. Although this can be a valid way to conduct research, little effort has been made to examine the fit between what teachers self-report and what they actually do. In an attempt to investigate this, the authors interviewed 47 preclinical faculty members at two large medical schools in 1990. The faculty members were initially given a questionnaire asking them to self-report in four categories: interactive skills; knowledge or abilities they considered important for students to develop; factors that influenced their curriculum development; and sources from which they sought pedagogical assistance. This was followed by four written simulations that examined four areas of teaching: small-group discussions, course design, lecturing, and test construction. In addition, the authors specifically sought to identify any differences in teaching philosophy and practice between those preclinical faculty who were physicians and those who were not, as well as any interinstitutional differences. Although in certain instances there was a strong correlation between self-reporting and performance as measured by a simulated teaching scenario, in most instances the correlation was quite low. Consequently, the authors suggest that researchers must be careful in their use of self-reporting as a means of assessing teaching behavior, and that whenever possible, researchers should observe the teachers they are studying.

Behavior↗