Biomedical subjects

P Silver

Publications and source records attributed to P Silver.

93 records · Page 6Linked to original sources

PubMedDate not supplied

Faculty members' provision of instructional accommodations to students with LD.

The existing research on the instructional accommodation process of college students with learning disabilities focuses on attitudes and theoretical models without delineating actual practices. To date, the discussion of facilitating factors and barriers to this process has been broad and lacking specificity. Surveys were mailed to 485 faculty members at the University of Massachusetts, Amherst, who received an instructional accommodation form from the office of Learning Disabilities Support Services in the fall of 1995. The survey focused on faculty members' reported degree of ease or difficulty in implementing instructional accommodations, their perceptions regarding adequacy of support, and their own beliefs and understandings concerning the need for and benefit of providing instructional accommodations. The results indicate that beliefs about the helpfulness of and need for instructional accommodations were associated with the provision of the accommodations. Also, a perception of support from the University influenced the ease of providing instructional accommodations. A significant difference was found between the behavior of tenure-track faculty and non-tenure-track faculty.

Adult↗

PubMedDate not supplied

Diagnosis and management algorithm of acute onset of central diabetes insipidus in critically ill children.

We devised a diagnosis and management algorithm for acute onset of central diabetes insipidus (CDI), and conducted a retrospective evaluation of its efficacy. Fourteen patients admitted to our pediatric intensive care unit (PICU) over a three year period were diagnosed with acute CDI secondary to various brain injuries. All patients were treated as per the algorithm guidelines. The initial dose of aqueous vasopressin ranged from 0.25 to 1.0 mU/kg/h. Low sodium content solution (0-0.5 normal saline) was used to replace urine output in excess of 3 ml/kg/h and for maintenance fluid therapy. The therapeutic goals included: urine output 2-3 ml/kg/h, urine specific gravity 1.010-1.020 and serum sodium 140-145 mEq/l. The pitressin dose was adjusted as deemed necessary to achieve the aforementioned goals. Our results indicate that urine specific gravity is the most sensitive parameter to respond to treatment. It was the best determinant of the adequacy of pitressin dose as it had the best linear correlation with it (r = 0.96; p = 0.009). Urine output was second best (r = 0.93; p = 0.02), whereas no linear correlation was established between pitressin dose and serum sodium concentration, nor with serum osmolality. We conclude that the algorithm developed and used by us for the management of CDI is generally efficacious. Changes in urine specific gravity follow changes in pitressin dose very closely and thus should be used as the primary parameter for determination of intravenous pitressin dose adjustment.

Acute Disease↗

PubMedDate not supplied

Community-based strategies for immunizing the "hard-to-reach" child: the New York State immunization and primary health care initiative.

The 1989-1991 measles epidemic in New York City drew attention to the low immunization coverage rates found in urban neighborhoods. This article describes a joint initiative of the New York State Department of Health and the Columbia University School of Public Health to mobilize parents to fully immunize their children. Eleven community-based organizations (CBOs) used a variety of outreach strategies to identify and enroll underimmunized children in primary care. They enrolled 4,555 children, of whom 75% needed at least one basic vaccine dose to be up-to-date for their age. Enrolled children were followed by CBOs to ensure compliance with appointments. After nine months of program operation, 73% of children in an evaluation sample were up-to-date for age for their immunizations. Immunization coverage increases were greatest for the youngest children, for whom coverage rates more than doubled in the first nine months of program operation. Ninety-one percent of these "hard to reach" children were tracked successfully by CBOs. This article compares the strategies used by the community organizations and concludes with suggestions for improvements of future community-based mobilization programs.

Child↗