Biomedical subjects

S A Hutchinson

Publications and source records attributed to S A Hutchinson.

At least 19 recordsLinked to original sources

PubMed2004

A(1) adenosine receptor agonists: medicinal chemistry and therapeutic potential.

Adenosine receptors are widely distributed in the body and modulate numerous physiological processes. Four receptor subtypes (termed A(1), A(2A), A(2B) and A(3)) have been identified based on their pharmacological profile and cloning. Activation of the A(1) adenosine receptors produces a number of effects including a reduction in heart rate and atrial contractility, the attenuation of the stimulatory actions of catecholamines on the heart as well as a reduction of lipolysis in adipose tissue. As a result, A(1)AR agonists have been targeted as anti-arrhythmic and cardioprotective agents. This review discusses the synthesis, structure-activity relationships and therapeutic potential of A(1)AR agonists.

Adenosine↗

PubMed2001

A critique of research on the use of activities with persons with Alzheimer's disease: a systematic literature review.

TOPIC: The topic of this paper concerns the use of therapeutic activities with persons with Alzheimer's disease (AD). PURPOSE: The purpose is to present a critique of the research on these activities, with an emphasis on methodology. ORGANIZING CONSTRUCT AND SCOPE: Nursing literature identifies a number of purposes for activities for persons with AD. Activities should be therapeutic, enhance quality of life, arrest mental decline, and generate and maintain self-esteem. Other purposes of activities for this population are to create immediate pleasure, re-establish dignity, provide meaningful tasks, restore roles, and enable friendships. Activities may be more important to the psychological state of well-being of persons with dementia than the general physical and social environments in which they live. SOURCES: The literature reviewed was identified with the use of computer data bases (Medline - 1991-March 2001; Cumulative Index of Nursing and Allied Health Literature (CINAHL) - 1991-March 2001; and PsychLit - 1988-March 1999). In addition, data bases of Science Citation Index and Social Science Citation Indexes as they appear in the computer base, Web of Science, were searched for 1992-2001. The time period for each search was determined by the manner in which the literature was grouped for inclusion in the particular database. Hand searches of 11 selected journals included the years 1993-2001. The search dates were selected to reflect the time period when the largest number of studies on activities and AD have appeared in the professional literature. We critique a total of 33 studies. CONCLUSIONS: While researchers have demonstrated interest in the use of activities with persons with AD, theoretical and methodological difficulties, unclear findings and gaps exist, including a lack of emphasis on gender, ethnic, racial or cultural differences. Sampling issues involving diagnosis and staging complicate the research on individuals with AD. Case studies, single subject experimental designs, and tightly controlled quasi-experimental and experimental designs are needed to advance knowledge in this important area.

Alzheimer Disease↗

PubMed2001

Low-income African American adolescents who avoid pregnancy: tough girls who rewrite negative scripts.

The purpose of this research was to generate a grounded theory that explains the social-psychological processes of low-income African American adolescents who avoided pregnancy. Data collection included focus groups and in-depth interviews with 17 women aged 19 to 26. Data analysis using the grounded theory method revealed that these girls were the recipients of negative social-psychological scripts, putting them at risk for poverty and early childbearing. The "tough girls" struggled to rewrite these scripts by recognizing their negativity, being disenchanted with the scripts, determining to be different, and creating better lives. These aware, introspective young women believed in self-responsibility, self-protection, education, and financial independence. Practice implications and considerations for programmatic interventions can be based on this analysis.

Adolescent↗

PubMed2001

The development of qualitative health research: taking stock.

The purpose of this article, which was a keynote presentation at the Qualitative Health Research Conference (QHR 2000) in Banff, Canada, is to provide a historical perspective of qualitative research in nursing over the past 20 years. Van Gennep's model of rites of passage is used as a heuristic. A discussion of the stages of stopping, waiting, transition, and entry is followed by speculation about the key characteristics necessary for qualitative research to be valued and valuable in the future.

Alberta↗

PubMed2000

Responses of family caregivers and family members with Alzheimer's disease to an activity kit: an ethnographic study.

This qualitative evaluation research focused on individuals with Alzheimer's disease cared for at home by a family caregiver. It aimed to assess the responses of family caregivers and family members to an activity kit containing 20 therapeutic activities (The BAG or 'Be Active with Games' kit). In-depth interviews with and observations of 21 caregiver/member dyads were analysed according to Spradley's ethnographic method. Responses to The BAG were contingent upon the family member's symptoms, prior experience, and time of day. For some caregivers The BAG was useful in filling time, inspiring additional activities, facilitating connections with the family member, and connecting family members with their past; for others it was an additional burden in an already frenetic life. The BAG engaged some family members with AD while it 'insulted' others. The value of activities for individuals with AD requires more theoretical and methodological exploration.

Activities of Daily Living↗

PubMed2000

Double binds and the reproductive and mothering experiences of HIV-positive women.

In spite of the increasing number of young women infected with HIV in the United States, little is known about the reproductive and mothering experiences of these women. The purpose of the grounded-theory research discussed in this article was to describe the reproductive and mothering experiences of HIV-positive women. Twenty HIV-positive women participated in 31 in-depth interviews. The grounded-theory method was used for data analysis. A communication pattern known in the psychiatric literature as a double bind was discovered to be a basic social psychological problem that affected the women's experiences with reproduction and mothering. An understanding of the power and influence of these double binds permits health care professionals to plan patient-centered programs and to individualize care specifically for HIV-positive women.

Adaptation, Psychological↗

PubMed2000

Warnings about vulnerability in clients with diabetes and hypertension.

The purpose of the grounded theory study discussed in this article was to discover and explicate the basic social problem in clients with diabetes and hypertension that affects their adherence to health care directives. In-depth interviews with 21 clients with both diabetes and hypertension and 3 health care providers who care for such clients were concurrently conducted, coded, and analyzed according to the grounded theory method. Clients with diabetes and hypertension described being bombarded repeatedly with warnings about their vulnerability. The warnings were both external (coming from health care providers, family, and friends) and internal (coming from within themselves). Internal warnings were discovered to be far more influential in affecting adherence. This discovery can be used to shape health care providers' social interactions and treatment plan strategies with clients with diabetes and hypertension.

Attitude to Health↗

PubMed1999

Adenosine receptor ligands with oxygenated N6-substituents.

A number of novel adenosine analogs bearing oxygenated substituents in the N6-position have been prepared and evaluated as A1 adenosine agonists. Improved conditions for the synthesis of N6-substituted adenosines and a new one pot procedure for the synthesis of 2-amino-7-oxabicyclo[2.2.1]hept-5-ene are also reported.

Bridged Bicyclo Compounds, Heterocyclic↗

PubMed1999

Nurse practitioners and the problem of discounting.

Nurse practitioners (NPs) are key primary care providers in health care reform. The purpose of this paper is to discuss discounting, a social problem for NPs discovered in this grounded theory study. Discounting refers to behaviours directed towards NPs that they perceived as degrading. Data collection included open-ended, in-depth interviews on the nature of NP practice with 23 NPs, and 10 key members representing the Florida State Board of Nursing, Florida Nurses Association, American Nurses Association, and National Council of State Boards of Nursing. Excerpts that illuminated discounting were obtained from field notes about organizational documents, state legislative committee hearings, and professional NP association meetings. Data analysis using the grounded theory method revealed that NPs in this study struggled to establish their roles from a position of marginality in a context of conflict and negativity. NPs were subjected to social psychological and social structural discounting. This research serves to raise the consciousness of NPs with the hope that such awareness will facilitate personal and group action to combat discounting in their daily work and at local, state and national levels.

Female↗

PubMed1999

Defensive mothering in HIV-positive mothers.

The grounded theory study discussed in this article provides an explanatory schema that illuminates the mothering experiences of women living with HIV infection. Eighteen HIV-positive mothers provided 24 in-depth interviews. The grounded theory method was used for data analysis. Defensive mothering was the basic social psychological process that these HIV-positive mothers used in response to their diagnosis and the inherent stigma. Their defensive posture afforded these mothers and their children some degree of psychological protection. Defensive mothering involved much mental work and included three subprocesses: preventing the spread of HIV, preparing the children for a motherless future, and protecting themselves through thought control.

Female↗

PubMed1998

Endoscopic saphenous vein harvest in infrainguinal bypass surgery.

BACKGROUND: Autologous greater saphenous vein is considered to be the optimal material for peripheral arterial reconstruction and coronary artery revascularization. We describe a new endoscopic technique of saphenous vein harvest in infrainguinal arterial bypass surgery. METHODS: A retrospective analysis of 64 infrainguinal bypass procedures was performed comparing the standard open technique of saphenous vein harvesting with a new less invasive endoscopic technique. RESULTS: There were no differences in age, gender, indications for surgery, or proximal or distal anastomosis between the two groups. There were also no significant differences in early wound complications, early patency, and transfusion requirements. In the endoscopic group, length of operation was longer (189 versus 158 minutes; P <0.005), length of stay was shorter (5.2 versus 8.1 days; P <0.05), and postoperative day of discharge was also less (3.3 versus 5.5 days; P <0.01). CONCLUSIONS: Our findings indicate that endoscopic saphenectomy is technically feasible, leads to earlier discharge from the hospital, and leads to increased operative time. Most importantly, the procedure can be performed safely without subjecting the patient to increased risk.

Aged↗

PubMed1998

The Theory of Unpleasant Symptoms and Alzheimer's disease.

This article evaluates the emergent fit of the Theory of Unpleasant Symptoms for Alzheimer's Disease (AD) clients in an effort to evaluate the usefulness of the theory in thinking about AD and planning nursing interventions. Qualitative data from a 3-year study on the range and diversity of behavioral symptoms in AD and published research, treated as textual data, illustrate the theory. Although the components of the theory appear blurred when used with AD client behavior, the theory is useful because it emphasizes the complexity and interaction of symptoms and the interrelationships among symptoms, influencing factors, and symptom consequences/performance outcomes. These interrelationships make assessment more challenging than when symptoms are considered individually. The importance of the caregiver and the social and environmental context, called situational factors in the theory, emerge as especially relevant in AD. When symptoms are examined in their entirety, and nursing interventions take the interactive nature of symptoms, influencing factors and symptom consequences/performance outcomes into consideration, interventions should be client specific and, therefore, more effective.

Aged↗

PubMed1997

Early probable Alzheimer's disease and awareness context theory.

The purpose of this research was to explore the explanatory value of Awareness Context Theory for social interactional issues in early probable Alzheimer's Disease (AD). Glaser and Strauss's Awareness Context Theory [Glaser and Strauss (1965) Awareness of Dying, Aldine, New York] served as the framework for the analysis of interview data from 14 early probable AD clients and 14 family caregivers, a written autobiographical account, a fictionalized account, observations of a family care-giver focus group, and excerpts that focused on early AD from field notes recorded during two years of participant observation at a specialized AD daycare center and a family caregiver support group. Initial open-ended study questions focused on the experience of early AD from the diverse perspectives represented in the data. After preliminary analysis of data suggesting emergent fit with Awareness Context Theory, questions were refocused to address awareness contexts. Data were coded and analyzed for fit with the theory. Awareness Context Theory provided a useful heuristic for thinking about the nuances and complexities of social interaction in early AD. Attention to awareness contexts should enable health care providers to suggest interventions to improve caregiver-client interactions.

Adaptation, Psychological↗

PubMed1997

Electrical defibrillation optimization: an automated, iterative parallel finite-element approach.

To date, optimization of electrode systems for electrical defibrillation has been limited to hand-selected electrode configurations. In this paper we present an automated approach which combines detailed, three-dimensional (3-D) finite-element torso models with optimization techniques to provide a flexible analysis and design tool for electrical defibrillation optimization. Specifically, a parallel direct search (PDS) optimization technique is used with a representative objective function to find an electrode configuration which corresponds to the satisfaction of a postulated defibrillation criterion with a minimum amount of power and a low possibility of myocardium damage. For adequate representation of the thoracic inhomogeneities, 3-D finite-element torso models are used in the objective function computations. The CPU-intensive finite-element calculations required for the objective function evaluation have been implemented on a message-passing parallel computer in order to complete the optimization calculations in a timely manner. To illustrate the optimization procedure, it has been applied to a representative electrode configuration for transmyocardial defibrillation, namely the subcutaneous patch-right ventricular catheter (SP-RVC) system. Sensitivity of the optimal solutions to various tissue conductivities has been studied. Results for the optimization of defibrillation systems are presented which demonstrate the feasibility of the approach.

Algorithms↗

PubMed1997

Negotiating symbolic space: strategies to increase NP status and value.

Nurse practitioners (NPs) have an unprecedented opportunity to become key primary health care providers, yet barriers to independent practice still exist. The purpose of this research was to explore and describe the practice of NPs from their perspective. Open-ended, interactive interviews were conducted with 23 NPs. Data analysis using the grounded theory method revealed that NPs attempt to establish their roles from a marginalized position and are often subjected to psychological and structural discounting. To combat discounting, the NPs in this research worked to negotiate the symbolic space required for their acceptance as valued health care providers. They used techniques of cultivating, bargaining, confronting, and disengaging. All of these techniques promote NP role definition by generating and preserving role boundaries, thereby moving NPs toward the symbolic space necessary for them to become part of the national consciousness. This research contributes to clarification of the NP role and the building of a formal theory of advanced nursing practice.

Attitude of Health Personnel↗

PubMed1996

Healing from incest: resurrecting the buried self.

Writers on the incest experience estimate conservatively that 10% to 30% of all girls and 30% of all boys have had at least one childhood experience of incest. Incest is emotionally devastating to a child as it involves betrayal, and the irretrievable loss of trust in the adults in the child's life. Little is written about the healing processes of incest survivors. The purpose of this study was to generate a substantive grounded theory that provides an explanatory schema for understanding the healing process of adult female incest survivors. The sample consisted of 10 adult women who had a history of incest and who volunteered to participate in in-depth interviews. Data were analyzed using grounded theory techniques. Data analysis revealed that these women had buried an integral part of the self because of the trauma of incest; The healing process required resurrecting the buried self through a series of seven phases. The model generated from this research provides a heuristic for nurse therapists that assists in assessing and counseling incest survivors.

Adaptation, Psychological↗

PubMed1995

Numerical analysis of electrical defibrillation. The parallel approach.

Numerical modeling offers a viable tool for studying electrical defibrillation, allowing the behavior of field quantities to be observed easily as the different system parameters are varied. One numerical technique, namely the finite-element method, has been found particularly effective for modeling complex thoracic anatomies. However, an accurate finite-element model of the thorax often requires a large number of elements and nodes, leading to a large set of equations that cannot be solved effectively with the computational power of conventional computers. This is especially true if many finite-element solutions need to be achieved within a reasonable time period (eg, electrode configuration optimization). In this study, the use of massively parallel computers to provide the memory and reduction in solution time for solving these large finite-element problems is discussed. Both the uniform and unstructured grid approaches are considered. Algorithms that allow efficient mapping of uniform and unstructured grids to data-parallel and message-passing parallel computers are discussed. An automatic iterative procedure for electrode configuration optimization is presented. The procedure is based on the minimization of an objective function using the parallel direct search technique. Computational performance results are presented together with simulation results.

Algorithms↗

PubMed1994

Benefits of participating in research interviews.

Interviews are a fundamental data collection method used in qualitative health research to help understand people's responses to illness or a particular situation. The risks associated with participating in 1 or 2 hour research interviews when a study focuses on vulnerable populations and sensitive issues are scrutinized by Institutional Review Boards (IRBs) and Human Subjects Committees. This paper shifts attention away from the risks to the benefits and describes catharsis, self-acknowledgement, sense of purpose, self-awareness, empowerment, healing, and providing a voice for the disenfranchised as the sometimes unanticipated benefits reported by interview participants.

Humans↗