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Biomedical subjects

S McDonald

Publications and source records attributed to S McDonald.

135 records · Page 8Linked to original sources
PubMedDate not supplied

The professional consequences of whistleblowing by nurses.

When nurses encounter misconduct in the workplace, their ethical codes of conduct bind them to the role of patient advocacy and compel them to safeguard the patient from harm. However, reporting misconduct can be personally and professionally risky. The aim of the research was to examine the professional consequences of whistleblowing and nonwhistleblowing in nursing. A descriptive survey design was used to examine the professional effect of reporting misconduct (whistleblowing) and not reporting misconduct (nonwhistleblowing). Ninety-five respondents were included in the study; 70 were self-identified as whistleblowers and 25 were self-identified as nonwhistleblowers. Results indicated that there were severe professional reprisals if the nurse reported misconduct, but there were few professional consequences if the nurse remained silent. Official reprisals included demotion (4%), reprimand (11%), and referral to a psychiatrist (9%). Whistleblowers also reported that they received professional reprisals in the form of threats (16%), rejection by peers (14%), pressure to resign (7%), and being treated as a traitor (14%). Ten per cent reported that they felt their career had been halted. These findings suggest that when nurses identify and report misconduct in the workplace, they may experience serious professional consequences.

Adolescent↗
PubMedDate not supplied

Effects of the herbicide atrazine on Ambystoma tigrinum metamorphosis: duration, larval growth, and hormonal response.

We exposed larval tiger salamanders (Ambystoma tigrinum) reared in the laboratory from eggs collected from a prairie wetland in North Dakota to three concentrations of atrazine (0, 75, and 250 micrograms/L) in a static renewal test to determine the pesticide's effect on (1) plasma corticosterone and thyroxine concentrations, (2) larval size, and (3) days-to-stage at stages 2 and 4 of metamorphic climax. We found significant effects of atrazine on each of these response variables. Plasma thyroxine was elevated in both atrazine-exposed groups compared with the control group; plasma corticosterone was depressed in the 75 micrograms/L treatment compared with both the control and 250 micrograms/L treatment. Larvae exposed to 75 micrograms/L atrazine reached stage 4 later but at a size and weight comparable to the control group. By contrast, larvae in the 250 micrograms/L treatment progressed to stage 4 at the same time but at a smaller size and lower weight than larvae in the control group. These results indicate that the herbicide has the potential to influence tiger salamander life history. We present a model consistent with our results, whereby corticosterone and thyroxine interact to regulate metamorphosis of tiger salamanders based on nutrient assimilation and adult fitness.

Ambystoma↗
PubMedDate not supplied

Effect of graft bed on long-term functional results of extremity skin grafts.

The purpose of the current study was to determine whether the long-term functional results of extremity burns grafted on fat were different from those grafted on fascia. Twelve patients (mean burn size, 38% TBSA) who had fascial excision of the majority of one or more extremities were examined a minimum of one year postinjury. Range of motion, motor strength, and sensation of the fascially excised extremities were measured. Twelve comparable patients with extremity burns (mean burn size, 35% TBSA) who had grafts placed on fat were used as positive controls. Patients whose burns were excised to fat had better joint mobility (P = 0.001) and sensory function (P = 0.001) than did patients whose burns were excised to fascia. Both groups had comparable muscle strength. These results indicate that patients with full-thickness burns of the extremities who have grafts placed on fat have significantly better long-term extremity function than do patients who have their skin grafts placed on fascia.

Adipose Tissue↗
PubMedDate not supplied

Whistle-blowing: effective and ineffective coping responses.

How do nurses respond when they identify misconduct in patient care settings? The authors used a descriptive survey (N = 95) to identify effective coping strategies of whistle-blowers (n = 70) and non-whistle-blowers (n = 25). Results identified four effective coping strategies used by whistle-blowers. The authors offer recommendations to nurses who encounter misconduct in their workplace.

Adaptation, Psychological↗
PubMedDate not supplied

Communication disorders following closed head injury: new approaches to assessment and rehabilitation.

In this paper communication disorders following closed head injury are described and various forms of language assessment techniques are reviewed. The usefulness of conventional, pragmatic and cognitive approaches is considered. A new cognitive-pragmatic approach is then advocated which is an amalgam of the last two approaches. From the examples given it is argued that such an approach is practical in terms of: 1) incorporating knowledge of co-existing cognitive deficits; and 2) focusing on normal everyday communication practices. It is also suggested that the use of a cognitive-pragmatic framework has potential in refining remediation and management strategies with the closed-head-injured population.

Aphasia↗
PubMedDate not supplied

Evaluating social skills following traumatic brain injury: the BRISS as a clinical tool.

Deficits in social behaviour are a major obstacle to the reintegration into the community of traumatically brain-injured (TBI) individuals. Recognition of the importance of social skill remediation has highlighted the need for a suitable assessment tool. The TBI population presents particular requirements with respect to the special nature of deficits which commonly occur as a result of frontal lobe impairment. The Behaviorally Referenced Rating System of Intermediate Social Skills (the BRISS) has been shown to have good psychometric properties with a TBI population. It also provides a measure of particular social skills associated with frontal lobe functioning. This study examines the ability of the verbal scales of the BRISS to identify social skill deficits at the individual client level and to detect significant changes in skills following an intervention programme involving five chronic TBI males. In the case of one client, who demonstrated significant clinical improvement in social behaviour, the BRISS was found to identify specific areas of apparent change. The difficulty of using the BRISS as a sole measure of social skills is discussed in the light of relatively large pre-intervention within-subject variability which was found with respect to some behaviours.

Adult↗
PubMedDate not supplied

Local health departments in Washington State use APEX to assess capacity.

THE ASSESSMENT PROTOCOL for EXCELLENCE in PUBLIC HEALTH process was carried out in the state of Washington to assess local health department capacity and to identify their self-perceived strengths and weaknesses. Staff from 24 of the 32 local health departments in Washington completed organizational capacity assessments. Fifty percent or more of the health departments identified the following eight indicators as strengths: legal authority, public policy and implementation, budget development, financial reporting and administration, audit, financial documentation, organization and structure of program management, and policy board procedures. Seven indicators were identified as weaknesses by 50% or more of the respondents: legal counsel, mission and role, data collection and analysis, planning and development, evaluation and assurance of community health assessment, community health assessment and planning, and community health policy. The results of the assessment highlight the traditional organizational and service delivery strengths of the local health departments and point out weaknesses in their ability to assess community health and to develop communitywide health policy.

Community Health Services↗