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Biomedical subjects

S Summers

Publications and source records attributed to S Summers.

At least 19 recordsLinked to original sources

HMEC-1: establishment of an immortalized human microvascular endothelial cell line.

The study of human microvascular endothelial cells has been limited, because these cells are difficult to isolate in pure culture, are fastidious in their in vitro growth requirements, and have a very limited lifespan. In order to overcome these difficulties, we have transfected human dermal microvascular endothelial cells (HMEC) with a PBR-322-based plasmid containing the coding region for the simian virus 40 A gene product, large T antigen, and succeeded in immortalizing them. These cells, termed CDC/EU.HMEC-1 (HMEC-1), have been passaged 95 times to date and show no signs of senescence, whereas normal microvascular endothelial cells undergo senescence at passages 8-10. HMEC-1 exhibit typical cobblestone morphology when grown in monolayer culture, express and secrete von Willebrand's Factor, take up acteylated low-density lipoprotein, and rapidly form tubes when cultured on matrigel. HMEC-1 grow to densities three to seven times higher than microvascular endothelial cells and require much less stringent growth medium. HMEC-1 will grow in the absence of human serum, whereas microvascular endothelial cells require culture medium supplemented with 30% human serum. These cells express other cell-surface molecules typically associated with endothelial cells, including CD31 and CD36 and epitopes identified by monoclonal antibodies EN4 and PAL-E. They also express the cell adhesion molecules ICAM-1 and CD44 and following stimulation with interferon-gamma express major histocompatibility complex class II antigens. HMEC-1 specifically bind lymphocytes in cell adhesion assays. Thus HMEC-1 is the first immortalized human microvascular endothelial cell line that retains the morphologic, phenotypic, and functional characteristics of normal human microvascular endothelial cells.

Antigens, Differentiation, Myelomonocytic

Concept analysis methodology: applications to altered level of consciousness.

Concept analysis is the first step in instrument development. Steps in the concept analysis process are discussed and applied to the analysis of altered level of consciousness (ALC) as a potential nursing diagnosis for submission to the North American Nursing Diagnosis Association. Criteria regarding ALC have been defined for the assessment of neurologically impaired patients and not for the neurologically intact postanesthesia patient. It is assumed that postanesthesia patients experience chemically induced ALC, and consensus regarding what constitutes this concept needs to be validated by PACU nurses. The first step in instrument development is a clear definition of the concept of interest. The criteria for ALC determined by the PACU nurses could then be used to construct a pencil-and-paper instrument that would allow the concept to be tested on postanesthesia patients as they emerge from anesthesia. This concept analysis-to-instrument development process discussion can be applied to any concept of interest to the PACU nurse.

Consciousness

Validation of concepts: the next step in instrument development for postanesthesia studies.

Validation of concepts through descriptive research is a major step in instrument development. The concept of hypothermia as observed in the postanesthesia patient is discussed, and data are compared with the North American Nursing Diagnosis criteria of hypothermia. What emerges from the data are items specific to postanesthesia patients, which have been labeled as inadvertent postanesthesia hypothermia (IPH). Thus, the importance of concept analysis in instrument development is emphasized because the omission of this step from instrument development may result in lack of clarity or "fuzzy data" in what is to be measured.

Anesthesia

Instrument development: writing the items.

An important step in instrument development is writing the items that are derived from concept analysis and validation. It is also important to determine if the instrument is to be constructed for criterion-referenced or norm-referenced measurement; examples for both are discussed. Also discussed are methods for developing a blueprint for a psychosocial instrument. Additional methods presented are how to construct the items as simple rather than complex sentences, to keep the sentences short and unambiguous, and to construct the items for an eighth-grade reading level to facilitate patient use.

Data Collection

Using microcomputers to facilitate research studies.

Microcomputers can facilitate research studies planned by busy PACU nurses. PACU nurses need to become computer literate to take advantage of these time-efficient methods. Computer hardware and software can be used to word process a research proposal, statistical software can be used for data analysis, and graphic and clip-art software can be used to summarize and to graphically present the results of this study.

Clinical Nursing Research

Introduction to instrument development for postanesthesia studies.

An important aspect of any research project is the selection of the instrument for which a "fit" exists between what is to be studied and the subjects. Physiological instruments are developed to objectively measure specific variables, such as temperature. Psychological instruments are usually developed to subjectively measure specific variables; however, there may not be a fit if the researcher used a paper-and-pencil instrument developed to measure anxiety in psychiatric patients to measure anxiety in the sedated, postanesthesia patient. An introduction to instrument development is presented including defining instruments, deciding what phenomena to measure and how to measure them, locating existing instruments, deciding when to develop an instrument, and identifying implications that arise from the use of inappropriate instruments.

Clinical Nursing Research

Selecting the sample for a research study.

Sample selection is a very important but sometimes underestimated part of a research study. Sampling theory describes two sampling domains: probability and nonprobability. Probability samples contain some type of randomization and consist of simple, stratified, systematic, cluster, and sequential types. Nonprobability samples lack randomization and consist of convenience or accidental, purposive, quota, volunteer, and expert types. The primary distinction between the two domains is that the probability sampling study findings can be generalized to the target population while the nonprobability sampling study findings can only be generalized to the institution where the sample was studied.

Humans

Axillary, tympanic, and esophageal temperature measurement: descriptive comparisons in postanesthesia patients.

Body temperature in postanesthesia patients is considered to be an important vital sign; yet, measurement sites may vary from oral to axillary and rectal to tympanic membrane. The reviewed literature indicated that axillary and rectal temperatures are measures of shell temperature and esophageal and tympanic temperatures are measures of core temperature. This study compared temperatures measured with axillary mercury-in-glass and electronic thermometers with those measured by tympanic and esophageal thermometers in 96 postanesthesia patients. Analysis of the data using paired t test indicated there was no significant difference between the esophageal and tympanic temperatures; however, significant differences were found between mercury and electronic axillary temperatures. Analysis of variance indicated no significant difference between the axillary temperatures as measured by mercury and electronic methods in the arm extended on an arm board during surgery. Further studies are needed using a larger, randomly selected sample to validate this study's findings.

Adult

Level of measurement: key to appropriate data analysis.

While PACU nurses are increasingly conducting research studies to validate nursing practice, it is important to consider logical rules for data analysis. Level of measurement is an important consideration when selecting statistical tests to analyze the data. Statistical tests need not remain a mystery since level of measurement is the deciding factor for selecting which tests are appropriate for answering the research questions or testing the hypotheses.

Clinical Nursing Research

Steps in reviewing literature.

Reviewing the literature is an important part of the research process. Systematic steps to follow when evaluating the literature include critiquing the following: title, abstract, problem, purpose, theoretical or conceptual framework or model, implications for nursing, review of literature, hypotheses or research questions, variables, instruments, subjects, ethical concerns, research designs, results, conclusions, recommendations, and future studies. Frequently, the reader must search for these topics since few studies list the above as separate headings; however, it is important to evaluate each to determine a study's relevance to the reader's research needs.

Humans

Defining components of the research process needed to conduct and critique studies.

The research process consists of a five-chapter approach. Chapters one through three are written during the planning stages of a study. Chapter one consists of problem, purpose, hypotheses or research questions, definitions, theoretical framework, and significance for nursing. Chapter two consists of the review of literature. Chapter three consists of the methodology: sample, setting, design, data analysis methods, and ethical concerns. Chapters four and five are written after the study is completed. Chapter four consists of results of data analysis. Chapter five consists of a discussion of results, conclusions, implications for nurses, and recommended future studies. It is important for nurses to review and apply this five-chapter approach when conducting or critiquing research studies.

Data Collection

Reviewing the research process for postanesthesia care unit studies.

Research studies are needed by and for nurses to validate nursing practice. PACU nurses are in an excellent position to validate PACU nursing practice through research studies that seek solutions to patient problems. Research ideas also may be derived from formal and informal discussions at professional meetings, by testing new products, and reviewing the literature; however, precise steps must be followed to assure accuracy of data collection and the interpretation of the results.

Clinical Nursing Research

The effects of two warming methods on core and surface temperatures, hemoglobin oxygen saturation, blood pressure, and perceived comfort of hypothermic postanesthesia patients.

An experimental study was conducted in two PACUs to test the effect of two warming methods on core and surface temperatures, oxygen hemoglobin saturation, blood pressure, and perceived comfort of hypothermic postanesthesia patients. The study was based by Selye's theory of stress, which states that when individuals are confronted with stressors, physiological adaptation occurs to maintain homeostasis. Subjects studied were 91 adult patients who were randomly assigned to two groups: group 1 patients were warmed with the Bair Hugger Warming System (Augustine Medical, Inc, Eden Prairie, MN), and group 2 patients were warmed with warmed bath blankets. Multiple analysis of variance with repeated measures demonstrated significant differences between the two groups on surface temperature, oxygen hemoglobin saturation, and perceived comfort. No significant differences were found between the two groups on core temperature and blood pressure. Implications for PACU nurses include an efficient, cost-saving method to promote patient adaptation to the stressors of inadvertent hypothermia. Further studies are needed to validate the findings from this study and to test nurses' responses to the Bair Hugger Warming System.

Adolescent

Effects of heparin versus saline solution on intermittent infusion device irrigation.

The purpose of this study was to compare the effectiveness of 1 ml of 0.9% sodium chloride with 10 units of heparin in 1 ml sodium chloride solution, both containing benzyl alcohol, in maintaining patency and reducing the incidence of phlebitis in patients with intermittent infusion devices. The subjects (N = 32) were randomly assigned in a double-blind experimental design. Repeated-measures analysis of variance revealed no significant difference between the groups in phlebitis or patency variables. The results from this controlled study would suggest that 0.9% sodium chloride is as effective as 10 units of heparin in sodium chloride solution in maintaining intermittent infusion device patency and preventing phlebitis.

Adult