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Biomedical subjects

C E Wills

Publications and source records attributed to C E Wills.

At least 19 recordsLinked to original sources
PubMed1999

Nurses' judgments regarding seclusion and restraint of psychiatric patients: a social judgment analysis.

Clinical judgment of psychiatric nurses was investigated using judgment analysis within the framework of social judgment theory. Nine nurses at a short-term psychiatric care facility made recommendations concerning restraint and seclusion for 80 patients described on paper in terms of 17 characteristics (cues). Nurses generally favored close observation of patients over seclusion and restraint, and information about current behavior and functioning had more impact on nurses' judgments than did patient history. Nurses had good insight into the nature of their own judgments. However, individual differences in cue utilization and inconsistency in strategy usage led to disagreement among nurses about specific recommendations for particular patients. No one patient received identical recommendations from all nurses, and nurses agreed with each other on specific recommendations only about a third of the time. The lack of agreement has implications for development of staff training programs and further research on the clinical judgment processes of nurses.

Cues↗
PubMed1994

A controversy in scaling of subjective states: magnitude estimation versus category rating methods.

Measurement issues surrounding the quantification of subjective states such as sensations and attitudes have received increasing attention in nursing in recent years. It has sometimes been argued that magnitude estimation (ME) procedures are superior to category rating (CR) methods for scaling of subjective states which require judgments of intensity or strength of perception. A critique of the two scaling methods is presented. In contrast to arguments first proposed by Stevens and others for the superiority of ME procedures and the ability to attain "direct" ratio level measurement with ME scaling, there is evidence to suggest that ME procedures do not in fact produce ratio level scales. The "characteristic" exponents associated with ME scaling are not necessarily intrinsic to particular subjective states. CR scales neither necessarily constrain nor lack the requisite sensitivity needed to produce valid responses. It is concluded that ME is not necessarily superior to the commonly used CR method for scaling of subjective states in nursing research. Implications of the controversy for selection of scaling methods for nursing research are discussed. Greater attention to the ordinal or rank-order properties of data is encouraged. A small set of data is used to illustrate the importance of rank order properties in scaling subjective states in nursing.

Attitude↗
PubMed1981

Hepatic morphology in obesity.

Changes in hepatic morphology were evaluated in 242 consecutive liver biopsy specimens obtained from nonalcoholic obese subjects. Steatosis occurred in 59.7% of the subjects but was moderate to severe in 28.7%. An alcoholic hepatitis-like picture was present in 8.7% and cirrhosis in 2.7%. Fibrosis of mild and moderate degrees was encountered in 26.1% and 5.8%, respectively. This study indicates that the histopathological changes that occur in the livers of obese subjects are similar to alcoholic liver injury.

Biopsy↗
PubMed1980

Liver injury following jejunoileal bypass. Are there markers?

Ninety-five of 105 patients who underwent jejunoileal bypass had preoperative and at least one set of postoperative liver tests and liver biopsy within 18 months of surgery. There were numerous and, at times, impressive histologic or biochemical abnormalities in obese patients who were not operated. No correlation was found between postoperative liver injury and the preoperative concentration of serum albumin or SGOT, or with the certain histologic lesions (steatosis, lobular necrosis or inflammation). However, the preoperative pericellular fibrosis persisted or progressed in eight of 11 of the patients. The rate of postoperative weight loss did not seem to influence liver morphology but the initial velocity of weight loss could not be determined in this study. Liver biopsy specimens demonstrated a trend for greater postoperative decreases of serum albumin concentrations (p less than 0.05) in those patients who developed more severe lesions. This study failed to demonstrate the presence of preoperative histologic or biochemical markers that could reliably predict the development of liver injury following jejunoileal bypass. The only exception was pericellular fibrosis, which was found in the preoperative liver biopsy specimens. Pericellular fibrosis is probably a risk factor for lobular fibrosis after jejunoileal bypass surgery in obese patients.

Alcohol Drinking↗