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Biomedical subjects

C Jordan

Publications and source records attributed to C Jordan.

121 records · Page 7Linked to original sources
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Establishing a PNP faculty practice clinic for Medicaid EPSDT screening.

Faculty practice added a new dimension to teaching clinical skills in a Pediatric Advanced Practice Nursing program. It offered the student immediate feedback concerning didactic knowledge and clinical skills and added consistency to learning obtained in the classroom setting. Inclusion of the Medicaid EPSDT program further enhanced student learning by offering a framework of comprehensive services that the student could offer to the patient in providing holistic well-child care. Research opportunities for faculty and students are also prevalent with the large quantity of data available from administration of the EPSDT program. In addition, many children from indigent settings who would not otherwise receive routine well-child care have been given the opportunity because of this program. The use of a faculty practice model that provides the Medicaid EPSDT screening seems to meet the well-child needs of faculty, students, and patients alike and provides an education/service model congruent with the preventative goals of health care reform today.

Child↗
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Measuring developmental outcomes of lead exposure in an urban neighborhood: the challenges of community-based research.

The Developmental Research on Attention and Memory Skills (DREAMS) Project measures developmental outcomes of approximately 330 children at risk for lead exposure within an ethnically diverse, inner-city neighborhood. This study is one project of the Phillips Neighborhood Healthy Housing Collaborative, a 6-year-old collaboration between residents of the Phillips community in Minneapolis, university researchers, and representatives of various public and private agencies. Our experience carrying out this research is used to highlight both the benefits of, and the challenges to, measuring exposure outcomes in inner-city children using a community-based research approach. Challenges to working within a community collaborative, to studying an ethnically diverse and economically disadvantaged neighborhood, and to utilizing neighborhood residents as project staff are discussed. The strategies used to address these issues are presented to offer ideas for surmounting the challenges inherent in community-based research. The investigation of community environmental health problems through a community-based research approach can result in improved methodology, enhanced quality of data collected, and increased effectiveness of data dissemination. In addition, it can lead to important findings that inform the scientific community and create positive community changes. It is paramount, however, that potential obstacles be anticipated and planned for, or else be detected early and promptly responded to, in a manner that preserves scientific rigor while respecting community needs and values.

Child, Preschool↗
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Clinical experience with auditory brainstem response audiometry in pediatric assessment.

We discuss our experience with evaluation of 167 children by auditory brainstem response audiometry in 1978. We summarize experience with referral sources, medication for sedation, and interpretation of test outcome. Medication for sedation was required for 136 children. Concommitant central nervous system involvement rendered auditory brainstem response ambiquous in some children; however, the technique still provide useful information about status of peripheral auditory sensitivity obtainable in no other way. Finally, agreement among auditory brainstem response, behavioral, and impedance audiometry predictions was usually quite good.

Audiometry↗
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A biomechanical comparison of lateral retinacular releases.

A lateral patellar retinacular release that transects the tendon of the vastus lateralis muscle may result in significant complications. To avoid such complications, the superior extent must be limited, and maximizing the inferior extent may be important in achieving an adequate release. The effective release of the patella from its lateral retinaculum was examined for 2 incision lengths using 10 fresh-frozen human cadaveric knees and comparing the medial displacement of the patella relative to the femur for 3 study groups (control, intact retinacula; Group A, retinacula cut from the inferior third of the vastus lateralis tendon down to the anterolateral arthroscopic portal; and Group B, retinacula cut from the inferior third of the vastus lateralis tendon down to the tibial tubercle) when a 22-N medially directed force was applied to the patella with the knee at 30 degrees and 60 degrees of flexion. The extended release (Group B) resulted in a significantly more effective release when compared with the standard release (Group A) or control group. This technique may allow an adequate release of the patella while preserving the function of the vastus lateralis muscle.

Arthroscopy↗
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Isolation of the vastus medialis oblique muscle during exercise.

The purpose of this study was to selectively challenge the vastus medialis oblique muscle in comparison with the vastus lateralis, the vastus intermedius, and the vastus medialis longus muscles by performing nine sets of strengthening exercises. These knee rehabilitation exercise included isometric knee extension with the hip at neutral, 30 degrees external, and 30 degrees internal rotation; isokinetic knee extension through full range; isokinetic knee extension in the terminal 30 degrees arc; sidelying ipsilateral and contralateral full knee extension; and stand and jump from full squat. Electrical activity of the vastus medialis oblique, the vastus lateralis, the vastus intermedius, and the vastus medialis longus muscles was measured in eight uninjured subjects. Our study showed that isometric exercises in neutral and external rotation of the hip will challenge both the vastus medialis oblique and the vastus lateralis muscles. The results suggest that the electromyographic activity of the vastus medialis oblique muscle was not significantly greater than that of the vastus lateralis, the vastus intermedius, and the vastus medialis longus muscles during the nine sets of exercises. Results suggest that the vastus medialis oblique muscle cannot be significantly isolated during these exercises.

Adult↗
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Monitoring evoked potentials during surgery to assess the level of anaesthesia.

The hypnotic and analgesic components of anaesthesia can be assessed using middle latency auditory evoked potentials (MLAEPs) and somatosensory evoked potentials (SEPs). To monitor these potentials reliably during clinical anaesthesia, we have developed an evoked potential (EP) system based around a portable personal computer, a DSP board and an isolated pre-amplifier unit. Unlike many currently available systems, this amplifier is largely immune to diathermy interference due to excellent isolation via a digital fibre optical link, small size and RF screening and filtering. The pre-amplifier unit has integral auditory and somatosensory stimulators, and automatic calibration and impedance checking. Stimulus intensity and profile are under software control and SEP stimulus level is constantly monitored. The unit is powered by two AA cells and battery status continuously monitored by the PC software. Up to eight channels of EEG may be recorded and displayed in a smoothly scrolling window and as moving average MLAEPs and SEPs.

Anesthesia↗
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Retrenchment: layoff procedures in a nonprofit organization.

One of the most unsettling experiences that human resources and other managers must face is a large-scale employee layoff. Authors Robert Fuller, national director of personnel, Cassandra Jordan, assistant director of personnel, and Robert Anderson, employment and training manager--all at the Legal Services Corporation--show how careful management planning, extensive staff involvement, and well-planned counseling and outplacement services helped employees of Legal Services Corporation wheather such a layoff. As the first step, the planning committee (personnel director, equal employment opportunity director, and general counsel) recommended that the corporation conduct staff education about layoffs for all employees, that a representative employee task force be established to develop specific details of the layoff plan, and that the corporation hire an experienced person to help staff members implement the plan. Members of the task force, who were elected by staff members (except for one additional member who was selected to ensure proper representation of minority groups and women), made specific recommendations on the way to determine seniority and bumping rights. The task force also dealt with such issues as method of notification, an appeals procedure, reemployment rights, the counseling and outplacement services. The task force also considered the issue of "willingness to leave".

Employment↗
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Factors affecting balance and ambulation following stroke.

Ninety consecutive patients with hemiplegic involvement following a single cerebrovascular accident were studied to assess the relative importance of factors affecting balance and ambulation. Only 50% of the patients achieved a community level of ambulation. Intact balance reactions correlated strongly with the ability to walk (r = 0.79). Balance was found to be dependent on limb control and proprioception. Age, sex, hemiplegic side, and structural factors did not correlate with function or recovery. The total score in each category of function was more highly correlated with balance and ambulation than were the individual scores.

Adult↗
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Does the APACHE II scoring system equate with the Nottingham Patient Dependency System? Can these systems be used to determine nursing workload and skill mix?

The development of a holistic patient dependency system for intensive care in Nottingham has enabled nursing staff to analyse their patient's needs more comprehensively and relate them to existing staffing levels. A recent publication (Chellel et al., 1995) implied that some units were using medical scoring systems to predict workload and that practitioners were dissatisfied with current scoring systems. Patient dependency scores were correlated with APACHE II scores by regression analysis on 1,743 patients from the Adult Intensive. Care Unit at the University Hospital, Nottingham. Analysis revealed that APACHE II had little ability to predict patient dependency and, therefore, is unreliable at predicting nursing workload and skill mix.

APACHE↗