PubMed Health⌕ Search

Biomedical subjects

C Marsden

Publications and source records attributed to C Marsden.

At least 19 recordsLinked to original sources
PubMed1999

CCD imaging for optical tomography of gel radiation dosimeters.

Several investigations have been carried out by a number of researchers over the past few years to evaluate the utility of imaging gel dosimeters for the three-dimensional measurement of radiation fields. These have been proposed to be of particular value in mapping radiation dose distributions associated with emerging and complex approaches to cancer treatment such as conformal (CRT), intensity modulated (IMRT), "gamma knife," and pencil beam radiotherapies. Imaging of the gels has been successfully accomplished with clinical MRI units and via laser-based optical scanning. However, neither of these methods is generally accessible to all potential users, limiting the broader study and implementation of this valuable tool. We report here the design, methodology, and results of a preliminary study carried out to evaluate the utility of a new, inexpensive, and simplified approach to tomographic imaging of gel radiation dosimeters. For the purpose of this initial investigation, an array of liquid scintillation vials was prepared, containing a ferrous sulphate xylenol orange (FSX) gelatin formulation. The FSX formulation undergoes a change in optical absorption characteristics following irradiation, and the resulting color change can be observed visually. The vials were irradiated individually to different doses. Three-dimensional imaging was accomplished by tomographic reconstruction from two-dimensional optical images acquired using a diffuse, fluorescent light source, a digital charge-coupled device camera, single-photon-emission-computed tomography software, and other simple components designed by the authors. The resulting transverse images were evaluated through a region-of-interest (ROI) analysis to obtain the average change in image density in each vial as a function of radiation dose. These measured ROI values were subjected to a linear regression analysis to fit them to a straight line, and to determine the goodness of fit. Results from multiple imaging trials are compared. The correlation coefficients obtained are typically on the order of 0.98, and the p value from analysis of variance is approximately 0.05, indicating a linear and reproducible response for the dosimeter formulation and imaging system.

Dose-Response Relationship, Radiation↗
PubMed1995

The nurse's role in end-of-life treatment discussions: preliminary report from the SUPPORT Project.

The methods of the Study to Understand Prognosis and Preferences of Outcomes and Risks of Treatment (SUPPORT), a five year, five-center study of decision making and communication in patients near the end of life, are described. Aspects of the study propose to describe the role of the staff nurse and the specially trained nurse facilitator in decision making in patients near the end of life. The nurse is in a unique position to initiate discussions about patient preferences for end-of-life treatment and quality of life; however, a review of related research describes discordance between clinicians' understanding and patients' preferences for treatment. Ethical issues, practice barriers, and practice innovations in end-of-life treatment are discussed.

Cohort Studies↗
PubMed1994

Is cardiopulmonary resuscitation training deleterious for family members of cardiac patients?

The purpose of the study was to determine the attitudes toward cardiopulmonary resuscitation (CPR) training and subsequent CPR use of 172 CPR-trained family members of cardiac patients. The majority (88.9%) reported positive attitudes. Only 14 (8.1%) reported feeling too responsible for their family member. One hundred and forty-one (81.9%) said that they would perform CPR if required to do so. Family members do not feel unduly burdened by learning CPR, and CPR training should be recommended to families of patients at risk for sudden cardiac death.

Adult↗
PubMed1993

Needs of recovering cardiac patients and their spouses: compared views.

Identifying the needs of patients and spouses following an acute cardiac event is an essential first step in the development of nursing interventions to facilitate couples' psychosocial adaptation. Therefore, the self-perceived needs of 49 couples were compared 5 months following the patients' hospitalization for an acute cardiac event (i.e. myocardial infarction or coronary artery revascularization). Both patients and spouses identified the need for information as being most important compared with all other needs; however, significant discrepancies were found in ratings between patients and spouses. Needs which spouses rated as having a high priority included receiving information about the patient's feelings during the recovery period, having time alone, talking with the patient about concerns, and receiving information about the expected psychological recovery. Patients did not consider these same needs as they related to their spouses particularly important. Rather, they rated the need for information about their condition, the need to have honest explanations, and the need to talk with a health professional about their problems as having the highest priority. Many of the needs that both patients and spouses ranked as being important or very important were unmet in 40-70% of the cases. In this study, both patients and spouses expressed similar needs for information, but the type of information that they wanted differed and, in the majority of cases, these needs were not met by nurses and physicians.

Adaptation, Psychological↗
PubMed1992

An ethical assessment of intensive care.

Any evaluation of intensive care must include an ethical assessment of that technology. This allows us to consider the use of technology in light of the ends that we desire. The most pressing ethical issues in intensive care are: forgoing life-sustaining treatment, dehumanization of patients and staff within the technological environment, and the allocation of the technology that is integral to intensive care.

Consensus↗
PubMed1992

Family-centered critical care: an option or obligation?

The patient was dying after undergoing aggressive treatment for a malignancy. Patient and family wanted "everything" to be done and the patient was transferred to the ICU for treatment of acute respiratory failure. The next day the patient's condition deteriorated further. The family decided against chest compressions or defibrillation; however, other aggressive treatment was continued. A "chemical code" was initiated and the patient was ventilated. The family was informed. As they stood in the hall outside the unit, the patient's wife asked if she could be with her husband. A nurse explained what she would see and accompanied her to the bedside. She stood at the head of the bed, stroked her husband's head and spoke softly in his ear. The patient's son came to the bedside and said his last words to his father. The wife was present when treatment was stopped and the patient was pronounced dead. She said to the nurse who had accompanied her, "You have given me the greatest gift possible--you allowed me to be with my husband at the end."

Critical Care↗
PubMed1991

Effects of a multidimensional cardiopulmonary rehabilitation program on psychosocial function.

The effects of participation in a structured, outpatient cardiac rehabilitation program on psychosocial function after acute myocardial infarction or coronary artery bypass surgery, or both, were evaluated prospectively in 141 patients who were married or living with "a significant other" (89% men, mean [+/- standard deviation] age 63 +/- 9 years old). Forty-one patients who were participants in a 3-month cardiac rehabilitation program were compared with 100 patients who did not participate in a formal program. On average, patients in both groups were well educated, older Caucasians who had minimal cardiac dysfunction (New York Heart Association class I or II). Patients in the 2 groups were not different at baseline in sociodemographic or clinical characteristics or in any of the dependent measures of anxiety, depression, psychosocial adjustment to illness or marital adjustment. Six months after initial testing, patients who attended cardiac rehabilitation were significantly less anxious (F[1,139] = 5.09, p = 0.03), less depressed (F[1,139] = 8.39, p = 0.004), had better psychosocial adjustment (F[1,139] = 5.87, p = 0.02), and were more satisfied with their marriages (F[1,139] = 8.6, p = 0.004) than nonparticipants. The findings support the effectiveness of group cardiac rehabilitation for this subgroup of patients in facilitating their psychosocial recovery after an acute cardiac event.

Adult↗
PubMed1991

Different perspectives: the effect of heart disease on patients and spouses.

Nurses working in critical care units play an important role in helping patients and their families cope with illness. In this article, heart disease is used as a paradigm for discussion of the coping processes of patients and families as they adapt to an acute event. Patients and spouses demonstrate different but equally important responses that may increase marital conflict and impede recovery. The denial frequently used by patients is in direct contrast to the oversolicitousness demonstrated by spouses. Early assessment of potential family dysfunction is essential in order to plan and implement interventions that promote family coping. In this article, the interventions available to nurses working with families in an acute care setting are reviewed. Interview data from one study of cardiac patients and their spouses is used to illustrate the family dynamics seen in the acute and chronic phase of recovery and to provide examples of the couples' differing perspectives on the helpfulness of various interventions.

Adaptation, Psychological↗
PubMed1988

Writer's cramp: a controlled trial of habit reversal treatment.

In uncontrolled studies, several behavioural methods, including habit reversal, were said to be useful in writer's cramp. In this controlled study, 23 subjects with writer's cramp recruited from a neurology clinic were randomly allocated to five sessions over four weeks of either habit reversal training or a control treatment of relaxation training. Three subjects dropped out. Twenty patients (9 habit reversers, 11 controls) completed the trial up to three months follow-up. Outcome measures included observation of writing within the session, assessment of writing tasks completed at home, and blind ratings by an independent assessor. The results showed that habit reversal was no better than relaxation. Taking both treatments together, patients improved to three months follow-up on seven of nine measures, but remained substantially handicapped.

Adult↗