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Biomedical subjects

C Monaco

Publications and source records attributed to C Monaco.

At least 55 records · Page 3Linked to original sources
PubMed1993

An evaluation of the effects of commingling cognitively and noncognitively impaired individuals in long-term care facilities.

A sample of 77 noncognitively impaired individuals residing in integrated long-term care units housing both demented and nondemented residents were assessed in terms of morale and satisfaction with their environment and with life. One third of these individuals lived near and/or shared a bathroom with a cognitively and/or behaviorally impaired individual. Residents placed next to demented individuals had significantly fewer kin contacts, were more likely to be unmarried or never married, and were more dissatisfied with their roommate/living situation.

Aged↗
PubMed1993

A primary care nursing model in long-term care facilities: evaluation of impact on affect, behavior, and socialization.

A primary care model of delivery of nursing aide care was implemented and evaluated in one small, rural nursing home and one large, urban facility. Experimental unit residents received primary care consisting of permanent assignment of nursing aide, a team approach and enhanced communication. The urban experimental residents improved significantly in behavior and affect as measured across several sources, while the comparison group declined or remained the same. Significant improvements in behavior and social activities were observed among the experimental rural nursing home residents as contrasted with the comparison group after implementation of primary care nursing. It was concluded that primary care nursing as applied to nursing attendants in long-term care is beneficial to residents in terms of decreasing disturbed behavior and improved affect.

Affect↗
PubMed1993

Outcomes for the mentally ill in a program for older homeless persons.

OBJECTIVE: The study evaluated the success of a generic service program for older homeless persons in improving the well-being of mentally ill clients. It attempted to identify factors that predicted the number of service encounters and outcome in seven areas, including housing, entitlements, physical and mental health, and sobriety. METHODS: All persons newly admitted to the program during a two-and-a-half-year period were asked to participate in structured interviews assessing their physical and mental health and their support networks. Two-thirds of those eligible, or 130, participated in the intake interviews. At three-year follow-up or last contact, outcome was compared for 41 psychiatric clients with psychotic symptoms or self-reported history of psychiatric hospitalizations and 89 clients with no psychiatric symptoms or previous hospitalizations. RESULTS: Persons with mental illness averaged 2.5 favorable outcomes, and a majority obtained temporary or permanent housing, improved their physical health, and secured entitlements. However, mentally ill clients had significantly fewer service encounters and favorable outcomes than clients who were not mentally ill. Types of presenting problems at intake were the only significant predictors of outcome for mentally ill clients. CONCLUSIONS: A generic service program for older homeless persons can successfully improve the well-being of mentally ill clients, although outcomes are less favorable for such clients than for clients who are not mentally ill.

Activities of Daily Living↗
PubMed1992

Special care units in nursing homes: prevalence in five states.

As part of a five-state study of the impact of special care units for demented residents, the authors surveyed (with telephone follow-up) nursing homes to identify those facilities that maintained some form of special care unit. The estimated prevalence was 11%; this finding suggests that special care units are far more numerous than had previously been reported. This difference is due in part to definitional considerations: many facilities maintain "cluster units" that do not differ appreciably from segregated units. However, more often than not, facilities did not regard these units as special care units.

Activities of Daily Living↗
PubMed1992

Project rescue: serving the homeless and marginally housed elderly.

The authors describe the engagement techniques and service components of a program for homeless and marginally housed elderly. On follow-up evaluation of 132 people, clients averaged three favorable outcomes (maximum = 7). Service delivery was conceptualized as a three-stage process based on the differential effects that variables had at each stage. The strongest predictors of outcome were number of service encounters, type of presenting problem, and perceived level of social support.

Aged↗
PubMed1992

Seasickness in totally-enclosed motor-propelled survival craft: five offshore oil rig disasters.

Five mobile offshore drilling unit disasters--Alexander L. Kielland, Ocean Ranger, Vinland, Ocean Odyssey, and Rowan Gorilla I--were studied to assess the degree to which seasickness occurs and endangers the lives of occupants of totally-enclosed motor-propelled survival craft (TEMPSC). Thousands of other peacetime marine incidents were reviewed and a literature search was conducted to assess the same seasickness problem. The one reported death in the Vinland abandonment appears to be the only one that could be associated, even remotely, with seasickness. It cannot be established whether or not seasickness contributed to the cause of death in the case of the Ocean Ranger victims, but it did occur in 75% or more of TEMPSC occupants in the other four rig disasters. It has occurred both in relatively calm waters of 1-m wave height and in severe seas of 15-m heights. Evacuees in an intact TEMPSC are able to survive many hours of severe seas; consequently, they should not be rescued until the weather and sea conditions improve. Moreover, practical survival training and good leadership is a principal cornerstone in the amelioration of seasickness.

Accidents↗
PubMed1992

Seasickness in totally-enclosed motor-propelled survival craft: remedial measures.

Totally-enclosed motor-propelled survival craft (TEMPSC) are used to evacuate the crews of mobile offshore drilling units in emergencies. The small size and flat bottom of the TEMPSC predispose most occupants to seasickness, even in relatively calm waters. This paper discusses efforts required to improve the well-being of occupants in terms of reducing seasickness, dehydration, hypothermia, anxiety, and the other factors that contribute to loss of comfort and the will to survive. Specific recommendations include the provision of climatic control to regulate temperature, remove odors and provide fresh air; potable water, electrolytes, and survival rations; and an ample supply of motion sickness bags. Overcrowding should be avoided. Anti-motion-sickness drug therapy to control vomiting should be administered in two ways: initial injection of intramuscular scopolamine for fast action followed by a transdermal ear patch for long-term protection. Leadership and seasickness management should be requisite survival training for all oil rig workers.

Antiemetics↗
PubMed1991

Factors differentiating hospital transfers from long-term care facilities with high and low transfer rates.

This paper examines the factors that account for differences among nursing homes in terms of the rates at which they transfer patients to hospitals. Data from nursing staff and charts were collected on the 286 most recent transfers from 10 nursing homes. Discriminant function analyses indicated that from relatively equivalent patient populations, high-rate facilities tended to transfer the more chronically ill, physically frail patients; patients with infection (a potentially treatable condition within the long-term care facility); and to make transfers because of lack of resources such as a lab and X-ray equipment. Lack of IV therapy, while a frequently cited primary nonmedical reason for transfer, did not discriminate between high- and low-transfer-rate facilities.

Female↗
PubMed1990

Impacts associated with special care units in long-term care facilities.

This study is a comprehensive, longitudinal assessment of the characteristics of special care patients. Demented patients in special care units (SCUs) within four nursing homes were compared with their demented counterparts in the same facilities who were not placed in SCUs. Results of this preliminary study suggest that the two groups differ in level of cognitive impairment, in behavior, and in functional and physical status. No deleterious or beneficial effects were associated with SCU residence during a 6-month period.

Cognition Disorders↗
PubMed1988

Compartmental analysis of lidocaine kinetics during extracorporeal circulation.

The aim of this study was to measure the effects of extracorporeal circulation (ECC) on lidocaine disposition and to determine if therapeutic concentrations were achieved during ECC. Anesthesia was obtained by administration of fentanyl (50 microg/kg plus 0.3 microg/kg/min) and pancuronium bromide (0.1 mg/kg) along with controlled ventilation (10 mL/kg, PaCO2, 30 to 34 mmHg). Lidocaine was administered to ten patients in bolus doses of 2 mg/kg at the time of endotracheal intubation and during ECC at aortic declamping. Samples were collected at 20 and 40 seconds, and at 1, 3, 5, 10, 15, 20, 25, and 30 minutes after drug administration. Blood sampling was arterial during anesthesia induction and from the oxygenator during ECC. Blood levels of lidocaine were determined by the immunofluorescence method. The kinetic studies of lidocaine showed increases in plasma volume and in the volume of the peripheral compartment, along with decreased volume in the compartment of well-perfused tissues during ECC. The fraction of the dose of lidocaine administered during ECC behaved accordingly, showing a decrease in the quantity of drug in the well-perfused tissues, and an increase in the other two compartments when compared to values before ECC. The doses administered gave plasma concentrations of 1.55 microg/mL, which are considered therapeutic. Thus, it is not recommended to increase the lidocaine dosage during ECC.

Aged↗
PubMed1986

Magnesium metabolism in open-heart surgery.

The levels of magnesium in serum, urine and erythrocytes were studied in 22 patients undergoing cardiac surgery for valvular prosthesis. Magnesium values were correlated with serum albumin and non-esterified fatty acids (NEFA). Data were collected before anesthesia, 10 min after sternotomy, heparinization and declamping of the aorta and in the 1st postoperative day. A slight decrease in magnesemia was observed before extracorporeal circulation (ECC) and was mainly due to haemodilution. The correlation of magnesium with NEFA was significant only after heparinization. The use of the St Thomas solution as cardioplegia fully corrected the hypomagnesemia previously reported during ECC as well as in the 1st postoperative day. A moderate hypermagnesemia was observed at the end of ECC, but no patient reached dangerous levels of serum magnesium. Urinary losses increased during and after ECC. Red blood cell magnesium showed a slight increase before ECC, followed by a significant reduction at the end of ECC.

Adult↗