Biomedical subjects
Publications and source records attributed to C Noone.
Computerized documentation in community health nursing is only now receiving the attention it deserves. The authors explain one agency's experience with adapting a computerized clinical documentation system to visiting nurses' needs and the nurses' responses to the process.
Should we or shouldn't we seek outside help for our home health agency organizational problem? Hiring consultants is an important consideration and can be nonproductive if proper care is not taken. Although not a panacea, the prudent choice of who, when, where, and how to use consultants can enhance the ability of managers to operate home health businesses. The authors discuss well-known reasons for client's resistance to consultants and reasons home care agencies have started to look to consultants to solve their problems. Specific guidelines for selecting and working with consultants are discussed to ensure that maximum benefit is achieved from consulting relationships.
Changes in intestinal permeability and lactose hydrolysis have been investigated in three adults and fifteen infants with acute rotaviral gastroenteritis by differential sugar absorption. The method involves chromatographic measurement of urinary lactose, lactulose and L-rhamnose excretion following combined ingestion in an iso-osmolar test solution. All patients had abnormal intestinal permeability indicated by raised urine lactulose/L-rhamnose excretion, ratio of percentages recovered in 5 h, of 0.462 (0.100-1.227) mean and range, compared with 0.027 (0.008-0.052) for healthy controls (P less than 0.001). Ten patients also had urinary lactose/lactulose excretion ratios raised above the normal range (0.014-0.41, mean 0.258) during their acute illness, indicating impaired intestinal lactose hydrolysis. Both indices had become normal 4 weeks after the acute illness, serial investigation of five patients showing that improvement was complete much earlier. Except for the short duration these changes are similar to those associated with villous atrophy in coeliac disease. The test procedure was verified with respect to intestinal lactose hydrolysis by demonstrating a linear relationship between lactose/lactulose excretion and log jejunal mucosal lactase activity by in vitro assay (R2 = 0.95) in a further group of subjects. Differential lactose/lactulose/L-rhamnose absorption provides a non-invasive and sensitive index of small intestinal integrity of value for the interpretation of prolonged or otherwise complicated enteritis and the distinction of primary secondary intestinal lactase deficiency.
Between 1 October 1981 and 30 September 1982, 74 children with acute gastroenteritis were admitted to the paediatric wards at St Thomas' Hospital, and a further 37 patients acquired gastroenteritis while in hospital. Rotaviruses were detected in the stools of 29 of 74 (39 per cent) of patients with community-acquired and 22 of 37 (59 per cent) of patients with hospital-acquired infection. Although patients were also admitted with bacterial stool pathogens, barrier nursing techniques were apparently successful in preventing spread of these. The use of a virucidal agent for handwashing might be effective in preventing hospital-acquired rotaviral infections.