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Biomedical subjects

D L Sexton

Publications and source records attributed to D L Sexton.

At least 19 recordsLinked to original sources
PubMed1993

Factors that influence CNSs' decision about specialization.

Few studies have explored nurses' decision making relative to advanced practice. The purposes of this study were to determine when the decision to prepare as a CNS in a particular specialty is made and to identify the factors that influence that decision. A survey was completed by 257 CNSs. Results indicated that more than half (69%) decided on their specialty after graduation from a basic nursing program. The factors that influenced choice of specialty included experience in first position (47%), clinical role model (37%), and student experience (35%). Critical care was rated the most desirable specialty and psychiatric nursing the least preferred.

Adult↗
PubMed1993

Patients' responses to postponement of coronary artery bypass graft surgery.

The purpose of this study was to determine the thoughts and feelings of patients (n = 24) awaiting coronary artery bypass graft (CABG) surgery and, in particular, the thoughts and feeling of those patients (n = 17) whose surgical procedure was postponed. On average these patients waited four additional days before the surgery could be performed. Patients reported that the most difficult part of CABG surgery was the wait itself. Those whose CABG surgery was postponed expressed anger and disappointment, had additional tests, procedures and medication, extended hospital stays and increased costs.

Adaptation, Psychological↗
PubMed1992

Frequency of long-term lower limb ischemia associated with intraaortic balloon pump use.

Lower limb ischemia is a frequent complication of intraaortic balloon pump (IABP) use. The incidence and risk factors for acute ischemia have been well-defined, but little is known about long-term ischemic complications. This prospective study evaluated the incidence, nature, progression and predisposing factors for long-term lower limb ischemia in 151 patients who were previously treated with the IABP. These persons were interviewed and their lower extremities examined 12 to 20 months after undergoing IABP counterpulsation. Limb ischemia, characterized primarily by ipsilateral discomfort and diminished pulses, occurred in 18% of those evaluated. Evidence of ischemia worsened over time in 14%. Logistic regression analysis, which was based on variables found to be significant in bivariate analysis, revealed that the occurrence of limb ischemia acutely, cardiogenic shock as an indication for IABP insertion, and smoking (at the time of hospitalization or having quit < 10 years previously) were risk factors for long-term lower limb ischemia. The adjusted odds ratio for acute limb ischemia was 8.89 (95% confidence interval 2.80 to 28.21), for cardiogenic shock 3.59 (95% confidence interval 1.01 to 12.75), and for smoking 2.87 (95% confidence interval 1.10 to 7.46). Increasing numbers of patients are undergoing IABP counterpulsation and a greater proportion of these are surviving their acute event and resuming active lives. It is essential to recognize that detrimental consequences of this device can persist long after hospitalization.

Adult↗
PubMed1989

Erythroid heterokaryons: a system for investigating the functional role of trans-acting factors in developmental hemoglobin switching.

We have shown that erythroid cells from widely divergent species such as amphibians and mammals can be efficiently fused using either calcium phosphate bridges or polyethylene glycol. Transient heterokaryons of adult mouse erythroid (MEL) cells and Rana catesbeiana (bullfrog) tadpole erythroid cells produce adult Rana alpha globin mRNA and adult Rana hemoglobin (Hb) tetramers. Rana tadpole/adult Xenopus erythroid heterokaryons also exhibit this switch to adult Rana globin gene expression. These results indicate that trans-acting factors--and the globin gene regulatory mechanism of which they are a part--are conserved in vertebrate phylogeny. We also wish to know whether the reciprocal Hb switch occurs in each of these two types of heterokaryons, i.e., whether embryonic or fetal globin genes are reactivated in the adult nucleus. Experiments to answer these questions are in progress and are briefly discussed. The influence of stage of erythroid differentiation of the larval and adult donor cells on the cross-inductions is also being explored. These types of experiments should indicate which cells will be the best sources of stimulatory and inhibitory factors that are globin-gene specific. This system may be useful as an in situ assay for the function of purified trans-factors, which could be encapsulated within RBC ghosts and delivered via cell fusion.

Aging↗
PubMed1987

Comparison of the MCMI and MMPI-168 as psychiatric inpatient screening inventories.

The Millon Clinical Multiaxial Inventory (MCMI) has been recently developed as an alternative to the Minnesota Multiphasic Personality Inventory (MMPI) and shares some of its psychometric advantages and disadvantages with the MMPI-168, a short form of the MMPI. The current study compared the structure and utility of the MCMI and MMPI-168 for a general hospital inpatient psychiatric population. Overall, the two instruments were highly correlated and found to have conceptually similar factor structures. Empirical comparison of the factor structures indicated that construct validity is greatest for neurotic traits. Both instruments demonstrated a similar utility in predicting discharge diagnosis.

Adolescent↗
PubMed1986

Pulmonary nurse specialists: preparation for the advanced practice role.

A survey was done to determine the factors that influence nurses' decisions to prepare as specialists in pulmonary nursing. A questionnaire that included items concerned with biographic variables and perceptions toward pulmonary nursing was distributed on selected adult units of two medical centers and one community hospital in south central Connecticut. Data were collected from 113 medical-surgical nurses. Subjects were primarily women (96.5%) and in the 20-30 age range (mean = 30, SD = 7.06, median = 27.6). On the average, subjects had been employed for 7.5 years (7.03, median = 5.37). Thirty percent of the sample expressed a desire to work with pulmonary patients. This group had a positive score on the semantic differential (p = 0.0001). Nurses (N = 11) who had worked with a pulmonary clinical specialist rated their impression of caring for pulmonary patients more positively than those who had not (p = 0.044). Although only 13 subjects expressed an interest in preparing as a pulmonary nurse specialist, they had a positive score on the semantic differential (p = 0.0001). Limitations, recommendations for further study, and implications for nursing and nursing education are addressed.

Adult↗
PubMed1985

Impact of a husband's chronic illness (COPD) on the spouse's life.

This study was conducted to determine the impact of a husband's chronic illness on the spouse's life. The sample was 76 married women, 46 whose husbands had a diagnosis of chronic obstructive pulmonary disease (COPD) and 30 whose husbands did not have a chronic illness. On a mailed questionnaire wives of COPD patients reported higher subjective stress (p = .032) and lower life satisfaction (p = .006) than the wives whose husbands did not have a chronic illness. The COPD wives assumed more new roles and responsibilities, relinquished more social activities, rated their health lower, and reported less frequent marital relations. Implications for future research are addressed.

Aged↗
PubMed1977

The patient with peripheral arterial occulsive disease.

Peripheral arterial occlusive disease predominantly involves the lower extremities. The greatest incidence occurs in males over 50 years of age. Manifestations include intermittent claudication, diminished or absent pulsations, pallor, and trophic changes. Patients are particularly vulnerable to infection, ulcer formation, and gangrene. The treatment program aims to promote circulation, and to prevent tissue damage and complications. Some patients have reconstructive surgery, which includes prosthetic grafts as well as bypass procedures.

Aortic Aneurysm↗