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Biomedical subjects

H Hubert

Publications and source records attributed to H Hubert.

10 recordsLinked to original sources
PubMed2001

Assessing excess nurse work load generated by multiresistant nosocomial bacteria in intensive care.

OBJECTIVE: To compare three methods for assessing the excess nurse work load related to recommended procedures for managing nosocomial infections (NI) due to multiresistant bacteria (MRB): two activity scores, the Omega score and the Projet de Recherche en Nursing (PRN) system, and a specific evaluation based on functional analysis of nursing procedures. SETTING: 10 beds in a medical intensive care unit (MICU). PATIENTS: Patients admitted from November 15, 1995, to June 15, 1996, were included and divided in two groups based on presence of MRB colonization or infection (MRB+ and MRB-groups). METHODS: Data were collected regarding length of stay (LOS) in days; Omega score for the entire stay; PRN score for the entire stay and per day; and time required to perform correctly four nursing procedures related to MRB NI, as evaluated specifically by the nursing staff, using a detailed functional analysis document that described all elementary nursing tasks in chronological order and all material needed to carry out those tasks. RESULTS: The LOS and total Omega and PRN scores were higher in the MRB+ group than in the MRB- group: LOS, 23 +/- 20.6 versus 12 +/- 15.3 days, (P<.001); Omega score, 164 +/- 103.4 versus 123 +/- 93.7 points (P<.001); PRN score, 3,606 +/- 3,187 versus 1,854 +/- 2,356 points (P<.001), respectively. The daily PRN score was also higher in MRB+ group (PRN, 160 +/- 25 vs 146 +/- 34 points in the MRB- group; P<.028). Four nursing procedures made necessary by MRB acquisition were identified: isolation precautions, with two levels according to whether the risk of contamination was mild-moderate or high; bathing the patient with antiseptic solution; bedpan management; and microbiological screening. The functional analysis indicated that the time needed to carry out these four procedures correctly was 245 minutes per patient per day, as compared to 85 minutes according to the PRN system. CONCLUSIONS: Our data confirm that MRB NIs are responsible for an increase in nurse work load, as estimated by LOS, Omega, and PRN scores. However, the daily excess nurse work load related directly to recommended procedures for managing MRB NIs in MICUs is underestimated by these activity scores, as compared to a specific functional analysis of nursing tasks. This may be of importance in evaluating potential links between nurse work load and MRB NIs and in determining the number of nurse hours needed to comply with infection control recommendations.

Cross Infection↗
PubMed1997

Efficiency of the OVATEC unit for estrus detection and calf sex control in beef cows.

Seventy five spring calving Gelbvieh and Angus cows were utilized over a three year period to evaluate the usefulness of the OVATEC intravaginal probe for indicating the onset of estrus and providing the possibility to influence the sex of the offspring by choosing a breeding time in relation to critical changes in cervical mucus conductivity. Cows were randomly assigned by breed each year into one of four treatments: (1) probed and inseminated when impedance values declined, creating conditions expected to favor X-bearing sperm and with it an increase in the conception of females (PF); (2) probed and inseminated when impedance values were rebounding, expected to favor Y-bearing sperms and with it an increase in the conception of males (PB); (3) standing estrus (AI); or (4) natural service by bull (NS). Cows grazed or were fed hay from tall fescue-legume pastures. Lutalyse was used to synchronize estrus in a two injection scheme. Vaginal probe readings were taken at first injection, second injection and every 12 h thereafter for 6 days. Visual observations for estrus were obtained for PF, PB and AI every 12 h postsecond injection. Rectal palpations of ovaries were obtained at standing heat in all but NS treatments. In cycling cows, probe readings increased prediction of estrus onset (P < 0.10) compared to visual observations and were similar (P > 0.95) to rectal palpations in all probed cows. PF cows delivered heifer calves at greater rates (P < 0.025) than all other treatments whereas PB cows delivered bulls at greater rates (P < 0.05) than all other treatments. Heifer to bull ratios were not different (P > 0.95) for AI or NS treatments. The results of this study indicate that the potential exists for increasing female offspring conceptions utilizing cervical mucus conductivity as a gauge for insemination times.

Administration, Intravaginal↗
PubMed1996

Relationship of running to musculoskeletal pain with age. A six-year longitudinal study.

OBJECTIVE: To determine, by longitudinal study, whether long-distance running, maintained for many years, is associated with increased musculoskeletal pain with age. METHODS: A 6-year prospective longitudinal study of 410 runners' club members and 289 community controls, age 53-75 years at study initiation, was conducted. Subjects were also categorized as ever-runners (n = 488) and never-runners (n = 211). The primary dependent variable was pain score as indicated on a horizontal double-anchored analog scale; data for this variable were available beginning in 1987. Statistical adjustment for age, education level, smoking, alcohol consumption, history of arthritis, and presence of other major medical conditions was done by analysis of covariance. Further analyses of previously reported associations of regular vigorous physical activity with decreased disability and mortality after 9 years were performed. RESULTS: The degree of musculoskeletal pain was slightly lower in the exercise group compared with controls, and the difference was statistically significant for women but not for men. Average adjusted pain scores for men were 18.3 (SEM 0.8) in runners' club members, 20.2 (1.2) in controls, 18.6 (0.8) in ever-runners, and 20.3 (1.6) in never-runners. For women, these scores were 17.5 (1.8) in runners' club members versus 22.8 (1.4) in controls (P < 0.05), and 17.2 in ever runners versus 23.7 (1.5) in never-runners (P < 0.002). Disability had continued to develop in runners' club members at a rate only one-third that in the controls after 9 years of observation. Mortality over 9 years consisted of 51 deaths, of which 41 were in the control group and only 10 were among runners' club members. CONCLUSION: Vigorous running activity over many years is not associated with an increase in musculoskeletal pain with age, and there may be a moderate decrease in pain, particularly in women. Vigorous physical activity is associated with greatly decreased levels of disability and with decreased mortality rates.

Age Factors↗
PubMed1991

The CARDIA dietary history: development, implementation, and evaluation.

To meet the objectives for dietary assessment in the Coronary Artery Risk Development in Young Adults (CARDIA) prospective study, we developed a dietary history to provide accurate and reliable quantitative data on habitual individual nutrient intakes at baseline. The CARDIA dietary history was an interviewer-administered method that included a short questionnaire regarding general dietary practices followed by a comprehensive food frequency questionnaire about typical intake of foods using the previous month as a reference for recall. For each broad category of foods, participants were questioned in detail about specific foods only if they indicated that they consumed foods from that category. Follow-up questions for selected foods concerned serving size, frequency of consumption, and common additions to these foods. Provision was made for reporting foods not found in the food frequency list. The interview took approximately 45 minutes. Cue cards prompted responses and plastic food models assisted in estimating usual amounts consumed. A precoded format standardized coding for reported items and established the detail needed for recall during the interview. Baseline nutrient analyses from the CARDIA dietary history provided estimates that agreed reasonably well with expected caloric intake for body mass index according to the age- and sex-specific Recommended Dietary Allowances, but were higher than those reported from 24-hour recalls for comparable age, sex, and race groups in the second National Health and Nutrition Examination Survey. The CARDIA dietary history is a comprehensive assessment tool that can provide a dietitian with detailed information regarding habitual eating patterns and nutrient intakes among adults.

Adult↗
PubMed1989

Viscoelasticity and red blood cell aggregation in patients with coronary heart disease.

Viscoelastic parameters were evaluated in 169 consecutive male patients with clinical signs of coronary heart disease. The patients were classified according to the extent of coronary artery stenosis. Levels of blood viscosity, erythrocyte aggregation, and plasma viscosity were elevated in patients with extensive coronary vessel disease. However, the differences between the several groups were not statistically significant. The increase of hemorheologic parameters was mainly due to high hematocrit, fibrinogen, and cholesterol concentrations. There was a significant correlation between plasma fibrinogen values and plasma viscosity levels. Blood viscosity and erythrocyte aggregation can be described by multiple linear regression as a function of the sum of log hematocrit, fibrinogen, cholesterol, and alpha 2-macroglobulin.

Blood Viscosity↗
PubMed1985

Regression analysis of data with correlated errors: an example from the NHLBI twin study.

Epidemiologic studies often involve genetically related individuals, spouses, or repeat observations on the same individual. When regression analysis is required in such studies, significant correlation of the residuals may affect the estimates of the standard errors of the regression coefficients. Ordinary least squares may not provide the best (minimum variance) estimates of the regression coefficients. Generalized least squares (weighted least squares) is more appropriate when the covariance matrix of the errors is known or can be estimated with some degree of confidence. Data from a twin study of pulmonary function were analyzed by three different regression techniques and comparisons of the coefficients and standard errors are made to illustrate the potential effects of correlated errors.

Age Factors↗
PubMed1978

[Clinical experiences with a 6% hydroxyethyl starch 40000 solution; metabolic parameters and tolerance].

A 6% hycroxyethyl starch solution with a mean molecular weight of 40 000 and a degree of substitution of 0.5--0.55 was tested under controlled conditions at 79 clinics in West Germany. The following parameters were evaluated: tolerance, circulation effectiveness, influence on serum electrolytes, hemoglobin and hematocrit. A total of 779 patients received either 6% HES 40 000 alone, 6% HES 40 000 and electrolyte solution or 6% HES 40 000 solution and other volume effective plasma substitutes for treatment of hypovolemia. The results show that stable circulation can be achieved in 4 to 6 hours during narcosis as well as in the subsequent phase with a sufficient supply of fluid through 6% HES 40 000 solution. One case of flush and a slight chill were reported as side effects related to the hydroxyethyl starch.

Fever↗