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Biomedical subjects

J J Warren

Publications and source records attributed to J J Warren.

At least 55 records · Page 3Linked to original sources

Sources of fluoride intake in children.

Wide variations in fluoride intake among children make estimating fluoride intake difficult. This paper discusses the various sources of fluoride intake among children, beginning with a review of the fluoride concentrations of water and other beverages, foods, and therapeutic fluoride products. A review of previous studies' estimates of fluoride intake from diet, dentifrice, fluoride supplements, fluoride mouthrinses, and gels, as well as total fluoride intake also is presented. Then, estimates of fluoride intake among young children of different age groups are summarized, and examples demonstrating the high level of variability of fluoride intake, both from individual sources and in total, are presented. Lastly, this paper discusses the implications of our current level of knowledge of children's fluoride intake, and presents recommendations for the use of fluoride for children in light of this current knowledge. The major recommendations are that: (1) the fluoride content of foods and beverages, particularly infant formulas and water used in their reconstitution, should continue to be monitored closely in an effort to limit excessive fluoride intake; (2) ingestion of fluoride from dentifrice by young children should be controlled, and the use of only small quantities of dentifrice by young children should be emphasized; and (3) dietary fluoride supplements should be considered a targeted preventive regimen only for those children at higher risk for dental caries and with low levels of ingested fluoride from other sources.

Adolescent↗

Patient outcomes: assessment issues for the CNS.

Patient outcomes are becoming markers of health care effectiveness and quality. The CNS is uniquely positioned to influence outcomes evaluation within nursing. One way to accomplish this is through recommendations on the selection and use of appropriate patient assessment tools within the patient database. Recommendations of the CNS should be based on: an awareness of patient outcomes of particular interest to nursing; a goal of standardized, retrievable clinical data; characteristics of clinically appropriate assessment tools for outcomes evaluation; and data needs of patient outcomes research as well as traditional clinical research.

Humans↗

A profile of patients in six dental school clinics and implications for the future.

Surveys were conducted of patients receiving care at six dental school clinics in the United States during a one-week period in the fall of 1993. Survey data were analyzed to determine who was using services provided by these dental schools, the types of services being provided, and why people chose to receive their care at these dental schools. Eighty-one percent of the patients indicated that low cost was an important reason for seeking care at a dental school; the patients receiving care at these dental schools tended to be low income. Seventy-six percent paid for some or all of their care out of pocket. As dental schools reevaluate their mission regarding patient care issues and assess the impact of their decisions, information about dental school clinics, particularly who seeks care there and why, should be an important consideration.

Academic Medical Centers↗

Molecular evidence of person-to-person transmission of a pigmented strain of Corynebacterium striatum in intensive care units.

During a 14-month period, a unique strain of Corynebacterium striatum that produces a diffusible brown pigment was isolated from purulent sputa of nine patients and from nonrespiratory sites of two additional patients. Seven nonpigmented clinical isolates from the same period and three reference strains of C. striatum were compared with the brown isolates. Most patients had multiple sputum cultures with no coryneforms before the brown strain emerged, suggesting that the organism was hospital acquired. DNA restriction fragment patterns and Southern hybridization with the att site probe of Corynebacterium diphtheriae indicated that the brown isolates were a single strain which was distinct from the heterogeneous nonpigmented strains. A common source for the brown C. striatum was not recognized, although all of these patients were located in two adjoining intensive care units. All of the brown isolates, three of the nonpigmented clinical isolates, and two reference strains had positive CAMP reactions with Staphylococcus aureus, which has not been reported for C. striatum prior to this study.

Bacterial Typing Techniques↗

Design and implementation of a rule based system for ambulatory nursing data management.

In order to effectively organize the use of nursing time during clinic check-in, we designed a forward chaining rule based program for nursing history taking, problem tracking, and documentation. The program consists of a medical logic module trigger engine which identifies relevant rules for nursing history, an interactive question manager for nursing history taking, and a rule generation shell implemented within a specially designed Medical Query Language (MQL) shcema. At clinic check-in, the engine refreshes the rule set for the patient from interaction with the computerized medical record. The interaction driver assists the nurse with tracking of elapsed time, and allows him/her to pursue questions, record data, and create or complete nursing interventions. Nursing question sets and interventions are maintained longitudinally to assure continuity of care. Nursing problems are created on the problem list within the computerized record as the rule system identifies their existence.

Academic Medical Centers↗

Information management in ambulatory care: the nurse and computerized records.

The ambulatory office setting is increasingly becoming a central focus of patient care. The nursing staff are integral to patient care management in this environment. They are frequently the heaviest users of medical records and are generally early advocates of well designed computer records systems. As our implementation of a Computer Stored Ambulatory Record (COSTAR V) has grown in complexity and utility, reorganization of the record and development of new features to support nursing has become critical. This demonstration will show how nursing information management has changed using a variety of computer record tools, including features of exam room data entry, specialized nursing displays and problem based patient summaries. Specific items for demonstration will include: nursing check-in module, rule driven nursing history program, prescription refill functions, documentation and billing for nursing procedures, nursing telephone management functions, a module for management of anticoagulation and document retrieval and display utilities.

Ambulatory Care Information Systems↗

A comparison of role conceptions and role deprivation of baccalaureate students in nursing participating in a preceptorship or a traditional clinical program.

In this study, the professional and bureaucratic role conceptions and role deprivation of students participating in a preceptorship program were compared to those in a traditional faculty-supervised clinical group. The role conceptions and role deprivation of nursing faculty and preceptors were also examined. One hundred eighteen students in a two-year upper division baccalaureate program participated in this study. The Corwin Nursing Role Conception tool was administered. Results indicated no differences in role conceptions or role deprivation in students participating in the preceptorship program and those who did not. There were no differences in the developmental pattern of role conception and role deprivation during two years of nursing education. Also, nursing faculty had a significantly higher professional role conception and a significantly lower bureaucratic role conception than preceptors but there were no differences in role deprivation between the two groups.

Adult↗

Accountability and nursing diagnosis.

A taxonomy of nursing diagnoses improves communication within the domain of nursing practice. The author contends that use of this tool throughout the health care delivery system could lead to improved management of nursing care. Improvements could be made in identification of staffing requirements, justification of third party payments, development of quality assurance programs, establishment of standard terminology between nurses, and generation of an extensive and valid research data base. Nursing administrators should consider using accepted nursing diagnoses as one of the tools available to improve nursing care and to document nursing accountability.

Communication↗

Performance characteristics of a commercial antibody-capture enzyme immunoassay for detection of Toxoplasma-specific IgM antibodies.

Antibody-capture enzyme immunoassay (EIA) for the detection of Toxoplasma-specific IgM has been shown to provide significantly higher specificity than the indirect IgM EIA. A new commercially available antibody-capture EIA (PLATELIA Toxo IgM EIA) converted 99 out of 100 false-positive Toxo-plasma IgM determinations to true negative. Experiments using Toxoplasma IgM calibrators demonstrated the antibody-capture EIA is approximately eightfold more sensitive than a new automated microparticle EIA for Toxoplasma IgM antibodies (IMX Toxo IgM EIA), and approximately equal in sensitivity to the indirect immunofluorescence assay. Precision studies of the antibody capture EIA using low, medium, and high calibrators gave coefficients of variation ranging from 3.0%-4.5% for within-run and 5.2%-11.4% for run-to-run variation experiments. Interference from high levels of bilirubin, albumin, hemoglobin, and lipid was not detected. Sera from patients with inflammatory or infectious disorders were tested for interference in the antibody-capture EIA. False-positive Toxoplasma IgM results were not observed, but low-level negative interference was detectable when patient sera was mixed with Toxoplasma-positive sera. Preparations of purified human IgM also produced negative interference in the antibody-capture EIA for Toxoplasma IgM.

Animals↗

The development of NANDA's nursing diagnosis taxonomy.

In the early 1970s the need for a precise and computerizable language of nursing phenomena was identified. This need stimulated the formation of the National Conference Group for the Classification of Nursing Diagnoses. The group began the work of identifying nursing diagnoses and developing a taxonomic structure for their classification. Based on the initial success with the development of nursing diagnoses, the conference group became the North American Nursing Diagnosis Association (NANDA). There are two benefits of taxonomic development within nursing: one is scientific in nature, while the other is applied or practical. The development of this taxonomy has occurred over a span of 17 years including nine national conferences. Details of this development have been abstracted from the proceedings of the nine conferences and the minutes of the Taxonomy Committee in order to explicate the taxonomic structure. The rules for the classification, developed by the committee, are presented. Future directions for taxonomic development and collaboration with other health care professions are proposed.

American Nurses' Association↗

Development of definitions for taxonomy II.

In the process of placing diagnoses into Taxonomy I, certain inconsistencies became apparent. Inadequate definition of both diagnoses and human response patterns, lack of defining characteristics, and inconsistency in the levels of abstraction within the taxonomic hierarchy made the task of assigning a diagnosis to a taxonomic pattern difficult. Ambiguity in the definitions of the nine patterns resulted in ambiguity in the basic foundation, which affected the entire structure. The Taxonomy Committee, before evaluating the current structure, had to make the following decisions regarding the current human response patterns: (1) Should the nine human response patterns be retained for further taxonomic work? and (2) If they are retained, what should be the first step in examining Taxonomy I-Revised? This second article in a series of four will familiarize the readers with the process and decisions by which Taxonomy II of the North American Nursing Diagnosis Association (NANDA) is evolving through the work of the Taxonomy Committee. This article also will identify the specific problems encountered in the development of Taxonomy I and Taxonomy I-Revised, and describe the steps establishing the validity of the process of formation of the nine human response patterns.

Classification↗