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Biomedical subjects

J Noyes

Publications and source records attributed to J Noyes.

At least 19 recordsLinked to original sources
PubMed2001

The perceived learning needs of paediatric intensive care nurses caring for children requiring haemofiltration.

This paper reports on a small exploratory phenomenological study to describe the lived experiences of paediatric intensive care nurses, who extended their roles to care for critically ill children requiring continuous veno-venous haemofiltration. In describing and understanding this learning experience, an insight into the educational and support needs of these nurses is offered. From the insight shared, five main themes were identified. These included the overwhelming need to be a competent practitioner, which was perceived within the context of knowledge for effective practice and technical dexterity.While generalizability of findings is not intended, the findings could be of value to other intensive care settings to guide the identification and implementation of strategies to meet the needs of nurses undertaking similar roles.

Child↗
PubMed2000

Enabling young 'ventilator-dependent' people to express their views and experiences of their care in hospital.

Discussion in this paper is drawn from a phenomenological study carried out in England describing the views and experiences of young 'ventilator-dependent' people aged 6-18 years, regarding their health and social care, education, and aspirations for the future. This study presented many methodological and ethical challenges in order to elicit and present their views in a meaningful way. Data were elicited through focused face-to-face interviews with 18 young people. Innovative methods of data collection were used with younger children and those who had a range of communication impairments. In addition, family members of 15 young people were interviewed. Presentation of findings is limited to views and experiences of the young people's care in hospitals. Findings reveal that a significant number of Articles in the United Nations (UN) Convention on the Rights of the Child were not respected or upheld. Young 'ventilator-dependent' people were discriminated against when trying to access health services because of their need for assisted ventilation. They were particularly excluded from making important decisions about their lives and were not always offered the full protection of the Children Act 1989 (England). Some young people were not able to maintain adequate contact with their families, first language, culture, nationality and religion. Almost all spent prolonged periods of time (in some cases years) in hospital when they no longer wanted or needed to be there. All those interviewed wanted to be discharged home far sooner. The generalizability of findings is unknown; however, important questions are posed in relation to nursing practice and research regarding the overall management of this group of young people. Issues include: respecting and upholding human rights; and challenging the boundaries of current nursing practice in order to move towards child-centred, appropriate and effective models of care.

Adolescent↗
PubMed2000

Are nurses respecting and upholding the human rights of children and young people in their care?

Children's nurses may assume that the care they provide for children and their families is family centred and meets their holistic needs. However, very little objective evaluation has been undertaken with children and young people regarding the health services and nursing care they receive. In this study, data were collected from 18 young ventilator-dependent people and their families in order to evaluate their experiences of health and social care. The UN Convention and other policy documents advocating client-focused services were used as benchmarks for analysis, demonstrating that the needs and aspirations of the young people are not being addressed and raising questions for nurses and other professionals.

Child↗
PubMed1999

The impact of knowing your child is critically ill: a qualitative study of mothers' experiences.

Discussion in this paper is drawn from an exploratory study designed to elicit mothers' lived experiences of crisis and coping, and their experiences of nursing following the unexpected emergency admission of their child to the paediatric intensive care unit (PICU). An in-depth critique of literature supporting this study has been published. Two theoretical perspectives serve as a basis for this exploratory study: firstly, the idea that in a crisis situation, a mother's ability to cope and function is influenced by therapeutic interventions of nurses by meeting her needs in a holistic way; and secondly, symbolic interactionism, that focuses on the meaning of events to mothers. Data were elicited through focused interviews with 10 mothers of children aged between 3 months and 15 years who had been admitted unexpectedly to the PICU with a life threatening condition. Findings reveal the major impact of crisis on mothers immediately following their child's critical illness and admission to PICU, and this specific aspect therefore warrants in-depth discussion and analysis. The study did not generate a theory; however, important recommendations are made for nursing practice and research in relation to the impact of crisis experienced by mothers. Nursing practice issues include meeting the psychosocial needs of parents prior to and immediately after admission, and the importance of family-centred nursing care. Issues for nursing research include exploring how families cope with the impact of crisis and critical illness.

Adaptation, Psychological↗
PubMed1999

The experiences and views of parents who care for ventilator-dependent children.

Discussion in this paper is drawn from the literature examining the management of children with long-term assisted ventilation, and a study of parents' experiences and views of caring for their ventilator-dependent child at home. Difficulties in undertaking research into this group of children are highlighted. Recommendations are proposed regarding future multidisciplinary, multiagency service development in order to meet the needs of ventilator-dependent children and their families.

Adaptation, Psychological↗
PubMed1999

Children's behaviour and the design of school furniture.

Children spend a large part of their school days in the classroom, and yet the effect of the design of school furniture on their behaviour and health has received comparatively little attention in the UK. An experimental study is reported that compares the effects on children's behaviour and sitting position of traditional classroom furniture with a recently designed chair known as 'Chair 2000' and associated tables. It was found that children showed a modest but significant improvement in on-task behaviour and a marked change in sitting positions following the introduction of the newly-designed furniture. However, these benefits need to be considered in the light of polarized opinion for and against the new furniture, and a high level of reported incidence of back pain significantly related to the frequency of non-standard sitting. In the absence of radically redesigned furniture, it is suggested that children should be given more choice in their seating, and better guidance should be given to individuals involved in education in order to inform their decision-making about classroom furniture and the postural, anthropometric and orthopaedic aspects of sitting and related activities.

Analysis of Variance↗
PubMed1998

A critique of studies exploring the experiences and needs of parents of children admitted to paediatric intensive care units.

This paper is based on a critique of studies exploring the experiences and needs of parents whose children are admitted to paediatric intensive care units (PICU). The majority of studies have been conducted in North America and attempt to quantify parental feelings and experiences. Few qualitative studies have been published. Major theoretical concerns are developed in relation to the validity of quantitative and qualitative methods of data collection which currently serve to inform nursing practice. While methodological issues abound, consistency across studies supports the importance of certain features of parents' experiences, such as being with their child and role conflict. None of the literature reviewed considered the specific needs of different ethnic and cultural groups, siblings, grandparents or the family as a unit. The views of fathers are also under-represented. Recommendations are made for future well-designed qualitative studies to be undertaken by experienced qualitative researchers from a holistic insider family perspective.

Adaptation, Psychological↗
PubMed1996

Home monitoring of infants at increased risk of sudden death.

Home apnoea and cardiorespiratory monitors are commonly used in the UK, the rest of Europe and USA in infants at increased risk of 'sudden infant death'. The efficacy of apnoea and cardiorespiratory monitors remains unknown. The use of transcutaneous oxygen monitoring is presented as an alternative method of home monitoring. Recommendations are proposed regarding nursing practice and the future of home monitoring in infants at increased risk of sudden death.

Attitude to Health↗
PubMed1995

An explanation of the differences between expert and novice performance in the administration of an intramuscular injection of an analgesic agent to a patient in pain.

It has been stated that nurse education in the United Kingdom (UK) currently draws upon Schön's concept of the reflective practitioner, and Benner's concept of the expert. Studies have explored the claim that experienced expert practitioners are unable to articulate all they know, and that their theoretical knowledge and clinical skills are of a qualitatively different type from that of novice practitioners. This paper aims to explain the differences between expert and novice performance using the example of administering an intramuscular injection of an analgesic agent to a patient in pain. Theoretical concepts concerning the nature of expertise are used to evaluate novice/expert performance in nursing. Criticisms of Benner's theory are developed in relationship to her methodology and the interpretation and assessment of nursing practice.

Clinical Competence↗
PubMed1994

Negative extrathoracic pressure ventilation in central hypoventilation syndrome.

Nine patients with central hypoventilation syndrome (CHS) were treated with negative extrathoracic pressure ventilation (VNEP). Treatment with VNEP was started between 20 days and 57 months of age, which was two days to 47 months after diagnosis. The equipment to provide VNEP utilised a new system with a latex neck seal and Perspex chamber allowing easy access to the child. Seven patients are managed with VNEP at home by their parents. They did not have a tracheostomy when VNEP was started at ages of 22, 24, 31, 38, and 75 days, 5 and 57 months. They have continued to be successfully managed with VNEP and without tracheostomy. Short periods of intubation and positive pressure ventilation were required on 10 occasions (median duration 7 days, range 4 to 21 days) in four subjects during respiratory tract infections. Three patients required periods of continuous positive airway pressure (CPAP) via a nasal mask or a nasopharyngeal airway during sleep to overcome upper airway obstruction. In three patients the hypoventilation improved and two of these do not require regular ventilatory support at 1.3 and 3.4 years of age. Six of these seven patients are developing normally. In two patients with long term tracheostomies, VNEP could not be established at an age of 29 and 52 months because of tracheal obstruction after temporary removal of their tracheostomy cannula. VNEP is an effective, non-invasive, treatment in infants with CHS if initiated before tracheostomy. It may improve the children's quality of life during the daytime. If upper airway obstruction is a problem in the first year of life, it may be combined with nasal mask CPAP.

Child Development↗
PubMed1988

Selective defect in the antibody response to Haemophilus influenzae type b in children with recurrent infections and normal serum IgG subclass levels.

We studied 15 children with recurrent infections and normal serum IgG, IgM, IgA, and IgG-subclass levels. After immunization, the geometric mean serum IgG antibody concentration to Haemophilus influenzae type b (Hib) was eightfold lower than that of age-matched control subjects (p = 0.002). The patients also had a lower geometric mean concentration of serum IgM and IgA directed to Hib, although these differences did not reach significance. However, the groups did not differ in their response to diphtheria toxoid and pneumococcal polysaccharides. To confirm these findings, an additional 11 patients were identified and immunized. The geometric mean serum IgG anti-Hib concentration for this group of patients was also significantly lower than of normal subjects (p = 0.004). We propose that the defect in the antibody response to Hib may be a marker for a poor antibody response to a variety of bacterial and viral antigens that results in an increased propensity to recurrent infections. The defect was not associated with IgG-subclass deficiency. The identification of children with selective antibody deficiency and recurrent infections is important for diagnostic and therapeutic reasons.

Adolescent↗
PubMed1986

IgG subtype abnormalities with normal total IgG in a clinical allergy practice.

Thirty-one of 75 patients with recurrent upper respiratory infections were found to have immunoglobulin G subclass deficiencies with normal levels of total immunoglobulin G in a clinical allergy and asthma practice. Sixteen were IgG3 deficient, thirteen IgG2 deficient, and two were IgG1 deficient. Only one patient had an IgA deficiency. Two patients have normal IgG with decreased PRP titers. Serum antibody titers to the capsular polysaccharide of Haemophilus influenzae type B (HibCP) were found to be low in seven patients. Other investigators have established relationships between these deficiencies and recurrent infections. When investigating patients with recurrent infections, it seems prudent to look beyond simple quantitative immunoglobulins.

Adolescent↗
PubMed1983

Chord keyboards.

Unlike the standard typewriter keyboard, keying on a chord keyboard is carried out by simultaneous patterned pressing of one or more keys. This results in fewer keys being needed on a chord keyboard when compared with a sequential keyboard, where keys are pressed one at a time. For example, five keys allow a total of 31 (2(5) - 1) different chord combinations to be generated. The feasibility of using a chord keyboard as a data entry input device was first seriously investigated in the mid-1950s by the Canadian Post Office. The trend towards research into chord keying reached a peak around 1960 when International Business Machines (IBM) studied two chord keyboards to rival the typewriter. It was not until the 1970s that chord keyboards became commercially available and within the last decade three chord keying devices have been marketed. The emphasis on the development of these recent keyboards has moved from task specific to more general purpose applications. This paper (based upon Martin (1980) the author's maiden name) reviews the chord keyboards which have been developed since the 1940s with special emphasis on the mail sorting application, and draws some conclusions concerning future developments.

Journal Article↗
PubMed1983

Multi-center, double-blind, placebo-controlled trial of fluocortin butyl in perennial rhinitis.

Fluocortin butyl (FCB) is a newly synthesized corticosteroid with a high ratio of topical to systemic activity. FCB was studied in a multi-center, double-blind, placebo-controlled trial of therapy of perennial rhinitis. The study was conducted between January and May 1981. Patients evaluated suffered from either chronic allergic or chronic nonallergic rhinitis or both. A total of 306 patients from 16 investigative centers were evaluated by comparing FCB to placebo. Three separate dosage regimens were employed. Patients received a total daily dose of 2, 4, or 8 mg. FCB was found to be an effective therapeutic agent. It reduced symptoms of nasal congestion, rhinorrhea, postnasal drainage, and sneezing. It also markedly reduced the use of concomitant medications (chlorpheniramine maleate and/or pseudoephedrine). Relief of symptoms was noted as early as the first week of therapy, and the degree of improvement increased progressively during the study. There was little difference between the relief produced by the 4 mg and 8 mg regimens. Both of these were superior to the 2 mg regimen. The drug was well tolerated; no significant side effects were noted.

Adult↗