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Biomedical subjects

J Waterman

Publications and source records attributed to J Waterman.

14 recordsLinked to original sources
PubMed2001

Training of acute confusion resource nurses. Knowledge, perceived confidence, and role.

Most nurses function as generalists; however, some function in "expert" roles based on informal training as Resource Nurses. Training usually focuses on assessment and management of a specific problem, with the goal of creating a readily available "expert" for every unit. The primary activity of the Resource Nurse is to provide expert care, education, and consultation for patients, families, and staff. The Iowa-Veterans Affairs Nursing Research Consortium (IVANRC) addressed the need to manage acutely confused/delirious clients by training staff nurse volunteers (N = 129) from all units of the four Iowa Veterans Affairs facilities to act as unit-based acute confusion Resource Nurses (ACRNs). A day-long workshop included didactic content addressing etiology and presentation of acute confusion (AC), use of the IVANRC protocol to assess for AC, and basic information on treatment and management of AC. The nurses also participated in an efficacy-based experiential learning program on AC assessment that involved demonstrating assessment of AC and role enactment practice exercises in which ACRNs practiced the assessment. A test of knowledge of AC and perceived level of confidence in assessing acutely confused patients was administered before and after completion of the program. Paired t tests comparing pre- and posttest scores showed that knowledge and confidence significantly increased for the nurses as a result of their participation in the educational program. Eighteen months later, a second program was conducted to update current ACRNs and train additional RNs to enact this role. Pre- and posttest scores were obtained, with paired t tests showing a significant increase in knowledge for the participants. Twenty-four (49%) of the second program attendees had attended the first program. These participants had significantly higher scores on the second program pretest than those participants who had not attended the previous program, indicating a retention of knowledge from the first program.

Acute Disease↗
PubMed1998

Unit-based acute confusion resource nurse: an educational program to train staff nurses.

Despite the high prevalence of acute confusion among elders and the importance of its early detection, there are few reports of systematic efforts to increase staff competence. This article describes the development and evaluation of an 8-hour educational program designed to prepare staff nurses to perform in a new role, the unit-based acute confusion Resource Nurse (ACRN). Pre- and posttest scores were obtained for the 80 registered nurses who participated in the program. Paired t tests showed that knowledge and confidence significantly increased for participants as a result of their participation in the educational program. This program can serve as an effective model for geriatric staff education.

Acute Disease↗
PubMed1998

Posttraumatic stress disorder among female juvenile offenders.

OBJECTIVE: While there is a growing body of evidence that psychopathology is common among incarcerated boys, relatively little is known about the prevalence and manifestations of mental health problems among incarcerated girls. This study examines the incidence of posttraumatic stress disorder (PTSD) in a sample of 96 adolescent female offenders and its relation to socioemotional adjustment. METHOD: Self-report questionnaires were used to tap socioemotional adjustment, and a semistructured interview was conducted to determine PTSD symptomatology. RESULTS: The results indicate that the rate of PTSD among incarcerated female delinquents not only is higher than that in the general population but surpasses the incidence of PTSD among incarcerated male delinquents. In addition, those who suffer from PTSD also tend to exhibit higher levels of distress and lower levels of self-restraint. CONCLUSIONS: These findings provide a starting point for more detailed investigations of the relations between trauma, psychopathology, and violence and suggest that the study of trauma may offer a new way of looking at links between victim and perpetrator.

Adolescent↗
PubMed1985

Oral features of Wegener's granulomatosis.

A review of the dental literature yielded ten cases of Wegener's granulomatosis manifesting in the oral cavity, but only one was found in the medical literature. The most common oral lesion is hyperplastic gingiva, which is red to purple, with many petechiae. Tooth mobility, loss of teeth, and failure of wounds to heal are also common manifestations. The disease may remain localized in the oral cavity for unusually long periods of time before multiorgan involvement occurs. Histologically, oral biopsy tissue does not exhibit the characteristic features of vasculitis and granulomas. There are, however, diagnostic histologic features that are consistently present, including pseudoepitheliomatous hyperplasia, epithelioid histiocytes, giant cells, and eosinophils. Failure to recognize these diagnostic clinical and histologic features resulted in a 24-month delay in the diagnosis and treatment of our patient.

Child↗
PubMed1985

Capital financing demands new, innovative practices.

Hospitals are facing challenges in the financing of capital expenditures. Credit ratings have shifted to a lower rating category. Interest rates for long-term debt have risen, and the use of short-term variable rate debt has increased. Also, the elimination of tax-exempt financing is being considered. Clearly, capital financing is in a state of flux. With a need for low cost capital, hospital financing is in a state of flux. With a need for low cost capital, hospital financial managers should study the changing credit market and consider innovative practices in healthcare financing.

Capital Financing↗
PubMedDate not supplied

Sexual abuse of children in day care centers.

Sexual abuse of children in day care center settings has received considerable attention in the past decade. The nature and extent of allegations of sexual abuse in day care poses unique challenges to clinicians. Cases of sexual abuse in day care typically involve multiple victims and multiple perpetrators, and use of extreme threats to prevent disclosure. This article reviews the available research findings on the types of abuse known to occur in day care, the dynamics involved including the types of threats used to silence young victims, and patterns of disclosure. The impact of sexual victimization in day care on children and parents is discussed. Implications for the clinical evaluation of preschool-aged children in cases of suspected abuse in day care settings are presented. Developmental considerations related to psychosexual development and the development of memory and language are reviewed. Psychological defenses in repetitive trauma are discussed.

Child↗
PubMedDate not supplied

Psychological testing in evaluation of child sexual abuse.

In order to assess the utility of psychological testing in evaluating allegations of child sexual abuse, the empirical literature is reviewed in an attempt to answer two questions. First, are there systematic and significant differences on psychological tests between sexually abused and nonabused children? Second, are these differences on psychological testing a direct result of sexual abuse, or are they a result of other coexisting factors that might cause psychological distress? Cognitive measures, personality inventories, symptomatology checklists, and projective tests with sexually abused children are reviewed. While a variety of standardized instruments have been administered to sexually abused children, relatively few have been utilized in empirical studies. Findings have been mixed, with stronger differences between sexually abused and nonabused children generally found on measures completed by parents than on measures administered directly to children. Sexually abused children often fall between nonabused and psychiatric groups. Use of measures specific to sexual abuse is advocated. While psychological tests may currently have limited use in validating suspected sexual abuse, they may be extremely useful in the clinical treatment of the child.

Adolescent↗
PubMedDate not supplied

Children's patterns of disclosures and recantations of sexual and ritualistic abuse allegations in psychotherapy.

Patterns of disclosures and recantations of abuse made in psychotherapy were examined in a sample of 63 children who reported sexual and ritualistic abuse in a preschool setting. Therapists completed a measure that instructed them to identify the time since the child began therapy when any disclosures or recantations were made, to specify the type of abuse disclosed or recanted, and to identify any events that might be related to the timing of a disclosure or recantation. The findings revealed that the majority of subjects (76.2%) disclosed abuse within the first month of therapy. Recantation occurred in 17 cases (27%) and all but two children who recanted redisclosed abuse after the initial recantation. There was some evidence that children's experiences within the legal system may have been associated with recantations. Subjects tended to make vague disclosures before revealing more specific acts, reveal less intrusive sexual abuse (e.g., kissing) before more intrusive types (e.g., intercourse), and to disclose ritualistic abuse after other types.

Adolescent↗
PubMedDate not supplied

Experiences, concerns, and service needs of families adopting children with prenatal substance exposure: summary and recommendations.

Parents who adopted children from out-of-home care with prenatal substance exposure were interviewed four months after the child's placement in the home, and again after the first year regarding their experience with adoption and their concerns about their child's development, attachment, and behavior; aspects of parenting and the adoption process; effects of prenatal substance exposure; and availability and helpfulness of resources. Adoptive parents found parenting children with prenatal substance exposure to be both more rewarding and more difficult than they had imagined.

Adoption↗
PubMedDate not supplied

Helping foster parents cope with separation, loss, and grief.

Major changes in planning for children in foster care have resulted in significant changes in the roles of and expectations for foster parents, accompanied by even less attention to the issues of foster families' grief and loss. This article focuses on (1) the many ways foster parents encounter loss and grief on a continuous basis; (2) factors that affect the intensity of the loss and the healthy expression and resolution of grief; (3) problems that can result when the grief of foster parents is not adequately addressed; and (4) ways in which professionals can be helpful to these caregivers around loss and grief.

Adoption↗