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Biomedical subjects

K A May

Publications and source records attributed to K A May.

30 records · Page 2Linked to original sources
PubMedDate not supplied

Impact of prescribed activity restriction during pregnancy on women and families.

Using grounded theory, I examined the experience of women and their families of prescribed activity restriction during pregnancy for treatment of preterm labor. The major finding in this study suggests that women and their families see themselves as "doing the best we can" as they attempt to balance the demands of activity restriction and the needs of individuals and the family. Invariably, maternal activity restriction resulted in increased emotional distress and, in some cases, family disruption. Those who succeeded in establishing a balance between these competing demands saw themselves as "doing okay" and found the emotional distress and family disruption to be manageable. In contrast, those who had difficulty balancing competing demands described themselves as "on the edge" and experienced uncomfortable levels of emotional distress and, occasionally. significant disruptions to the family. Conditions associated with these two modes of functioning, as well as consequences of this experience for women and their families, are identified.

Adaptation, Psychological↗
PubMedDate not supplied

Effect of omentectomy on adhesion formation in horses.

OBJECTIVE: To determine if omentectomy would decrease the frequency of postoperative intraabdominal adhesions. STUDY DESIGN: Retrospective study. ANIMALS OR SAMPLE POPULATION: 44 horses that had either two ventral median celiotomies or a ventral median celiotomy and a necropsy more than 4 days later; 19 of these horses had their omentum removed at the initial surgery. METHODS: Data retrieved from the records included location and type of intraabdominal adhesions; location of the surgical lesion; relationship of adhesions to the surgical lesion; surgical procedures; duration of initial surgery; time interval between procedures; age, gender, and breed of the horse; and clinical outcome. Fisher's exact test was used to evaluate the association between categorical explanatory and outcome variables. The effect of potential risk factors on the incidence rate of adhesion formation was estimated using a proportional hazards regression model. RESULTS: Of 25 horses in the nonomentectomy group, 15 (60%) had postoperative adhesions that resulted in the need for a second surgical intervention, whereas of 19 horses that had omentectomy initially, only 4 (21%) had postoperative adhesions that required a second procedure. Rate of adhesion formation was higher in horses that did not have omentectomy initially (incidence ratio rate [IRR], 0.46; 90% confidence interval [CI], 0.18 to 1.19). At initial surgery, 24 horses had a small intestinal lesion, and 20 horses had a large intestinal lesion. Fifteen horses (63%) with small intestinal lesions subsequently developed adhesions compared with four horses (20%) with an initial large intestinal lesion (P = .006). At the second procedure, small intestine lesions were identified in 32 horses and large intestine lesions in 12 horses (1 horse had both small and large intestine lesions), and 1 horse had a gastric lesion. Adhesions were identified as the cause of colic signs in 19 (61%) horses with small intestinal lesions and in none of the horses with large intestine lesions. The frequency of adhesion development leading to colic associated with only the small intestine at the second surgery or necropsy was significantly greater (P = .001) than the frequency only in the large intestine. CONCLUSIONS: Omentectomy reduced the rate of postoperative adhesion formation. Adhesions are more likely to occur after small intestinal surgery and if they do occur likely involve the small intestine. CLINICAL RELEVANCE: Omentectomy is a safe procedure and should be considered prophylactically for reduction of adhesion formation after abdominal surgery in horses.

Animals↗
PubMedDate not supplied

Urinary bladder marsupialization for treatment of obstructive urolithiasis in male goats.

OBJECTIVES: To describe a surgical procedure for urinary bladder marsupialization and to report the results obtained from its use in the treatment of obstructive urolithiasis in male goats. STUDY DESIGN: Retrospective evaluation. ANIMALS OR SAMPLE POPULATION: Male goats with obstructive urolithiasis. METHODS: Medical records of male goats that had urinary bladder marsupialization for the treatment of obstructive urolithiasis were reviewed. Data retrieved from the medical records included signalment, postoperative treatment, duration of hospitalization, and short-term and long-term complications. Median values for measured variables were calculated. RESULTS: A total of 18 of 19 goats survived. Urinary flow was re-established in all 19 goats at the conclusion of surgery. Short-term postoperative complications (bladder mucosal prolapse and death) were observed in 2 goats. Long-term postoperative complications (cystitis and fibrotic stomal closure) occurred in 2 animals. Median duration of hospitalization was 4 days. At the time of follow-up, mild urine scald was reported for all goats. Clinical signs of upper urinary tract disease or obstruction were not reported. A total of 15 of 17 owners were satisfied with the procedure. CONCLUSIONS: Urinary bladder marsupialization provided long-term resolution of urinary outflow obstruction in all goats with acceptable morbidity. CLINICAL RELEVANCE: Urinary bladder marsupialization is a procedure that provides a good prognosis for long-term resolution of obstructive urolithiasis in male goats.

Animals↗
PubMedDate not supplied

Fetal surgery for congenital hydronephrosis.

Fetal surgery is a treatment approach to anatomic lesions which, if left untreated, may be incompatible with life. Diagnosis of conditions amenable to surgical treatment has become possible because of recent advances in ultrasonography. Correction of such lesions may interrupt the pathologic process and enable the infant to live a normal life. Currently, fetal surgical treatment at the University of California, San Francisco, is limited to correction of posterior urethral valve obstruction and ureteropelvic junction obstruction. Two procedures have been used at the university for surgical correction of anomalies of the urinary tract of the fetus: an open technique and a closed technique. The procedures, parental responses to the treatment, and the role of the clinical specialist in the care of patients having this experimental surgery are described.

Ethics, Nursing↗
PubMedDate not supplied

Impact of maternal activity restriction for preterm labor on the expectant father.

OBJECTIVE: To describe the impact on expectant fathers of their partners' activity-restricted pregnancies. DESIGN: Qualitative. SETTING: Private physician practices and two teaching hospitals in a large southern city. PARTICIPANTS: Self-selected sample of 15 fathers recruited within 2 weeks of initiation of their partners' activity restriction for high-risk pregnancy (phase 1) and 15 fathers recruited 1-2 years after a previous experience with their partners' activity-restricted pregnancies (phase 2). DATA COLLECTION: In phase 1, two semistructured interviews during the period of activity restriction and one interview after the birth. In phase 2, one semistructured, focus group interview. RESULTS: Fathers reported high levels of worrying immediately after diagnosis of their partners' preterm labor and initiation of activity restriction. Later, fathers also reported distress related to responsibility for child care, household management, and maintaining a supportive environment for their partners. Fathers reported few sources of personal support and little or no contact with health professionals during their partners' activity restriction. CONCLUSIONS: Activity restriction during pregnancy may have a significant psychological impact on expectant fathers. High levels of emotional distress may result in family disruption. Systematic nursing assessment and intervention may prevent or ameliorate distress.

Adaptation, Psychological↗
PubMedDate not supplied

Effect of stress on family functioning during pregnancy.

A theoretical model hypothesized to predict family functioning was tested in four groups of expectant parents, followed by exploratory model building. The groups studied during the 24th to 34th weeks of pregnancy included 153 high-risk hospitalized women, 75 of their partners, 218 low-risk women from the general obstetric clinic, and 147 of their partners. Both partners in the high-risk situation reported greater discrepancy in family functioning than partners in the low-risk situation. The hypothesized models proved to have low explanatory power, accounting for 13% to 15% of the variance. The final empirical models developed explained 33% of the variance in family functioning among high-risk women and 48% among their partners, 23% among low-risk women, and 32% among their partners. The empirical models differed from the hypothesized models in that variables postulated to have only indirect effects were shown to have direct effects on family function and inter-generational variables significantly expanded the theoretical model.

Adolescent↗
PubMedDate not supplied

Theoretical models for studying the effect of antepartum stress on the family.

Three models are proposed to predict the effect of antepartum stress on the family. These models consider external and internal family environments and individual characteristics as they influence an individual family member's health status, dyadic relationships within the family, and the family's functioning as a unit. Research to date validates the complex interrelationships between antepartum stress, social support, self-esteem, sense of mastery, anxiety, depression, and their effect on health status, dyadic relationships, and family functioning. The theoretical models presented identify relationships between these important variables that can guide much-needed research on the effects of antepartum stress on the childbearing family.

Anxiety↗
PubMedDate not supplied

Three phases of father involvement in pregnancy.

A field study focusing on men's experiences of first-time expectant fatherhood, including intensive interviews with 20 expectant couples, short field interviews with 80 additional fathers, participant observation in prenatal classes and clinics, and content analysis of popular literature was conducted for the purpose of description and generation of substantive theory. Interview and field data were analyzed using constant comparative analytic technique for qualitative data. Evidence suggest a characteristic pattern of development of subjective emotional involvement in pregnancy among first-time expectant fathers. This pattern consists of three phases: an announcement phase, a moratorium and a focusing phase. The length of the second phase appears to be related to the man's perception of his own readiness for pregnancy. The father's speed of progression though these phases may affect later adjustment to fatherhood. Further testing and validation of these findings is indicated.

Adaptation, Psychological↗