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Biomedical subjects

K Buckwalter

Publications and source records attributed to K Buckwalter.

28 records · Page 2Linked to original sources
PubMed1993

Behavioral responses of family members during critical illness.

This articles describes the behavioral responses of adult family members to critical illness and how these responses change over the course of the hospitalization. A convenience sample of 52 family members of patients in intensive units completed the Iowa ICU Family Scale, a self-report tool measuring sleep, eating, activity, family role, and support behaviors. Scales were completed by family members each day during the first week and then weekly throughout the patient's ICU stay. Family members reported sleeping less with a poorer quality of sleep, less nutritional intake, an increased use of cigarettes, alcohol, and over-the-counter and prescription medications, and spending more time talking, visiting the patient, and waiting. Stress was highest at the time of the ICU admission, began to plateau at Day 6, and then dropped considerably by Day 28. These findings suggest that crisis intervention is important during the early phase of caring for critically ill patients and their family members.

Adaptation, Psychological↗
PubMed1992

Precision of hyaline cartilage thickness measurements.

Measurement of cartilage thickness in vivo is an important indicator of the status of a joint as the various degenerative and inflammatory arthritides directly affect the condition of the cartilage. In order to assess the precision of thickness measurements of hyaline articular cartilage, we undertook a pilot study using MR imaging, plain radiography, and ultrasonography (US). We measured the cartilage of the hip and knee joints in 10 persons (4 healthy volunteers and 6 patients). The joints in each patient were examined on two separate occasions using each modality. In the hips as well as the knee joints, the most precise measuring method was plain film radiography. For radiographs of the knees obtained in the standing position, the coefficient of variation was 6.5%; in the hips this figure was 6.34%. US of the knees and MR imaging of the hips were the second best modalities in the measurement of cartilage thickness. In addition, MR imaging enabled the most complete visualization of the joint cartilage.

Adult↗
PubMed1989

The effects of mental dysfunction on nursing home care.

Many of the residents of nursing homes have mental health problems. These can be expected to affect the quantity of nursing care they require. Analysis of 285 nursing home residents, most of whom had moderate behavioral problems, reveals that their mental health characteristics can be summarized in terms of three factors: cognition, affect and aggressiveness. Cognitive deficits significantly increase the quantity of basic nursing services patients require. Negative affect increases the amount of psychosocial care received. The results of the analysis are interpreted as indicating that nursing home reimbursement systems should account for moderate as well as severe mental illness.

Aged↗
PubMed1989

Computed arthrotomography of the shoulder: comparison of examinations made with internal and external rotation of the humerus.

We assessed the best positioning of the humerus for CT scans obtained after air-contrast shoulder arthrography by performing 54 examinations with both external and internal rotation of the humerus. Of the 30 abnormalities of the anterior portion of the labrum, 27 (90%) were identified on the scans obtained with the arm in internal rotation. The other three (10%) were shown best or solely on the scans obtained with the arm in external rotation. All 22 abnormalities of the anterior capsule were shown on the scans obtained with internal rotation. In no case were scans obtained in external rotation superior. Five posterior labral and capsule abnormalities were found; two of them were identified best or only on scans obtained with external rotation. The other three were shown equally well with the arm in either position. The results show that a modest (9%) increase in diagnostic yield can be expected when CT scans obtained with the arm in external rotation are added to studies performed solely with the arm internally rotated.

Adolescent↗
PubMed1988

Adaptive histogram equalization in digital radiography of destructive skeletal lesions.

Adaptive histogram equalization, an image-processing technique that distributes pixel values of an image uniformly throughout the gray scale, was applied to 28 plain radiographs of bone lesions, after they had been digitized. The non-equalized and equalized digital images were compared by two skeletal radiologists with respect to lesion margins, internal matrix, soft-tissue mass, cortical breakthrough, and periosteal reaction. Receiver operating characteristic (ROC) curves were constructed on the basis of the responses. Equalized images were superior to nonequalized images in determination of cortical breakthrough and presence or absence of periosteal reaction. ROC analysis showed no significant difference in determination of margins, matrix, or soft-tissue masses.

Bone Neoplasms↗
PubMedDate not supplied

Magnetic resonance imaging of knee hyaline cartilage and intraarticular pathology.

Injuries to the hyaline cartilage of the knee joint are difficult to diagnose without invasive techniques. Even though these defects may be the most important prognostic factors in assessing knee joint injury, they are usually not diagnosed until arthrotomy or arthroscopy. Once injuries to hyaline cartilage are found and/or treated, no technique exists to follow these over time. Plain radiographs, arthrograms, and even computed tomography fail to detail most hyaline cartilage defects. We used magnetic resonance imaging (MRI) to evaluate five fresh frozen cadaver limbs and 10 patients whose pathology was known from arthrotomy or arthroscopic examination. Using a 0.35 Tesla superconducting magnet and spin-echo imaging technique with a head coil, we found that intraarticular fluid or air helped to delineate hyaline cartilage pathology. The multiplane capability of MRI proved to be excellent in detailing small (3 mm or more) defects on the femoral condyles and patellar surface. Cruciate ligaments were best visualized on sagittal oblique projections while meniscal pathology was best seen on true sagittal and coronal projections. MRI shows great promise in providing a noninvasive technique of evaluating hyaline cartilage defects, their response to treatment, and detailed anatomical information about cruciate ligaments and menisci.

Adolescent↗
PubMedDate not supplied

Organizational and employee predictors of outcomes of long-stay nursing home residents.

OBJECTIVE: Use three types of functional ability as predictors of nursing home patient outcomes. DESIGN: Best-subsets regression analysis. SETTING: 10 nursing homes. RESULTS: Initial functional ability was the most important predictor. Organizational variables such as workload, stress, and morale also explained some of the variance in patient outcomes. Characteristics of organizational structure predicted outcomes as well as employee self-reports and could be substituted for them without substantially reducing the explained variance. CONCLUSION: Future research projects should explore the causal relationship between structure and outcomes.

Activities of Daily Living↗
PubMedDate not supplied

Infusing research into practice to promote quality care.

This article describes the Iowa Model of Research in Practice, a heuristic model used at the University of Iowa Hospitals and Clinics for infusing research into practice to improve the quality of care. The components of the model are presented with examples. The impact of the model on patient, staff, and fiscal outcomes is delineated.

Clinical Protocols↗
PubMedDate not supplied

Effects of child visitation in adult critical care units: a pilot study.

OBJECTIVE: To examine the behavioral and emotional responses of the child and of the nonhospitalized adult family member (NHAFM) to facilitated child visitation in the critical care setting. DESIGN: Quasi-experimental, posttreatment design. SETTING: An adult surgical intensive care unit at a large Midwestern teaching hospital. PARTICIPANTS: Twenty families participated in the study, 10 families in a restricted and 10 families in a facilitated visitation group. Each family unit had a child, an NHAFM, and a critically ill family member. In the control group the NHAFMs visited the patient in the customary routine, but children were restricted from visiting. After a 2-week waiting period a facilitated child visitation intervention was implemented for the experimental group. OUTCOME MEASURES: The child completed measures on anxiety as measured by the Manifest Anxiety Scale and behavioral and emotional changes as measured by the Perceived Change Scale. The NHAFM completed measures on anxiety as measured by the State-Trait Anxiety Inventory and mood as measured by the Mood Adjective Check List. Family functioning, as measured by the Feetham Family Functioning Survey, and life event changes, as measured by the Life Event Scale, were examined as extraneous variables. INTERVENTION: The Child Visitation Intervention encompassed systematic facilitation and supervision of children visiting a critically ill adult family member in a surgical intensive care unit and provision of emotional support before, during, and after visitation (the intervention protocol may be obtained from the investigators on request). RESULTS: Children in the facilitated visitation group had a greater reduction (t = 4.0, df = 18, p = 0.0004) in negative behavioral and emotional changes as measured by the Child-Perceived Change Scale when compared with children in the restricted visitation group. CONCLUSION: Facilitated child visitation may help children deal with the critical illness of an adult family member and deserves further study.

Adolescent↗