Biomedical subjects
Publications and source records attributed to K Cook.
The SITE instrument appears to combine advantages of other instruments previously described. It meets the proposed objectives of an efficient cutter where tissue is removed at the front end of the tip. It allows the surgeon complete control of the suction and reflux systems. The instrument is of a simple modular dsign. A fiber optic attachment is available. It is dependable and safe.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
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Recently, nursing programs that admit nonnurse college graduates to graduate study in nursing have emerged around the country. The University of Texas at Austin has such a program called the Alternate Entry Master of Science in Nursing (AEMSN) program. Using a grounded theory approach, 13 telephone interviews were conducted with alumni of the AEMSN program to examine the socialization of these nontraditional graduates into the profession of nursing. Participants reported some anxiety as they approached graduation. They were particularly aware of a disconnection between their academic credentials and their limited professional nursing experience. To manage others' and their own expectations of them, the participants chose various strategies, such as using positive self-talk and seeking a manager who understood and favored the AEMSN program. Eventually the graduates found places where they felt comfortable and where they could hone their skills. As they began to function in roles that they believed were consistent with master's level nursing, the AEMSN graduates began to embrace the identity of master's-prepared nurses.
This study examined the association of contaminated fish consumption and polychlorinated biphenyl (PCB) body burden by comparing the similarity of the congener pattern in yellow perch, caught near the point source of industrial pollution, and in other local fish to the pattern found in the breast milk of Mohawk women from Akwesasne, a Native American community located along the St. Lawrence River in New York, Ontario, and Quebec. The similarity is defined by the weighted Euclidean distance between two congener patterns. Ninety-seven Mohawk mothers participated and provided samples of breast milk. One hundred fifty-four nursing women from the Supplemental Nutrition Program for Women, Infants and Children (WIC) of Warren and Schoharie counties, New York, who gave birth during the same time period, were used as the comparison group. Results revealed that the breast milk of the Mohawk women, who ate the most local fish, had a congener pattern that more closely resembled that of perch caught near the waste site or average sampled fish caught in the Reserve than Mohawk women who ate less fish or the controls. The outcome demonstrates how PCBs may be "fingerprinted" as they migrate offsite from industrial sources and ultimately result in human exposure.
A study was conducted to assess the extent to which the consumption of local fish contaminated with p,p'-dichlorodiphenyl dichloroethylene (p,p'-DDE), mirex, and hexachlorobenzene (HCB) has impacted the concentrations of these compounds in the milk of nursing Mohawk women residing along the St. Lawrence River. From 1986 to 1992, 97 Mohawk women were interviewed, and each donated a one-time sample of at least 50 ml of breast milk. The comparison population consisted of 154 Caucasians from other rural areas in New York State. After adjustment for potential confounders, Mohawk mothers who gave birth from 1986 to 1990 had significantly higher geometric mean p,p'-DDE milk concentrations than did the control group, but no significant differences were observed from 1991 to 1992. In contrast, mirex was significantly elevated among the Mohawks throughout the study period, while HCB showed no difference at any point. Mohawk women with the greatest estimated cumulative lifetime exposure to p,p'-DDE from local fish consumption had a significantly higher geometric mean milk level of that compound relative to control women, but no differences in mirex or HCB concentrations in breast milk by local fish consumption were found. The reduction in breast milk p,p'-DDE concentrations among the Mohawk women from 1986 to 1990 parallels a corresponding decrease in local fish consumption, and may be the result of the advisories that have been issued over the past decade recommending against the consumption of local fish by pregnant and nursing Mohawk women. Elevations in the concentrations of mirex in the breast milk of the Mohawks are consistent with the fact that it is a common contaminant in the region and throughout the Lake Ontario-St. Lawrence River Basin.
Two novel, distinct truncated forms of apolipoprotein B (apo B) designated as apo B-90 and apo B-40 were found in five members of a kindred with hypobetalipoproteinemia. Sodium dodecyl sulfate gels and immunoblots of plasma or low density lipoprotein (LDL) (d = 1.019 to 1.063 g/ml) of the affected members demonstrated the presence of one or both of the truncated apo B bands. Employing four monoclonal anti-LDL antibodies with defined regional specificities, we demonstrated that amino terminal epitopes of the truncated apo Bs were intact, but that 10% and 60%, respectively, of the carboxyl terminal regions were absent. Thrombin digestion of apo B-90 generated an abnormally small T2 fragment, confirming that approximately 550 amino acids had been deleted from the carboxyl terminus of apo B-100. Restriction fragment length polymorphism analysis and variable number of tandem repeat typing of the 3' flanking hypervariable region of the apo B gene made it possible to distinguish all four parental alleles and therefore to follow the inheritance of the apo B variants through the family. This pedigree analysis confirmed the inheritance of the apo B-90 and apo B-40 identified by monoclonal antibody binding studies. Siblings heterozygous for apo B-90 or apo B-40 exhibited greater than 65% lower concentrations of apo B-90 or apo B-40 relative to apo B-100 and had 5th percentile LDL cholesterol concentrations. Compound heterozygotes (apo B-90/apo B-40) had the lowest LDL levels, and their LDL particles were small in size.(ABSTRACT TRUNCATED AT 250 WORDS)
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A study was conducted to determine concentrations of polychlorinated biphenyls (PCBs) in local fish and to establish patterns of fish consumption of nursing Mohawk women residing near three industrial hazardous waste sites. From 1986 to 1992, 97 Mohawk women were interviewed within one month postpartum. A comparison group consisted of 154 nursing Caucasians. Samples of 348 local fish were analyzed for PCBs. The results indicated that fish in the Mohawk area, especially those collected offshore from the waste sites, had been contaminated with PCBs. The dietary data showed a greater past prevalence of local fish consumption among Mohawk mothers, with an overall annual mean of 23.5 local fish meals more than one year before the pregnancy compared with 14.1 for the control women (p < 0.001). The prevalence of consumption by the Mohawks, however, declined over time, resulting in overall mean rates of 9.2 local fish meals one year or less before pregnancy, and 3.9 meals per year during pregnancy (p < 0.001 for linear trend). Compared to the Mohawks, significantly fewer control women stopped eating local fish, and their rates declined less sharply. A secular trend was also observed in the overall rate of consumption during pregnancy for the Mohawks, with those who gave birth in 1986-1989 having a mean of 10.7 local fish meals per year during pregnancy, compared with means of 3.6 and 0.9 respectively for women who delivered in 1990 and 1991-1992 (p < 0.05 for linear trend). No such trend was apparent for the controls. No background variable was significantly related to the rate of local fish consumption among the Mohawks, but a decrease over time in the rate of local fish consumption was greater among those Mohawks who ate the most local fish initially (r = -0.76, p < 0.001), or who also reduced their alcohol intake during pregnancy (r = 0.35, p < 0.05). Mohawks were also more likely than the controls to trim the fat, remove the skin from, and fry and fish they ate during the past year. These dietary changes may be the result of advisories that have been issued over the past decade recommending against the consumption of local fish by pregnant and nursing Mohawk women. Such changes, if sustained, should reduce their exposure to PCBs and correspondingly the potential for adverse health effects.
Interviews with 25 nurses in this grounded theory study show that when nurses recognized that a child's death was inevitable, they struggled with both grief distress and moral distress. Their distress occurred within the context of the nurse-patient relationship. Nurses employed a range of strategies to manage their distress. Several conditions facilitated or constrained nurses' strategies, and resulted in far-reaching implications both professionally and personally.