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L Rodriguez

Publications and source records attributed to L Rodriguez.

162 records · Page 9Linked to original sources
PubMedDate not supplied

Creating a clinical development plan for acute care nurses.

This article explores the rationale and creation of Clinical Development plans for acute care nursing staff development. The Clinical Development Plan is suggested as a method of determining the learning needs of nurses on various acute care nursing units by identifying required performance. Development is covered from novice to expert levels. Competencies are categorized into technical, interpersonal, and critical thinking skills. Such a plan is helpful for identifying ongoing training needs of nursing personnel.

Education, Nursing, Continuing↗
PubMedDate not supplied

End of life issues in ESRD. A study of three decision variables that affect patient attitudes.

The substantial end-stage renal disease (ESRD) mortality rate reflects an older population, worsening comorbidity, and increased cardiovascular disease. Advance directives in ESRD may simplify issues such as cardiopulmonary resuscitation (CPR) and dialysis discontinuation. However, ESRD patients with advance directives may change their mind or allow surrogate leeway for override of end-of-life decisions. Three decision variables (requesting CPR, discontinuation of dialysis with depression, or discontinuation with dementia) were studied in 141 ESRD patients through a 47 item questionnaire. Duration of dialysis (> or = 4 years) (P = 0.002) and prior CPR experience (P = 0.02) increased the probability of refusing CPR by 12 times. The use of surrogates and substituted judgement for dialysis discontinuation with depression was more likely in women (P = 0.0006) and in patients with higher levels of education (P = 0.003). The odds of deciding to discontinue given dementia were three times greater for hemodialysis than peritoneal dialysis patients (P = 0.03). Eighty-three percent of the patients requested that physicians periodically check with them to determine if their advance directives had changed. The authors conclude that advance directives may assist ESRD patients, families, and staff with end-of-life decisions. Three end-of-life decision variables are significantly affected by duration and type of dialysis, previous CPR, gender, and level of education.

Adult↗
PubMedDate not supplied

[MHC-dependent molecular mechanisms of susceptibility and protection in type I diabetes in Mexicans].

MHC class II genes play an important role in the autoimmune destruction of the pancreatic b-cell occurring in IDDM. The genetic pattern of the disease was investigated in Mexican Mestizos. The serological findings of HLA antigens showed a significant association of DR3, DR4, DQ2 and DQ8 and a protective effect of DR11, DR15, DQ5, DQ6 and DQ7. With these results, DNA analysis of HLA-DRB1, B3, B4, DQA1, DQB1, DPA1, DPB1 genes was performed using PCR with allele specific oligotyping. Among the patients, 92.78 carry DQA1 alleles that have ARG in position 52 of DQa chain, and 78.2% are ASP- in DQ5-57. The RR for homozygotes is 32.8 and 5.6, respectively. The main haplotype involved is DRB1*0405, DQA1*0301, DQB1*0302. Thus, DQa and DQb form a relevant recognition site for the "diabetogenic peptidett which induces the autoimmune destruction. Positions 57 and 74 of DRB1 locus contribute highly to the expression and severity of IDDM in Mestizos and other ethnic groups, but not in Caucasians or Blacks.

Adolescent↗