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Biomedical subjects

M J Gordon

Publications and source records attributed to M J Gordon.

96 records · Page 6Linked to original sources
PubMedDate not supplied

Identifying and overcoming barriers to providing sexuality information in the clinical setting.

While the scope of the clinician-patient relationship in rehabilitation includes the opportunity to provide information on sexuality, all too often this does not occur. This article identifies barriers to providing information on sexuality and makes suggestions for overcoming them. At a preconference workshop, "Sexuality After Spinal Cord Injury: Understanding the Effects of Knowledge and Attitude on Dissemination Practices," held during the Association of Rehabilitation Nurses 22nd Annual Educational Conference, participants explored barriers to providing sexuality information to their patients and ways for nurse managers and staff members to ameliorate their own discomfort and that of their patients. The barriers identified included lack of time, lack of knowledge, personal attitudes about sexuality, and patient lack of readiness. Approaches that can improve the comfort levels of nurse managers and staff include using educational films and written materials, conducting role playing to explore typical patient questions, and initiating conversation about sexuality with patients. Participants' suggestions for increasing patient comfort level included adopting an open and nonjudgmental listening mode, distinguishing between the physical and emotional aspects of sexual issues, and promoting peer counseling.

Attitude of Health Personnel↗
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Purification and partial characterisation of an alpha-tocopherol-binding protein from rabbit heart cytosol.

An alpha-tocopherol-binding protein has been isolated and purified from rabbit heart cytosol. The purified protein had an apparent molecular mass of 14,200, as derived from SDS-PAGE. The content of the protein in rabbit heart was around 11.8 micrograms per g of tissue. The binding of alpha-tocopherol to the purified protein was rapid, reversible, and saturable. Neither gamma nor delta tocopherol could displace the bound alpha-tocopherol from the protein, suggesting a high specificity for alpha-tocopherol. alpha-Tocopherol-binding protein did not bind oleate. Transfer of alpha-tocopherol from liposomes to mitochondria was stimulated 8-fold in the presence of the binding protein, suggesting that this protein may be involved in the intracellular transport of alpha-tocopherol in the heart.

Animals↗
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The relationship of family dynamics/social support to patient functioning in IDDM patients on intensive insulin therapy.

A 6 month pilot study was conducted to examine the relationship between family dynamics/social support and patient functioning in diabetic patients on intensive insulin therapy. Intensified therapy was associated with improvements in the DUHP symptom score, MHI psychological well-being score, and in the DUHP social functioning score. In diabetic patients, regardless of therapy, extreme family dynamics were correlated with higher DUHP symptom scores and lower MHI psychological well-being scores at the initial measurement time. However, over the 6 month study period, extreme family dynamics were predictive of improvements in the DUHP symptoms score and in the quality of friendships in diabetic patients on intensive insuline therapy. In diabetic patients, regardless of therapy, higher levels of social support correlated with higher levels of psychological and social functioning at the initial measurement time, and with improvements in quality of family life over the 6 month measurement time. Higher social support was also associated with improvements in quantity of friends and the DUHP social functioning score in diabetic patients on intensive insulin therapy. The study also generated empiric support for co-evolutionary models of disease states/family dynamics/treatment systems by showing that 6 month changes in family dynamics were predicted by the initial FACES adaptability measure and the initial mean monthly glucose value. Intensified therapy predicted lower family cohesion and more family rigidity over the 6 month study period. These findings also suggest, when combined with the result that diabetic patients from more cohesive families experienced a rise in monthly mean glucose values, that some diabetic patients may become trapped in a vicious cycle which perpetuates poor glucose control and extreme family dynamics.

Adaptation, Psychological↗
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Changes in cognitive and social functioning of diabetic patients following initiation of insulin infusion therapy.

Functional health outcomes resulting from intensive insulin regimens may differ depending upon the age of the diabetic patient. This study tested the hypothesis that health functioning is poorer for younger insulin-dependent diabetic (IDDM) patients following a change to the insulin infusion pump regimen, with progressive improvements occurring in functional health status at higher age levels. Thirty IDDM patients aged 10-47 years were administered health status instruments prior to changing to the new regimen, and again six months later. The instruments assessed physical, cognitive, psychological, and social health functioning. When compared at six months to an age-matched control group on conventional insulin therapy, declines in social activities were found for younger insulin pump patients, with improvements occurring linearly as age increased. Lower performance levels were also found for the younger patients in Conceptual Quotient (CQ), an indicator of cognitive functional status, with progressive improvements with age through the early 30s. However, corresponding declines in function occurred at the oldest age levels. Adaptation to an intensive diabetes regimen appears to be more difficult at younger and older age levels.

Activities of Daily Living↗
PubMedDate not supplied

A prerogatives-based model for assessing and managing the resident in difficulty.

This paper describes a comprehensive, well-tested approach to managing residents with vexing noncognitive performance and attitudinal difficulties. Frustrations surrounding such cases often stem from inadequately defining and acknowledging the boundaries of faculty and resident prerogatives. Conceptual order is brought to these ill-structured problems by dividing nonroutine assessment into two cycles; a work-up cycle for suspected problems in which the resident is the primary decision maker, and a probation cycle for more serious issues in which faculty are the primary decision makers. By replacing adversarial positioning with a "let's find out" approach, the model encourages faculty to raise suspected issues early while supporting resident autonomy and professional responsibility. Finally, it recognizes the absolute discretion of faculty to judge trainee performance, to impose special requirements, or to terminate a resident's contract for cognitive or noncognitive deficiencies. Application of the model is illustrated through sample dialogues.

Algorithms↗