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Biomedical subjects

M L Ellett

Publications and source records attributed to M L Ellett.

At least 19 recordsLinked to original sources
PubMed1993

Dietary management of chronic diarrhea in children.

This study evaluated the benefit of a gastroenterology nurse clinician providing dietary instructions to parents of children with recurrent diarrhea. These instructions for returning the child to a normal age-appropriate diet were given by telephone at the time of referral. Data analysis indicated that parents reported a decreased number of stools and an improved stool consistency during the waiting period for a clinic appointment, regardless of whether or not they received dietary instructions. Children in the control group lost an average of 0.4 g/day of weight while those whose parents received dietary instructions gained an average of 1.57 g/day. This difference in weight is clinically important and reinforces the premise that children with chronic diarrhea often receive calorie-deficient diets. The results of this study emphasize the important role that gastroenterology nurses play in the management of chronic diarrhea in children.

Child↗
PubMed1993

Budget for a research proposal.

As a result of the growing consumer demand to cut health care costs, employing institutions cannot be expected to finance research studies. Therefore, outside funding must be found. The proposal budget is critical to the success of a study. A reviewer can determine much about the principal investigator's ability to conduct the proposed study by scrutinizing the budget; therefore, the budget should not be treated as an afterthought. A good budget consists of three separate parts: the budget, the budget explanation, and a section in the narrative devoted to the budget. Ask for the funds that are needed to complete the study and then justify the need. The goal of a good budget is to answer the reviewers' questions before they occur.

Budgets↗
PubMed1991

Alpha 1-antitrypsin deficiency.

alpha 1-Antitrypsin (AAT) is a polymorphic protein with many variants collectively known as the Pi system. The most common alleles are the M, S and Z, which are co-dominantly inherited. Infants with PiZZ have approximately 16% of the normal AAT serum concentration. alpha 1-Antitrypsin deficiency (AATD) is an inborn error of metabolism which is principally associated with liver disease in children and emphysema in young adulthood. Individuals with AATD produce an abnormal protein which accumulates in the liver, resulting in decreased serum levels. Affected individuals cannot protect their lungs from digestion by elastase. Smoking is a significant risk factor for the early development of emphysema. Prolastin, human alpha 1-protease inhibitor, is now available as replacement therapy. Weekly intravenous administration, with the goal of maintaining the serum AAT greater than 80 mg/dl, appears to arrest pulmonary damage. Its effect on liver disease is unknown at this time. A recombinant alpha 1-protease inhibitor is being tested in aerosol form with promising early results.

Humans↗
PubMed1991

General anesthesia: an alternative to sedation for pediatric endoscopic procedures.

The main objective of pediatric endoscopy is to examine completely the upper or lower gastrointestinal tract with the least trauma and risk to the child. The purpose of this manuscript is to present a method that has been used successfully at a midwest children's hospital for a number of years. Both pros and cons will be discussed.

Anesthesia, General↗
PubMed1990

Clinical nursing research: recipe for success.

Clinical nursing research is gaining popularity. The following is a step-by-step process the novice researcher can follow to successfully complete a research study. The process begins with identifying the research problem and ends with publication of results. Tips for avoiding common pitfalls are suggested. The value of the practicing nurse's contribution in identifying clinical problems for investigation is becoming appreciated. Educators are looking for access to subjects and are thus interested in collaborating with practicing nurses. Funding sources are interested in well-planned clinical studies. The timing is perfect--so get involved.

Clinical Nursing Research↗
PubMed1989

Living with chronic hepatitis.

Chronic hepatitis (CH) may be defined as persistence of an inflammatory reaction in the liver for greater than 4 months. Different immune mechanisms of liver damage are operative in children with the three common types of CH. In autoimmune CH the cytotoxic effect is mostly confined to the non-T cell lymphocyte fraction. Autoimmune CH is steroid responsive and has a generally favorable prognosis. In hepatitis B virus (HBV) hepatitis both T and non-T lymphocytes are responsible for the cytotoxic reaction. Steroid or interferon treatment is controversial and the prognosis is less favorable. Hepatitis delta virus (HDV) hepatitis only occurs in children with HBV hepatitis as either a co-infection or superinfection. As a co-infection the HBV is usually eliminated and CH does not ensue. Superinfection with HDV, however, frequently leads to rapidly progressive liver damage and a more serious prognosis. Non-A, non-B (NANB) hepatitis is a diagnosis of exclusion. In NANB hepatitis, the cytotoxic effect is predominantly T cell. NANB hepatitis generally runs a mild course, and no treatment is usually recommended.

Child↗
PubMed1985

Vitamin E sufficiency in children with cholestasis: a comparison between erythrocyte peroxide hemolysis and serum alpha-tocopherol.

Vitamin E sufficiency was assessed in 19 children with chronic cholestasis by determining both erythrocyte peroxide hemolysis (EPH) and serum alpha-tocopherol (alpha-T) levels. Eight had normal alpha-T (1.19 +/- 0.67 mg/dl; normal greater than 0.5). The mean EPH in this group was 13.1 +/- 14.3% (normal less than 20%). The remaining 11 patients had low alpha-T levels (0.25 +/- 0.15 mg/dl) and elevated EPH (83.9 +/- 17.1%). Children found to be vitamin E deficient received either oral alpha-T (50-100 IU/kg per day) or parenteral alpha-tocopherol acetate in sesame oil every 2-4 wk (200-300 mg). This permitted serial monitoring of EPH and alpha-T. We found that normalization of the EPH was uniformly accompanied by normalization of the alpha-T level. However, normal alpha-T levels occurred with elevated EPH (between 20% and 80%) on 11 occasions. EPH greater than 80% correctly identified vitamin E deficiency in all cases. Hence, EPH is a satisfactory screening test of vitamin E sufficiently. When the EPH is less than 20%, the patient is vitamin E sufficient. Conversely, when the EPH is greater than 80%, the patient is vitamin E deficient. Serum alpha-T measurements are needed to determine vitamin E sufficiency when the EPH is greater than 20% and less than 80%.

Adolescent↗
PubMedDate not supplied

Constipation/encopresis: a nursing perspective.

Constipation/encopresis is a common pediatric problem. The purpose of this article is to describe this problem that has a tremendous negative impact on both child and family and to present a plan of care that has been used successfully with more than 2000 children. This treatment program involves clearing the impaction, using medication to overcome stool withholding, and establishing a regular bowel habit to keep the problem from returning. A knowledgeable, sensitive nurse practitioner usually can manage this problem independently and can greatly improve the quality of life of these children.

Child↗
PubMedDate not supplied

Data analysis for repeated measures studies.

Many research questions in nursing can best be answered by designing studies using repeated measures representing pretreatment and posttreatment observations on the same subject. In this article, the author discusses both a parametric statistical test and its nonparametric counterpart and provides guidance regarding when it is appropriate to use each. The steps used in computing both statistics are also provided.

Chi-Square Distribution↗
PubMedDate not supplied

SGNA endoscopic disinfectant survey.

The purpose of this study was to describe the prevalence of health problems, use of protective attire, and health surveillance practices in a large group of healthcare workers exposed to glutaraldehyde. The results revealed that 37.8% of respondents reported at least one symptom/illness before exposure to glutaraldehyde. Nearly 60% of respondents reported symptoms/illnesses after glutaraldehyde exposure. Healthcare workers employed > or = 5 years tended to report fewer health problems preexposure and slightly more problems postexposure compared with all respondents. Surprisingly, smokers reported a nearly equal number of symptoms/illnesses both pre- and postexposure when compared with the total group. Approximately 95% of respondents always wore gloves, usually latex; 52% always wore moisture-proof outer wear; 28% always wore masks; and 55% always wore eye protection when exposed to glutaraldehyde. Those who used protective attire reported as many symptoms/illnesses as those who did not. Healthcare workers need to demand that the ambient glutaraldehyde level in the endoscopy cleaning area be checked periodically and records of these checks kept. Manufacturers need to produce more effective protective attire. Employers need to purchase protective attire for employees, and employees need to wear it until alternative endoscopic disinfectant/sterilization methods can be found.

Adolescent↗
PubMedDate not supplied

Gilbert syndrome.

Two or three times a year, a healthy patient (> 1 year old) with mild unconjugated hyperbilirubinemia as the only abnormality on routine liver function testing will be referred to the gastroenterologist. A diagnosis of Gilbert Syndrome (GS) is made, and the patient may or may not be seen in the clinic or office because GS is a benign condition. Either way, the nurse needs to understand the pathophysiology of this condition so he/she can provide necessary patient/family education. The purpose of this article is to review the existing literature on GS and to summarize it in a manner useful to both nurses and families.

Adolescent↗
PubMedDate not supplied

Prevalence of gastric cancer in a large group of healthcare workers routinely exposed to Helicobacter pylori.

Secondary data analysis of the Society of Gastroenterology Nurses and Associates Endoscopic Disinfectant Survey was undertaken to answer the question, "What was the prevalence of gastric cancer among endoscopy personnel who were routinely exposed to Helicobacter pylori (HP) in their work environment?" This large sample of healthcare personnel (4,001) was occupationally exposed to both endoscopic disinfectants and HP. There is a known positive relationship between the prevalence of HP infection, gastritis, and gastric cancer. Results indicated that zero respondents reported gastric cancer in this sample.

Adult↗
PubMedDate not supplied

Society of Gastroenterology Nurses and Associates, Inc. (SGNA) Endoscopic Disinfectant Survey results compared with control group.

Disinfectant surveys from responding members of the American Society of Postanesthesia Nurses were divided into two groups based on whether or not they considered themselves to be exposed to disinfectants in their work environment. Their survey responses were then compared with those obtained previously from members of the Society of Gastroenterology Nurses and Associates, Inc., who were regularly exposed to 2% alkaline glutaraldehyde in the work setting. There were significant differences among the groups in the percentage of respondents who reported having headaches, eye irritations, respiratory problems, shortness of breath, rashes, memory loss, mood swings, and fatigue. These findings support the association of these complaints with 2% alkaline glutaraldehyde exposure. In contrast, there were no significant differences among the groups in the percentage of respondents who reported having asthma, rhinitis, chest pain, nausea, diarrhea, muscle/joint pain, visual disturbances, or dermatitis.

Adult↗
PubMedDate not supplied

Development of the Vulnerability Scale.

Developing a new data collection scale is a time- and labor-intensive process. Initially, the items may be developed from a review of the appropriate literature, clinical expertise of the developer, in-depth interviewing of potential subjects, or any combination of these techniques. Next, evidence of the validity (content-related, construct-related, and criterion-related), internal consistency reliability, and reliability of the scale must be established. The new scale may be administered to one or two small samples (pilot studies) before it is ready for use with a larger group. Gathering evidence regarding the scale's validity and reliability with different groups and consequent revision are ongoing processes. In this article, the authors describe how this process was followed in developing the Vulnerability Scale.

Adaptation, Psychological↗
PubMedDate not supplied

ALARA study of teaching effectiveness on reducing radiation exposure.

The purpose of this study was to measure the effectiveness of radiation safety instruction and the impact on radiation film badge levels. A convenience sample of 144 endoscopy nurses and technicians was pretested for radiation safety knowledge, given a course in radiation safety, and then posttested immediately after the course and then 6 months later. Radiation badges were analyzed for radiation exposure at preinstruction, 1 month postinstruction, and 6 months postinstruction. Results showed that the instruction was effective. There was only a slight decrease in radiation badge readings; the decrease, however, was not statistically significant.

Adult↗
PubMedDate not supplied

Prevalence of feeding tube placement errors & associated risk factors in children.

PURPOSE: The purpose of this study was to determine the prevalence of feeding tube placement errors in children. DESIGN AND METHODS: The hospital records of 201 children having both an enteral tube and at least one radiograph showing tube placement were retrospectively reviewed. Chart review was also used to determine the risk factors associated with these errors. Tube placement error was defined as tube tip or orifices in the esophagus or intestine (if the tube was supposed to be in the stomach) or tip or orifices in the esophagus or stomach (if the tube was supposed to be in the intestine.) RESULTS: On the first day, a radiograph documenting tube placement showed that 32 of the 201 children (15.9%) had tube placement errors. Overall, 53 tube placement errors were evident during the 385 observation days on which radiographs were obtained (13.8%). Of the 201 children, 42 (20.9%) had experienced tube placement errors at some time during the period reviewed. Over all radiograph days, activity level was independently related to radiographic tube placement (p = < 0.02), with more errors among active children. Also, classification regression tree analysis showed that age, level of consciousness (alert or comatose versus semicomatose), abdominal distention, vomiting, and orogastric tubes were associated with more tube placement errors. NURSING IMPLICATIONS: Nurses need to be especially careful in assessing tube placement if the pediatric client has one or more of the identified risk factors. Health care providers need to carefully weigh the benefits and risks of feeding by nasal or oral enteral tubes versus the benefits and risks of feeding by endoscopically or surgically placed enteral tubes.

Adolescent↗