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Biomedical subjects

M Pickett

Publications and source records attributed to M Pickett.

At least 19 recordsLinked to original sources
PubMed2001

Beyond sexual assessment: lessons learned from couples post radical prostatectomy.

PURPOSE: To share selected experiences of advanced practice nurses (APNs) who implemented a home-based nursing protocol related to psychosexual function for couples following radical surgery for prostate cancer. DATA SOURCES: Selected research-based articles, the PLISSIT Model for sexual rehabilitation counseling, and the authors' experiences. CONCLUSIONS: Five lessons related to communicating about sexuality and intimacy were synthesized from the experience, including examining knowledge and self-awareness regularly, using a structured interview guide to facilitate the process, developing a trusting relationship with the couple, attending to verbal and nonverbal cues, and providing information about the full range of sexual expression. IMPLICATIONS FOR PRACTICE: Include an assessment of sexual health as an integral part of a general health assessment. Patients do not generally volunteer information about their sexual concerns unless the subject is introduced by the APN.

Clinical Protocols↗
PubMed2001

Development of a home-based family caregiver cancer education program.

INTRODUCTION: This article describes a home-based educational program developed specifically for family caregivers of cancer patients who receive hospice and home care. The overall aim of this educational program is to specifically address family caregivers' needs for acquisition of necessary knowledge and skills to meet the physical and psychosocial demands associated with caring for a patient with advanced cancer. PROGRAM DEVELOPMENT: Originally, components of this program were offered in a small group discussion format within hospital and community settings. The educational program was transformed to accommodate the unique needs and constraints of homebound family caregivers who have very limited time and/or opportunities for support and education outside of the home. The program is comprised of educational modules that provide hospice and home care professionals with written and audiovisual materials designed to facilitate brief, structured, educational encounters with family caregivers in the home setting. DISCUSSION: Two hundred thirty-seven educational module kits were distributed to professionals affiliated with twenty-four home care and hospice agencies in the Greater Philadelphia area. Results of a telephone survey designed to elicit evaluation data from professional staff members who had used the educational modules are presented. Limitations, plans for future program evaluation, cost implications, and implementation recommendations related to this educational program are described.

Caregivers↗
PubMed2000

A typology of residential fire survivors' multidimensional needs.

This article presents an analysis of the tangible, psychological, and general needs of adults and their children reported by residential fire survivors approximately 14 weeks postfire. Three hundred and seven survivors, who identified that they needed help for themselves or their children, differed from 133 survivors who did not request help. Those needing help were more likely to be women with children younger than age 18 living in their household, have low-income status, less education, and to have already received services from church groups. The classification of self-identified needs of fire survivors included the need for specific tangible and social service assistance, psychological and spiritual support, and nonspecific assistance. This classification contributes to our understanding of the relationship between needs and loss, grief, and changes in family and life situations postfire.

Adaptation, Psychological↗
PubMed1998

Palliative care: past, present, and future perspectives.

OBJECTIVES: To provide a review of the development and impact of palliative care; to discuss quality of lie as a framework for guiding clinical practice and research in palliative care; and to identify future trends that are likely to affect palliative care services. DATA SOURCES: Research studies, review articles, and book chapters. CONCLUSIONS: Palliative care is in the process of dynamic change. Advocates of palliative care are suggesting that cost-effective holistic care strategies should be available to patients and families throughout the illness trajectory, not just reserved for end of life care. IMPLICATIONS FOR NURSING PRACTICE: Incorporation of palliative care principles across the cancer illness trajectory requires an attitude shift by all members of the multidisciplinary team.

Hospice Care↗
PubMed1998

Psychosocial aspects of palliative care.

OBJECTIVES: To provide information about factors that affect psychosocial adjustment among individuals and families who are faced with chronic illness; to discuss assessment guidelines and risk factors that may indicate a need for professional intervention; and to review psychosocial interventions that are used to minimized distress and promote adaptation. DATA SOURCES: Research studies, review articles, and book chapters. CONCLUSIONS: The majority of cancer patients experience emotional turmoil that occurs at transition points along the illness trajectory. Psychosocial issues faced by patients and their families are influenced by individual, sociocultural, medical, and family factors. IMPLICATIONS FOR NURSING PRACTICE: Supportive psychotherapeutic measures help to minimize distress, enhance feelings of control, and improve quality of life.

Adaptation, Psychological↗
PubMed1998

Sociocultural influences and care of dying children in Japan and the United States.

Caring for dying children and their families is one of the most difficult and challenging aspects of professional nursing. An analysis of cultural influences provides insight into the diverse worldviews held by people in Japan and the United States that affect nursing care of dying children. Selected cultural aspects that influence behaviors in Japanese and American cultures are reviewed in this article. Characteristics of support models for dying children and their families established in Western cultures are discussed. This cross-cultural review of prevalent sociocultural influences on the care of dying children and their families in Japan and the United States clearly demonstrates numerous contrasts and parallels.

Attitude to Death↗
PubMed1998

Establishing mechanisms to conduct multi-institutional research--fatigue in patients with cancer: an exercise intervention.

PURPOSES/OBJECTIVES: To describe the process of establishing a multi-institutional interdisciplinary team of oncology researchers and conducting a pilot study of an exercise intervention for fatigue. DATA SOURCES: Project meeting minutes and records, research team members' logs, subjects' research records, the research study proposal, and team members' individual and collective shared experiences. DATA SYNTHESIS: Site investigators established research teams at five academic medical centers. Fifty subjects were enrolled in the study and tested during their cancer treatment. Study methods, including instrumentation, were evaluated carefully and revised. CONCLUSIONS: The multi-institutional network of researchers is an effective and efficient model for testing an intervention to manage fatigue during cancer treatment. IMPLICATIONS FOR NURSING PRACTICE: Exercise is a feasible and potentially beneficial intervention to combat distressing cancer treatment-related fatigue. A pilot study is essential to determine the best methods for conducting a clinical trial and to develop the teams of researchers necessary for such a project.

Exercise Therapy↗
PubMed1997

Comparative performance of Colisure.

Colisure presence-absence medium was compared with standard reference methods for detecting low numbers of total coliform bacteria and E. coli in drinking water when the bacteria were subjected to chlorine stress. When Colisure was compared with established reference methods to detect total coliforms in dilute, disinfected samples, Colisure yielded more positive results after 24, 28, and 48 h than lauryl tryptose broth (LTB) confirmed in bile green lactose broth after 48 h. Colisure also detected higher levels of chlorine-injured E. coli than LTB confirmed in EC medium with 4-methylumbelliferyl B-D-glucuronide (EC/MUG). The sensitivity and specificity of Colisure were also evaluated and were determined to be between 96 and 100 percent on nonchlorinated samples when positive and negative tests were verified.

Bacteriological Techniques↗
PubMed1996

Assessment of adult sibling grief: a review of measurement issues.

Over the past decade hospice care has been delivered to an increasing population of persons with Acquired Immunodeficiency Syndrome (PWAS) and their families. Adult siblings likely comprise a large number of these surviving family members. Investigations that examine sibling bereavement are scarce (Osterweis, Solomon & Green, 1984) and assessment of the unique experience of adult sibling grief requires careful consideration before existing measures can be applied. The purpose of this paper is to present theoretical and psychometric considerations regarding assessment of adult sibling grief that are pertinent for hospice workers who provide bereavement care to this population.

Acquired Immunodeficiency Syndrome↗
PubMed1995

Comparative performance of Colisure (TM) and accepted methods in the detection of chlorine-injured total coliforms and E.coli.

Studies were done to examine the comparability of Colisure (TM) and accepted reference methods to detect low numbers of total coliform bacteria and E.coli subjected to chlorine stress. Colisure (TM) is a medium designed to concurrently detect coliform bacteria and E.coli in drinking water by the specific action of beta-galactosidase (total coliforms) and beta-glucuronidase (E.coli). The methods used to compare the performance of various media followed a protocol established by the USEPA. Samples (31) of sewage from six different regions of the US were treated with sufficient concentrations of chlorine (1.2-2.5mg/l) to reduce viability 1-3 logs (39% average injury) and diluted with drinking water to achieve ca. 3 viable coliforms/100ml. The mean log reductions in viable bacteria, determined with various media following disinfection of the 31 samples were: mEndo = 1.87 (TC), Colisure (TM) = 1.55 (TC), mTec = 3.63 (E.coli) and Colisure (TM) = 2.01 (E.coli). When Colisure (TM) was compared with accepted methods to detect total coliforms in the dilute, disinfected samples, Colisure (TM) yielded results that were 1.6 times greater than LTB confirmed in BGLB at 28h. Colisure (TM) also detected 1.7 times greater levels of E.coli than LTB confirmed in EC/MUG at 28h. Sensitivity and specificity of Colisure (TM) were between 96 and 100% when positive and negative tests were verified. These findings indicate that Colisure (TM) is superior to certain accepted reference methods in the detection of chlorine-injured coliforms and E.coli under conditions that resemble contaminated drinking water.

Bacteriological Techniques↗
PubMed1994

In vivo and in vitro effects of mutagenesis of active site tyrosine residues of mercuric reductase.

X-ray crystal structure analysis of mercuric reductase suggested that the binding site for Hg2+ consisted of two tyrosine residues, Tyr264 and Tyr605, as well as two cysteine residues, Cys207 and Cys628. We have previously shown that mutagenesis of Tyr605 to Phe lowered the kcat of the enzyme 6-fold, whereas the same mutation of Tyr264 resulted in a reduction of 160-fold [(1993) Biochemistry 32, 7475-7478]. Tyr605 occupies the same position in mercuric reductase as the active site His residue in the related enzyme glutathione reductase. The mutation of Tyr605 of mercuric reductase to a His residue produced a 24-fold decrease in kcat and a 15-fold decrease in Km. The in vivo resistance to Hg2+ of E. coli strains carrying wild type or mutant merA genes correlated with the in vitro measurements of kcat/Km for mercuric reductase activity.

Bacillus↗
PubMed1994

Psychological distress in survivors of residential fires.

This paper presents preliminary findings from an ongoing study of survivors of residential fires. The purpose of this study was to examine psychological distress and extent of loss in order to provide a psychological profile of survivors overtime. The sample (N = 69) was drawn consecutively from the database of residential fires available through the Philadelphia Fire Department. Levels of psychological distress were measured as well as reports of symptoms consistent with the diagnostic criteria for Post-traumatic Stress Disorder. The major findings indicate that residential fires caused significant and sustained distress. An agenda for further research and for services to survivors of these fires is presented.

Adolescent↗
PubMed1994

Short report: identification of a specific pattern of vascular endothelial growth factor mRNA expression in human placenta and cultured placental fibroblasts.

Reverse transcription and the polymerase chain reaction (PCR) were used to detect vascular endothelial growth factor (VEGF) mRNA in human placental tissue and cultured placental fibroblasts obtained during the first trimester of pregnancy. The primers for VEGF corresponded to areas in exon 4 and exon 8 of the VEGF gene. After one round of PCR three products, equivalent to VEGF121, VEGF165 and VEGF189, were detected within placental tissue and cultured placental fibroblasts. A further round of PCR revealed the presence of two more products equivalent to VEGF206 and VEGF145. Thus, in addition to the production of readily secreted forms of VEGF (VEGF121 and VEGF165), the placenta produces several transcripts expected to increase the growth factor pool of the extracellular matrix.

Base Sequence↗
PubMed1994

Molecular epidemiology of trachoma in a Gambian village.

The application of a diagnostic and genotyping technique based on the polymerase chain reaction (PCR) to the study of trachoma epidemiology in the Gambian village of Jali is reported. PCR based on the major outer membrane protein (MOMP) gene of Chlamydia trachomatis appears to be more sensitive than either isolation or antigen detection by enzyme immunoassay; it had a specificity of 95% and sensitivity of 51% against clinical signs. PCR genotyping identified genotypes A and B of Chlamydia trachomatis circulating in Jali. Sequencing revealed a Pst1 restriction endonuclease site in the amplified MOMP gene of some B strains but not others; Pst1 digestion of the PCR product proved an easy method of distinguishing these strains. The distribution of serotypes and B strain variants shows a significant degree of household clustering (p < 0.001). PCR based genotyping combined with strain typing provides a new and powerful epidemiological tool for the study of transmission events in trachoma.

Antigens, Bacterial↗
PubMed1993

Role of tyrosine residues in Hg(II) detoxification by mercuric reductase from Bacillus sp. strain RC607.

Two tyrosine residues of mercuric reductase (MerA), Tyr-264 and Tyr-605, which were shown by the X-ray crystal structure to be involved in metal binding, were changed to phenylalanine residues by site-directed mutagenesis, both singly (Y264F, Y605F) and to form a double mutant (Y264,605F). The effect of these mutations on Hg(II) reduction activity varied. While MerA Y605F has a similar apparent Km to the wild-type enzyme and an apparent kcat reduced by 6-fold, MerA Y264F has an apparent Km 5-fold lower than the wild type and apparent kcat 160-fold lower. The double mutant MerA Y264,605F has the same apparent Km as MerA Y264F, but its apparent kcat was reduced by a further 7-fold. These results show that the roles of the two tyrosine residues are not equivalent and that Y264 is important for catalysis, possibly by destabilizing the binding of Hg(II) to the two ligating thiolates at the active site of MerA.

Amino Acid Sequence↗
PubMed1993

Cultural awareness in the context of terminal illness.

While cultural awareness provides direction for planning effective nursing interventions at all stages of health and illness, this article specifically addresses applications for patients who are terminally ill. Professional nurses encounter unique challenges in caring for terminally ill patients. Assisting patients to achieve an "appropriate death" requires communication and collaboration among patients, family members, and professional caregivers. Since patients and their families represent many systems of complex beliefs and values, nurses must be aware of the impact of cultural pluralism on nursing assessment and intervention in terminal illness. Reordering priorities and redistributing resources have been identified as new approaches in caring for terminally ill patients and their families. Two concepts that cut across all cultural boundaries are loss and grief. Expressions of loss and grief take on a variety of forms among members of diverse cultures. It is critical that nurses recognize, understand, and respect each family's culture-specific patterns with regard to terminal illness. Understanding the culture will lead to the design of culturally appropriate nursing care for patients and families. Culture brokerage is defined as an act of translation, where messages, instructions, and belief systems are exchanged between cultural groups. This strategy has the potential to increase understanding among those with diverse cultural backgrounds, resulting in increased patient/family satisfaction within the supportive care setting. Consonance between patients' needs and nurses' understanding of those needs will lead to more culturally appropriate intervention strategies.

Attitude to Death↗