PubMed Health⌕ Search

Biomedical subjects

M Rich

Publications and source records attributed to M Rich.

At least 37 records · Page 2Linked to original sources
PubMed2000

Asthma in life context: Video Intervention/Prevention Assessment (VIA)

OBJECTIVE: Video Intervention/Prevention Assessment (VIA) was developed to determine whether medical information gathering might be augmented by video diaries created by patients to show clinicians the realities of managing chronic disease in the contexts of their lives. DESIGN: Children and adolescents who met National Heart, Lung, and Blood Institute criteria for moderate or severe asthma were enrolled from an urban pediatric hospital and an inner-city health center. Comprehensive, asthma-specific medical histories were obtained from study participants in standard clinical interviews. Participants were trained to use video camcorders and recorded visual narratives of how they lived with and managed their asthma over a 4- to 8-week period. These visual narratives were screened by a trained observer, who completed the initial comprehensive medical history based solely on viewing the video. Information from participants' medical history interviews was compared with observations of their visual narratives. RESULTS: Twenty young people 8 to 25 years old completed the VIA Asthma study. Important variations were found between participants' medical history interviews and their visual narratives. All 20 participants reported specific environmental triggers for their asthma; 19 had 1 or more of these triggers documented on video in their daily living environments (video illustrations online, available at: ). Exposures to known triggers ranged from 25% (noxious fumes) to 91% (mold). Exposure to tobacco smoke that was denied in the interview was revealed on video in 63%. The 18 participants who revealed medication use in their visual narratives were assessed for adherence: 33% exceeded prescribed doses, 28% discontinued medications without consulting a clinician, and 72% used ineffective inhaler technique. CONCLUSIONS: VIA visual narratives extended a comprehensive, standard of care medical history, yielding a more complete and accurate understanding of exacerbating environmental exposures and inappropriate medication usage of children and adolescents with asthma. VIA is an effective tool for revealing the physical and psychosocial environments in which young people live with disease. Patient-created video can enrich our understanding of the illness experiences of children and adolescents. VIA has the potential to enhance clinical data gathering, guide the development of more effective and sensitive management strategies, and educate clinicians about the realities of the young person living with illness.

Adaptation, Psychological↗
PubMed1999

Rhetoric to practice: the challenge of collaboration of academe and industry.

Community health nursing is a complex practice that encompasses nurses working in many diverse settings. This article discusses the development of a project which focused on better preparation of students for potential employment in community settings. The formation of the working team and the development of the curriculum is outlined. A focus is given to the linking of primary health care principles in the teaching and facilitation of students within hospital and community settings. Comprehensive conclusions cannot be made yet from the project's preliminary findings. However, the process of collaboration has demonstrated several issues. These will have an impact on everyone who has been part of this project, and the issues are discussed in this article. The article provides an overview of the first year of collaboration of a 4-year project.

Community Health Nursing↗
PubMed1998

Aggressors or victims: gender and race in music video violence.

OBJECTIVE: To examine portrayals of violence in popular music videos for patterns of aggression and victimization by gender and race. DESIGN AND SETTING: Content analysis of 518 music videos broadcast over national music television networks, Black Entertainment Television (BET), Country Music Television (CMT), Music Television (MTV), and Video Hits-1 (VH-1) during a 4-week period at randomly selected times of high adolescent viewership. MAIN OUTCOME MEASURES: Differences in the genders and races portrayed as aggressors and victims in acts of violence. RESULTS: Seventy-six (14.7%) of the analyzed music videos contained portrayals of individuals engaging in overt interpersonal violence, with a mean of 6.1 violent acts per violence-containing video. Among the 462 acts of violence, the music video's main character was clearly the aggressor in 80.1% and the victim in 17.7%. In 391 (84.6%) of the violence portrayals, the gender of the aggressor or victim could be determined. Male gender was significantly associated with aggression; aggressors were 78.1% male, whereas victims were 46.3% female. This relationship was influenced by race. Among whites, 72.0% of the aggressors were male and 78.3% of the victims were female. Although blacks represent 12% of the United States population, they were aggressors in 25.0% and victims in 41.0% of music video violence. Controlling for gender, racial differences were significant among males; 29.0% of aggressors and 75.0% of victims were black. A logistic regression model did not find direct effects for gender and race, but revealed a significant interaction effect, indicating that the differences between blacks and whites were not the same for both genders. Black males were more likely than all others to be portrayed as victims of violence (adjusted odds ratio = 28.16, 95% confidence interval = 8.19, 84.94). CONCLUSIONS: Attractive role models were aggressors in more than 80% of music video violence. Males and females were victims with equivalent frequency, but males were more than three times as likely to be aggressors. Compared with United States demographics, blacks were overrepresented as aggressors and victims, whereas whites were underrepresented. White females were most frequently victims. Music videos may be reinforcing false stereotypes of aggressive black males and victimized white females. These observations raise concern for the effect of music videos on adolescents' normative expectations about conflict resolution, race, and male-female relationships.

Black or African American↗
PubMed1997

Violence and weapon carrying in music videos. A content analysis.

BACKGROUND: The positive portrayal of violence and weapon carrying in televised music videos is thought to have a considerable influence on the normative expectations of adolescents about these behaviors. OBJECTIVES: To perform a content analysis of the depictions of violence and weapon carrying in music videos, including 5 genres of music (rock, rap, adult contemporary, rhythm and blues, and country), from 4 television networks and to analyze the degree of sexuality or eroticism portrayed in each video and its association with violence and weapon carrying, as an indicator of the desirability of violent behaviors. METHODS: Five hundred eighteen videos were recorded during randomly selected days and times of the day from the Music Television, Video Hits One, Black Entertainment Television, and Country Music Television networks. Four female and 4 male observers aged 17 to 24 years were trained to use a standardized content analysis instrument. Interobserver reliability testing resulted in a mean (+/- SD) percentage agreement of 89.25% +/- 7.10% and a mean (+/- SD) kappa of 0.73 +/- 0.20. All videos were observed by rotating 2-person, male-female teams that were required to reach agreement on each behavior that was scored. Music genre and network differences in behaviors were analyzed with chi 2 tests. RESULTS: A higher percentage (22.4%) of Music Television videos portrayed overt violence than Video Hits One (11.8%), Country Music Television (11.8%), and Black Entertainment Television (11.5%) videos (P = .02). Rap (20.4%) had the highest portrayal of violence, followed by rock (19.8%), country (10.8%), adult contemporary (9.7%), and rhythm and blues (5.9%) (P = .006). Weapon carrying was higher on Music Television (25.0%) than on Black Entertainment Television (11.5%), Video Hits One (8.4%), and Country Music Television (6.9%) (P < .001). Weapon carrying was also higher in rock (19.8%) and rap (19.5%) videos than in adult contemporary (16.1%), rhythm and blues (6.9%), and country (6.3%) videos (P = .002). The videos with the highest level of sexuality or eroticism were found to be less likely to contain violence (P < or = .04). CONCLUSION: Because most music videos are between 3 and 4 minutes long, these data indicate that even modest levels of viewing may result in substantial exposure to violence and weapon carrying, which is glamorized by music artists, actors, and actresses.

Adolescent↗
PubMed1997

Tobacco and alcohol use behaviors portrayed in music videos: a content analysis.

OBJECTIVES: Music videos from five genres of music were analyzed for portrayals of tobacco and alcohol use and for portrayals of such behaviors in conjunction with sexuality. METHODS: Music videos (n = 518) were recorded during randomly selected days and times from four television networks. Four female and four male observers aged 17 to 24 years were trained to use a standardized content analysis instrument. All videos were observed by rotating two-person, male-female teams who were required to reach agreement on each behavior that was scored. Music genre and network differences in behaviors were analyzed with chi-squared tests. RESULTS: A higher percentage (25.7%) of MTV videos than other network videos portrayed tobacco use. The percentage of videos showing alcohol use was similar on all four networks. In videos that portrayed tobacco and alcohol use, the lead performer was most often the one smoking or drinking and the use of alcohol was associated with a high degree of sexuality on all the videos. CONCLUSIONS: These data indicate that even modest levels of viewing may result in substantial exposure to glamorized depictions of alcohol and tobacco use and alcohol use coupled with sexuality.

Adolescent↗
PubMed1996

Effectiveness of a program of early hospital discharge of cardiac surgery patients.

Managed care was the impetus for a program designed to move adult patients from acute care to the lowest level of appropriate services after cardiac surgery. Clinical pathways and a home care cardiac specialty team were the major components of the Early Discharge Program. The program was evaluated based on both financial and clinical outcomes. A convenience sample of 119 pretest patients was compared with 101 posttest patients 3 months after program implementation. Hospital length of stay decreased only 0.34 days on average, but inpatient direct variable costs decreased by an average of $1,790 per patient. Based on the 101 patients in the posttest group, $180,790 in direct variable hospital costs were saved. The largest decrease in resource use was in those patients who were discharged to home care. Complications and home caregiver burden after discharge were no higher in patients discharged early. Early discharge of cardiac surgery patients appears to be safe and cost-effective.

Aged↗
PubMed1996

Managing asthma with the adolescent.

Adolescents are at high risk for poor outcomes from asthma owing to lifestyle and developmental changes. Not only are its prevalence, morbidity, and mortality steadily increasing, but asthma is the most common chronic disease of adolescents and it can have a profound impact on every aspect of their lives. However, through a management approach based on education, environmental modification, self-monitoring, and medication, adolescents can take control of a disease that otherwise controls them. Step therapy based on the National Heart, Lung, and Blood Institute asthma severity classification scale indicates the use of inhaled anti-inflammatory agents as maintenance medications and bronchodilators as rescue medications, thus preventing exacerbations and intervening when they occur. Through clinician-patient comanagement, asthma can be controlled and adolescents' lives normalized.

Adolescent↗
PubMed1996

Bladder stimulation therapy improves bladder compliance: results from a multi-institutional trial.

PURPOSE: We examined data from multiple institutions to determine whether intravesical bladder stimulation therapy is effective in improving bladder compliance by increasing bladder capacity and lowering bladder storage pressures. MATERIALS AND METHODS: The charts of 568 patients from 11 institutions were evaluated. Of the 568 patients 335 had adequate and accurate pretreatment and posttreatment urodynamic studies, and were included in this study. A total of 155 patients was from Children's Memorial Hospital, while the remaining 180 were from 10 other institutions. Bladder capacity and bladder capacity pressure were determined for each patient before and after therapy. RESULTS: Overall, 53% of patients had increased bladder capacity of 20% or greater after treatment (average increase 105 cc), which represents a 63% increase from pretreatment values. This increase occurred in an average of 1.9 years. Further analysis of this subset of patients revealed that in 90% intravesical storage pressures were decreased or maintained within a safe range (less than 40 cm. water). Evaluation of patients who did not respond to bladder stimulation with a 20% or greater increase in bladder capacity revealed that they had nearly normal bladder capacity before therapy. When the data on bladder capacity and bladder capacity pressure from Children's Memorial Hospital were compared to results from the 10 other institutions, there were no appreciable differences. CONCLUSIONS: Bladder stimulation is effective in increasing bladder capacity without significantly elevating storage pressure in a majority of patients. We conclude that this technique is safe and effective in improving bladder compliance, and that it is reproducible elsewhere.

Adolescent↗
PubMed1993

Latex allergy and anaphylaxis.

Latex allergy is a potential cause of unexplained intraoperative anaphylaxis. Latex allergic reactions range from mild wheal and flare episodes to cardiovascular collapse. High-risk patient populations merit latex allergy testing. Preoperative prophylactic regimens may prevent or attenuate serious intraoperative latex allergic reactions in susceptible individuals. Additional work is needed to better characterize and understand latex allergy.

Anaphylaxis↗
PubMed1993

Clinical safety and cost of heparin titration using bedside activated clotting time.

OBJECTIVE: To evaluate the clinical safety of heparin titration and the procedural cost of anticoagulation measurement using bedside low-range activated clotting time. DESIGN: Quasi-experimental study using data gathered through retrospective record review. SETTING: Coronary care, medical intensive care and telemetry units of a community hospital. SUBJECTS: Sample of 102 patients undergoing elective percutaneous transluminal coronary angioplasty. INTERVENTION: Intravenous heparin therapy was titrated using low-range activated clotting time in 51 percutaneous transluminal coronary angioplasty patients. Data from this group were compared to a matched sample of 51 angioplasty patients whose intravenous heparin therapy was titrated using activated partial thromboplastin time. RESULTS: No differences in procedural, early or late complications were found between the groups. The cost of managing heparin therapy with low-range activated clotting time was less than with activated partial thromboplastin time. CONCLUSION: These results suggest that titrating heparin therapy based on bedside low-range activated clotting time for the angioplasty patients in this sample was as safe as with activated partial thromboplastin time. Use of bedside low-range activated clotting time saved money for the hospital.

Angioplasty, Balloon, Coronary↗
PubMed1991

Predisposing factors in bladder calculi. Review of 100 cases.

One hundred patients, aged twenty to ninety-two years, underwent 111 procedures for removal of bladder calculi. Most patients (88) had some type of bladder outlet obstruction. Two types of stones were identified: those that had apparently formed in the upper tract and been trapped in the bladder (17 cases) and those that appeared to have formed in the bladder in the presence of various types of outlet obstruction. Stone analysis revealed uric acid stones in 50 percent, calcium oxalate stones in 19 percent, and stones of mixed composition in 31 percent. Five patients had metabolic abnormalities predisposing to stone formation; in 2 cases, these abnormalities were discovered during the evaluation for stone disease. Treatment depended on stone characteristics, associated pathology, and the general health of the patient. A review of the literature with regard to the morbidity and mortality of combining treatment of vesical calculi and bladder outlet obstruction secondary to prostatic obstruction is included.

Adult↗