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Biomedical subjects

M Staley

Publications and source records attributed to M Staley.

At least 19 recordsLinked to original sources
PubMed1998

Crystallization and preliminary X-ray studies of the Rhizobium meliloti DctD two-component receiver domain.

The Rhizobium meliloti DctD two-component receiver domain was expressed in Escherichia coli and purified to homogeneity. Crystals were obtained using the hanging-drop vapor-diffusion geometry with ammonium phosphate as the precipitant. The crystals diffract to 2.3 A and exhibit the symmetry of space group I222 or I212121. The unit-cell dimensions are a = 59.0, b = 58.6 and c = 169.8 A. The asymmetric unit contains a dimer and the crystals have a Vm of 2.16 A3 Da-1.

Bacterial Proteins↗
PubMed1995

Learning with piece-wise linear networks.

A new feedforward architecture is presented for empirical model building and regression. The network consists of two hidden layers of units, where each unit utilizes a piece-wise linear activation function. A procedure for determining both the number of units and their connectivity is developed. The most notable feature of the network is its associated learning algorithm which allows for recursive updating of the parameters. A smoothness constraint is employed to limit the range of solutions, so that practical models may be built with small amounts of data. The network is applied to some function estimation tasks, as well as to a forecasting problem using data from the Santa Fe Institute time-series competition.

Algorithms↗
PubMed1984

Group counseling in cardiac rehabilitation: effect on patient compliance.

A multicenter clinical trial was conducted to evaluate the effects on compliance of a group counseling program for cardiac patients and spouses. The sample comprised 58 couples in which one of the partners had documented atherosclerotic heart disease and was enrolled in an outpatient cardiac rehabilitation program. The experimental intervention involved a ten-week series of group sessions based on symbolic interactionist role theory. The research used a quasi-experimental, three-group, time-series design: Experimental group 1 consisted of 17 patients and their spouses who participated in group counseling; experimental group 2 consisted of 22 patients and their spouses, but only the patients participated in the group series; the control group consisted of 19 patients and their spouses who did not participate in the experimental program. Data were collected at baseline, ten weeks, and six months on four cardiac risk factors: weight loss, blood pressure, exercise, and smoking. Repeated measures analysis of variance showed a significant difference (P less than 0.01) in mean body fat among treatment groups, with experimental group 2 having the greatest decrease over time. Patients in both experimental groups demonstrated lowered blood pressure, with a significant decrease (P less than 0.05) in systolic blood pressure. Again, the largest decrease was in experimental group 2. Changes in weekly exercise level were not significantly different among groups, although the highest compliance was reported by experimental group 1 patients. Results support the efficacy of group counseling based on an interactionist role theory framework to increase compliance. The anticipated effect of spouse participation was not confirmed.

Counseling↗
PubMedDate not supplied

The elderly patient with burns: treatment considerations.

When therapists treat elderly patients with burns, they should ask themselves several questions: Am I treating elderly patients with burns "just like other patients with burns?" Am I assessing the patient's joint mobility and strength as critically as I should? Am I ensuring that further tissue trauma is avoided by instructing the nursing staff in turning/transfer techniques? Am I routinely monitoring heart rate and blood pressure? Am I requiring repetition and practice of exercises before the patient's discharge? Is my patient safe to function in the environment to which he or she is being discharged? Most physical changes in the elderly population are attributed to the aging process but often are due to diminished movement disorders arising from poor physical fitness and disuse. The "slowdown" in the older adult may result from a lack of appropriate movement practice and failure to receive reinforcement for activity. Regardless of age, physiological challenges result in enhanced functional status. Training for a specific skill increases performance in that skill just as strength training increases strength. Practice or repetition of a task improves movement and response time for that task. Appropriate physical training programs for the elderly can (1) counterbalance age-associated declines in work capacity and physical performance; (2) maintain and improve range of motion, strength, flexibility, balance, and endurance; and (3) reduce the disability of the cardiovascular, respiratory, and musculoskeletal systems that may result in decreased risk of falls and accidents. Practice of a task and maintenance of physical fitness helps ensure a high level of motor performance and speed as a person grows older. One is never too old to exercise!

Accidental Falls↗
PubMedDate not supplied

Photographic measurement of volar forearm skin movement with wrist extension: the influence of elbow position.

An important function of skin is to allow joint range of motion to occur. An assumed clinical relationship exists between joint movement and skin pliability. The purpose of this research was to document skin movement of the forearm and wrist with photography, to quantify the amount of skin movement during wrist extension, and to investigate the influence of elbow positions on forearm skin movement. Twenty volunteers had markings placed on the skin of the volar forearm. Each subject performed the motion of wrist extension in two elbow test positions of flexion and extension. Photographs were taken of the skin markings at the beginning and end of wrist extension. A significant difference was found in the amount of forearm skin movement that occurred when the elbow was extended and flexed (p < 0.001). These results substantiate the use of multijoint range of motion during burn rehabilitation.

Adult↗
PubMedDate not supplied

The wide variety of designs for dorsal hand burn splints.

A search of the burn literature to find standard dimensions for fabrication of a typical splint to use with patients with a dorsal hand and finger burn is an elusive endeavor. The original impetus for such a search stemmed from a discussion with a student therapist on how to properly splint a burned hand. An ongoing interest was sustained when no one set of universal dimensions for a hand splint design was found to exist. In fact, the literature is replete with numerous individual recommendations on the dimensions to make such a hand splint. In general, dorsal hand burn splints can be classified either as position of function or antideformity splints. However, there is little agreement among authors about how to make these splints. The purpose of this investigation was to document the wide range and variable designs among splints for dorsal hand burns and present the findings for use as a resource guide when making decisions about their fabrication.

Burns↗
PubMedDate not supplied

The effect of extremity range of motion on vital signs of critically ill patients and patients with burns: a pilot study.

The purpose of this study was to evaluate the effects of range-of-motion exercise on vital signs of critically ill patients. The vital signs of 10 consecutive critically ill patients were evaluated during passive and active-assistive range-of-motion exercise. Vital signs monitored were heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure. The average length of an exercise session was 22.6 minutes. No clinically significant difference was found between pretreatment and treatment heart rate, systolic blood pressure, diastolic blood pressure, or mean arterial pressure. It appears from this study that passive and active-assistive range-of-motion exercise can be performed safely, without unnecessary physiologic stress, on critically ill patients.

Adult↗
PubMedDate not supplied

Functional outcomes for the patient with burn injuries.

In health care, outcome measures have become important tools to assist with monitoring the efficacy of therapeutic interventions. This article defines functional outcomes and describes why therapists should begin monitoring the care of patients with burn injuries in terms of function. Suggestions are provided on the identification and documentation of functional outcomes for patients with burn injuries.

Activities of Daily Living↗
PubMedDate not supplied

Mathematic model to estimate change in burn scar length required for joint range of motion.

Burn scar contracture results from an insufficient amount of extensible tissue to permit complete range of motion. The purpose of this study was to develop a mathematic model to estimate additional tissue length required for full range of motion in the presence of a scar contracture. Seven areas with a known predilection for burn scar contracture were assessed. Twenty-five volunteers with normal range of motion had the length of their limbs measured at predetermined angles. Changes in limb length through range of motion were documented. On the basis of these changes, a mathematic model was developed to estimate the additional amount of tissue length required to complete range of motion for each area. This information may be useful to determine burn patient rehabilitation potential or need for reconstructive surgery.

Adult↗
PubMedDate not supplied

To splint or not to splint--past philosophy and present practice: Part I.

The purposes of this study were to document (1) the historical use of splints, (2) record the current practice of splint application, and (3) compare splint philosophy of the past with present practice. One hundred burn references were reviewed for information on the past use of splints. Present practice was determined on the basis of a survey of 99 burn centers. Information is presented as to when splints are applied to burn patients in their course of recovery for 12 body areas prone to scar contracture. The influence of burn depth is noted. A change in the practice of applying splints to burn patients appears to have occurred. Part I of this series describes the global results and details whether splints are necessary.

Burn Units↗
PubMedDate not supplied

Return to school as an outcome measure after a burn injury.

Outcome measures have become an important tool to assist with monitoring the efficacy of burn care. One such measurement for children is the time required for them to return to school, as well as their behavior and academic performance in school after a burn injury. The purpose of this study was to relate demographic data with return-to-school time and school performance. Through medical record review and interviews with patients, parents, and school teachers, information was obtained regarding the patient's burn injury, as well as home and school status before and after the burn injury. School information before the burn injury was obtained after patient admission. Schools were contacted 6 months after hospital discharge for data after the burn injury. Thirty-four patients aged 6 to 16 years had their outcomes evaluated from September 1993 to June 1995. Average total body surface area burned was 25.9%; the mean area of full-thickness burn was 17.5%. Length of stay averaged 30.8 days. Sixty-five percent of patients were discharged with splints, and all were discharged with a pressure program. Children returned to school an average of 7.4 days after discharge, and the average number of missed school days was 22. Thirty-four percent of the children had a school reentry visit, and either a phone call, written material, or both were provided in lieu of a visit to the other schools. For this population, burn injury did not appear to impact outcome negatively as it related to a child's return or function in school. These children returned to school rather rapidly after discharge and functioned as well or better after injury. Little loss of grade was noted, and only those children with problems in school before the burn injury had problems after the burn injury. Contact with the child's school before reentry might have assisted with the smooth transition.

Adolescent↗
PubMedDate not supplied

Directional variance in skin movement.

Skin tension is known to affect the amount of movement in normal skin and has been theorized to have a possible influence on burn scars. This study measured the directional variance in skin movement, which is related to this theory. Twenty adult female volunteers had 5 predetermined skin sites tested; these sites were on the ventral surface of the upper extremities (UE), from the shoulder to the wrist. A 1 kg axial traction force was randomly applied to each skin site in both proximal and distal directions. The skin was load-cycled 6 times before movement was measured with the use of a laser beam projection. Analysis was performed for each site, and pooled data was normalized for the entire UE. Distal skin movement was significantly greater than proximal movement at each of the 5 test sites and for the UE as a whole (P < .001). No significant differences were found among like-direction sites. Only subject height and length of UE correlated strongly (r = .88). This study demonstrates a difference in skin movement and discusses how these findings may relate to the theory that skin tension could be involved in burn scar contracture and hypertrophy.

Adult↗
PubMedDate not supplied

A silver anniversary tribute to therapists of the American Burn Association.

The year 1993 marks the Twenty-fifth Anniversary of the American Burn Association (ABA). Since Dr. Curtis P. Artz extended an invitation for membership in 1968, therapist membership has increased to 387 current members. During the quarter century the ABA has met, therapists have presented 211 abstracts, and 17 therapists have presented instructional courses and educational symposia. Thirty-three therapists have moderated correlative sessions, and 95 therapists have fulfilled this capacity for Breakfast Symposia. The OT/PT Special Interest Group has been lead by 12 therapists, whereas 30 therapists have participated in two rehabilitation workshops. On the organizational level, three therapists have served as At-Large Members to the Board of Trustees, whereas 11 others have served on the At-Large Advisory Board. Sixty-three therapists have worked on 11 ABA committees. As senior authors, therapists have had 118 articles published in the Journal of Burn Care & Rehabilitation. In addition, four therapists have served the Journal in an editorial capacity. Therapists have been recognized for their efforts as recipients of Distinguished Service Awards, Educational Exchange Grants, and President's Continuing Education Awards.

Burns↗