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Biomedical subjects

R Adams

Publications and source records attributed to R Adams.

At least 145 records · Page 8Linked to original sources
PubMed1987

The impact of utilization review on nursing.

At first glance, nursing's role in UR appears to be of strategic significance to the profession. But there are several issues that nurse executives need to consider. First, since UR departments are seldom part of the nursing department, UR nurses are practicing outside the realm of nursing. What responsibility, if any, does the nursing department have to nurses practicing in the hospital, yet not in the nursing department? What can the nursing department do to help UR nurses maintain their identification with the profession and appreciate the strategic importance of their role, with its legal and financial ramifications? Second, UR is changing the established role of the primary care nurse. In your institution UR may already have taken the staff nurses' discharge planning function. It appears that several factors are contributing to this role change. Patient acuity has increased the time needed to administer physical care. The nursing shortage means more patients are assigned to each professional nurse and paraprofessionals are doing more patient care. There is less and less time left for the primary nurse to practice the professional attributes of nursing, primarily discharge planning. This function is shifting to the UR Department. Is discharge planning a function nurse executives wish to relinquish? Finally, we are entering another period of severe nurse shortages, where recruitment and retention of staff are paramount. Actively competing for our staff are the UR departments. Forty professional nurses work in three regional centers of the American Health Network, American Group Insurance Company (Dallas, Texas). In one hospital of 450 beds, nine nurses are employed by the UR department.(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1987

The role of osmotic effects in haloadaptation of Vibrio costicola.

Growth rates of Vibrio costicola showed a broad optimum between 0.8 and 1.5 M-NaCl, and there was no growth above 3.3 M-NaCl in a peptone-based medium. The minimum requirement of 0.5 M-NaCl for growth in NaCl alone was reduced to 0.3 M-NaCl when the total solute concentration was raised to 0.5 to 1.0 M equivalent with sucrose or glycerol. Compared with equivalent NaCl concentrations, higher concentrations of sucrose were more inhibitory to growth, whereas glycerol had less effect. Increasing the medium NaCl concentration suddenly by 2- or 3-fold with either a constant starting, or final, salt concentration showed that, after the shift-up, the lag in growth, the rate of growth, and the inhibition of phospholipid synthesis depended both on the final NaCl concentration and the magnitude of the shift in salinity. The time-courses of phospholipid synthesis following a 2- or 3-fold shift-up in NaCl or sucrose media were very similar and exhibited a relative increase in phosphatidylglycerol synthesis over that of phosphatidylethanolamine. This 'switch-over' was not seen following shift-up in glycerol media when there was also a stimulation, rather than inhibition, of phospholipid synthesis. It is concluded that during phenotypic haloadaptation of V. costicola, osmotic effects play a significant part in the sensing of and response to raised external salinity.

Glycerol↗
PubMed1987

Contribution of whole blood L-lactate, pyruvate, D-lactate, acetoacetate, and 3-hydroxybutyrate concentrations to the plasma anion gap in horses with intestinal disorders.

Increased anion gap (AG) was due, in part, to L-lactic acidosis in 14 of 14 horses with intestinal disorders. In a few horses, increased whole blood concentrations of D-lactate made a minor contribution to the AG. However, the increase in AG was often greater than the sum of the increases in these 2 acid anions. This unexplained increase was not a result of increases in whole blood pyruvate, 3-hydroxybutyrate, or acetoacetate concentrations or serum albumin or phosphate concentrations. Identification of other anions causing increased AG could lead to better understanding, diagnosis, and treatment of metabolic imbalances in critically ill horses.

3-Hydroxybutyric Acid↗
PubMed1986

Acuity and staffing under prospective payment.

Nursing administrators are debating the desirable mix of professional (RN) and paraprofessional (LPN) nursing staff under the prospective payment system (DRGs). The staffing mix reflects the cost and quality of nursing care provided by an acute care hospital. Based on a reliable and valid acuity/care plan system, standards of care and nursing diagnoses, several DRGs were analyzed on an eight-bed medical/surgical intensive care unit with regard to intensity of care and staffing mix. This study showed nursing administrators that the staffing mix on an intensive care unit varies according to the acuity/care plan rather than DRGs or nursing diagnoses.

Diagnosis-Related Groups↗
PubMed1985

Neurologic diseases.

The responses of apparently healthy newborn foals to neurologic testing differ significantly from those of adult horses. These responses and the diagnostic techniques pertinent to neurologic problems are reviewed as a basis for evaluation of the compromised neonatal foal. The more frequently encountered neurologic diseases are discussed in a problem-oriented format. These clinical problems include behavioral abnormalities, convulsions, changes in consciousness, blindness, ataxia without loss of strength, ataxia with weakness and paralysis, and the floppy foal.

Animals↗
PubMed1985

Evaluation of a technique for measurement of gamma-glutamyltranspeptidase in equine urine.

gamma-Glutamyltranspeptidase (GGT) activity in equine urine was measured, using an assay developed for use with serum and was found to be reproducible. The GGT activity was measured in samples prepared by serial dilution of exogenous GGT with equine urine, and the activity was determined to be linear between 21 IU/L and 407 IU/L. The behavior of exogenously added GGT was compared in equine serum and urine. The enzyme behaved similarly in both fluids. The GGT activity was measured in serum and urine samples after storage at -20, 4, and 25 C for 24 and/or 72 hours. Enzyme activity decreased after storage at all temperatures and times, but the decrease was greatest and most variable at -20 C. The urine GGT: urine creatinine ratio was calculated on serial urine samples collected over 24 hours. Although the urine GGT activity and creatinine concentration had significant variation, the ratio remained constant. The urine GGT: urine creatinine ratio was calculated from random urine samples collected from 27 clinically healthy adult horses and was found to be 10.52 +/- 4.78 (mean +/- SD).

Animals↗
PubMed1985

Urinary gamma-glutamyl transpeptidase activity in dogs with gentamicin-induced nephrotoxicity.

Serum creatinine concentrations, 24-hour endogenous creatinine clearance, and 24-hour urinary gamma-glutamyl transpeptidase (UGGT) activity were measured daily in 6 dogs given nephrotoxic dosages of gentamicin (10 mg/kg of body weight) every 8 hours for 10 days. Mean UGGT activity was significantly increased by day 5 (P less than 0.05) and preceded significant increases in serum creatinine values (greater than 2.0 mg/dl) observed on day 9. Endogenous creatinine clearance remained within normal limits (2.98 +/- 0.96 ml/min/kg) until day 8. Urinalyses performed 8 days after initiation of gentamicin treatment indicated renal tubular damage (granular casts) in 1 of the 6 dogs, and glucosuria in 3 of the 6 dogs. Measurement of UGGT activity was a more sensitive and reliable method of assessing acute renal tubular damage induced by gentamicin than were serum creatinine concentrations or 24-hour endogenous creatinine clearance.

Animals↗
PubMed1985

Computerization of patient acuity and nursing care planning. New approach to improved patient care and cost-effective staffing.

Patient classification systems are essential for nurse administrators to justify nursing staff and to project budget. To answer these needs effectively, a computerized patient classification system must be customized to existing physical and human resources within each health care facility. Nursing administrators at Riverside Medical Center met this need by developing a computerized patient classification system that integrates patient acuity with patient care plans and nursing diagnoses. Direct cost accounting of nursing care according to patient needs and outcomes can be justified by correlating this management and practice data.

Computers↗
PubMed1984

For debate . . . medical research output 1973-81: a romp around the United Kingdom research centres.

In order to measure output of medical research in the United Kingdom, the computerised database of Excerpta Medica was used to count the number of publications emanating from each centre of research based on a medical school in 1973-81. Data were amalgamated for the first four years (1973-6) and the final four years (1978-81) and the two sets of data were compared. Eight centres showed a substantial change (20% or more) between the first and second periods. In London three medical schools showed an increase in output and one showed a decrease in output. Elsewhere Leicester, Nottingham, and Southampton schools showed an increase and Bristol showed a decrease. The overall contribution of Cambridge did not increase over the decade but the proportion of clinical papers among those produced at Cambridge did increase. There are deficiencies in this type of exercise as all articles are treated equally, but probably some of these problems could be overcome in a more sophisticated analysis. Some measure of weighting of the importance of each paper needs to be devised.

Academies and Institutes↗
PubMed1984

Neurological examination of newborn foals.

Behaviour and response to neurological testing of apparently healthy newborn foals differed significantly from the adult in several ways. Foals responded to external stimulation with exaggerated movements although they tended to sink into a relaxed state when restrained. They had a more angular head position and assumed a base wide stance. The menace reflex developed during the first two weeks post partum. In general, the foals' gait was choppy or dysmetric. In lateral recumbency the foals had increased extensor tone, hyperreflexive tendon reflexes, crossed extensor reflexes as well as recumbent extensor thrust reflexes in all four limbs.

Animals↗
PubMed1984

Suggested revision of NEMA standards.

The purpose of the NEMA Standards is to "eliminate misunderstandings between the manufacturer and the purchaser and to assist the purchaser in selecting the proper product for its particular need" (NEMA Bylaw Art. V, Sec. 1). The sections on count-rate performance, however, have caused considerable misunderstanding of NEMA specifications by salespersons and users, many of whom fail to distinguish between input and observed count rates and between intrinsic and system (extrinsic) performance. The "maximum count rate" is shown to be an unreliable index of camera performance at useful count rates, and is misconstrued by some users to mean the maximum clinically useful count rate. The sections on count-rate performance can be made more meaningful to users by substituting "observed count rate" for "input count rate," by deleting the section on "maximum count rate," and by adding a section on system count-rate performance.

Radionuclide Imaging↗
PubMed1983

Activated charcoal in tricyclic antidepressant poisoning: pilot controlled clinical trial.

1 A randomised clinical trial was carried out to assess the effects of activated charcoal in the management of suspected tricyclic antidepressant poisoning. 2 Forty-eight patients entered the study, twenty receiving supportive care plus activated charcoal (10 g) and twenty-eight supportive care alone. 3 Drug screening showed that only seventeen patients had taken tricyclic antidepressants alone. 4 Activated charcoal had no effect on either the rate of lightening of coma or the fall in plasma antidepressant concentration in the 'pure' tricyclic antidepressant poisoning group. 5 No serious side-effects of activated charcoal were reported.

Adolescent↗