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Biomedical subjects

R Waterman

Publications and source records attributed to R Waterman.

18 recordsLinked to original sources
PubMed2001

Evaluation of a patient-empowering hand hygiene programme in the UK.

Partners in Your Care, a patient education behavioral model for increasing handwashing compliance and empowering the patient with responsibility for their care was evaluated in an acute care hospital in Oxford, UK. A controlled prospective intervention study comparing medical and surgical patients was performed. Ninety-eight patients were eligible for the study. Thirty-nine patients (40%) agreed to participate in the programme Partners in Your Care by asking all healthcare workers who were going to have direct contact with them "Did you wash your hands?" Compliance with the programme was measured through soap/alcohol usage and handwashings per bed day before and after its introduction. Partners in Your Care increased handwashing on average 50%. Healthcare workers washed hands more often with surgical patients than with medical (P< 0.05). Alcohol gel was used on less than 1% of occasions. Sixty-two percent of patients in study felt at ease when asking healthcare workers "Did you wash your hands?" Seventy-eight percent received a positive response (washed hands). All patients asked nurses, but only 35% asked physicians. Partners in Your Care increased handwashing compliance in the UK. This programme empowers patients with responsibility for their care, provides infection control staff with a continuing means for providing handwashing education without additional staff and can save costs for a hospital.

Hand Disinfection↗
PubMed2001

The LN54 radiation hybrid map of zebrafish expressed sequences.

To increase the density of a gene map of the zebrafish, Danio rerio, we have placed 3119 expressed sequence tags (ESTs) and cDNA sequences on the LN54 radiation hybrid (RH) panel. The ESTs and genes mapped here join 748 SSLp markers and 459 previously mapped genes and ESTs, bringing the total number of markers on the LN54 RH panel to 4226. Addition of these new markers brings the total LN54 map size to 14,372 cR, with 118 kb/cR. The distribution of ESTs according to linkage groups shows relatively little variation (minimum, 73; maximum, 201). This observation, combined with a relatively uniform size for zebrafish chromosomes, as previously indicated by karyotyping, indicates that there are no especially gene-rich or gene-poor chromosomes in this species. We developed an algorithm to provide a semiautomatic method for the selection of additional framework markers for the LN54 map. This algorithm increased the total number of framework markers to 1150 and permitted the mapping of a high percentage of sequences that could not be placed on a previous version of the LN54 map. The increased concentration of expressed sequences on the LN54 map of the zebrafish genome will facilitate the molecular characterization of mutations in this species.

Animals↗
PubMed2000

Nociceptin receptor activation produces nitric oxide-mediated systemic hypotension.

The purpose of the present study was to investigate the effects of L-N5-(1-iminoethyl)ornithine hydrochloride (L-NIO), an inhibitor of nitric oxide (NO) formation, and [Phe1-psi(CH2NH)-Gly2]Nociceptin(1-13)-NH2 (Phe-NOC), a nociceptin receptor antagonist, on the systemic vasodepressor response to nociceptin in the anesthetized rat. The systemic vasodepressor response to bolus intravenous (i.v.) injections of nociceptin was significantly reduced by L-NIO and Phe-NOC. The present data suggest activation of nociceptin receptors dilates the systemic vascular bed through a NO-dependent pathway. These data also demonstrate Phe-NOC is an efficacious and selective nociceptin receptor antagonist in vivo.

Animals↗
PubMed1999

Patient education model for increasing handwashing compliance.

BACKGROUND: A review of the literature on handwashing has documented the absence of research on the education of the patient as an intervention model for changing staff behavior regarding handwashing compliance. The primary objective of this project was to conduct a prospective control study of the effect of patient handwashing education on staff compliance with handwashing. METHOD: A prospective, controlled, 6-week intervention/control study was performed in 4 community hospitals in South Jersey. Each hospital served as its own control. Patients were educated within 24 hours of admission about the importance of asking their health care workers to wash their hands. Soap usage and handwashing was calculated by bed-days. Patient follow-up was conducted through telephone interviews 2 weeks after discharge. RESULTS: The patient handwashing education model increased soap usage by health care workers an average of 34% (P =.021); this increase was consistent across hospitals regardless of the initial soap usage rates. Of the patients interviewed, 81% read the materials provided, 57% asked health care workers whether they had washed their hands, and 81% of this 57% said they received positive responses. CONCLUSIONS: For the first time, our findings document that education of patients regarding their role in monitoring handwashing compliance among health care workers can increase soap usage and handwashing and provide sustainable reinforcement of handwashing principles for health care workers.

Cost-Benefit Analysis↗
PubMed1991

Faecal indicator bacteria on the hands and the effectiveness of hand-washing in Zimbabwe.

Two aspects of hand-washing were explored in this study. Mothers and children from 80 families in Zimbabwe were asked to wash their hands in the traditional manner in sterile water. Mothers were asked to answere a socio-economic questionnaire. By using the questionnaire and observations in conjunction with the microbiological data from hand-washing, factors were identified which contributed to high counts on the hands. These were: high relative humidity, living on a commercial farm, and having an infant in the family. Mothers and children 1-5 years of age had higher counts than children of 6-12 years. People recently involved in outdoor physical activities such as farming had higher counts than those involved in other activities. The traditional hand-washing method was also compared with two other hand-washing methods: hand-washing using soap and hand-washing using a container known as the mukombe. Hand-washing with soap was the most effective method closely followed by hand-washing using the mukombe. The least effective method was traditional hand-washing.

Adult↗
PubMed1990

Failure to prevent preterm labour and delivery in twin pregnancy using prophylactic oral salbutamol.

A double blind, controlled study was performed to see whether the use of prophylactic oral salbutamol would reduce the incidence of preterm labour in twin pregnancy. Of the 144 women studied, 74 took salbutamol and 70 placebo. No difference was found in the length of gestation, birthweight or fetal outcome, although fewer babies suffered from respiratory distress syndrome in the salbutamol group. Women did not experience troublesome side-effects from salbutamol.

Administration, Oral↗
PubMed1989

The New Mexico experiment: educational innovation and institutional change.

Over the past ten years the University of New Mexico School of Medicine has conducted an educational experiment featuring learner-centered, problem-based, community-oriented learning. The experiment was introduced into an established institution by means of an innovative educational track running parallel to the more conventional curriculum. Students in the innovative track, compared with those in the conventional tract, tended to score lower on the National Board of Medical Examiners (NBME) Part I examination (basic sciences) and higher on NBME Part II (clinical sciences), received higher clinical grades on clinical clerkships, and experienced less distress. They were more likely than conventional-track students to retain their initial interest in or switch their preference to careers in family medicine. The parallel-track strategy for introducing curriculum reform succeeded in fostering institutional acceptance of continuing educational innovation. Generic steps in overcoming institutional barriers to change are identified.

Curriculum↗
PubMed1986

Xanthogranulomatous abscess of a mullerian duct remnant. A rare lesion of the rectum and anus.

A rare example of xanthogranulomatous inflammatory mass and abscess of a Mullerian duct remnant involving the anorectal area is reported. A barium enema showed a bilobed precoccygeal mass of moderate size involving the posterior aspect of the distal rectum. Computed tomography (CT) showed two nonfatty, round masses, one of which contained a small central cystic area. The other mass had a homogeneous appearance and was believed to be in the wall of the rectum. The pathologic specimen showed organizing abscesses and a chronic xanthogranulomatous inflammation in tissue compatible with urogenital tissue, presumably a Mullerian duct remnant. This is the first documented report of anorectal xanthogranulomatous abscess in a Mullerian duct remnant with radiologic findings and histopathologic correlation. Though rare, this lesion should be considered in the differential diagnosis of extrinsic and intramural rectal masses seen on barium enema and CT examinations.

Abscess↗
PubMed1982

Undergraduate medical education for primary care: a case study in New Mexico.

To address the dual problems of maldistribution of physicians and an increasing need for physicians who are lifelong learners, an experimental curricular track was developed at the University of New Mexico School of Medicine. Increased student responsibility for learning is encouraged by student-centered, small-group, problem-based tutorial learning, and early, primary care role modeling is offered during an early, lengthy, rural preceptorship. Preliminary outcomes reveal there is reinforcement of career interest in rural primary care with important linkages forged between the university and communities as a program by-product. Further, the experimental students, as compared to students in the conventional track, showed a greater appreciation of their learning environment, showed less stress, and failed to become cynical. The reorientation of undergraduate medical education toward the future health care needs of communities and the learning needs of physicians may require major modifications of curriculum design and role modeling experiences.

Curriculum↗
PubMed1982

Teaching clinical skills to pre-clinical medical students: integration with basic science learning.

Clinical skills are usually learned by pre-clinical students in a manner divorced from their basic science foundations. The value of previously learned basic sciences thus fails to be re-enforced. A clinical skills course was developed for an experimental curriculum of medical students in their first year. It was organized and taught by a team of basic and clinical scientists and emphasized the basic pathophysiological principles underlying clinical skills. Sessions were supported by related basic science audiovisual resources and a series of clinical problems with questions obliging the student to reason through basic-science mechanisms. Over the span of the course, students' interest shifted dramatically from a focus on proficiency in motor skills to an understanding of basic pathophysiological mechanisms underlying observed phenomena. Compared to conventional curriculum students, those in the experimental curriculum failed to show a diminution in perceived value of basic sciences in their future career and, on cumulative, cognitive examinations, scored equally in basic science, but significantly higher in clinical science subjects. A clinical skills course integrating both teachers and concepts from basic, as well as clinical sciences can improve student attitudes toward basic sciences.

Clinical Competence↗
PubMedDate not supplied

Radionuclide, computed tomography, and digital imaging of duplicated inferior vena cava.

Duplication of the inferior vena cava (IVC) is not an uncommon vascular anomaly. We describe here the appearance of double IVC by radionuclide angiography, computed tomography (CT) scan, and digital angiography. It is important to confirm the presence of duplicated IVC, which is usually first seen on CT scan, because patients undergoing certain surgical procedures would be at greater risk for injury to the IVC as well as other complications.

Aged↗