Biomedical subjects

Sandra Smith

Publications and source records attributed to Sandra Smith.

6 recordsLinked to original sources

PubMed2006

They only see it when the sun shines in my ears: exploring perceptions of adolescent hearing aid users.

Hard-of-hearing (HOH) young people may encounter multiple challenges to their educational, social, and emotional development. The benefits of wearing hearing aids to enhance communication may be countered by negative stigma associated with hearing aids. This study explored the experience of 16 bilaterally, moderately to severely HOH adolescents in mainstream education to understand their perceptions of using hearing aids. A core category of "normality" emerged from the data, which captures the predominant issue for these young people. The sense of being normal may be situationally determined, but those who are able to perceive their use of hearing aids in a given context as normal most frequently use them. Regardless of the age of diagnosis or length of time since fitting, if use of hearing aids is perceived as not normal then their use is disguised or negated. The perceptions of the young people indicate that psychosocial supports focused on promoting their identity as HOH young people and normalizing the use of hearing aids should be a key feature of interventions.

Adolescent↗

PubMed2005

Designing an electronic medication reconciliation system.

Unintended medication discrepancies at hospital admission and discharge potentially harm patients. Explicit medication reconciliation (MR) can prevent unintended discrepancies among care settings and is mandated by JCAHO for 2005. Enterprise-wide, we are linking pre-admission and discharge medication lists in our outpatient electronic health records (EHR) with our inpatient order entry applications (OE) - currently not interoperable - to support MR and inform the development of comprehensive MR among hospitalized patients.

Hospitalization↗

PubMed2004

Preparing RNs for the OR through a certificate in perioperative nursing program.

The need for qualified perioperative nurses is an ongoing issue, and many hospitals are training their own. Often, a facility will invest time and money to train a perioperative nurse, only to have the nurse leave to work for a competitor. This article describes how hospitals in the city of Louisville, Ky, pooled resources to develop a certificate in perioperative nursing program to address these issues.

Adult↗

PubMed2004

The evolution and implementation of a pediatric computerized order entry system: a case study.

Implementing CPOE is not an easy undertaking. Designing and implementing a pediatric-focused CPOE presented a unique challenge because of the age and weight considerations inherent with a pediatric patient population. Through the experiences involved in an implementation, key elements of a successful implementation include high-level sponsorship, involvement of clinicians up-front in the process, excellent communication and round-the-clock support. When everyone works together with common objectives, milestones are met, and goals are realized.

Decision Support Systems, Clinical↗

PubMed2003

Personal exposure to nitrogen dioxide (NO2) and the severity of virus-induced asthma in children.

BACKGROUND: A link between exposure to the air pollutant nitrogen dioxide (NO2) and respiratory disease has been suggested. Viral infections are the major cause of asthma exacerbations. We aimed to assess whether there is a relation between NO2 exposure and the severity of asthma exacerbations caused by proven respiratory viral infections in children. METHODS: A cohort of 114 asthmatic children aged between 8 and 11 years recorded daily upper and lower respiratory-tract symptoms, peak expiratory flow (PEF), and measured personal NO2 exposures every week for up to 13 months. We took nasal aspirates during reported episodes of upper respiratory-tract illness and tested for infection by common respiratory viruses and atypical bacteria with RT-PCR assays. We used generalised estimating equations to assess the relation between low (<7.5 microg/m3), medium (7.5-14 microg/m3 ), and high (>14 microg/m3) tertiles of NO2 exposure in the week before or after upper respiratory-tract infection and the severity of asthma exacerbation in the week after the start of an infection. FINDINGS: One or more viruses were detected in 78% of reported infection episodes, and the medians of NO2 exposure were 5 (IQR 3.6-6.3), 10 (8.7-12.0), and 21 microg/m3 (16.8-42.9) for low, medium, and high tertiles, respectively. There were significant increases in the severity of lower respiratory-tract symptom scores across the three tertiles (0.6 for all viruses [p=0.05] and >2 for respiratory syncytial virus [p=0.01]) and a reduction in PEF of more than 12 L/min for picornavirus (p=0.04) for high compared with low NO2 exposure before the start of the virus-induced exacerbation. INTERPRETATION: High exposure to NO2 in the week before the start of a respiratory viral infection, and at levels within current air quality standards, is associated with an increase in the severity of a resulting asthma exacerbation.

Air Pollutants↗

PubMed2002

Frequency, severity, and duration of rhinovirus infections in asthmatic and non-asthmatic individuals: a longitudinal cohort study.

BACKGROUND: Rhinovirus infections cause exacerbations of asthma. We postulated that people with asthma are more susceptible to rhinovirus infection than people without the disease and compared the susceptibility of these groups. METHODS: We recruited 76 cohabiting couples. One person in every couple had atopic asthma and one was healthy. Participants completed daily diary cards of upper-respiratory-tract (URT) and lower-respiratory-tract (LRT) symptoms and measured peak expiratory flow twice daily. Every 2 weeks nasal aspirates were taken and examined for rhinovirus. Mixed models were used to compare risks of infection between groups. We also compared the severity and duration of infections. FINDINGS: We analysed 753 samples. Rhinovirus was detected in 10.1% (38/378) of samples from participants with asthma and 8.5% (32/375) of samples from healthy participants. After adjustment for confounding factors, asthma did not significantly increase risk of infection (odds ratio 1.15, 95% CI 0.71-1.87). Groups did not differ in frequency, severity, or duration of URT infections or symptoms associated with rhinovirus infection. First rhinovirus infection was associated more frequently with LRT infection in participants with asthma than in healthy individuals (12 of 28 infections vs four of 23, respectively, p=0.051). Symptoms of LRT associated with rhinovirus infection were significantly more severe (p=0.001) and longer-lasting in participants with asthma than in healthy participants (p=0.005). INTERPRETATION: People with atopic asthma are not at greater risk of rhinovirus infection than healthy individuals but suffer from more frequent LRT infections and have more severe and longer-lasting LRT symptoms.

Adult↗