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Biomedical subjects

U E Westfall

Publications and source records attributed to U E Westfall.

9 recordsLinked to original sources

Nursing chronotherapeutics: a conceptual framework.

Nurses frequently make decisions about when treatments and actions are performed. The nursing concern driving this review is the timing of nursing activities to optimize desired and minimize untoward effects. A nursing conceptual framework is proposed that highlights individual and environmental factors, as they relate to rhythmic responses; as well as places within the framework for nursing actions based on customary and usual temporal patterns.

Biological Clocks

Activating clinical inferences: a component of diagnostic reasoning in nursing.

In this exploratory study, nursing inferences were examined within a framework of information processing theory. Verbal responses to a patient simulation by 28 nursing students and 15 practicing nurses were used as data. Six different categories of inferences were identified. Inferences most frequently activated across educational levels were those about immediate situational concerns. Practicing nurses activated significantly more complex inferences than the student groups. In each group, the majority of inferences were activated during the first half of the encounter. These results of this preliminary analysis support the proposition that inference activation is an important component of the diagnostic reasoning process used by both nurses and nursing students.

Cognition

Systemic responses to different enteral feeding schedules in rats.

The purpose of this study was to describe selected temporal systemic responses to different enteral feeding schedules using an animal model, as one prerequisite for determining optimal delivery times for human enteral feedings. The effect of feeding schedules and time of day were examined relative to body weight and plasma glucose, insulin, glucagon, and corticosterone levels. Adult male Sprague-Dawley rats (N = 80) were used in a 4 x 4 randomized block design. Rats started the feeding schedules on Day 11 post-gastrostomy tube placement. The following feeding schedules, often used by humans, were tested: 24-hour enteral; 24-hour oral; 12-hour (rest time) enteral; and 12-hour (rest time) oral. Plasma was collected on Day 20. Despite very different feeding schedules, there were no statistical differences in weight gain, or plasma glucose and glucagon levels. Levels of insulin and corticosterone were significantly influenced by time of day and/or feeding group. Temporal pattern disruption was greatest in the rest-time fed enteral group. Both route and timing of enteral delivery modified metabolic hormone patterns.

Analysis of Variance

Diagnostic reasoning strategies of nurses and nursing students.

This study described and compared the cognitive strategies of diagnostic reasoning used by junior nursing students (n = 15), senior nursing students (n = 13), and practicing nurses (n = 15). Verbal responses to three videotaped vignettes provided the data. Findings suggested that diagnostic reasoning processes of both nurses and nursing students can be described by a general model developed from studies of physicians. Subjects activated diagnostic hypotheses early in the encounter and used systematic information gathering to rule in and rule out hypotheses. With increased levels of knowledge and experience, there was a trend toward more systematic data acquisition and greater accuracy in diagnosis. The number of hypotheses activated, the earliness with which they were activated, and their diagnostic accuracy were task-specific components of the process, but selection of data-acquisition strategies appeared to be more generalizable across cases.

Cognition