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Biomedical subjects

Y Brown

Publications and source records attributed to Y Brown.

18 recordsLinked to original sources
PubMed1992

The crisis of pregnancy loss: a team approach to support.

When a pregnancy loss occurs, a woman and her family may require help to facilitate grieving. Several support strategies can be recommended. We established a volunteer, hospital-based perinatal crisis support group that provides intervention, assists clients in moving through the period of disorganization, and offers information and support. Four examples illustrate the work of the group and its collaboration with personnel in other departments and agencies. Guidelines are provided for the establishment of a support team.

Adolescent↗
PubMed1991

Population pharmacokinetics of intravenous indomethacin in neonates with symptomatic patent ductus arteriosus.

The population pharmacokinetics of intravenous indomethacin were investigated with 665 indomethacin serum concentrations from 83 neonates (mean +/- SD: gestational age, 28.8 +/- 2.5 weeks; postnatal age, 5.7 +/- 4.7 days; birth weight, 1.13 +/- 0.40 kg) receiving indomethacin for symptomatic patent ductus arteriosus. A one-compartment open model was used for pharmacokinetic analysis. Hypotheses were tested to determine which developmental and demographic data influenced clearance (CL) and volume of distribution (V(area)). In the final regression equation CL and V(area) were modeled as a function of body weight and postnatal age (PNA) from 0 to 20 days. Final estimates were as follows: CL (ml/hr) = 2.63.weight (kg) + 0.244.PNA (days) and V(area) (L) = 0.28.weight (kg) + 0.0041.PNA (days). The coefficients of variation for interindividual variability in CL and V(area) were 77% and 28%, respectively. Intraindividual variability was 19%. These mean population parameter estimates should prove useful in designing dosage regimens to achieve desired indomethacin concentrations for neonates from 0 to 20 days of age with symptomatic patent ductus arteriosus.

Birth Weight↗
PubMed1991

Indomethacin pharmacokinetics in neonates: the value of volume of distribution as a marker of permanent patent ductus arteriosus closure.

Indomethacin (INDO) pharmacokinetics were examined in 18 neonates on 19 occasions, before and after patent ductus arteriosus (PDA) closure. Patients received INDO as an initial dose of 0.25 mg/kg intravenously, and INDO serum concentrations were measured 2 and 8 h after the dose. Subsequent doses were individualized based on clinical response, toxicity, and INDO pharmacokinetics. PDA status was confirmed echocardiographically at the start and end of therapy. INDO pharmacokinetic parameters varied from dose-to-dose within the same patient, and wide interpatient variability was also observed. Pre- and post-PDA closure, only INDO volume of distribution differed significantly (p less than 0.001) with mean values of 0.36 (+/- 0.06) L/kg and 0.26 (+/- 0.08) L/kg. The reason for this occurrence remains unclear. However, a new application for pharmacokinetics as a probe of physiology is demonstrated.

Biomarkers↗
PubMed1990

Problem resolution and repetition of parasuicide. A prospective study.

Resolution of presenting problems at three-month follow-up was studied in 228 parasuicides. 'Non-resolvers' presented with less severe problems, but prodromes were longer, prior episodes more frequent, and they experienced more powerlessness and internally directed hostility than the resolvers. At follow-up resolvers had improved more on measures of depression, externally and internally directed hostility, locus of control, powerlessness, self-esteem, sensitivity to criticism, and social adjustment. Baseline problem severity, powerlessness (negatively), and 'normlessness' 'predicted' degree of problem resolution, while baseline problem severity, the number of previous parasuicide episodes, and baseline internal hostility (the latter two variables negatively) were associated with problem resolution as a dichotomous variable. Resolvers improved more in social functioning during the follow-up than non-resolvers, but a similar proportion (16%) in each group reported repeat episodes of parasuicide at follow-up.

Adolescent↗
PubMed1990

The effect of knowledge on nursing students' attitudes toward individuals with AIDS.

The purpose of this study was to determine if increased knowledge changes nursing students' attitudes toward individuals with AIDS. A pretest/post-test design was used to administer a questionnaire, developed and validated in the United States, and adapted for use in this study. Subjects were total population of first to fourth year baccalaureate undergraduate nursing students attending a 1-day AIDS workshop. Questions dealt with knowledge and fears concerning AIDS and caring for AIDS patients, and attitudes toward homosexuality and toward the terminally ill. With the level of significance set at (p less than .05), post-test results indicated that all groups of students displayed a knowledge gain (p = .000) and a more positive attitude toward caring for AIDS patients (p = .001), particularly by e, first and third year students (p = .001). Although positive, younger students and students who had cared for AIDS patients were less positive. In this study, AIDS education had a positive influence on attitudes of nursing students. This finding supports the use of education to foster positive attitudes toward AIDS and individuals with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Indomethacin for patent ductus arteriosus closure. Application of serum concentrations and pharmacodynamics to improve response.

Indomethacin dosing for patent ductus arteriosus closure has been standardized despite wide interpatient variability in indomethacin pharmacokinetics. We compared a novel indomethacin dosing approach using individual pharmacokinetic and pharmacodynamic information (group A) with a control group from our institution (group B) and a level 3 university-based intensive care nursery (group C) who were dosed using current dosing guidelines. Permanent patent ductus arteriosus closure was achieved in 27 of 28 (96.4%) group A patients, 10 of 16 (62.5%) group B patients, and 7 of 13 (52.8%) group C patients. Success rates were significantly higher in group A than Groups B and C (P less than .02). Renal toxicity was the only toxicity reported in any group. The major manifestations of renal toxicity, ie, urine output below 1 mL/kg/h or increased serum creatinine by greater than or equal to 0.5 mg/dL, occurred in none of the group A patients but in seven (43.8%) group B and eight (61.5%) group C patients. Renal toxicity was significantly greater in groups B and C than group A (P less than .02). A pharmacodynamic concentration versus response curve was developed and proved predictive of patent ductus arteriosus closure rates in previous studies where indomethacin concentration versus response data were available. Serum concentration monitoring is a valuable adjunct to indomethacin therapy for patent ductus arteriosus closure, especially when a pharmacodynamic approach is used.

Algorithms↗
PubMedDate not supplied

Perinatal loss: a framework for practice.

Perinatal death is a crisis for women and their families. By using a conceptual framework to guide care, caregivers can facilitate grief and help the healing process. The framework described in this article is centered on the key concept of meaning or significance of the loss to the woman, her partner, family, friends, community, and society. The loss may encompass many meanings, and the meanings may differ from person to person. Sociocultural, spiritual, psychological, developmental, and physiological variables are presented. Goals of intervention include promotion of personal choice; support for decisions made; and promotion of dignity and respect for the woman, baby, and family. Intervention modes are supportive, informational, and facilitative.

Adult↗
PubMedDate not supplied

Nurses' knowledge about and attitudes toward patients with AIDS.

With the increasing incidence of AIDS, it is probably inevitable that most nurses working in acute care settings will at some time come in contact with a patient who has AIDS. Nurses must be prepared to give safe, competent, and compassionate care to patients with AIDS. This article reports the results of a survey of registered nurses' knowledge and attitudes related to AIDS and AIDS patients. The respondents displayed moderate scores on the knowledge questions, high scores on transmission and treatment, but low scores on epidemiology and pathophysiology. On the attitude subscales, scores were above three on a five-point scale, indicating a lack of negative attitudes. Recommendations for educational programming are included.

Acquired Immunodeficiency Syndrome↗