The elderly form a physiological heterogeneous group. This thesis is concerned with the activity of plasma aspirin esterase and several other plasma esterases in the fit, community-dwelling and frail hospitalized elderly. I, Several studies have produced evidence to suggest that drug metabolism is altered in the frail elderly and some of this work has centred around the plasma esterases. Kinetic analysis of plasma from young people, and fit and frail elderly people showed that the reduced plasma aspirin esterase in the latter group was most likely due to a reduced amount of cholinesterase enzyme (a reduced maximal activity) rather than that of a compromised affinity of the enzyme (increased Km). Purification of whole plasma achieved the removal of 97% of the albumin component of plasma aspirin esterase. Subsequent kinetic analysis confirmed that there was no change in the Km value of plasma aspirin esterase in the three groups as a result of isolating the cholinesterase enzyme. Following this, it was postulated that the reduced activity of several plasma esterases in the frail elderly may be due to their often poor nutritional status. A group of frail elderly people were randomised and half received a supplemented hospital diet. Plasma aspirin esterase, cholinesterase, paraoxonase, phenylacetate esterase, red blood cell intracellular esterase and red blood cell acetylcholinesterase in addition to anthropometric measurements were measured at 0,4 and 8 weeks of the study period. The control group did not gain weight whereas the group who received a supplemented diet gained an average 1.3Kg (non-significant). The post study weight and TSF measurements between the fed and control groups differed signifcantly at p<0.05. There were no significant changes in any of the esterases at 8 weeks however plasma cholinesterase did show a significant increase in activity at 4 week (p < 0.05) and plasma paraoxonase showed a trend towards an improved activity.

Thesis (M.S.)--University of Wisconsin--Madison, 1968. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 50-51).

Thesis (M.S.)--University of Wisconsin, School of Nursing. / eContent provider-neutral record in process. Description based on print version record.

Thesis (M.S.)--University of Wisconsin--Madison. School of Nursing, 1968. / Typewritten. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 48-50).

Class of 2009 Abstract / OBJECTIVES: To assess whether patients at University Medical Center (UMC) in Arizona who have indications for venous thromboembolism (VTE) prophylaxis receive treatment, determine whether appropriate pharmacologic VTE prophylaxis is implemented, and analyze the incidence of VTE associated with prescribed regimens. METHODS: Data were derived from a retrospective chart review on risk factors for VTE and prescription of pharmacological and non-pharmacological thromboprophylaxis. Two risk assessment models were used to evaluate adherence to treatment standards: the 2008 American College of Chest Physicians (ACCP) evidence-based consensus guidelines and the Caprini score. Clinical outcomes were evaluated with regard to proper thromboprophylaxis including assessment of appropriate time, type, intensity, and duration of treatment. RESULTS: A total of 366 patients met inclusion critera. Based on the Caprini score, 94% of patients were judged to be at risk for VTE. Of those at risk, 90% received thromboprophylaxis; however, only 35% of treated patients received proper thromboprophylaxis. Ten patients (2.7%) experienced a VTE during their hospital stay or within the following 6 months after discharge. There was not a significant difference in incidence of VTE with respect to treatment versus no treatment or proper versus improper prophylaxis (p=0.15 and 0.65, respectively); however, a favorable trend in incidence of VTE was observed for treated patients and patients treated with correct thromboprophylaxis based on risk assessment. CONCLUSIONS: Most patients at UMC who were indicated for VTE prophylaxis received treatment; however, the type, intensity, and duration of thromboprophylaxis were often inappropriate despite the existence of various guidelines.

Thesis (M.S.)--University of Michigan, 1981.

Thesis (M.S.)--University of Michigan, 1981.

<p> Parents' participation in the care of their hospitalized child is an integral part of pediatric nursing practice and is considered to be beneficial for children and parents. However, parents may not discuss their participation with nurses and instead base their activities on their perceptions of nurses' assumptions and expectations regarding parents' participation in care. Nurses may assume a gate keeping role regarding parents' participation, deciding what parents will do and then monitoring these activities. Nurses' heavy workloads may preclude the teaching necessary for parents to participate in certain aspects of care. As a result, parents' actual participation in care may be more or less than their desired level of participation. Measuring actual participation alone may thus give an incomplete picture of a family's situation.</p> <p> To date, no attempt has been made to measure the difference between parents' actual and desired participation in care. A cross-sectional, descriptive design was used to measure parents' actual level of participation in care and their desired level of participation in care, and to describe the congruency between them. Parents of children admitted to medical and surgical units in a tertiary care children's hospital (N = 191) completed two instruments measuring desired and actual participation in care as well as providing demographic data. Study results indicate a difference between parents' actual and desired participation, with the majority of parents expressing a desire to increase their participation. Parents' care activities included providing comfort, assisting with activities of daily living, assisting with mechanical care and advocating for the hospitalized child. Recommendations are made for nursing practice at the bedside, for nursing administration and for future research. Measuring congruency between actual and desired levels of participation can contribute to our understanding of parents' experiences of their child's hospitalization and may provide a unique perspective on parental participation in care.</p> / Thesis / Doctor of Philosophy (PhD)

Diss. (sammanfattning) Uppsala : Univ., 2004. / Härtill 4 uppsatser.

Thesis (M.S.)--University of Wisconsin--Madison, School of Nursing, 1968. / Typewritten. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 87-92).