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Biomedical subjects

C Carr

Publications and source records attributed to C Carr.

68 records · Page 4Linked to original sources
PubMedDate not supplied

Lesbian mothers. Health care experiences.

A self-administered questionnaire was completed by 35 women who had delivered within the last five years and were self-identified lesbians when they conceived. The majority of women conceived through donor insemination and used the medical care system to achieve pregnancy. All sought prenatal care within the first 16 weeks, 89% participated in childbirth classes, and 80% breastfed for six months or more. Over half of the women (51%) sought obstetrical care from physicians, while 49% selected midwives. The majority (91%) disclosed their sexual orientation to their provider. Overall the women described their experience with obstetrical care providers as positive. However, a greater percentage of women who selected midwives reported higher levels of support from and satisfaction with their provider compared to those who selected physicians.

Adult↗
PubMedDate not supplied

A two-step mechanism for the interaction of Re lipopolysaccharide with erythrocyte membranes.

In this report, a unique model system that allows the investigation of the interaction of lipopolysaccharide (LPS) with erythrocyte membranes is described. Rabbit red blood cells exposed to S. minnesota (Re mutant) R595 LPS were rendered sensitive to the cationic antibiotic polymyxin B in a manner independent of the temperature of incubation of erythrocytes with LPS (subsequent addition of polymyxin B induced hemolysis of erythrocytes sensitized with LPS). Following sensitization of red blood cells with R595 LPS, a time-dependent decrease in susceptibility of the cells to polymyxin B-mediated hemolysis occurred, which was shown not to be the result of dissociation of LPS from rabbit erythrocytes. The demonstration that the decrease in sensitivity of red blood cells to polymyxin B was dependent on the temperature of incubation of LPS with red blood cells is not inconsistent with the proposal that the decrease in sensitivity is attributable to a hydrophobic rearrangement of lipid-rich R595 LPS within the lipid bilayer of the erythrocyte membrane. The importance of this putative rearrangement of LPS within cell membrane in cellular triggering of LPS is unknown.

Animals↗
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Prescribing exercise for cardiac patients: knowledge, practices, and needs of family physicians and specialists.

PURPOSE: To determine the following about prescribing exercise for cardiac patients: physicians' present and needed knowledge; their present practices; barriers that hinder them; and perceived need for and content of a protocol for prescribing exercise. METHODS: (1) Questionnaire mailed to 371 family physicians (FPs), 31 internists, and 25 cardiologists; and (2) four focus groups consisting of 25 FPs, 1 internist, and 3 cardiologists. RESULTS: Questionnaire response rate was 45% (n = 192). Because responses were similar and the group was small, internists and cardiologists were combined as "specialists." Generally, questionnaire data agreed with focus group data, with the latter providing more detail. Family physicians perceived they know little about prescribing a specific exercise program while specialists perceived they know little about motivating patients to begin an exercise program. The method most frequently used by both physician groups to increase exercise is providing general advice. The main barriers to prescribing exercise were inadequate knowledge (FPs only), patient education materials, and community resources. Both groups rated highly the need for a protocol for prescribing exercise and indicated it should: (1) include identification of patient's stage of change; (2) include indications and contraindications for exercise; (3) provide guidelines for developing a specific exercise prescription; (4) contain patient education materials, and (5) be simple and short. CONCLUSIONS: Family physicians perceive they know little about prescribing a specific exercise program for cardiac patients while specialists perceive they know little about motivating patients. Physicians rate highly the need for a protocol to help them prescribe exercise for cardiac patients.

Adult↗
PubMedDate not supplied

The fate of the nonoperated hip in cerebral palsy.

Thirty-six cerebral palsied patients who underwent a unilateral operative procedure for spastic hip subluxation or dislocation were reviewed for assessment of the effect on the nonoperated hip. Unilateral soft tissue procedures on patients less than 9 years of age had a definite untoward effect on the contralateral, nonoperated hip (progressive subluxation and development of a windswept pelvis deformity). The effect of unilateral bony procedures on the nonoperated hip was not statistically significant. Following unilateral surgery, nonambulators are at increased risk of demonstrating deterioration of the nonoperated hip in comparison to ambulators.

Cerebral Palsy↗
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Planning priorities for empowered teams.

Many companies are considering using self-managed teams to move from a traditional management structure to a system that gives employees much greater responsibility and involvement. But companies can stumble badly in setting up these teams. Here are six ways to sidestep the planning pitfalls.

Efficiency↗
PubMedDate not supplied

A four-week observation of maternity care in Finland.

The increasing infant mortality rate in the United States is of concern to all people, especially those involved in the care of mothers and infants. Of the 20 industrialized countries in the world, Finland, Sweden, and Japan rank first in lowest infant mortality rates. A four-week observational experience at a maternity and women's hospital in Helsinki, Finland, led to the identification of two contributing factors: 1) incentive for early antepartum care and 2) public education.

Female↗
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Meta-analysis of dietary restriction during fecal occult blood testing.

CONTEXT: Dietary restriction is often recommended during fecal occult blood testing (FOBT) as a means of increasing test accuracy, but concern surrounds whether such restriction also reduces the chance that patients will complete the test. PURPOSE: We conducted a systematic review and meta-analysis to determine if advice about dietary restrictions affects the rate of completion of FOBT and the rate of positive results. METHODS: We searched the MEDLINE database and hand-searched the bibliographies of other systematic reviews and clinical practice guidelines to identify randomized trials of advice to perform dietary restriction during FOBT. We included only trials that reported the proportion of patients who completed the occult blood tests (completion rate). When such information was available, we also recorded the proportion of patients who had positive test results (positivity rate). RESULTS: Five randomized trials met our inclusion criteria. All used guaiac-based Hemoccult tests; none reported results from rehydrated test slides. In four trials, there was little or no difference in test completion between patients assigned to dietary restriction and those with no restriction. In one small trial that used an especially restrictive diet, completion was 21 percentage points lower in the restricted group. Positivity rates were reported in four trials, none of which found a statistically significant difference between groups. Meta-analysis showed no difference in the summary positivity rate between those assigned to dietary restriction versus those not restricted (difference in positivity rate, 0%; 95% CI, -1% to 1%). CONCLUSIONS: Available data suggest that advice to perform modest dietary restriction during unrehydrated FOBT does not affect the completion rate, but more severe restrictions may. Dietary restriction also does not appear to affect positivity rates. On the basis of these data, physicians do not need to advise patients to restrict their diet for nonrehydrated FOBTs.

Aged↗
PubMedDate not supplied

Maternal mortality in the Irish Republic, 1989-1991.

The aim was to study the numbers and causes of Maternal Mortality in the Irish Republic in the years 1989-1991, inclusive and publish sufficient detail to allow for international comparative studies. Maternal Deaths were identified via Death Certificates, Coroners' Reports and Hospital Annual Reports. Details of these deaths were then obtained from relevant clinicians and analysed by the authors with further consultation with involved parties, if necessary. There were nineteen deaths notified in the three year period. According to ICD9 these were classified as five direct, seven indirect, and seven fortuitous deaths. Amongst the five Direct deaths, two were associated with amniotic fluid embolism, and one with each of eclampsia, septicaemia and pulmonary embolism, a direct maternal mortality rate of 3.2 per 100,000 births.

Cause of Death↗