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Biomedical subjects

C Kemp

Publications and source records attributed to C Kemp.

At least 37 records · Page 2Linked to original sources
PubMed1999

The reproducibility of central aortic blood pressure measurements in healthy subjects using applanation tonometry and sphygmocardiography.

AIM: Sphygmocardiography via applanation tonometry is a non-invasive, bedside technology which utilises tonometric analysis of the radial artery pulse wave and measurement of peripheral arterial blood pressure (BP) to derive a central arterial pulse wave, central arterial BP and related indices. The present study was designed to determine: (1) the inter-operator variability in measurements obtained using this technique; (2) the relationship between measured peripheral arterial BP and derived central arterial BP. METHOD: Multiple measurements were made from 25 healthy subjects (15 male), mean age 33 (s.d. 10.3) years, mean arterial BP 90 (s.d. 12) mm Hg by two trained observers at the same time of day on three separate occasions. RESULTS: The mean inter-operator difference was 0.1 (s.d. 1.7) mm Hg for derived systolic aortic BP and 0.1 (s.d. 0.7) mm Hg for derived diastolic aortic BP (Bland and Altman analysis). Pulse wave Augmentation Index (AIx) values, ranged from -22% to +40%, with the inter-operator measurement difference being only 0.4 (s.d. 6.4)%. Buckberg ratio measurements ranged from 119% to 254%, with the inter-operator measurement difference being only 2.7 (s.d. 15.4)%. The relationship between derived central systolic BP and peripheral systolic BP readings in individual patients was not constant and showed significant variance when compared on different days (ANOVA, P = 0.03). This was not explained by any significant variance in heart rate (ANOVA, P = 0.39). CONCLUSION: Applanation tonometry has excellent inter-observer reproducibility when used by trained observers. Moreover, the inconsistency in the relationship between peripheral and central aortic BP suggests that the former is not a perfect surrogate for the latter. Further prospective studies are required to define whether derived central aortic BP may be a better predictor of cardiovascular morbidity and mortality and the impact of different antihypertensive therapies on the relationship between peripheral and central arterial BP.

Adult↗
PubMed1996

Cancer detection activities coordinated by nursing students in community health.

This article describes ongoing cancer screening in a low-income and ethnically diverse community (primarily Southeast Asian and Hispanic). These services are part of the comprehensive care provided in a district nursing community health clinical. Screening services occur within the refugee community and include mammograms, individualized breast self-exam (BSE) teaching, home follow-up on the BSE teaching, and assistance obtaining any additional screening or treatment, if necessary. Except for technician activities, students plan, implement, and evaluate all services. The first event was in spring 1995, the second in summer 1995, and the third in fall 1995. Thus far, 85 women have received services. Cambodian and Laotian women show the lowest level of knowledge and experience related to breast cancer detection. This article provides some of the first data on cancer screening for low-income Cambodian and Laotian women in the United States. The article also shows how ongoing cancer screening and prevention services can be provided to populations that have not been successfully reached through usual means, e.g., referral by nurse practitioner, physician, and electronic or print media. Specific means of overcoming barriers to screening, prevention, and learning are described in detail.

Breast Neoplasms↗
PubMed1994

Community health clinical experiences: the primary care setting.

Applying the nursing process to the health of populations is a challenge in undergraduate community health nursing education. We evaluated a method of applying the process in primary health care settings. Key factors were using case management and other means to assess systems from the client's perspective, assessing population needs, diagnosing community needs-service mismatch, planning in partnership with communities, and implementing and evaluating plans. Because these are difficult, if not impossible, to accomplish in a one-semester undergraduate course, students transferred projects and cases from one semester to another. Case management is the principal interface of students to individual and family clients.

Community Health Nursing↗
PubMed1991

A practical approach to writing successful grant proposals.

Success in the planning and writing of grant proposals for health care services is enhanced by using a methodical approach. First, explore the problem and the resources. Obtaining direct experience is superior to a library-based literature review in understanding the problem. Second, identify funding sources and begin to plan the project, matching community needs to organizational strengths and funding priorities. Third, write the proposal and finish planning. Plans are refined as the proposal is written. This article provides practical information on commonly needed documents, characteristics of successful proposals and sources of information on funding.

Documentation↗
PubMed1989

Effect of aerobic exercise on mouth-to-cecum transit time.

To examine the premise that exercise reduces the gastrointestinal transit time, we evaluated the effect of walking 4.5 km in an hour on mouth-to-cecum transit time. Twenty-three healthy volunteers, 9 men and 14 women, with an age range of 19-28 yr, were studied. After an overnight fast, the subjects ingested 10 g of lactulose in 150 ml of water while breath hydrogen concentrations were analyzed at 15-min intervals. On separate days, in random sequence, subjects either sat in a chair or walked on a treadmill for 60 min. Mean transit time was 55 +/- 8 min when resting and 89 +/- 4 min when exercising (p less than 0.001). In conclusion, light aerobic exercise prolonged the mouth-to-cecum transit time. On the basis of this observation, exercise as a causative factor in runner's diarrhea and its value in the management of chronic constipation may be questioned.

Adult↗
PubMed1987

Vitamin E deficiency and its clinical significance in adults with primary biliary cirrhosis and other forms of chronic liver disease.

The vitamin E status of 146 adults with chronic liver disease was assessed by estimating both their serum vitamin E concentration and the ratio of serum vitamin E to serum cholesterol concentration. Low levels of vitamin E occurred most frequently in patients with primary biliary cirrhosis and other forms of chronic cholestatic liver disease. When a serum vitamin E concentration of 12.3 mumol/l (mean-2 SD of a control population) was taken as the lower limit of normal, 44% of patients with primary biliary cirrhosis and 32% with other chronic cholestatic liver disease had a reduced concentration, indicating a biochemical deficiency of vitamin E. If a vitamin E/total cholesterol ratio of 2.35 mumol/mmol was taken as the lower limit of normal, then 64% and 43% of patients with primary biliary cirrhosis and other chronic cholestatic liver disease, respectively, had a biochemical deficiency of vitamin E. Of the patients with chronic cholestasis and a serum bilirubin concentration greater than 100 mumol/l, 91% had a reduced vitamin E/cholesterol ratio. Twelve patients with primary biliary cirrhosis and severe vitamin E deficiency (serum vitamin E less than 5.0 mumol/l and a vitamin E/cholesterol ratio less than 1.0 mumol/mmol) underwent extensive neurological investigation. Five had a mild mixed sensorimotor peripheral neuropathy, which was not, however, typical of the neurological syndrome associated with vitamin E deficiency. In patients with severe biochemical deficiency of vitamin E (less than 5 mumol/l and less than 1 mumol/mmol total cholesterol), administration of large oral doses of vitamin E only increased serum concentrations to within the normal range in one patient; in the others even weekly parenteral administration over a 3-month period did not correct deficiency. In patients with less severe biochemical deficiency, the serum vitamin E concentration and vitamin E/total cholesterol ratio were restored to normal by oral or intramuscular supplements of the vitamin.

Cholestasis↗
PubMed1987

Atrial cannulation for long-term sequential blood collection in gilts.

Polyvinyl chloride tubing (ID, 1.27 mm; OD, 2.29 mm) was placed via the jugular vein into the right atrium of thirty-five 120- to 200-day-old gilts. Catheters remained patent for 14 to 88 days (mean, 41 days). The major cause of loss of function was damage inflicted by the gilt (20 catheters), whereas only 3 catheters lost patency because of blockage. Using a pulley and counterweight system the exteriorized end of the catheter was suspended above the gilt, facilitating blood collection and minimizing disturbance of the gilts.

Animals↗
PubMedDate not supplied

Teaching strategies for operationalizing nursing's agenda for healthcare reform.

Nursing's Agenda for Healthcare Reform presents a vision and specific suggestions for the future of nursing. Changes proposed by the agenda challenge nursing educators to prepare new practitioners to deliver healthcare in community settings. The authors offer specific means for nursing educators to provide students with clinical experiences that are consistent with the agenda. These experiences include practice in primary-care settings and case management, and more effective health promotion activities.

Curriculum↗
PubMedDate not supplied

Palliative care for patients with acquired immunodeficiency syndrome.

This article provides a clinically-oriented overview of palliative care for patients with AIDS. Indicators of decreased survival time are divided into categories of infections/illnesses, clinical signs and symptoms, immunological and serological markers, and psychosocial factors. Primary symptoms in AIDS are discussed according to etiology and treatment. However, treatments of opportunistic infections per se are not directly addressed in this article. Problems discussed include pain, confusion, depression and anxiety, fatigue, fever, dyspnea, nausea and vomiting, diarrhea, wasting, and dehydration. The article also briefly addresses clinical and ethical questions and challenges presented by AIDS to hospice or palliative care providers, and the various stages of HIV infection.

Acquired Immunodeficiency Syndrome↗