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Biomedical subjects

C Morrison

Publications and source records attributed to C Morrison.

141 records · Page 8Linked to original sources
PubMedDate not supplied

Visual testing for readiness to drive after stroke: a multicenter study.

OBJECTIVE: The purpose of this study was to determine the ability of a visual-perception assessment tool, the Motor-Free Visual Perception Test, to predict on-road driving outcome in subjects with stroke. DESIGN: This was a retrospective study of 269 individuals with stroke who completed visual-perception testing and an on-road driving evaluation. Driving evaluators from six evaluation sites in Canada and the United States participated. Visual-perception was assessed using the Motor-Free Visual Perception Test. Scores range from 0 to 36, with a higher score indicating better visual perception. A structured on-road driving evaluation was performed to determine fitness to drive. Based on driving behaviors, a pass or fail outcome was determined by the examiner. RESULTS: The results indicated that, using a score on the Motor-Free Visual Perception Test of < or =30 to indicate poor visual-perception and >30 to indicate good visual perception, the positive predictive value of the Motor-Free Visual Perception Test in identifying those who would fail the on-road test was 60.9% (n = 67/110). The corresponding negative predictive value was 64.2% (n = 102/159). Univariate logistic regression analyses revealed that older age, low Motor-Free Visual Perception Test scores and a right hemisphere lesion contributed significantly to identifying those who failed the on-road test. CONCLUSIONS: The predictive validity of the Motor-Free Visual Perception Test is not sufficiently high to warrant its use as the sole screening tool in identifying those who are unfit to undergo an on-road evaluation.

Aged↗
PubMedDate not supplied

Decreased homovanilic acid in cerebrospinal fluid correlates with impaired neuropsychologic function in HIV-1-infected patients.

To determine whether dopamine metabolism is abnormal in HIV infected patients and whether dopamine metabolism abnormalities are related to specific neuropsychologic characteristics in HIV-infected patients, we measured cerebrospinal fluid (CSF) levels of homovanilic acid (HVA), the primary dopamine metabolite, in 10 HIV-infected patients and compared it to HVA levels in CSF in a group of 13 healthy control subjects. HIV-infected patients were also assessed with a battery of neuropsychologic tests and HVA levels were then correlated with performance on specific neuropsychologic tests. The mean (+/-SD) HVA level in CSF was 100.9 +/- 29.3 nmol/L in the HIV-infected study group and 230.5 +/- 50.0 nmol/L in the non-HIV-infected control group (p < 0.0001). The decrease in concentrations of HVA in CSF correlated with impairment on performance on neuropsychologic testing (Spearman r = 0.67; p = 0.03). When the relationship between HVA levels and specific cognitive domains was evaluated, we observed trends for positive correlation between HVA levels and tests that measure motor speed (r = 0.59; p = 0.074) and those testing attention, concentration, and executive control (r = 0.54; p = 0.108). There was no relationship between performance on memory tests and CSF HVA levels (r = -0.0061; p = 0.987). These results further support the hypothesis that dopaminergic dysfunction plays an important role in the pathogenesis of AIDS dementia complex (ADC) and suggest that specific motor and cognitive abnormalities may be related to depressed dopaminergic activity. This may have important implications for the development of treatments or preventive strategies for ADC.

Adult↗
PubMedDate not supplied

A practical approach to stress fractures.

Stress fractures may be fatigue or insufficiency related. Fatigue stress fractures result when healthy bones are exposed to intense and/or repetitive loads for which the bone is not prepared. Insufficiency stress fractures result from normal loads to bones weakened by genetic, metabolic, nutritional, or endocrine processes. Fracture usually begins as a small cortical infarction that progresses as stress increases or continues. Pain is the hallmark symptom of both types. When confronted with signs and symptoms consistent with stress fractures, providers must consider risk factors, comorbid conditions, and whether or not the mechanism of the injury is consistent with the clinical picture. Though the two types of stress fractures are treated differently, in both, the prognoses are dependent on early identification and intervention.

Comorbidity↗
PubMedDate not supplied

"Remember who you are".

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Determining crucial correlates of breast self-examination in older women with low incomes.

PURPOSE: To investigate the frequency and proficiency of breast self-examination (BSE) in older women with low incomes and to identify predictors of BSE to facilitate more effective clinical encounters and improved educational programs. DESIGN: Correlational, nonexperimental survey. SETTING: Urban tertiary-care center. SAMPLE: 204 women (ages 40-86) self-referred or recruited from the community for free breast cancer screening. Criteria for inclusion were age 40 or older, a household income of less than two-and-one-half times the poverty level, and uninsured or underinsured status. METHODS: The Mamon and Zapka Breast Self-Examination Survey was modified for use with this population. Telephone surveys were conducted during the period between the initial contact and screening. MAIN RESEARCH VARIABLES: 102 independent variables were correlated with frequency and proficiency. Part correlations were calculated to determine unique contributions. Variables with significant part correlations were entered into regression equations. FINDINGS: The mean frequency and proficiency scores were 2.9 out of 4 and 3.4 out of 19, respectively. Four variables explained 40% of the variance in frequency, and eight explained 66% of the variance in proficiency. Frequency and proficiency were significantly related. CONCLUSIONS: 10 variables were found to predict BSE behavior in this population: confidence, confidence level, awareness of mammography, provider influence, desire for reconstruction, knowledge of parity risk factor, education, having been taught the correct time of month to perform BSE, adequate time devoted to BSE, and exposure to BSE messages from a clinician. IMPLICATIONS FOR NURSING PRACTICE: The study identifies variables to include in clinical encounters and educational programs designed to promote BSE. Of importance is considering the characteristics and specific needs of the recipients of educational and interventional programs.

Adult↗
PubMedDate not supplied

Recruitment of underserved women for breast cancer detection programs.

PURPOSE: The purpose of this correlational, nonexperimental study was to survey a sample of uninsured/underinsured women entering a no-cost, state-funded breast cancer screening program to identify factors that might enhance existing recruitment strategies and adherence to breast cancer screening. OVERVIEW: Inadequate access to breast cancer screening contributes to the high morbidity and mortality that have been documented in low-income American women with breast cancer. Two hundred and four participants in a no-cost cancer screening program at the Johns Hopkins Oncology Center's East Baltimore Community Health Program in Maryland were surveyed by telephone to identify methods to enhance recruitment strategies. The survey solicited information in areas such as demographics, healthcare practices, and recruitment sources. Knowledge about breast cancer and its treatment, perceived control over health matters, and the practice of preventive measures were low in this group. Based on the data obtained, recruitment strategies better tailored to this population were developed and implemented. CLINICAL IMPLICATIONS: Recruiters and clinicians must understand that for impoverished women, day-to-day survival takes precedence over most other issues. The possibility of a condition that may cause illness or death 10 to 20 years from now is of less importance than obtaining food, clothing, and shelter today. This program demonstrates that services such as transportation and child care are important elements of care for this population. Culturally sensitive recruitment strategies, personalized care, and vigilant follow-up are important requisites to breast cancer screening programs. A multidisciplinary team effort is critical in bringing together the elements required for a successful screening program.

Adult↗
PubMedDate not supplied

The significance of nipple discharge: diagnosis and treatment regimes.

Breast cancer is one of the most dreaded diseases affecting women and is associated with a high degree of morbidity and mortality. Any breast complaint has the potential for creating a great deal of anxiety for patients and providers alike. An in-depth understanding of the pathophysiology of common breast complaints, particularly those with low probability of association with cancer such as nipple discharge, can serve to allay anxiety and prevent the financial and emotional burden of unnecessary diagnostic evaluations. It will then improve the quality of care for each patient experiencing the symptom. Although the greatest incidence of nipple discharge is not secondary to malignant processes, the fact that some are requires that all persons with nipple discharge receive the benefit of a thorough assessment. When planning a course of action to assess and treat nipple discharge, a thoughtful stepwise, planned approach is necessary. The evaluation of nipple discharge can be undertaken with minimal difficulty by performing a thorough history, a careful physical examination, and following a logical thought process in linking the type of discharge with the suitable adjunct diagnostic testing. Appropriate management evolves from this process. It is important to view the patient in total, considering such issues as family history, other risk factors, how disruptive the level of anxiety about the symptom. Primary care providers, working with their parents, are well positioned to design appropriate diagnostic and treatment regimes to assess and treat nipple discharge. A thoughtful, prudent approach to this symptom can save both health care dollars and lives.

Breast Diseases↗