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Biomedical subjects

D Murnaghan

Publications and source records attributed to D Murnaghan.

18 recordsLinked to original sources

A smoking reduction and cessation program with registered nurses: findings and implications for community health nursing.

A smoking reduction and cessation program was implemented with registered nurses in 3 Canadian provinces. Nurses (n = 117) participated in either an 8-week group or self-directed program using a resource specifically designed for nurses. Questionnaires were administered prior to and at the end of the 8-week interventions and at 6 and 12 months postintervention. Statistically significant changes at 8 weeks in nurses' smoking practices were found on the number of nurses continuing to smoke, mean number of cigarettes smoked, and movement in the stage of behavioral change. Attrition and variation in patterns of quitting over the 12-month study period made assessing participants' longer term outcomes difficult. This study highlights the complexity of assisting nurses to quit smoking and of implementing and evaluating a program based on accepted community health models of practice.

Adult↗

The Prince Edward Island Conceptual Model for Nursing: a nursing perspective of primary health care.

The philosophy of primary health care (PHC) recognizes that health is a product of individual, social, economic, and political factors and that people have a right and a duty, individually and collectively, to participate in the course of their own health. The majority of nursing models cast the client in a dependent role and do not conceptualize health in a social, economic, and political context. The Prince Edward Island Conceptual Model for Nursing is congruent with the international move towards PHC. It guides the nurse in practising in the social and political environment in which nursing and health care take place. This model features a nurse/client partnership, the goal being to encourage clients to act on their own behalf. The conceptualization of the environment as the collective influence of the determinants of health gives both nurse and client a prominent position in the sociopolitical arena of health and health care.

Family Nursing↗

Communication between family physicians and oncologists: qualitative results of an exploratory study.

OBJECTIVE: To study communication between family physicians (FPs) and oncologists, and to look at the factors that may influence FP involvement in cancer care. DESIGN: This survey design uses a qualitative methodology, where the data are analyzed using a modified grounded theory approach. SETTING: This was a multisite study using 14 focus groups of FPs, followed by structured telephone interviews with 116 FPs in 6 different Canadian provinces. MAIN OUTCOME MEASURE: Interview questions were used to explore the actual and desired roles of FPs in cancer care, and the quality of communication with oncologists with reference to a particular cancer patient in the FPs' practice. RESULTS: Physicians providing cancer care must consider complex psychosocial and biomedical factors, more so than with other chronic diseases, and so written communication alone is inadequate. Family physicians require face-to-face and/or telephone communication with the oncologist to negotiate their respective roles, and to discuss the patient's prognosis and the effectiveness of proposed treatments. Family physicians expressed a desire to become more involved in all stages of cancer care in both the biomedical and psychosocial aspects, and to help better define their roles throughout the illness trajectory. CONCLUSION: These results suggest opportunities to improve the communication, coordination and comprehensiveness of shared cancer care provided by family physicians and oncologists in different clinical settings.

Canada↗

Actinomyces pyogenes septic arthritis in a diabetic farmer.

We report a case of septic arthritis and osteomyelitis of the left ankle due to Actinomyces pyogenes in a diabetic farmer. Few confirmed human cases of A. pyogenes infection have been reported, partly because of inadequate identification of this bacterium. Bacteriological characteristics of the organism, which resembles Arcanobacterium haemolyticum, are described with a review of previous case reports.

Animals↗

Atlantic Breast Cancer Information Project: formation of a "town-gown" partnership.

The Atlantic Breast Cancer Information Project (ABCIP) is one of 5 breast cancer information exchange projects funded by Health Canada. This article describes the development of ABCIP and thereby contributes to the limited knowledge on successful partnership formation in the face of restraints but with support from enabling factors. Partnership formation is presented in the context of alliances in management, coalitions in health promotion, and social movements. The restraining factors were the inertia of the status quo, provincial structures and concerns about empowering others. The enabling factors fell into 3 categories: timely logistics, roles of individuals who participated at critical points in the process, and the evolution of a supportive cultural environment. The article outlines ABCIP's achievements to date.

Breast Neoplasms↗

Primary hyperoxaluria--a case report.

A case of primary hyperoxaluria which presented with progressive renal failure in a 34 year old woman is reported. The patient died six years following the initial diagnosis and post mortem examination revealed widespread deposition of oxalate crystals in her tissues.

Adult↗

Renal failure and thyroid function tests: the effects of commencing haemodialysis.

Thyroid function tests are often noted to be abnormal in patients with chronic renal failure. We investigated thyroid and pituitary function in six patients with renal failure. In order to study the effects of improvement in the uraemic state on these tests, they were repeated after regular haemodialysis was commenced. Serum thyroxine and free thyroxine levels were at the lower limit of the normal range prior to dialysis and both showed a non-significant increase after regular haemodialysis was started. The TSH response to TRH (TRH test) decreased in five of the six patients after dialysis but this did not achieve statistical significance. The abnormalities in thyroid function tests often observed in clinically euthyroid patients with renal failure do not appear to change significantly after the institution of regular dialysis.

Adolescent↗

Effect of dialysis on plasma and CSF tryptophan and CSF 5-hydroxyindoleacetic acid in advanced renal disease.

Patients with uraemic encephalopathy were previously found to have low total tryptophan (bound plus free), but high free tryptophan concentrations in the plasma and high CSF tryptophan concentrations. The 5-hydroxytryptamine metabolite 5-hydroxyindoleacetic acid was also raised in the CSF. A study of the effect of dialysis treatment on these substances in chronic uraemic patients with and without dialysis dementia is described. After an episode of dialysis the patients without dialysis dementia showed increased plasma total tryptophan and decreased free tryptophan. These changes were associated with a decrease of plasma free fatty acid. The patients with dialysis dementia did not show changes in tryptophan, but plasma free fatty acid rose. CSF concentrations of 5-hydroxyindoleacetic acid fell moderately in both groups of patients on dialysis.

Adult↗

Cerebral transmitter precursors and metabolites in advanced renal disease.

Patients with chronic renal disease had low plasma total tryptophan but an abnormally high proportion of this was in the free state. The subjects with encephalopathy had raised plasma free tryptophan, CSF tryptophan, and CSF 5-hydroxyindoleacetic acid. CSF tryptophan correlated better with plasma free than with plasma total tryptophan. Plasma and CSF tyrosine concentrations were normal but CSF homovanillic acid was raised especially in subjects with encephalopathy. The possible significance of these changes in advanced renal disease is discussed.

Adult↗