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Biomedical subjects

G C Davis

Publications and source records attributed to G C Davis.

104 records · Page 6Linked to original sources
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Migraine, physical health and psychiatric disorder: a prospective epidemiologic study in young adults.

In a prospective study of a random sample of 1,007 young adults, we examined the association between migraine and psychiatric disorder, physical complaints, indicators of functional impairment, and use of mental health services. A history of migraine was associated with increased lifetime rates of major depression, anxiety disorders, illicit drug use disorders, nicotine dependence, and suicide attempts. Compared with subjects without a history of migraine, those with such a history had significantly more physical symptoms and were more likely to report job absenteeism, assess their general health as fair or poor, and use mental health services. Follow-up data, gathered 14 months after the baseline interview, revealed that subjects with a history of migraine at the baseline had significantly increased rates of first incidence major depression and panic disorder during the interval period (odds ratio (OR) for major depression = 4.2, 95% confidence interval (CI) 2.0-9.2; and OR for panic disorder = 12.8, 95% CI 4.1-39.8). The risk for these psychiatric disorders in persons with prior history of migraine was unrelated to the recentness of their migraine attacks. These findings suggest that the link between migraine, major depression and anxiety might reflect a common predisposition.

Adult↗
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Joint 1994 Wolff Award Presentation. Migraine and major depression: a longitudinal study.

UNLABELLED: Recent epidemiologic studies have reported an association between migraine and major depression. Little is known about the mechanisms that link the two disorders, or the natural history of their co-occurrence. We examined the association between migraine and major depression in a sample of young adults, using longitudinal data. METHOD: A random sample of 1,007 young adults (21-30 years of age) members of a large HMO in Southeast Michigan was interviewed in 1989; 97% of the sample were reinterviewed 3.5 years later, in 1992. A structured diagnostic interview was used to elicit information on DSM-III-R major depression and IHS migraine in lifetime (in the 1989 interview) and during the 3.5 year follow-up interval (in the 1992 interview). Using Cox-proportional hazards models with time-dependent covariates, we estimated the relative risk for major depression associated with prior migraine and the relative risk for migraine associated with prior major depression. RESULTS: In this sample of young adults, the incidence of migraine per 1,000 person years, based on the prospectively gathered data, was 5.0 in males and 22.0 in females. The estimated relative risk for major depression associated with prior migraine, adjusted for sex and education, was 3.2 (95% CI 2.3-4.6). The adjusted relative risk for migraine associated with prior major depression was 3.1 (95% CI 2.0-5.0). CONCLUSIONS: The study provides the first body of evidence that the previously observed cross-sectional association between migraine and major depression can result from bidirectional influences, with each disorder increasing the risk for first onset of the other. The explanation that major depression in persons with migraine represents a psychologic response to migraine attacks would have been more plausible had we found an influence only from migraine to depression. By diminishing the plausibility of a simple causal explanation for the migraine-depression comorbidity, the findings favor the shared mechanisms explanation.

Adult↗
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Measurement and clinical decision making: focus on instrument development.

Valid and reliable instruments are essential to responsible and accurate diagnosis, planning, and evaluation by professional nurses working independently or collaboratively with other healthcare professionals. The author provides an overview of the instrument development process and emphasizes the importance of measurement as an intrinsic part of the clinical decision-making process. Discussion focuses attention on the differences between an index and a scale, both of which are needed as part of assessment protocols. Some differences in strategies required for estimating validity and reliability for scales and indexes are highlighted.

Clinical Competence↗
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Effect of halothane and pentobarbital anesthesia on the dispersion of indicator particles passing through the central circulation of the dog.

To investigate the effect of different anesthetics on the flow properties of the central circulation, curves were obtained by the multiple indocyanine-green indicator-dilution technic from 7 dogs anesthetized with halothane or pentobarbital. The width of the curve provided a measure of the dispersion of indicator particles during passage through the central circulation. The vascular resistance of the animals was altered by the administration of methoxamine and sodium nitroprusside. The authors found that dispersion in the central circulation is linearly related to the total peripheral resistance (TPR). For any value of TPR, the amount of dispersion of indicator particles passing through the central circulation was greater with halothane plus pentobarbital anesthesia than with pentobarbital only. The study indicates that the type of anesthesia influences the dispersion of indicator particles passing through the central circulation. A better under standing of this process will be helpful in interpreting the results of indicator-dilution cardiac-output determinations performed in persons under general anesthesia.

Anesthesia↗
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Learning about nursing management.

Summaries of the discussions were compiled in a booklet. The group then expressed an interest in getting some feedback on their decisions from nurse managers, so a meeting was arranged in the hospital where they were completing their nursing management practicum. The prepared booklet was distributed to each nurse manager attending the meeting: several head nurses, the director of medical/surgical nursing, and the assistant vice president for nursing. The resulting discussion provided a good summary and an opportunity for testing ideas. The interest and feedback of these nurses were very encouraging to the students. Overall, the mix of fantasy and realism provided a successful way of helping students gain a realistic view of nursing management. An understanding of and identification with the issues faced by today's nurse manager should help new graduates to appreciate and adapt to the realities of the clinical setting, regardless of their position.

Administrative Personnel↗
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Keeping the focus on nursing.

Keeping the curriculum focused on nursing will take the best efforts of nursing educators, administrators, and practitioners. Nursing knowledge based on systematic study has expanded and is now developing more quickly than ever. This, along with the recognized need for general education courses in the curriculum, has helped nursing move into the mainstream of higher education. New approaches to curriculum organization and to teaching nursing should be considered in the effort to provide the best possible education. The many advances made by nursing education and practice in the past century now challenge us to consider curriculum changes that could significantly alter our traditional approaches.

Clinical Competence↗