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Biomedical subjects

G Johnston

Publications and source records attributed to G Johnston.

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

Where do patients with cancer die in Belfast?

BACKGROUND: Most patients with cancer prefer to die at home but the majority die in institutions. AIM: To determine place of death for patients with cancer in Belfast, to examine changes over time and identify factors associated with place of death. METHODS: A survey of deaths registered in Belfast over a six-month period for 1977, 1987 and 1997 identified patients dying from cancer. Epidemiological data included age, gender, malignancy, social class, marital status, area of residence and place of death. RESULTS: Home deaths fell from 35% in 1977 to 28% in 1997. Hospital deaths fell from 50% in 1977 to 40% in 1987 rising to 42% in 1997. Hospice deaths rose from 13% in 1977 to 25% in 1987 falling to 23% in 1997. There was an association between place of death and age, marital status, type of cancer and area of residence, but not with social class or gender. CONCLUSION: The majority of people fail to achieve a home death. Resources need to be targeted to those most at risk of an institutional death; females, the elderly, the unmarried, those with haematological malignancies and residents of South Belfast.

Aged↗
PubMedDate not supplied

Transplantation of the canine distal ulna as a free vascularized bone graft.

An autogenous free vascular bone graft of the canine distal ulna was evaluated. The vascularity of the graft was based on a musculoperiosteal sheath supplied solely by the caudal interosseous artery and vein. Four autogenous heterotopic (ulna to tibia) vascular transfers were performed. Two avascular transfers were performed to provide baseline criteria from which the success of vascularized transfers could be assessed. Clinical lameness evaluation, serial radiographs, bone scintigraphy, and sequential fluorochrome bone labeling were performed after surgery in both vascular and avascular transfers. All dogs were free of lameness in the donor limb by the 26th postoperative day. Serial radiographs revealed rapid graft incorporation and hypertrophy in all vascularized grafts and severe bone resorption in nonvascularized grafts. Histology, microangiography, and evaluation of fluorochrome bone labels were performed 90 days after surgery to determine graft viability, incorporation and temporal remodeling patterns. Microangiography and fluorochrome assessment complemented the histological findings. Based on these findings the distal ulnar bone graft was determined to be both viable and structurally adequate for selected cases of long bone reconstruction.

Angiography↗
PubMedDate not supplied

Managing awareness: negotiating and coping with a terminal prognosis.

This study examined the way in which a terminal cancer prognosis was negotiated by patients and their lay carers, and the complexities involved in managing a context of awareness. Individual semi-structured interviews were undertaken with 16 patients and 14 lay carers. These were transcribed verbatim and analysed using a grounded theory approach. The process started with being given bad news, when the concept of life was no longer open-ended. The need to maintain hope influenced the amount of information sought by patients and their families and was an important strategy in helping patients cope with the knowledge of their disease. Levels of awareness appeared to be influenced less by setting, than by the way the prognosis was managed within individual families. Difficulties facing patients and carers in knowing how to communicate with each other within a context of open awareness suggest that they need help in learning how to do this. Achieving an environment to enable this requires private space and staff skilled in enabling and facilitating the complexities of communication between patients and their carers.

Adaptation, Psychological↗
PubMedDate not supplied

Prevalence of high risk sexual behaviour in adolescents attending school in a county in Nova Scotia.

High school students ina county in Nova Scotia were asked about sexual activity, including high risk practices. Fifty-five per cent had had intercourse, including 82% of those 18 and 19 years of age. Being sexually active was associated with poorer school performance, having parents with less than a university education, being female, and living with other than both parents. Forty per cent of sexually active students had more than one partner in the year before the survey. Thirty-five per cent always used condoms for vaginal intercourse. Students having regular intercourse used condoms less, but less frequent condom use was not associated with having fewer sexually partners. Twenty per cent of sexually active students engaged in anal intercourse; 18% of females and 35% of males reporting this practice used condoms for all sexual encounters. Students in this high school population are highly sexually active, and report high risk sexual activities at levels which should be of concern to both public health practitioners and educators.

Adolescent↗
PubMedDate not supplied

Disadvantaged women and smoking.

High rates of smoking are found among disadvantaged women, and there is a demand for cessation interventions specifically targeted to meet their needs. This project used a number of information sources to examine the factors associated with these women's smoking behaviours and the potential barriers and supports to cessation. Few of the women-centred cessation programs whose representatives were contacted were appropriate for, or available to, disadvantaged women in Canada. Interviews with 386 disadvantaged women revealed that their smoking was intimately linked with their life situation of poverty, isolation and caregiving; smoking was a mechanism for coping with the stress of their lives. Agencies outside traditional tobacco control organizations, such as women's centres, were well positioned to initiate or expand services that support smoking cessation for these women and were trusted by the women who used their services. The findings have implications for programs, research and policy.

Adolescent↗