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J A Collier

Publications and source records attributed to J A Collier.

7 recordsLinked to original sources

Evolving role of CNSs in developing risk-anchored preventive interventions.

Emerging emphases on systems of care, cost containment, and preventive interventions require the CNS to recognize risk factors and change health behaviors before complications develop. To lower substantially the rate of nontraumatic lower extremity amputation, high-risk populations must be screened and must receive appropriate management, including education and self-care interventions. In this article, two studies that examined foot risk factors in ambulatory elderly with intact feet are compared. American Diabetes Association and Gillis W. Long Hansen's Disease Center risk criteria were applied to both datasets. Recommendations for education, management, and referrals based on the calculated level of risk are presented.

Aged

Inhibition of neutrophil and monocyte defensive functions by nicotine.

To learn more about the effects of smokeless tobacco on the defensive functions of neutrophils, we studied the influence of nicotine on these cells in vitro, looking at their bactericidal activity against oral pathogens, and at their ability to produce microbicidal reactive oxygen species (oxygen radicals). Exposure of human blood neutrophils to nicotine (0.01% to 0.1%) inhibited their ability to kill Actinomyces naeslundii, Actinobacillus actinomycetemcomitans, and Fusobacterium nucleatum. Although these concentrations of nicotine are high, such concentrations are relevant to phagocytes in the gingival sulcus, because smokeless tobacco contains 0.5% to 3.5% nicotine by dry weight. Nicotine had no such inhibitory effect when the killing assay was performed in an anaerobic environment, implying that nicotine preferentially affected oxygen-dependent killing mechanisms. To further investigate the effects of nicotine on production of oxygen radicals, neutrophils were primed with lipopolysaccharide and triggered with f-met-leu-phe or phorbol ester in the presence of nicotine. Nicotine inhibited production of superoxide anion (measured by reduction of cytochrome c) and hydrogen peroxide (measured by oxidation of phenol red). Nicotine inhibition of superoxide production was reversible by washing away the nicotine. By observing that nicotine inhibited the reduction of cytochrome c by reagent potassium superoxide, we determined that nicotine directly absorbed superoxide. In addition, by examining nicotine inhibition of the uptake of oxygen by neutrophils, we determined that nicotine also interfered with the production of oxygen radicals by these cells. Nicotine also inhibited production of superoxide and interleukin-1 beta by monocytes. Nicotine did not affect the viability of neutrophils and monocytes, as determined by their ability to exclude trypan blue dye. Inhibition of the aerobic antimicrobial functions of neutrophils and monocytes by nicotine may alter the microbial ecology of the oral cavity, and this might be one mechanism by which nicotine compromises the oral health of users of tobacco products.

Actinomyces

Family-focused nursing care of hospitalized elderly.

The purposes of this research were to gain an understanding of how nurses in acute care settings involve families of elderly patients in planning and giving care, and to determine the extent of that involvement in nursing documentation. Data were obtained from patient records and interviews with nurses. Evaluated were characteristics of elderly patients and families, documentation of family involvement in care, and nurses' descriptions of family care. A comparison of data sources indicated that nurses verbalized far more inclusion of families in care than the written records documented. Results of this research support the importance of clarifying and promoting acute care-nurses' involvement of family members who are central to the care of increasing numbers of elderly persons.

Aged

The reliability of the microscopic diagnosis of malaria in the field and in the laboratory.

Four hundred and seventy thick and thin blood films were prepared from 129 villagers in the Solomon Islands. After staining with Giemsa, Leishman's, and Field's stains, they were randomized and examined in the field, using a miniature McArthur microscope. The specimens were then examined in the local central laboratory and by a microbiologist at a hospital in England. Films over which there was disagreement were examined by an expert at the Liverpool School of Tropical Medicine. The rate of false negative diagnoses (for thick films) was 3% for the field worker, 9% for the malaria laboratory, and 27% for the English hospital. Field diagnosis was no less reliable than laboratory diagnosis (P less than 0.001). Field's stain was the most reliable stain for both thick films (P less than 0.001) and thin films (P less than 0.05), for which a new staining technique is described.

Azure Stains

Public relations.

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Public Relations