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Biomedical subjects

J N Morris

Publications and source records attributed to J N Morris.

At least 19 recordsLinked to original sources
PubMed1991

Impact of work on the quality of life of community-residing young elderly.

Using a random sample of 310 Massachusetts community-residing elderly between the ages of 65 and 74, this study investigates the relationship between employment status and quality of life using a modified version of the Spitzer Uniscale QL index. The odds of reporting the highest quality of life rating, after controlling for socioeconomic and health characteristics, was 3.51:1 for those who worked versus those who did not do so.

Aged↗
PubMed1990

The epidemiology and natural history of pressure ulcers in elderly nursing home residents.

We analyzed prospective data from 19,889 elderly residents of 51 nursing homes from 1984 to 1985 to determine the prevalence, incidence, and natural history of pressure ulcers. Among all residents admitted to nursing homes, 11.3% possessed a stage II through stage IV pressure ulcer. For those residents admitted to the nursing home without pressure ulcers during the study period, the 1-year incidence was 13.2%. This increased to 21.6% by 2 years of nursing home stay. People already residing in a nursing home at the start of the study had a 1-year incidence of 9.5%, which increased to 20.4% by 2 years. Pressure ulcers were associated with an increased rate of mortality, but not hospitalization. Longitudinal follow-up of residents with pressure ulcers demonstrated that a majority of their lesions were healed by 1 year. Most of the improvement occurred early in a person's nursing home stay. Although nursing home residents with pressure ulcers have a higher mortality, with good medical care pressure ulcers can be expected to heal.

Aged↗
PubMed1990

Designing the national resident assessment instrument for nursing homes.

In response to the Omnibus Reconciliation Act of 1987 mandate for the development of a national resident assessment system for nursing facilities, a consortium of professionals developed the first major component of this system, the Minimum Data Set (MDS) for Resident Assessment and Care Screening. A two-state field trial tested the reliability of individual assessment items, the overall performance of the instrument, and the time involved in its application. The trial demonstrated reasonable reliability for 55% of the items and pinpointed redundancy of items and initial design of scales. On the basis of these analyses and clinical input, 40% of the original items were kept, 20% dropped, and 40% altered. The MDS provides a structure and language in which to understand long-term care, design care plans, evaluate quality, and describe the nursing facility population for planning and policy efforts.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1990

Exercise in leisure time: coronary attack and death rates.

Nine thousand three hundred and seventy six male civil servants, aged 45-64 at entry, with no clinical history of coronary heart disease, were followed for a mean period of 9 years and 4 months during which 474 experienced a coronary attack. The 9% of men who reported that they often participated in vigorous sports or did considerable amounts of cycling or rated the pace of their regular walking as fast (over 4 mph, 6.4 km/h) experienced less than half the non-fatal and fatal coronary heart disease of the other men. In addition, entrants aged 55-64 who reported the next lower degree of this vigorous aerobic exercise had rates less than two thirds of the remainder; entrants of 45-54 did not show such an effect. When these forms of exercise were not vigorous they were no protection against the disease, nor were other forms of exercise or high totals of physical activity per se. A history of vigorous sports in the past was not protective. Indications in these men are of protection by specific exercise: vigorous, aerobic, with a threshold of intensity for benefit and "dose response" above this threshold, exercise that has to be habitual, and continuing, which suggests that protection is against the acute phases of the disease. Those men who took vigorous aerobic exercise were demonstrably a favourably "selected" group; they suffered less of the disease, however, whether at low risk or high by the several risk factors that were studied. Men with exercise-related reduction in coronary heart disease also had lower death rates from the total of other causes, and so lower total death rates than the rest of the men.

Coronary Disease↗
PubMed1986

The effect of treatment setting and patient characteristics on pain in terminal cancer patients: a report from the National Hospice Study.

Debilitating pain is the symptom most often associated with cancer by the general public. The National Hospice Study (NHS) evaluated pain control among terminal cancer patients served in hospital based (HB) and home based (HC) hospices, and in conventional care settings (CC) such as outpatient clinics and oncology units. Pain was reported by the patient when able to respond and by the patients' primary care person (PCP) during repeated interviews until death. Patient and PCP pain reports were correlated at 0.43. PCPs reported that around 16% of patients were pain free in the last weeks of life while 18% were in persistent pain. Statistically adjusting for differences in the CC, HB, and HC samples, HB patients were less likely to report having persistent pain than either CC or HC patients, although there were no differences in the proportion of patients who were pain free. Age was negatively correlated with the level of pain. As expected, brain and bone metastases were related to pain in opposite directions, with more pain among those with bone involvement and less among those with brain involvement. Conclusions about whether HB hospices really are superior at pain control must be made cautiously in view of the relationship between age and pain and the greater age of hospice patients in our study.

Adult↗
PubMed1986

Last days: a study of the quality of life of terminally ill cancer patients.

Behavior of a number of Quality of Life measures gathered from two samples of terminal cancer patients over the last weeks of their lives are reported. Samples represent patients in the 26 hospices participating in a nationwide U.S. demonstration project and patients in the palliative care units of two Montreal hospitals. The U.S. data reported are quality of life measures made by a lay principal care person (PCP) or trained interviewer; the Montreal measures were made by both an attending doctor and an attending nurse. The general finding, as expected, is one of increasing deterioration in quality of life, with accelerated deterioration between 3 and 1 week of death. Pain follows a somewhat different pattern than other measures. More patients are in either of the extreme categories at an earlier point in time than found for other measures, and there are fewer changes as death is approached. Finally, about 20% of the patients do not fall into extremely low quality of life categories, even in the week prior to death.

Activities of Daily Living↗
PubMed1979

Scottish hearts.

Explore the source record for details and available documents.

Coronary Disease↗
PubMed1979

Social inequalities undiminished.

Traditional differences in death-rates by social class continue in Britain in the 1970s, mostly at lower levels of mortality. The professions do well, unskilled workers and their families particularly badly. Data on health services are scanty, but they suggest that lower-class families, with greater needs, do not make proportionate demands on some services and receive less of others. Continuing socioeconomic inequalities, disparities in child health and education, and current smoking and exercise habits indicate that inequalities in health will persist. Some ways of levelling up are suggested, starting with children: by creating more equal opportunities for the under-5s through education and day care, expanding child benefit and family endowment, concentrating health services on the socially disadvantaged, and setting an upgraded "health education" to the task--with mothers and children and the whole population.

Acute Disease↗