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Biomedical subjects

J Waterhouse

Publications and source records attributed to J Waterhouse.

At least 73 records · Page 4Linked to original sources
PubMed1995

Blood pressure, heart rate, and skin temperature in preterm infants: associations with periventricular haemorrhage.

The mean arterial blood pressure (MABP), heart rate, and skin temperature were monitored every 15 minutes in the first 10 days after birth in 34 preterm infants, gestational age 24 to 33 weeks. Ultrasound brain scans carried out daily showed that a periventricular haemorrhage (PVH) occurred in a subgroup of infants (n = 15) of lower birthweight and gestational age. In infants without PVH the daily median of MABP increased with birthweight and postnatal age; that of heart rate was not affected by postnatal age, body weight, or gestational age; and that of skin temperature showed a slight fall with postnatal age. In infants with PVH, on or before the day of PVH, daily medians of MABP and skin temperature were not significantly different from those of infants without PVH, but the daily median of heart rate tended to be slightly higher. The percentage of positive correlations between the 96 15 minute values per day for heart rate and MABP increased with postnatal age and with birthweight, but did not differ in infants who developed a PVH. The coefficient of variation (CV) of the 96 15 minute values for MABP tended to be higher in infants on the day of PVH, and a similar trend was apparent on the day before. The processes of development of blood pressure, heart rate, and skin temperature are similar in infants with or without PVH but at lower gestational ages altered blood pressure control may cause brain haemorrhage.

Birth Weight↗
PubMed1995

Heart rate variation, age, and behavior in subjects with senile dementia of Alzheimer type.

Minute-by-minute heart rate (HR) recordings over a period of 24 h were obtained once for 30 elderly subjects diagnosed as having senile dementia of Alzheimer type (SDAT). Twenty-one of the subjects were studied in a hospital ward setting, and nine were studied in their own homes. Twelve were men and 18 were women. Eleven took some form of sedative medication; 10 took no medication. Thirty-minute mean values were unmasked to take account of the effects of activity and sleep on HR. Results indicate that the masked HR circadian rhythm of SDAT may be more often unimodal than that of normal subjects of similar age, and that phase shift of the endogenous, clock-mediated component of the rhythm (with higher HR at night) is to be expected in a proportion of individuals with SDAT.

Age Factors↗
PubMed1994

Evaluation of a rapidly rotating shift system for tolerance of nurses to nightwork.

Fifteen female nurses, aged between 21 and 29 years and employed in an intensive care unit, were examined with the aim of evaluating their psychophysical adaptation to one of the most commonly used, rapidly rotating shift systems, the "metropolitan rota" (2-2-2-2), with the length of the shifts modified according to the work load (including night shifts of 10h) and with the start of the morning shift delayed (to 7 a.m.). Subjective evaluations of work load and psycho-physical conditions as well as performance measures (reaction time, search and memory test), blood pressure and heart rate were recorded at the start, middle and end of the work shifts on the last 4 days of the shift cycle, comprising one morning, one afternoon and two consecutive nights. During the shifts, plasma cortisol and urinary excretion rate of 6-sulphatoxymelatonin, adrenaline and noradrenaline were also recorded, as well as oral temperature and activity-sleep logs. The results showed that this rapidly rotating shift system including two consecutive night shifts does not significantly alter the normal circadian rhythms of the body, particularly as concerns performance levels, body temperature and hormone excretion. Moreover, the lengthening of the night shift to 10h can be considered acceptable in terms of work efficiency, provided that work load is reduced and there are sufficient rest pauses available to compensate for tiredness and sleepiness. On the other hand, the shortening of the day shifts to 7h and the delayed start of the morning shift to 7 a.m. appeared convenient in relation to both work load and sleep duration.

Adult↗
PubMed1994

The meaning of good sleep: a longitudinal study of polysomnography and subjective sleep quality.

The present study sought to investigate the meaning of subjectively good sleep, using a longitudinal and intraindividual design. Eight subjects slept in an isolation unit according to an irregular schedule of 6 h sleeps and 1 h naps, designed to give normal amounts of time in bed (1/3 of total), but variable sleep quality. Eight sleeps and eight naps were used for longitudinal simple and multiple regression analyses with standard polysomnographical sleep variables as predictors and subjective sleep quality as dependent variables. The results showed that subjective sleep quality (and related variables) was closely related to sleep efficiency, but not sleep stages. At least 87% efficiency was required for ratings of 'rather good' sleep. In addition, sleep quality ratings improved with closeness (of the awakening) to the circadian acrophase (17.00-21.00 hours) of the rectal temperature rhythm. The subjective ease of awakening differed from most other other variables in that it was related to low sleep efficiency. Objective and subjective homologues of sleep length and sleep latency showed high mean intraindividual correlations (r = 0.55 and 0.64, respectively). It was concluded that objective measures of sleep continuity were closely reflected in perceived sleep quality and that sleep quality essentially means sleep continuity.

Journal Article↗
PubMed1994

Haemodynamic effects of atrial natriuretic peptide in hypoxic chronic obstructive pulmonary disease.

BACKGROUND: Pulmonary artery pressure is elevated in patients with advanced chronic obstructive pulmonary disease (COPD). Release of atrial natriuretic peptide (ANP) is increased in pulmonary hypertension and this hormone may both selectively vasodilate pulmonary vessels and inhibit pulmonary vascular remodelling. The hypothesis that ANP has a physiological role in protection of the pulmonary circulation from pressure overload, and that it may be beneficial in patients with COPD, has been examined. METHODS: Ten patients with hypoxic COPD were infused for 30 minute periods with saline followed by ANP at 0.4, 2, and 10 pmol/kg/min respectively via a pulmonary artery catheter whilst monitoring haemodynamics and oxygenation. RESULTS: Levels of immunoreactive ANP (irANP) increased from a mean (SD) of 23 (15) pmol/l to a maximum of 94 (41) pmol/l. Neither systemic blood pressure, cardiac output nor total systemic vascular resistance showed any correlation with irANP levels. There were negative correlations between levels of ANP and mean pulmonary artery pressure which fell from 28.7 to 25.9 mm Hg, pulmonary artery wedge pressure which fell from 6.5 to 4.6 mmHg, and total pulmonary vascular resistance which fell from 489 to 428 dynes s cm-5. There was a small fall in PaCO2 from 6.2 to 5.9 kPa, whilst venous admixture and oxygen delivery both increased non-significantly. CONCLUSIONS: At these pathophysiological concentrations there was evidence that ANP selectively reduced right ventricular afterload. These data support the hypotheses that increased plasma levels of ANP may be beneficial in hypoxic COPD, and that endogenous ANP may ameliorate pulmonary hypertension in humans.

Aged↗
PubMed1994

The subjective meaning of good sleep, an intraindividual approach using the Karolinska Sleep Diary.

The present experiment used an intraindividual design to investigate the meaning and measurement of "good sleep". Each of 16 subjects slept in an isolation unit according to a schedule (15 sleeps) designed to give variable quality of sleep. Self-rated sleep measures (from the Karolinska Sleep Diary) were obtained after each sleep and subjected to intraindividual regression analyses across time. Most subjective sleep measures showed a strong covariation across conditions. Subjective quality of sleep mainly involved variables of sleep continuity, in particular, perceived calmness of sleep and sleep efficiency. "Sleep quality," "calm sleep," "ease of falling asleep," and ability to "sleep throughout" the time allotted strongly covaried and formed an index of sleep quality. Self-rated ease of awakening deviated from the general pattern and was associated with poor sleep quality. So was reported dreaming (related to awakenings). It was concluded that most subjective sleep measures tend to covary across conditions and that "good sleep" is mainly a question of sleep continuity.

Adolescent↗
PubMed1994

Circadian rhythms, jet lag, and chronobiotics: an overview.

This overview considers the origins of jet lag in terms of altered circadian rhythmicity. The properties required of a chronobiotic--an agent to cause phase adjustment of the body clock--are discussed, and an account is given of the major candidates at the present time: light, melatonin, activity, and benzodiazepines. It is concluded that current knowledge indicates that a combination of factors is likely to be most effective.

Animals↗
PubMed1994

Effect of masking on circadian adjustment and interindividual differences on a rapidly rotating shift schedule.

OBJECTIVES: The aim of the present study was to define the effect of masking on the estimation of circadian adjustment of and interindividual differences between nurses on a rapidly rotating shift schedule. METHODS: The phase shift of the circadian rhythm of rectal temperature was studied in 17 subjects. The following three different methods for estimating the circadian phase shift were compared: (i) cosinor analysis, (ii) a method using normative endogenous data in which the masking effects are removed ("purification"), and (iii) a method using normative endogenous data in which the masking effects are not removed. RESULTS: The mean phase delay during the second night shift (compared with the morning shift) was 6.3 h according to the cosinor analyses of the raw data and 6.2 h according to the cross-correlation method of the raw data. When the masking effects were removed ("purification"), the phase shift was only 1.7 h. Diurnal type did not significantly explain the differences between individuals in the amount of phase shift of the raw data but was the only significant factor, explaining 32% of the variation between individuals in the phase shift of the purified data. CONCLUSIONS: Masking effects on body temperature should be taken into account before any definite conclusions can be drawn about the relation between individual factors and the adjustment of the circadian rhythm of body temperature.

Adaptation, Psychological↗
PubMed1993

Discussing sexual concerns with health care professionals: positive attitudes in healthy subjects.

Sexuality is an important part of human health and should be addressed in numerous aspects of nursing care. Many nurses have difficulty providing patients with care in the area of sexuality, however, and usually do not address sexual concerns unless the patient asks specific questions. This study explored the attitudes of healthy individuals toward physicians and nurses discussing sexual concerns with clients. Most subjects thought discussing sexual concerns with nurses was appropriate, and all subjects thought that physicians should discuss sexual concerns with clients. Regression analyses indicated that attitudes were not influenced by variables such as age, gender, or marital status. These findings suggest that nurses can feel comfortable addressing sexuality with many more of their clients and that when unsure about discussing sexuality with clients, nurses should refer clients to their physicians.

Adult↗
PubMed1993

Regulation of sleep and naps on an irregular schedule.

For many occupational groups there is an implicit requirement that sleep be taken according to very irregular schedules. The purpose of this study was to investigate the effects of an irregular sleep schedule on sleep and to determine if such effects could be attributed to the timing of sleep. Eight subjects slept in an isolation unit according to an irregular schedule comprising four 8-hour sleep periods, 12 6-hour sleep periods and 12 1-hour naps. The schedule was designed to give normal amounts of time (1/3 of total) in bed. Large variations in mean sleep efficiency (100-46%) were observed, which in individual cases frequently involved a complete absence of sleep. In 6-hour sleep periods the loss was due to an inability to maintain sleep, whereas in naps the loss was due to an inability to initiate sleep. The major causes of reduced sleep were short prior time awake and bedtime close to the circadian acrophase of rectal temperature (i.e. late afternoon). These two components accounted for 46% of the intraindividual variance of total sleep time (TST). TST increased by 9.2 minutes for each hour of prior time awake and by 10 minutes for each hour of deviation from the circadian acrophase of rectal temperature. Prior time awake also exerted a strong influence on slow-wave sleep (SWS), and circadian phase exerted a similar influence on rapid eye movement sleep. We concluded that irregular sleep patterns strongly affect sleep and that circadian and homeostatic influences are clearly discernible despite the irregularity.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

Skin temperature and heart rate rhythms in infants of extreme prematurity.

Nine preterm infants of 26 to 29 weeks' gestational age and 792 to 1200 g birth weight spent six to 17 weeks in our neonatal medical unit. Hourly recordings of skin temperature and heart rate were carried out. The first five to 15 weeks were spent in the intensive care ward, in continuous light, due to various medical conditions. After recovery they were moved to a nursery for one to nine weeks, with 12 hourly periods of light and darkness. Four infants developed circadian rhythms in temperature and three in heart rate in light-dark periods, the remainder failing to do so. Some infants take longer than others to develop circadian rhythms but the reasons for this are not clear. It is suggested that earlier exposure to a light-dark environment may synchronize the 'body clock' to a 24 hour period in more preterm infants.

Circadian Rhythm↗
PubMed1991

The development of ultradian and circadian rhythms in premature babies maintained in constant conditions.

Twenty very premature babies, born at 24-29 weeks gestation, have been studied while they were maintained in intensive care with continuous intravenous feeding and constant ambient lighting and temperature. Hourly records of insulated skin temperature and heart rate were made for a continuous period of 6-17 weeks, always starting the recording within 24 h of birth. The development of rhythms within the ultradian, circadian and infradian domains was sought by methods including maximum entropy spectral analysis and autocorrelation. Circadian and ultradian rhythms were present, but not regularly so; rather they appeared and disappeared erratically in successive weeks. As a consequence, the group as a whole did not show an increasing rhythmicity with chronological age. In some cases, babies were later placed in a ward in which the lighting was dimmed at night, and feeding by mouth at regular intervals was instituted. There was some evidence for increases in circadian and ultradian rhythmicity after these changes. These results enable inferences to be drawn as to the origin of fetal rhythms in the third trimester of pregnancy, as well as speculation to be made on the ontogeny of ultradian and circadian rhythms in the neonate.

Age Factors↗
PubMed1991

Attitudes toward nurses discussing sexual concerns with patients.

Attitudes toward nurses discussing sexual concerns with clients were examined in 73 healthy subjects using Section A of the Sexual Adjustment Questionnaire. The variables of age, sex, race, occupation, educational level, marital status, importance of sexual activity, frequency of discussing sexual relationship with partner, and number of others with whom sexual concerns are discussed were examined to determine influence on subject's attitudes. Ninety-two per cent of subjects thought that nurses should discuss sexual concerns with clients. Weighted least squares analysis showed that only two variables (number of others with whom sexual concerns are discussed and race) were significant predictors of attitudes.

Adult↗
PubMed1990

General hospital admission in the management of parasuicide. A randomised controlled trial.

Suitably trained junior doctors selected parasuicides with no immediate medical or psychiatric treatment needs on initial assessment in a casualty department. This group was then randomly allocated to hospital admission (38 cases) or discharge home (39 cases). One week later there were no significant differences between groups on diverse outcome measures, including repetition rate, psychological symptoms, and social functioning. A second follow-up using the same measures at 16 weeks also failed to demonstrate any differences between groups, both of which showed considerable overall improvement. A parasuicide management policy consisting of assessment in a casualty department and selective discharge was appropriate for 15% of a hospital-referred population. This lends support to recent government recommendations, but caution should be exercised before such a result is generalised.

Adult↗
PubMed1988

The effects of long term methyldopa in patients with hypoxic cor pulmonale.

Methyldopa (alpha-methyldopa) was given to patients with cor pulmonale secondary to chronic obstructive airways disease (COAD) to determine its effect on pulmonary haemodynamics. Twenty-five patients were randomly allocated to methyldopa (750 mg daily) or placebo. Pulmonary haemodynamics were measured twice, 12 months apart. Conventional therapies were continued unchanged. The effects of the drug on pulmonary haemodynamics were inconclusive when considered overall, but total pulmonary vascular resistance (TPVR) fell in all patients on active therapy in whom measurements were obtained both at rest and upon exercise. Only one patient in the placebo group achieved this. Over the trial period there was one death in the active but five in the placebo group. Survival was unrelated to abnormalities in pulmonary haemodynamics at the commencement of the trial in this study although the numbers of patients was small. Postural hypotension developed in patients receiving methyldopa and limited the dose that could be administered. The problems involved in long term trials of vasodilators in hypoxic cor pulmonale are discussed.

Aged↗