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Biomedical subjects

K Martin

Publications and source records attributed to K Martin.

323 records · Page 18Linked to original sources
PubMedDate not supplied

Nurse practitioners' use of nursing diagnosis.

The role of the nurse practitioner (NP) represents a unique blend of nursing and medical functions. Few studies exist that address the nursing component of the NP role and no literature is available to document the extent to which nurse practitioners utilize nursing diagnoses in their clinical practice. Thus, the author reports findings of a study that sought to describe the use of nursing diagnosis in current NP practice and to identify advantages and barriers to the use of nursing diagnoses by NPs. Fifteen percent of nurses surveyed used nursing diagnoses in their practice. The diagnoses most commonly used reflected attention to clients' lifestyles and daily living problems.

Humans↗
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The effect of event recording home infant apnea/heart rate monitoring in the greater Los Angeles area.

This study presents the findings of 54 infants sent home on event recording apnea/heart rate monitors over a seven month period. The average gestational age was 35 weeks. The number of referring facilities was 13 hospitals and the number of referring physicians was 41. We separated the admitting diagnostic groups into the following categories: Apnea of prematurity, apnea of infancy, apparent life threatening event, subsequent SIDS sibling, gastroesophogeal reflux, maternal substance abuse, seizure disorders, respiratory distress syndrome, bradycardia of unknown origin, bronchopulmonary dysplasia, and Pierre Robin syndrome. From March 1990 to October 1990, a period of seven months, these children were placed in our services on event recording home apnea/heart rate monitors. The average time on service for these patients was 2.90 months, (p less than .07). This data indicates that event recording home apnea/heart rate monitoring greatly decreases the length of home monitoring.

Apnea↗
PubMedDate not supplied

Contraceptive use in Canada: 1984-1995.

CONTEXT: In every country, contraceptive behavior has important implications for fertility and the prevalence of sexually transmitted diseases (STDs). There has been relatively little attention to contraceptive practices in Canada, however, particularly how patterns of method use may have changed. METHODS: Data on contraceptive use were collected from 5,315 women in the 1984 Canadian Fertility Survey, and from 3,220 women and 3,449 men in the 1995 General Social Survey. RESULTS: Among Canadian women aged 15-49, current contraceptive use declined from 69% to 60% between 1984 and 1995. Pill use dropped from 19% to 17%, and IUD use declined from 6% to 3%. However, during the same period, condom use increased from 6% to 10%; tubal ligation declined from 24% to 17%, while vasectomy increased. In addition, the proportion of women sterilized for reasons other than contraception rose between 1984 and 1995. Men were less likely to rely on sterilization than were women (31 % vs. 40%). Men reported higher levels of condom use (22%), but lower levels of pill use among their partners (9%), than did women (10% and 17%, respectively). CONCLUSIONS: Contraceptive behavior in Canada is unique: The decline in contraceptive use over the last decade has left Canada's overall contraceptive prevalence among the lowest in the industrialized world, and the rate of sterilization among the highest These changes in contraceptive behavior complicate efforts to plan for social and health needs, particularly policy decisions focusing on reducing infections with STDs.

Adolescent↗
PubMedDate not supplied

[Effects of cognitive aging on memory performances].

PSYCHOLOGY OF AGING: This article sums up studies on influence of normal aging in memory. Aging is a process involving many dimensions: Psychological, Biological and Social. These elements interact with each other and needed to be considered in the description of human memory aging. COGNITIVE APPROACH OF HUMAN MEMORY: Moreover, researches on human memory have been conducted within the framework of current theoretical views of memory. The present review provides an outline of the cognitive neuropsychology models of memory, its nature, components and organization. CLINICAL APPROACH OF AGING AND MEMORY, CONSEQUENCES: This introduction may help the reader to understand more clearly empirical evidence of age-related differences in memory and attentional functioning. In closing, the human factors psychologists must be take in account while adopting a global approach of the understanding of memory aging. Psychological field provides a complete structure for assessing human being and is helpful before to conclude between normal or pathological memory aging.

Adult↗
PubMedDate not supplied

Concurrent consultations with physicians and providers of alternative care: results from a population-based study.

OBJECTIVE: We examined the factors related to consultations with both physicians and alternative practitioners, compared with visits to physicians only. METHODS: A telephone survey (random-digit dialling) collected information from 818 adults living in and around Saskatoon. Respondents reported consultations with alternative practitioners and physicians in the previous 12 months. RESULTS: Approximately one in five respondents had consulted both a physician and an alternative practitioner. Among respondents under 65 years of age, having one or more chronic medical conditions significantly increased the likelihood of concurrent use of care. Men, individuals suffering from back pain or migraines, those reporting an elevation level of distress, and those for whom spiritual values were important were also more likely to use both types of care. INTERPRETATION: Consultations with alternative care providers occur as an adjunct to, rather than a replacement of visits to physicians. Particular types of medical conditions as well as psychosocial and spiritual factors are determinants of concurrent use of physicians and alternative practitioners.

Adult↗
PubMedDate not supplied

Effectiveness and safety profile of leflunomide in rheumatoid arthritis: actual practice compared with clinical trials.

OBJECTIVE: Leflunomide, an immunosuppressant agent for treating rheumatoid arthritis, was first marketed in France in 2000. Three years after its launch, we sought to assess its prescription patterns in the real world of prescription and use, and to see if its efficacy and safety profiles observed during clinical trials were confirmed. METHODS: All patients treated with leflunomide from May 2000 to April 2003 in the Department of Rheumatology of the Bordeaux University Hospital were identified, and their treatment patterns and outcome ascertained. This was compared to data from clinical trials. RESULTS: 116 were included (mean age = 55 years, 70% women). Almost 21.7% stopped treatment for lack of efficacy (after a mean delay of 3.6 months), 16% for secondary loss of efficacy (median = 7 months), and 32% for the occurrence of an adverse event (half within 4 months). Over a similar time frame in clinical trials, in patients of about the same age and sex but with less severe disease, the corresponding figures were 7-17% for lack or loss of efficacy, and 14-22% for adverse effects. At one year of follow-up, the discontinuation rate was 70% in the cohort compared to 28-47% in clinical trials. DISCUSSION: The differences between the two populations confirm the need to conduct post-marketing studies in order to obtain better knowledge on the effectiveness and safety of a new drug. In many cases, a simple drug utilization study can provide relevant information on the degree of shift between populations included in clinical trials and those treated in real life.

Antirheumatic Agents↗
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Human courage to endure.

Explore the source record for details and available documents.

Adaptation, Psychological↗
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AIDS and antibodies to human immunodeficiency virus (HIV) in children and their families: clinical experience at Yale-New Haven Hospital.

As of December 1986, we have identified 23 symptomatic children with human immunodeficiency virus (HIV) infection in New Haven. Twelve developed AIDS as manifested by lymphocytic interstitial pneumonitis, Pneumocystis carinii pneumonia (PCP), and/or disseminated mycobacterial infections; seven of them have died. The remainder have milder clinical syndromes, which include failure to thrive, diffuse lymphadenopathy, and parotid swelling. When compared to adults with AIDS, children often have hypergammaglobulinemia and normal numbers of T4 lymphocytes. Intravenous drug abuse by the mother or mother's consort is the risk factor in 87 percent of these children. Two families have now been identified with more than one symptomatic child, but in no family is there evidence of spread from symptomatic children to uninfected siblings. A prospective study was begun to attempt to assess the risk of developing symptomatic HIV infection when a child is born to a mother with antibodies to HIV.

Acquired Immunodeficiency Syndrome↗
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[Cardiotocographic changes in epidural analgesia with bupivacaine].

During the first stage of labor in a large number of births, temporarily pathologic patterns become manifest in the cardiotocogram after epidural analgesia. Statistical comparisons showed a significant level of correlation (in the region of 1%) between pathologic heart rate pattern and a fall in blood pressure after the main epidural dose (in all cases, premedication was given before commencement of analgesia). This jeopardy to the fetus in the first 20-30 minutes after administration of the main dose, visible in the cardiotocogram, makes it imperative for the clinician to pay the utmost attention to all women in labor during this period, not just those regarded as risk patients. After 10-20 minutes, labor is intensified, and this can coincide with possible jeopardy to the fetus. As this change in the course of labor manifests itself inordinately strongly in the labor-frequency parameter, and since absolute intrauterine pressure did not represent a threat to life in any of the cases described here, the authors feel that monitoring of labor by external tocometry is sufficient for clinical needs.

Anesthesia, Epidural↗
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Nonexpression of CD15 by neoplastic glia: a barrier to metastasis?

Cluster of differentiation 15 (CD15) monoclonal antibodies recognise cell adhesion molecules on the surface of many cells including normal astrocytes and metastatic carcinoma cells. The CD15 epitope (fucosyl-N-acetyl-lactosamine), an adhesive oligosaccharide, functions as a ligand for the selectin family of membrane receptors. These include CD62, a cytokineinducible glycoprotein found in platelets and endothelial cells. CD15 is one of a series of putative adhesion molecules expressed in nervous tissue. Selectin-carbohydrate interactions have been implicated in the metastatic spread of cancer cells. We have immunostained a variety of cultured human brain tumours, three cell lines derived from experimental rat gliomas, two specimens of cultured human foetal astrocytes, two metastatic carcinoma cell lines and human umbilical vein endothelial cells (HUVEC) using two monoclonal antibodies which recognise CD15. While all of the animal glioma cells were positive for CD15, only two human glioma cell lines, derived from an anaplastic astrocytoma and a glioblastoma multiforme, respectively, displayed limited reactivity. Chromium radiolabel binding assays of CD15-positive and -negative cell lines including glioma and carcinoma-derived cells, using HUVEC as an attachment substrate, were carried out in the presence and absence of CD15 monoclonal antibody. The level of adhesion of neoplastic cells to HUVEC not only corresponded to CD 15 expression but application of anti-CD 15 monoclonal antibodies considerably reduced adhesion. We postulate that the absence of CD15 on human glioma cells may explain, to some extent, the general failure of intrinsic brain tumours to metastasis by precluding the adhesion of circulating neoplastic glia to 'target' organ endothelium.

Brain Neoplasms↗
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Healthy Lifestyle Check. A computerized health screening program.

The Healthy Lifestyle Check program is a computerized tool used to survey current health status and risk factors for potential ill health as well as to promote a healthy lifestyle. The program is an innovative teaching tool for student nurses, facilitating the integration of practice, education, and research. The program required self-report answers to questions relating to health history and current health-related behaviors with results of cholesterol, blood pressure, height, and weight assessment. Feedback to participants was provided by use of on-screen displays and printed reports containing public health messages, as well as counseling by the nurses. Results indicated that participants had not been screened for testicular, prostatic, and cervical cancers, or breast self-examination and medical checkups, and that they indulged in high levels of risk-taking behaviors such as high levels of alcohol consumption and low levels of exercise. The Healthy Lifestyle Check program is a valuable research tool that collects data and provides health information to participants, and has been used to teach nursing students the application of education and research to nursing practice.

Adolescent↗