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Biomedical subjects

M Crawford

Publications and source records attributed to M Crawford.

At least 73 records · Page 4Linked to original sources
PubMed1996

First-line managers: scope of responsibility in a time of fiscal restraint.

Fiscal restraint and government cost control have contributed to the downsizing and restructuring of Canadian health care organizations. As key players in the hospital sector, the role and responsibilities of first-line nurse managers have been significantly affected by these changes. This paper presents data from a survey of 200 first-line nurse managers in British Columbia which investigated the current scope of the first-line manager's role, the number of hierarchical levels within nursing departments, and views on managerial union membership.

British Columbia↗
PubMed1996

Heterotopic ossification after hip arthroplasty: a randomized double-blind multicenter study tenoxicam in 147 hips.

147 patients due to have a cemented total hip arthroplasty were randomized to 4 groups. They received either tenoxicam 20 mg or 40 mg, or placebo, for 5 days or morphine on the day of operation and placebo for 4 days. During the first 5 days 14 patients were excluded. The patients were followed for 1 year, during which another 10 patients were excluded. At follow-up, significantly fewer patients had heterotopic ossifications in the tenoxicam groups than in the placebo and morphine groups. There was no significant difference between the 2 tenoxicam-treated groups, and we therefore conclude that tenoxicam 20 mg for 5 days postoperatively can reduce heterotopic ossification after cemented total hip arthroplasty.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1996

Learning to care: gender issues for male nursing students.

The following article is a description of one aspect of a phenomenological research study designed to investigate the lived experience of male nursing students as they learned to care as nurses. Data-collection strategies included paradigm case narratives and interviews. Data analysis was characterized by four major strategies: analysis, synthesis, criticism, and understanding. These strategies were used to identify meanings of the text of transcribed interviews and to generate interpretive commentary. Learning to care was described by the participants as a complex entity that incorporates the gender of the student, the patient, the teacher, and the nurse. As students progressed through the program, their experience of gender issues in learning to care was shaped by personal experiences, the expectations of a predominantly female faculty and nursing staff, and their evolving understanding of the ways of caring that are gender based.

Adolescent↗
PubMed1996

Attrition from a male batterer treatment program: client-treatment congruence and lifestyle instability.

Although patient compliance is a problem for almost all forms of therapy, treatment programs for male batterers face special concerns. Male batterers are often perceived as coming to therapy only because of the external pressures of courts or intimate partners. In the present study, we examined the rates at which male batterers failed to attend treatment following an initial assessment interview. Of the 526 men recommended for treatment, only 218 (41%) attended a single treatment session, and only 132 (25%) completed the brief (10-week) treatment program. The variables associated with attrition fell into two general categories: (a) those associated with lifestyle instability (e.g., moves, unemployment, youthfulness), and (b) those variables indicating a congruence between the clients' self-identified problems and the targets of treatment (e.g., self-admitted problems with spousal assault). Suggestions are provided as to how programs could reduce their attrition rates by attending to the issues of client-treatment congruence and lifestyle instability.

Adult↗
PubMed1995

Capital decisions. Where is the smart money being invested?

Health care executives are faced with a welter of priorities when it comes to allocating their increasingly scarce capital: they need to build information systems, organize primary care physicians, and expand outpatient services. But what are the defining issues? We asked five executives to explain how their strategies are changing as a result of managed care growth and integration. What emerges is a snapshot of the new capital allocation reality.

Capital Expenditures↗
PubMed1995

CEO summit. The leadership experience--roundtable discussion.

All across the country, hospitals, physicians and insurers are sizing each other up as potential strategic partners. But there's much ground to be covered before a final agreement is reached, and not every decision is based on facts and figures. Sometimes it's the personal interaction between CEOs that makes the deal happen--or not. McManis Associates and Hospitals & Health Networks brought together a roundtable of CEOs to talk about the ups and downs and the ins and outs of the leadership experience. Following is a series of first-person accounts by roundtable participants.

Chief Executive Officers, Hospital↗
PubMed1995

Transformations in null mutants of Hox genes: do they represent intercalary regenerates?

In the minds of many, Hox gene null mutant phenotypes have confirmed the direct role that these genes play in specifying the pattern of vertebrate embryos. The genes are envisaged as defining discrete spatial domains and, subsequently, conferring specific segmental identities on cells undergoing differentiation along the antero-posterior axis. However, several aspects of the observed mutant phenotypes are inconsistent with this view. These include: the appearance of other, unexpected transformations along the dorsal axis; the occurrence of mirror-image duplications; and the development of anomalies outside the established domains of normal Hox gene expression. In this paper, Hox gene disruptions are shown to elicit regeneration-like responses in tissues confronted with discontinuities in axial identity. The polarities and orientations of transformed segments which emerge as a consequence of this response obey the rules of distal transformation and intercalary regeneration. In addition, the incidence of periodic anomalies suggests that the initial steps of Hox-mediated patterning occurs in Hensen's node. As gastrulation proceeds, mesoderm cell cycle kinetics impose constraints upon subsequent cellular differentiation. This results in the delayed manifestation of transformations along the antero-posterior axis. Finally, a paradigm is sketched in which temporal, rather than spatial axial determinants direct differentiation. Specific, testable predictions are made about the role of Hox genes in the establishment of segmental identity.

Animals↗
PubMed1995

Trial-to-trial variability of corticospinal volleys in human subjects.

The trial-to-trial variability of the different components of corticospinal volleys evoked by transcranial electrical stimulation of the motor cortex using a constant stimulus intensity was measured from epidural recordings during surgery to correct scoliosis. The recordings were made when there was no operative interference, and blood pressure, temperature, ventilation and anaesthetic regimen were stable. A simple D wave with a single negative peak of 10-30 microV amplitude was recorded in 4 patients. It varied little in amplitude (S.D.s < 8% for 100 consecutive single responses). In 4 patients the stimulus was adjusted to produce a complex D wave with 3 components, the earliest 2 of which arise from subcortical/brain-stem sites. The variability of amplitude of these components was high (S.D.s of 13-50%), but the variability of latency was low (S.D.s of 2-3%). Eighteen I waves were recorded in 6 of the subjects. Their variability from trial to trial was similar to that of the components of the complex D wave. It is argued that there would be greater trial-to-trial variability of the corticospinal volley in the awake state, particularly when the stimulus was magnetic rather than electrical. Explanations for changes in the compound muscle action potential produced by transcranial stimulation, electrical or magnetic, must take into account that a constant stimulus does not evoke an identical descending volley.

Adolescent↗
PubMed1995

Retrograde intramedullary nailing of supracondylar femur fractures above total knee arthroplasty. A preliminary report of four cases.

Four supracondylar fractures of the femur in three patients with total knee arthroplasties were treated by retrograde intramedullary nailing using an interlocking renamed nail (GSH Nail, Smith and Nephew Richards, Memphis, TN) specifically designed for fractures of the distal femur. Three cases were acute fractures and one was a refracture through a screw hole of a previously plated supracondylar fracture. All fractures healed and there were no complications. The procedure is performed by closed nailing using fluoroscopic guidance with the nail placed through the intercondylar notch of the femoral prosthesis and interlocking to the fracture fragments with a percutaneous targeting device. The advantages are that the procedure is performed by closed techniques that preserve the fracture hematoma and reduce operative blood loss, the fracture is stabilized by a load-sharing nail, and immediate motion with limited weight bearing is possible.

Aged↗
PubMed1995

How male nursing students learn to care.

the current definitions of caring in nursing education denote a mutual relationship between teachers and students in which they interact to provide an environment which supports the students' personal and professional development. The learning of caring in an interactional context is typical of the female experience. It is unknown if this is representative of the male experience. The lived experience of 20 male students as they learned to care as nurses was the focus of this phenomenological research study. The participants concurred that, although caring as a nurse could be learned if one was 'open to learning', teachers could only facilitate this learning; they could not directly teach it. The interactional strategies of storytelling, modelling, being cared for, the 'aha' encounter, and observing and giving care, were used by the participants in learning to care as nurses. The implications of these findings for nursing education and research are presented.

Adult↗
PubMed1995

Progression of HIV infection is associated with HLA-DQ antigens in Caucasians and African Americans.

In our previous work with human leukocyte antigen (HLA) association in human immunodeficiency virus (HIV) infection, African Americans (Afr Ams) and Caucasians (Caucs) exhibited HLA markers that were associated with protection or disease. The present study was designed to establish if HLAs were associated with the severity of HIV infection and progression to AIDS in Afr Am and Cauc adults. The frequency of serologically determined antigens (Ags) in the regional control population was compared to the HIV-infected population and the HIV-infected slow progressors were compared to rapid progressors by race. chi 2 analysis with Bonferroni adjustment, Kaplan-Meier survival analysis, linear logistic regression, Cox model of proportional hazards and standardized deltas were applied as applicable. Immune parameters were monitored over a mean follow-up period of 23 +/- 2 months for Afr Ams (n = 35) and 25 +/- 5 months for Caucs (n = 24). A better prognosis in the HIV+Afr Am group was associated with HLA-DQ1 with a risk ratio of 0.295. In the HIV+Cauc group, a preferable prognosis was associated with HLA-DQ3 with a risk ratio of 0.11, and a poor prognosis was associated with HLA-DQ2 with a risk ratio of 7. Afr Am haplotypes that appeared to have the greatest association with rapid progression of HIV infection were A69(28)-B40 and related haplotypes as well as B12-DR14(6). Cauc haplotypes with the strongest association with rapid and slow progression of HIV infection were A28-B17-DR9 and A30(19)-B67, respectively. The DR Ags of at least one haplotype that led to rapid progression in both races were associated with DQ9(3). An 'immune response' gene (DQ region) may control the progression of HIV infection in adults. The rapidly progressive DQ-associated peptide might block the progression of HIV if given as a novel vaccine.

Adolescent↗
PubMed1995

Fatty acid composition of plasma and red cell phospholipids of preterm babies fed on breast milk and formulae.

UNLABELLED: Fatty acids of plasma and red cells of preterm babies, gestational age 28-33 weeks, weighing less than 2200 g were studied between birth and the expected date of delivery (EDD). Babies were fed either mothers' breast milk, or if they were unable, or chose not to breast-feed, randomly assigned to milk formula A or B. Milk B had 26% oleic acid, 0.5% docosahexaenoic acid (DHA) and 0.12% arachidonic (AA); A had 13% oleic acid, less than 0.05% AA and no DHA. The proportions of gamma linoleic and the other fatty acids, and the ratio of linoleic acid (LA)/alpha linolenic acid (ALA) were comparable in the two formulae. Diet and/or physiological adaptation seemed to be responsible for the significant changes in the proportions of certain fatty acids between birth and EDD. Incorporation of DHA in formula B increased its concentration in plasma and red cells, and reduced the conversion of LA to AA. With respect to maintenance of DHA status, milk B was superior to milk A but did not match breast milk. CONCLUSION: Fortification of formula with DHA without concomitant incorporation of AA may precipitate AA insufficiency and may have developmental implications.

Arachidonic Acids↗