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Biomedical subjects

M Crowe

Publications and source records attributed to M Crowe.

At least 19 recordsLinked to original sources
PubMed1997

An analysis of the sociopolitical context of mental health nursing practice.

This paper will explore the delivery of mental health nursing care within a neo-liberal model of mental health care delivery in New Zealand. Mental health nursing as a socially constructed activity occurs within a particular political context, which determines its role and function. This environment determines the nature of the nurse-patient relationship which is integral to the role of mental health nurses. Critical analysis of the New Zealand Government's neo-liberal health policies will be conducted to explore their effect on mental health care delivery and the nurse-patient relationship. Some of the ideologies and values maintained by current dominant discourses within nursing and the State are discussed. To establish therapeutic partnerships with service-users, mental health nurses are urged to critically analyse their practice and the context in which it occurs.

Delivery of Health Care↗
PubMed1996

Clinical features and antibiotic treatment of septic arthritis and osteomyelitis due to Yersinia enterocolitica.

Yersinia enterocolitica bone and joint infections are rare. Over a period of 7 months four patients with deep-seated skeletal infections due to Y. enterocolitica were seen at the University Hospital, Nottingham. Sites of infection included the knee (one patient) the hip (one) and the spine (two). None of the patients had major underlying disease or risk factors for developing invasive Y. enterocolitica infection. The organisms were sensitive to the second- and third-generation cephalosporins, gentamicin and fluoroquinolones. A literature search covering the period 1970-1994 revealed 20 other cases of skeletal infections due to Y. enterocolitica; there was no uniformity in the choice of antimicrobial agent for treating these infections. Oral ciprofloxacin was used as the principal antimicrobial agent in the patients described here and therapeutic success was achieved in three of these patients. Ciprofloxacin should be considered as first line therapy for invasive infections due to Y enterocolitica.

Administration, Oral↗
PubMed1996

Establishing a therapeutic milieu with adolescents.

Adolescents with acute psychiatric illness need an environment that emphasizes containment, structure, support, involvement and validation. Within such an environment therapeutic relations based on collaboration can be developed. However, these relations require nursing actions that facilitate adolescents' acceptance of containment, their ability to form attachments and development of achievement. The proposed collaborative approach for nursing care positions the adolescent as an active participant in the treatment process. The collaborative approach encourages a sense of responsibility for self and enhances the adolescent's skills to cope with situations and relations that pose difficulties through the development of self-awareness and problem-solving abilities.

Adolescent↗
PubMed1996

Cutting up: signifying the unspeakable.

This article uses a feminist framework to explore women's self-injurious behaviour in response to abuse. It deals specifically with 'cutting up' as a response to physical or sexual abuse. The position pursued regards the body as an inscriptive surface that provides an interface between subject/object and explores how women may lack a means by which to signify to others what their experience means to them. The language available to women does not always provide an adequate means of self-expression. This inadequacy of language often leaves women with no option but the use of non-verbal corporeal inscription. It is proposed in this paper that 'cutting up' is a means of establishing a sense of self while perpetuating a sense of the body as a site for abuse. Discursive constructions of femininity and mental illness perpetuate both the abuse and what is being signified by the act of 'cutting up'. It is argued that this framework for understanding self-injurious behaviours will provide the mental health nurse with an approach to nursing interventions that acknowledges the woman's needs, while at the same time offering the opportunity to signify distress in a manner that does not perpetuate the body's role as an object of abuse.

Child↗
PubMed1995

Clinical and epidemiological features of an outbreak of acinetobacter infection in an intensive therapy unit.

Sporadic examples of infection with multi-resistant Acinetobacter spp. have occurred in Nottingham hospitals since at least 1977, punctuated by more prolonged outbreaks involving larger numbers of patients, particularly those confined to the intensive therapy unit (ITU) with severe underlying disease. In the most recent outbreak, 11 patients were infected with multi-resistant Acinetobacter strains and 26 patients were colonised. Four of the infected patients died directly or indirectly from infection with multi-resistant Acinetobacter spp., either while in the ITU or after discharge to a general ward. The mean interval from admission to the first isolation of a multi-resistant Acinetobacter strain was 6.7 and 12.1 days in the infected and colonised groups, respectively. Multi-resistant Acinetobacter strains were isolated most frequently from the respiratory tract, and eight patients had probable or suspected pneumonia caused by a multi-resistant Acinetobacter sp. All infected patients were treated with imipenem, with or without an aminoglycoside, except one patient who died before a diagnosis of acinetobacter infection was confirmed. Multi-resistant Acinetobacter spp. were isolated from various environmental sites in the ITU, and patient and environmental isolates were found to be related closely by biotyping, antibiograms, pulsed-field gel electrophoresis of chromosomal fingerprints and ribotyping. The outbreak was controlled ultimately by transfer of infected or colonised patients to an isolation cubicle, cohort nursing, emphasis on the importance of hand washing before and after patient contact and when handling case notes, and the use of disposable aprons and gowns during patient contact.(ABSTRACT TRUNCATED AT 250 WORDS)

Acinetobacter↗
PubMed1994

What events precede violent incidents in psychiatric hospitals?

BACKGROUND: The study aimed to identify, classify and measure the relative frequency of events preceding violent incidents in psychiatric hospitals. METHOD: Possible antecedents for 1000 incidents in three associated psychiatric hospitals over 13 months were investigated with an 'untoward incident database'. RESULTS: From eyewitness accounts, 921 incidents (92%) could be related to one of 15 categories of antecedent involving characteristics of the patient, or of the hospital regime, or interactions with other individuals. Overall, the most common antecedents involved patients who were generally agitated or disturbed (286), restrictions on patients associated with the routine hospital regime (192) or provocation by other patients, relatives or visitors (175). Incidents arising from staff members initiating contact with patients were very rare (7). Twenty-one patients were involved in 10 or more incidents, including 19 (90%) who were detained under the Mental Health Act. These patients were more likely to commit assaults after certain antecedents (self-harm, absconding or arson) which were serious incidents in themselves. CONCLUSIONS: Staff training on specific safety issues will be needed under the new Management of Health and Safety at Work Regulations.

Adult↗
PubMed1994

Problem-based learning: a model for graduate transition in nursing.

This article is a discussion paper related to the use of problem-based learning to assist in the professional role socialization that occurs during the transition from student to graduate nurse. Through the use of a preceptorship program which incorporates the principles of problem-based learning this transition can be a positive experience for both the graduate and the health care setting. It encourages the graduate to develop independent problem-solving skills in order to make clinical judgements and develop and evaluate action plans with a client-centred focus. The graduate would be encouraged to critically evaluate and challenge ready-made principles and norms to develop creative approaches to care which are sensitive to the client's physical, psychological, social and spiritual needs. As a model of preceptorship it provides the graduate with the opportunity to explore clinical situations within a framework of critical reflection and problem resolution.

Education, Nursing, Continuing↗
PubMed1993

Effects of anions on the binding of the cAMP receptor protein to the lactose promoter.

The DNA binding affinities of several gene-regulatory proteins, restriction endonucleases and the Escherichia coli RNA polymerase have previously been found to be dependent on the nature of the dominant buffer anion. To discover whether the E. coli cAMP receptor protein (CAP) exhibits a similar dependency, we measured its affinity for its primary lactose promoter binding site (lac site 1) in buffers in which the principal anion was chloride, phosphate, sulfate, acetate, or glutamate. We found that the affinity of CAP for lac site 1 is affected only slightly by changes in the dominant buffer anion. The binding of cAMP is similarly insensitive to buffer anion type, indicating that specific protein-anion interactions, if they occur, must be similar for the free and cAMP-bound forms of the protein. The effect of anion substitution on the ability of acrylamide to quench the intrinsic fluorescence of tryptophanyl residues of CAP is also small, suggesting that changes in buffer anion composition have minimal effect on the conformation of tryptophan-proximal regions of CAP. This conclusion is extended by the finding that anion substitution has a relatively small effect on the urea-concentration dependence of CAP denaturation. Taken together, these results support the notion that neither CAP nor CAP.cAMP nor the CAP.cAMP complex with lac promoter DNA interact selectively with anions present in the surrounding buffer. A possible role for this anion-insensitivity in the in vivo function of CAP is suggested.

Anions↗
PubMed1992

Oral estrogen retains potency as an aversion agent in eggs: implications to studies of community ecology and wildlife management.

The first of two experiments with laboratory rats demonstrated that oral estrogen (17 alpha-ethinylestradiol) can remain in the albumen of eggs at room temperature for up to 8 days with undiminished capacity to produce conditioned taste aversion. The second experiment showed that estrogen remains potent in the yolk of eggs for at least 4 days. There is now greater assurance that egg prey placed into the field will induce reliable CTA among mammalian predators. Community ecologists interested in such processes as competitive release and the responses of prey populations to reduced predation upon their eggs can selectively factor predation out of field experiments without the need for physically excluding predators. Wildlife biologists interested in reducing predation upon the eggs of endangered species now have greater assurance that estrogen-treated egg baits will suppress predation in a more cost-effective manner and with less likelihood of discrimination between treated eggs and those of endangered species.

Animals↗
PubMed1990

Outcome of stroke related admissions to a general hospital.

In a prospective study of patients admitted to a general hospital, 43 patients with stroke were identified accounting for 3.9% of all medical admissions over a six month period. Of these, 23.2% died in hospital, whilst 46.5% were discharged to the community, and 30.3% to institutional care after a mean length of stay in hospital of 24.5 and 34 days respectively. At follow-up seven months following discharge, most patients were alive and still residing in the community or institution to which they had been discharged. The majority of survivors (57%) however, were severely handicapped, 37% of whom were resident with carers in the community. Our study emphasises the overly long stay of stroke patients in the acute hospital, and the high morbidity in survivors with consequent demand on institutional and community care services.

Aged↗
PubMed1985

The size and strength of the quadriceps muscles of old and young men.

The mean isometric strength of the stronger quadriceps muscles of 12 healthy men in their seventies was 39% less than that of 12 healthy men in their twenties (P less than 0.001). The cross-sectional area of the quadriceps was measured at mid-thigh, by ultrasound scanning; the older men's stronger quadriceps were 25% smaller (P less than 0.001). The ratio of the stronger quadriceps' strength to its cross-sectional area was very similar in the old men to values obtained previously for both old and young women, but averaged 19% less than in the young men (P less than 0.02). Quadriceps size and strength were correlated in the old men (r = 0.77, P = 0.03) but not in the young men (r = 0.15). The principal axis of the relationship between quadriceps size and strength in the old men was very similar to those previously reported for both old and young women. The quadriceps strength of some young men is greater than would be expected from the size of the muscle.

Adult↗
PubMed1984

Size and strength of the quadriceps muscles of old and young women.

Muscle weakness and wasting may be evaluated objectively by dynamometry and compound ultrasound imaging. We have measured the voluntary isometric strength of the quadriceps muscles of healthy women in their 70s (n = 25) and in their 20s (n = 25) and have compared it with the mid-thigh cross-sectional area of the same muscles. The two groups of women showed similar variability when strength was measured on consecutive days (coefficients of variation: 8%). The older women were 35% weaker than the young women (P less than 0.001) and their quadriceps cross-sectional area was 33% less (P less than 0.001). Quadriceps strength and cross-sectional area were correlated (r = 0.66, P less than 0.001, elderly; r = 0.53, P less than 0.01, young) and the principal axis of the relationship was closely similar for the two groups of women. There is therefore no difference in the intrinsic strength of the quadriceps muscles of healthy women in their third and eighth decades. This report also provides normative data for the objective evaluation of quadriceps weakness and/or wasting in female patients. The techniques involved are straightforward, the dynamometer is easily made, and compound ultrasound imaging is widely available.

Adult↗