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Biomedical subjects

M D Harris

Publications and source records attributed to M D Harris.

At least 37 records · Page 2Linked to original sources
PubMed1998

Activation of p21ras/MAPK signal transduction molecules decreases with age in mitogen-stimulated T cells from rats.

Signal transduction is ubiquitously involved in the initiation of physiological signals that lead to growth and proliferation of cells. The signaling cascade mediated by the mitogen-activated protein kinase (MAPK) is considered essential for T cell growth and function. Therefore, it was of interest to determine the influence of age on the induction of MAPK in mitogen-activated T cells. T cells from young (4-6 months) and old (24-26 months) rats responded to concanavalin A (Con A) stimulation by increasing MAPK, c-jun amino terminal kinase (JNK), and p21ras activities. The time course of induction of MAPK/JNK and p21ras activities was similar in T cells isolated from young and old rats. The induction of JNK activity did not change significantly with age; however, the induction of MAPK and p21ras activities was significantly less (50 to 65%) in T cells from old rats than in T cells from young rats. Although the relative protein levels of p42 and p44 MAPK did not change with age, the proportion of the phosphorylated p44 MAPK decreased with age. In addition, it was found that the in vitro kinase activities of the T cell receptor-associated protein tyrosine kinase Lck (p56Lck) and ZAP-70 but not Fyn (p59Fyn) were lower in T cells from old rats than in T cells from young rats. The decline in activities of these signaling molecules with age was not associated with changes in their corresponding protein levels. Thus, our results demonstrate that aging alters the activation of the signal transduction cascade that leads to T cell activation.

Aging↗
PubMed1998

The physical therapist as a member of the home healthcare team: caring for patients with replacements.

The projected life of a total knee and total hip replacement today is approximately 15 years. Orthopedic surgeons are therefore very cautious to replace joints in patients who are young, believing that if patients receive joint replacements in their mild or early 60s, there is a good possibility they may outlive the replacement and thereby require a revision. One role of physical therapy with the postoperative replacement patient is education of the patient in precautions that should be observed and guidelines to be followed for general activities. This is very valuable information that should be shared with the patient before surgery and reinforced afterward. In the changing healthcare environment of the 1990s, home healthcare professionals are being challenged to provide effective, skilled care that is the most cost effective and appropriate for patients. It is important that all professional home healthcare personnel work as a team to accomplish these goals. The PT is an important member of this team. After an acute illness or injury, or throughout the course of a chronic illness, there are numerous times when home healthcare patients will benefit from skilled PT services. Home healthcare nurses are in a unique position to recognize the need to work with the patient's physician for referral to other members of the healthcare team.

Arthroplasty, Replacement, Hip↗
PubMed1998

Volunteers as members of the home healthcare and hospice teams.

A volunteer program has multiple advantages to the patients, their families, their nurses, the hospice, and the volunteers themselves (Harris, 1990). Home care volunteerism make good sense. If properly administered, it is cost-efficient and delivers a quality of care that can be acquired in no other way (Sodano, 1997;764). Given the many changes that continue to take place in home healthcare and hospice regulations and financing, volunteers are a vital component of both programs so that patients and families continue to receive high-quality care. Volunteers are important members of the home healthcare and hospice teams.

Community Health Nursing↗
PubMed1998

The impact of the Balanced Budget Act of 1997 on home healthcare agencies and nurses.

"Medicare home health agencies are facing a regulatory purgatory as measures to reduce home health spending by about $16 billion over five years take effect with little government guidance. Home health providers are grappling with new surety bond requirements, the banning of venipuncture as a qualifying procedure for other home health services, and an interim payment system to scale back reimbursement levels before a prospective payment system takes effect in fiscal year 2000" (Cassil, 1998). The challenges of surviving and conquering all of the current issues facing home healthcare nurses and agencies seem overwhelming. All of these legislative and regulatory issues with the resulting financial and clinical implications are occurring as agency staff and administrators continue to provide quality home healthcare services to patients of all ages. Please share your strategies for meeting the challenges of 1998 with the editor.

Community Health Nursing↗
PubMed1998

Home healthcare nurses as leaders.

There has never been a more important time for home care nurses to be involved in the profession and in their local, state, and national communities. The opportunities for home healthcare nurses to serve as role models and leaders in the lay and professional communities are unlimited. This article discusses the importance of providing this leadership and gives examples nurses can follow to become more involved.

Community Health Nursing↗
PubMed1998

The chaplain as a member of the hospice team.

Hospice care is dedicated to the alleviation of pain. It is imperative for the interdisciplinary team to determine the presence of spiritual and/or religious pain in order to create a plan of care that will provide the necessary resources to meet patients' needs. Spiritual and/or religious wholeness or pain is a highly personal concept and concrete measurements are almost impossible to determine with consistent accuracy. However, it is important to include these assessments as part of the total patient assessment (Abington Memorial Hospital Home Care Hospice Manuual, 1998). The concept of spiritual care is an important for patients who receive home healthcare services as well as care through the hospice benefit. When possible, the valuable resources and expertise of a chaplain or faith community leader should be available to all patients. This may be possible through a referral process within the home care and hospice programs, or services may be available through a local ministerium association, contract, volunteer arrangement, pastoral care department of a local hospital, or by working with students from local religious educational facilities. A total patient assessment that includes the spiritual and religious needs and addresses all identified needs will enable patients and their families to meet their goals, even if the patient remains physically ill.

Community Health Nursing↗
PubMed1998

Medical reference databases used by Army primary care physicians in field environments.

A cross-sectional survey of U.S. Army primary care physicians was done to answer two questions: (1) which medical reference materials are Army primary care physicians currently using when deployed to a field environment? and (2) what would they like to have for medical reference in a field environment? Of 740 surveys delivered to their intended recipients, 445 (60%) were returned. Currently, 96% of primary care physicians use books, 37% use journals, and 11% use computer software in their medical reference database. Of those now using books, 72% were satisfied with them, compared with 61% of those using journals and 45% of those using software. The most common book used was the Merck Manual. The most important characteristics desired in a field medical database were broad coverage, ease of use, and light weight. The majority of respondents believe that a good medial reference database is important but that current medical databases limit the quality of the medicine they practice in the field.

Attitude of Health Personnel↗
PubMed1998

The physician as a member of the home healthcare team.

The physician is a vital member of the home healthcare team. Based on the Medicare legislation and regulations. The physician's participation is required for patient care and agency reimbursement. The home health care nurse is the important link between the patient and the physician. The compliance with, and sharing of, information related to the clinical, administrative, legislative and regulatory aspects of care benefits the patient, family, physician, nurse and the home health agency.

Community Health Nursing↗
PubMed1997

The increase in the induction of IL-2 expression with caloric restriction is correlated to changes in the transcription factor NFAT.

The objective of this study was to determine if the increase in the induction of interleukin-2 (IL-2) expression with caloric restriction correlates with changes in binding activity of the IL-2-specific transcription factor NFAT (nuclear factor of activated T cells) and/or the ubiquitous transcription factor AP-1 in T cells from male Fischer 344 rats. Splenic T cells were isolated from young (6-month) and old (24-month) rats fed ad libitum and from old (24-month) rats fed a restricted diet (40% caloric restriction) that began at 6 weeks of age. T cells were stimulated with concanavalin A (Con A) and the expression of IL-2 and the DNA binding activity of the transcription factors NFAT and AP-1 were measured in these cells. We found that the induction of IL-2 activity and mRNA levels decreased with age and that caloric restriction significantly (P < 0.05) reduced the age-related decline in IL-2 expression. The ability of nuclear extracts from T cells isolated from old rats fed ad libitum and restricted old rats to bind to the NFAT oligonucleotide or AP-1 oligonucleotide decreased with age. Caloric restriction significantly (P < 0.05) reduced the age-related decline in NFAT but had no significant effect on AP-1 binding activity. We also measured the induction of c-fos and c-jun expression by Con A in T cells from young and old rats fed ad libitum or caloric-restricted diet. The induction of c-fos protein and mRNA levels but not c-jun protein or mRNA levels decreased significantly with age. Caloric restriction significantly (P < 0.05) reduced the age-related decline in c-fos expression but had no significant effect on c-jun expression. Therefore, the increase in IL-2 expression with caloric restriction correlates with an increase in binding activity of transcription factor NFAT and an increase in the expression of c-fos, which is a component of the NFAT-protein complex.

Aging↗
PubMed1997

How the Federal Register affects your practice.

The Federal Register System is comprised primarily of two major publications, the Federal Register and the annually revised Code of Federal Regulations. These two publications work together to provide an up-to-date version of any agency regulation. To understand the system, one must understand each separate publication and the relationship between the two. Copies of home healthcare-proposed regulations are often made available to members through the National Association for Home Care and state home care associations. Other options include federal depository libraries, reprints of a specific issue for a fee, or a subscription for CD-ROM on a monthly basis.

Facility Regulation and Control↗
PubMed1997

The occupational therapist as a member of the home healthcare team.

In the changing healthcare environment of the 1990s, home healthcare professionals are being challenged to provide successful, cost-effective, and appropriate skilled care for patients. It is important that all professional home healthcare personnel work as a team to accomplish these goals. The OT is an important member of this team. After an acute illness or throughout the course of a chronic illness, there are numerous times when home healthcare patients benefit from skilled OT services. Home healthcare nurses are in a unique position to recognize the need to work with the patient's physician for referral to other members of the healthcare team.

Community Health Nursing↗
PubMed1997

The home health aide as a member of the home healthcare team.

Individuals of all ages are discharged from acute-care facilities with a variety of medical and nursing diagnoses. Many of these individuals require home health aides services in addition to their skilled care. In the changing healthcare environment of the 1990s, home healthcare professionals are being challenged to provide effective, skilled care that is the most cost-effective and appropriate for patients. It is important that all professional home healthcare personnel work as a team with home health aides to accomplish these goals. The home health aide is an important member of the home care team.

Home Care Services↗