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Biomedical subjects

M Grant

Publications and source records attributed to M Grant.

At least 19 recordsLinked to original sources
PubMed1995

Survey of the provision of supportive care services at National Cancer Institute-designated cancer centers.

PURPOSE: The purpose of this survey was to determine the scope of supportive care services (SCS) designed to promote quality of life during cancer therapies at National Cancer Institute (NCI)-designated cancer centers. METHODS: A survey was mailed to the medical directors and nursing directors of 52 NCI-designated comprehensive (n = 26), clinical (n = 11), and planning cancer centers (n = 15) in the United States. Only one survey was completed from each institution. Survey questions identified services provided such as pain management, terminal care, psychosocial programs, and spiritual care. RESULTS: Thirty-nine questionnaires were received for a total response rate of 75%. Of the respondents, 45% were comprehensive cancer centers, 24% clinical cancer centers, and 29% planning centers. One center did not identify their NCI designation. Sixty-one percent of the centers reported research programs in supportive care. Outside funding was reported in 51% of the respondents, with 39% having American Cancer Society (ACS) or National Institutes of Health (NIH) funding and 28% having private industry funding. Overall SCS self-ratings improved from a 21% rating of excellent to very good 5 years ago to the current 54% rating. CONCLUSION: Survey results provide data on SCS across a representative sample of NCI cancer centers and can be used to develop standards for future cancer control programs.

Cancer Care Facilities↗
PubMed1995

An institutional commitment to pain management.

PURPOSE: To share the development, implementation, and evaluation of a program called "An Institutional Commitment to Pain Management," which is based on the philosophy of organizational influence on pain management. METHODS: A tested pain education model was disseminated to 32 physician/nurse teams in settings throughout California, after which the 64 professionals returned to their institutions to serve as role models and catalysts to change the practice of pain management. Each team member completed a 39-item survey about knowledge and attitudes related to pain, which was developed by B.R.F. and colleagues, and also identified three goals for the implementation of course information. Precourse data also included administration of the knowledge and attitudes survey to participating physicians' and nurses' colleagues (10 physicians and 20 nurses per institution). Each team completed five chart audits using the pain audit tool (PAT), which was developed by B.R.F. and colleagues at the City of Hope National Medical Center. The PAT identifies how pain is managed currently at the institutional level. Final course evaluation 8 months after course completion included a summary of activities implemented by the teams as well as the factors that served as barriers and benefits to improve the quality of pain management. RESULTS: Two hundred seventy-two physicians and 629 nurses completed the survey about knowledge and attitudes related to pain, and 154 PATs were submitted. These results, as well as evaluation at the completion of the course, are discussed. CONCLUSION: The Institutional Commitment to Pain Management program is an evolving model that was developed to overcome barriers to pain relief by obtaining the commitment from institutions to improve the management of pain for their patients.

Adult↗
PubMed1995

Unscheduled readmissions for uncontrolled symptoms. A health care challenge for nurses.

The purpose of this study was to measure the impact of nursing strategies to improve cancer pain management on hospital readmission for uncontrolled pain. Strategies include implementing a pain resource nurse program (PRN), making pain management a focus in the continuous quality improvement process of the institution and creating a supportive care service. Admissions were compared before and after implementation of the strategies. Results for 1989 to 1990 revealed 5772 total admission with 4.4% (255) admissions for uncontrolled pain; results for 1992 to 1993 revealed 4066 total admissions with 3.0% (121) admissions for uncontrolled pain. Findings indicate that strategies were effective in reducing the number of readmissions for uncontrolled pain.

Adolescent↗
PubMed1995

Not a business matter.

Some Canadians believe that turning Canada's public health care system into a privately based operation is the panacea for the health care debt. The Alberta government is at the forefront of this movement toward a privately managed, business-oriented health system.

Alberta↗
PubMed1995

Nurses' perceptions of the meaning of quality of life for bone marrow transplant survivors.

Nurses play an integral role in the care of bone marrow transplant (BMT) patients from pre-transplant to posttransplant. The purpose of this study was to explore the nurses' perceptions of the impact of transplant on the quality of life (QOL) of survivors. The conceptual framework for the study was the model of QOL developed by Ferrell, Grant, Schmidt, Rhiner, Whitehead, and Forman (1992). It depicts the QOL domains of physical well-being, psychological well-being, social concerns, and spiritual well-being. One hundred fifty nurses responded to a mailed survey. The items were based on the Quality of Life-BMT Survey used previously with patients. Nurses' and patients' responses to the same item were compared. Results reflect that transplant nurses generally perceived patients as having a poorer QOL than they actually reported. Nurses described transplant as having both positive and negative consequences. Transplant was seen as providing patients with a second chance at life and an opportunity to increase their QOL. Nurses described negative consequences as resulting from physical losses, psychological distress, financial distress, and loss of relationships. The findings of the study have implications for training future transplant nurses and for improving nursing care for transplant patients.

Adult↗
PubMed1993

Polymerase chain reaction for the detection of methylation of a specific CpG site in the G6pd gene of mouse embryos.

This chapter describes the polymerase chain reaction (PCR) detection of methylation changes at specific CpG sites in DNA isolated from minute quantities of biological material, such as single preimplantation mouse embryos or small numbers of stem cells, or germ cells. We have concentrated on refining these techniques to monitor specific sites in X-linked genes for methylation changes associated with X-chromosome inactivation. The general principles of the HpaII-sensitive PCR assay described here should be applicable and adaptable to specific CpG sites in other genes of interest.

Animals↗
PubMed1993

The pain resource nurse training program: a unique approach to pain management.

Adequate pain management is a 24 hr a day responsibility for health-care professionals working with cancer patients. Because nurses spend more time with patients in pain than any other member of the health-care team, they play a central role in pain assessment and pain management. The City of Hope National Medical Center, a clinical cancer center, developed a pain management course for staff nurses entitled "The Pain Resource Nurse (PRN) Training Program." The purpose of this innovative course was to prepare staff nurses to assume an active role in pain management. Twenty-six registered nurses participated in the 40-hr didactic and clinical course. The curriculum included information on pain assessment, pharmacology, nondrug interventions, and cultural, ethical, and psychosocial issues related to pain. After completion of the course, program staff have remained available to the PRNs to provide current information on pain management, and to assist with role implementation and guidance on interfacing with staff. This paper reports on the development, implementation, and 3-mo evaluation of this unique program.

Education↗
PubMed1993

The structure and correlates of alcohol dependence: WHO collaborative project on the early detection of persons with harmful alcohol consumption--III.

The cross-cultural validity of the Alcohol Dependence Syndrome was tested on 13 symptoms of alcohol dependence which were assessed as part of a WHO collaborative study of the early detection of harmful drinking. The subjects were drinking patients in health care settings in Australia, Bulgaria, Kenya, Mexico, Norway, and the US. Principal Components Analyses were performed on the symptoms in each centre, and the degree of agreement between the results was assessed by calculating coefficients of congruence between the item loadings on the first principal component. In all six centres the first Principal Component accounted for at least half of the total variance and all symptoms had positive loadings greater than 0.40 on the first Principal Component. The coefficients of congruence were all 0.98 or more, and the 13 symptoms had internal consistency coefficients of 0.94 or more. An alcohol dependence score defined by the sum of positive responses to the 13 alcohol dependence symptoms was positively correlated with self-reported alcohol consumption, alcohol-related problems, serum gamma glutamyltransferase and a clinical examination assessment of alcoholism in all six samples.

Adolescent↗
PubMed1993

Women's health beliefs regarding hypertension.

Two hundred and forty female clients attending primary health care centers in Montego Bay and the Kingston Metropolitan Area were interviewed to obtain information about their beliefs with regard to hypertension. This study revealed that the variables-perceived susceptibility, perceived severity and 'cue to action'-identified in the Health Belief Model need to be strengthened if patient compliance and adoption of health-promoting behaviours are to be realized. This study also pointed out the pressing need for health care providers to enhance health promotion programmes relative to hypertension. These programmes should be aimed at increasing clients' knowledge base and self-care abilities in order to to help prevent and/or control this disorder.

Adult↗
PubMed1992

Measurement of quality of life in bone marrow transplantation survivors.

This study was designed to assess the reliability and validity of a Quality of Life (QOL) instrument on a sample of 179 allogeneic Bone Marrow Transplant (BMT) survivors. The QOL-BMT tool was developed specifically for this population and was based on the investigators' prior research and a conceptual model of Quality of Life. Patients who were at least 100 days post BMT completed the 30 item visual analogue questionnaire. The instrument measured physical symptoms (e.g., weight loss, frequent colds, skin changes, cataracts, sexual problems), psychological symptoms (e.g., worry about recurrence, adjustment to illness), social concerns (e.g., relationship adjustment, return to work), and spiritual well-being (e.g., sense of control, future goals). Psychometric analysis of the instrument included measures of reliability and validity. The study findings demonstrate the unique aspects of QOL dimensions in BMT survivors and the value of QOL assessment in clinical practice and research.

Adaptation, Psychological↗
PubMed1992

Studies on the immediate and delayed leucocytosis elicited by brief (30-min) strenuous exercise.

Eight healthy male volunteers exercised for two 30-min sessions starting 3 h apart on an electronically braked cycle ergometer at a work load (mean 155.9 W, SD 33.4 W) which required an oxygen consumption that was 70% of their maximal rate of oxygen uptake. Venous blood samples were taken through an indwelling cannula over a period of 6 h beginning shortly before the first bout of exercise and were analysed for routine haematological parameters and for lactate, noradrenaline, adrenaline and cortisol. Both bouts of exercise induced an immediate leucocytosis due to rises in lymphocytes and neutrophils but only the first exercise bout induced a substantial delayed neutrophilia. In at least five subjects, changes in lymphocyte and platelet numbers were correlated (Spearman's rank procedure, P less than 0.05) with simultaneous changes in the plasma concentrations of lactate, noradrenaline and adrenaline over the 6-h period studied. Increases in the plasma concentration of cortisol due to exercise correlated positively with the percentage changes in neutrophil numbers at 3 h and 6 h. These results are consistent with the suggestion that the immediate and delayed leucocytosis induced by exercise are mediated respectively by catecholamine and by cortisol.

Adult↗
PubMed1992

Tolerance to the effects of ethanol on the speed and success of reaction time responding in the rat: effects of age and intoxicated practice.

An animal model of human reaction time (RT) was used to investigate the effects of age and intoxicated practice on the development of tolerance to the motor impairing effects of ethanol (EtOH). Young (8-9 month) and old (24-26 month) Fischer 344 rats were trained to release a lever in response to an auditory and visual stimulus in order to avoid mild footshock. The animals were divided into groups to receive either intoxicated (EtOH-before) or unintoxicated (EtOH-after) RT testing. Successful avoidance and response latencies were impaired in young and old rats after the initial exposure to EtOH (EtOH-before group). Tolerance developed to EtOH's effects on successful avoidance and on response latencies whether or not the rats received intoxicated RT practice; however, intoxicated practice facilitated tolerance development to EtOH's effects on successful avoidance but not on response latencies. While the initial sensitivity and the level of tolerance that developed to EtOH's effects were similar in young and old rats, the old rats were generally more sensitive to EtOH and developed tolerance at a slower rate. These results suggest that tolerance develops to the effects of EtOH on RT and that intoxicated practice can have different effects on the parameters of the behavioral response.

Aging↗
PubMed1992

In vitro formation and expansion of cysts derived from human renal cortex epithelial cells.

Acquired renal cysts derive from terminally differentiated tubular epithelium in adults as a consequence of increased epithelial cell proliferation, fluid accumulation and extracellular matrix remodelling. To understand better how human epithelial cysts may be initiated and progressively expand, cells from primary cultures of normal human adult renal cortex were dispersed in polymerized type I collagen. The transparent matrix permitted repeated observation by light microscopy of cyst formation from individual renal cells. The cyst cells reacted strongly with distal nephron histochemical markers (cytokeratin antibodies AE1/AE3, epithelial membrane antigen, and Arachis hypogaea lectin) but inconsistently or not at all to markers of proximal tubules (Tetragonolobus purpureas lectin and Phaseolus vulgaris erthroagglutinin lectin). The number of spherical, fluid-filled epithelial cysts that developed in a standardized microscope field quantified cyst initiation. Cyst progression was determined from the increase in the diameter (surface area) of cysts and represents a hyperplastic event. EGF or TGF alpha, were required in serum-free defined medium to cause cysts to develop from individual epithelial cells dispersed in the matrix; insulin was required as a co-factor. The EC50 for EGF was approximately 0.1 ng/ml, and for insulin 1 microgram/ml. Early cultures of normal cortex formed cysts more efficiently when dispersed in collagen matrix than cells passaged several times before suspension in the gel. Agonists of adenylate cyclase (PGE1, AVP, VIP, PTH, forskolin, cholera toxin), methylisobutylxanthine, and 8-Br-cAMP, though incapable of causing cyst formation alone in defined medium, enhanced cyst initiation and progression in the presence of EGF and insulin. Angiotensin II, TNF alpha, beta-estradiol, and pertussis toxin had no effect in the absence or presence of EGF and insulin. Pertussis toxin inhibited cyst initiation and expansion caused by EGF and forskolin but potentiated cyst initiation and expansion caused by EGF and PGE1. Cyst formation and expansion were inhibited by TGF beta 1 and 2-chloroadenosine. Polarized monolayers of human renal cortical cells grown on permeable membranes were used to independently quantify the effects of agonists on the net secretion of solute and water from the basolateral to the apical surface of the cells. PGE1, forskolin, and 8-Br-cAMP stimulated net fluid secretion that was sustained for several days; EGF enhanced forskolin-stimulated fluid secretion. We conclude that the formation and expansion of in vitro cysts derived from solitary human cortex cells depends on the coordinated interplay between cellular proliferation and fluid secretion.(ABSTRACT TRUNCATED AT 400 WORDS)

Body Fluids↗
PubMed1992

Methylation of CpG sites of two X-linked genes coincides with X-inactivation in the female mouse embryo but not in the germ line.

To further our understanding of initiation and imprinting of X-chromosome inactivation, we have examined methylation of specific CpG sites of X-linked Pgk-1 and G6pd genes throughout female mouse development. Methylation occurs around the time of inactivation and earlier for Pgk-1, which is closer to the X-inactivation centre. In female primordial germ cells, the inactive X chromosome escapes methylation; this may underly the reversibility of inactivation at meiosis. Similarly, the genes are unmethylated on the inactive X chromosome in sperm; hence, the imprint specifying preferential X-inactivation in extra-embryonic tissues must reside elsewhere.

Animals↗