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M J Clark

Publications and source records attributed to M J Clark.

95 records · Page 6Linked to original sources
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The effects of community health nurse monitoring on hypertension identification and control.

Identification and control of hypertension are important public health concerns. Lack of regular health care makes diagnosis and control difficult in some populations. Community health nursing services in settings where clients regularly congregate promote identification and control of hypertension. This study focused on the effects of community health nursing screening and monitoring services for hypertension provided to participants in a breadline, a senior nutrition program, an English as Second Language (ESL) class, and employees providing these services. Community health nurses (CHNs) provided 2,407 blood pressure-related service encounters. Blood pressures were elevated in 19% of encounters, and 10% of clients had elevations that warranted referral for medical assistance. At the end of the 18-month study period, 67% of all clients with elevations and 71% of those referred for medical assistance had achieved normal blood pressures. One-way analysis of variance indicated a significant relationship between the number of encounters with the nurses and a positive outcome for all clients with elevations. This relationship was not supported for those clients referred to medical assistance. The effectiveness of intervention appeared to vary somewhat among subgroups with some groups more likely than others to achieve a positive outcome. Group differences in outcome were not statistically significant.

Adult↗
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Predictors of demand for emergency prehospital care: an Australian study.

INTRODUCTION: Determining the predictors of demand for emergency prehospital care can assist ambulance services in undertaking policy and planning activities. HYPOTHESIS: Demand for prehospital care can be explained by demographic, health status, and economic determinants. METHODS: The study used a cross-sectional design to investigate the association of demographic, health status, and insurance factors with the use of prehospital, ambulance care. Core data items including age, gender, marital status, country of origin, triage score, diagnosis, time of presentation, method of arrival, and patient disposition were collected for every patient who presented at the Emergency Department of the study hospital over a four-month period. Ambulance usage was analysed using Poisson regression. RESULTS: For the 10,229 patients surveyed, only a small number were triaged as having the highest level of urgent medical need (0.8%), but the majority of these used prehospital emergency medical care (90.2%). Predictors of ambulance use included age > 65 years (Prevalence Ratio [PR] = 2.92; 95% confidence interval [CI]: 2.35-3.63), being married or in a de-facto relationship (PR = 0.69; 95% CI: 0.60-0.79) or divorced, separated, or widowed (PR = 0.83; 95% CI: 0.70-0.98), triage score level 1 or 2 (PR = 1.95; 95% CI: 1.68-2.28), or triage score level 3 (PR = 1.54; 95% CI: 1.38-1.72), diagnosis involving either mental (PR = 4.29; 95% CI: 1.84-10.01), nervous (PR = 2.74; 95% CI: 1.19-6.31) or trauma (PR = 2.33; 95% CI: 1.03-5.27) conditions, and insurance status (PR = 1.54; 95% CI: 1.40-1.71). Ethnicity, gender, and time of day were not associated with usage. CONCLUSION: Demand for ambulance services can be predicted by a number of demographic, medical status, and insurance variables. Age and triage levels are key influences on demand for ambulance services. Ambulance insurance status provides an economic incentive to use ambulance services regardless of the urgency of the medical condition.

Adolescent↗
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Inhibition of the metabolism of urethane in the mouse by dimethyl sulfoxide (DMSO).

Previous studies from this laboratory have shown that alcohols inhibit the localization of nitrosonornicotine and urethane in tissues of the mouse. Subsequent studies demonstrated that this inhibition of the localization of urethane was apparently due to an almost total inhibition of the metabolism of that compound by ethanol. We now report that dimethyl sulfoxide (DMSO) also almost completely inhibits the localization of urethane metabolites in tissues of the mouse and maintains a high concentration of urethane in blood. Since metabolism is essentially the only route of elimination of urethane in the mouse, this indicates that DMSO inhibits the metabolism of urethane. These studies lend further support to the suggestion that urethane is metabolized by either an alcohol dehydrogenase, an aldehyde dehydrogenase, or an alcohol-preferring isozyme of cytochrome P-450. These results indicate that studies on the metabolism as well as the carcinogenic activity of urethane (and possibly other chemicals) also may be affected by concurrent administration of DMSO.

Animals↗
PubMedDate not supplied

Therapeutic touch: is there a scientific basis for the practice?

The research-related literature on the topic of therapeutic touch is critically reviewed. The purpose of the review is to explore the current scientific basis for the teaching and practice of therapeutic touch as a treatment modality. An examination of published research literature indicates that empirical support for the practice of therapeutic touch is, at best, weak. The results of well-designed, double-blind studies have been transient, of no significance, or are in need of independent replication. Current practice of therapeutic touch is empirically little more than practice of placebo. Considerations for further nursing research are also presented.

Animals↗