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Biomedical subjects

M Munro

Publications and source records attributed to M Munro.

At least 19 recordsLinked to original sources
PubMed2001

Antenatal counselling, resuscitation practices and attitudes among Australian neonatologists towards life support in extreme prematurity.

A questionnaire survey of Australian neonatologists was conducted to ascertain their antenatal counselling and resuscitation practices, and attitudes towards life support in the extremely preterm infant. This study showed that in antenatal parental counselling, whether a paediatrician was given the opportunity to participate depends on the gestation at the time of the threatened preterm delivery The counselling employed almost invariably covered mortality and morbidity. The obstetrician's opinion was considered to be of utmost importance. Both financial and moral obligations were found to be of little importance in counselling and resuscitation. Only one-third of institutions had guidelines for limiting resuscitation. The onus remained on the neonatologists concerning which infant to resuscitate, and the level of the resuscitation to be conducted. In Australia, resuscitation at birth was restricted to infants of 23 weeks' gestation or above, and neonatologists did not believe the legal system has a role to play in limiting or mandating resuscitation of extremely preterm infants. Neither were they concerned with the threat of litigation when they decide to limit resuscitation. The majority of neonatologists agreed with their institution's approach to life support in extremely preterm infants. One grey area was the question of withholding assisted feeding in an infant for which the decision to withdraw life support has been made. Australia lacked a current consensus policy on selective non-treatment. The establishment of national guidelines would be helpful to aid Australian obstetricians and neonatologists in their clinical practice.

Adult↗
PubMed2001

Hemoprotozoa of freshwater turtles in Queensland.

Blood smears from 27 turtles (15 Emydura signata, nine Elseya latisternum, and three Chelodina longicollis) from southeastern Queensland (Australia) were examined for infections by hemoprotozoan parasites between January and June 1999. Infections were found in 26 (96%) of the turtles. Twenty five (93%) were infected with the adeleorin coccidian Haemogregarina clelandi, eight (30%) with the hemosporidian Haemoproteus chelodinae, 11 (41%) with the kinetoplastid flagellate Trypanosoma chelodinae, and eight (30%) with a novel Trypanosoma sp. Despite the high prevalence and intensity of infections, there was no evidence of clinical disease in any of the turtles.

Animal Diseases↗
PubMed2000

The Prince Edward Island Conceptual Model for Nursing: a nursing perspective of primary health care.

The philosophy of primary health care (PHC) recognizes that health is a product of individual, social, economic, and political factors and that people have a right and a duty, individually and collectively, to participate in the course of their own health. The majority of nursing models cast the client in a dependent role and do not conceptualize health in a social, economic, and political context. The Prince Edward Island Conceptual Model for Nursing is congruent with the international move towards PHC. It guides the nurse in practising in the social and political environment in which nursing and health care take place. This model features a nurse/client partnership, the goal being to encourage clients to act on their own behalf. The conceptualization of the environment as the collective influence of the determinants of health gives both nurse and client a prominent position in the sociopolitical arena of health and health care.

Family Nursing↗
PubMed1999

Risk and the welfare state.

The British welfare state developed as a state-centred response to the problem of handling the risks encountered in a typical life-course. The influential work of Giddens and others implies that the traditional welfare state is under attack from two directions: a changing international politico-economic environment limits the freedom of national governments to pursue independent policies involving relatively high taxation to finance social spending. At the same time, changes in the experience of risk and declining confidence in the expertise of welfare state planners and professionals undermine support for state-centred solutions. This approach fails to acknowledge that available non-state services are often inadequate to meet many everyday life risks and that the authority of private sector advisers, insurers and professionals is also increasingly open to question. This article discusses whether people reject welfare state solutions to problems of risk in the context of research on the perceptions and behaviour of people buying or selling their homes, considering provision for long-term care needs and defrauding social security carried out by the ESRC's Economic Beliefs and Behaviour programme. Individual responses endorse the continued provision of state welfare in order to meet unprovided risks alongside disenchantment with the record of both state and private professionals and planners and awareness that state retrenchment requires greater individual responsibility for meeting one's own needs. The theory of risk society requires development to recognize that citizens are not necessarily alienated from state welfare.

Attitude to Health↗
PubMed1997

Successful implementation of process review in ophthalmology services.

Explains that considerable recent publicity has been given to the claim that around 70 per cent of business process re-engineering exercises are unsuccessful, mainly because of failure to take human factors into account. Outlines the work undertaken in a single specialist surgical service, within an acute services National Health Service Trust, and the outcomes achieved. Suggests that there are points arising from the project to be learned both by the Trust and by other health-care employers contemplating similar exercises: in particular, deciding objectives; the preparation undertaken prior to the project; and detailed post-implementation benefit analysis.

Hospital Restructuring↗
PubMed1995

Arbuscular mycorrhizal induced changes to plant growth and root system morphology in Prunus cerasifera.

We compared root system morphogenesis of micropropogated transplants of Prunus cerasifera L. inoculated with either of the arbuscular mycorrhizal (AM) fungi Glomus mosseae or Glomus intraradices or with the ericoid mycorrhizal species Hymenoscyphus ericae. All plants were grown in sand culture, irrigated with a nutrient solution that included a soluble source of phosphorus, for 75 days after transplanting. Arbuscular mycorrhizal colonization increased both the survival and growth (by over 100%) of transplants compared with either uninoculated controls or transplants inoculated with H. ericae. Arbuscular mycorrhizal colonization increased root, stem and leaf weights, leaf area, root length and specific leaf area, and it decreased root length/leaf area ratio, root/shoot weight ratio and specific root length. Both uptake of phosphorus and its concentration in leaves were increased by AM infection, although the time course of the relationships between intensity of AM infection and P nutrition were complex and suggested a role for factors other than nutrition. The time course for the development of infection varied. It was most rapid with G. mosseae, but it was ultimately higher with G. intraradices. None of the treatments significantly affected the lengths of adventitious roots or the first-, second- or third-order laterals that developed from them. Arbuscular mycorrhizal colonization increased the intensity of branching in all root orders with the effect being most obvious on first-order lateral roots where the number of branches increased from under 100 to over 300 brances m(-1). As a result, although first-order laterals made up 55% of the root systems of control plants, the comparable value was 36% in AM-infected plants. In contrast, second-order laterals represented 25% of control root systems, but 50% of AM-colonized root systems. Glomus intraradices but not G. mosseae increased root diameter. Anatomical studies revealed no changes in the overall form of the root tip, although there were changes in the diameter of the root cap, cell numbers and cell size. Hymenoscyphus ericae increased the duration of the metaphase index. Both AM fungal treatments increased the concentrations of soluble proteins in root extracts and modified the protein profiles by the elimination and addition of protein bands detected by PAGE analysis. We conclude that AM fungal inoculation influenced processes in the root system at different levels, but not all effects were due to improved P nutrition or increased physiological age.

Journal Article↗
PubMed1994

Incisional Hernia Following Laparoscopy: A Survey of the American Association of Gynecologic Laparoscopists

In order to estimate the risk factors and incidence of post-laparoscopy incisional hernias a one-page questionnaire was sent to all individuals on a mailing list purchased from the AAGL. Adequately completed responses were entered into a computer-based data bank for analysis. Of the 11,500 surveys mailed, 3293 were returned of which 3217 (28%) were evaluable. A total of 933 hernias were reported from an estimated 4,385,000 laparoscopic procedures (21 per 100,000). Of these, 167 (17.9%) were reported to have occurred despite fascial closure. Symptoms or hernia-related morbidity occurred in 648 cases (69.5%), with 157 instances (16.8%) of direct involvement of the large or small intestine. Six hundred sixty-five patients (71.3%) underwent subsequent surgical repair. Of the 840 hernias in which the size of the initial fascial defect was noted, 725 (86.3%) occurred in sites where 10 mm or greater ports had been placed. Respondents reported hernia location in 152 cases with the umbilical locale being the most common (75.7%). Lateral hernias comprised 23.7% of these cases and the suprapubic site was involved only once. In conclusion, post-laparoscopy incisional hernias are uncommon, but far from rare. They are most likely to occur when large ports are used and at the umbilical site. Closure as currently practiced is not completely protective. Further methods and/or devices must be developed so as to minimize the risk of hernia formation.

Journal Article↗
PubMed1990

Ambiguities and contradictions in the provision of sheltered housing for older people.

This paper examines the current model of sheltered housing and explores a central contradiction in that model: namely that if only those people who most need and appreciate the unique features of sheltered housing were allocated places in schemes, the existing model ultimately could not provide sufficient support. This central contradiction leads to a fundamental lack of clarity in the role of sheltered housing. This is reflected in the ambiguities apparent in allocation practices, where judgements are typically made not only in relation to the tenants' needs and demands but also in relation to the impact on schemes. Evidence is presented from a recent study of sheltered and amenity housing in Scotland, which exposes these issues and suggestions are made as to how the traditional model of sheltered housing can be made more flexible and more suited to those who need and value it most.

Activities of Daily Living↗
PubMed1983

The hunt.

Explore the source record for details and available documents.

Career Choice↗
PubMed1980

Intestinal bypass for morbid obesity: a consecutive personal series.

Forty-five patients who underwent end-to-side jejunoileal bypass, with 51 cm in circuit, were followed up from 8 months to 8 years (average 3.4 years). There was no early or late mortality but morbidity was considerable; it included inadequate weight loss or late gain in 22%, malnutrition and liver failure in 11%, severe diarrhea and electrolyte imbalance in 11%. Cholelithiasis and wound complications also occurred. Reanastomosis was necessary in 13% (six patients). The result of the bypass was good in only 20%, satisfactory in 44% and unsatisfactory in 36%. This type of bypass is not adequate treatment for morbid obesity because the proportion of unsatisfactory results (36%) is too high and the number of good results too low and because the outcome is unpredictable. The complication of malnutrition characterized by a decline in body cell mass, an expansion of the extracellular mass and an increase in the ratio of total exchangeable sodium to total exchangeable potassium is quickly and effectively treated by intravenous administration of amino acids or protein hydrolysates. Long-term management of protein malnutrition requires a high protein diet (100 g/d) or reanastomosis.

Adult↗