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Biomedical subjects

Michael Murphy

Publications and source records attributed to Michael Murphy.

67 records · Page 4Linked to original sources
PubMed2002

Barriers to health care research for children and youth with psychosocial problems.

CONTEXT: The 1999 surgeon general's report on mental health concluded that insufficient attention to mental health disorders is being paid in children's primary medical care services. This lack of attention has occurred despite considerable attention to this issue in the planning documents of many federal agencies. OBJECTIVE: To assess the extent to which federal agencies' portfolios of funded research grants were consistent with the directives for primary care-based mental health services for children and adolescents featured in their planning documents. DATA SOURCE: A cross-sectional review of the 66 749 abstracts listed in the April 2001 Computer Retrieval of Information on Scientific Projects (CRISP) database of currently funded research grants supported by the US Department of Health and Human Services. Abstracts were rated by whether they targeted primary care, examined behavioral or emotional issues, and examined or modified a facet of primary care. DATA SYNTHESIS: Of the 45 022 research abstracts in the CRISP database, 2720 (6%) contained the words children, adolescents, or youth. Sixty-three abstracts contained work on children, adolescents, or youth in primary care (0.14% of the portfolio). Of these 63 abstracts, only 21 (0.05% of the portfolio) addressed behavioral or emotional issues. Of the 21 projects, only 11 examined aspects of the primary care process. When the distribution of child and adult studies on the treatment of depression within primary care settings was examined, it was found that adults received 15 times the research attention compared with children. CONCLUSION: Even though the importance of primary care as a system for identifying and treating behavioral and emotional problems in children has been recognized for more than 20 years, little attention is being paid to this topic in the research portfolios of the National Institutes of Health and other federal agencies that support research.

Adolescent↗
PubMed2002

Design of the Omapatrilat in Persons with Enhanced Risk of Atherosclerotic events (OPERA) trial.

The Omapatrilat in Persons with Enhanced Risk of Atherosclerotic events (OPERA) trial is a large clinical trial of omapatrilat, a vasopeptidase inhibitor, in patients with stage 1 isolated systolic hypertension (ISH). OPERA is the first study to examine whether effective antihypertensive treatment can provide survival and clinical end point benefits in older persons with this common condition. This 5-year multinational, randomized, double-blind, parallel-group, placebo-controlled, forced-titration study will be conducted in approximately 12,600 subjects randomized by approximately 1100 study centers worldwide over a recruitment period of approximately 2 years. The primary objective of OPERA is to determine whether treatment with once-daily omapatrilat (target dose 40 mg) will reduce cardiovascular (CV) morbidity and mortality in older (> or = 65 years) men and women with enhanced risk for atherosclerotic events due to stage 1 ISH plus other risk factors for which currently there is no evidence-based requirement for treatment. Blood pressure inclusion criteria are systolic blood pressure (SBP) 140 to 159 mm Hg (SBP 125 to 139 mm Hg in diabetic individuals) and diastolic blood pressure (DBP) <90 mm Hg. The primary end point is defined as the composite of fatal/nonfatal stroke, fatal/nonfatal myocardial infarction, fatal/nonfatal heart failure, and other CV mortality. Secondary end points include the individual components of the primary end point, CV mortality, and major cardiovascular end points, as well as effects on cognitive function and initiation of treatment for diabetes. Additional analyses will be conducted in men and women, in diabetic patients, in different risk classes and according to prior evidence of vascular disease.

Arteriosclerosis↗
PubMed2002

Trends and differentials in menarcheal age in China.

This study examines trends in menarcheal age of women born in China between 1950 and 1973, and explores the impact of relevant social background characteristics on the timing of first menarche. Data on recalled ages of menarche collected in the 1988 Chinese Two-per-Thousand Fertility Survey are used in a linear regression model where the covariates are transformed with the help of an Alternating Conditional Expectation (ACE) algorithm. The results indicate that a trend towards early menarche has evolved in China during recent decades. The pattern of early menarche is especially pronounced among women residing in urban areas, and those who are better educated.

Adolescent↗
PubMed2002

Low CD7 expression in benign and malignant cutaneous lymphocytic infiltrates: experience with an antibody reactive with paraffin-embedded tissue.

Loss of CD7 expression by neoplastic lymphocytes is considered a distinguishing characteristic of mycosis fungoides (MF) and cutaneous T-cell lymphoma. Reports to date examining for the CD7 immunophenotype in MF have been performed on fresh-frozen tissue. In this study, we used a paraffin-reactive antibody directed against CD7 to determine its range of expression in MF and to compare these results with those in controls. Examining 22 cases of MF and 61 controls, we found minimal CD7 expression by lymphocytes in MF and in a few cases of benign inflammatory dermatosis (BID). The lowest mean CD7 counts (as a percentage of total lymphocytes) were found in MF (patch stage: 5% +/- 5%, range: 0-10; plaque and tumor stages: 15% +/- 5%, range: 5-25), and these counts were significantly lower than those for BID (35% +/- 20%, range: 5-80; p = 0.001). By logistic regression analysis, low CD7 expression (<10% lymphocytes labeling) had sensitivity and positive predictive values of 80% and 72%, respectively, and specificity and negative predictive values of 93% and 96%, respectively, for the diagnosis of patch stage MF. False-positive results were found for spongiotic dermatitis. Moreover, spongiotic dermatitides exhibited a progressive decrease in mean CD7 counts from acute to subacute to chronic stages (50% versus 35% versus 30%, respectively). In conclusion, minimal CD7 expression is a specific finding for MF. Benign inflammatory infiltrates can also show low CD7 expression, however, which rarely matches that of patch stage MF. Progressive loss of CD7 expression in BID is the likely consequence of expansion of antigen-selected CD3+CD4+CD7- T cells. These inflammatory CD4+CD7- T cells may represent the physiologic counterpart to the neoplastic lymphocyte of MF.

Antibodies, Neoplasm↗
PubMed2002

No association between functional catechol O-methyl transferase 1947A>G polymorphism and smoking initiation, persistent smoking or smoking cessation.

Nicotine stimulates dopamine release and activates dopaminergic reward neurones in central pathways giving rise to dependence. Catechol O-methyl transferase (COMT) inactivates extraneuronally released dopamine and is present in dopaminergic brain regions. A functional polymorphism (COMT 1947A>G) resulting in increased enzyme activity has been associated with alcoholism and polysubstance abuse. We examined the relationship between the COMT 1947A>G polymorphism and smoking initiation, smoking persistence and smoking cessation. We genotyped 266 current smokers, 270 ex-smokers and 265 lifetime non-smokers (never smokers), matched for age and gender, for the COMT 1947A>G polymorphism. Smoking status was ascertained by self-report. There was no difference in genotype frequencies between never smokers and ever smokers (current + ex-smokers); between non-smokers (never + ex-smokers) and current smokers; or between current smokers and ex-smokers. These data suggest that the COMT 1947A>G polymorphism is not associated with smoking initiation, smoking persistence or smoking cessation.

Adult↗
PubMed2002

Does cigarette smoking increase time to conception?

Data are reported on the relationship between cigarette smoking and other health-related behaviours and time to conception in a population-based sample of women who acted as a control group in a case-control study of twinning. Women who continued to smoke close to the time of conception took significantly longer to become pregnant than women who never smoked or stopped smoking before the year during which they attempted to conceive. A hierarchical regression analysis performed on time-to-conception data in women who continued to smoke in the year before conception provided weak evidence for a dose-response relationship between time to conception and number of cigarettes smoked per day. No significant relationships were found between time to conception and other health-related behaviours.

Adult↗
PubMed2002

Oklahoma City and Tulsa Metropolitan Medical Response System.

The tragic loss of lives on September 11 followed by the Anthrax contaminations reinforced the need for work already underway through the Metropolitan Medical Response System (MMRS). Through leadership from the Medical Director for the Medical Control Board and EMSA, Oklahoma City and Tulsa have been the beneficiaries of nearly $1.5 million dollars in funding to prepare for nuclear, chemical or bioterrorism. The two Oklahoma cities were among the second wave of cities invited in 1999 to participate in the federally funded program for Metropolitan Medical Response. Many of the requirements of the contract have already been met under the capable guidance of Michael Murphy, a 23 year paramedic with 12 years of management experience with EMSA. Among the plans completed or underway are a Development Plan, MMRS System Plan, Forward Movement of Patients Plan, Pre-hospital Response Plan, a Biological Incident Plan, a Hospital Response Plan, a Training Plan and an Equipment and Pharmaceutical Plan. Coordinated planning between the two cities bring the added benefit of seamless sharing of personnel between both ends of the turnpike should a disaster impact one rather than both communities.

Civil Defense↗
PubMed2001

New directions in the genetic mechanisms underlying nicotine addiction.

Major advances have been made in understanding nicotine addiction and smoking behaviour in recent years. In particular, evidence for the relative importance of genetic and environmental effects on smoking initiation and persistence has emerged from behaviour genetic studies. These data have supported evidence from molecular genetic studies for the role of particular candidate genes in tobacco dependence. Studies of the personality correlates of smoking behaviour suggest that these factors mediate the association between genetics and smoking initiation, while learning models of nicotine addiction suggest a role for dopaminergic genes in facilitating neuroadaptations associated with smoking persistence and development of nicotine dependence. Integrating these different avenues of research represents one of the most interesting and potentially fruitful ventures in the treatment of tobacco dependence.

Journal Article↗
PubMedDate not supplied

Audit of a behaviour modification program for weight management.

BACKGROUND: The traditional management of overweight and obesity is to make weight loss the primary goal and to offer advice about eating less and exercising more. In controlled settings participants who remain in weight loss programs usually lose 10% of their weight, However, one to two-thirds of the weight lost is regained within one year, and almost all is regained within five years. METHOD: At the Melbourne Weight Management and Eating Behaviour Clinic we designed a program to assist patients achieve and maintain a healthy weight. The program is based on achieving behaviour change rather than focussing on weight loss as the primary goal. The focus is on the reasons why patients exceed their most healthy weight, setting realistic behaviour change and accepting what cannot be changed. DISCUSSION: We conducted an audit of this program to identify changes in eating behaviour and weight management, and examine whether any change were maintained after the completion of the program.

Behavior Therapy↗