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Biomedical subjects

R J Murphy

Publications and source records attributed to R J Murphy.

At least 37 records · Page 2Linked to original sources
PubMed1996

Patients' views of low back pain and its management in general practice.

BACKGROUND: Low back pain is a common and persistent problem. Research studies seeking to improve the quality of management of this condition have tended to ignore the opinions of patients. There is a growing acceptance of the importance of taking patients' views into account in developing management and educational programmes for a variety of conditions. AIM: This study set out to elicit the views of patients concerning low back pain and its management in general practice. METHOD: Fifty-two in-depth interviews were conducted with patients selected from a broad range of 12 general practices. RESULTS: Analysis of the interviews identified seven themes relating to: quality of life, prognosis, secondary prevention, help-seeking behaviour, explanation of underlying pathology, satisfaction with general practitioner management, and complementary therapy. Different patient viewpoints or perspectives were expressed within each of these themes. Patients adapted to the progress of their low back pain and were not seeking a 'magical cure' from either conventional or complementary therapies. CONCLUSION: Patients' views on low back pain are heterogeneous. The dissatisfaction expressed with medical explanations for the pain may be related to superficial clinical management and the constraints of general practice. Good management of low back pain needs to take patients' complex views of the condition into account.

Adolescent↗
PubMed1995

Patient education for low back pain in general practice.

This comparative study of patient and general practitioner perceptions of patient education for low back pain (LBP) revealed significant differences in perspective. It suggests that although some general practitioners recognise the importance of patient education, they blame patients for its assumed failure as a management strategy. The patients in this study identified a range of reasons which explain their difficulties in following prevention advice which relate to not only limitations in themselves, but also to broader contextual factors over which they have little control. It is argued that both the inadequacy of current professional assumptions and the contextual factors that influence patients' prevention behaviours need to be acknowledged as a first step towards improving patient education for LBP in general practice.

Adult↗
PubMed1995

General practitioner perceptions of low back pain patients.

General practitioners' perceptions of low back pain (LBP) patients were investigated through a series of in-depth semi-structured interviews, as part of a wider study which also investigated patient perceptions. An exhaustive analysis of the interview transcripts revealed six principal ways in which GPs distinguished between different patients as a means of deciding how to treat them. This differentiation, on the basis of patient characteristics, is the major focus for the resulting discussion and conclusions, and is used as a way of exploring more effective strategies for the future.

Attitude of Health Personnel↗
PubMed1994

Towards an integrated model of competence in midwifery.

Currently in the UK, there is no consensus as to what constitutes an adequate definition of a competent midwife. Yet, given the rapidly changing midwifery needs of childbearing women and society, such clarification has never been more important. In this paper some concepts of competence taken from a review of midwifery, nursing, educational and industrial literature are reviewed, and it is hoped that discussion leading to conceptualisation of an integrated model of competence in midwifery will be stimulated. Questions raised include--What is it that makes midwives competent? Can competence be inferred from performance? How can capability be recognised? Can competence be broken into elements for assessment without losing meaning?

Clinical Competence↗
PubMed1988

Congenital rickets associated with magnesium sulfate infusion for tocolysis.

The records of five neonates born to mothers treated with intravenously administered magnesium sulfate for tocolysis were retrospectively reviewed to assess the presence of radiographic, clinical, and biochemical abnormalities. Two infants had radiographic bony abnormalities; one had frank rachitic changes and dental enamel hypoplasia. One of these patients, as well as an additional infant, had transient hypocalcemia. We hypothesize that prolonged infusion of magnesium sulfate, especially when initiated during the second trimester, may lead to fetal parathyroid gland suppression with consequent abnormalities resembling rickets.

Adult↗
PubMed1988

Heat problems in the tennis player.

Any athlete, regardless of the sport or exercise, should allow an appropriate period to get in condition before exerting maximal effort. Athletes should be encouraged to observe environmental conditions and sharply curtail or postpone activity if the humidity reaches 95 per cent at any temperature. In addition, athletes should expose as much skin as possible to the air, and remain well hydrated before, during, and after exercise.

Athletic Injuries↗
PubMed1987

Thrombocytopenia in a bisexual adolescent male with a history of intravenous drug use.

Immunologically mediated thrombocytopenia has been reported as a manifestation of human T-lymphotropic virus type III (HTLV-III) infection and intravenous (IV) drug abuse. The case report describes thrombocytopenia in a bisexual adolescent male with antibody to the HTLV-III virus and a history of infrequent IV drug abuse. The case underscores the need to consider HTLV-III infection and/or IV drug abuse in the differential diagnosis of thrombocytopenia in an adolescent.

Acquired Immunodeficiency Syndrome↗
PubMed1986

The case for health promotion programs containing health care costs: a review of the literature.

A review is conducted of major studies dealing with the impact of work site health promotion programs on health care costs. Inconsistent results were produced due to measurement, design, and sampling problems. A study of Blue Cross-Blue Shield of Indiana employees provided the best evidence of program-related health care cost reductions. Suggestions are made which, if implemented, should enable researchers to more confidently attribute cost reductions to health promotion program activities.

Adult↗
PubMed1984

Citizen cardiopulmonary resuscitation training and use in a metropolitan area: the Minnesota Heart Survey.

To assess the prevalence and utility of citizen cardiopulmonary resuscitation (CPR) training, a systematic population-based sample of Minneapolis-St. Paul area adults, age 25-74 years, was interviewed in 1980-81. Twenty-three per cent were CPR trained. Of these, 13 percent have encountered out-of-hospital cardiac arrests and 38 per cent reported using their skills in such an emergency. Most of those performing out-of-hospital CPR (59 per cent) were health professionals. Only 19 per cent of trainees have maintained their certification by retraining within one year.

Adult↗
PubMed1983

Unrecognized aspiration of an oropharyngeal airway.

A case of unsuspected aspiration of an oropharyngeal airway causing dysphagia is described. Visualization of this airway on plain film would be facilitated if radio-opaque material were included at manufacture.

Adolescent↗
PubMed1983

A study of combined arm and leg exercise with application to nordic skiing.

A laboratory test was developed to study the metabolic and gas exchange effects of arm, leg and combined arm and leg work. The test incorporated movement patterns similar to those used in cross-country skiing. The work rate for the arm test at maximal effort was 33% (125 watts) and the leg test was 81% (302 watts) of that for the combined test (375 watts). The maximum oxygen uptake (VO2 max) was not significantly different when comparing the leg test to the combined test, but VO2 at submaximal work levels was significantly less during the combined test. The anaerobic threshold (AT) occurred at 68, 73 and 76% of VO2 max for the arm, leg, and combined test, respectively. Although there were no significant differences in VO2 and percent of VO2 max, at the AT between the leg test and the combined test, AT was significantly delayed with respect to time and work rate in the latter condition. Application of these results to cross-country skiing supports the proposal for greater upper body involvement in skiing.

Arm↗
PubMed1982

Results of a study to determine the effects of three oral contraceptives on serum lipoprotein levels.

A multicenter, double-blind investigation with random allocations of subjects to Ortho-Novum 1/50 tablets, Ortho-Novum 1/35 tablets, or Modicon tablets (Ortho Pharmaceutical Corporation, Raritan, NJ) was conducted. Each subject remained on the same oral contraceptive (OC) for at least four cycles. Serum high-density lipoprotein (HDL) cholesterol, low density lipoprotein (LDL) cholesterol, triglyceride, and cholesterol were measured prior to the initiation of OC therapy and were repeated after treatment cycles 2 and 4. There were no significant changes in HDL, LDL, or serum cholesterol levels. Triglyceride levels increased but remained significant only with the lowest dose product. These were no significant differences among the three drugs for the four parameters studied.

Adolescent↗
PubMed1982

CPR with simultaneous compression and ventilation at high airway pressure in 4 animal models.

CPR with simultaneous chest compression and ventilation at high airway pressure (SCV-CPR) improves blood flow in some studies but not in others, perhaps because of differences in the animal models employed. To resolve such discrepancies, we compared SCV-CPR to standard CPR in 4 mechanically different canine models, using both small and large dogs and small and large compression pads. The 4 groups were: large dogs receiving chest compression through a large pad (model A), large dogs receiving chest compression through a small pad (model B), small dogs receiving chest compression through a large pad (model C), and small dogs receiving chest compression through a small pad (model D). Cardiac output (CO) during CPR was determined by a specially modified indicator dilution method. Models A, B, and C all had similar mean COs of 14 ml/min . kg body weight during standard CPR, and 27 ml/min . kg during SCV-CPR. However, in model D, there was no significant difference during standard vs. SCV-CPR, and the mean output was 33 ml/min . kg. We conclude that in models A, B, and C, little direct heart compression occurred and the higher intrathoracic pressure pulses produced by SCV-CPR improved blood flow. However it seems likely that there was effective cardiac compression in model D. In the absence of direct cardiac compression, SCV-CPR provides an alternative means of generating satisfactory flow in a mechanically appropriate animal model.

Animals↗
PubMed1982

High-pressure ventilation during CPR with 95% O2:5% CO2.

The effects of two different breathing-gas mixtures on blood flow, blood pressure, and arterial blood pH and PCO2 were measured in dogs during 2 different modes of CPR with high-pressure ventilation (50 cm H2O). Ventilation was either applied simultaneously with every compression (1:1) or interposed after every fifth compression (1:5). Ventilation with pure oxygen under either condition caused severe arterial alkalemia with hypocarbia after 2-min episodes of cardiac arrest and resuscitation (pH = 7.63, PCO2 = 5.0 after 1:1; pH = 7.63, PCO2 = 5.4 after 1:5). Ventilation with 5% CO2-enriched oxygen during CPR maintained acid/base status near prearrest values (pH = 7.22, PCO2 = 30.3 after 1:1; pH = 7.26, PCO2 = 28.0 after 1:5). Values obtained with radioactive microspheres for cardiac output (CO) and regional blood flow to brain, heart, and kidney were not significantly different under the 4 conditions. Electrical ventricular defibrillation was easily accomplished despite arterial alkalemia and hypocarbia. Ventilation at high pressures with CO2-enriched oxygen does not alter hemodynamics during CPR, but does prevent severe arterial alkalemia.

Alkalosis↗