PubMed Health⌕ Search

Biomedical subjects

C A Holmes

Publications and source records attributed to C A Holmes.

At least 19 recordsLinked to original sources
PubMed1999

Lipoxygenase inhibitors as potential cancer chemopreventives.

Mounting evidence suggests that lipoxygenase (LO)-catalyzed products have a profound influence on the development and progression of human cancers. Compared with normal tissues, significantly elevated levels of LO metabolites have been found in lung, prostate, breast, colon, and skin cancer cells, as well as in cells from patients with both acute and chronic leukemias. LO-mediated products elicit diverse biological activities needed for neoplastic cell growth, influencing growth factor and transcription factor activation, oncogene induction, stimulation of tumor cell adhesion, and regulation of apoptotic cell death. Agents that block LO-catalyzed activity may be effective in preventing cancer by interfering with signaling events needed for tumor growth. In fact, in a few studies, LO inhibitors have prevented carcinogen-induced lung adenomas and rat mammary gland cancers. During the past 10 years, pharmacological agents that specifically inhibit the LO-mediated signaling pathways are now commercially available to treat inflammatory diseases such as asthma, arthritis, and psoriasis. These well-characterized agents, representing two general drug effect mechanisms, are considered good candidates for clinical chemoprevention studies. One mechanism is inhibition of LO activity (5-LO and associated enzymes, or 12-LO); the second is leukotriene receptor antagonism. Although the receptor antagonists have high potential in treating asthma and other diseases where drug effects are clearly mediated by the leukotriene receptors, enzyme activity inhibitors may be better candidates for chemopreventive intervention, because inhibition of these enzymes directly reduces fatty acid metabolite production, with concomitant damping of the associated inflammatory, proliferative, and metastatic activities that contribute to carcinogenesis. However, because receptor antagonists have aerosol formulations and possible antiproliferative activity, they may also have potential, particularly in the lung, where topical application of such formulations is feasible.

Animals↗
PubMed1998

Preclinical drug development paradigms for chemopreventives.

Preclinical screening studies and animal efficacy testing models currently are used by the National Cancer Institute's chemoprevention drug discovery program to assess and identify chemical agents and natural products that may have the potential to prevent human cancer. Identification of potential cancer preventing agents begins by subjecting each compound to a sequential series of short-term, in vitro prescreens of mechanistic, biochemical assays to provide quantitative data to help establish an early indication of chemopreventive efficacy and to assist in prioritizing agents for further evaluation in longer-term, in vitro transformation bioassays and whole animal models. Promising chemical agents or combinations of agents that work through different inhibitory mechanisms subsequently are tested in well-established, chemically induced, animal tumor models, which include models of the lung, bladder, mammaries, prostate, and skin. These preclinical bioassays afford a strategic framework for evaluating agents according to defined criteria, and not only provide evidence of agent efficacy, but also serve to generate valuable dose-response, toxicity, and pharmacokinetic data required prior to phase I clinical safety testing. Based on preclinical efficacy and toxicity screening studies, only the most successful agents considered to have potential as human chemopreventives progress into clinical chemoprevention trials.

Animals↗
PubMed1998

Attitudes toward service use among wife caregivers of frail older veterans.

This study investigated (a) attitudes toward service use among wife caregivers of frail older veterans; and (b) the relationship between those attitudes and service utilization by the wives. The study focused on three sets of attitudinal variables: attitudes towards various kinds of dependencies; individual and family ethos concerning service use; and perceptions of responsibility for care. Respondents were 80 wife caregivers of frail older (age 55+) veterans at a Department of Veterans Affairs Medical Center in a Midwestern state. Most caregivers agreed that it is acceptable to get help with the physical care of the husband and to get help themselves for the emotional strains caused by caregiving. Acceptability of a wife's getting help with the physical care of her husband was a positive predictor of number of services ever used and frequency of in-home service use. Wives' view that help from outside agencies should be used only as a last resort was the strongest and most consistent negative predictor of both number of services ever used and frequency of service use.

Aged↗
PubMed1997

Culture, needs and nursing: a critical theory approach.

This paper will bring the critique of culture, notably that undertaken by the Frankfurt School of Critical Social Science, to bear on the problem of needs, and expose its significance for the practice and discipline of nursing. The paper begins by reviewing ways in which the idea of 'needs' has been depicted in nursing literature, and it is suggested that this depiction is inadequate in fundamental ways. The critique of existing culture is then outlined and the implications for nursing are suggested in terms of the dissolution of hegemonic practices and the development of a concept of need built around the notion of 'praxis'.

Culture↗
PubMed1997

Lost in space?

Explore the source record for details and available documents.

Computer Communication Networks↗
PubMed1997

Service utilization by wife caregivers of frail older veterans.

This study investigated patterns and predictors of service utilization among wife caregivers of frail older veterans. The study focused on the following sets of variables: predisposing, enabling, care-receiver need, and caregiver need. Respondents were 80 wife caregivers of frail older (age 55+) veterans at a Department of Veterans Affairs Medical Center (VAMC) in a Midwestern state. Wife caregivers used a mix of VAMC and non-VAMC services. Care-receiver functional status was a significant predictor of both frequency of service use and number of services ever used. Caregivers' perception of service availability and attitude toward service use were the strongest predictors of number of services ever used.

Activities of Daily Living↗
PubMed1996

The politics of phenomenological concepts in nursing.

This paper challenges those nurses who champion Heideggerian phenomenology, by outlining some of the possible political consequences of that philosophy. Some relationships between phenomenology and fascism are discussed, with special reference to anti-humanism and authenticity. Heidegger's commitment to Nazism is affirmed and, following the lead of other recent contributions to the debate, it is suggested that this was the likely, if not inevitable, result of his phenomenological philosophy. It is concluded that, because of its immanent fascism, Heideggerian phenomenology is at odds with the general value orientation publicly espoused by the nursing profession, and that this may render it not only unsuitable as a means of understanding and elaborating nursing knowledge, but also actively counter-productive to the conventional aspirations of nurses.

Humanism↗
PubMed1995

The inner ache: an experiential perspective on loneliness.

This paper examines the various theoretical approaches that have informed both the conceptualizations and the research approaches to investigations of loneliness. A focus on phenomenological and existential perspectives of loneliness can assist in an understanding of what is essentially a subjective distressing experience. The elderly, particularly those residing in nursing homes, are vulnerable to feelings of existential loneliness because following busy lives, often they are left without meaningful roles. Concomitant to this sense of loss of meaning is an alteration in the perception of lived time. It is the purpose of this paper to stimulate research into what is a common but profoundly distressing experience.

Aged↗
PubMed1994

Weight, water, and cation losses in horses competing in a three-day event.

Body weight of 48 horses competing in a 3-day event was measured the day before the event (baseline), following the dressage phase of the event (day 1), after the endurance phases of the event (day 2), and 18 to 24 hours after the endurance phases (day 3). Plasma sodium and potassium concentrations were measured the evening before, immediately after, and 10 minutes after the endurance phases. Total body water, water loss, and net exchangeable cation loss were then calculated. Body weight and total body water were significantly decreased, compared with baseline values, at all times during the event, and significant water loss was detected. The largest changes were recorded after the endurance phases of the event. Water deficits were still detected 18 to 24 hours after the endurance phases of the event. Mean plasma sodium concentration was significantly increased immediately after the endurance phases of the event, compared with concentration measured the evening before, and remained increased after the 10-minute recovery period, presumably because of dehydration. Mean plasma potassium concentration was significantly increased immediately after the endurance phases of the event, compared with concentration measured the evening before, but was not increased after the 10-minute recovery period.

Animals↗
PubMed1994

Nursing the postmodern body: a touching case.

Using touch as a medium for exploring the ways in which it is constructed by nurses, the body is here characterized by a plethora of competing and co-existing terms: disobedient, obedient, mirroring, stigmatized, sinful, post-mortem, sanitized, angelic, desexualized, dangerous, dominant, dominating, deceitful, submissive, disciplined, postmodern and communicative. We have tried to be provocative by juxtaposing contradictory messages and evoking conflicting emotions, and we hope that the reader will not assume that we believe everything we write, or that everything may be taken only at face value. There are as many messages and meanings in the paper as each reader thinks there are.

Attitude to Health↗
PubMed1993

'Holism' in the discourse of nursing.

Holism is a turbid, amorphic term, of Quixotic character, the meaning of which alters according to the context in which it is located. Coming to grips with holism has been likened to trying to hold ice, because it disappears in the attempt. This paper assesses the variety of meanings attached to the term, and the extent to which the distinctive features of holism have melted away in the hands of nursing.

Holistic Health↗
PubMed1993

Biomechanics of pin and screw fixation of femoral neck fractures.

Using an in vitro cadaveric femoral neck osteotomy model and a paired experimental design, we compared fixation stiffness and yield load for three- and four-pin configurations for both Knowles pins and Asnis screws and for three Asnis screws versus an AO-ASIF sliding hip screw. Repeat measure analyses of variance indicated a significant increase in stiffness (p < 0.05) with the use of three versus four pins; the yield load did not depend significantly on the number of pins. Fixation was significantly stiffer (p < 0.01) and stronger (p = 0.02) for Knowles pins if the osteotomy was oblique rather than transverse to the femoral neck; the opposite was found for Asnis screws. Femoral fixed with hip screws were significantly stiffer (p < 0.01) than the contralateral side fixed with three Asnis screws. No significant difference in yield load was observed, however. Clinically, it appears from these findings that the use of three Asnis screws or three Knowles pins provides modest increases (averaging 4%) in fixation stiffness with no degradation in strength when compared with four screws or pins. Parallel placement of Asnis screws also provides advantages over nonparallel Knowles pins by allowing controlled impaction of the femoral head. While three Asnis screws provide fixation stiffness approximately 40% less than that found with a sliding hip screw, there is no compromise in fixation strength.

Aged↗
PubMed1993

QALYs (Quality Adjusted Life Years): a nurse's view.

Examines the political and ideological significance of measures of quality of life, specifically Quality Adjusted Life Years (QALYs). Briefly reviews recent developments in the debate surrounding the economic and political functions of quality of life measures. The dialectic between conceptions of the quality of life and the implicit realpolitik of socio-economic pressures, ecological conditions, political ethos and cultural norms and expectations, is conceived as a powerful means for the critique of our aspirations concerning health. Argues that existing approaches to assessing quality of life, in denying this dialectic, have jeopardized their potential contribution to the planning, implementation and evaluation of health are policy. Resource allocation challenges us to develop openly ideological strategies and measures.

Australia↗
PubMed1993

Praxis: a case study in the depoliticization of methods in nursing research.

This paper offers a case study in the depoliticization of the concept of praxis as it enters the nursing literature through Margaret Newman's (1990) paper Theory of Health as Praxis, which draws on Lather's (1986) description of 'research as praxis.' Newman's view of the relationship between consciousness and matter is contrasted with that of Marxism and her concept of health-illness is discussed. These considerations yield some examples of the liberal-democratic ideological position which underwrites her theory, and it is suggested that in drawing on the notion of praxis, Newman borrows from an ideology which is ultimately at odds with her theoretical construction of nursing.

Communism↗
PubMed1992

The drama of nursing.

This exploratory paper considers a few possibilities for conceiving nursing as a form of aesthetic praxis. More specifically, drawing on the works of Erving Goffman on dramaturgy, and Elizabeth Burns on theatre, it makes some suggestions concerning nursing as a form of dramatic performance, and briefly attempts to relate this to concepts of praxis drawn from the writings of Hannah Arendt and critical social theorists. In contrast to Goffman's dramaturgy, which stresses the artifice of social relations and suggests a cynical view of human interactions, a critical theory of dramatic praxis introduces a normative dimension in which performance may become self-realizing and emancipatory as it aspires to the status of aesthetic praxis. Conceived in such terms, nursing practice becomes a powerful form of self-expression which has the potential to become liberating for the nurse and the patient.

Art↗
PubMed1992

Human immunodeficiency virus transmission in health care settings. Risks to health care workers.

Taken together, studies of seroconversion, exposure incidents, and compliance with Universal Precautions Policy help researchers understand the risks to health care workers of occupationally acquired HIV infection. The seroconversion studies show that the risk of infection is low (1 in 250) even when the incident is a percutaneous exposure to blood from a known HIV-positive patient. When the exposure is to blood from a patient whose HIV-status is unknown, or if the exposure is not through the skin, or if the exposure is to a body substance other than blood, the risk is considerably lower. The studies of exposure incidents show that for most health care workers, percutaneous exposures to blood are infrequent. Studies of compliance with Universal Precautions Policy show that exposure incidents that do occur can be prevented nearly half the time. The risk of patient-to-provider transmission of HIV is small but not completely negligible. This small risk can be made even smaller by adhering to recommended infection control guidelines, but it cannot be eliminated completely. Although most health care workers enter the medical field accepting that their work may expose them to infectious agents, there is still a desire for risk-free practice. Achieving an entirely risk-free practice is probably impossible; it is certainly not within reach today. For the foreseeable future, the only reasonable course is to fully understand the risks, to enter into practice psychologically prepared to accept these risks, and to practice in a way that minimizes exposures without compromising patient care.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Arthroscopic surgery of the knee on the U.S. Naval Hospital Ships during Operation Desert Shield.

Between September 1990 and January 1991, while deployed to the Persian Gulf for Operation Desert Shield, 118 patients underwent arthroscopic surgery of the knee on the U.S. Naval Hospital Ships USNS Mercy and USNS Comfort. There were 113 men and 5 women, with an average age of 28 years (range, 19-59 years). The most common findings at the time of arthroscopy were meniscus tears (53%), anterior cruciate ligament tears (29%), and normal arthroscopic examinations (9%). There were three complications, two hemarthroses and one superficial portal site infection. Seventy patients (59%) were able to be returned to duty at an average of 6 days post-operatively, obviating the need to evacuate these patients out of the Middle East theater to Europe or the United States, thus avoiding additional delay, expense, and loss of the service member to his military unit.

Adult↗