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Biomedical subjects

D Howell

Publications and source records attributed to D Howell.

At least 19 recordsLinked to original sources
PubMed2002

Murine gammaherpes virus as a cofactor in the development of pulmonary fibrosis in bleomycin resistant mice.

Studies of human tissue have suggested an association between productive Epstein Barr virus and idiopathic pulmonary fibrosis (IPF). However, a pathogenic role for the virus has not been established. This study was undertaken to develop an animal model, which would explore the association between viral infection and pulmonary fibrosis. BALB/c mice (n=30), resistant to bleomycin, were primed with murine gammaherpesvirus 68 and then given intraperitoneal bleomycin. The mice were sacrificed at 28 days after bleomycin and their lungs assessed histologically and biochemically. Lung pathology was scored 0-3 for fibrotic and inflammatory change. BALB/c mice given virus and bleomycin showed more lung fibrosis (median score 2.2) compared to those given bleomycin alone (median 0), virus alone (median 0.2) or phosphate-buffered saline (PBS) control (median 0). Similarly mice given both virus and bleomycin showed more lung inflammation (median score 1.9) compared to those given bleomycin (median 0.5), virus (median 0.8), or PBS control (median 0.2). There was a significant difference in collagen content between the bleomycin and virus group (mean 1.86 mg) compared to the belomycin alone group (mean 1.52 mg). These results suggest that virus alone does not result in pulmonary fibrosis but that replicating virus in the presence of an exogenous injury may promote the development of pulmonary fibrosis.

Animals↗
PubMed2001

Footprints in sand: the response of a granular material to local perturbations.

We experimentally determine ensemble-averaged responses of granular packings to point forces, and we compare these results to recent models for force propagation in a granular material. We use 2D granular arrays consisting of photoelastic particles: either disks or pentagons, thus spanning the range from ordered to disordered packings. A key finding is that spatial ordering of the particles is a key factor in the force response. Ordered packings have a propagative component that does not occur in disordered packings.

Journal Article↗
PubMed2001

Advancing the quality of oncology nursing care: Interlink Community Cancer Nurses' model for reflective practice.

Since 1996, Interlink Community Cancer Nurses have been using reflective practice as a team to share knowledge and experience amongst peers. The use of reflective practice enables the nurse to examine decision-making in patient situations and uncover the knowledge and artistry that is embedded in nursing practice. This article describes how reflection is practised by specialist cancer nurses to advance the quality of caregiving. The use of a structured framework for reflection which incorporates ways of knowing in nursing is an essential feature of the Interlink model for reflection. The development of a process for reflection within the Interlink program has at times been challenging. However, the Interlink nurses' experience with reflection is believed to be critical to the ongoing development of the program and the individual nurse. Interlink nurses have found that guided reflection, the creation of an environmental milieu for reflection and personal knowing, and self-evaluation are critical to the process of becoming a self-reflective practitioner.

Caregivers↗
PubMed2000

Influencing nurses' knowledge, attitudes, and practice in cancer pain management.

The purpose of this study was to explore the effects of an education intervention on nurses' knowledge, attitudes, and practice in pain assessment and management over 3 months. The education intervention program was designed to change knowledge and influence the attitudes of registered nurses through a values clarification process using a conceptual framework based on a theory of reeducation. Participants in this descriptive, exploratory study were 53 nurses from six oncology units. Data were collected on their knowledge, attitudes, documentation practices, and analgesic choices in defined patient situations. The intervention was effective in changing the knowledge, attitudes, and behaviors of nurses in the study, but the effect was not maintained over time. Study findings suggest that further educational and organizational support is needed for effective practice in pain assessment and management. Further research should explore education programs that will maintain new knowledge over time. In addition, assessment of the effect that new knowledge has on the achievement of improved pain relief for patients should be explored in the future.

Attitude of Health Personnel↗
PubMed2000

Predictors of physical fitness in a college sample.

The present study examined the relationships among self-reported amounts of exercise, body composition, age, weight, blood pressure, and physical fitness. Participants reported their duration and frequency of exercise, which were combined to obtain individual indexes of exercise. VO2 max predicted from a 1-mi. walk test, percent body fat via sum of skinfolds, blood pressure, and flexibility of the lower back and posterior thigh were measured. Findings indicated that age and exercise index were significant predictors of fitness for women, and percent body fat was a significant predictor for men. Results suggest individuals' exercise index moderately correlates with fitness, although it is not the only contributing factor.

Adolescent↗
PubMed1999

Response

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Journal Article↗
PubMed1999

Memories in sand: experimental tests of construction history on stress distributions under sandpiles.

We report experiments on piles of cohesionless granular materials showing the effect of construction history on static stress distributions. Stresses under piles are monitored by sensitive capacitive techniques. The piles are formed either by pouring granular material from a funnel with a small outlet (localized source), or from a large sieve (homogeneous rain). Localized sources yield stress profiles with a clear stress dip near the center of the pile; the homogeneous rain profiles have no stress dip. We show that the stress profiles scale linearly with the pile height. Experiments on wedge-shaped piles show similar but weaker effects.

Journal Article↗
PubMed1999

Canadian women's perspectives on ovarian cancer.

OBJECTIVE: To describe the perspectives of Canadian women living with ovarian cancer regarding their experiences with the disease. DESIGN: A cross-sectional survey of a convenience sample of Canadian women with ovarian cancer. SETTING: Survey questionnaires were sent to physicians in 26 cancer programs that treat women with ovarian cancer and to ovarian cancer self-help groups for subsequent distribution to women. PARTICIPANTS: Women diagnosed with ovarian cancer and able to read English or French. MAIN OUTCOME MEASURES: A variety of individual items in the survey related to information received, communication, physical and psychosocial symptoms, impact of illness and quality of life. RESULTS: A total of 315 women returned the survey. The average age of the respondents is 59 years. Each province and territory is represented in the sample. Over one-half of the women received a diagnosis of ovarian cancer within a month of seeking help for a concern and 85% had multiple treatment modalities. The majority of the women felt adequately informed (80%) and were satisfied with communication with their physicians (mean of 4.1 to 4.5 on a 5-point scale). A majority (62%) said that their lifestyle had changed as a result of their disease. Problems were experienced most frequently regarding side effects (58%), fear of recurrence (54%), sleeping difficulties (46%), bowel difficulties (44%), fear of dying (36%) and difficulty concentrating (32%). Many who experienced problems reported receiving inadequate help for them (16% to 49%). Quality of life was reported as significantly lower following the diagnosis and treatment of ovarian cancer (p = 0.0001). CONCLUSION: This study provides an important foundation for further investigation. There is a pressing need for research regarding the early identification of ovarian cancer and issues of support and coping. Care for women with ovarian cancer requires the expertise of a range of disciplines and community-based agencies working collaboratively as a team.

Adaptation, Psychological↗
PubMed1998

Experiences of mothers in five countries whose child died of cancer.

Although increasing attention is being focused on the emotional aspects of caring for dying children and their families, few research reports concentrate on the experiences of mothers, particularly in different countries. This article describes the findings of an exploratory, descriptive study that investigated the experiences of mothers from five different countries who each had a child die from cancer in the past 6 months. Principal investigators, members of the International Work Group on Death, Dying, and Bereavement, conducted semistructured interviews with 21 mothers in their own countries. No culturally related differences were noted among mothers, and the mothers' recall of their experiences are more similar than different. All mothers, irrespective of country, described similar reactions to the diagnosis, management of the end-stage illness, and challenge of coping with bereavement. Lessons learned from this project provide suggestions for future research across countries.

Adolescent↗
PubMed1998

Management of occluded biliary Wallstents.

BACKGROUND: Wallstents (Schneider Stent, Inc., USA) used for the palliation of malignant biliary strictures, although associated with prolonged patency, can occlude. There is no consensus regarding the optimal management of Wallstent occlusion. AIMS: To evaluate the efficacy of different endoscopic methods for managing biliary Wallstent occlusion. METHODS: A multicentre retrospective study of patients managed for a biliary Wallstent occlusion. RESULTS: Data were available for 38 patients with 44 Wallstent occlusions, all of which had initial endoscopic management. Twenty four patients had died and 14 were alive after a median follow up of 231 (30-1095) days following Wallstent occlusion. Occlusions were managed by insertion of another Wallstent in 19, insertion of a plastic stent in 20, and mechanical cleaning in five. Endoscopic management was successful in 43 (98%). Following management of the occlusion, bilirubin decreased from 6.0 (0.5-34.3) to 2.1 (0.2-27.7) mg/100 ml (p < 0.05). No complications occurred. The median duration of second stent patency was 75 days (95% confidence interval 43 to 107) after insertion of another Wallstent, 90 days (71 to 109) after insertion of a plastic stent, and 34 days (30 to 38) after mechanical cleaning (NS). The respective median survivals were 70 days (22-118), 98 days (54-142), and 34 days (30-380) (NS). Incremental cost effective analysis showed that plastic stent insertion is the most cost effective option. CONCLUSION: Although all three methods are equally effective in managing an occluded Wallstent, the most cost effective method appears to be plastic stent insertion.

Cholestasis↗
PubMed1998

The 1997 Helene Hudson Memorial Lecture. Reaching to the depths of the soul: understanding and exploring meaning in illness.

The nurse who hopes to respond to the experience of individuals and their families with a diagnosis of cancer must understand and explore meaning in illness. Meaning has been described as a fundamental dimension of personhood (Cassel, 1982). There can be little understanding of the person's behaviour and responses to cancer without understanding the meaning of illness in their lives. The meaning ascribed to a situation can have a profound impact on the individual and family's coping and adjustment and may influence their relationships with the health care team. Meaning in illness may be influenced by cultural beliefs, religion, values, life philosophy and past experience. Meaning goes beyond the surface reactions of the individual to the very depths of the person's soul and can be a source of despair and suffering. Meaning evolve throughout the illness trajectory and can have a profound influence on the person's lived experience. The skills required to understand meaning and the lived experience of illness for the individual are extensive. It is only through true presence, mutual understanding and a sharing of the life of the other that nurses are able to understand and co-construct meaning. It is a respect and understanding of the individual within the whole context of their personhood and the meanings assigned to their experience of cancer which allows the nurse to practice beyond the surface, to touch the person's soul.

Adaptation, Psychological↗
PubMed1998

Making cancer bearable: the Interlink Community Cancer Nurses model of supportive care.

Most cancer patients and their families experience the full impact of their diagnosis and the disruptions cancer brings to their lives in their own homes and communities. Access to supportive care programs within the community is critical if we are to assist these individuals in coping and adjusting to the realities of cancer. Interlink Community Cancer Nurses, a nonprofit nursing agency, provides supportive care across the continuum of cancer care from early diagnosis and treatment through to remission and/or palliative care through its independent model of supportive care delivered by expert oncology nurses. The program utilizes a unique, client-centred model of care delivery to ensure that needs are met, and to link patients to community services which promote their ability to meet the demands of cancer. Interlink's program of supportive care demonstrates that oncology nurses can make a significant impact on the outcomes of cancer for individuals and their families which may impact on cost, influence survival and enhance quality of life.

Community Health Nursing↗