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Biomedical subjects

K R Murphy

Publications and source records attributed to K R Murphy.

14 recordsLinked to original sources
PubMed1998

Computer-based patient education.

The computer can be a powerful ally in clinicians efforts to empower their patients to make the right individual decisions. The Internet, in particular, is an extremely valuable resource that enables patients to quickly obtain the latest information on support groups, therapeutic modalities, late-breaking research, and individual coping strategies. The technology is now mature enough that every provider should consider incorporating some type of computer-based patient education into his or her practice.

Computer-Assisted Instruction↗
PubMed1998

Performance evaluation in work settings.

Recent research from 1993 on performance evaluations in work settings is reviewed and integrated with the prior reset and historical bases. Contemporary research reflects several themes: General models of job performance are being developed, the job performance domain is being expanded, research continues to explore the psychometric characteristics of performance ratings, research is developing on potential bias in ratings, rater training is examined, and research continues in terms of efforts to attach utility values to rated performance. We conclude that research is progressing in traditional content areas as well in the exploration of new ground. Researchers are recognizing that job performance is more than just the execution of specific tasks and that it involves a wider array of important organizational activities. There is also an increased optimism regarding the use of supervisory ratings and recognition that such "subjective" appraisal instruments do not automatically translate into rater error or bias.

Employee Performance Appraisal↗
PubMed1996

Motor vehicle driving competencies and risks in teens and young adults with attention deficit hyperactivity disorder.

PURPOSE: To evaluate the motor vehicle driving knowledge, skills, and negative driving outcomes of older teens and young adults with attention deficit hyperactivity disorder (ADHD). LOCATION: A university medical center clinic for adult ADHD. SUBJECTS: A total of 25 young adults with ADHD and 23 young adults without ADHD 17 to 30 years old drawn from the community and equated for age, gender, and educational level. MEASURES: Structured interview, behavior ratings by self- and others, video test of driving knowledge, computer simulated driving test, and official motor vehicle records. RESULTS: ADHD young adults were cited more often for speeding, were more likely to have had their licenses suspended, were involved in more crashes, were more likely to have had crashes causing bodily injury, and were rated by themselves and others as using poorer driving habits. Official driving records corroborated these negative outcomes. Although no group differences in driving knowledge were evident, young adults with ADHD had more crashes, scrapes, and erratic steering during the computer-stimulated driving test than did the control subjects. CONCLUSIONS: Findings supported previous research suggesting that greater driving risks are associated with ADHD and suggested that ADHD does not interfere with driving knowledge so much as with actual performance (motor control) during vehicle operation.

Accidents, Traffic↗
PubMed1991

Influence of job characteristics on the acceptability of employee drug testing.

Measures of the acceptability of employee drug testing were obtained from a sample of college students (N = 371) and a second sample of nontraditional, older college students (N = 112) and were correlated with job-analysis data from the Position Analysis Questionnaire (PAQ) and Dictionary of Occupational Titles (DOT) databases, and with measures of perceived danger from impaired performance in each job. Both PAQ and DOT data accounted for variance in ratings of acceptability. Perceptions of danger were the best single predictor of acceptability and appeared to mediate the relationships between job characteristics and the acceptability of employee drug testing.

Adult↗
PubMed1991

Increasing adolescent mothers' knowledge of child development: an intervention program.

This study focused upon an intervention program that allowed adolescent mothers to have major input in identifying knowledge they needed concerning their children's growth and their own parenting skills. Seventy-six females participated in the 4-month program. A pretest-posttest design was used to measure changes in self-esteem, knowledge of child development, and tendencies toward inappropriate interactions with children. Analysis of effectiveness of this program indicated that it had been effective. Results revealed significant differences between pre- and posttest measures of child development knowledge in the areas of infant and toddler development. Further analysis indicated a significant change in the subjects' child abuse potential at the end of the program. No significant difference could be found in measures of self-esteem between the beginning and end of the program. A 10-month follow-up study coordinated between two public agencies found that none of the adolescent parents who had completed the program had been reported for child abuse or neglect. The results support the importance of short-term intervention programs for adolescent parents.

Adolescent↗
PubMed1990

Refractory congestive heart failure after ribavirin in infants with heart disease and respiratory syncytial virus.

Although treatment with ribavirin has been known to be associated with a decreased mortality in infants with congenital heart disease (CHD) who have respiratory syncytial virus (RSV), few data are available regarding morbidity. We reviewed records of 10 consecutively hospitalized infants with CHD during a recent RSV epidemic. Despite the presence of left-to-right shunt in each patient, symptoms of RSV were respiratory at presentation. After ribavirin, decreased respiratory symptoms were found in 8 infants but in 2 assisted ventilation were required 1 and 3 days after admission. Congestive heart failure worsened in 8 patients, 6 of whom had improved respiratory status after ribavirin. Of the 8 patients with worse CHF (pulmonary edema), 3 responded to medical management but 5 were refractory and 4 required surgical repair of CHD. One patient died of pulmonary hemorrhage. Medically refractory CHF may develop in infants with CHD who become infected with RSV and are treated with ribavirin. Further studies are needed to determine whether the pulmonary edema is caused by RSV, ribavirin, or combination of effects on pulmonary capillary function or some other unrecognized mechanism.

Heart Defects, Congenital↗
PubMed1987

Accurate patient diagnosis of acute porcine valve failure.

Spontaneous porcine bioprosthetic valve failure is usually of gradual onset. We report a case of acute porcine mitral valve rupture resulting in rapid hemodynamic decompensation. The patient perceived the moment of valvular failure as the abrupt onset of a vibrating sensation in his chest. As the number of patients with porcine bioprostheses continues to increase, acute valvular failure may become a more common clinical entity.

Acute Disease↗
PubMed1986

The requirement for polymorphonuclear leukocytes in the late asthmatic response and heightened airways reactivity in an animal model.

The antigen-induced late asthmatic response (LAR) and subsequent heightened airways reactivity after this response have been associated with increased airways inflammation. Employing an animal model of the LAR in rabbits previously developed in our laboratory, 3 phases of experiments were performed to investigate the role of polymorphonuclear leukocytes (PML) in the LAR and heightened reactivity. In all 3 phases, airways reactivity to histamine and bronchoalveolar lavage analysis were performed 3 days before and 3 days after bronchial challenge with ragweed extract. In Phase 1, 2 groups of rabbits receiving nitrogen mustard were studied: an immune group received immune serum containing antiragweed IgE, and a control group received nonimmune serum. In Phase II, nitrogen mustard was administered to immune rabbits during aortic occlusion to allow the lungs to be exposed to nitrogen mustard while limiting exposure of the bone marrow to this drug, preventing depletion of PML. In Phase III, both an immune and a nonimmune group of rabbits received nitrogen mustard as in Phase I; however, prior to antigen challenge, they were repleted with a neutrophil-rich population of PML. In all experiments, no group of control (nonimmune) rabbits, whether depleted or repleted of PML, developed an immediate asthmatic response (IAR) or a LAR. In addition, no significant increases in lavage cells or airways reactivity occurred after ragweed challenge. In contrast, those animals receiving immune serum and nitrogen mustard developed an IAR; however, no LAR occurred, and no significant change in airways reactivity was observed. Rabbits receiving immune serum and nitrogen mustard with aortic occlusion developed an IAR and LAR, and airways reactivity increased.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1986

Inflammation and the late phase reaction in asthma: the effect of polymorphonuclear leukocyte depletion on airways obstruction and bronchial hyperreactivity in an animal model.

Increases in airway reactivity noted after antigen exposure in which a late asthmatic response (LAR) develops may be related to pulmonary inflammation. Employing an animal model of the LAR developed in our laboratory, we conducted experiments to determine if depletion of polymorphonuclear leukocytes (PMLs) would ablate the LAR and inhibit subsequent increases in airways reactivity. Four groups of ten animals each were studied. The first group was given immune sera (I) containing anti-ragweed IgE. The second group received non-immune sera (NI). A third group of animals received immune sera plus nitrogen mustard (I + NM), while a fourth group received non-immune sera plus nitrogen mustard (NI + NM). Airways reactivity to histamine and the evaluation of different cell types in bronchoalveolar lavage fluid (BALF) were determined three days before and three days after bronchial challenge with ragweed extract (RWE). No control rabbit (NI or NI + NM) developed either an immediate asthmatic response (IAR) or an LAR, and no significant increases occurred in their airways reactivity or cells in lavage fluid after bronchial challenge with RWE. In contrast, the sensitised rabbits not given nitrogen mustard developed an LAR and airways reactivity increased markedly three days later. Those animals receiving immune sera and nitrogen mustard developed an IAR; however, no LAR occurred and no significant change in airways reactivity ws observed. BALF analysis seventy-two hours after ragweed challenge in the animals that received immune sera showed a significant increase in PMLs. However, there was no significant increase on BALF PMLs in the animals receiving immune sera and nitrogen mustard.(ABSTRACT TRUNCATED AT 250 WORDS)

Airway Obstruction↗
PubMed1985

Increases in airway reactivity to histamine and inflammatory cells in bronchoalveolar lavage after the late asthmatic response in an animal model.

An increase in airway reactivity after the late asthmatic response (LAR) has been noted in humans. Although these alterations in reactivity have been proposed to be associated with inflammation, no clinical study of the LAR has shown both increased airway reactivity and evidence of pulmonary inflammation. Employing an animal model of the LAR in rabbits developed in our laboratory (Am Rev Respir Dis 1982; 126:493-498), we examined changes in airway reactivity and pulmonary inflammation in rabbits having a late asthmatic response. Two groups of rabbits were studied: a control group (n = 10) received nonimmune serum, and a sensitized group (n = 10) received serum containing homocytotropic antibody (IgE) to ragweed extract (RWE) from rabbits previously immunized from birth with ragweed. Airway reactivity to histamine and the evaluation of different cell types in bronchoalveolar lavage fluid were determined 3 days before and 3 days after bronchial challenge with RWE in all rabbits. No control rabbit developed a LAR, and no significant changes occurred in this group's airway reactivity or cells in lavage fluid after bronchial challenge with RWE. In contrast, all sensitized rabbits developed a LAR, and airway reactivity for this group was markedly increased 3 days later. In addition, the total number of cells including both polymorphonuclear and mononuclear cells in lavage fluid increased significantly 3 days after the LAR. Ten days after the LAR in the sensitized group (n = 8), as airway reactivity returned towards baseline, so did the cells in lavage. We conclude that increased airway reactivity to histamine is temporally associated with pulmonary inflammation as defined by cells in lavage after the LAR in this model.

Animals↗
PubMedDate not supplied

Measles control in Yaounde: justification of a one dose, nine month minimum age vaccination policy in tropical Africa.

For tropical countries the World Health Organisation recommends a single dose of measles vaccine, administered at a minimum age of 9 months. In some African nations, however, up to 26% of all reported measles occurs before the age of 9 months, and many African nations have been reluctant to follow the WHO recommendation. In 1974 the Ministry of Health of the United Republic of Cameroon made several changes in the existing measles control strategy, including increasing the minimum age for measles vaccination from 6 to 9 months. Surveillance of measles in Yaounde, the capital city, during the five years after the increase in age at vaccination did not reveal a need to return to the minimum age of 6 months. In fact, by 1979, with measles vaccination coverage among children 12-23 months of age at 40%, there had been a 44% decrease in reported measles among children of all ages, including a 64% decrease in the measles attack rate among children under the age of 9 months. These observations support the one dose, 9 month minimum age measles vaccination policy in tropical Africa.

Acute Disease↗