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Biomedical subjects

L Dumas

Publications and source records attributed to L Dumas.

At least 19 recordsLinked to original sources
PubMed2005

[Fight against tobacco and promote breastfeeding: a distinctive challenge].

Quebec's breastfeeding rates are in a deplorable state, and even more so for smoking mothers. Public health providers are trying to increase breastfeeding rates and decrease smoking in this specific target group. Should they prioritise tobacco cessation interventions, or breastfeeding promotion interventions, or give equal priority to both goals at the same time? The authors attempt to scientifically answer this question, through a comprehensive literature review over the last ten years. In general, women who smoke have the tendency be younger, be less educated and more underprivileged than mothers who do not smoke and to breastfeed less often. Smoking mothers who do breastfeed usually wean off breastfeeding earlier than those who do not smoke. Pregnancy is considered an ideal moment to stop smoking, but relapse after giving birth is very high. In light of the range of difficulties faced when trying to quit smoking, health professionals should encourage smoking mothers to breastfeed since the benefits of breastfeeding could actually serve to reduce some of the harmful effects related to tobacco. Nicotine patches can be prescribed to increase the chances for successful tobacco cessation amongst these mothers. To date, few studies have been carried out on nicotine replacement therapies and breastfeeding smokers. More research is needed to evaluate the risks and benefits of nicotine substitutes for this sub-group, in both the short and long term.

Adult↗
PubMed2000

Home care nursing think tank.

Nurses in academic roles can build bridges between clinical practice, education, research, and policy. Although they work with individual providers in clinical placements, nurses need to take advantage of opportunities to network as a community of academics and providers in addressing current challenges in home care. As agencies close or merge, long-standing placements for students are often a casualty and seldom a priority. Developing creative strategies for collaboration among providers and educators has thus become a growing challenge in home care.

Clinical Clerkship↗
PubMed1998

Plasma volume expansion with Haemaccel does not impair haemostasis during reduction mammaplasty.

OBJECTIVES: An in vivo study under well-controlled conditions was undertaken to determine the effect of Haemaccel, a colloidal plasma volume expander, on normal haemostasis. METHODOLOGY: Twenty patients, who were admitted for reduction mammaplasty, were included in this study. A standardised anaesthesia protocol was followed with all patients. Ten patients received 500 ml Haemaccel and 10 controls received 1,500 ml Ringer's lactate, a crystalloid solution. The solutions were administered intravenously during surgery over a period of 30-40 minutes. Standardised clinical observations and haematological tests were done at the following time intervals: after anaesthesia but before infusion of the plasma substitute, immediately after infusion was completed, and 20, 40 and 60 minutes after infusion. RESULTS: The blood pressure, pulse rate and O2 saturation levels were not influenced by the treatment given. Haemodilution was similar for the two patient groups. The platelet count and plasma levels of fibrinogen decreased in parallel with haemodilution. Thereafter the platelet count gradually increased to pre-infusion counts at 60 minutes. The prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin time (TT) and platelet aggregation in response to adenosine diphosphate (ADP) and collagen were not affected by the plasma volume expander given. Arachidonic acid-induced aggregation decreased significantly after Ringer's lactate was given but did not change when Haemaccel was given. The bleeding time was prolonged slightly, but not significantly, from 7.4 +/- 1.6 minutes to 8.8 +/- 1.6 minutes with Ringer's lactate and from 6.9 +/- 2.0 to 9.7 +/- 3.7 minutes with Haemaccel. CONCLUSIONS: We could not find any scientific evidence that Haemaccel affects haemostasis; neither does it increase bleeding relative to Ringer's lactate.

Adult↗
PubMed1996

[Socioprofessional integration of users of a service teaching work habits].

Programs for the social and professional rehabilitation of people suffering from mental illness are more or less successful. A substantial proportion of people cannot with this help, find or maintain a job; moreover many prematurely leave their rehabilitation program. This retrospective study attempts to identify variables associated to 1) the fact of completing the program and related to 2) maintaining a working activity in a regular environment, once the program is completed. The research is conducted with 67 people registered in an apprenticeship of working habilities program. The study shows that the fact of being in a first stage of socioprofessional rehabilitation is associated with participants staying in the program. The time spent in the program and the participants' level of education are also related to the success of integration. Variables regarding diagnosis are not associated to the different trajectories of the people. Suggestions to adjust intervention are proposed in this paper.

Humans↗
PubMed1996

[The impact of a child's death on the family].

The death of a child has major repercussions on the family system. To develop a reference framework for intervention by health care professionals, the authors describe their research on Quebec families who have lost a child. Semi-structured interviews and a questionnaire were used to gather data from families who had experienced the death of a child up to age 18 during the past six years. The final sample consisted of 76 participants. Analysis of the data highlights the impact of the death on the family's functioning and structure. Adjustment to the absence of the deceased member is a major cause of stress that effectively redefines the role of every family member. Their social network undergoes transformations and family members experience a period of great emotional vulnerability. The authors believe that specific, structured and appropriate support can make the difference between an extended period of psychosocial distress or greater family cohesion. Thus, a nurse who wishes to intervene with families in mourning following a perinatal death, a sudden death or an anticipated death, can use the intervention plan the authors developed for this purpose.

Adaptation, Psychological↗
PubMed1995

[University and community health center collaboration].

Nurses from a CLSC in Hull, Quebec are defining a positive role for community health nurses in a multidisciplinary environment. They base their professional day-to-day practice on Orem's conceptual nursing framework. Many of these home care nurses studied in a post-RN baccalaureate nursing program at the University of Quebec in Hull, where they learned different aspects of conceptual frameworks and the nursing process. Two nurse clinicians and a nurse administrator submitted a project based on Orem's model to the administrators of their community health centre. Once it was approved, a nursing professor from the university agreed to act as a consultant and principal researcher to implement the process. The authors describe this three-year collaborative project between home care nurses and the researcher. This includes its objectives, the participants' roles, the tools developed, the process, and the repercussions on nursing care, nurses, and the multidisciplinary team.

Community Health Nursing↗
PubMed1994

Hospice nursing. The concept of palliative care.

In this article, some differences are presented between hospice and home care nurses. Issues related to pain control, symptom management, and dehydration are highlighted. Emphasis is placed on the spiritual dimensions of hospice care and the holism implicit in its concept.

Costs and Cost Analysis↗
PubMed1994

Nursing for the public good.

This article examines the concept of community nursing, from the origins of nursing in the public health movements of the early twentieth century. Past and present are inextricably linked as community nursing reemerges with a public health mission.

Community Health Nursing↗
PubMed1993

[Orem's family evaluation].

Nurses are beginning to realize that clients' deficits influence family members and, conversely, that family members play an important role in the development and resolution of these deficits. The authors attempted to find published literature describing a family nursing evaluation based upon Orem's conceptual framework. Previous nursing research has described how Orem's model is applied to nursing interventions with individual clients, but none has addressed the application of nursing interventions to multiperson units within a family situation. The authors developed their own concept from their personal and family experiences and a theoretical background of Orem's model. They chose to integrate systemic and communication theory, and developmental and functional approaches with Orem's concept of nursing care of multiperson units. According to the authors, this approach is consistent with Orem's model and represents a holistic vision of the family. Orem emphasizes that the nurse intervening with multiperson units should understand the structure and function of groups and be able to identify the actual ongoing process. Although Orem's theoretical framework is not based upon a systemic approach, the authors believe that it is possible to blend the systemic theory concepts with Orem's model. This article reviews the three basic concepts found within Orem's conceptual framework: self-care; self-care deficit, and nursing systems. The authors also outline their theoretical assumptions for the use of this approach with family nursing interventions, based upon six functional dimensions of the family as described by Epstein et al. and Guttman. In addition, the article provides a concrete example of how nursing evaluation can be structured within this scheme of reference.

Family↗
PubMed1992

Lung cancer in women. Rising epidemic, preventable disease.

Lung cancer is a preventable disease. Like acquired immunodeficiency syndrome, lung cancer is reaching epidemic proportions in women. This article overviews selected epidemiology of lung cancer and discusses public health issues that are gender-specific to women. Community nursing approaches are advocated that address risk behaviors in women and girls.

Adolescent↗
PubMed1992

Addicted women. Profiles from the inner city.

This article has focused on addicted women and the contexts in which they present to the community nurse. An effort has been made to broaden the clinical applications to include the societal problems underlying addiction and the policy issues that must be addressed to solve them. Addicted women can be described from a societal dimension, in which the health care system reflects disarray and fiscal chaos, and from a community dimension. The two dimensions link the public and the private spheres. To evaluate addicted women and the options for their recovery more effectively, it is helpful to integrate the societal and personal milieu--public issues and the private lives that illustrate them. This is how policy is best formulated. The numbers of addicted women in the health care system reflect only the tip of the iceberg. Health care providers must strive to reach women who are outside of the health care system who have not been connected to a hospital, shelter, or home care agency. Researchers need to differentiate sample patient populations, and the patient selection bias needs to be addressed early on. A model of a community support for recovery located within a housing project was a viable option for reaching addicted women. The role of nurses is becoming increasingly unique. Nurses are skilled as caregivers and clinicians. They can open doors of opportunity for inner-city women and children by developing health-promotive programs in hospital settings for substance abusing women and by continuing to work with their colleagues in the community context. On both dimensions, nurses have front-line accessibility to women and children who are vulnerable. Often, commonality of gender strengthens the nurse/patient relationship and facilitates trust as well as empathy between female addicts and their nurse advocate counterparts. Never has the call to inner-city nurses been more compelling. The problems related to drug abuse and parenting are multidimensional. They resist easy definition and solution. Nurses have the education and the clinical expertise to provide front-line interventions for inner-city women who are addicted to drugs. Nurses are educated holistically as caregivers and teachers. Ideally, nurses can exert their strongest impact on health promotion in the neighborhoods of communities. In reality, this has not worked, and nurses remain part of a health care system that has failed inner-city poor women and their children. Nurses in hospitals and in community setting spend most of their time applying "bandages" to the psychologic and physical wounds that emerge from the addiction to drugs.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1992

[The nursing process according to Orem. A concrete very simple example explains how to follow this nursing process].

The author shows how Orem's theory, based on self care, can be applied to the nursing care of a patient with severe cardiac illness. To do so, she explains in detail what is looked for in the patient's history to delineate problems, and then uses a systematic care plan approach to solve them. In the patient's history, the nurse looks for information on each need, and on the specific factors in the patient's life and health history that will have an impact on the patient's capacity to meet Orem's goal of self care. Inabilities are labelled self care deficits. When the self-care deficit is well understood, it is important then to determine the source of the patient's difficulty. Orem states that there are two main phases to self-care: the decision and the action. The author illustrates this through a discussion of the patient's difficulty to stop smoking. She then explains a particular method to write a nursing diagnosis that directs the nurse to work, not on the deficit itself, i.e. in this case smoking, but rather on the patient's lack of knowledge. The "SMART" approach to writing nursing care objectives (specific to the patient and the current situation, measurable, attainable by the client in a reasonable period of time, realistic for the current situation, and truthful or having clear significance for the patient at the moment) is detailed along with interventions that respect Orem's concept of nurse-patient contracts. The nursing process based on Orem's conceptual framework is not difficult to manage.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1988

Ambiguous effect of chlorpromazine on doxorubicin activity against P388D1 tumours in mice.

Chlorpromazine (CPZ) can decrease the toxicity of doxorubicin (DOX). We wanted to determine whether this CPZ pretreatment could affect the response of tumours to therapeutic doses of DOX. Six groups of eight female CDF1 mice received 1 million leukaemia P388D1 cells i.p. For 5 days, they received DOX i.p. (total dose 0, 6 or 12 mg/kg), preceded by saline or 5 mg/kg CPZ s.c. CPZ in the absence of DOX had no effect on survival [median survival time (MST) of 19 days vs. 20]. In mice receiving DOX only, MST was greater than 60 days. Mice receiving DOX + CPZ were similar to DOX till day 25, but subsequently died earlier (MST of 27 and 34 days, for DOX 6 and 12 mg/kg). At death or day 60, 31% (5/16) of DOX mice and 88% (14/16) of DOX + CPZ had macroscopic tumours (P less than 0.005, both DOX dose groups combined). However, only 19% (3/16) of DOX and 6% (1/16) of DOX + CPZ had tumours in the abdominal cavity, the others being in the abdominal wall close to the site of injection. The results suggests that while CPZ did not affect the killing of cancer cells in the abdominal cavity, it did block the effect of DOX on cells in the abdominal wall and skin. This block may be caused by decreased local delivery of DOX, due to the hypothermia produced by CPZ.

Animals↗
PubMed1986

Growth changes of 3T3 cells in the presence of mineral fibers.

The relationship between exposure to asbestos fibers and the development of mesothelioma or bronchial carcinoma prompted many countries to ban its use from commercial products. The biological mechanism by which asbestos induces or promotes mesothelioma or carcinoma is still unknown. In order to study the influence of fibers on the cell surface, 3T3 fibroblasts were cultured in the presence of various mineral fibers. The acute cytotoxicity produced by mineral fibers was evaluated by the trypan blue dye exclusion method; growth of 3T3 cells was measured as well as the maximum cell density at saturation. We found that growth of 3T3 cells was slower in the presence of chrysotile while light microscopy revealed an increased cellular chromogenicity and a modification of the cell-cell arrangement in the presence of this fiber. We describe an assay in which chrysotile causes an increase in the maximum cell density at saturation.

Animals↗