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Biomedical subjects

M A Christopher

Publications and source records attributed to M A Christopher.

18 recordsLinked to original sources
PubMed1997

Caregiver safety.

Explore the source record for details and available documents.

Caregivers↗
PubMed1994

Community health nursing--shelter from the storm.

The East Coast experienced a debilitating storm just before Christmas 1992. Nurses went above and beyond the call of duty to care for their community; from their exemplary work, one agency developed a policy to prepare the entire community so that the next disaster won't be a disaster.

Community Health Nursing↗
PubMed1993

Health, income, and postretirement employment of older adults.

After a poor response to advertisements for employment for older adults, a community health nursing agency surveyed 216 individuals ranging in age from 60 to 96 years to examine their attitudes toward postretirement work, perceptions of barriers to and facilitators of employment, and the influence of perceived health status and income on these factors related to labor force participation. The findings are consistent with continuity theory of aging, and underscore the need for public policies aimed at supporting the decision of older persons to work or retire.

Aged↗
PubMed1993

Neighborhood nursing--the community as partner.

Neighborhood nursing seeks to make community health nursing activities more far reaching than those currently reimbursed by third parties, focusing on the issues of health promotion and disease prevention as significantly as the industry has focused on the acute care provision in home care. Yet variables in community nursing have changed what was the traditional focus of community health nursing practice. One agency is developing a program that will allow delivery of a different type of community health nursing. The outcome is a much richer delivery of care.

Community Health Nursing↗
PubMed1992

Promoting the community health clinical nurse specialist.

The role of the community health nurse clinical specialist (CHNCS) has been clearly delineated by the profession as having a responsibility to the community as client. The need for this specialist has escalated as communities try to address health problems that are preventable and overwhelming their resources. Yet, a survey conducted in New Jersey and counsel from the Rutgers College of Nursing Community Health Nursing Advisory Committee suggest that nurses and agencies may not be aware of the role of the CHNCS and how to use this advanced practitioner most effectively. This article discusses the role of the CHNCS as described by the American Nurses' Association, the need for the CHNCS, a survey of the perceived need for Master's-prepared community health nurses, the role of a CHNCS in a New Jersey community health nursing agency (MCOSS, Inc.), and recommendations for promoting the role of the CHNCS.

Community Health Nursing↗
PubMed1991

A comparison of the health status of residents of sheltered care facilities in Monmouth County, New Jersey.

In the past 20 to 30 years the number of sheltered care facilities in the United States has risen dramatically. Serving what many consider to be marginal populations, they are often poorly regulated or unregulated, with little or no attention to the health of residents. A retrospective record review of 647 clients residing in boarding homes, rooming houses, a homeless shelter, and residential facilities in Monmouth County, New Jersey, suggested that whereas some differences exist among facilities in terms of clients' physical and psychosocial health problems, these differences may not be meaningful. Since New Jersey regulations require some minimal health supervision to be provided by residential facilities but not by the others, these results suggest that regulations of the other facilities should be revised to reflect better the needs and problems of the populations they serve.

Adult↗
PubMed1991

Use of activated charcoal to reduce elevated serum phenobarbital concentration in a neonate.

The course of a neonate administered activated charcoal orally for elevated phenobarbital concentration is described. The neonate required a serum concentration of phenobarbital eventually exceeding 80 micrograms/mL for seizure control. However, due to the severe CNS injury as a result of the asphyxia at birth, a diagnosis of cerebral death by electroencephalogram and apnea test was pursued. This required the phenobarbital concentration to be less than 30 micrograms/mL. Serial phenobarbital concentrations during this time indicated a 250 hour half-life, which would require two weeks for the phenobarbital to drop below 30 micrograms/mL. With the administration of six doses of activated charcoal at 0.7 g/kg/dose, the phenobarbital serum concentration decreased to 22 micrograms/mL, giving an estimated phenobarbital half-life of 22 hours. This, and two other subsequent cases, indicates repeated doses of activated charcoal are effective in augmenting the clearance of certain drugs in the neonatal age group.

Administration, Oral↗
PubMed1990

A mobile clinic for the homeless and mentally ill: meeting the needs of a target population.

Six years ago, a home care nurse doing research for a school project discovered a population of elderly, mentally ill, and homeless people who were not receiving adequate health care. The nurse's efforts resulted in her home care agency's expanding its services to include a mobile clinic program. Today, the program employs five nurses who provide health assessment and group education to over 1,000 people.

Aged↗
PubMed1989

Clinical relevance of the interaction of theophylline with diltiazem or nifedipine.

The results of previously published studies indicate that calcium channel blockers are capable of competitively inhibiting cytochrome P-450 activity in hepatic microsomes, the pathway of theophylline metabolism. In addition, case reports have suggested that theophylline serum concentrations change when a calcium channel blocker has been added to or deleted from a stable theophylline regimen. To determine the clinical relevance of this potential interaction in patients with chronic asthma, we measured a peak steady-state theophylline serum concentration in 21 subjects while receiving theophylline alone (400 to 1,500 mg/day), and again, at least seven days later, after the addition of continuous therapy with maximally tolerated doses of either diltiazem (n = 18) or nifedipine (n = 16). The diltiazem dose was increased in 120 mg/day increments, as tolerated, to a maximum of 240 to 480 mg/day, while the nifedipine dose was increased in increments of 40 mg/day, to a maximum dose of 80 to 160 mg/day. The mean +/- SEM theophylline serum concentrations were 13.6 +/- 1.4 micrograms/ml before and 14.0 +/- 1.2 micrograms/ml during concurrent diltiazem therapy, and 12.6 +/- 1.0 micrograms/ml before and 12.2 +/- 1.1 micrograms/ml during nifedipine (p greater than 0.05). With this sample size there is a 5 percent chance that we missed a 20 percent change in serum concentration (type II error). Thus, maximum tolerated doses of diltiazem or nifedipine do not impair the metabolism of theophylline to a clinically relevant degree and adjustment of theophylline dosage is not required after the addition or discontinuation of diltiazem or nifedipine. In addition, these data suggest that currently available in vitro techniques for evaluating drug interactions in the hepatocyte do not predict the clinical relevance of such an interaction in patients who might require both drugs for different therapeutic indications.

Adolescent↗
PubMed1988

The effects of nalmefene, a potent oral opiate antagonist, on exercise-induced bronchospasm.

Endogenous opioids are released during exercise and have been demonstrated to induce mast cell degranulation when they are administered intradermally. Thus, these peptides may play a role in the pathogenesis of exercise-induced bronchospasm (EIB). However, in two previous studies, intravenous naloxone did not provide significant protection from EIB. To determine if these failures were due to inadequate dosage (pharmacokinetic failure) or lack of an inherent pharmacologic effect (pharmacodynamic failure), the present study was conducted with nalmefene (Key Pharmaceuticals, Inc., Miami, Fla.), a slowly metabolized, orally bioavailable opiate antagonist, with 30 times the potency of naloxone. Ten subjects with mild intermittent asthma and a greater than or equal to 20% decrease in FEV1 after a standardized exercise test were studied. nalmefene, 20 mg, and identically appearing placebo tablets were administered orally in a double-blind, randomized, crossover design 2 hours before bronchoprovocation. Treadmill exercise was performed for 6 minutes at a minute ventilation of 55% to 66% of the calculated maximum voluntary ventilation and not exceeding 75% to 85% maximal heart rate for age. Spirometry was performed before and 3, 5, 8, 10, and 15 minutes after exercise. The mean decrease in FEV1 after exercise was 28.6 +/- 4.5% with placebo and 30.3 +/- 4.5% with Nalmefene (p = 0.6; beta = 0.04 for a 15% difference). Thus, we conclude that narcotic antagonists do not alter airway reactivity to exercise. In addition, these data suggest that endogenous opioids probably do not play an important role in the pathogenesis of EIB.

Administration, Oral↗