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Biomedical subjects

M Coulter

Publications and source records attributed to M Coulter.

16 recordsLinked to original sources

Perceptions of registered nurses working with assistive personnel in the United Kingdom and the United States.

This study examines registered nurse perceptions of their role in acute care hospitals that use nursing care assistants (NCA) and unlicensed assistive personnel (UAP). Also studied was registered nurse (RN) satisfaction with nursing care assistants and unlicensed assistive personnel in the United Kingdom (UK) and the United States of America (USA). The purpose of this study is to assist RNs and managers in the re-design of health-care delivery systems by investigating: 1. The differences and similarities of registered nurses in the UK and the USA in the perceptions of changes in the RN role when working with nursing care assistants or unlicensed assistive personnel. 2. The differences between and similarities of registered nurses in the UK and the USA in perceptions of NCA and UAP abilities to perform delegated duties, to communicate pertinent clinical information and to provide more time for professional nursing activities. Registered nurse perceptions in the UK were compared with the findings of a previous study of RN role changes and satisfaction in the USA. Registered nurses in the UK did not perceive a profound change in their role when working with UAP and were more satisfied with their use than were RNs in the USA.

Adult↗

Invasive infections due to a fish pathogen, Streptococcus iniae. S. iniae Study Group.

BACKGROUND: Streptococcus iniae is a pathogen in fish, capable of causing invasive disease and outbreaks in aquaculture farms. During the winter of 1995-1996 in the greater Toronto area there was a cluster of four cases of invasive S. iniae infection in people who had recently handled fresh, whole fish from such farms. METHODS: We conducted a prospective and retrospective community-based surveillance for cases of S. iniae infection in humans. To obtain a large sample of isolates, we studied cultures obtained from the surface of fish from aquaculture farms. Additional isolates were obtained from the brains of infected tilapia (oreochromis species). All the isolates were characterized by pulsed-field gel electrophoresis (PFGE). RESULTS: During one year, our surveillance identified a total of nine patients with invasive S. iniae infection (cellulitis of the hand in eight and endocarditis in one). All the patients had handled live or freshly killed fish, and eight had percutaneous injuries. Six of the nine fish were tilapia, which are commonly used in Asian cooking. Thirteen additional S. iniae isolates (2 from humans and 11 from infected tilapia) were obtained from normally sterile sites. The isolates from the nine patients were indistinguishable by PFGE and were highly related to the other clinical isolates. There was substantial genetic diversity among the 42 surveillance isolates from the surface of fish, but in 10 isolates the PFGE patterns were identical to those from the patients with S. iniae infection. CONCLUSIONS: S. iniae can produce invasive infection after skin injuries during the handling of fresh fish grown by aquaculture. We identified a clone of S. iniae that causes invasive disease in both humans and fish.

Adult↗

Variation in process S: effects on sleep continuity and architecture.

Given the two-process model of sleep regulation, and the hypothesis that the sleep disorder in depressive illness is a consequence of a deficient Process S, it was predicted that relatively high levels of S would result in enhanced sleep continuity, increased slow-wave sleep (SWS), prolonged rapid-eye-movement (REM) latency, and less REM sleep. These predictions were tested in two studies. In Study 1, the level of Process S (at 0900 h prior to a 3-h sleep episode) was varied by altering the time and duration of prior nocturnal sleep (2400-0300 h, 0300-0600 h, 2400-0600 h). In Study 2, the leve of Process S (at 2400 h prior to an 8-h sleep episode) was varied by studying subjects when they had not napped or had taken 2-h naps beginning at either 1000 or 1900 h. As predicted by the model, SWS varied reliably depending on the level of S at bedrest, as did indices of sleep continuity at night. Contrary to prediction, however, REM sleep was either increased (Study 1) or did not change reliably (Study 2). It is suggested that, contrary to the other aspects of sleep, REM sleep is strongly influenced by circadian and homeostatic processes and that Process S plays a relatively minor role in its regulation.

Adult↗

The time course of 'process S': comparison of visually scored slow wave sleep and power spectral analysis.

The sleep of 4 groups (N = 8) of young healthy subjects was recorded during naps at either 09.00, 14.00, 19.00 or 24.00 h. For the first hour of sleep, conventionally scored slow wave sleep (SWS) and computed EEG power density (0-25 Hz) were found to increase exponentially as a function of prior wakefulness (range 3-18 h). The equations based on SWS and spectral analysis of the sleep EEG gave values for r' (the growth rate of the function) that were similar to each other (0.038 and 0.039, respectively) and to that reported by Daan et al. (1984; 0.055). These data are consistent with the proposal that process S, 1 of 2 processes believed to regulate sleep and wakefulness, increases exponentially during the waking day (Daan et al. 1984). In addition, they indicate that in this context SWS and spectral analysis provide measures of slow wave activity that are equally sensitive to changes in prior wakefulness.

Adult↗

The influence of prior wakefulness on REM sleep.

Data from studies of naps and of shifted sleep were used to determine the relationship between two measures of rapid eye movement (REM) sleep (percentage of REM in the first 2 hr of sleep and REM latency) and prior wakefulness. For each sample, we calculated the difference between the observed value and that predicted by a cosine function that estimated the circadian rhythm of REM sleep propensity. The difference values were found to correlate reliably with hours and log hours of prior wakefulness. We conclude that while REM sleep is regulated in part by an endogenous circadian oscillator, it is also influenced by the duration of prior wakefulness.

Adult↗

Slow-wave sleep in daytime and nocturnal sleep: an estimate of the time course of "Process S".

Daan et al. (1984) have proposed that sleep and wakefulness are regulated, in part, by a "Process S" that increases during wakefulness and declines during sleep. Data derived from several studies were taken to determine the time course of Process S during both wakefulness and sleep. As required by the model, slow-wave-sleep (SWS; an index of Process S) was found to increase exponentially as a function of prior wake time (equation 1) and to decline exponentially as a function of time asleep (equation 2). The equations accounted for 91% and 96% of the variance, respectively. In addition, equation 1 accurately predicted the amount the amount of SWS in the first hour of nocturnal sleep.

Adolescent↗

Increased lead absorption in inner city children: where does the lead come from?

Pica for lead-containing paint has been questioned as the principal mechanism for the widespread moderately elevated blood lead levels (30 to 80 microgram/100 ml) in inner city children. This study explored the hypothesis that lead-contaminated household dust is a major source of lead for these children; hand contamination and repetitive mouthing is the proposed mechanism of ingestion. Forty-nine inner city children with blood lead 40 to 70 microgram/100 ml were matched with 50 children with blood lead less than or equal to 29 microgram/100 ml from the same inner city environment. House dust lead and lead on hands were found in significantly greater quantity among experimental subjects. Other factors differed between groups; lead content of peeling paint, soil lead, and pica affected more experimental than control children, but did not account for more than 50% of experimental cases. The cause of moderate blood lead elevation is multifactoral: no single source accounted for all children with elevated levels. However, lead contamination of house dust and hands appears to be a major factor in this condition.

Child, Preschool↗

The noncoordinate expression of muscle-specific proteins in mutant rat skeletal myoblasts and reinitiation of differentiation in hybrids.

In rat skeletal myoblasts which are resistant to 5-azacytidine and fusion-incompetent, the muscle-specific protein, creatine phosphokinase, is produced but muscle-specific myosin is not. In human diploid fibroblast X rat myoblast hybrids, myoblast-specific properties are extinguished. Clones can be selected from the hybrids after a number of doublings which reexpress fusion but do not produce creatine phosphokinase. The conclusion is drawn that the expression of muscle-specific phenotype is not coordinate and fusion of myoblasts is not an essential requirement for the appearance of myoblast-specific proteins.

Animals↗

Obstetric, neonatal, and psychosocial outcome of pregnant adolescents.

Obstetric, neonatal, and psychosocial outcomes were compared for 82 matched adolescents who had been pregnant, been delivered of an infant, and received health care in three sites in Rochester, New York. There were no major differences in obstetric and neonatal outcome of adolescents and their babies according to health site. Differences in outcome were expected in the psychosocial area where a specialized maternity project (Rochester Adolescent Maternity Project [RAMP]) offered more services. On follow-up two years later, school attendance and reliance on full or partial assistance were similar. Repeated pregnancy and postpartum use of contraception favored RAMP.

Adolescent↗

Management of teenage pregnancies in three different health care settings.

A retrospective study was undertaken to determine if differences existed in obstetric outcome, contraceptive usage, and repeat pregnancy rates of teenage patients cared for in three different health care settings. The sites included the Rochester Adolescent Maternity Project (RAMP), a traditional obstetric clinic, and a neighborhood health center. Comparison of the three groups revealed that RAMP patients experienced a lower incidence of anemia and preeclampsia than patients in the other programs. At one year postpartum, 25% of the hospital clinic patients were using contraception compared to 45% for the health center and 49% for RAMP patients, compared to 15.8% for the health center and 6.5% for the RAMP group.

Adolescent↗

Design and test of a system for tracking referrals.

Many health and welfare programs are based on a model in which services needed by consumers are identified by one agency with referral to others for provision of services. The referring agency often does not know whether the services recommended are received, yet it is assumed that receipt of those services by their clients is essential to achievement of program goals. A procedure was devised for tracking families evaluated by North Carolina's State-supported developmental evaluation centers (DECs), agencies that reflect this model. The multidisciplinary evaluation teams of these centers serve children and their families of all income levels. The developmental evaluation family tracking system is a method for determining if recommended services are received, the reasons why they are not, and whether the family desires additional help from the center or othersources. The system was piloted in the Greensboro DEC with a selected group of 67 families. Parents were contacted, mostly by telephone, at 6 months and 18 months following evaluation. Tracking forms were completed for 61 families. Professional staff spent only 2.7% of their working hours during a 3-month period on direct tracking activities and other tasks in behalf of the consumers contacted. The cost was $7.15 per case for immediate tracking and $14.49 if additional activities generated by the tracking contact were included. The system, which provides the information necessary for achieving program goals, was implemented for all 11 DECs in North Carolina in 1976.

Child↗