PubMed Health⌕ Search

Biomedical subjects

M E Harrison

Publications and source records attributed to M E Harrison.

9 recordsLinked to original sources

Female physicians in Mexico: migration and mobility in the lifecourse.

To date there have been few studies of professional women in health care in the developing world. With the increased feminization of the Mexican health work force, an estimated 30 per cent of all physicians are female, there is an urgent need to study this group of workers in terms of their impact on the health service. In particular, the potential for female physicians to migrate could have a dramatic impact on the health service. Indeed, it has long been recognised by the Mexican health authorities that there is an uneven spatial distribution of physicians and yet little is known about the distribution and mobility of female physicians. To this end this paper will analyse the migration and mobility of female physicians through the lifecourse in provincial Mexico. The paper examines the factors that control and structure female physician migration in childhood, during their training and career development. Data for this study were obtained during a period of ten months fieldwork in Mexico. Primary data were obtained from interviews with a sample of physicians in five study states. The interviewees also completed a diary for three months to outline their daily, weekly and monthly routine activities. Secondary data sources were various health employment records, medical school output statistics and the Atlas of Professionals produced by the Mexican census service. Material presented in this paper demonstrates that female physicians in provincial Mexico are not highly mobile. A lack of mobility is due to the constraining factors of education, gender, institutional structures and family and household imperatives.

Career Mobility↗

Treatment of chronic hepatitis C with interferon with or without ursodeoxycholic acid: a randomized prospective trial.

The only effective and approved therapy for chronic hepatitis C is interferon-alpha. Because sustained response rates with interferon alone are disappointingly low, multidrug treatment regimens are currently being investigated. Ursodeoxycholic acid has been used in other chronic liver diseases and can limit hepatocyte injury. To evaluate the potential benefit of ursodeoxycholic acid in combination with interferon-alpha for the treatment of chronic hepatitis C, we conducted a prospective, double-blinded, randomized, placebo-controlled trial comparing the combination therapy of interferon-alpha 2b and ursodeoxycholic acid with interferon alone. Thirty-one patients with chronic hepatitis C were randomized to receive 3 million units of interferon-alpha 2b subcutaneously three times per week and either 13 to 15 mg/kg/day ursodeoxycholic acid or placebo orally for 6 months. The 6-month treatment period was followed by 6 months of observation. Biochemical normalization at the end of treatment occurred in 5 of 14 (36%) patients receiving monotherapy versus 8 of 15 (53%) patients (p = 0.34) receiving combination therapy. No patient treated with interferon alone had a sustained biochemical response 6 months after therapy; however, 3 of 12 patients (25%) treated with combination interferon and ursodeoxycholic acid maintained biochemical normalization at 6 months after therapy (p = 0.08). No difference in liver histology or clearance of hepatitis C viral RNA was noted 6 months after treatment. We conclude that combination therapy with ursodeoxycholic acid and interferon-alpha 2b was no more effective than interferon monotherapy in inducing a biochemical response in previously untreated patients with chronic hepatitis C. Ursodeoxycholic acid, however, may be useful in prolonging the biochemical response to interferon therapy.

Adult↗

Determination of lysergide in urine by high-performance liquid chromatography combined with electrospray ionisation mass spectrometry.

A quantitative method which avoids derivatisation is described for the determination of lysergide (LSD) levels in urine. Sample preparation included addition of methysergide as an internal standard followed by solid-phase extraction. LSD was analysed on a system consisting of a C18 stationary phase and a mobile phase of 0.1 M acetate buffer pH 8.0-acetonitrile-triethylamine (75:25:0.25, v/v). LSD was detected by electrospray ionisation mass spectrometry with selected ion monitoring. The quantification limit was 0.5 ng/ml and the method was linear up to 10 ng/ml of LSD in urine.

Gas Chromatography-Mass Spectrometry↗

Mercury bougie dilation of benign esophageal strictures.

Dilation with mercury filled bougies is the oldest and simplest technique available for treatment of benign esophageal strictures. In the majority of patients, mercury-filled dilators are effective and quite safe. Dilation is successful in 80-90%, and the rate of complication is less then 0.2%. Maloney dilators have superseded Hurst dilators because their tapered, flexible tip allows better guidance of the dilators into the lumen of the stricture. Several cautions are in order when using Maloney dilators. Dilation of difficult strictures should be observed by fluoroscopy to prevent misdirection of the dilator and esophageal perforation. Where possible, Maloney dilators should not be used to treat narrow, elongated, or angulated strictures. Dilation need not be rushed. Treatments may be repeated over months to years, both to achieve symptomatic relief initially and to maintain that state. Finally, patients susceptible to endocarditis require antibiotic prohylaxis prior to treatment.

Dilatation↗

High-performance liquid chromatographic-mass spectrometric assay of high-value compounds for pharmaceutical use from plant cell tissue culture: Cinchona alkaloids.

The use of high-performance liquid chromatography (HPLC) interfaced with thermospray (TSP) mass spectrometry is described for the separation and identification of various alkaloids from Cinchona ledgeriana extracts. The use of water-acetonitrile-acetic acid (71:25:4) with 0.01 M ammonium acetate (pH 3.0) as the mobile phase gave good HPLC separation and good TSP sensitivity. The specificity obtained by single-ion monitoring allowed the analysis of commercially important alkaloids such as quinine and quinidine in plant material, transformed roots and in cells from tissue culture, with relatively simple extraction and work-up procedures. TSP gave protonated species with few fragment ions but collision-induced dissociation offers the promise of increased analytically specificity from the fragment ion data. This work has important implications for the biotechnological production of pharmaceuticals normally obtained from plant sources.

Chromatography, High Pressure Liquid↗

An estimation of mineral losses through arm sweat of preadolescent children.

Balance studies were conducted to determine the effects of three levels of nitrogen intake on the loss of nitrogen through sweat in preadolescent boys and girls. During the studies, the losses of calcium, iron, magnesium, manganese, potassium, sodium, and zinc were determined in the arm sweat of the subjects. Sweat from the forearm was collected in a polyethylene bag for 1 hr on three different occasions. Using the concentrations of nitrogen in the arm bag and in the whole body collection and the concentration of minerals in the arm bag, the total body loss of minerals were estimated. Losses of minerals through sweat, expressed as a percentage of intake, ranged from 0.12 to 1.10%. Under conditions of these studies, sweat losses of the essential minerals were not a significant factor in estimating total losses.

Calcium↗

Hobby or job? Mexican female health workers.

A critical analysis of the role and status of female health workers in the primary health care service (PHC) of the Secretary of Health in the Federal District of Mexico is presented. Women are key workers in the health service; however, since the creation of the PHC service, women appear to have been kept in low-pay, low-status jobs. Data from questionnaires and in-depth interviews with female health workers in the Federal District illustrate the situation. Female health workers' status is determined by the structure and operation of the PHC system; by family and personal needs; by the cultural context of Mexican society; and by the fact that some female health workers view their job as a hobby, placing family considerations above career enhancement.

Adult↗

Identity and experience: a study of selected female physicians in five provincial states of Mexico.

The aim of this paper is to analyse the identity(ies) and experiences of a selected group of female physicians in five provincial states of Mexico. In the last 30 years the number of female physicians in Mexico has grown considerably and yet little is known about these women. Data for this work were drawn from two in-depth interviews with 99 female physicians during 1995-1996. In addition, physicians were asked to complete a personal diary to illustrate the nature of their daily experiences over a three-month period; the gap between the two interviews. Analysis reveals female physician identity is shaped by Mexican health care service structures, personal characteristics and goals, and career development choices and opportunities. Association with particular spaces and places influences female physician career development and identity. The multiple identities of these professional women and their lived experiences can result in various pressures and tensions in family and career life. As a result these women make choices about career development; some reassess their career goals given their family and household circumstances and thus their career development may appear to be constrained. The paper concludes by suggesting that changes in Mexican health institutions and the science of medicine may lead to changes in female physician identity.

Career Mobility↗