PubMed Health⌕ Search

Biomedical subjects

Michael Mulvihill

Publications and source records attributed to Michael Mulvihill.

6 recordsLinked to original sources

Composition of chlorinated hydrocarbon contaminants among major adipose tissue depots of polar bears (Ursus maritimus) from the Canadian high Arctic.

Monitoring of environmental contaminants in Canadian Arctic polar bears (Ursus maritimus) typically has used superficial adipose tissue samples collected as part of controlled native subsistence hunts. However, little attention has been paid to the compositional difference in contaminants that may exist among the major adipose depots that are routinely collected. To address this knowledge gap, we investigated the profiles and concentrations of chlorinated hydrocarbon contaminants (CHCs), including major polychlorinated biphenyl (PCB) congeners and organochlorine (OC) pesticides and metabolites, in six major adipose depots (i.e. superficial, inter-muscular and intra-abdominal regions) obtained from adult male polar bears in the vicinity of Resolute Bay, Canadian high Arctic. Concentrations and congener patterns of PCBs (20 congeners) and OCs (14 compounds; chlordanes and dichlorodiphenyltrichloroethanes and metabolites, chlorinated benzenes, hexachlorocyclohexane isomers, octachlorostyrene and dieldrin) were found to be relatively uniform throughout the adipose tissue of male polar bears. The only exception was the inter-muscular adipose depot from the cervical region, which was characterized, compared to other major depots routinely sampled, by lower proportions of higher-chlorinated and recalcitrant congeners such as CB170/190, 180, 194 and 206, and higher contribution of the lower-chlorinated PCBs, CB47, 74 and 99. No difference in the OC makeup and concentrations was found among the adipose depots investigated. In view of this, we conclude that the determination of CHCs in adipose tissue of polar bears from any major depots, with the potential exception of the fat under the neck muscles, would give a representative picture of the overall CHC composition and concentrations in polar bear fat for purpose of trend monitoring.

Adipose Tissue↗

Hospital care at the end of life: an institutional assessment.

Decisions about care at the end of life are not only influenced by doctor-patient-family relationships and physician practice, but also by institutional "culture." An institutional assessment of the quality of care provided to dying hospitalized patients was undertaken to characterize and identify factors influencing it and to find opportunities for improvement. An analysis of hospital data, three physician and nursing focus group discussions, structured review of records of targeted patients (61) who had an "expected death," and interviews with 31 surviving family members of the targeted patients served as the basis for an institutional needs assessment intended to precede the development of a quality improvement program to improve hospital care of patients at the end of life. Data were primarily gathered regarding older adults, including a significant number of nursing home residents. The assessment led to a methodology for developing a quality improvement program based upon feedback to physicians and nurses regarding the quality of end-of-life care.

Adult↗

Women's knowledge and experience of atypical Pap results in a high risk community.

We sought to describe the knowledge of, understanding of, and follow-up after atypical cervical cytology among low-income, urban women. Of 554 women who had an ASCUS or atypical Pap result in 1996,215 (39%) completed a telephone survey. Many (19%) had poor follow-up. Thirty percent of women denied ever being told of abnormal cytology; Spanish-speakers were more likely to be unaware (43.2% vs. 22.7%, p < .01) of abnormal cytology. Cancer fear was quite high, as were misconceptions regarding cause. Many women were unsatisfied with the information they received regarding their cytology.

Adolescent↗

Trends in mortality due to legal intervention in the United States, 1979 through 1997.

OBJECTIVES: This report identifies trends in the number and rate of deaths due to law enforcement actions (International Classification of Diseases, Ninth Revision, category "legal intervention") in the United States. METHODS: The Centers for Disease Control and Prevention's Compressed Mortality File was used to determine age-, race-, and sex-specific death rates due to legal intervention for the years 1979 through 1997. RESULTS: Males account for nearly all deaths, with the death rate for Black males several times that of White males. For both Whites and Blacks, the highest rates of death were observed for ages 20 to 34. Death rates declined significantly from 1979 to 1988 and remained stable thereafter. CONCLUSIONS: While legal intervention is an uncommon cause of death, some subpopulations experience rates of death many times that of the US population as a whole.

Adolescent↗

Utilization of Cardiovascular Drugs in the Aged in a Long-Term-Care Institution for the Aged over a 5-Year Period 1987--1992.

A comparative study was made of the utilization of cardiovascular drugs in a long-term-care facility for the aged for 1987 and 1992 during which the age and sex distributions and incidence of usage were similar. There were statistically significant declines in the usage of diuretics and potassium supplementation, digoxin, antihypertensives, antiarrhythmics, and beta blockers and a rise in the use of calcium-channel blockers. There was a slight fall in the use of antianginal drugs. The ACE inhibitors introduced after 1987 were taken by 6.1%. The dosages of digoxin and diuretics decreased as management was adequate and toxicity avoided and usage of digoxin reduced in accordance with the concept that digoxin is useful in failure only when left ventricular output is impaired.

Journal Article↗