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Biomedical subjects

A Adams

Publications and source records attributed to A Adams.

At least 109 records · Page 6Linked to original sources
PubMed1995

Impact of varying panel membership on ratings of appropriateness in consensus panels: a comparison of a multi- and single disciplinary panel.

OBJECTIVE: The objective of the study was to examine the appropriateness ratings for the use of spinal manipulation for low back pain of a multidisciplinary panel of medical and chiropractic physicians, and those of a panel composed only of chiropractic physicians. DATA SOURCES: The study analyzed data from two consensus panels conducted at RAND in 1990 and 1991. STUDY DESIGN: The study design followed that of the traditional RAND consensus panels. Nine individuals comprised each panel, and each panelist was asked to rate, on a nine-point scale, the indications for spinal manipulation twice, the first time alone and the second time jointly with the panel. DATA COLLECTION: The ratings of the panelists from both groups, for both round one and round two, were collated and compared. PRINCIPAL FINDINGS: While both panels were more likely to rate the indications as inappropriate than appropriate, the single disciplinary panel was more likely to rate an indication as appropriate than the multidisciplinary panel. CONCLUSION: The composition of a panel clearly influences the ratings and those who use a given procedure in practice, in this case manipulation, are more likely to rate it as appropriate than those who do not use the procedure.

Chiropractic↗
PubMed1994

The Physician-Delivered Smoking Intervention Project: factors that determine how much the physician intervenes with smokers.

OBJECTIVE: To determine factors that affect how much physicians trained to use a patient-centered smoking intervention intervene with their smoking patients. DESIGN: Forty internal medicine residents and ten internal medicine attending physicians trained in a patient-centered counseling approach were randomized to an algorithm condition (provision of intervention algorithm at each patient visit) or a no-algorithm condition. Smoking intervention steps used by physicians with patients were assessed with Patient Exit Interviews (PEIs). SETTING: Ambulatory clinic; academic medical center. PATIENTS: Five hundred twenty-seven adult smokers seen in clinic between June 1990 and April 1992. MAIN RESULTS: There was no difference in overall PEI scores or in individual PEI steps taken between the algorithm and no-algorithm conditions. Two patient baseline factors (reporting thinking of stopping smoking within six months and higher Fagerstrom Tolerance Score) and one physician factor (older age) were significantly predictive of higher PEI score. CONCLUSION: Provision of an intervention algorithm at each patient visit does not increase the likelihood that trained physicians who are cued to intervene will perform more of the intervention steps taught. Trained physicians are more likely to intervene with smokers who are more nicotine-dependent and who expect and desire to stop smoking.

Adolescent↗
PubMed1994

The effects of graduate nurse education on clinical practice and career paths: a pilot study.

The recent proliferation of graduate courses in nursing has increased the need for educational administrators to evaluate the impact of such programmes on clinical practice and the career of participants. 40 registered nurses undertaking graduate studies were surveyed as a pilot for an extensive longitudinal study of their perception of the effects of study on work performance and career opportunities. Overall, positive effects were noted by respondents on their job satisfaction, self-esteem, professional thinking and career moves. Increases in professional behaviours such as mentoring, research and writing for publication were noted. Negative consequences were noted by a minority and were related to alterations to health status and increased levels of stress.

Career Mobility↗
PubMed1994

Nurses and smoking: a comparative study of students of nursing and teaching.

This exploratory study compared three student groups (n = 221)--college student nurses, hospital student nurses and student teachers--in terms of their smoking behaviour, factors influencing smoking and their beliefs and values. More student nurses, both hospital and college students, smoked than student teachers while more hospital student nurses were smoking than college student nurses. The majority of students who smoked started smoking before they started their nursing and teaching courses. The influence of friends was the most important factor in starting smoking while enjoyment was the main reason for continuing to smoke. The risks in smoking were acknowledged by all groups. Student nurses were more likely to believe that smoking reduces stress levels. Hospital student nurses and student teachers were unconvinced about the health promotion role of nurses.

Adult↗
PubMed1993

A possible case of transient hereditary fructose intolerance.

A patient is described who presented with the signs and symptoms of hereditary fructose intolerance a few hours after her first fructose challenge. The diagnosis was confirmed by the demonstration of reduced activity of hepatic aldolase B towards fructose-1-phosphate. A second liver biopsy 10 months later had normal aldolase B activity towards fructose-1-phosphate and a fructose tolerance test was also normal. A possible explanation for these findings is proposed.

Female↗
PubMed1993

Antibodies to collagen in patients with idiopathic pulmonary fibrosis.

STUDY OBJECTIVE: The pathogenesis of idiopathic pulmonary fibrosis (IPF) is uncertain. This investigation was undertaken to determine if antibodies to human native collagens and their chains are present in the serum of the patients with IPF and to examine their relationship with clinical factors. MATERIALS: Serum specimens were obtained from 45 subjects. The subjects were separated into three distinct groups: group 1 consisted of 16 patients with IPF; group 2a, 9 patients with pulmonary fibrotic scars from previous tuberculosis were examined as a control group; group 2b, 20 normal individuals matched by age and sex. The collagen antigens used in this study consisted of four genetically distinct types, I, II, III, IV and their corresponding chains alpha 1(I) + alpha 2(I), alpha 1(II), and alpha 1(III). METHODS: a passive microhemagglutination assay was used to test the antibody activity in the sera of both patients and controls. Titration was performed in microtiter plastic plates, using 0.5 percent cell suspension. The specificity of anticollagen antibodies was then tested using an absorption serum technique with native collagens and their chains. Hemagglutination enhancement and inhibition tests, as well as chromatography, were used to determine the type of antibodies. RESULTS: Thirteen of 16 (81 percent) patients with IPF (group 1) had antibodies against at least one type of native collagen or one type of collagen chain in titers up to 1:512. Twelve patients exhibited anticollagen antibodies with titers above 1:16. By contrast, only 2 of 9 (22 percent) subjects with fibrotic scars (group 2a) and 3 of 20 (15 percent) normal subjects (group 2b) had antibody activity in titers up to 1:8. The differences between group 1 and group 2a and 2b were statistically significant, (p < 0.05 and p < 0.001, respectively). There was an inverse, statistically significant correlation between duration of the disease (IPF) and antibody activity. The correlation coefficient between duration of the disease and titers of antibodies to type III collagen (native and/or chain) was higher than the correlation coefficient between duration of the disease and titers to collagen I. The enhancement and inhibition of agglutination tests, as well as the chromatography, showed that the agglutination factors were antibodies of IgG and IgM classes. The antibody absorption test revealed that the anticollagen antibodies were specific for each collagen and its chain and there was no cross-reaction. CONCLUSION: This study suggests that the anticollagen antibodies could be a marker of IPF activity and may perpetuate the lung tissue inflammation. It is still unclear if the autoimmunity of the collagen participates in the pathogenesis of IPF or the presence of the anticollagen antibodies is simply an epiphenomenon.

Adult↗
PubMed1993

First-line nurse managers in NSW: perceived role competencies (Part I).

A survey of 412 first-line nurse managers employed in hospitals in New South Wales, Australia was undertaken to determine the competencies they believed an individual should possess to fulfil that managerial role. Factor analyses identified both the significant functions of the role as well as areas of role conflict and confusion. Thirteen factors identified from four major scales indicated that first-line nurse managers perceived their role to be extremely comprehensive in terms of managerial knowledge and skills. The analyses clearly indicate that competencies related to staffing and financial issues are perceived to be essential to role performance. However, the correlation coefficients (factor loadings) indicate that ambiguity exists with competencies concerning patient care, perhaps as the remnants of the charge nurse role are discarded.

Clinical Competence↗
PubMed1993

First-line nurse managers in NSW: perceived role competencies (Part II).

A survey of 412 first-line nurse managers employed in hospitals in New South Wales, Australia was undertaken to determine the competencies they believed an individual should possess to fulfil that managerial role. Factor analyses identified both significant functions of the role as well as areas of role conflict and confusion. 13 factors were identified from 4 major scales indicating that first-line nurse managers perceived their role to be extremely comprehensive in terms of managerial knowledge and skills. The analyses clearly indicate that competencies related to staffing and financial issues are perceived to be essential to role performance. However, the correlation coefficient (factor loadings) indicate that ambiguity exists with competencies concerning patient care, perhaps as the remnants of the charge nurse role are discarded. The findings in this study have been presented in two parts: Part 1 discussed the factors identified in two scales, Functional Management and Patient Care Management; Part II discusses the factors identified in the remaining two scales, Staff Management and Leadership (subdivided into two subscales for analysis).

Clinical Competence↗
PubMed1993

[Technetium TC 99m pyrophosphate myocardial scintigraphy in amyloidosis. Correlations with Doppler echocardiography].

Technetium 99m cardiac scintigraphy as practiced at present for diagnosing amyloisodid only provides a visual semi-quantitative assessment of uptake of the isotope. To improve the diagnostic accuracy of the method, the authors evaluated prospectively a personal technique of scintigraphy quantification based on early images obtained at the 20th minute in 15 patients with neuropathic amyloidosis. Doppler echocardiographic studies indicated that 9 patients had cardiac involvement whilst 6 were free of cardiac amyloidosis. The index of isotopic uptake (ratio of cardiac/abdominal uptake) was 0.44 to 1.58 in the first group and 0.09 to 0.31 in the second group. The correlation between the scintigraphic index and interventricular septal or posterior wall thickness measured by echocardiography was poor. These results obtained in 15 patients with neuropathic amyloidosis suggest that the scintigraphic index measured at the 20th minute is discriminatory and allows identification of those patients with cardiac involvement. On the other hand, the correlations with echocardiographic wall thickness are poor. Technetium 99m cardiac scintigraphy with this technique of quantification is a useful tool for diagnosing cardiac amyloidosis, especially when echocardiography is difficult to interpret.

Adult↗
PubMed1993

Epidemiological studies of onchocerciasis in southern Benin.

We studied the prevalence of human onchocerciasis in four geographically different regions of the southern part of Benin in West Africa. In a total of thirteen villages 1596 individuals were examined for clinical and parasitological signs of onchocerciasis. Prevalence of microfilariae of Onchocerca volvulus in skin snips was 29% in region I (lower Oueme river), 64% in region II (Mono river), 56% in region III (upper Oueme river) and 70% in region IV (Okpara river). Based on endemicity criteria of the WHO regions II and IV were found to be hyperendemic, region III mesoendemic and region I hypoendemic for onchocerciasis. The community microfilarial load ranged from 4 mf/mg skin in the hypoendemic region to 10.5 mf/mg skin in the hyperendemic regions. The prevalence of nodules was 21% in region I, 30% in region II, 17% in region III and 41% in region IV. The overall prevalence of chronic onchocercal dermatitis was 12%. Of 689 individuals infected with O. volvulus 388 were treated with a single dose of ivermectin.

Adolescent↗
PubMed1992

Polyadenylic:polyuridylic acid-induced protection of BALB/c mice against acute murine cytomegalovirus infection.

Treatment of BALB/c mice with poly(A):poly(U) 18 h prior to infection with a lethal dose of murine cytomegalovirus (MCMV) increased survival. In parallel with increased survival, a 10- to 100-fold reduction of plaque-forming MCMV was found in the liver and spleen of mice 4 days post-infection with a sublethal dose of MCMV. Poly(A):poly(U) did not significantly increase natural killer cell activity or prolong the duration of elevated cytotoxic activity in infected animals. The possible role of interferon in the poly(A):poly(U)-induced protection of BALB/c mice is discussed.

Animals↗
PubMed1991

The value of drills in developing and maintaining numeracy skills in an undergraduate nursing programme.

The purpose of this study was to determine whether mathematical drills enhanced the ability of students of nursing to calculate drug dosages accurately. First year students were drilled and then tested over the next 2 years in drug calculations. It was found that repeated drilling improved students' ability to calculate drug doses but that this skill level diminished over time, in some instances to predrill levels of accuracy. An increase in the number of correct calculations was noticed in the two semesters in which students had a clinical placement leading the authors to conclude that, contrary to previous findings, work experiences do enhance the ability to calculate medication dosages. As safety and competency are essential in those areas of nursing practice which depend on mathematical ability, educational strategies which develop and retain mathematical skills are needed.

Drug Therapy↗
PubMed1990

Characterization of human fructose-1,6-bisphosphatase in control and deficient tissues.

The regulatory properties of human liver and muscle fructose-1,6-bisphosphatases (FBPase) have been studied in control tissues obtained at autopsy and in tissues from a neonate with FBPase deficiency who died as a result of an overwhelming acidosis. Evidence is presented which suggests that the alkaline isoenzyme of FBPase, which is widely regarded as a laboratory artefact, may have an important role in vivo in the regulation and control of glycolysis and gluconeogenesis. FBPase exhibits the hysteretic and dissociative properties associated with regulatory enzymes, and many of the factors which effect FBPase have inverse effects on phosphofructokinase activity, thus providing an integrated regulatory cycle for the control of the direction and rate of flux through the glycolytic pathway.

Catalysis↗
PubMed1990

Health promotion as a nursing function: perceptions held by university students of nursing.

Health care in Australia is more often perceived to be illness rather than health focused in nature. The increasing cost of health care has prompted a movement towards health promotion in the community demanding increasing involvement of health care professionals. This three year study was undertaken to determine the attitudes of students towards health promotion on entry and throughout a tertiary nursing programme. This longitudinal study was exploratory in nature and examined the attitudes of two student cohorts over the programme's three years. Entering students cited the health promotion function more frequently than did those nearing programme completion. There is a need to emphasise health promotion as a role if this is seen as desirable behaviour for comprehensively educated nurses. The perceptions of three intakes of students were examined. The function of health promotion was perceived to be important by entry students and was within the three most frequently mentioned functions.

Attitude of Health Personnel↗