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Biomedical subjects

A Cameron

Publications and source records attributed to A Cameron.

At least 37 records · Page 2Linked to original sources

Do new roles contribute to job satisfaction and retention of staff in nursing and professions allied to medicine?

BACKGROUND: Studies have suggested that job dissatisfaction is a major factor influencing nurses' and occupational therapists' intention to leave their profession. It has also been related to turnover of qualified nurses. However, literature relating to these factors among nurses and professions allied to medicine in innovative roles is scarce. AIMS: This paper considers the views of 452 nurses and 162 professionals allied to medicine (PAMs) in innovative roles, on job satisfaction, career development, intention to leave the profession and factors seen as hindering and enhancing effective working. METHODS: A self-completion questionnaire was developed as part of a larger study exploring new roles in practice (The ENRiP Study). FINDINGS: Overall there was a high level of job satisfaction in both groups (nurses and PAMs). Job satisfaction was significantly related to feeling integrated within the post-holder's own professional group and with immediate colleagues, feeling that the role had improved their career prospects, feeling adequately prepared and trained for the role, and working to protocol. Sixty-eight percent (n = 415) of respondents felt the role had enhanced their career prospects but over a quarter of respondents (n = 163; 27%) said they would leave their profession if they could. Low job satisfaction was significantly related to intention to leave the profession. CONCLUSIONS: The vast majority of post-holders in innovative roles felt that the role provided them with a sense of job satisfaction. However, it is essential that the post-holders feel adequately prepared to carry out the role and that the boundaries of their practice are well defined. Career progression and professional integration both being associated with job satisfaction.

Adult↗

Efficacy of an ovine caseous lymphadenitis vaccine formulated using a genetically inactive form of the Corynebacterium pseudotuberculosis phospholipase D.

Caseous lymphadenitis (CLA) is an economically significant disease of sheep caused by the gram-positive bacterium Corynebacterium pseudotuberculosis. CLA vaccines are currently formulated using formalin inactivated culture supernatants that are rich in the C. pseudotuberculosis phospholipase D (PLD) exotoxin. One alternative to chemical detoxification is to inactivate the PLD genetically. This procedure not only provides a means to remove an onerous chemical treatment step but also the opportunity to increase gene expression, therefore improve protein yields. Using site-specific mutagenesis the C. pseudotuberculosis PLD was inactivated by substituting a serine residue at histidine 20 within the enzyme active site. CLA vaccine formulated using genetically inactivated PLD protected 44% of sheep against C. pseudotuberculosis challenge compared with 95% protection offered by the formalin inactivated preparation. Since there was no apparent difference in immune response mounted by vaccinated sheep the reason for this variation in vaccine efficacy remains unclear. Although genetic inactivation can be a convenient means to produce toxoid vaccines its use to develop a new CLA vaccine provided no net benefit over the conventional formulation.

Animals↗

A model for the assessment of sensory recovery of experimental skin grafts.

The return of sensation to skin grafts is often suboptimal. Although the reinnervation of skin grafts has been examined by a number of authors during the past century, studies in humans have left a number of unanswered issues, whereas animal studies have been largely confined to histological work and a few electrophysiological studies. Based on knowledge that rats exhibit a reflexive flick of the back skin in response to stimulation, the authors hypothesized that it should be possible to develop a noninvasive model for assessing return of sensation in experimental skin grafts. Full-thickness skin grafts were created, one per animal, on the dorsa of male Sprague-Dawley rats. Sensory testing was performed using a hand-held pinprick device designed to deliver a stimulus of reproducible force. A positive response was observed as a flick of the dorsal skin--a very reliable reflex involving the cutaneus trunci muscle. The stimulus was delivered to each of 25 sectors of the graft on days 9, 13, 16, 20, 40, 60, and 110 postoperatively. Results were analyzed regarding the percentage of grafts responding at each time point as well as the topographical pattern of sensory return. Evidence of sensation was first detected at day 13 at the margins of the skin grafts and then progressed centrally until homogenous reinnervation (94% of the graft surface) was observed at day 40 and was maintained through the end of the study. Growth Associated Protein (GAP)-43 immunostaining was used to document reinnervation of the skin grafts histologically.

Animals↗

Veterinary vaccines: In-VITRO--International Veterinary Industry Test Replacement Organisation.

The International Veterinary Industry Test Replacement Organisation (In-VITRO) was established in 1995 with the aim of developing, validating and harmonising in vitro alternatives to replace in vivo methods for in-process and potency testing of veterinary clostridial vaccines. The emphasis has been on the reduction of animal usage in the Clostridium chauvoei potency assay and its eventual replacement by an in vitro assay. Replacement of the toxin neutralisation assay for Cl. tetani by an internationally validated indirect ELISA has already started. A validation programme involving a collaboration organised through EDQM which could ultimately lead to the standardisation of in vitro tests for all clostridial vaccines is in progress. In addition In-VITRO is now considering the setting up of a programme for Erysipelas vaccines. The collaboration between manufacturers of veterinary vaccines in the development and validation of in vitro tests is a major step towards the reduction and replacement of animal tests.

Animal Testing Alternatives↗

Relationship between diet, dental calculus and periodontal disease in domestic and feral cats in Australia.

OBJECTIVE: To compare the dental calculus scores and prevalence of periodontal disease in domestic cats eating commercially available canned and dry foods with those in feral cats consuming a diet consisting of small mammals, birds, reptiles and insects. ANIMALS: Twenty-nine feral cats and 20 domestic cats were included in the study. PROCEDURE: A dental chart and dental calculus scores were recorded using the maxillary canine, maxillary third and fourth premolar, mandibular canine, mandibular fourth premolar and first molar teeth on both sides. Periodontal disease was recorded using gingival recession, increased periodontal pocket formation, radiographic alveolar bone loss, osteomyelitis, furcation and root exposure, and the presence of calculus as indicators. RESULTS: Dental calculus scores were significantly higher in domestic cats than in feral cats. There was no statistical difference in the prevalence of periodontal disease between the two groups. CONCLUSIONS: It can be inferred that diet may play a role in the accumulation of calculus, but a diet based on live prey does not protect cats against periodontal disease.

Animal Feed↗

Prenatal diagnosis and management of urethral obstruction.

Eighteen cases of bladder outlet obstruction were diagnosed at Queen Mother's Hospital, Glasgow, over a period of 6 years. Commonest cause was posterior urethral valve in 11 cases (61%). Oligohydramnios was present in 78% of cases with a mortality of 67% mainly due to pulmonary hypoplasia. The 6 surviving infants (33%) underwent early postnatal surgery. Two of these have chronic renal failure on follow-up.

Female↗

Malaria in Honiara, Solomon Islands: reasons for presentation and human and environmental factors influencing prevalence.

During February and March 1995, out-patients attending health clinics and the Central Hospital in East Honiara, Guadalcanal, Solomon Islands, were surveyed with the aim of determining factors influencing the differing rates of malaria, the proportion of transmission occurring within the town, and the reasons for presentation. Three hundred and nine adult patients, who were sick and had blood smears taken, were asked about their general knowledge of malaria transmission. Of those interviewed, 120 were visited at their home in East Honiara, to determine variables. EpiInfo 5.1 was used in analysis. A history of fever alone was not a good indicator of parasitemia. Most precautions, including bed nets, window screens and personal precautions were of little benefit. Significant protection was afforded individuals and families with indoor kitchens. Patients not completing their antimalarial treatment fared worse in terms of parasitemia and malaria history. Most malaria/parasitemia was indigenous to Honiara. Many patients had a good knowledge of malaria transmission and mosquitos, but this did not translate into a lower rate of parasitemia or malaria.

Adolescent↗

Nurses taking on junior doctors' work: a confusion of accountability.

The number of hospital based posts in which nurses take over clinical work previously done by junior doctors is growing. Accountability for the scope of such new roles and the standards of practice which apply to them are still unclear. When analysed together and compared, the regulations arising from the professional bodies (GMC and UKCC), civil law concerning certain wrongs to patients, and employment law are sometimes contradictory and hard to interpret. The resulting uncertainties about appropriate management for clinical roles evolving between the professions, coupled with an increasingly litigious public, put the nurses and consultants involved at risk of complaints and of disciplinary and legal action. Drawing on our current research into changing clinical roles at the medical-nursing interface, we suggest strategies to reduce risk. Doctors and nurses should be equal partners in planning and managing these new posts, patients should be informed adequately about the nature of the postholder's role and training, significant changes in the work of such postholders should be formally acknowledged by the employer and relevant insurers, individuals taking up new roles should have access to legal advice and support to cover legal risk, and national regulatory bodies need to work together to harmonise their codes of practice in relation to changing clinical roles between the professions.

Humans↗

Coronary bypass surgery with internal-thoracic-artery grafts--effects on survival over a 15-year period.

BACKGROUND: Aortocoronary bypass surgery has been performed most often with the patient's saphenous vein as the conduit. The internal-thoracic-artery graft, which has superior patency rates, has been shown to have clinical advantages, but it is not known how long these advantages persist. METHODS: We identified all the patients in the registry of the Coronary Artery Surgery Study who had undergone first-time coronary-artery bypass grafting. Those with internal-thoracic-artery bypass grafts (749 patients) were compared with those with saphenous-vein bypass grafts only (4888 patients) with respect to survival over a 15-year follow-up period. RESULTS: In a multivariate analysis to account for differences between the two groups, the presence of an internal-thoracic-artery graft was an independent predictor of improved survival and was associated with a relative risk of dying of 0.73 (95 percent confidence interval, 0.64 to 0.83). This improved survival was also observed in subgroups including patients 65 years of age or older, both men and women, and patients with impaired ventricular function. The survival curves of the two groups showed further separation over the years of follow-up, with a more marked downsloping after eight years in the curve for the group with saphenous-vein grafts only than in that for the group with internal-thoracic-artery grafts. CONCLUSIONS: As compared with saphenous-vein coronary bypass grafts, internal-thoracic-artery grafts conferred a survival advantage throughout a 15-year follow-up period. The survival advantage increased with time, suggesting that the initial selection of the conduit was a more important factor in survival than problems appearing long after surgery, such as the progression of coronary disease.

Aged↗