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Biomedical subjects

A Chamberlain

Publications and source records attributed to A Chamberlain.

At least 19 recordsLinked to original sources
PubMed1999

An encyclopedia of mouse genes.

The laboratory mouse is the premier model system for studies of mammalian development due to the powerful classical genetic analysis possible (see also the Jackson Laboratory web site, http://www.jax.org/) and the ever-expanding collection of molecular tools. To enhance the utility of the mouse system, we initiated a program to generate a large database of expressed sequence tags (ESTs) that can provide rapid access to genes. Of particular significance was the possibility that cDNA libraries could be prepared from very early stages of development, a situation unrealized in human EST projects. We report here the development of a comprehensive database of ESTs for the mouse. The project, initiated in March 1996, has focused on 5' end sequences from directionally cloned, oligo-dT primed cDNA libraries. As of 23 October 1998, 352,040 sequences had been generated, annotated and deposited in dbEST, where they comprised 93% of the total ESTs available for mouse. EST data are versatile and have been applied to gene identification, comparative sequence analysis, comparative gene mapping and candidate disease gene identification, genome sequence annotation, microarray development and the development of gene-based map resources.

Animals↗
PubMed1999

The Pathways study: a model for lowering the fat in school meals.

We describe the development and implementation of the Pathways school food service intervention during the feasibility phase of the Pathways study. The purpose of the intervention was to lower the amount of fat in school meals to 30% of energy to promote obesity prevention in third- through fifth-grade students. The Pathways nutrition staff and the food service intervention staff worked together to develop 5 interrelated components to implement the intervention. These components were nutrient guidelines, 8 skill-building behavioral guidelines, hands-on materials, twice yearly trainings, and monthly visits to the kitchens by the Pathways nutrition staff. The components were developed and implemented over 18 mo in a pilot intervention in 4 schools. The results of an initial process evaluation showed that 3 of the 4 schools had implemented 6 of the 8 behavioral guidelines. In an analysis of 5 d of school menus from 3 control schools, the lunch menus averaged from 34% to 40% of energy from fat; when the menus were analyzed by using the food preparation and serving methods in the behavioral guidelines, they averaged 31% of energy from total fat. This unique approach of 5 interrelated food service intervention components was accepted in the schools and is now being implemented in the full-scale phase of the Pathways study in 40 schools for 5 y.

Asian People↗
PubMed1997

The use of a ward-based educational teaching package to enhance nurses' compliance with infection control procedures.

Obtaining study leave is becoming difficult for clinical nurses in the current economic climate, but the need to develop new clinical skills and to maintain existing good practice remains of prime importance to patient care and will become mandatory with the advent of post-registration education and practice (PREP) in the UK. The ward is widely acknowledged as the best venue for learning clinical skills by nurse educationalists and for many nurses is the preferred learning environment. The feasibility of using a ward-based teaching package to enhance nurses' compliance with key infection control precautions (hand decontamination, the use of gloves and the safe handling and disposal of sharp instruments) was tested in a quasi-experimental research study conducted on matched surgical wards in a teaching hospital, controlling for variables likely to influence performance (knowledge, availability of resources to perform infection control, previous opportunity to develop infection control expertise and nursing workload). Nurses on two wards received the intervention (experimental group). The remaining wards, which received no intervention, operated as controls. The ward-based sessions consisted of a carefully planned sequence of theory and practical demonstration delivered to qualified nurses in the clinical environment at convenient times selected by the ward managers. Performance of infection control precautions was audited before the intervention and 3 months afterwards. The sessions were well evaluated and the clinical environment was considered suitable for teaching by the nurses, but heavy and unpredictable workload prevented the teaching programme from being implemented as planned. The analysis of covariance failed to detect any changes in performance between nurses in the control and experimental groups. The implications of the study findings are discussed to help develop creative new ways of strengthening ward-based educational programmes.

Education, Nursing, Continuing↗
PubMed1995

Communication aids for the speech impaired. Cost and quality-of-life outcomes of assessment programs provided by specialist Communication Aids Centers in the United Kingdom.

An evaluation was conducted of the approaches, costs, and quality-of-life outcomes associated with communication aid assessment programs for the speech-impaired provided by specialist Communication Aids Centres (CACs) in the United Kingdom. The average costs of CAC assessment programs was 410 pounds per client, which is not excessive. There was evidence of moderate quality-of-life benefits from clients' use of the recommended aids.

Adolescent↗
PubMed1994

Infection control as a topic for ward-based nursing education.

The link between nursing theory and practice remains a topic of ongoing debate. Related to this issue is the best place to effectively combine the two. The solution may be ward-based teaching programmes as part of formal continuing staff development, involving collaboration between college-based lecturers and acknowledged clinical experts. Using infection control as an example of a topic in need of regular and continual updating for qualified practitioners, it is argued that such programmes would be desirable because they would afford sufficient flexibility to fulfil individual learning needs and could be assessed to indicate whether nursing practice had been enhanced. Participants could be accredited for successful completion of ward-based programmes.

Accreditation↗
PubMed1994

Gram-negative bacteria. The challenge of preventing cross-infection in hospital wards: a review of the literature.

Gram-negative bacteria are responsible for a high proportion of nosocomial infections, particularly among the critically ill and those in hospital for long periods. Colonization (asymptomatic carriage on the skin) occurs before the emergence of overt clinical infection (appearance of the signs and symptoms of disease) and is therefore worth reducing. Spread is principally via the hands of staff, so handwashing is the chief method of prevention. Gram-negative bacteria survive best in a moist environment and are more readily transferred via damp than dry surfaces; hands and equipment should therefore be kept as dry as possible. Good skin can also help prevent cross-infection as Gram-negative bacteria colonize damaged skin more readily than if it is in good condition.

Cross Infection↗
PubMed1993

Pharmacokinetics of ampicillin and sulbactam in pregnancy.

OBJECTIVE: This study evaluated the effects pregnancy had on pharmacokinetic parameters of ampicillin and sulbactam. STUDY DESIGN: Twenty-two women undergoing cesarean section for obstetric indications were randomly assigned to receive a single intraoperative dose of either 1 gm of ampicillin intravenously or 1 gm of ampicillin plus 0.5 gm of sulbactam intravenously after umbilical cord clamping. Blood was drawn from an indwelling intravenous catheter at 15, 30, 45, 60, 120, 240, and 360 minutes after infusion of the antibiotic for determination of serum ampicillin and/or sulbactam levels. Pharmacokinetic parameters were determined by fitting data (serum concentrations versus time) to a single-compartment model that provided elimination rate constants, beta-intercept (calculated concentration at 0 minutes), area under the time-versus-concentration curve, half-life of the drug, total body clearance, and volume of distribution. After the examination 6 weeks post partum, each subject was given an additional dose of the drug she had received during cesarean section, and a second pharmacokinetic study was performed and compared with the previous results. RESULTS: Pregnancy significantly increased the elimination rate constant, decreased the area under the drug-versus-time curve, shortened the serum half-life, and increased the total body clearance in comparison with these parameters in the nonpregnant state for ampicillin. Sulbactam kinetics were similarly affected, although these changes failed to attain statistical significance. CONCLUSION: Because pregnancy is associated with more rapid elimination of beta-lactam drugs, physicians treating infections in pregnant or newly parturient women should consider using shorter intervals between antibiotic doses when a range of dosage intervals is under consideration.

Ampicillin↗
PubMed1993

Evaluation of Communication Aid Centres in England and Wales.

This paper reports the findings of an evaluation (funded by the Department of Health) of six Communication Aid Centres established in 1983. The evaluation was undertaken to assess the effectiveness of these Centres in meeting their set objectives, and to examine service costs and client satisfaction. The findings show that the work of each Centre was effective in meeting its stated objectives, but that the work of individual Centres reflected its own specialised interests. Two problems with current funding arrangements were highlighted. First, the need to replace the original funding by locally based finance, and second, the funding of communication aids for clients. The findings also show that the specialist service provided by these Centres can be managed at costs per person assessed at, or below, non-specialist services in health districts. Client satisfaction with the services provided by the Centres was high.

Communication Devices for People with Disabilities↗
PubMed1992

Evaluation of a heart disease survey and education program for general practitioners.

In 1989 we mailed a questionnaire to all 461 general practitioners (GPs) identified as currently practising in the Eastern Metropolitan Health Region of Sydney. This was the first phase of a program to assess, amplify and reassess GPs' knowledge of the risk factors for heart disease and measure their attitudes and beliefs about their role in the prevention of cardiovascular disease. The second phase was an education program designed to meet the needs identified by the first questionnaire. Phase three was a postintervention questionnaire. Fifty-six per cent (260/461) responded to the first questionnaire. This follow-up group were mailed the second questionnaire, to which 52 per cent (135/260) responded. Thirty per cent of the original sample (139/461) attended the education program and 30 per cent (79/260) of the follow-up group did so. At baseline, the respondents' level of risk factor knowledge was good, but after the education program there was still a large gap between what they said they knew and the amount of advice they said they would give to patients. The only significant increase in the amount of advice after the intervention was to 'control blood pressure'. This applied whether the GP had participated in the intervention or not. When GPs were asked how often in the last month they had actually given advice to reduce cardiovascular disease risk, program attenders reported offering it more frequently than nonattenders. We also attempted to determine whether any particular demographic characteristics could predict respondents to the questionnaires and/or the educational program.

Australia↗
PubMed1992

Home parenteral nutrition in chronic intestinal failure.

In children with severe failure of intestinal function, intravenous nutrition is at present the only treatment able to maintain adequate nutrition for prolonged periods of time. Over the last five years we have discharged 10 patients home on parenteral nutrition for a total of 25 patient years and here the outcome of these children is presented. Of the 10 patients, one has discontinued home parenteral nutrition (HPN), seven patients remain well, one patient has recently moved to the USA, and one patient has died after major abdominal surgery. All children had either normal or an accelerated rate of growth on HPN and developmentally all have progressed well. All the children over 5 years attend normal schools. The major complication of treatment was line sepsis with an overall rate of one episode in 476 days and a total of nine central lines (five patients) have required replacement giving an average line life of 680 days. For those children unfortunate enough to suffer from severe intestinal failure, HPN is preferable to prolonged hospital treatment and offers the chance of a good quality of life with prolonged survival.

Adolescent↗
PubMed1987

Targeting the smoker in an anti-smoking campaign.

Between May and September 1983, 1,661 smokers from a random sample of the populations of Sydney and Melbourne were interviewed in their homes. Of the first group, 219 were followed up 12 months later, representing a 75% response rate. Intention, measured by perceived likelihood to quit, was validated as a predictor of a later attempt to quit smoking in the cohort study. Males reported likelihood to quit more often than females. Perceived importance of smoking as a community health problem was also important in predicting attempts to change smoking status, indicating the possible importance of an agenda-setting role for the mass media in promoting change. The key finding was the interaction between health beliefs and social influence in predicting level of intention. On their own, health beliefs showed no relationship to perceived likelihood to quit, and social influence could be counterproductive. However, taken together, these two variables were strongly predictive of change. This suggests that a combination of these two messages should be used in anti-smoking campaigns.

Adolescent↗
PubMed1986

Evaluation of the Sydney "Quit. For Life" anti-smoking campaign. Part 1. Achievement of intermediate goals.

The "Quit. For Life" campaign was a media-based programme that was aimed at reducing the prevalence of smoking in Sydney. The programme committee set four intermediate goals which it felt had to be met for such a change in prevalence to occur. From households selected at random in Sydney and Melbourne, 5713 people were interviewed to assess whether the campaign attained these goals. The television commercials that were designed for the campaign, their frequency and the timing of their screening produced a higher recall of the commercial's message and the use of campaign back-up services than were specified originally in the goals. During the campaign there was a progressive increase in the number of smokers in Sydney who reported that they were likely to quit; this was significantly different from Melbourne data by the end of the campaign and thus fulfilled another campaign goal. However, shortly after the campaign ended, the proportion of smokers who intended to quit smoking was the same in the two cities. A cohort study of 949 people from the baseline study showed that, during the 12-month period of follow-up, 66% of Sydney smokers tried to stop or to reduce their smoking. In the control city, Melbourne, 60% of smokers reported making such attempts. Of the original smokers, 23% in Sydney and 9% in Melbourne quit during the follow-up period--a statistically significant difference. As well, 10% of the original ex-smokers in Sydney and 11% in Melbourne relapsed, while 4% of nonsmokers in both cities began smoking by the end of the second survey.

Adolescent↗
PubMed1985

Pulmonary epithelial permeability after inhaling saline, distilled water "fog" and cold air.

It is recognized that hyperventilation of cold air and the inhalation of fine mists of distilled water provoke significant bronchoconstriction in the asthmatic individual, yet little is known as to how these provocations affect the structural integrity of the alveolar epithelial membrane. In 11 normal subjects, the following effects have been studied: cold air hyperventilation for three minutes, inhalation of 80 L of ultrasonically nebulized distilled water "fog," and 80 L of isotonic saline "fog" on the half time clearance (T1/2) from the alveoli of technetium 99m diethylene triamine penta acetate (DTPA), inhaled as an aerosol. The DTPA T1/2 provided a measurement of pulmonary epithelial permeability.

Aerosols↗
PubMed1984

Issues in fertility control for mentally retarded female adolescents: I. Sexual activity, sexual abuse, and contraception.

Little information is available about sexual activity, sexual assault, and contraceptive use among mentally retarded adolescents. The experience in these areas among 87 mentally retarded females is reviewed. (A companion paper focuses on these patients' parental attitudes toward sterilization.) All subjects attended a multiservice adolescent clinic with a large developmentally disabled patient group. Charts were reviewed and 69 parents were interviewed. The patients had an age range from 11 to 23 years (mean 16.7). Forty-one subjects were mildly retarded (IQ 55 to 69), 23 were moderately retarded (IQ 41 to 54), and 23 were severely retarded (IQ less than 41). Half of the mildly retarded had had sexual intercourse, a proportion comparable to the general adolescent population. Thirty-two percent of the moderately retarded and nine percent of the severely retarded adolescents had had intercourse. One third of the mildly retarded and one fourth of the moderately retarded adolescents had been victims of rape or incest. Continued sexual activity correlated with sexual abuse, but the majority of victims had no prior or subsequent evidence of intercourse. Forty-two subjects (48%) had used contraception at some time; intrauterine devices and injectable medroxyprogesterone acetate were preferred to oral contraceptives. Six of the 14 patients (43%) who continued sexual activity became pregnant, suggesting that currently available contraception is not providing sufficient protection.

Adolescent↗