Biomedical subjects
Publications and source records attributed to B Kelly.
A map location of the gluconate-6-phosphate dehydrogenase (gnd) marker was estimated in Escherichia coli C at approximately 46 min by P1 transduction. The gnd locus appears to lie between the co-transducible histidine and prophage P2 location I markers.
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A series of independent Escherichia coli K eductants has been isolated and tested to determine the extent of their deletions. The deletions cover the P2 prophage in location H, the his operon, a suppressor of the recBC phenotype (sbcB), the gene for gluconate-6-phosphate dehydrogenase (gnd), a locus involved in cell wall synthesis (rfb), and in some cases all or part of genes involved in methylgalactoside uptake (mglP). One end of the deletion, the P2 prophage end, appears to be the same for all eductants. The other end, however, can be located before, within, and after the mglP locus.
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AIMS: The psychological outcome of family carers after bereavement is an important issue in evaluating palliative care services. Palliative care services have the potential to provide preventive psychosocial intervention to family carers prior to bereavement, but are faced with the need to identify those who may have greatest risk of adverse outcome. This prospective study examines predictors of psychological outcome for family carers of cancer patients following bereavement based on factors identified at referral to a palliative care agency. METHODS: Cancer patients and their family carer were consecutively recruited and assessed on a range of clinical and psychological measures at referral to a palliative home care service in a metropolitan centre (Time 1). Carers were again assessed following the death of the patient, on average at 4 months post-bereavement (Time 2), using measures of bereavement symptoms and psychological morbidity. RESULTS: 178 carers were assessed on both occasions. The chief predictors of carer psychological symptoms and severity of grief at follow-up were psychological symptom scores at the time of referral (Time 1). Factors also measured at Time 1 were significant predictors of symptoms and grief scores at Time 2: greater number of adverse life events, carer's coping responses, past bereavement and separation experiences, the relationship with the patient, and greater severity of patient's illness at the time of palliative care referral. CONCLUSIONS: The findings indicate clinical risk factors for adverse short-term bereavement outcome that can be identified in family carers during palliative care treatment, that have implications for identifying the psychological needs of carers, and that form a potential basis for interventions to enhance the psychological outcome for family carers.
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The purpose of this study was to examine the expectations of senior nursing undergraduates in the "real world" of hospital nursing practice, with particular regard to the ethical dimensions of their role. The method was qualitative; specifically, a grounded theory approach was used. The sample consisted of 23 senior baccalaureate nursing students, from a possible population of 120, who were in their final clinical rotation before graduation. Informants were volunteers who gave informed consent, having been briefed on the purposes of the study and how their confidentiality would be protected. Data were collected through audiotaped interviews and clinical logs and analyzed through the constant comparative method. The study concluded that (1) senior nursing students were not naive about the reality of practice; (2) most perceived themselves as fairly powerless; (3) they voiced a commitment to the ethical principle of respect for the client as evidenced by listening, providing information, accepting values, and encouraging a climate for self-determination; (4) they experienced guilt when they did not "say something"; and (5) they expressed disappointment that nurses did not "stand up" for patients.
A cross-sectional study was performed to investigate the prevalence and predictors of suicidal ideation and past suicide attempt in an Australian sample of human immunodeficiency virus (HIV)-positive and HIV-negative homosexual and bisexual men. Sixty-five HIV-negative and 164 HIV-positive men participated. A suicidal ideation score was derived from using five items selected from the Beck Depression Inventory and the General Health Questionnaire (28-item version). Lifetime and current prevalence rates of psychiatric disorder were evaluated with the Diagnostic Interview Schedule Version-III-R. The HIV-positive (Centers for Disease Control and Prevention [CDC] Stage IV) men (n = 85) had significantly higher total suicidal ideation scores than the asymptomatic HIV-positive men (CDC Stage II/III) (n = 79) and the HIV-negative men. High rates of past suicide attempt were detected in the HIV-negative (29%) and HIV-positive men (21%). Factors associated with suicidal ideation included being HIV-positive, the presence of current psychiatric disorder, higher neuroticism scores, external locus of control, and current unemployment. In the HIV-positive group analyzed separately, higher suicidal ideation was discriminated by the adjustment to HIV diagnosis (greater hopelessness and lower fighting spirit), disease factors (greater number of current acquired immunodeficiency syndrome [AIDS]-related conditions), and background variables (neuroticism). Significant predictors of a past attempted suicide were a positive lifetime history of psychiatric disorder (particularly depression diagnoses), a lifetime history of infection drug use, and a family history of suicide attempts. The findings indicate increased levels of suicidal ideation in symptomatic HIV-positive men and highlight the role that multiple psychosocial factors associated with suicidal ideation and attempted suicide play in this population.
Erotomania is a rare disorder in which an individual has a delusional belief that a person of higher social status falls in love and makes amorous advances towards him/her. Little is known about the background, classification, treatment, or outcome of individuals with this disorder. The purpose of this study was to evaluate current criteria for diagnosing and classifying primary and secondary erotomania in addition to examining course, outcome, and impact on victims of erotomania. Semistructured interviews covering personal and family details in addition to treatment and outcome to date were performed on a series of erotomanic patients identified in a defined area. Evaluation of diagnosis used DSM-IV and other criteria. Fifteen erotomanic subjects (11 female, four male) were identified. Most were isolated, without a partner or full-time occupation. Forty percent had a first-degree relative with a psychiatric history and of those half had a first-degree relative with a mono-delusional disorder. Less than half of the objects of their affection, mainly noncelebrities, were subject to harassment. Subjects with primary erotomania and erotomania secondary to other psychiatric diagnoses were identified using DSM-IV criteria. Ellis and Mellsop's criteria were found to be useful in assessing erotomania but we could not replicate Seeman's fixed and recurrent groups. Treatment and outcome was better than expected particularly for those with primary erotomania and erotomanics with a diagnosis of bipolar affective disorder. In this series, erotomanic symptoms largely occurred in the context of other psychiatric disorders, although subjects with pure erotomanic symptoms were seen. Subjects were less dangerous and engaged in less harassment of victims than the literature suggests. Subjects were often isolated, unemployed, and with few social contacts. Strong family psychiatric histories were seen particularly with regard to mono-delusional disorders raising the possibility of genetic inheritance. An adaptation of Ellis and Mellsop's criteria was suggested for the diagnosis of primary and secondary erotomania. Response to treatment and prognosis was good, particularly for primary erotomania and erotomania secondary to bipolar affective disorder.
A novel human aorta phantom built by medical rapid prototypingfor use in computed tomography (CT) scanning is described. The phantom contained a stent graft that was deployed internally to mimic a repaired aortic aneurysm. The phantom was produced to allow assessment of the CT appearance of a stent graft inside an aorta using the new virtual intravascular endoscopy image presentation technique. The stent graft utilized contained suprarenal components (metalfixation struts), and these were placed with these struts covering the renal artery ostia. The phantom was filled with iodinated contrast medium at a concentration that produced a density similar to that found in normal CT angiographic scanning. The model was scanned at a variety of slice thicknesses, pitch and image reconstruction intervals. Visualization of the stent suprarenal components in relation to the renal artery ostia is shown and the overestimation of stent wire strut diameter demonstrated.
The author's purpose in presenting this article is to describe and interpret the phenomena that contributed to a state of extended bereavement in an 83-year-old window. The problem concerned a newly admitted nursing home resident who appeared to be experiencing profound grief at the loss of a husband who had died 12 years earlier. The method was qualitative, specifically, ethnographic. This case study focuses on the life history of one individual as she perceived it. The question posed for the study was what are the factors contributing to a grief reaction in an elderly widow 12 years after her husband's death? To answer this question a series of interviews were conducted with the informant. The data were then analyzed for meaning in light of current theory in grief and bereavement. The findings, presented in the informant's words, highlight the importance of suddenness, multiplicity of losses, relationship with the deceased spouse, and personal characteristics of the bereaved.
PURPOSE: Risk-reducing surgery is an important option for women with BRCA1 and BRCA2 mutations. There are reports in the literature that insurance reimbursement for these procedures varies greatly. Because health insurance coverage significantly affects medical decision-making, current information regarding reimbursement practices of third-party payers is needed. METHODS: Retrospective study of hospital billing records of 38 women with documented BRCA1 or BRCA2 mutations who underwent either a risk-reducing mastectomy or a risk-reducing oophorectomy between March 1, 1997, and July 30, 2000. RESULTS: Complete billing and reimbursement information was available for 35 women undergoing a total of 39 risk-reducing surgeries. A total of 38 of 39 (97%) risk-reducing surgeries were covered in full, less applicable coinsurance and deductibles. The rate of insurance reimbursement did not vary with type of insurance, personal history of cancer, or type of procedure. CONCLUSION: Insurance carriers reimbursed the vast majority of BRCA mutation carriers undergoing risk-reducing surgery.
As we rush around attending to the essentials of our lives (family, friends, clients, employers), what is left? Nursing Forum invites readers to engage in thoughts and activities that may awaken an untouched place. We hope these writings will kindle your personal involvement in something that was previously avoided--because of bias, fear, or uneasiness--in order to stretch your mind and spirit. The purpose of this paper is to explore the act of speaking up as a moral obligation and its relationship to moral courage and habit. The difficulties of speaking up and the consequences of silence are examined. The benefits of speaking up are raising self-respect, gaining courage, forming good habits and passing on that legacy.