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Biomedical subjects

C Fitzpatrick

Publications and source records attributed to C Fitzpatrick.

At least 19 recordsLinked to original sources
PubMed1999

Competencies and problems of Irish children and adolescents.

This study set out to investigate the behavioural and emotional problems and competencies of Irish children and adolescents using Achenbach's Child Behaviour Checklist (CBCL) and Youth Self Report (YSR). The Child Behaviour Checklist was completed by parents of 481 Irish school children aged 7-9 years and 13-15 years, and the Youth Self Report was completed by 240 adolescents. The schools were selected to represent a wide social and cultural spread. Irish young people of all ages scored significantly lower than their American counterparts on measures of competence, whether rated by themselves or their parents. The parents of the 7-9 year olds rated their children as having significantly lower total problem scores than their American counterparts, but for 13-15 year olds there were no differences in total problem scores between the Irish and American samples, whether rated by parents or the adolescents themselves. Total problem scores and externalizing scores increased with age on the CBCL and the YSR, a pattern in which Irish young people differed from those in most other cultures. Despite differences in sampling and methodology, the Irish results are similar in many respects to those seen in a number of other European studies.

Adolescent↗
PubMed1999

Glucocorticoid metabolism in proximal tubules modulates angiotensin II-induced electrolyte transport.

The hormonal interactions that regulate electrolyte transport in the proximal tubule are complex and incompletely understood. Since endogenous glucocorticoids and angiotensin II each can affect electrolyte transport in this renal segment, we hypothesized that local metabolism of glucocorticoids by the enzyme 11beta-hydroxysteroid dehydrogenase (11beta-HSD) might alter the response to angiotensin II. Studies were conducted in cultured origin defective SV-40 transformed immortalized renal proximal tubule cells (IRPTC) derived from weanling Wistar rat kidney. The 11beta-HSD contained in these cells uses NADP+, has an apparent Km for corticosterone of 1.6 microM, but functions only as a dehydrogenase (corticosterone --> 11-dehydro-corticosterone). When mounted in modified Ussing chambers, IRPTC generate a transmembrane current, and angiotensin II (10 pM to 10 microM) increases this sodium-dependent current. Cells incubated with corticosterone (100 nM) and the 11beta-HSD inhibitor carbenoxolone (CBX) (1 microM) for 24 hr and then acutely stimulated with angiotensin (10 nM) show a greater rise in current than do cells exposed to corticosterone alone and stimulated with angiotensin (corticosterone + CBX: 64.2% +/- 20.5% vs. corticosterone: 18.8% +/- 5.9%; P < 0.02 at 180 min)[mean +/- SE percentage above baseline, n = 8/group]. Cells exposed to corticosterone (100 nM) or CBX (1 microM) alone for 24 hr and then stimulated with angiotensin II (10 nM) had responses similar to controls. Thus glucocorticoids can enhance angiotensin II-induced electrolyte transport in proximal tubule epithelial cells when local 11beta-HSD is inhibited.

11-beta-Hydroxysteroid Dehydrogenases↗
PubMed1998

Initial experience with a multi-station objective structured teaching skills evaluation.

PURPOSE: To explore the applicability of using an objective structured evaluation to assess community preceptors' teaching performances. METHOD: The authors developed and, in 1996, administered an objective structured teaching evaluation (OSTE) at the University of California, Irvine, College of Medicine. They compared assessments of teaching skills made by faculty observers and standardized students, and examined instrument reliability, realism, and utility. RESULTS: Reliabilities of the OSTE varied with individual stations but, in several instances, approached acceptable standards. Faculty observers' and standardized students' evaluations of preceptors' performances were similar. Participants' feedback indicated that the greatest OSTE-related benefit was derived by the faculty observers. CONCLUSIONS: An OSTE that reflects realistic teaching situations can be successfully developed. Objective structured evaluation can be successfully applied to assessing faculty teaching performance. However, it may be no more discriminating than are student evaluations. An OSTE's utility may be greatest in guiding faculty development initiatives.

Ambulatory Care Facilities↗
PubMed1994

Children's disclosure of sexual abuse during formal investigation.

This study set out to provide information on children's disclosures of sexual abuse during formal child sexual abuse investigation. The study was carried out in a Child Sexual Abuse Assessment Unit based in a Children's Hospital, staffed by a multidisciplinary team and receiving referrals from community child protection agencies, pediatricians, general practitioners, and the police. Two hundred and fifty one children who had full assessments over a 12-month period formed the study group. They were divided at time of referral into two groups: (a) those who had previously told someone about abusive experiences prior to investigations; and (b) those who had not. There was a strongly positive correlation between having previously told someone about sexual abuse and disclosure of such abuse during formal investigation. There was also a strongly positive correlation between not having previously told someone and not disclosing during formal investigation. Age was an important variable, with children under 5 being least likely to disclose abuse during formal investigation, irrespective of whether they had previously told someone about abuse. Disclosure of sexual abuse during investigation was strongly positively correlated with abuse being regarded as confirmed. These results call into question the value of formal sexual abuse investigation in children who have not previously told someone about abuse. The value of a "nonleading" interview style with young children is also called into question, given that many young children who had previously disclosed abuse, did not repeat this information during formal investigation in which "nonleading" interviews were used.

Adolescent↗
PubMed1994

The process of faculty-mentored student research in family medicine: motives and lessons.

BACKGROUND AND OBJECTIVES: Research suggests that the strongest predictor of postgraduate research activity is medical student research involvement. Yet many medical students still regard family medicine as a "nonresearch" specialty. The purposes of this study were to discover what motivated a group of first-year medical students (and their faculty mentors) to participate in a summer research assistantship and how both groups evaluated the challenges and satisfactions of the experience. METHODS: The study used a grounded theory qualitative methodology that emphasizes an in-depth, inductive approach to evaluation research. Over a 2-year period, 11 first-year medical students who participated in a summer research assistantship and their 10 faculty mentors completed written questionnaires and were interviewed by our research team. Various categories of analysis were constructed and refined over the course of the study to explain the raw data collected through interviews, written questionnaires, and field notes. RESULTS: Findings included identification of a core theme or meaning that motivated participation in the project for students and faculty. This theme was expressed in terms of professional, personal, relational, and societal goals. The study also identified three interrelated mechanisms (socialization, relationship, and technical skill transmission) used in varying degrees by students and faculty to achieve these goals. CONCLUSION: In addition to technical mastery and knowledge, students were actively seeking professional relationships with faculty mentors, greater understanding of other peoples and cultures, and increased self-understanding and self-esteem. Junior and senior faculty reflected differing and multilevel motivations for participating in a research assistantship program.

Adult↗
PubMed1993

Periurethral collagen for urinary incontinence after gender reassignment surgery.

We report on 2 patients, one female and one male transsexual; in both, Type III stress urinary incontinence developed after gender reassignment surgery. Both patients were treated by periurethral injection of gluteraldehyde cross-linked collagen resulting in a marked symptomatic improvement in association with a significant rise in abdominal leak point pressures. We believe these are the first reported cases of collagen injection being used for urinary incontinence after gender reassignment surgery.

Adult↗
PubMed1992

Teenage girls attending a Dublin sexually transmitted disease clinic: a socio-sexual and diagnostic profile.

Over a 12 month period, 32 teenage girls attended the sexually transmitted disease clinic in the Mater Misericordiae Hospital, Dublin for the first time, accounting for 17.8% of all first visits. Their mean age was 18.2 years (range 15-19 years). Twenty-four (75%) were from social class V. Five (15.6%) were abusing drugs. The mean age of first coitus was 16.1 years (range 13-19 years). The mean number of sexual partners was 1.8 (range 1-5). Four (12.5%) had been sexually abused in the past. Fourteen (43.8%) had never used contraception. Twenty-three (71.9%) were nulligravidae: 2 were diagnosed as being pregnant in the clinic. Twelve (37.5%) were unaware of cervical cytology screening. Of 29 having intercourse without condoms, none considered themselves to be at risk of contracting HIV from their present partner. A total of 26 diagnoses were made in 23 patients (71.9%). The most common diagnosis was ano-genital condylomata acuminata (6, 18.8%); Chlamydia trachomatis was located in 2 patients and Neisseria gonorrhoea in one. Mild to moderate dyskaryosis was reported in 4 cervical smears (12.5%). This data highlights the need for priority targeting of this high risk group.

Adolescent↗
PubMed1991

Clinical note: childhood neurotic disorders with a sexual content need not imply child sexual abuse.

Two cases are described of childhood obsessional states in which the content of the symptomatology led parents and professionals to suspect child sexual abuse. Following assessment it was felt, on the balance of probabilities, unlikely that child sexual abuse had occurred in either case. Both children had previously engaged in "sex play" with peers. Maternal attitudes to sexuality were felt to have influenced their daughters' views about sexual behaviour and to have contributed to the children's guilt feelings. Response to appropriate treatment was rapid and has been sustained in the short-term. The importance of avoiding lengthy and possibly damaging assessment procedures in such cases is discussed.

Behavior Therapy↗
PubMed1990

Cultural differences in family communication about Duchenne muscular dystrophy.

This study compared the patterns of communication and use of professional support systems of Irish and American families with sons with Duchenne muscular dystrophy (DMD). Structured interviews were used with the parents of 34 Irish boys and 21 American boys attending the muscular dystrophy services of Central Remedial Clinic, Dublin, and Children's Hospital, Boston. A matched control group was interviewed in each culture to compare use of professional support systems. Difficulties in communicating about DMD with their spouses and with their affected sons were reported by significantly more Irish parents than by their American counterparts. More Irish parents had never spoken about DMD with their affected sons. American DMD families reported significantly more contact with professional support systems than did the Irish families. Factors which may contribute to these cultural differences are discussed.

Adaptation, Psychological↗
PubMed1989

A new system for port films.

A novel system for port films is described which incorporates a high-quality fluorescent screen lying behind a flat, heavy-metal screen or filter and the film pressed between them is not an X ray type but a single-emulsion, very high contrast graphics or line-type film. In experimental comparisons using 4 MV, 6 MV, and 25 MV photon beams, the new Peter MacCallum Cancer Institute (PMCI) system produced clearer images, about X2 higher in contrast yet lower in relative noise levels, than did the conventional commercially-available systems which use x-ray film between heavy-metal screens. Direct clinical comparisons, chiefly using 6 MV accelerators, confirmed that anatomical details were correspondingly better visualized and in general, the PMCI port film could be matched against the simulator radiograph with greater confidence. Routine use for greater than 2 yr in this Institute (4000 new patients per yr, 20 cassettes made for use with four 6 MV accelerators) has shown the PMCI system to be an economical and practical device, giving reproducibly high quality images in all the common port film applications.

Humans↗