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Biomedical subjects

C Morrell

Publications and source records attributed to C Morrell.

13 recordsLinked to original sources
PubMed2000

Large-scale cDNA analysis reveals phased gene expression patterns during preimplantation mouse development.

Little is known about gene action in the preimplantation events that initiate mammalian development. Based on cDNA collections made from each stage from egg to blastocyst, 25438 3'-ESTs were derived, and represent 9718 genes, half of them novel. Thus, a considerable fraction of mammalian genes is dedicated to embryonic expression. This study reveals profound changes in gene expression that include the transient induction of transcripts at each stage. These results raise the possibility that development is driven by the action of a series of stage-specific expressed genes. The new genes, 798 of them placed on the mouse genetic map, provide entry points for analyses of human and mouse developmental disorders.

Animals↗
PubMed1999

An inverse relation between blood pressure and birth weight among 5 year old children from Soweto, South Africa.

STUDY OBJECTIVE: To examine the relation between birth weight and blood pressure at 5 years in a cohort of South African children. DESIGN: Prospective cohort study. PARTICIPANTS: 849 five year old children. SETTING: Soweto, a sprawling urban area close to Johannesburg, South Africa, which was a designated residential area for people classified as "black" under apartheid legislation. MAIN RESULTS: Systolic blood pressure at 5 years was inversely related to birthweight (r = -0.05, p = 0.0007), independent of current weight, height, gestational age, maternal age or socioeconomic status at 5 years. There was no relation between birth weight and diastolic blood pressure. After adjusting for current weight and height, there was a mean decline in systolic blood pressure of 3.4 mm Hg (95% confidence intervals 1.4, 5.3 mm Hg) for every 1000 g increase in birth weight. CONCLUSIONS: These data from a disadvantaged urbanised community in Southern Africa extend the reported observations of an inverse relation between birth weight and systolic blood pressure. The study adds to the evidence that influences in fetal life and early childhood influence systolic blood pressure. Further research is required to assess whether efforts to reduce the incidence of low birthweight babies will attenuate the prevalence of hypertension in future generations.

Birth Weight↗
PubMed1998

Using a supervisory framework to support and evaluate a multiproject practice development programme.

The paper describes a multiproject practice development programme undertaken over a period of 1 year. The background and development of the programme are outlined, whilst attention is paid to the innovatory nature of the work, particularly the use of inductive, deductive and integrated approaches to both change implementation and project supervision. The programme was monitored throughout using different data sources and the paper uses evaluative material retrospectively to provide answers to organizational and professional difficulties which arose during the course of the programme. The authors conclude that the use of combinations of different models for practice development has potential, but requires careful supervision. They also recommend that those involved in practice development are made fully aware of its local or micropolitics, and develop strategies to deal with change before it occurs, not after it has taken place.

Evidence-Based Medicine↗
PubMed1997

Biologically erodable microspheres as potential oral drug delivery systems.

Biologically adhesive delivery systems offer important advantages over conventional drug delivery systems. Here we show that engineered polymer microspheres made of biologically erodable polymers, which display strong adhesive interactions with gastrointestinal mucus and cellular linings, can traverse both the mucosal absorptive epithelium and the follicle-associated epithelium covering the lymphoid tissue of Peyer's patches. The polymers maintain contact with intestinal epithelium for extended periods of time and actually penetrate it, through and between cells. Thus, once loaded with compounds of pharmacological interest, the microspheres could be developed as delivery systems to transfer biologically active molecules to the circulation. We show that these microspheres increase the absorption of three model substances of widely different molecular size: dicumarol, insulin and plasmid DNA.

Adhesiveness↗
PubMed1997

Practitioner based quality improvement: a review of the Royal College of Nursing's dynamic standard setting system.

OBJECTIVE: To explore and describe the implementation of the Royal College of Nursing's approach to audit--the dynamic standard setting system--within the current context of health care, in particular to focus on how the system has developed since its inception in the 1980s as a method for uniprofessional and multiprofessional audit. DESIGN: Qualitative design with semistructure interviews and field visits. SETTING: 28 sites throughout the United Kingdom that use the dynamic standard setting system. SUBJECTS: Quality and audit coordinators with a responsibility for implementing the system; clinical staff who practice the system. MAIN MEASURES: Experiences of the dynamic standard setting system, including reasons for selection, methods of implementation, and observed outcomes. RESULTS: Issues relating to four themes emerged from the data: practical experiences of the system as a method for improving patient care; issues of facilitation and training; strategic issues of implementation; and the use of the system as a method for multiprofessional audit. The development of clinical practice was described as a major benefit of the system and evidence of improved patient care was apparent. However, difficulties were experienced in motivating staff and finding time for audit, which in part related to the current format of the system and the level of training and support available for clinical staff. Diverse experiences were reported in the extent to which the system had been integrated at a strategic level of quality improvement and its successful application to multiprofessional clinical audit. CONCLUSIONS: The Royal College of Nursing's dynamic standard setting system can successfully be used as a method for clinical audit at both a uniprofessional and multiprofessional level. However, to capitalise on the strengths of the system, several issues need to be considered further. These include modifications to the system itself, as well as a more strategic focus on resources and support for audit, better integration of quality initiatives in health care, and a continuing focus on ways to achieve true multiprofessional collaboration and involvement of patients in clinical audit.

Evaluation Studies as Topic↗
PubMed1982

Behavioral treatment for the anticipatory nausea and vomiting induced by cancer chemotherapy.

The nausea and vomiting experienced by one in four cancer patients in anticipation of chemotherapy is probably a learned response to treatment. To determine whether behavioral approaches for altering learned responses might be useful treatments for these symptoms, we compared the effects of "systematic desensitization" (a behavioral treatment in which relaxation is learned as a response to situations in which patients have had anticipatory nausea and vomiting) with those of counseling and of no treatment. Sixty ambulatory cancer patients with anticipatory nausea and vomiting before their third and fourth chemotherapy treatments were randomized equally to the three groups. Significantly more patients receiving desensitization reported no anticipatory nausea before their fifth and sixth chemotherapy treatments than patients given counseling (P less than 0.05) or no treatment (P less than 0.01). Desensitized patients also reported significantly less severe anticipatory nausea (P less than 0.01) and vomiting (P less than 0.05) and a shorter duration of anticipatory nausea (P less than 0.01). We conclude that systematic desensitization appears to have an antiemetic effect in cancer patients who receive chemotherapy, and may be useful in the management of these problems.

Adult↗
PubMedDate not supplied

Enhancing nurses' reliance on patients' perceptions of pain during pain assessment: a comparison of two educational methods.

The purpose of this quasi-experimental study was to determine if an educational program on pain assessment that includes both knowledge and attitude domains is more effective than a didactic educational offering in encouraging nurses' reliance on patients' self-reports of pain during assessment for pain. Twenty-two registered nurses and seven licensed practical nurses at the Tucson Veterans Affairs Medical Center participated. Group A received a lecture and watched a videotape. Group B received a lecture, watched a videotape, and participated in a group discussion on attitudes. Participants in both groups completed the Pain Management Questionnaire developed by Ferrell, Eberts, McCaffery & Grant (1991). No significant differences were found between groups with respect to results on the pain management questionnaire.

Education, Nursing, Continuing↗
PubMedDate not supplied

Clinical audit.

Explore the source record for details and available documents.

Clinical Nursing Research↗
PubMedDate not supplied

Clinical audit makes progress in care and teamwork.

Clinical audit should be about improving the delivery of care to patients as well as promoting multidisciplinary working in clinical teams. For clinical audit to move forward it must relate to, and be integrated with, four key areas: clinical effectiveness, the contracting process, patient-focused care and the development of clinical teams. This article discusses how users of health services can be helped to participate fully in clinical audit and its role in enhancing professional development of team members.

Humans↗