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Biomedical subjects

E Townsend

Publications and source records attributed to E Townsend.

At least 37 records · Page 2Linked to original sources
PubMed1993

Occupational therapy guidelines for client-centred practice: impact study findings.

The Guidelines Impact Study investigated use and usefulness of the guidelines for client-centred practice produced in the 1980's by the Department of National Health and Welfare and the Canadian Association of Occupational Therapists. This paper outlines the study, summarizes findings, and discusses implications for revising and updating the Guidelines. Qualitative interview data from key informants across Canada were incorporated into a quantitative survey of a 5% sample of CAOT members. Data reveal variable use of the Guidelines, with greatest use in acute care and rehabilitation services; and mixed interpretations of the Model of Occupational Performance, particularly 'environment' and 'spiritual component'. Recommendations include: clarification of the purpose and audience of revised Guidelines; national consultation during updating to include diverse forms of practice; and rethinking the Model of Occupational Performance as a dynamic model. Updated Guidelines should include both generic concepts and specific applications for different types of occupational therapy practice.

Attitude of Health Personnel↗
PubMed1992

Development of a sensitive peptidase assay: in search of cell associated proteases responsible for the cleavage of preproTGF alpha.

A radiometric assay has been developed for the detection of proteolytic activity capable of releasing transforming growth factor alpha (TGF alpha) from its membrane bound precursor. The assay is dependent upon the separation by thin layer chromatography of hydrolytic products of a nonapeptide substrate containing a radioactive iodinated tyrosine residue as a reporting group N-terminal to an octapeptide which is cognate to the N-terminal cleavage sequence of TGF alpha. We describe the selectivity of the peptidase assay with commercially purified proteases and with cell-associated peptidases, its exquisite sensitivity, and its applicability to defining peptidase activity, which may be responsible for the processing of the membrane-bound prepro TGF alpha. The activity of two different elastases had different profiles which thus may be of use in characterizing them. The characteristics of the intact and extracted HeLa cell assay with respect to time, cell density, and peptidase concentration are defined, as are conditions needed to remove endogenous, confounding, proteolytic activity from the serum used to support cell culture. Intact HeLa cell cultures exhibit both exo- and endo-peptidase activity at approximately equal levels in both sparse and dense monolayer culture without relationship to cell density, and at a level equal to 1-2% of total cell activity of these enzyme classes.

Amino Acid Sequence↗
PubMed1992

Large field studies of hospital based services: lessons from occupational therapy.

A study with a quasi-experimental design was developed to evaluate the effectiveness of hospital-based occupational therapy services in Nova Scotia. Seven hospitals with occupational therapy services were matched with seven hospitals without occupational therapy services. Within the two hospital groups, subjects were matched on the basis of diagnosis and disability. Outcome measures included measures of functional performance in activities of daily living, and community living skills. This paper discusses some of the strengths and weaknesses of conducting large field studies of hospital based services. It is based on our experience with an occupational therapy outcome evaluation. Some of the strengths include well developed and implemented hospital admission and discharge practices, personal contact with key hospital staff, support of the hospital occupational therapy directors and the Nova Scotia Department of Health, and professional support through national guidelines on the client-centered practice of occupational therapy. Study weaknesses can be categorized into three major areas including evaluation issues, hospital issues, and professional issues. Our experience can contribute to the scientific literature on outcome studies on occupational therapy and to the conduct of large field studies of hospital based services in general.

Data Collection↗
PubMed1990

Developing guidelines for client-centred occupational therapy practice.

The Canadian Guidelines for the client-centred practice of occupational therapy are national, generic, consensus guidelines developed to address growing concerns inside and outside the profession for assuring the quality of health services. From 1979 to 1987, successive Task Forces, sponsored by the Department of National Health and Welfare and the Canadian Association of Occupational Therapists, developed three volumes of guidelines. A pivotal guideline in Volume I is a conceptual framework of occupational therapy's central concern: occupational performance within an individual's physical, cultural and social environment. Volume I also outlines stages in the process of client-centred occupational therapy practice, and specific assessment and program planning guidelines. Volume II covers issues, concepts and fundamental elements of intervention, as well as specific guidelines for intervention, discharge, follow-up and evaluation. Volume III reviews issues in outcome measurement given occupational therapy's primary concern for occupational performance. The authors, members of the Task Forces, provide an overview of the development of and their hopes for the Guidelines. Uses and influences of the Guidelines have not been formally documented. However, projects are arising from the Guidelines and a new CAOT Client-Centred Practice Committee is proposing an updating process for the three volumes.

Canada↗
PubMed1989

Factors influencing mortality and morbidity following oesophageal resection.

Operative mortality and morbidity following oesophageal resection has fallen in recent years. We have attempted to identify the factors responsible for this improvement by reviewing the results of surgery at this hospital over the last 6 years. Two hundred and two oesophageal resections were performed between January 1981 and June 1987 for carcinoma. Of these, 21 patients (10.4%) died before leaving hospital. Fourteen patients died of multisystem failure, 1 died of pure respiratory failure and 2 died of renal failure. Two died of surgical causes (other than anastomotic leak), 1 died of pulmonary embolus and 1 from a cerebro-vascular accident. No patient died of purely cardiac causes. The most significant risk factors in those dying (Chi-square test) were: postoperative respiratory failure, defined as reventilation after initial successful extubation, (P less than or equal to 0.001), reoperation as an emergency in the early postoperative period (P less than or equal to 0.001), anastomotic leak (P less than or equal to 0.01) and age over 70 (P less than or equal to 0.005). Less significant risk factors were chyle leak and histologically undifferentiated tumour. Of the 181 survivors, 103 left hospital with no complications of any kind. The mean stay in hospital for survivors was 15 days. Respiratory infection occurred in 22% of patients, prolonged gastric stasis in 8%, wound infection in 5% and empyema in 1%. As long as high risk groups are accepted for radical surgery, operation will carry a significant mortality in those groups. In others, we believe that perioperative monitoring and early aggressive treatment of complications can further reduce mortality and morbidity.

Adenocarcinoma↗
PubMed1989

Implementing a health promotion strategy in occupational therapy education and practice.

In response to the growing emphasis on health promotion, this article addresses four major questions: 1) How is occupational therapy's client-centered philosophy reflected in the principles outlined by the World Health Organization (1984)? 2) What are the roles of occupational therapy in health promotion? 3) How will occupational therapy education foster this development? 4) How will the practice of occupational therapy respond to the challenges and implement the strategies outlined in "Achieving Health for All: A Framework for Health Promotion"? Despite similarities between occupational therapy's client-centered approach and the health promotion framework, the need for occupational therapy education to reflect the developments in health promotion and prevention is very evident. A four part model is proposed, and the implications for graduate education as well as continuing professional education are outlined. Recommendations for practice, education, research and development are discussed.

Canada↗
PubMed1989

Criteria mapping: a method of quality assurance.

Criteria mapping is a flexible and responsive method of chart audit that allows the simultaneous assessment of both the process and the outcome of care by means of health record abstraction. This method of audit is particularly suited to occupational therapy because it includes branching to reflect the sequential judgments of therapists and does not penalize the clinician for omitting unnecessary procedures. The purpose of this study was to determine the utility and reliability of the criteria mapping process in evaluating the quality of care for a self-care disability in an acute care setting. Three occupational therapists and one independent abstractor evaluated 12 charts twice. Intraobserver reliability calculated with intraclass correlation coefficients was .77 for the therapists and .65 for all observers. Interobserver reliability was .73 for the therapists and .72 for all observers. The criteria map provided comprehensive and relevant information about each chart. This paper discusses the implications of these findings for the ongoing monitoring of the quality of care in occupational therapy.

Disability Evaluation↗
PubMed1988

Developing community occupational therapy services in Canada.

International trends in health care point to increasing development of community services. However, the majority of occupational therapists work in institutional settings. A study, between 1985 and 1987, defined and created a profile of existing community occupational therapy services across Canada, and identified the processes and strategies which led to the development of these services. One hundred and eighty nine (189) services, including home care, other salaried services, and private or consulting services were identified. A national sample of community occupational therapy program developers described processes and strategies from which the author suggests a general "ripple effect" strategy to enhance the occupational therapy contribution to the community.

Canada↗
PubMed1987

Strategies for community occupational therapy program development.

Occupational therapists who wish to see services expand in community settings must be prepared to take an active role in program development. The article examines 12 program development strategies which are illustrated using the experience of developing a rural program in a social service system. Community occupational therapy services in Prince Edward Island were initially developed, from 1977 to 1979, by a small group of occupational therapists. The group obtained Federal Welfare Demonstration Grant funding for a pilot project which was administered by the provincial Department of Social Services. In 1979, the Prince Edward Island Provincial Government approved on-going funding for an Island-wide community occupational therapy service.

Community Health Services↗
PubMed1983

Do antibodies to myelin basic protein isolated from multiple sclerosis cross-react with measles and other common virus antigens?

Immunological activity to various antigens, including brain components, measles and other viruses, has been associated with IgG in multiple sclerosis (MS). One possible explanation for the presence of anti-viral antibodies and antibody to myelin basic protein (MBP) in MS patients is that there are antigenic determinants common to certain viruses and MBP. To assess this possibility, IgG from individual brains and sera from patients with MS, subacute sclerosing panencephalitis (SSPE) and controls was isolated by protein A and MBP-Sepharose affinity chromatography. Antibody to MBP was measured with a solid phase radioimmunoassay and antibody to measles and other viruses by immunofluorescence and/or complement fixation. Anti-MBP activity was detected in brain extracts and sera of all MS patients tested. In contrast to the low levels of antibody to MBP in control brains, high levels of anti-MBP antibodies were found in most of the normal sera. There was no correlation between the presence and levels of serum anti-measles antibodies and the anti-MBP activity. None of the anti-MBP antibodies affinity purified from brain and serum of MS patients reacted with any of the viruses tested, including measles. IgG purified from SSPE patients or from a rabbit hyperimmunized with measles antigen had no reactivity to MBP, despite high levels of anti-measles antibody. It is concluded that there is not direct link between the presence of antibody to MBP and antibody to measles and other viruses in MS patients.

Adenoviridae↗
PubMed1981

Effects of methylprednisolone and azathioprine on bronchial healing following lung autotransplantation.

The effect of low-dose immunosuppressive therapy upon the healing of the bronchial anastomosis and skin wound following lung autotransplantation was evaluated. Autotransplantation was performed in two groups of dogs: Group 1 (15 dogs) received no immunosuppression and Group 2 (13 dogs) received postoperative immunosuppression with methylprednisolone (2 mg/kg) and azathioprine (1.5 mg/kg). Two to four skin incisions 7 cm in length were made in the dorsal region of each dog. Dogs were put to death at 4, 9, 16, and 23 days postoperatively and the bronchial anastomoses and skin wounds were evaluated by breaking strength measurements. Bronchus and skin breaking strength increased with time in both groups. Bronchus breaking strength was similar in the two groups at day 4 and day 9. However, by day 23 bronchus breaking strength was significantly higher in Group 1 (p less than 0.001). Skin breaking strength was significantly higher in Group 1 on days 9 and 16 (p less than 0.005) and on day 23 (p less than 0.001). Our results suggest that low-dose methylprednisolone and azathioprine significantly affect the breaking strength of both bronchial anastomoses and healing skin incisions following canine lung autotransplantation.

Animals↗
PubMedDate not supplied

Reversible depigmentation of human melanoma cells by halistanol trisulphate, a novel marine sterol.

The pigmented human melanoma cell line, MM418, became demelanized when treated continuously with a nontoxic level of halistanol trisulphate (HTS), a C29 steroidal detergent isolated from a marine sponge. Nontoxic levels of halistanol or of a range of anionic, cationic and neutral detergents had no such effect. Control MM418 cells varied greatly in size, appearance and pigmentation; HTS-treated cells were smaller than controls, had a uniform, generally bipolar appearance, and lacked pigment. HTS induced only minor changes in cell ultrastructure, with fewer mature melanosomes being found in treated cells. Suppression of melanin synthesis was apparent within 24 h of addition of HTS, as judged by inhibited incorporation of the false precursor, 5[125I]-2-thiouracil. Reversal of inhibition occurred within the same period after removal of HTS. Tyrosinase activity gradually decreased to 25% of the control value during a 19-day treatment with HTS, and expression of two carbohydrate-dependent tyrosinase epitopes, 5C12 and 2B7, was abolished. Expression of one other melanosomal protein and of vimentin was not affected. The results suggest that HTS inhibits maturation of tyrosinase to a form associated with melanin synthesis.

Animals↗