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Biomedical subjects

F Gill

Publications and source records attributed to F Gill.

At least 19 recordsLinked to original sources
PubMed2002

General practitioners' attitudes to patients who have learning disabilities.

BACKGROUND: Previous research suggests that the inadequate primary health care received by people with learning disabilities may be the result of general practitioners' (GPs) negative attitudes. Few studies have investigated the evidence for this assumption. This study uses psychological theory to inform an investigation of the attitudes and emotions experienced by GPs when working with learning disabled patients, as assessed by reliable and valid measures. METHOD: A questionnaire comprising an attitude measure and emotion measure was developed and tested for reliability and validity. This was mailed out to a total of 613 GPs registered with three Health Authorities, 310 questionnaires (51%) were returned. RESULTS: GP respondents held positive attitudes to working with patients who have learning disabilities. However, they were less positive about adapting their behaviour. Attitudes varied according to respondents' age and frequency of professional contact with this patient group. There was a strong association between attitudes and emotional experience. Attitudes were unaffected by learning disability training and non-professional contact. CONCLUSIONS: Negative perceptions about working with patients with learning disabilities do not fully explain the inadequate healthcare provided to this group. Other factors may include insufficient awareness of the benefits of adapting the format of a consultation, and the quality of the interface between the GP and the carer accompanying the patient.

Adult↗
PubMed2000

Credentialling Australian critical care nurses: the pilot study.

In October 1998, the Australian College of Critical Care Nurses (ACCCN) launched a model to credential specialist level critical care nurses. This model was 'road tested' during a pilot study, when experienced critical care nurses were invited to apply to become the first Australian credentialled critical care nurses. The pilot study was designed to ensure all individuals taking part in the process were surveyed regarding adequacy of the credentialling package and the credentialling process. Applicants were required to provide evidence of practise at the specialist level, as described in the Competency Standards for Specialist Level Critical Care Nurses. Evidence was presented via curriculum vitae, professional journal and supported by three peer reviewers and two referees. Each application was sent to a three-person assessor panel, which assessed the evidence in the application against the Competency Standards for Specialist Level Critical Care Nurses. A total of six applications from five states and one territory were received by April 1999. Five of the applicants were assessed to have met the Competency Standards and were awarded the credential, Australia Credentialled Critical Care Nurse (ACCN), which they will hold for a period of 3 years. Feedback from assessors, applicants, peer reviewers and referees involved in the pilot study has resulted in the further refinement of the credentialling package and processes. Australian critical care nurses will now have the opportunity to seek to be credentialled four times per year.

Australia↗
PubMed2000

Precision error of fan-beam dual X-ray absorptiometry scans at the spine, hip, and forearm.

The current study investigated short-term precision of fan-beam dual X-ray absorptiometry scans using a sample of subjects typically seen in a routine practice. Seventy-two women were scanned twice each in array fan-beam mode at the lumbar spine and 71 at the hip on a Hologic QDR 2000. Sixty-five were scanned at the forearm on a Hologic QDR 4500A in array mode. Each of the two scans was analysed without reference to its companion scan (independent analysis). The second assessment was also reanalyzed using the manufacturer's "Compare" function (compared analysis). Coefficients of variation (CVs) were calculated for the two forms of analysis at all the sites measured. Paired t-tests were performed to see whether the "Compare" function improved precision. The CV at the lumbar spine was 1.1% in both forms of analysis. The "Compare" function did not improve precision significantly at this site. The highest precision at the hip was found at the (Total) site of the hip (1.2-1.0%, independent and compared analyses, respectively) and the lowest at Ward's triangle. The Compare function significantly improved precision at Ward's triangle. The forearm had the best precision of all the sites measured with the Total site of the forearm being highest (0.5-0.7%) and the ultradistal site lowest (1.6-1.8%). The Compare function significantly decreased precision at the mid-distal and Total sites of the forearm. In conclusion, the highest precision was found at the Total site of the hip, the Total site of the forearm, and the spine. The Compare function did not significantly improve precision at the spine or hip (with the exception of Ward's triangle) and decreased precision at the forearm.

Absorptiometry, Photon↗
PubMed1997

Metal ions play a passive role in the hairpin ribozyme catalysed reaction.

The hairpin ribozyme is an example of a small catalytic RNA which catalyses the endonucleolytic transesterification of RNA in a highly sequence-specific manner. The hairpin ribozyme, in common with all other small ribozymes such as the hammerhead, requires the presence of a divalent metal ion co-factor (typically magnesium) for the reaction to take place. To investigate the role of magnesium ions in the hairpin catalysed reaction we have synthesised two epimeric modified substrates in which a phosphorothioate replaces the scissile phosphodiester bond. Previously, Burke and co-workers have reported that no thio-effect is observed with the Rp-phosphorothioate isomer. We observe the absence of a thio-effect with both diastereomeric phosphorothioate hairpin substrates. Furthermore we report that inert cobalt (III) complexes are capable of supporting the hairpin ribozyme reaction, with a similar efficiency to Mg2+,even in the presence of EDTA. Variation of the net charge on the inert cobalt complex does not change the observed rate of reaction. These results suggest that metal ions play a passive role in the hairpin ribozyme catalysed reaction and are probably required for structural purposes only. This places the hairpin ribozyme in a different mechanistic class to other small ribozymes such as the hammerhead.

Base Sequence↗
PubMed1996

[Preperitoneal pelviscopic Burch colposuspension using the "Nottingham needle"].

By 40 women with stress incontinence II.-III. degrees we performed a preperitoneal pelviscopic colposuspension (Burch) modified by Gill with the "Nottingham Needle". An urodynamic and sonographic assessment before and 6-9 months after the pelviscopic operation were done. In 38 cases from the 40 women (95%) we saw a good result. The new modification of the pelviscopic colposuspension showed us a low intra- and postoperative morbidity and we consider it a big advantage for obese women.

Female↗
PubMed1996

[A new surgical aid--the "endo-stitch disposable suture device"--for pelviscopic pre-peritoneal Burch incontinence operation. A pilot study].

OBJECTIVE: It is the therapeutical aim of urogynecology to correct urinary incontinence. Which advantages offers the use of the Endo-Stitch needle in Burch's pelviscopic colposuspension? METHODS: When extending the field of pelviscopic surgery, in a prospective study we performed Burch's pelviscopic preperitoneal colposuspension using the disposable Endo-Stitch suture instrument in 12 patients with stress incontinence grades 2 or 3. Clinical and urodynamic evaluations were performed before and 8.5 months after the pelviscopic operation. RESULTS: Clinical and urodynamic follow-up examinations revealed continence in 10 (83%) out of 12 patients. CONCLUSIONS: Our preliminary experience suggests that the pelviscopic incontinence operation by means of the Endo-Stitch needle is a good alternative to abdominal colposuspension. Follow-up results of a large number of patients will have to prove advantages in contrast to conservative surgery.

Adult↗
PubMed1995

Bleeding complications after CASH.

We assessed the frequency and studied the possible mechanisms of bleeding after classic abdominal Semm hysterectomy (CASH) in a retrospective, nonrandomized review of 70 women (47 premenopausal) undergoing the procedure with 1-year minimum follow-up. In several women CASH was associated with adhesiolysis, and in more than 50% with bilateral oophorectomy. Of the 47 patients who were menstruating prior to surgery, 6 (13%) reported postoperative menstruation. Two additional patients required repeat surgery, and one required transfusion. Endometrial glands were present in one excised specimen, suggesting the possibility that menstruation and hematometra may occur.

Abdomen↗
PubMed1992

[Struma ovarii maligna].

Benign and malignant struma ovarii are very rare ovarian teratomas. Specific therapy guidelines should be established. A case of a malignant struma ovarii is presented and results of therapy discussed.

Adult↗
PubMed1992

[Pelviscopic hysterectomy--a prospective comparative study of 40 cases].

We review to date 20 pelviscopic extirpations of the uterus. This new method of hysterectomy shows some advantages over the common vaginal hysterectomy. Anatomy of the supporting ligaments of the uterus remains the same, recovery from the operation goes quicker. Morbidity rate seems to be less than in the case of vaginal hysterectomy.

Adult↗
PubMed1989

An histo-morphological evaluation of ninety surgically excised human umbilical vein grafts.

Morphological, histological, and scanning electron microscopy examinations were performed on 90 surgically excised human umbilical vein grafts. Most of the explanted grafts were removed because of thrombosis or infection and were removed typically from a patient in the mid 60s and after an average duration of implantation of 11 months. Multiple structural defects were found including deep folds, breaks on the luminal surface, and delamination. These areas as well as anastomotic sites represented potential areas for thrombotic accumulation. A higher incidence of infection was observed in grafts composed of 2 or 3 segments. Bacteria were often found in folds and could be seen invading the wall of the prosthesis. In addition, bacteremic colonization was often seen in noninfected grafts. The late aneurysmal formations were also of particular concern. The biodegradation of the wall and the disruption of the polyester mesh were the probable causes. The second generation Dardik Biograft aimed at reducing these formations. The success of this new processing remains to be evaluated.

Adult↗
PubMed1989

Expanded polytetrafluoroethylene prostheses as secondary blood access sites for hemodialysis: pathological findings in 29 excised grafts.

The popularity of expanded polytetrafluoroethylene (PTFE) arteriovenous fistulas for hemodialysis access is increasing. The low infection rate, low thrombogenicity and low body reactivity make it an important blood access for patients on routine hemodialysis. The authors examined 29 PTFE graft fistulas surgically excised from patients on hemodialysis for one or more of the following complications: infection 7, 2 with associated hemorrhage; thrombosis 9; aneurysm 11, 3 with associated thrombosis; stenosis 5, 3 with associated thrombosis; hemorrhage 4 and arterial steal 2. The explanted prostheses were reinforced Gore-tex in 20, Gore-tex thin wall in 1, Impra I in 4, Impra II in 3 and Vitagraft in 1. It was also noted that the implants failed in the short term mainly because of infection, in the medium term mainly because of thrombosis and stenosis, and in the long term usually because of aneurysm.

Adult↗
PubMed1989

Biologic and structural evaluation of 80 surgically excised human umbilical vein grafts.

Human umbilical vein is a valuable alternative to autogenous saphenous vein in lower-limb revascularization. However, the long-term patency is not as good. To understand better the reasons for this, the authors studied the biologic and structural changes occurring in 80 segments of human umbilical vein (HUV) grafts excised from 70 patients. Morphologic, histologic and scanning electron microscopy examinations were performed on each specimen. It was noted that increasing duration of implantation was associated with greater encapsulation and less surrounding inflammatory reaction. Twenty-six percent of clinically noninfected grafts were found to harbour bacteria. Bacteremic colonization was often in the folds of the luminal surface. As a result of these findings, the authors emphasize the need for complete excision of clinically infected grafts. Anastomoses between HUV segments are discouraged because they are associated with a high frequency of infection and a corresponding decrease in duration of implantation. Delamination of the wall was common, and such sites may represent areas at risk for further degradation. Continued surveillance of the biologic and structural changes occurring in excised grafts remains an important method in increasing our understanding of the evolutive complications of HUV grafts.

Adult↗