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Biomedical subjects

J Costello

Publications and source records attributed to J Costello.

At least 19 recordsLinked to original sources
PubMed1991

Boarding out as an option for the care of elderly people.

There has been some experiment in Ireland in recent years with boarding out of elderly persons. This comprises the placement, usually with a non-relative in a private household, of an elderly person, with the carer receiving some reward. This study assesses the cost of care for a small group of elderly persons in boarding-out care compared with a similarly dependent group of elderly persons in welfare home institutional care. The cost of boarding out care is less than half the cost of care in the welfare home. This result is encouraging given the feeling that quality of care in boarding out is not below that of institutional care.

Aged↗
PubMed1991

The effect of preceptorship upon diploma program nursing students' transition to the professional nursing role.

This quasi-experimental study determined the effect of a 17-week pregraduate preceptorship program upon diploma nursing students' (N = 22) performance of the professional nursing role. Nine students participated in the preceptorship program; 13 received the standard pregraduate clinical experience. Nursing performance was measured using Schwirian's Six Dimension Scale of Nursing Performance prior to, during, and upon completion of the pregraduate clinical experience. Based on the faculty adviser's appraisals, the preceptorship program was associated with significantly greater improvements in nursing performance within the teaching/collaboration and planning/evaluation dimensions.

Adult↗
PubMed1991

Asthma--the problem and the paradox.

Asthma is a common condition world-wide. Recent data show an increase in prevalence in the United Kingdom, and there is disturbing evidence of increases in morbidity and mortality from asthma in many countries. The reasons for these increases are unclear, but they are occurring in the face of dramatic increases in the sales of potent anti-asthmatic medications, with a particular emphasis on the use of beta agonists and inhaled corticosteroids. Furthermore, despite much publicity and education, the management of acute severe asthma is variable and often ineffectual. Identification of the reasons for the epidemiological trends is essential. The development of new potent prophylactic agents for treatment will help; it is, however, incumbent on us to examine our current pharmacological approach to asthma and to re-evaluate the drugs currently available, both in terms of their clinical use and our understanding of their modes of action. Comparison of morbidity and mortality figures between countries, and relating these figures to what is known about the use of medication in those countries should help clarify and co-ordinate approaches to treatment, and dispel some of the therapeutic myths which have currency at present.

Adolescent↗
PubMed1990

Activity of phospholipase A2 in plasma increases in uremia.

We measured phospholipase A2 (PLA2; EC 3.1.1.4) activity in normal and uremic plasma, using [1-14C]oleate-labeled autoclaved Escherichia coli as substrate. Hydrolysis of bacterial phospholipid by crude plasma from both groups was optimal at pH 5.5, was specific for the 2-acyl position of phospholipids, and had an absolute requirement for calcium. Activity was greatest in the presence of added Ca2+, 5 mmol/L, but this increase was inhibited by several divalent cations (Mg2+, Zn2+, Cu2+, Ba2+, Co2+, Pb2+, Fe2+) and by Fe3+. PLA2 activity was also inhibited by heparin at acid and alkaline pH, normal plasma being more sensitive than uremic plasma to this inhibition. Enzyme activity in undiluted plasma was eightfold greater in uremic than in normal plasma. Dilution of plasma by two to fourfold increased the total activity of both normal and uremic plasma. However, the relative differences in total activity between the groups remained constant (eight- to 11-fold). The cause and consequences of the increased PLA2 activity in uremia remain to be established.

Calcium Chloride↗
PubMed1989

Human ehrlichiosis.

Ehrlichiosis is one of the latest tick-borne illnesses to be reported in humans. The authors describe two cases of this rickettsial disease that were apparently acquired in Missouri. They discuss diagnosis and treatment.

Animals↗
PubMed1979

Morbidity and mortality study of shale oil workers in the United States.

The study of the carcinogenic potential of domestic U. S. shale oil has increased significantly in importance because of the present energy problem and resulting research into alternative sources of fuel. With the increased scope of planned oil shale activity on the Colorado Plateau, it is important that an attempt be made to determine the health effects, if any, of occupational exposure to shale oil. This paper briefly reviews some past work of Soviet and British investigators concerning potential health hazards of shale oil. It reviews the results and conclusions of the 1952-1955 dermatological study of oil shale workers by the U. S. Public Health Service, and it discusses in detail the plans of a NIOSH morbidity and mortality study currently under way.

Aging↗
PubMed1979

Occupational safety and health implications of increased coal utilization.

An area of major concern in considering increased coal production and utilization is the health and safety of increased numbers of workers who mine, process, or utilize coal. Hazards related to mining activities in the past have been especially serious, resulting in many mine related accidental deaths, disabling injuries, and disability and death from chronic lung disease. Underground coal mines are clearly less safe than surface mines. Over one-third of currently employed underground miners experience chronic lung disease. Other stresses include noise and extremes of heat and cold. Newly emphasized technologies of the use of diesel powered mining equipment and the use of longwall mining techniques may be associated with serious health effects. Workers at coal-fired power plants are also potentially at risk of occupational diseases. Occupational safety and health aspects of coal mining are understood well enough today to justify implementing necessary and technically feasible and available control measures to minimize potential problems associated with increased coal production and use in the future. Increased emphasis on safety and health training for inexperienced coal miners expected to enter the work force is clearly needed. The recently enacted Federal Mine Safety and Health Act of 1977 will provide impetus for increased control over hazards in coal mining.

Anthracosilicosis↗
PubMed1978

Theophylline disposition in acutely ill hospitalized patients. The effect of smoking, heart failure, severe airway obstruction, and pneumonia.

Theophylline disposition (clearance, volume of distribution, and half-life) was measured in 31 normal volunteers and 26 acutely ill patients with airway obstruction within 24 hours of hospital admission and again when intravenous aminophylline was discontinued 2 to 10 days later. Sex, age, race, the diagnosis of asthma, and the diagnosis of chronic bronchitis were not significantly correlated with clearance. Clearance was significantly increased in smokers and significantly decreased in patients with congestive heart failure, pneumonia, and severe bronchial obstruction. The volume of distribution was not correlated with these variables. Within 24 hours of admission, the mean clearance in our patients without congestive heart failure or pneumonia was 44.5 ml per hour per kg of body weight, 40 per cent less than the value on which the widely used 0.9 mg per kg per hour dosage is based. The unexplained interindividual variability of clearance was significantly higher amont patients than control subjects, but intraindividual variability in clearance was not different in these 2 groups after correction for the effects of smoking, congestive heart failure, and so on. Large variability in clearance among patients makes the plasma theophylline concentration resulting from any dosage relatively uncertain. Based on the the results of this study, recommendations are made concerning theophylline dosage computation, and the clinical circumstances calling for determination of plasma theophylline concentrations.

Acute Disease↗
PubMed1978

Pleural effusion from malignancy.

Pleural effusion from metastatic malignancy can cause major impairment of respiratory function and eventual death. Although cure is not possible, successful palliative treatment allows months to years of productive life, obviating the need for continuous hospitalization and repeated thoracenteses. Successful palliative treatment requires obliteration of the pleural space. Literature survey indicates that a wide variety of medical agents and surgical methods have been used with variable success. Medical methods include instillation of antineoplastic agents, antimicrobial agents, or colloidal radioisotopes into the pleural space; quinacrine and tetracycline are moderately to highly effective agents, but the toxicity of the former is substantial. Bedside talc poudrage with thoracostomy-tube drainage is a safe and highly effective alternative. Pleurectomy is the definitive method of preventing reaccumulation of pleural fluid that results from metastatic malignancy, even when other methods have failed, but thehigh morbidity and mortality of the procedures mandate careful patient selection.

Anti-Bacterial Agents↗
PubMed1977

Acid-base induced alterations in glutamine metabolism and ureogenesis in perfused muscle and liver of the rat.

The effects of altered acid-base balance on the production of urea and the metabolism of glutamine were investigated in the isolated perfused liver and hindquarter of the rat. In the isolated perfused rat liver, lowering of perfusate pH without altering bicarbonate concentration significantly reduced urea production and increased net glutamine synthesis, although the converse did not obtain. In the isolated perfused rat hindquarter when perfusate pH and bicarbonate were simultaneously reduced glutamine synthesis was significantly increased. The combined hepatic and muscle increase in glutamine synthesis accounted for 89% of the decrease in hepatic urea synthesis under these experimental conditions. These changes in nitrogen metabolism are interpreted in terms of adaptations which offset the initial alterations in hydrogen ion homeostasis.

Acid-Base Imbalance↗
PubMed1976

Concurrent modification of incorrect responses and off-task behaviors occurring during articulation instruction.

Incorrect articulation responses and inappropriate off-task behaviors occurring during programmed articulation instruction were concurrently modified by the presentation of an identical punishing stimulus for both groups of behaviors or by the presentation of different punishing stimuli for each group of behaviors. Results indicated that both procedures were equally effective in reducing both groups of undesirable behaviors. The nature of the relationship between articulation responses and off-task behaviors is discussed in detail, especially in terms of behavioral covariation.

Behavior Therapy↗
PubMed1976

Punishment contingencies for the reduction of incorrect responses during articulation instruction.

A comparison was made between the effects of punishment combined with positive reinforcement and reinforcement alone for the reduction of incorrect articulation responses. Three different punishers (a buzzer, response cost, and "No!") were studied for six young children while they were receiving programmed articulation instruction. The results indicated (1) that punishment in combination with positive reinforcement was generally more effective than positive reinforcement alone; (2) that whether or not a particular stimulus acted as a punisher could be determined only be empirical demonstration; and (3) that the introduction of punishment contingencies did not produce increased rates of disruptive, off-task behaviors. Conversely, off-task behaviors tended to increase in rate when punishement contingencies for articulation responses were removed.

Child Behavior↗