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Biomedical subjects

J Kendall

Publications and source records attributed to J Kendall.

At least 37 records · Page 2Linked to original sources
PubMed1999

Serological diagnosis of Parelaphostrongylus tenuis infection in white-tailed deer and identification of a potentially unique parasite antigen.

Serological diagnosis of Parelaphostrongylus tenuis infection should offer many advantages over the currently used method of fecal analysis that relies on a patent infection. Toward this end, we investigated the presence of P. tenuis-specific antibodies in experimentally infected white-tailed deer (WTD) and of unique P. tenuis antigens that may be exploited for serodiagnosis. WTD infected with 6, 20 or 100-150 P. tenuis third-stage larvae (L3) had anti-parasite antibodies from as early as 21 days postinoculation (dpi) until the end of the experiment (147 dpi). Peak anti-P. tenuis enzyme-linked immunosorbent assay (ELISA) titers in individual animals ranged from 1:70 to 1:5,700. Serum from infected WTD reacted with 5 distinct P. tenuis L3 antigens (105, 45, 37, 32, and 19 kDa) as detected by the immunoblotting technique. Serum from caribou infected with Parelaphostrongylus andersoni or Elaphostrongylus rangiferi reacted with all antigens except the 37-kDa antigen of L3, indicating that it may be unique to P. tenuis and can serve as a serodiagnostic antigen. The 37-kDa antigen appears to be present in the adult P. tenuis but not adult E. rangiferi or E. cervi. The development of an ELISA utilizing the unique antigen of P. tenuis should lead to a reliable diagnostic assay for P. tenuis infection in WTD.

Animals↗
PubMed1999

Adaptation of the AMRU-1 strain of Plasmodium vivax to Aotus and Saimiri monkeys and to four species of anopheline mosquitoes.

A chloroquine-resistant strain of Plasmodium vivax (AMRU-1) from Papua New Guinea has been adapted to grow in 4 species of Aotus monkeys (Aotus lemurinus griseimembra, Aotus vaciferans, Aotus nancymai, and Aotus azarae boliviensis), hybrid Aotus monkeys, and Saimiri boliviensis monkeys. Whereas it was possible to infect Saimiri monkeys with this parasite by inoculation of parasitized erythrocytes, only 42% of Saimiri monkeys became infected, compared to 92% of Aotus monkeys attempted. Comparative mosquito feedings showed that only A. vociferans, A. l. griseimembra, and Saimiri boliviensis monkeys produced infections in mosquitoes. Oocysts were observed on the guts of the 4 species of mosquitoes used (Anopheles gambiae, Anopheles stephensi, Anopheles freeborni, and Anopheles dirus), but sporozoite transmission was effected only with the intravenous inoculation of sporozoites from An. dirus into an A. l. griseimembra monkey.

Adaptation, Biological↗
PubMed1998

Point of care testing: randomised controlled trial of clinical outcome.

OBJECTIVES: To describe the proportion of patients attending an accident and emergency department for whom blood analysis at the point of care brought about a change in management; to measure the extent to which point of care testing resulted in differences in clinical outcome for these patients when compared with patients whose samples were tested by the hospital laboratory. DESIGN: Open, single centre, randomised controlled trial. Blood samples were randomly allocated to point of care testing or testing by the hospital's central laboratory. SETTING: The accident and emergency department of the Bristol Royal Infirmary, a large teaching hospital which cares for an inner city population. SUBJECTS: Representative sample of patients who attended the department between April 1996 and April 1997 and who required blood tests. Data collection was structured in 8 hour blocks so that all hours of the day and all days of the week were equally represented. MAIN OUTCOME MEASURES: The proportion of patients for whom point of care testing brought about a change in treatment in which timing was considered to be critical to clinical outcome. Mortality, the length of stay in hospital, admission rate, the amount of time spent waiting for results of blood tests, the amount of time taken to decide on management plans, and the amount of time patients spent in the department were compared between patients whose samples were tested at the point of care and those whose samples were sent to the laboratory. RESULTS: Samples were obtained from 1728 patients. Changes in management in which timing was considered to be critical occurred in 59 out of 859 (6.9%, 95% confidence interval 5.3% to 8.8%) patients in the point of care arm of the trial. Decisions were made 74 minutes earlier (68 min to 80 min, P < 0.0001) when point of care testing was used for haematological tests as compared to central laboratory testing, 86 minutes earlier (80 min to 92 min, P < 0.0001) for biochemical tests, and 21 minutes earlier (-3 min to 44 min, P = 0.09) for analyses of arterial blood gases. There were no differences between the groups in the amount of time spent in the department, length of stay in hospital, admission rates, or mortality. CONCLUSION: Point of care testing reduced the time taken to make decisions on patient management that were dependent on the results of blood tests. It also brought about faster changes in treatment for which timing was considered to be critical in about 7% of patients. These changes did not affect clinical outcome or the amount of time patients spent in the department.

Adult↗
PubMed1998

Elevation in tumour necrosis factor-alpha (TNF-alpha) messenger RNA levels in the uterus of pregnant gilts after oestrogen treatment.

In pigs, induction of embryonic degeneration, by exogenous oestrogens given early in gestation, has been long recognised. However, the underlying mechanisms responsible for this degeneration remain unclear. The present study was conducted to determine whether oestrogen-induced early porcine embryonic mortality was associated with changes in the levels of tumour necrosis factor-alpha (TNF-alpha) messenger RNA in the uterine endometrium. Prepubertal gilts were induced into oestrus with PG600 and artificially inseminated at their second natural oestrus and again 24 h later. After insemination, gilts were randomly assigned to treatment and given 0.5 ml intramuscular injections of either oestradiol valerate (10 mg ml-1) or corn oil on day 9 and 10 of gestation. The gilts were slaughtered on day 12, 15 or 18 of gestation. The reproductive tract was removed from each gilt and the uterine horns were flushed to check for the presence and integrity of embryos. Samples of uterine endometrial tissues were collected, snap-frozen in liquid nitrogen and stored at -80 degrees C. Total cellular RNA was isolated from frozen tissues using a guanidine isothiocyanate-cesium chloride method. The abundance of TNF-alpha messenger RNA was determined by Northern blot hybridisation analysis. Treatment of pregnant gilts with oestrogen resulted in severe fragmentation of embryos on days 15 (2/3) and 18 (2/2), confirming the embryocidal effect of exogenous oestrogen. Uterine TNF-alpha messenger RNA level was elevated in oestrogen-treated gilts compared with controls (P < 0.05). This observation of an association between increased levels of TNF-alpha mRNA in the uterus and embryonic degeneration in oestrogen-treated gilts suggests that TNF-alpha may be involved in mediating oestrogen-induced early embryonic mortality in the pig.

Animals↗
PubMed1998

Understanding women's risk of HIV infection in Thailand through critical hermeneutics.

Approximately 20% of all new AIDS cases in Thailand are women of childbearing age. Women are particularly vulnerable to HIV infection because of the social and sexual practices of men frequenting prostitutes, even after marriage, and the inability of women to exert control on decisions regarding sexual health. Women's oppression in Thailand is discussed and a position made of the moral imperative to use counterhegemonic methodologies in the study of HIV risk and prevention in Thai women. Interpretive and critical research methodologies are reviewed, and a case is made for using critical hermeneutics as an approach for investigating women's oppression in Thailand and their vulnerability to HIV infection.

Female↗
PubMed1998

Can accident and emergency nurse practitioners interpret radiographs? A multicentre study.

OBJECTIVE: To assess the ability of nurse practitioners in accident and emergency (A&E) to interpret distal limb radiographs, by comparison with senior house officers. DESIGN: Nurse practitioners and senior house officers in 13 A&E departments or minor injury units were shown 20 radiographs of distal limbs, with brief history and examination findings, and asked to record their interpretation. OUTCOME MEASURE: A total score for each subject was calculated by comparing answers against agreed correct responses. RESULTS: Nurse practitioners in general compared favourably with senior house officers. Those nurse practitioners who interpret radiographs as part of their role in minor injury units performed as well as the experienced senior house officer group. CONCLUSIONS: Nurse practitioners in A&E are able to interpret radiographs to a standard equal to senior house officers with three to five months' experience. Those nurse practitioners actively interpreting radiographs as part of their role in minor injury units are able to interpret radiographs to the same standard as senior house officers with more than five months' experience.

Analysis of Variance↗
PubMed1998

Outlasting disruption: the process of reinvestment in families with ADHD children.

The goal of the research described in this article was to generate a grounded theory of how parents of children with attention deficit hyperactivity disorder (ADHD) coped with this chronic behavioral disorder. Interview data from 15 families with ADHD children (N = 59) were analyzed using the grounded theory method. Data analysis revealed that parents outlasted the disruption of ADHD through three subprocesses of "reinvesting": making sense, recasting biography, and relinquishing the "good ending." Findings suggest that there is a developmental trajectory of how parents adjust to the disorder over time and that there is a need for increased social and mental health services for all members of the family over the course of the disorder.

Adaptation, Psychological↗
PubMed1997

Expanding the praxis debate: contributions to clinical inquiry.

Nursing science continues to debate the adequacy of various philosophic paradigms for their ability to forward the discipline. Nursing must embrace multiple paradigms, methodologies, and their philosophic assumptions to adequately address the complex and multifaceted human phenomena that is the focus of clinical inquiry in nursing. This article examines the differences in interpretive and critical approaches to clinical inquiry relative to praxis, expanding how praxis can be used to inform nursing practice. Differences in the nature of knowledge, goals of inquiry, and claims to praxis between the interpretive and critical traditions are discussed. Praxis, realized through clinical inquiry in both the interpretive and the critical paradigms, may contribute important pieces of the puzzle to improve the human condition. Expanding the praxis debate challenges nurses to consider the emancipatory possibilities of clinical inquiry within both interpretive and clinical paradigms.

Clinical Nursing Research↗
PubMed1996

Long-term outcome and cost-effectiveness of parenteral nutrition for acute gastrointestinal failure.

Although there are several published audits of long-term home parenteral nutrition for chronic gastrointestinal failure, there is little data concerning the long-term outcome following prolonged in-patient parenteral nutrition for an episode of acute gastrointestinal failure. Between 1983 and 1 July 1993, 162 patients received total parenteral nutrition (TPN) in our unit for acute gastrointestinal failure for a total of 4997 patient days and using 192 central venous catheters. Over the 10 years there were 11 mechanical complications resulting in one death. Although the overall catheter infection rate was 5.7%, in the last 4 years it was 0%, associated with a reduction in the frequency of site dressing and change of giving set from three times to once weekly. All patients had lost more than 10% of their body weight before TPN. In the non-malignant group, fed for more than 21 days (mean 50 days), the 10-year survival was 74% at a cost of 4723 pounds sterling per year of life saved. In the malignant group, the 5-year survival was 27% at a cost of 8351 pounds sterling per year of life saved. These costs compare favourably with other technologies, such as dialysis for acute renal failure. Better patient selection, fewer complications and lower costs are obtained when this treatment is carried out by an expert team.

Journal Article↗
PubMed1996

Human association as a factor influencing wellness in homosexual men with human immunodeficiency virus disease.

In-depth interviews of 29 homosexual men with varying degrees of human immunodeficiency virus illness were conducted using grounded theory methodology. The study participants indicated that the need for intimacy and community were of paramount importance to living well and suggested that feeling connected to others was a synergistic process that promoted an existential/ spiritual understanding of one's self as being well. Clinical recommendations for nurses include the use of intimacy-building care strategies that are capable of helping clients construct meaning of their experience to enhance individual well-being.

Adult↗
PubMed1996

Creating a culturally responsive psychotherapeutic environment for African American youths: a critical analysis.

Psychotherapy has been used by psychiatric nurses in advanced practice since the 1950s. The majority of research and clinical literature on the processes and outcomes of psychotherapy as an intervention in treating mental health difficulties have involved primarily Euro-American populations with little emphasis on ethnic, cultural, or class distinctions. If the epistemic origins of psychotherapy and its emphasis on the "interior self" of emotions, thoughts, and perceptions are a holdover from 19th-century individualism, where does this leave African Americans, whose social and cultural experience is more embedded in communal activities of church, neighborhood, and family than that of Euro-Americans? This article critically examines the role of psychotherapeutic mental health care as an emancipatory action, seeking to create a more culturally responsive psychotherapeutic environment for African American youths.

Adolescent↗
PubMed1996

Munchausen syndrome presenting as major trauma.

The case is described of a man who feigned being struck by a vehicle, leading to an unnecessary major trauma response by the ambulance service and hospital. Suspicion that the patient suffered from Munchausen syndrome was confirmed by later investigation. Accident and emergency staff should file details of such patients on the department computer records system, where available, so that staff are alerted automatically to their presence, and share this information with neighbouring hospitals. All such patients should be treated according to ATLS guidelines until injury is ruled out, as for any other patient.

Accidents, Traffic↗
PubMed1996

Alkalinisation of lignocaine to reduce the pain of digital nerve blockade.

OBJECTIVE: To see if the alkalinisation of lignocaine caused a reduction in the pain of injection for digital nerve blockade. METHODS: The study was a prospective randomised double blind study with each patient acting as their own control. During the study period, all patients aged 16 years and over presenting to the accident and emergency department with a condition requiring digital nerve blockade were considered for inclusion in the study. Each patient received an injection of both alkalinised and non-alkalinised lignocaine. The pain of each injection was then assessed on a visual analogue scale. RESULTS: 98 patients were entered in the study. The mean difference in pain scores between the non-alkalinised and alkalinised injections was 0.739, P < 0.001, 95% confidence interval 0.47 to 1.01. CONCLUSIONS: Alkalinisation of lignocaine reduces the pain of injection for digital nerve blockade.

Adolescent↗
PubMed1992

Stomach position as an in utero predictor of neonatal outcome in left-sided diaphragmatic hernia.

An 8-year review of neonates with left-sided congenital diaphragmatic hernia who presented in severe respiratory distress at birth was retrospectively reviewed looking at stomach position, thoracic or abdominal, as a predictor of survivability. Survival was 93% with the stomach below the diaphragm compared with 29% when the stomach was thoracic in location. Stomach position may be an important early in utero predictor of high mortality in neonates with left-sided congenital diaphragmatic hernias.

Female↗