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Biomedical subjects

J McIntosh

Publications and source records attributed to J McIntosh.

At least 37 records · Page 2Linked to original sources
PubMed1998

Aversive and appetitive events evoke the release of corticotropin-releasing hormone and bombesin-like peptides at the central nucleus of the amygdala.

There is wide agreement that corticotropin-releasing hormone (CRH) systems within the brain are activated by stressful stimuli. There is also mounting evidence for the role of bombesin (BN)-like peptides in the mediation of the stress response. To date, however, the extent to which other stimuli increase the activity of these peptidergic systems has received little attention. In the present investigation we validated and used in vivo microdialysis sampling followed by ex vivo radioimmunoassays to monitor the release of CRH and BN-like peptides during appetitive (food intake) and stressful (restraint) events. It is demonstrated for the first time that the in vivo release of CRH and BN-like peptides at the central nucleus of the amygdala was markedly increased by both stressor exposure and food ingestion. In fact, the meal-elicited rise of CRH release was as great as that associated with 20 min of restraint stress. Paralleling these findings, circulating ACTH and corticosterone levels were also increased in response to both food intake and restraint. Contrary to the current views, these results indicate that either food ingestion is interpreted as a "stressful" event by certain neural circuits involving the central amygdala or that the CRH- and BN-related peptidergic systems may serve a much broader role than previously envisioned. Rather than evoking feelings of fear and anxiety, these systems may serve to draw attention to events or cues of biological significance, such as those associated with food availability as well as those posing a threat to survival.

Adrenocorticotropic Hormone↗
PubMed1997

Listening in the care environment--chaos or clarity for the hearing-impaired elderly person.

The reported study evaluates listening circumstances within long-stay wards in an attempt to understand the nature of the environment and so develop and subsequently evaluate a programme of nursing intervention for hearing-impaired residents. Evidence is presented which indicates that improvement of the residents' listening environment, promotes adaptation to hearing aids and enhances residents' quality of life. It is recommended that attending to the listening environment becomes a concern of nurses working within continuing care facilities for elderly people.

Aged↗
PubMed1997

Anxiogenic behavior in the light-dark paradigm follwoing intraventricular administration of cholecystokinin-8S, restraint stress, or uncontrollable footshock in the CD-1 mouse.

The influence of restraint stress (0, 15, 30, or 60 min), uncontrollable footshock (0, 15, 30, or 60 shocks), or intraventricular CCK-8S administration (0, 5, 25, or 50 ng delivered in a 1 microliter volume) were evaluated on transition frequency and cumulative time in light among CD-1 mice in the light-dark paradigm. Mice exposed to restraint stress of either 15 or 60 min were indistinguishable from nonrestrained animals, while the 30-min session of restraint decreased time in light and transition scores. The presentation of 15, 30, or 60 uncontrollable footshocks were equally effective in decreasing cumulative time in light but had no effect on transition scores. Intraventricular infusion of 25 and 50 ng doses of cholecystokinin-8S reduced cumulative time in light and transition frequency in CD-1 mice relative to vehicle or 5 ng CCK-8S-treated animals in the light-dark paradigm. The time in light and transition data secured among mice with repeated light-dark exposure and 30 min of restraint were comparable to the corresponding scores secured when performance was only evaluated on trial 1. Transition scores were reduced on trial 1 of mice exposed to 30 min of footshock, but time in light was reminiscent of the performance detected among mice with prior light-dark experience. Potential neurochemical correlates associated with the anxiogenic effects associated with stressor exposure and CCK-8S administration in the light-dark task are discussed.

Animals↗
PubMed1997

The practice-based context of educational innovation: nurse and midwife preparation in Scotland.

The use of an illuminative approach to the national evaluation of the first 18 months of Project 2000 nurse and pre-registration midwifery education in Scotland has facilitated the generation of data about the contexts in which the new programmes function. The aim of this paper is to present some of the data generated from programme participants about the conditions students experience in practice-based learning experiences. The reported issues are direct or indirect effects of policy initiatives and service reforms. The current climate of change in health care provision has fostered a limited number of developments which are consistent with the aspirations of the new programmes and which offer highly valued learning experiences to students. More often however the reforms have served to frustrate the intent of the programmes to offer students experiences which are patient-centred, holistic-care and health oriented.

Community Health Nursing↗
PubMed1996

Assessing need for district nursing: study findings.

To determine whether an appropriate level of nursing care is being provided in the community, this study aimed to explore whether patients' needs are being identified through the referral system and whether those needs are being met.

Health Services Needs and Demand↗
PubMed1996

The question of knowledge in district nursing.

This paper focuses on the development of the experiential knowledge base in district nursing with reference to changes in professional preparation for district nurses and to a research study conducted by the author during the 1970s. The process of conducting the research showed that an exclusive focus on activity fails to capture the range and depth of nursing care in the home. Schön's concept of professional artistry is employed as an interpretive framework to consider some of the study findings and with reference to more recent research studies the author concludes that while it has always been central to skilled nursing, professional artistry has remained hidden. The problems confronting academics and practitioners in articulating such knowledge are explored together with the possible consequences of continued failure to address this issue. These difficulties are discussed in the context of the current changes in the National Health Service with particular reference to the introduction of grade mix in community nursing. The paper concludes by arguing that a better understanding of the district nurse's knowledge base must be vigorously pursued.

Community Health Nursing↗
PubMed1996

Decision making in community nursing: an analysis of the stages of decision making as they relate to community nursing assessment practice.

This paper considers the nature of decisions made in the context of community nursing practice, in the light of the stages of decision making distilled by Carroll & Johnson from the work of various theorists, and explores the relevance of each stage to community nurses' decision making. Illustrative examples of specific theoretical perspectives are included throughout the paper. The discussion forms part of the literature review for research currently being undertaken by the authors into patient assessment by community nurses. As decision making is a key element of community nurses' assessment practice, the paper argues that decision making theory forms a useful conceptual framework for investigating this aspect of community nursing.

Community Health Nursing↗
PubMed1996

The use of the Nominal Group Technique in research with community nurses.

The use of group-based techniques to generate ideas and offer solutions to problems is commonplace in many disciplines and for many purposes. What were originally useful adjuncts to market research have become valuable and illuminating tools in education, policy and research. This paper will describe the use of one such technique, the Nominal Group Technique, and its practical application in bridging the gap between researchers and practitioners in one particular study of community nursing.

Community Health Nursing↗
PubMed1996

Bolus or infusion teicoplanin for intravascular catheter associated infections in immunocompromised patients?

An unexpected low efficacy of teicoplanin in the treatment of coagulase negative staphylococcal (CNS) infections on a regional Bone Marrow Transplant (BMT) Unit led to a retrospective study. CNS infections treated with gylcopeptides in BMT patients with in-dwelling central venous lines between May 1990 and May 1995 were reviewed. Efficacy rates of 50% for teicoplanin compared with 80% for vancomycin despite comparable antibiotic susceptibility. Glycopeptides have bactericidal action which is time dependent. Teicoplanin was administered by bolus injection during the study period and it is suggested that this observed difference in efficacy is caused by the short duration of exposure of luminal bacteria.

Adult↗
PubMed1996

The Roy Adaptation Model: a consideration of its properties as a conceptual framework for an intervention study.

The underlying premise of this paper is the belief that one of the core values of nursing research is its ability to demonstrate that nursing interventions influence care outcomes. From this perspective the contribution offered by the Roy Adaptation Model for Nursing within an intervention study is evaluated. Although it was believed that the model enriched the study in several ways, its overall contribution was likened to a "conceptual stepping stone', used by the researcher en route back towards its underlying theories and classical intervention design methodologies.

Adaptation, Psychological↗
PubMed1995

Susceptibility to astrocytoma and meningioma: influence of allelism at glutathione S-transferase (GSTT1 and GSTM1) and cytochrome P-450 (CYP2D6) loci.

We describe a case-control study to identify associations between polymorphism at the cytochrome P-450 (CYP2D6) and glutathione S-transferase (GSTT1 and GSTM1) loci and susceptibility to astrocytoma and meningioma. Accordingly, genotype frequencies in 112 astrocytoma and 50 meningioma patients were compared with frequencies in 577 controls. GSTM1 genotype frequencies in these groups were not different. Logistic regression analysis showed GSTT1 null and CYP2D6 poor metabolizer were risk factors in astrocytoma (odds ratio = 2.67 P = 0.0005 and odds ratio = 4.17 P = 0.0043, respectively) and meningioma (odds ratio = 4.52, P = 0.0001 and odds ratio = 4.90, P = 0.0132, respectively) when corrected for the other variables. No interactive effects between genotypes were identified. The data suggest polymorphism at loci encoding carcinogen-metabolizing enzymes influences susceptibility to astrocytoma and meningioma, possibly by determining effectiveness in the detoxification of environmental carcinogens.

Adult↗
PubMed1995

A preliminary report on urinary BT-PABA/PAS excretion index, serum pancreatic isoamylase and faecal chymotrypsin tests of pancreatic dysfunction in Sowetan Africans.

The steady increase in chronic pancreatitis among black Africans at Soweto, RSA, in the past 40 years necessitates an objective and non-invasive test to detect the disease at an early stage. Given the biphasic nature of the disease--secretory hyperfunction with periodic active inflammatory episodes followed by steady exocrine impairment--we assessed three potential aids. Urinary BT-PABA/PAS excretion index (PEI), serum pancreatic isoamylase (PIA) and faecal chymotrypsin activity (FCA) were measured in the following groups: 16 outwardly healthy hospital workers, 16 consecutive patients with calcifying chronic pancreatitis and 19 with abdominal pain ascribed to other conditions (disease controls). (1) Healthy controls had lower PEI than those at Manchester, UK, or Madras, India, from subclinical acinar loss--as shown by lower PABA recovery whereas intestinal absorptive capacity was maintained, as shown by recovery of PAS. (2) Using the popular cut-off for PEI (0.75) only 9 of 14 patients with chronic pancreatitis were identified (sensitivity 64%, 2 tests unsatisfactory), while a value of less than 0.54, the mean -2 S.D. in local controls, yielded sensitivity of 50%. (3) If PEI of less than 0.75 or PIA outside the reference range was taken to indicate the disease, 5 of 9 disease controls would have been classed as chronic pancreatitis (among those with both tests satisfactory): retrospective ultrasound scans did not identify these. (4) Although FCA was less than the preselected cut-off, 5 units/g, in every patient with chronic pancreatitis (100% sensitivity) its poor predictive value was indicated by low specificity: subnormal levels in 4 of 14 and 6 of 16 healthy controls or disease controls, respectively, most of whom had near-normal values of PEI, PIA or both. (5) Collectively, these results suggest a high frequency of subclinical chronic pancreatitis at Soweto, but also that the combination of tests required to identify it may prove impractical--whether in field surveys or hospital practice.

4-Aminobenzoic Acid↗
PubMed1995

Drug metabolizing enzymes of mussels as bioindicators of chemical pollution.

The GSTs of M. edulis provide an easily assayed activity which would be expected to respond to changes in pollution status. The main GST and a related GSH-binding protein have been purified and biochemically characterized. The former protein is most similar to the Pi class while the latter is a catalytically inactive monomer which appears to be related to the Mu class. This enzyme activity has been assessed as a potential indicator of exposure to chemical pollutants in both Cork Harbour and Venice Lagoon (using the closely related species, M. galloprovincialis). Controlled exposure studies with mussels in holding tanks have indicated that the herbicide aldicarb gives a slight but significant increase in GST activity consistent with the inducibility of these enzymes by xenobiotics in this bivalve. At present, we are studying samples which have been deliberately exposed to PAH and PCB compounds. Studies of this type are important in helping to understand the effects and fate of chemical pollutants released into estuarine environments.

Animals↗
PubMed1994

Multiple nocardial brain abscesses: report of two patients.

Two patients presented with nocardial brain abscesses, one as secondary to overwhelming pulmonary infection following a thoracic empyema, the second as a primary abscess. Both patients had immunopression. Such an infection should be considered early in any patient who is immunocompromised.

Adult↗