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Biomedical subjects

J Morrell

Publications and source records attributed to J Morrell.

At least 19 recordsLinked to original sources
PubMed2005

Lower urinary tract reconstruction for spina bifida -- does it improve health related quality of life?

PURPOSE: Reconstruction for incontinent myelomeningocele is assumed to improve health related quality of life (HRQOL) yet there are no published data to support this assumption. MATERIALS AND METHODS: A retrospective cohort study was performed of 36 consecutive incontinent meningomyelocele cases undergoing surgery (augmentation, with or without Mitrofanoff, bladder neck reconstruction and cecostomy). Controls were matched 2:1 for age, lesion level, parental marital status, ambulatory status and shunt status. HRQOL was assessed with a previously validated disease specific discriminative instrument that stratifies for ages 12 years or less and 13 years or greater. An additional 5-point Likert questionnaire was used for self-scoring of bladder and bowel continence. RESULTS: Responses were 89% and 84% for cases and controls, respectively. The 2-sample t testing for subjects 12 years old or younger revealed no significant difference in mean HRQOL score between those who underwent reconstruction (12, mean 165 +/- 23) and those who did not (9, mean 162 +/- 27, p=0.73). Results in older subjects were similar for cases (20, mean 190 +/- 23) and controls (3, mean 192 +/- 26, p=0.80). This finding occurred despite the fact that 78% of reconstructed cases achieved urinary continence for 3 hours or more with equal or superior self-reported bladder and bowel continence compared to controls. CONCLUSIONS: We were unable to demonstrate superior HRQOL in patients over controls. Several possible interpretations exist, such as surgery may have no impact on HRQOL, patients might have scored much lower without surgery, or perhaps only caregiver quality of life improves. The impact of urinary tract reconstruction upon quality of life in the myelomeningocele population warrants further study.

Adolescent↗
PubMed2002

NHS Direct and nurses--opportunity or monotony?

NHS Direct, the 24-hour telephone helpline providing information and advice about health problems, is available throughout England and Wales. It was envisaged as a nurse-led service presenting a new opportunity for the nursing profession. Free text comments from a postal survey of NHS Direct nurses revealed that a large proportion of nurses were happy with working in NHS Direct, and that it presented some nurses with the opportunity of a new and challenging role. However, a minority found the work monotonous and felt that NHS Direct is likely to face the challenge of staff retention.

Career Choice↗
PubMed1995

Make an application for flexible (part time) training.

Part time training posts are advertised in the BMJ each year in August or September in an advertisement placed by the Department of Health. Although the advertisement is placed by the department and manpower approvals are allocated centrally, each region runs its own scheme, and the first person to approach is the regional postgraduate dean (most regions have an assistant dean responsible for flexible training). If an application is successful then part time trainees are interviewed by the same appointments committee as full time applicants and they are judged by the same criteria. Manpower approval is granted to applicants who reach the same standard as full time applicants, but there may be a waiting list if there are more suitable applicants than training places available. The next stage is to gain educational approval from the relevant higher training committee for the proposed training programme, followed by funding from the region.

Female↗
PubMed1994

Characterization of a gene coamplified with Ki-ras in Y1 murine adrenal carcinoma cells that codes for a putative membrane protein.

We report the sequence and genomic organization of a gene linked to Ki-ras in the mouse and coamplified in Y1 murine adrenal carcinoma cells. The entire 4.4-kb cDNA sequence as well as promoter and splice sites for each of the three exons was determined. The gene, designated KRAG (Ki-ras-associated gene) has a CG-rich first exon and promoter region and a long 3' untranslated region and encodes 216 amino acids. The putative 23.9-kDa protein has four potential transmembrane hydrophobic domains. The hydropathy plot resembles that of certain tumor-associated antigens, including CO-029 and ME491. A potential human homologue, EST05985, was identified and provisionally mapped to human chromosome 12, a chromosome syntenic to mouse chromosome 6, the previously mapped location of KRAG.

Adrenal Gland Neoplasms↗
PubMed1991

Prevention of heart disease in general practice: the use of a risk score.

Between 1987 and 1988 seven general practices took part in a pilot study of a predictive risk score for ischaemic heart disease in men aged 40-59 years. The aim was to assess the feasibility and usefulness of this score as part of a coronary prevention programme. The score was generally well received by practice nurses and general practitioners, and found to be helpful as a method of focusing preventive activity. Most chose to reveal the score to the patient, although there was some concern that this could lead to false reassurance being perceived by those with a low score but remediable risk factors. Practitioners were able to use the score as a method for identifying a priority group for intervention, and it is concluded that the risk score is a useful component of health checks.

Adult↗
PubMed1990

Morphine conditioned place preference in the hamster.

Two experiments investigated the ability of morphine to produce a conditioned place preference in the hamster. In Experiment 1, it was found that a 15 mg/kg dose of morphine produced a conditioned place preference after eight conditioning trials. In addition, naloxone (0.4 mg/kg blocked the development of the morphine-conditioned place preference and itself produced a conditioned place aversion after four conditioning trials. In Experiment 2, the effects of four doses of morphine (0, 2.5, 5 and 15 mg/kg) on the acquisition of a conditioned place preference were studied. Only the 15 mg/kg dose produced a significant place preference. Compared to similar findings in the rat, the present results indicate that a relatively high dose of morphine is required to produce a conditioned place preference in the hamster.

Animals↗
PubMed1988

Physiological arousal of obese persons to food stimuli.

Physiological arousal was measured in 20 obese and 20 normal-weight subjects during presentation of imagery tasks with food- and nonfood-related stimuli and during presentation and eating of food. No differential arousal, as measured by skin conductance, was obtained between the groups for any of the stimuli. Presentation and eating of the food did produce significant arousal in subjects.

Adult↗
PubMed1977

Receptivity of physicians in a teaching hospital to computerized drug interaction monitoring and reporting system.

Physicians at Stanford University Medical Center were surveyed to evaluate their responses to a computerized drug interaction warning system one year after its installation. While one-fourth of the 862 respondents had personally received at least one warning report, the educational benefits of the system had diffused to many physicians in the hospital. Reports were found to be useful for patient management and 44 per cent of the physicians who had received reports indicated they had changed their behavior in response to the information. The system was particularly beneficial for interns and medical students, and appears to have potential as an educational tool for training in therapeutics. While several problems with the system were noted, the overall attitude of the respondents toward it was favorable. The drug interaction warning system appears to have a promising future for reducing the problem of drug interactions among hospitalized patients.

Attitude of Health Personnel↗
PubMed1976

Factors affecting the use of physician services in a rural community.

This paper examines the relative importance of various independent variables for predicting five separate measures of physician utilization in a rural community. The independent variables include socioeconomic, demographic, attitudinal, and health status factors. The results are comparable to those of national studies which find that health status is the primary determinant of utilization. Income, price measures, and travel time are notable for their relative unimportance in this rural area. This suggests that resources are more likely to be allocated on the basis of medical need within a given health care market than across a number of market areas.

Adolescent↗