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Biomedical subjects

J Sangster

Publications and source records attributed to J Sangster.

10 recordsLinked to original sources
PubMed2001

Work in progress. Integrating physicians' services in the home.

OBJECTIVE: While increasing acuity levels and the concomitant complexity of service demand that physicians be involved in in-home care, conflicting evidence and opinions do not show how this can best be achieved. DESIGN: A phenomenologic research design was used to obtain insights into the challenges and opportunities of integrating physicians' services into the usual in-home services in London, Ont. SETTING: Home care in London, Ont. PARTICIPANTS: Twelve participants included three patients, two family caregivers, two family physicians, the program's nurse practitioner, two case managers, and two community nurses. METHOD: In-depth interviews with a maximally varied purposeful sample of patients, caregivers, and providers were analyzed using immersion and crystallization techniques. MAIN FINDINGS: Findings revealed the potential for enhanced continuity of care and interdisciplinary team functioning. Having a nurse practitioner, interdisciplinary team-building exercises and meetings, regular face-to-face contact among all providers, support for family caregivers, and 24-hour coverage for physicians were found to be essential for success. CONCLUSION: Integration of services takes time, money, and sustained commitment, particularly when undertaken in geographically isolated communities. Informed choice and a fair remuneration system remain important considerations for family physicians.

Adult↗
PubMed2000

Masking and unmasking the sexual abuse of children: perceptions of violence against children in "the Badlands" of Ontario, 1916-1930.

This article explores the legal and social understandings of incest in early-twentieth-century Canada, examining the way in which sexual abuse was identified in sensational court cases but ideologically masked in social consciousness. First, the legal treatment of incest is examined through court cases, with special focus on one case that animated a grand jury report on a rural area where incest and violence supposedly flourished. Second, the grand jury's legal, medical, and social assumptions about incest, reflecting eugenic priorities as well as class and gender prejudices, are surveyed. Third, the actual use of the grand jury report in subsequent cases is probed. The report became a generalized explanation for all kinds of familial violence placing blame for violence on poor, degenerate, and immoral parents but ignoring the structural problems of power and patriachy.

Canada↗
PubMed1997

Iron chelators of the pyridoxal isonicotinoyl hydrazone class. Relationship of the lipophilicity of the apochelator to its ability to mobilize iron from reticulocytes in vitro: reappraisal of reported partition coefficients.

The partition coefficients P between n-octanol and water of pyridoxal isonicotinoyl hydrazone and 34 analogues have been determined experimentally; the values indicate that the partition coefficients calculated for these compounds, and previously reported (P. Ponka, D.R. Richardson, J.T. Edward, and F.L. Chubb. Can. J. Physiol. Pharmacol. 72: 659-666. 1994; D.R. Richardson, E.H. Tran, and P. Ponka. Blood, 86: 4294-4306. 1994), are too low by 2-3 orders of magnitude. The calculations, using Rekker's additive method, failed because the molecules have two or more hydrophilic sites close together. More recent additive schemes (CLOGP, KOWWIN, ACD/LogP) also failed. The only reliable method was the semi-empirical method of Hansch. This requires the experimental determination of the partition coefficient of at least one representative in each series of compounds of related structure. In the present paper, determination of log P of three representatives enabled us to calculate the partition coefficients of the other 32 compounds with acceptable accuracy. The new results show that apochelators have maximum activity in releasing 59Fe from reticulocytes when they have log P = 2.8 (P = 630), and not log P = 0 (P = 1), as reported by Ponka et al. (P. Ponka, D.R Richardson, J.T. Edward, and F.L Chubb. Can. J. Physiol. Pharmacol. 72: 659-666 1994).

Iron↗
PubMed1996

Teaching child and adolescent psychiatry to family medicine trainees: a pilot experience.

OBJECTIVE: To develop learning objectives for teaching child psychiatry to family medicine trainees and to evaluate the best method of teaching these objectives. METHOD: For this descriptive study, knowledge, attitude, and skill objectives were presented to trainees at the start of a 6-month rotation, and an evaluation mechanism was developed based on the learning objectives. The method of instruction in each of the training locations was described independently by the child psychiatry consultant and attending family physician. The trainees' evaluations were presented according to training locations. RESULTS: Family medicine trainees perceived the teaching-consultation method, with live interviews, to be the most helpful and the didactic lecture format to be least helpful. CONCLUSION: The importance of teaching family medicine residents to recognize mental health problems in children and adolescents, preferably by using live interviews, and the implications for postresidency practice are emphasized.

Adolescent↗
PubMed1993

Pilot study: effects of G-CSF on neutrophil ex-vivo function post bone marrow transplantation.

The effects of human recombinant granulocyte colony stimulating factor (G-CSF) on neutrophil recovery have been studied in patients undergoing bone marrow transplantation for haematological disease. Nine patients (five autografts and four allografts) were studied while receiving daily doses of G-CSF (range 2-20 micrograms/kg body weight) were compared to eight patients (four autografts and four allografts) who did not receive G-CSF as a control group. In both groups flow cytometry was used to determine neutrophil IgG Fc receptor (FcRII, FcRIII) expression. Phagocytosis and metabolic burst was assessed using IgG opsonized bacteria. The patients' neutrophils were studied prior to conditioning in autografts and donor cells were studied in allografts. Studies were repeated at neutrophil recovery (neutrophil count 1.0 x 10(9)/l) and ten days post recovery. At recovery FcRII expression was slightly increased in all groups, whereas the number of cells expressing FcRIII was reduced. This reduction was significant in the patients receiving rG-CSF at recovery and post recovery compared to the pretreatment levels. The ability to phagocytose bacteria in cells from patients receiving G-CSF was also reduced. The associated metabolic burst was significantly reduced in the autograft group but not the allograft group receiving rG-CSF. The reduced function and reduced expression of FCRIII suggests the presence of immature neutrophils in patients receiving rG-CSF post BMT.

Bone Marrow Transplantation↗
PubMed1990

Flow cytometric analysis of the functional ability of neutrophils from patients with autoimmune neutropenia.

Flow cytometry has been used to evaluate the functional ability of neutrophils and the expression of IgG Fc receptors (FcRII and FcRIII) in autoimmune neutropenia. Quantification of the neutrophil oxidative burst was made by assaying the production of 2'7'-dichlorofluorescein (DCF) from non-fluorescent 2'7'-dichlorofluorescein trapped within the cell, by flow cytometric analysis of cellular fluorescence. In the present study the DCF assay was used to examine the response of neutrophils to stimulation by opsonized and non-opsonized Staphylococcus aureus. In addition, the rate of uptake of S. aureus labelled with the red nuclear dye propidium iodide was determined. The presence of surface-bound immunoglobulin, which may affect the phagocytic capacity of the neutrophil, was also measured. No correlation between the neutrophil count and level of membrane-bound IgG or the rate of bacterial uptake was found. The studies were performed on twenty patients with autoimmune neutropenia, twelve with other autoimmune disorders and fourteen normal controls. The rate of uptake of bacteria was considered in relation to the expression of FcRII and FcRIII. Good correlation was found with the level of expression of FcRII, the major receptor for neutrophil activation, and the rate of uptake of bacteria (r = 0.64).

Autoimmune Diseases↗