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Biomedical subjects

J Walsh

Publications and source records attributed to J Walsh.

At least 361 records · Page 20Linked to original sources
PubMedDate not supplied

Data analysis needs for health sector reform.

This paper addresses the role of information in health policy reform. It recognizes that reform can be based on data, but that there are other influences on health policy. The steps involved in making policy, including problem identification, comparison of solutions, policy adoption, implementation, and amendment, all require information. When information is unavailable for any of these steps, the policy process sometimes proceeds without it. The policy makers must make difficult choices regarding the potential benefit of comprehensive information to the policy outcome versus the potential drawbacks, in terms of time and cost, of seeking the missing information. Different areas where data are needed within health policy are enumerated, as are sources of health policy data, and examples of strategies are given. Finally, three case studies are presented, highlighting the use of information in policy making. The National Epidemiology Board in Thailand commissioned studies by experts on relevant policy topics. It had a substantial impact on changing policies in the areas of AIDS control, iodine deficiency, essential drugs and vaccination. The attempt at decentralizing health administration to the province level in Papua New Guinea is the second example presented. At the time of the evaluation, this effort had not yet attained its objectives of improving the health of the people, nor had it reduced costs or lessened inequity among regions. If this reform had been tested in a pilot project, its problems may have been discovered at an earlier stage of implementation when they would have been easier to correct. The final case concerns the UNICEF child survival interventions during the 1980s. These interventions were chosen based on cost-effectiveness analysis and were successfully implemented. The use of cost-effectiveness analysis in prioritizing interventions is one example of the way in which information can improve policy and health outcomes.

Data Collection↗
PubMedDate not supplied

Spantide: failure to antagonize bombesin-induced stimulation of gastrin secretion in dogs.

Spantide ([d-Arg1, d-Trp7,9, Leu11] substance P) was shown to function not only as a substance P receptor antagonist but also as a bombesin receptor antagonist. This study examined the effects of spantide on intravenous bombesin-induced stimulation of gastrin and acid secretion. Dogs were infused with spantide (1 or 10 nmol kg 1 hr 1) or saline and bombesin (60 pmol kg-1 hr-1), and the gastric acid and plasma gastrin responses were monitored. Spantide did not significantly modify gastrin or gastric acid secretion induced by bombesin. It is concluded that spantide may not be a useful bombesin antagonist for in vivo studies.

Animals↗
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Intraislet somatostatin inhibits insulin (via a subtype-2 somatostatin receptor) but not islet amyloid polypeptide secretion in the isolated perfused human pancreas.

It is our hypothesis that intraislet somatostatin regulates beta cell secretion in the isolated perfused human pancreas. The present study was designed to determine the relative influence of intraislet somatostatin on the regulation of islet amyloid polypeptide (IAPP) and insulin secretion, and to determine the effect of specific somatostatin receptor (SSTR) agonists on beta cell secretion during immunoneutralization of endogenous somatostatin in the isolated perfused human pancreas. Single-pass perfusion was performed in pancreata obtained from seven cadaveric organ donors using a modified Krebs medium with 3.9 mmol/L glucose. Sequential test periods were separated by basal periods and experiments were performed by infusion of any of the following: (1) somatostatin monoclonal antibody (S-Ab); (2) S-Ab + SSTR2 agonist (DC32-87); or (3) S-Ab + SSTR5 agonist (DC32-92). The changes in insulin and IAPP secretion from basal levels during each stimulation were calculated. Infusion of S-Ab resulted in a significant increase in insulin secretion (2033 +/- 429 pmol/L; P <0.05) but not IAPP. In the presence of S-Ab, infusion of the SSTR2 agonist resulted in a significant inhibition of insulin secretion (-1128 +/- 457 pmol/L; P <0.05) but not IAPP. In the presence of S-Ab, infusion of the SSTR5 agonist had no significant effect on insulin or IAPP secretion. We conclude that intraislet somatostatin inhibits insulin secretion via SSTR2, but not IAPP secretion, in the isolated perfused human pancreas model and that this effect occurs via SSTR2. These results also suggest that insulin and IAPP secretion are regulated by different mechanisms despite being co-localized to the beta cell.

Adolescent↗
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Exploring attitude and belief correlates of adhering to the new guidelines for low-risk single-occasion drinking: an application of the theory of planned behaviour.

The present study explores the correlates of adhering to the recent low-risk single-occasion drinking (LRSOD) guidelines. This was achieved by exploring key beliefs and attitudes underlying adherence to these guidelines within the framework of the theory of planned behaviour (TPB). Female students (n = 173) provided information about their LRSOD and beliefs and attitudes pertaining to LRSOD. Analyses of the resultant data showed the TPB to be significantly predictive of LRSOD, accounting for 27% of the variance, with normative beliefs, behavioural beliefs, and attitude emerging as significant predictors in the regression analysis. The implications of the study findings are discussed in terms of the current utility of the LRSOD limits for reducing alcohol-related harm.

Adolescent↗
PubMedDate not supplied

Win-win mentoring.

This article describes strategies to build and enhance mentor/protégé relationships, expand nurses' experience, and help new nurses develop.

Humans↗
PubMedDate not supplied

Corpus callosotomy for intractable epilepsy: seizure outcome and prognostic factors.

We reviewed the outcome of corpus callosal section in 64 adult and pediatric patients to identify factors associated with a good outcome: 48% of patients had a favorable outcome for overall seizure frequency. Improvement was noted in several seizure types and was most likely for drop attacks, particularly in the setting of a unilateral focal cerebral lesion or a true generalized epilepsy of Lennox-Gastaut type. Poor outcomes for drop attacks were more likely if there was associated severe intellectual handicap or bilateral independent spikes on interictal EEG. Complex partial seizures (CPS), most commonly of frontal lobe origin, also responded favorably. The complications of callosal section were usually mild and transient. New focal seizures occurred in only 2 patients and were not as frequent or disabling as preoperative seizures types. A worthwhile improvement in seizure outcome was achieved by completion of the callosotomy in 6 of 10 patients with unsatisfactory results from anterior callosotomy.

Adolescent↗
PubMedDate not supplied

Conditioning program for competitive figure skating.

To test the feasibility that traditional interval training methods could be adapted to the needs of competitive figure skaters, an interval skating program was conducted during a 3-month period for a group of skaters at diverse levels of proficiency. The program required only a small portion of the total ice time utilized by the skaters on a daily basis, i.e., 1/2 hr, three times a week. On alternate days, the skaters used the same amount of time in a strength training program. A flexibility-stretching facet was to be done by the skaters on a daily basis. Progress was evaluated by treadmill oxygen consumption determinations and ability to perform a 1/2-mile skate effort. Over the course of the 3-month period, the skaters in the program showed an average increase in oxygen consumption of 9% from 44.73 cc per kg per min to 55.51 cc per kg per min. This was accompanied by an average 10-sec reduction in the timed effort at the 1/2-mile skate. Subjectively, the skaters were less fatigued during their freestyle skating programs and were able to improve consistency at skilled maneuvers in the last minute of their performances. This initial effort to evaluate the efficacy of this type of a training program for competitive figure skating seems to have proven to be beneficial to the skaters. Currently, we are continuing our efforts to expand the program.

Adolescent↗
PubMedDate not supplied

The four-layer bandage system from a nursing perspective.

This article describes an evaluation that took place in 20 health centres, community clinics and hospitals throughout the UK. The aim was to explore nurses' opinions of three different four-layer bandage systems: kit A (System 4); kit B (Charing Cross); and kit C (Profore). Fifty-seven pairs of nurses were involved; within each pair, one was the applier and one the wearer. Each nurse was asked to complete a questionnaire which highlighted their opinions relating to ease of application, conformability, comfort and preferred bandage length. Responses were analysed using simple frequency counts, means, standard errors, Fisher's exact test and Kruskal-Wallis' one-way analysis of variance. The nurses involved were regular users of either the Charing Cross or Profore systems. Kit A was significantly easier to apply than kit B for layer 1 (P < 0.001), layer 2 (P < 0.05) and layer 3 (P < 0.01). There was no significant difference in relation to layer 4. With regard to ease of application there were no statistically significant differences between kits A and C or B and C. Layer 1 of kit A was significantly more conformable than layer 1 of kit B (P < 0.001). There were no significant differences between kits B and C, or A and C or in relation to comfort for all bandage kits. Overall preference by the applier was: 25 for kit A, nine for kit B and 15 for kit C. Overall preference by the wearer was: 23 for kit A, 10 for kit B and 14 for kit C.

Attitude of Health Personnel↗
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Leg ulcer care: an audit of cost-effectiveness.

Our objective was to establish an audit mechanism to determine the cost and effectiveness of leg ulcer care across two Health Authorities. Following identification of all patients with active ulcers over a two-month period, leg ulcer treatment, costs and outcome were prospectively audited over three months. We found that leg ulcer care is currently expensive and appears to be largely ineffective, especially when compared to the community clinic approach.

Cost-Benefit Analysis↗
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The attenuation of hemorrhage-induced liver injury by exogenous nitric oxide, L-arginine, and inhibition of inducible nitric oxide synthase.

We investigated the role of nitric oxide (NO) in its ability to reduce liver injury in an animal model of hemorrhagic shock (HS). Ninety-six Sprague-Dawley rats weighing 250 to 300 g were divided in 6 groups (n = 16 per group) that included treatment at the beginning of resuscitation with normal saline (groups 1, 3) sodium nitroprusside (NP) (0.5 mg/kg) (groups 2, 4) L-arginine (300 mg/kg) (group 5), and L-N6-(1-iminoethyl) lysine (L-NIL, 40 mg/kg) (group 6). The experimental model of HS consisted of the withdrawal of 3 mL blood per 100 g in a 15-min period, tail amputation (75%), and drug administration at 30 min. This was followed by fluid resuscitation (FR) with lactated Ringer's (LR) solution to reach a mean arterial pressure (MAP) of 40 mm Hg, then a hospital phase of 60 min with hemostasis and FR with LR solution to reach a MAP of 70 mm Hg with a 3-day observation phase. NP, L-Arginine, and L-NIL significantly reduced fluid requirements for resuscitation (p =.0001) as well as significantly increased MAP after resuscitation from hemorrhage. We also observed an improved statistically significant difference (p =.001) in tests demonstrating less hepatic injury and histology damage. The mRNA expression of cytokines in the liver (interleukin [IL]-1alpha, IL-beta1, tumor necrosis factor [TNF]beta, IL-3, IL-4, IL-5, IL-6, IL-10, TNFalpha, IL-2, interferon [IFN]gamma) was reduced by NP treatment, L-arginine, and L-NIL. These data suggest that excess NO mediates hemorrhage-induced liver injury and that the suppression of inducible nitric oxide synthase (iNOS)-generated NO bioavailability with the NO donor sodium nitroprusside may reduce the pathophysiologic consequences of severe hemorrhage. This effect could be possibly related to the scavenging of to superoxide radicals (O2-) or the blockade of the deleterious effects of TNF and other inflammatory cytokines. The protective action noted with L-arginine cannot be fully explained within the context of this article, although it could be most likely associated with the supplementation of eNOS-generated NO.

Animals↗
PubMedDate not supplied

Coexistence of TRH with other neuroactive substances in the rat central nervous system.

Colocalization of thyrotropin-releasing hormone-like immunoreactivity with other neuroactive substances was examined immunohistochemically in colchicine-treated rat brains using double-staining or elution-restaining methods. Thyrotropin-releasing hormone-like immunoreactivity was shown to be located in the same neurons as: 1. enkephalin-, gamma-amino butyric acid- and tyrosine hydroxylase-, but not somatostatin-like immunoreactivity in the glomerular layer of the olfactory bulb 2. oxytocin- and cholecystokinin-, but not vasopressin-like immunoreactivity in the supraoptic nucleus 3. cholecystokinin-like immunoreactivity in posterior pituitary 4. enkephalin-like immunoreactivity in the perifornical area of the hypothalamus and 5. neuropeptide Y- and neurotensin-like immunoreactivity in the periaqueductal central grey. These findings provide further examples of coexistence of thyrotropin-releasing hormone with classical neurotransmitters and/or peptides in the rat central nervous system.

Animals↗