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Biomedical subjects

John Beard

Publications and source records attributed to John Beard.

24 records · Page 2Linked to original sources

Evidence-based practice for young people who self harm: can it be sustained and does it improve outcomes?

In 1998-1999, two Area Health Services in NSW conducted a project to implement evidence-based service enhancements for the clinical management of young people who present with Deliberate Self Harm (DSH) behaviour. The present study examined what structures and procedures were required to implement and sustain evidence-based practice in different health care settings for patients with DSH behaviour. Service provision was assessed at three points during the initial project to assess the degree of change that occurred, and 9 months after the completion of the project to allow an assessment of sustainability of the service provision. We examined staff perceptions of the importance of education, management directives, policy and procedure changes, and cultural/attitudinal changes, in implementing clinical best practice. Results indicated that support from both service management and clinical staff is necessary for successful implementation of service enhancements. High levels of staff education and policy development were also associated with high levels of service performance. The best sustained enhancements were those that were developed by the services themselves.

Adolescent↗

Substance use disorders in an Australian community survey.

A community survey of the common mental disorders in a geographically defined treatment service area was used to explore the socio-demographic correlates and service utilization of people with alcohol and drug use disorders living in the area. These data represent the most comprehensive data on substance use disorders in a defined geographic region in Australia. Alcohol and drug use disorders were most likely to be found in the young, with those aged 18-34 years being three times more likely to have an alcohol use disorder than those aged 55 years and over. A third (33%) of those people with an alcohol use disorder and 42% of those with a drug use disorder had consulted a health professional in the past 12 months for their substance use disorder.

Adolescent↗

Hemochromatosis protein (HFE) and tumor necrosis factor receptor 2 (TNFR2) influence tissue iron levels: elements of a common gut pathway?

Quantitative genetic analysis of hepatic and splenic iron levels in recombinant inbred mice yielded a quantitative trait locus that was found to coincide with the genomic locale encompassing the tumor necrosis factor receptor 2 gene (Tnfr2). When fed an iron-enriched diet, mice nullizygous with respect to Tnfr2, but not the Tnfr1 gene, showed a significant increase in splenic non-heme iron levels. This result contrasted with mice deficient in the hemochromatosis protein, HFE, which demonstrated a significant increase in normally high hepatic iron levels, but no change in splenic iron, when fed an iron-enriched chow. Both Tnfr2 knockout and HFE knockout mice fed an iron-enriched diet failed to demonstrate intestinal epithelial cell iron following the application of the Perls' stain, as compared to both Tnfr1 knockout and normal control mice. Moreover, intestinal intraepithelial lymphocytes (IELs) isolated from HFE knockout mice did not show an increase in TNF expression following challenge with the iron-enriched diet, in contrast to normal controls. These results suggest that HFE and TNFR2 are both involved in regulating iron deposition in tissues and that the regulation occurs at the level of the intestine through IEL-orchestrated production of TNF following the binding to TNFR2. These data suggest that HFE and TNFR2 may contribute to a common pathway of the iron stores regulator insuring the controlled efflux of gut iron.

Animals↗