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Biomedical subjects

L Daniels

Publications and source records attributed to L Daniels.

At least 19 recordsLinked to original sources
PubMed2002

Australian Longitudinal Study of Ageing: prospective evaluation of anthropometric indices in terms of four year mortality in community-living older adults.

The Australian Longitudinal Study of Ageing (ALSA) aims to identify factors that contribute to & predict the health & social well-being of older Australians. Analyses were performed to determine the predictive value of anthropometric measurements in older Australians for four-year mortality. Weight, height, skinfolds (triceps, abdominal, supra-spinale, sub-scapular, medial calf, and front thigh) & girth (arm, waist, hip, calf) measurements were performed on a randomly selected community-living sample of 772 men & 624 women aged>70 years. Waist: Hip, % weight loss, corrected-arm-muscle area (CAMA) & BMI were calculated. These measures were categorised into quartiles & also according to commonly adopted definitions of nutritional status. Cox regression analysis was undertaken to assess the predictive value of the independent anthropometric variables for four-year mortality, adjusting for potential confounders (age, gender, marital status, smoking, alcohol status, self-rated health, basic activities of daily living & co-morbidity). Risk of four-year mortality increased with weight loss >10% over two years (HR=2.53, CI=1.37-4.67) & CAMA <21.4cm2(M) & <21.6cm2(F) (HR=1.93, CI=1.03-3.60) independent of confounding variables. These results confirm that selected anthropometric indices (weight loss, CAMA) independently increase the risk of four-year mortality & highlights their potential use in the nutrition screening and assessment of community-living older adults.

Aged↗
PubMed2001

Structures of coenzyme F(420) in Mycobacterium species.

The structure of coenzyme F(420) in Mycobacterium smegmatis was examined using proton NMR, amino acid analysis, and HPLC. The two major F(420) structures were shown to be composed of a chromophore identical to that of F(420) from Methanobacterium thermoautotrophicum, with a side chain of a ribityl residue, a lactyl residue and five or six glutamate groups (F(420)-5 and F(420)-6). Peptidase treatment studies suggested that L-glutamate groups are linked by gamma-glutamyl bonds in the side chain. HPLC analysis indicated that Mycobacterium tuberculosis, Mycobacterium bovis BCG, and Mycobacterium fortuitum have F(420)-5 and F(420)-6 as the predominant structures, whereas Mycobacterium avium contains F(420)-5, F(420)-6 and F(420)-7 in significant amounts. 7,8-Didemethyl 8-hydroxy 5-deazariboflavin (FO), an intermediate in F(420) biosynthesis, accounted for about 1-7% of the total deazaflavin in cells. Peptidase treatment of F(420) created F(420) derivatives that may be useful for the assay of enzymes involved in F(420) biosynthesis.

Amino Acids↗
PubMed2001

Use of transposon Tn5367 mutagenesis and a nitroimidazopyran-based selection system to demonstrate a requirement for fbiA and fbiB in coenzyme F(420) biosynthesis by Mycobacterium bovis BCG.

Three transposon Tn5367 mutagenesis vectors (phAE94, pPR28, and pPR29) were used to create a collection of insertion mutants of Mycobacterium bovis strain BCG. A strategy to select for transposon-generated mutants that cannot make coenzyme F(420) was developed using the nitroimidazopyran-based antituberculosis drug PA-824. One-third of 134 PA-824-resistant mutants were defective in F(420) accumulation. Two mutants that could not make F(420)-5,6 but which made the biosynthesis intermediate FO were examined more closely. These mutants contained transposons inserted in two adjacent homologues of Mycobacterium tuberculosis genes, which we have named fbiA and fbiB for F(420) biosynthesis. Homologues of fbiA were found in all seven microorganisms that have been fully sequenced and annotated and that are known to make F(420). fbiB homologues were found in all but one such organism. Complementation of the fbiA mutant with fbiAB and complementation of the fbiB mutant with fbiB both restored the F(420)-5,6 phenotype. Complementation of the fbiA mutant with fbiA or fbiB alone did not restore the F(420)-5,6 phenotype, but the fbiA mutant complemented with fbiA produced F(420)-2,3,4 at levels similar to F(420)-5,6 made by the wild-type strain, but produced much less F(420)-5. These data demonstrate that both genes are essential for normal F(420)-5,6 production and suggest that the fbiA mutation has a partial polar effect on fbiB. Reverse transcription-PCR data demonstrated that fbiA and fbiB constitute an operon. However, very low levels of fbiB mRNA are produced by the fbiA mutant, suggesting that a low-level alternative start site is located upstream of fbiB. The specific reactions catalyzed by FbiA and FbiB are unknown, but both function between FO and F(420)-5,6, since FO is made by both mutants.

Antitubercular Agents↗
PubMed2001

Educational opportunities in palliative care: what do general practitioners want?

It is important to support general practitioners (GPs) in maintaining and developing their palliative care skills as most of the final year of a patient's life is spent at home under the care of the primary health care team. The training needs and uptake of GPs have been explored, but little is known about how GP educational preferences vary. The aim of this study was to explore the current educational preferences of GPs in different geographical locations as part of an evaluation of an educational intervention. The methods used included postal questionnaires sent to 1061 GPs. Results from 640 (60%) of GPs revealed that half (51%) wanted education in symptom control for non-cancer patients. More inner-city GPs wanted education in opiate prescribing (43%), controlling nausea and vomiting (45%), and using a syringe driver (38%) than their urban and rural colleagues (26%, 29% and 21%, respectively). Increased educational preference and increased difficulty in accessing information was associated with reduced confidence in symptom control. To maximize educational uptake it will be important for educational strategies to be developed and targeted according to variations in demand, and in particular to respond to the need for palliative care education in symptom control for patients suffering from advanced non-malignant disease.

Adult↗
PubMed2001

Developing a framework for primary palliative care services.

Practice and empirical data indicate concerns regarding the delivery of primary palliative care, particularly the provision of a multidisciplinary approach. A collaborative study was undertaken between an academic unit and primary care practice to evaluate current care provision and explore methods of developing services. A two-phase study was carried out over a period of 18 months using an action research approach, in order to facilitate concurrent service evaluation, change in practice, and the involvement of professionals in research and practice development. The first phase highlighted the need to enhance primary palliative care services; a number of practice changes were identified and implemented during the second phase and evaluated using quantitative and qualitative methods. Data demonstrated the enhancement of services, benefits to patient care and professional working and the viability of an innovative model of palliative care delivery - that of a surgery-based clinic for palliative care patients and carers. A framework for the provision of multidisciplinary palliative care in the community was developed.

Adult↗
PubMed2001

The way forward: identifying palliative nursing research priorities within a hospice.

This article presents how practice issues within a hospice were identified as a means of prioritizing areas for research and development. The Delphi technique was employed to facilitate nurses working in the hospice to participate in the study. Forty-six practice issues were identified by the nurses and prioritized as areas of research in the hospice. This enabled comparisons with other studies and the literature to be made. The identified research priorities were then utilized to structure a framework for practice development in the hospice which included the use of weekly nurse meetings, interest groups and nurses studying for degrees and diplomas in order to address systematically the practice issues and develop an evidence-based practice approach.

Attitude of Health Personnel↗
PubMed2000

Providing palliative care in primary care: how satisfied are GPs and district nurses with current out-of-hours arrangements?

The complex needs of palliative care patients require an informed, expert, and swift response from out-of-hours general medical services, particularly if hospital admission is to be avoided. Few general practitioners (GPs) reported routinely handing over information on their palliative care patients, particularly to GP co-operatives. District nurses and inner-city GPs were least satisfied with aspects of out-of-hours care. Most responders wanted 24-hour availability of specialist palliative care. This indicates a need to develop and evaluate out-of-hours palliative care procedures and protocols, particularly for GP co-operatives, and to improve inter-agency collaboration.

Adult↗
PubMed1999

Metabolism of selenite in men with widely varying selenium status.

OBJECTIVE: This study was undertaken to investigate the metabolism of selenite in men with life-long intakes of deficient, adequate and excess selenium. METHODS: Stable isotopes of selenium were infused for five hours into Chinese men living in deficient, adequate or excessive selenium areas, and 24-hour urine and blood samples were collected daily for the next seven days. Stable isotopic selenium excretion was determined in urine and in whole plasma and plasma fractions. RESULTS: Even though there was a positive correlation of selenium intake with the urinary excretion of this element, this relationship was not linear over the entire range (deficient, adequate, excessive) of selenium intake. When the urine excretion was normalized internally within each group, a sharp increase in the slope of this relationship was found when long-term intake increased to adequate amounts, but the slope reached a plateau when the daily intake exceeded the adequate group. The plasma selenoprotein P fraction was labeled initially, but the incorporation in the glutathione peroxidase fraction subsequently increased by a small amount. A two-month dietary restriction of selenium of the subjects from the excess area did not result in a reduction of urinary excretion of infused selenite. CONCLUSION: A complex relationship exists between long-term intake of selenium and selenium status, and subjects living in the excess area are more saturated with selenium than anticipated. More than two months of depletion are required to affect urinary excretion of selenium.

Adult↗
PubMed1999

Quantitative significance of measuring trimethylselenonium in urine for assessing chronically high intakes of selenium in human subjects.

The purpose of the present study was to investigate the effects of Se restriction on the excretion of Se in men who had consumed high levels of this element during their entire lives. With the use of stable isotopes of Se as selenite, the excretion of methylated Se in urine was investigated in Chinese men (n 10) who had habitual chronic high intakes of this element. The relationship between either urine Se or trimethylselenonium (TMSe) to the estimated long-term Se intake was not linear over the entire range of intake, which was also true for the infusion of labelled selenite. A non-linear relationship was also found between urine TMSe and urine Se both for TMSe arising from catabolism of endogenous body Se and that from infused selenite. The data suggest a close precursor-product relationship of urine Se and its TMSe component based on the nearly identical specific activities for these two selenocompounds. Although dimethylselenide in breath was not measured in the present study, combining urinary TMSe with this breath test may be more useful in the assessment of long-term Se status.

Adult↗
PubMed1998

Compliance with anti-tuberculosis preventive therapy among 6-year-old children.

There are no published data regarding compliance with anti-tuberculosis preventive therapy among children in Australia and limited published data worldwide. This study aimed to determine the compliance rate among 6-year-old children prescribed preventive therapy for tuberculosis infection. A prospective cohort study was conducted on 78, 6-year-old children prescribed antituberculosis preventive therapy. Compliance was measured by compliance with prescribed preventive therapy as reported by parents who were administered questionnaires on completion of the course. In a subsample of 44 children, the proportion of children who complied with scheduled visits to the hospital, and pharmacy records of isoniazid dispensed were used as measures of compliance. Questionnaire data indicated a reported compliance rate for completion of the 6-month course of preventive therapy of 70.5% (55 children). For those 55 who reported completing the full course, 91% reported missing less than 1 tablet per week. In the subsample of 44 children, only 59% attended all follow-up clinic visits, and 54% collected all 6 months of isoniazid prescribed. Compliance with antituberculosis preventive therapy is suboptimal. Improved methods to measure compliance and strategies to optimise compliance with preventive therapy is required.

Antitubercular Agents↗
PubMed1998

Molecular analysis of the gene encoding F420-dependent glucose-6-phosphate dehydrogenase from Mycobacterium smegmatis.

The gene fgd, which codes for F420-dependent glucose-6-phosphate dehydrogenase (FGD), was cloned from Mycobacterium smegmatis, and its sequence was determined and analyzed. A homolog of FGD which has a very high similarity to the M. smegmatis FGD-derived amino acid sequence was identified in Mycobacterium tuberculosis. FGD showed significant homology with F420-dependent N5,N10-methylene-tetrahydromethanopterin reductase (MER) from methanogenic archaea and with several hypothetical proteins from M. tuberculosis and Archaeoglobus fulgidus, but FGD showed no significant homology with NADP-dependent glucose-6-phosphate dehydrogenases. Multiple alignment of FGD and MER proteins revealed four conserved consensus sequences. Multiple alignment of FGD with the hypothetical proteins also revealed portions of the same conserved sequences. Moderately high levels of FGD were expressed in Escherichia coli BL21(DE3) carrying fgd in pBluescript.

Amino Acid Sequence↗
PubMed1998

A group cognitive-behavioral and process-oriented approach to treating the social impairment and negative symptoms associated with chronic mental illness.

Major changes in health insurance have brought challenges in managed mental health care services to the forefront. Given slim capitation margins, brief treatment with proven efficacy had become the standard. These developments have significant ramifications for the treatment of chronic mental illnesses, which often require lifelong treatment. Efficacious short-term group treatment may help fill the gap between quality of care and the ideal economic allocation of mental health care services for people with chronic mental illnesses. The present treatment outcome study was designed to determine the extent to which Interactive-Behavioral Training (IBT)--a group psychotherapy model that actively combines cognitive-behavioral and group process techniques--can provide significant gains for people who suffer from chronic and debilitating social impairment and negative symptoms.

Adult↗
PubMed1997

The Centre for Palliative Care Education and Research.

This article describes the role and function of the Centre for Palliative Care Education and Research at the University of Central England in Birmingham. The authors describe the development of the centre, which is a multidisciplinary venture in collaboration with Cancer Relief Macmillan Fund and palliative care providers throughout the west Midlands. Current educational and research initiatives are identified and some future challenges indicated.

Academies and Institutes↗
PubMed1997

Presence of F420-dependent glucose-6-phosphate dehydrogenase in Mycobacterium and Nocardia species, but absence from Streptomyces and Corynebacterium species and methanogenic Archaea.

A range of organisms known to contain F420 or to be relatives of mycobacteria were examined for F420-dependent glucose-6-phosphate dehydrogenase (FGD) and NADP-dependent glucose-6-phosphate dehydrogenase (NADP-G6PD) activities. All free-growing Mycobacterium species examined (including a virulent Mycobacterium tuberculosis strain) had FGD activities of 0.014-0.418 mumol min-1 mg protein-1, and NADP-G6PD activities of 0.013-0.636 mumol min-1 mg-1. Armadillo-grown Mycobacterium leprae had FGD activity of 0.008 mumol min-1 mg-1, but no detectable NADP-G6PD activity. Nocardia species also had FGD activity (0.088-0.154 mumol min-1 mg-1). Streptomyces and Corynebacterium species had no FGD, but had NADP-G6PD. Methanogenic Archaea had neither activity.

Corynebacterium↗
PubMed1997

The use of breastmilk in a neonatal unit and its relationship to protein and energy intake and growth.

OBJECTIVE: A nutritional audit was performed to determine whether current feeding regimes were achieving nutritional goals and to evaluate the use of breastmilk (BM) in a neonatal unit (NNU). METHODS: All fluid consumed or infused daily was documented with daily weight and weekly length and head circumference measurements in 90 preterm infants (gestational age 30.1 +/- 2.6 weeks) while in the NNU for 60 +/- 27 days. Daily protein and energy intakes were calculated using values for South Australian preterm BM. RESULTS: Parenteral nutrition provided 85% of the daily energy in week 1 falling to 11% by week 6. Ninety per cent of infants received some of their mother's BM and 62% were discharged at least partially breastfed. Protein and energy intakes were 1.03 +/- 0.35 g and 55 +/- 10 kcal/kg/day in week 1, increasing to 2.52 +/- 0.60 g and 109 +/- 15 kcal/kg per day by week 4. Protein intake correlated with weight gain (r2 = 0.39). Weight gain was 14.0 +/- 2.0 g/kg per day and z-scores for weight declined from -0.25 on admission to -1.22 on discharge, P < 0.0001. When infants were divided into two groups comprising those who received BM or formula as their predominant enteral feed, growth and protein intake (but not energy intake) were lower in the BM-fed infants. However, enteral feeds were tolerated earlier and more quickly in those infants receiving predominantly BM. CONCLUSION: Energy requirements were readily met using current feeding regimes for preterm infants but protein intakes were marginal. Mothers of preterm infants had similar breastfeeding rates to mothers of term infants in South Australia. The long-term effects of the lower growth rates of preterm infants fed predominantly BM compared with those fed predominantly formula are unknown and need be balanced against the benefits of BM.

Analysis of Variance↗