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Biomedical subjects

L Higgins

Publications and source records attributed to L Higgins.

33 records · Page 2Linked to original sources
PubMed1995

Idiopathic steatohepatitis in childhood: a multicenter retrospective study.

OBJECTIVE: To describe the clinical, laboratory, and histopathologic features of idiopathic steatohepatitis in children. STUDY DESIGN: Retrospective review of all liver biopsies performed at Boston Children's Hospital, Massachusetts General Hospital, and the University of Massachusetts Medical Center from 1991 to 1994. Chart review was performed when biopsies demonstrated steatosis. RESULTS: Eighty-two patients had biopsy-proven hepatic steatosis. Fourteen patients had fatty liver without evidence of inherited, infectious, autoimmune, endocrinologic, toxicologic, or iatrogenic causes. All 14 patients were obese, averaging 159% of ideal body weight (range, 121% to 222%). Nine patients initially had transient abdominal pain, two had hepatomegaly, and one was identified by incidental laboratory evaluation. These 12 patients had biopsies because of persistent elevations of aminotransferase levels. Two other patients without risk factors for steatosis were identified at staging laparotomy for Hodgkin lymphoma. The 10 boys and 4 girls had an average age of 13.5 years (range, 10 to 18 years). Aminotransferase elevations were modest, with aspartate aminotransferase and alanine aminotransferase values averaging 77 +/- 38 IU and 129 +/- 73 IU, respectively. All had imaging studies demonstrating diffuse fatty change. Histologic examination of biopsy specimens revealed varying degrees of steatosis with inflammation and fibrosis. CONCLUSION: Idiopathic steatohepatitis occurs predominantly or exclusively in obese peripubertal children. This entity represents a frequent reason for liver biopsy in this age group. The degree of steatosis, fibrosis, and inflammation does not correlate with symptoms or signs, and significant liver injury with bridging fibrosis may be present.

Adolescent↗
PubMed1995

Providing eye care education in the clinical setting.

A strategy integrating patient managed learning and nurse directed teaching was developed with the aim of improving eye care education in the clinical setting. The effectiveness of the strategy was assessed in a quasi-experimental study involving 34 older adult patients undergoing cataract surgery. On a measure of eye care knowledge, patients taught using the strategy outperformed patients taught by conventional face-to-face methods. The strategy was found to require substantially less direct teaching time. These results are seen as justifying further clinical application and assessment of the strategy.

Aged↗
PubMed1994

Development of a monoclonal antibody specific for the COOH-terminal of beta-amyloid 1-42 and its immunohistochemical reactivity in Alzheimer's disease and related disorders.

The beta-amyloid peptide (beta AP) has been characterized by protein sequencing techniques as a 39-43 amino acid protein with heterogeneous COOH-termini. Controversy exists regarding the predominant form of beta AP in neuritic plaques (NP) and cerebral vasculature of Alzheimer's disease (AD) brain. A monoclonal antibody was developed that selectively recognizes the free COOH-terminal of beta AP 1-42 but not beta AP species with shorter or longer COOH-termini. Brain sections from AD and related disorders were examined using this antibody. In AD samples, the antibody stained diffuse amyloid and NP cores, many intraneuronal and extraneuronal neurofibrillary tangles (NFT), but not cerebrovascular amyloid. Pick and Lewy bodies lacked immunoreactivity. These findings suggest that beta AP 1-42 is present in early and mature amyloid deposits and NFT, but that species of beta AP other than 1-42 comprise human vascular deposits.

Adult↗
PubMed1993

When I'm calling you ....

Discussion groups among sectors of the population often excluded from consultation homed in on healthcare needs, say Paul Duncan and Liz Higgins, looking at findings from Waltham Forest HA.

Attitude to Health↗
PubMed1986

The innovative rehabilitation team: an experiment in team building.

This article describes an effort by one rehabilitation team to create innovative approaches to team care in a medical rehabilitation hospital. The major arena for implementing change was the weekly patient rounds. We worked to increase patient involvement, developed a rounds coordinator role, used a structured format, and tried to integrate research findings into team decision making. Other innovations included use of a preadmission questionnaire, a discharge check list, and a rounds evaluation questionnaire. The impact of these changes was evaluated using the Group Environment Scale and by analyzing participation in rounds based on verbatim transcripts obtained prior to and 20 months after formation of the Innovative Rehabilitation Team (IRT). The results showed decreased participation by medical personnel during rounds, and increased participation by patients. The rounds coordinator role increased participation rates of staff from all disciplines and the group environment improved within the IRT. These data are compared with similar evaluations made of two other groups, which served as control teams. The problems inherent in making effective, lasting changes in interdisciplinary rehabilitation teams are reviewed, and a plea is made for other teams to explore additional ways to use the collective creativity and resources latent in the team membership.

Decision Making↗
PubMed1979

Fractionation of antibodies to L-cell colony-stimulating factor by affinity chromatography.

Purified L-cell colony-stimulating factor (CSF) was coupled to cyanogen-bromide-activated Sepharose and used to selectively fractionate antibodies to this factor. With the use of a simplified two-step washing and elution technique, there was 50%--70% binding of the anti-CSF, with recovery of 60%--100% of the bound material. Both the native antiserum and purified anti-CSF fractions were inhibitory to murine granulocyte-macrophage colony formation. The purified antibodies contained only IgG and were reduced in protein concentration to 0.1% of the serum IgG values. These fractions should prove useful tools for the study of granulocyte and macrophage differentiation.

Animals↗
PubMedDate not supplied

Diagnosis and treatment of anterosuperior rotator cuff tears.

Nineteen of 407 patients who underwent rotator cuff repair surgery over a 6-year period were found to have a tear of the subscapularis in combination with the supraspinatus and infraspinatus tendons. Nine of these patients had an unsuccessful prior surgery, which failed to recognize the extent of the subscapularis component. Surgical repair of the subscapularis tendon required a deltopectoral approach, and repair of the supraspinatus and infraspinatus components of the tear could only be accomplished through this approach in 4 patients. In the remaining 15, an extended superior approach was required to mobilize and repair the supraspinatus and infraspinatus tendons. In all cases, the biceps tendon was either torn or severely degenerated, requiring tenodesis. At a mean follow-up of 40 months (range 24 to 75 months), subjective results were excellent in 5 patients, good in 3, fair in 4, and poor in 7. The modified Constant score improved to a mean of 69% (range 23% to 130%), compared with a preoperative mean of 38% (range 23% to 100%). Physical findings positive for subscapularis insufficiency persisted in 14 of 19 patients. A significant correlation (P <.05) was found between a lower Constant score and duration of symptoms longer than 6 months as well as an appearance of severe fatty degeneration and atrophy of the subscapularis muscle on magnetic resonance imaging. We conclude that anterosuperior rotator cuff tears are an infrequent configuration that may require surgical repair through an extended approach combining deltopectoral mobilization of the subscapularis with transdeltoid mobilization of the supraspinatus and infraspinatus. Repair before 6 months of symptoms is associated with a better functional outcome and is the result of less involution of muscle and tendon tissue.

Adult↗
PubMedDate not supplied

Association between continuing education and job satisfaction of nurses employed in long-term care facilities.

BACKGROUND: The purpose of this descriptive, correlational study was to investigate the relationship between continuing education and job satisfaction among RNs and licensed practical nurses (LPNs) employed in long-term care facilities. METHOD: Herzberg's Motivational-Hygiene Theory was used as a framework to guide the design of the study. The Professional Educational Activities Scale and the McCloskey/Mueller Satisfaction Scale were completed by 110 nurses employed in long-term care facilities. RESULTS: No difference was found between type of employment status (full-time versus part-time) on the level of professional educational activities. However, RNs participated in more continuing education activities than LPNs. Nurses who reported higher family incomes also had greater participation in educational activities. Registered nurses reported greater job satisfaction than LPNs. No significant difference was found between the degree of job satisfaction for Black and White nurses. The results of this study indicated nurses who participated in more continuing education activities scored higher on the job satisfaction scale. CONCLUSION: As the elderly population increases, a critical need exists for nurses to be knowledgeable about current research-based information, including the economic and psychosocial effects of illness in later life. To provide the most effective care for the elderly population, nurses in long-term care must be knowledgeable about the complexity and specific characteristics of chronic illnesses. Continuing education activities are an important way to access this information.

Adult↗
PubMedDate not supplied

Cataract patients' post-op eye-care: development and evaluation of a teaching program.

A project was undertaken to develop and trial an eye care education program for use in routine nursing care. It was initiated in response to research findings that suggested patients may have been discharged from a particular hospital inadequately prepared to perform their own eye care following cataract surgery. The trial assessed the program's effectiveness in relation to predetermined standards of eye care behaviour; its practicability and its performance relative to a conventional teaching approach. Outcomes of the trial indicated that neither the program nor the conventional teaching approach provided adequate preparation for the self delivery of eye care. This is believed to relate to the limited time nurses had for face-to-face teaching and, hence, for facilitating the consolidation and application of learning. The study concludes that the provision of effective eye care education in an inpatient context lies in approaches which reduce the amount to be taught in the limited teaching time that is available. It is suggested that the relevance may not be confined to eye care education.

Cataract Extraction↗
PubMedDate not supplied

How adequately are nurses being prepared for their health teaching role?

Forty-five Australian faculties and schools of nursing were surveyed by questionnaire to gain information about the health education component of undergraduate and postgraduate programs, and about current research activity relating to the educational role of nurses. Response rate achieved was 69%. Almost all institutions indicated involvement in preparing nursing students for an educational role, yet only five respondents described research activity relating to this. Most preparation was provided in an integrated context rather than in separate course units and the length of time allocated varied substantially. Responses to questions about content and clinical experiences were often omitted or were very general, with those involved in providing separate courses being much more likely to supply detailed or specific information. It is hypothesised that in general nurses are graduating from Australian colleges and universities inadequately prepared for the health educator role.

Australia↗