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Biomedical subjects

M Muller

Publications and source records attributed to M Muller.

At least 163 records · Page 9Linked to original sources
PubMed1997

[Operationalization of a model for the development of clinical nursing standards].

One of the requirements for a nursing model in any field of nursing is its practical implementation. The purpose of this article is to describe how the model for the development of nursing standards in a nursing service was implemented and evaluated. An exploratory and descriptive research design was followed, with a simple pilot study during which 9 nurses were requested to give their view on the model. The model was sucessfully implemented in the nursing service of an academic hospital. Evaluation revealed that the implementation facilitated quality nursing, the resocialising of values and the professional and personal growth of nurses in that nursing service.

Academic Medical Centers↗
PubMed1997

[A program to facilitate quality of work-life of psychiatric nurses].

The aim of this study was to describe guidelines for a personal and professional development programme to facilitate the quality of work-life experienced by psychiatric nurses in a hospital. An explorative and descriptive research design with a qualitative research orientation was employed. The study was divided into three phases. In phase one the needs, desires and expectations of psychiatric nursing in a hospital nursing service were explored and described. In phase two the factors in a nursing service which influence the quality work-life of nurses, were explored and described. Consequently, the last phase of the study was conducted, being inferred from data of phases one and two which lead to the conceptual framework upon which the guidelines and programme are based. A personal and professional development programme for psychiatric nurses to facilitate quality of work-life experienced, consisting of three parts, was described to enclose aspects of the psychiatric nurse's internal and external environments, as well as patterns of interaction between the internal and external environments.

Education, Nursing, Continuing↗
PubMed1997

Guidelines for professional development in the formulation of nursing standards.

Quality improvement is a process of standard formulation, evaluation whether nurses comply with these standards, as well as remedial action to improve the quality of nursing care rendered. This article describes guidelines for the professional development in the formulation of nursing standards. It is based on the Model for standard development and was successfully implemented in a nursing service. An exploratory and descriptive research strategy was utilised and executed in a nursing service of an academic hospital in Gauteng. The implementation of these guidelines should facilitate excellence in standard formulation.

Humans↗
PubMed1997

[A model for handling grievances in nursing services].

A model for management of grievances in a nursing service is described, in terms of the guidelines for model generation, based on a qualitative, exploratory, descriptive and theory generating research strategy and design. Potgieter's (1992) research served as the conceptual framework for the description of a model case. The statements derived from this description was used as basis for the description of the model. The central concepts were identified, defined and classified. The model was implemented in practice and was evaluated by means of a retrospective case study. Guidelines for the implementation of the model were consequently described and the model was positively evaluated by a panel of experts. The testing of hypothesis is recommended to validate the model.

Employee Grievances↗
PubMed1997

[Function analysis of the job responsibilities of head nurses].

There are many internal and external factors impacting on the utilisation of the Chief Professional Nurse in South African State hospitals. The aim with this research is to undertake a functional analysis of the post responsibilities of the Chief Professional Nurse in South African State hospitals. This objective is justified by means of an exploratory, descriptive and qualitative research strategy. The existing job descriptions of the Chief Professional Nurse are explored and described, followed by an analysis of the expectations of various role-players (the Senior Nursing Service Manager, Chief Professional Nurse, Senior Registered Nurse, as well as the provincial policy makers in health care) regarding the post responsibilities of the Chief Professional Nurse. A content analysis of existing job descriptions is performed, followed by focus group interviews with the Nursing Service Managers and Chief Professional Nurses, work shops with the Senior Registered Nurses, and written inputs by the provincial policy makers in health care services. The results reveal misutilization of the Chief Professional Nurse in South African State hospitals. The expectations of the different role players focus on the traditional generic functions of the Chief Professional Nurse, viz. patient care, administration, education and research. New insights are added to ensure that the Chief Professional Nurse is utilised as a clinical nurse specialist.

Education, Nursing↗
PubMed1997

[A program for personnel staffing in a nursing service].

A staffing programme for a nursing service in a private hospital can be very costly. The aim with this study was to describe and implement a staffing programme for a nursing service in a private hospital and to determine the success thereof by means of a cost-analysis. An exploratory, descriptive and instrumental research design was employed. The cost saving was statistically significant without jeopardizing the quality of nursing care. It is recommended that a staffing programme be implemented in private hospitals to improve cost-effectiveness.

Cost Control↗
PubMed1997

Change management in health services: the South African experience.

The purpose with this article is to describe the principles of change management in health services, as experienced in South Africa to date. The driving forces are highlighted, followed by a brief explanation of the three phases in change management. The principles and process of change management, as applied to the South African health system, are described as perceived by the author. The paper was read as an invited presentation at the Commonwealth Nurses Federation's General Meeting and workshop on 13 June 1997 in Vancouver, Canada.

Consultants↗
PubMed1997

[Nurses' knowledge of aspects of the trade union system].

The democratisation of the work place has implications for the nursing profession where conflict exists between the registered nurse as employee and professional practitioner with related professional-ethical responsibilities, and membership of a trade union with access to industrial action. It appears as if trade unions have recruited a significant number of nurses as members over the last few years. The aim with this research is to determine the knowledge of registered nurses with regard to aspects related to trade unions. An exploratory and descriptive research design was followed, utilising a structured questionnaire in a survey to determine the knowledge of registered nurses on certain aspects related to trade unions, within the context of hospitals in Gauteng and in the Free State. The study reveals inadequate knowledge of registered nurses regarding aspects related to trade unions (average percentage of knowledge is 33.8%) and empowerment through education in this regard seems necessary.

Data Collection↗
PubMed1996

Sequence-specific antitumor activity of a phosphorothioate oligodeoxyribonucleotide targeted to human C-raf kinase supports an antisense mechanism of action in vivo.

To determine the mechanism of action responsible for the in vivo antitumor activity of a phosphorothioate antisense inhibitor targeted against human C-raf kinase (ISIS 5132, also known as CGP69846A), a series of mismatched phosphorothioate analogs of ISIS 5132 or CGP69846A were synthesized and characterized with respect to hybridization affinity, inhibitory effects on C-raf gene expression in vitro, and antitumor activity in vivo. Incorporation of a single mismatch into the sequence of ISIS 5132 or CGP69846A resulted in reduced hybridization affinity toward C-raf RNA sequences and reduced inhibitory activity against C-raf expression in vitro and tumor growth in vivo. Moreover, incorporation of additional mismatches resulted in further loss of in vitro and in vivo activity in a manner that correlated well with a hybridization-based (i.e., antisense) mechanism of action. These results provide important experimental evidence supporting an antisense mechanism of action underlying the in vivo antitumor activity displayed by ISIS 5132 or CGP69846A.

Animals↗
PubMed1996

Fab-7 functions as a chromatin domain boundary to ensure proper segment specification by the Drosophila bithorax complex.

Fab-7 deletions in the bithorax complex have a novel gain-of-function phenotype, typically transforming parasegment 11 (PS11) into PS12 identity. Genetic analysis indicates that removal of the Fab-7 element results in the fusion of the iab-6 (PS11) and iab-7 (PS12) cis-regulatory domains into a single regulatory domain that inappropriately regulates Abdominal-B in PS11. This has led to the hypothesis that Fab-7 is a chromatin domain boundary that normally functions to ensure the autonomous activity of the iab-6 and iab-7 cis-regulatory domains. We use several different enhancer blocking assays to demonstrate that Fab-7 has the insulating properties expected of a domain boundary. We define a minimal fragment of Fab-7 sufficient for enhancer blocking, and demonstrate that it is completely distinct from an adjacent Polycomb-dependent silencer. We compare Fab-7 to the su(Hw) insulator element, and show that Fab-7 enhancer blocking activity is intermediate between that of five and twelve reiterated binding sites for the Su(Hw) protein. These results support the model that Fab-7 functions as a domain boundary within the context of the bithorax complex, making Fab-7 one of the first boundary elements that is known to have an essential function in vivo.

Animals↗
PubMed1996

Inhibition of growth of human tumor cell lines in nude mice by an antisense of oligonucleotide inhibitor of protein kinase C-alpha expression.

A 20-mer phosphorothioate oligodeoxynucleotide (ISIS 3521) designed to hybridize sequences in the 3'-untranslated region of human protein kinase C-alpha (PKC-alpha) mRNA has been shown to inhibit the expression of PKC-alpha in multiple human cell lines. In human bladder carcinoma (T-24) cells, inhibition of PKC-alpha was both concentration dependent and oligonucleotide sequence specific. ISIS 3521 had a IC50 of 50-100 nM for PKC-alpha mRNA reduction and was without effect on the expression of other members of the PKC family of genes (PKC-eta and zeta). Toxicity studies in mice revealed that the oligodeoxynucleotide was well tolerated at repeat doses of 100 mg/kg i.v. for up to 14 days, with no acute toxicity apparent. The oligodeoxynucleotide was found to also inhibit the growth of three different human tumor cell lines, the T-24 bladder, human lung carcinoma (A549), and Colo 205 colon carcinoma grown in nude mice. The inhibition was dose dependent with ID50 values for the growth inhibition between 0.06 and 0.6 mg/kg daily when given i.v., depending on the cell line examined. Three control phosphorothioate oligodeoxynucleotides not targeting human PKC-alpha were without effect on the growth of the tumors at doses as high as 6 mg/kg. Recovery of ISIS 3521 from tumor tissue and resolution by capillary gel electrophoresis revealed that 24 It after the final dose of oligodeoxynucleotide, intact, full-length 20-mer material was present as well as some apparent exonuclease degradation products (e.g., n-1 and n-2 mers). These studies demonstrate the in vivo antitumor effects of an antisense oligodeoxynucleotide targeting PKC-alpha and suggest that this compound may be of value as a chemotherapeutic agent in the treatment of human cancers.

Animals↗
PubMed1996

DNA bending by the silencer protein NeP1 is modulated by TR and RXR.

NeP1 binds to the F1 silencer element of the chicken lysozyme gene and, in the presence of TR, v-ERBA or RAR, synergistically represses transcriptional activity. This repression involves a silencing mechanism acting independently of the relative promoter position. Here we show that NeP1 alone can induce a significant directed bend on DNA. The chicken homologue of human NeP1, CTCF, shows identical binding and bending properties. In contrast, the isolated DNA binding domain of CTCF efficiently binds DNA, but fails to confer bending. Similarly, the TR-RXR hetero- or homodimer, binding adjacent to NeP1 at the F2 sequence, do not show significant DNA bending. The binding of the T3 ligand to TR changes neither the magnitude nor the direction of the NeP1 induced bend. However, when all factors are bound simultaneously as a quaternary complex, the TR-RXR heterodimer changes the location of the bend center, the flexure angle and the bending direction.

Animals↗
PubMed1996

A novel classification of planar four-bar linkages and its application to the mechanical analysis of animal systems.

A novel classification of planar four-bar linkages is presented based on the systematical variation of one, two or three bar lengths and studying the transmission properties (input-output curves) of the linkages. This classification is better suited to the study of biological systems than the classical Grashof-classification used in engineering as it considers the change of structural elements, in evolution for example, instead of evaluating the possibilities for the rotation of a particular bar. The mechanical features of a wide range of planar linkages in vertebrates, described by various authors, have been included in this classification. Examples are: skull-levation and jaw-protrusion mechanisms in fishes, reptiles and birds, the coral crushing apparatus of parrotfishes, and catapult-mechanisms in feeding pipefishes. Four-bar replacement mechanisms, e.g., crank-slider mechanisms in feeding systems of fishes and cam-mechanisms in mammalian limb-joints, and more complex linkages than four-bar ones, e.g., six-bar linkages and interconnected four-bar linkages in fish feeding mechanisms are also discussed. In this way, an overview is obtained of the applicability of planar linkage theory in animal mechanics to mechanical functioning and the effect of possible variations of bar lengths and working ranges in evolution. Four-bar system analysis often provides a rigorous method of simplifying the study of complex biological mechanisms. The acceptable width-range of necessary and undesired hysteresis ('play') in biological linkages is also discussed.

Animal Population Groups↗
PubMed1996

The association of human papillomavirus type 16 E6 and E7 antibodies with stage of cervical cancer.

OBJECTIVE: Previous investigators have reported higher HPV type 16 antibody positivity among cervical cancer patients than among healthy women. The objective of this study was to determine the association of HPV 16 antibody levels with the stage of cervical cancer. METHODS: Pretreatment tumor biopsies and sera were obtained from 137 newly diagnosed cervical cancer patients residing in Mexico. Using peptide ELISA and radioimmunoprecipitation assay (RIPA), HPV 16 E6- and E7-specific antibodies were measured. RESULTS: By ELISA, elevated antibody titers to HPV 16 E6 and E7 were detected in 16.8 and 32.8% of the women, respectively. While sera positivity did not differ by disease stage, the mean absorbance in the E7-positive sera was 0.42, 0.62, 0.91, and 0.81 for stages I to IV, respectively. Using RIPA, anti-E6 and E7 positivity was demonstrated in 46.7 and 38.7% of the females, respectively. Although no difference across disease stage was detected for E6, increasing proportions of positivity to E7 with stage of disease was detected. The rates for increasing disease stage were 0.14, 0.37, 0.40, and 0.67. Sera from the 6-month postradiation follow-up examinations of a small group of patients demonstrated a statistically significant decrease in antibody positivity from pretreatment positivity to HPV 16 E6 (n = 14; P = 0.01) and HPV 16 E7 (n = 20; P = 0.0001) using ELISA. CONCLUSIONS: These data suggest that HPV 16 E7 antibody positivity may be associated with stage of cervical cancer. Such immune parameters may be applicable to disease staging, monitoring of recurrence and, perhaps, diagnosis. Further investigation into the relationship of HPV 16 E6 and E7 antibodies with stage of cervical cancer and response to therapy is warranted.

Adult↗
PubMed1996

The development and psychometric validation of a brain cancer quality-of-life questionnaire for use in combination with general cancer-specific questionnaires.

A self-report questionnaire module consisting of 24 items, comprising 5 scales and 7 single items, has been developed for measuring health-related quality of life in patients with brain cancer. Module development proceeded through several stages, including a listing of patient, family and health care professional concerns, the writing of items, field testing in 105 patients with brain cancer and subsequent item reduction and scale construction after multitrait scaling analysis and assessment of internal consistency (Cronbach's coefficient alpha). The final version of the module exhibits reasonable test-retest stability over a period of one week. Differences in the responses between patients with recently-diagnosed and recurrent cancer and between patients with a Karnofsky Performance Score (KPS) of 50-70 and 80-100 were in the expected direction, indicating that the module of questions is responsive to differing conditions. Patients with either mental confusion, motor deficit or dysphasia indicated problems in several domains and single items as compared to patients without these neurological deficits. Thus, differences in the responses to the items in the brain cancer module appear to reflect differences in neurological status. In addition, deteriorating neurological status was accompanied by a marked increase in emotional distress, future uncertainty and motor dysfunction. A comparison of the responses in the module with the KPS and with a modified Barthel Activities of Daily Living Index (BADLI) shows moderate correlations, primarily with scales and items that pertain to motor dysfunction, while other scales (such as emotional distress, visual disorder and communication deficit) and most single items are not associated with the KPS or BADLI. Since the emotional distress scale of the module was found to be highly correlated with the emotional function scale of the EORTC QLQ-C30, it could be omitted when the module is used in combination with the QLQ-C30. This would reduce the module to a total of 20 items with four scales and seven single items. The intention is to combine this module of questions with other core or general quality-of-life questionnaires when studying patients with brain cancer in clinical trials.

Adult↗
PubMed1996

Circulating adhesion molecules in the critically ill: a comparison between trauma and sepsis patients.

OBJECTIVE: The time course of circulating adhesion molecules was monitored in traumatized and sepsis patients. DESIGN: Prospective, descriptive. SETTING: A surgical intensive care unit of a university hospital. PATIENTS: A total of 30 consecutive critically ill patients suffering either from trauma (n = 15) or postoperative sepsis (n = 15). INTERVENTIONS: All patients were on continuous analgo-sedation and mechanical ventilation. MEASUREMENTS AND RESULTS: From arterial blood samples, plasma levels of soluble adhesion molecules [endothelial leukocyte adhesion molecules (sELAM-1), intercellular adhesion molecule-1 (sICAM-1)], and vascular cell adhesion molecule-1 (sVCAM-1) were measured on the day of admission (trauma patients) or on the day of diagnosis of sepsis (= baseline values), and during the following 5 days. In the trauma group, sELAM-1 (57.9 +/- 11.0 ng/ml) and sVCAM-1 (698 +/- 93 ng/ml) were within normal ranges at baseline, whereas they were markedly elevated in the sepsis group (sELAM-1: 340 +/- 95 ng/ml; sVCAM-1; 1,042 +/- 449 ng/ml). In the sepsis patients, sELAM-1 significantly decreased and sVCAM-1 increased, but remained almost unchanged in the trauma patients. Non-survivors showed markedly elevated plasma levels of sELAM-1 and sVCAM-1. sICAM-1 was elevated in both groups at baseline and was higher in the sepsis group (1,266 +/- 261 ng/ml) than in the trauma group. In the septic patients, sICAM-1 increased further (2,022 +/- 609 ng/ml) and remained unchanged in the trauma group. All non-survivors showed sICAM-1 plasma levels of > 800 ng/ml. CONCLUSIONS: Endothelial damage may result in multiple-organ dysfunction syndrome. Adhesion molecules are considered to be a cornerstone in this process. Trauma patients showed lower plasma levels of circulating adhesion molecules than did sepsis patients indicating more pronounced (inflammatory related) endothelial activation or damage in sepsis. Therapeutic modulation of circulating adhesion molecules may be of benefit to the patients outcome and therefore warrants further study.

Adult↗
PubMed1996

Intracranial germ-cell tumours--treatment results and residuals.

UNLABELLED: There is only sparse information about the development of children after successful treatment for intracranial germ-cell tumours. Between January 1981 and June 1992, 26 children with intracranial germ-cell tumours were treated in the University Hospital Hamburg-Eppendorf. We report on treatment results, long standing residuals and the "quality of life" of these patients. The long-term event-free survival was 88% for the germinomas and 43% for the malignant teratomas. Of the patients 58% had no relevant functional neurological deficits and 37% had mild impairment. Only 1 patient with metastatic disease was severely handicapped. Six patients showed neuro-endocrine dysfunction. All of them had suprasellar/hypothalamic lesions and all received successful substitution therapy. As to neuropsychological functions, 53% of the patients had no or only mild disturbances. The most affected function was speed of information processing. Of the children 69% were able to proceed with their education at the same level as before therapy. The overall self-assessment revealed good results in 75% of the patients. CONCLUSION: After surgical removal and radiation therapy long-term survival of intracranial germinomas amounts to 88%. Despite craniospinal axis radiation severe residuals are rare and a good quality of life is common. In malignant teratomas treatment regimens including chemotherapy are much less successful.

Adolescent↗