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Biomedical subjects

M Ryan

Publications and source records attributed to M Ryan.

At least 217 records · Page 12Linked to original sources
PubMed1994

Nursing professorate in America: projected retirements and replacements.

New paradigms are emerging in higher education, and institutions are facing financial shortfalls. Faculty retirements and resignations may have an impact on the quality of education across disciplines. Will adequate numbers of doctorally prepared replacements be entering nursing education to meet projected retirements and resignations? A national study was conducted of National League for Nursing-accredited baccalaureate and higher degree nursing programs with 296 (58%) responding. The purpose was to determine faculty profiles, policies related to retirement, and projected replacements. Projected retirements and resignations over the years 1992 to 2006 are estimated to be approximately one third of the current faculty work force. Numbers of anticipated graduates at the master's level seem to be adequate. However, doctorally prepared candidates will most certainly not fill all the gaps that will exist in nursing education. Implications call for an examination of clinical teaching practices to ensure continued quality nursing education. An examination of faculty retirement policies and plans is warranted.

Adult↗
PubMed1994

Intervening with high risk youth: a program model.

This paper describes a program model being implemented for older, high-risk adolescents who are beginning to exhibit significant substance use problems. The program provides an initial assessment and refers clients to appropriate services. Only a small percentage are being referred to inpatient treatment; most clients enter outpatient intervention groups, which are conducted by the program. These groups have three purposes: to allow staff to monitor and evaluate clients so that those who are in imminent danger can be placed in protective treatment settings; to help clients see themselves as candidates for recovery and to introduce them to treatment resources by accompanying them to AA and NA meetings; and to change behavior, a goal that seems more immediately achievable for youth with stable community ties who have more to lose if they get into further trouble. Besides describing the program model, this paper examines some of the difficulties of getting referrals from a variety of community agencies.

Adolescent↗
PubMed1994

Hypersensitivity reactions to etoposide. A report of three cases and review of the literature.

Etoposide (VP 16) is an antineoplastic agent that has major activity against a number of tumors, including germ cell neoplasms, small cell lung cancer, and malignant lymphoma. It is a derivative of podophyllin, and acts by inhibiting mitosis. Common side effects include bone marrow suppression, alopecia, and gastrointestinal symptoms. Hypersensitivity reactions are uncommon however, and the underlying mechanism is unclear. We report three cases of etoposide hypersensitivity and review the literature.

Adult↗
PubMed1993

A chemiluminescent substrate for the detection of phosphatidylinositol-specific phospholipase C.

A water-soluble, chemiluminescent substrate for sensitive detection of bacterial phosphatidylinositol-specific phospholipase C (PI-PLC) activity was synthesized. This was achieved by replacing the diacylglycerol moiety found in the natural substrate, phosphatidylinositol, by a dioxetane-containing moiety, resulting in the synthetic substrate (+/-)-3-(4-methoxyspiro[1,2-dioxetane-3,2'- tricyclo[3.3.1.1(3,7]decan]-4-yl)phenyl myo-inositol-1-O-hydrogen phosphate (LUMI-PI). PI-PLC-catalyzed cleavage of the phosphodiester bond of LUMI-PI results in the formation of a chemiluminescent precursor, the labile anion AMP-D, which decays with emission of light. An assay procedure was developed using 96-well microtiter plates with detection of the chemiluminescence on autoradiography film. With this procedure the detection limit of purified phospholipase C was about 10 pg. Furthermore, PI-PLC activity was readily detected in situ using small quantities (< 1 microliters) of liquid cultures of PI-PLC-producing bacterial strains.

Adamantane↗
PubMed1993

A constitutive form of heat-shock protein 70 is located in the outer membranes of mitochondria from rat liver.

HSP73, the constitutive form of heat-shock protein 70, has been implicated in the translocation of preproteins across the mitochondrial membranes, being required for maintaining mitochondrial preproteins in an import competent conformation. Here we report that highly purified mitochondrial outer membranes contain a protein indistinguishable from HSP73 as a tightly associated peripheral component of the membrane. This membrane form of HSP73 was photolabelled with [alpha-32P]ATP and could be released from the outer membrane with sodium carbonate, but not after incubation of the membranes with salt or with ATP. A sensitive immunoassay with an anti-HSP73 monoclonal antibody, revealed the association of HSP73 with mitochondrial outer membrane vesicles at a level similar to that of preprotein import receptors.

Adenosine Triphosphate↗
PubMed1993

Health care in Moscow.

In the Russian Federation privatisation is affecting the health care sector as much as it is industry and commerce. That the general public support the transfer of state clinics to the private sector is a mark of their dissatisfaction with the old state run system. Doctors too see better opportunities to practise good medicine and be paid better for doing so. In Moscow the health department has set up a commission to license all clinics providing treatment, which should ensure standards of safety, training, and equipment. The Russian Federation is also trying to establish a medical insurance system to cover its citizens for health care, but in Moscow and elsewhere its implementation has been delayed by arguments and bureaucracy. In the meantime the health of Muscovites remains poor, with a high incidence of birth defects, and illnesses among the young.

Delivery of Health Care↗
PubMed1993

Menopausal symptoms in Australian women.

OBJECTIVES: To describe Australian-born women's experience of symptoms during the natural menopause transition and the relative contribution of menopausal and health status, social factors and lifestyle behaviours. DESIGN: A community based cross-sectional survey by telephone interview was carried out on a randomly derived sample of Melbourne women. PARTICIPANTS: The participants were 2000 Australian-born women, aged between 45 and 55 years. OUTCOME MEASURES: A list of 22 symptoms was used. Explanatory variables were: sociodemographic variables; menopausal and health status; lifestyle behaviours; attitudes to ageing and to menopause. RESULTS: A 70% response rate was achieved for eligible women who could be contacted during the study. Premenopausal women were the least symptomatic and perimenopausal women the most symptomatic. Factor analysis found seven common factors from the 22 symptoms studied. Menopausal status based on menstrual history was significantly related to two groups of symptoms: vasomotor symptoms, which increased through the menopausal transition; and general somatic symptoms which were more frequent in the perimenopause. Analysis of variance of factor scores found fewer symptoms with increasing years of education, better self-rated health, the use of fewer non-prescription medications, the absence of chronic health conditions, a low level of interpersonal stress, the absence of premenstrual complaints, not currently smoking, exercise at least once a week, and positive attitudes to ageing and menopause. CONCLUSIONS: Many factors unrelated to hormonal changes contributed to the symptoms. Longitudinal investigation is needed to determine the relative importance of hormonal, psychosocial and lifestyle variables in the aetiology of mid-life symptoms.

Attitude↗
PubMed1993

Personalia and the current health crisis.

Recent changes in the Russian government introduced by Boris Yeltsin include the appointment of Eduard Nechaev as health minister at the beginning of this year. The appointment received little publicity in the West, although his predecessor was sacked after only one year for failing to make any effort to improve health care. The challenges facing the new minister are enormous. Not only does he have to introduce a new medical insurance system but he has to tackle the problems of falling population, rising childhood illness linked to poor diet, and the spread of polio and diphtheria. It remains to be seen whether his experience in the military medical service has equipped him for the job.

Delivery of Health Care↗
PubMed1993

Agency in health care: getting beyond first principles.

This paper is concerned with the application of the theory of agency to health care. It is argued that the basic theory of agency raises more questions than it provides answers when it is applied to the doctor-patient relationship. More research is needed into the nature of both the patient's and the doctor's utility functions. Only then can we begin to devise optimal incentive structures to encourage doctors to take adequate account of patient preferences.

Contract Services↗
PubMed1993

The way to economic prescribing.

Concern about the size of the NHS drugs bill in the UK has resulted in three main policy initiatives by government: regular increases in prescription charges, the introduction of restrictions on the range of prescribable drugs, and the implementation of prescribing budgets. This paper argues that such policies, whilst reducing the NHS drugs bill, have given little consideration to the efficiency of prescribing. Other policy options are considered which may reduce the NHS drugs bill in ways more consistent with efficient prescribing.

Budgets↗
PubMed1993

Crystallization of phosphatidylinositol-specific phospholipase C from Bacillus cereus.

Phosphatidylinositol-specific phospholipase C (PI-PLC) cleaves phosphoinositides into two parts, lipid-soluble diacylglycerol and the water-soluble phosphorylated inositol. Two crystal forms of Bacillus cereus PI-PLC have been obtained by the vapor diffusion technique. Hexagonal crystals were grown from solutions containing polyethylene glycol (PEG; 4,000 to 8,000 D). The space group of these hexagonal crystals is P6(1)22 (or the enantiomorphic space group P6(5)22), with cell constants a = b = 133 A, and c = 231 A. The crystals diffract to 2.8 A. The second crystalline form was grown from a two-phase PEG (600 D)-sodium citrate solution. The phase diagram and PI-PLC distribution between phases has been determined. The enzyme crystallizes from the PEG-rich phase. The crystals are orthorhombic with space group P2(1)2(1)2(1) (a = 45 A, b = 46 A, c = 160 A), and contain one PI-PLC monomer per asymmetric unit. The orthorhombic crystals diffract to 2.5 A. Both the hexagonal and orthorhombic forms are suitable for crystallographic studies.

Bacillus cereus↗
PubMed1993

Parenchymal emphysema measured by CT lung density correlates with lung function in patients with bullous disease.

In subjects with chronic obstructive pulmonary disease (COPD) computed tomographic (CT) lung density correlates with direct pathological measurements of the size of the distal airspaces, as well as with measurements of airflow limitation and impairment of the diffusing capacity. Thus, CT lung density can be used to quantify emphysema in life. We wanted to assess the use of CT scanning to detect and measure the extent of bullous lung, and to quantify the severity of emphysema in the non-bullous areas of the lungs. In patients with bullous emphysema (21 males and 2 females; aged 31-69 yrs; forced expiratory volume in one second (FEV1) 14-84% predicted; volume corrected diffusing capacity of the lungs for carbon monoxide (DLCO/VA) 17-114% predicted). CT lung density was measured in electromagnetic imaging (EMI) units. The extent of bullous emphysema correlated poorly with all respiratory function measurements. In contrast, the severity of emphysema in the non-bullous parts of the lungs, expressed as either the mean EMI number, or the EMI number of the lowest 5th percentile of the CT lung density histogram, correlated well with measurements of airflow limitation and diffusing capacity. Our findings, thus, suggest that in patients with bullae the major determinant of respiratory function is the severity of the emphysema in non-bullous lung, and that the extent of the bullae has less functional importance.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Insertion sequence elements in Bacillus thuringiensis subsp. darmstadiensis.

Two variants of insertion sequence IS231, named IS231G and H, were isolated from Bacillus thuringiensis subsp. darmstadiensis 73-E-10-2 (BTD2), an isolate toxic to dipteran insects, and characterized by DNA sequence analysis. They are encoded consecutively as direct repeats on an EcoRI fragment of 5.6 kilo base pairs. Direct tandem repeats of IS231 elements have not been previously reported. Both elements are closely related to other members of the IS231 family that have been isolated from B. thuringiensis strains toxic to lepidopteran as well as to dipteran insects. A close correlation exists between the evolutionary relationships of the IS231 sequences determined to data and the toxicity spectrum of the host cell. Probing of BTD2 DNA with a radiolabeled IS231G fragment demonstrated that IS231 elements are located on 55- and 34-MDa plasmids as well as on chromosomal DNA. Chromosomal DNA, but not plasmids, from BTD2 also hybridizes to another, unrelated insertion sequence, IS240, from B. thuringiensis subsp. israelensis, an isolate toxic to dipteran insects. BTD2, therefore, contains IS elements once thought to reside exclusively in either dipteran- or lepidopteran-specific subspecies of B. thuringiensis.

Bacillus thuringiensis↗
PubMed1993

Medical and economic consequences of gang-related shootings.

Treatment costs for victims of gang violence have fueled the withdrawal of hospitals from trauma networks. Not included in such tallies are the medical resources that these seriously ill and medically indigent patients divert from other areas. We examined the surgical care requirements, costs incurred, and outcomes at a Level I trauma center. Local law enforcement records were matched with hospital admissions over a 1-year period to identify with hospital admissions over a 1-year period to identify casualties of gang violence. Of 191 gunshot wound admissions, 107 (56%) were gang related. The majority were males (92%); ages ranged from 14 to 50 and trauma scores from 1-16. Eighty-six were admitted during periods of minimum staffing (7:00 PM to 7:00 AM), pre-emptying the use of limited resources for other medical/surgical emergencies. Fifty-eight (54%) needed emergency surgery: laparotomy (38), thoracotomy (5), and neck/extremity (15). Forty required multiple surgical procedures, and eight patients required nine subsequent surgeries. There were two deaths. Average hospital stay ranged from 1 to 180 days; inpatient days totalled 1003, 270 of which were spent in the ICU. Total charges neared +2.0 million. Ninety-four patients (88%) were medically indigent. On discharge, 75 patients were disabled, six permanently. We conclude: 1) Gang activity caused the majority of gunshot wounds at our trauma center; 2) multiple injuries predominated, requiring extensive ICU use; 3) the combination of indigent patients and high hospital costs underestimate the financial burden as valuable resources are diverted from other areas; 4) subsequent community costs include rehabilitation and chronic care.

Adolescent↗