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Biomedical subjects

M Sullivan

Publications and source records attributed to M Sullivan.

At least 199 records · Page 11Linked to original sources
PubMed1995

Survey and critique of studies related to shift length variations in nursing from 1970 to 1993.

The purpose of this study was to describe the current status, stage of staffing change, and findings of research relating to shift length variations in nursing. This was accomplished through a review of the literature to (a) evaluate the quality of the research, (b) summarize and draw conclusions related to variations in nursing shift length, and (c) identify gaps in the literature for the purpose of making recommendations for future studies related to nursing shift length variations. Multiple methods were utilized for locating potential studies to include in this project. Smith and Stullenbarger's (1991) Quality of Study instrument was used to rate the studies. None of the research reviewed explicitly identified a conceptual or theoretical framework or model, and few studies could be classified as scientifically rigorous. This study illuminates the state of the art and findings related to length of shift variations in nursing, and as such has implications for practice and research in nursing service administration.

Australia↗
PubMed1995

A model curriculum for mental disorders and behavioral problems in primary care.

Changes in the health care delivery system will increasingly emphasize the role of the primary care physician in diagnosing and treating mental disorders and behavioral problems. This increasing emphasis points to the need for more systematic definition of the knowledge and skills that future primary care physicians will need for effective delivery of mental health services. The model curriculum described in this paper represents the efforts of a multidisciplinary Task Force to describe basic training objectives for the psychiatric education of future primary care physicians.

Clinical Competence↗
PubMed1995

The Swedish SF-36 Health Survey--I. Evaluation of data quality, scaling assumptions, reliability and construct validity across general populations in Sweden.

We document the applicability of the SF-36 Health Survey, which was translated into Swedish using methods later adopted by the International Quality of Life Assessment (IQOLA) Project procedures. To test its appropriateness for use in Sweden, it was administered through mail-out/mail-back questionnaires in seven general population studies with an average response rate of 68%. The 8930 respondents varied by gender (48.2% men), age (range 15-93 years, mean age 42.7), marital status, education, socio-economic status, and geographical area. Psychometric methods used in the evaluation of the SF-36 in the U.S. were replicated. Over 90% of respondents had complete items for each of the eight SF-36 scales, although more missing data were observed for subjects 75 years and over. Scale scores could be computed for the vast majority of respondents (95% and over); slightly fewer in the oldest subgroup. Item-internal consistency was consistently high across socio-demographic subgroups and the eight scales. Most reliability estimates exceeded the 0.80 level. The highest reliability was observed for the Bodily Pain Scale where all subgroups met the 0.90 level recommended for individual comparisons; coefficients at or above 0.90 were also observed in most subgroups for the Physical Functioning Scale. Tests of scaling assumptions including hypothesized item groupings, which reflect the construct validity of scales, were consistently favorable across subgroups, although lower rates were noted in the oldest age group. In conclusion, these studies have yielded empirical evidence supporting the feasibility of a non-English language reproduction of the SF-36 Health Survey. The Swedish SF-36 is ready for further evaluation.

Adolescent↗
PubMed1995

Swedish Obese Subjects (SOS)--an intervention study of obesity. Measuring psychosocial factors and health by means of short-form questionnaires. Results from a method study.

Lengthy questionnaires should be shortened to enable better compliance in large-scale trials also ensuring adequate measurement precision. As the number of questions sufficient to create reliable scales may vary considerably depending on the complexity of concepts and purposes, consecutive participants of a large study, the Swedish Obese Subjects (SOS), received a second mailing of original long-form questionnaires after 1 week to be compared with the SOS short-form measures. Internal consistency, unidimensionality, robustness and reproducibility were tested for scales reflecting social support and life events, personality traits, health perception and psychosocial functioning. Very brief generic scales could perform satisfactorily for study-specific purposes in diseased populations. The short-form social support scales yielded satisfactory psychometric properties and the short life events module was best divided into two multi-item variables. High and consistent metric values were found for the personality, general health and psychosocial functioning scales. Our method study thus guided in striking a balance between scaling properties/reliability levels and length of questionnaires/subject burden. We recommend a method study like ours in every instance where patient-based data recordings are among the primary measures of outcome.

Attitude to Health↗
PubMed1995

Evaluating translations of health status questionnaires. Methods from the IQOLA project. International Quality of Life Assessment.

There is growing demand for translations of health status questionnaires for use in multinational drug therapy studies and for population comparisons of health statistics. The International Quality of Life Assessment (IQOLA) Project is conducting a three-stage research program to determine the feasibility of translating the SF-36 Health Survey, widely used in English-speaking countries, into other languages. In stage 1, the conceptual equivalence and acceptability of translated questionnaires are evaluated and improved using qualitative and quantitative methods. In stage 2, assumptions underlying the construction and scoring of questionnaire scales are tested empirically. In stage 3, the equivalence of the interpretation of questionnaire scores across countries is tested using methods that closely approximate their intended use, and empirical results are compared. Data analyses from Sweden and the United Kingdom, as well as other research cited, support the feasibility of cross-cultural health measurement using the SF-36.

Activities of Daily Living↗
PubMed1995

Vaginal cysts causing tenesmus in a bitch.

An eight-year-old female border collie was referred with a two-month history of faecal tenesmus. Ultrasonography and radiology identified fluid-filled masses in the cranial vagina. The fluid was drained from the vaginal cysts via an episiotomy and the clinical signs resolved. Histological examination confirmed that the cysts were of urogenital origin. This is believed to be the first report of vaginal cysts causing faecal tenesmus in the dog.

Animals↗
PubMed1995

Tumor necrosis factor, natural killer activity and other measures of immune function and inflammation in elderly men with heart failure.

OBJECTIVE: To determine the status of tumor necrosis factor (TNF) and other measures of immunity and inflammation in chronic heart failure (CHF) in the elderly. DESIGN: Comparative survey study of subjects with heart failure and age-matched controls. SETTINGS: University affiliated tertiary care VA Medical Center, Heart Failure Clinic. PATIENTS: Twenty men with New York Class II and III heart failure and 17 age-matched controls. INTERVENTIONS: None. MAIN OUTCOME MEASURE: Levels of lymphocyte mitogenesis, TNF, natural killer (NK) cell activity, elastase-alpha 1-antitrypsin (E/alpha) and cross-linked fibrin D-dimers (XDP). RESULTS: TNF levels (p = 0.27), NK activity (p = 0.56), and lymphocyte mitogenesis (p = 0.67) were similar in patients and controls. E/alpha levels were somewhat lower in CHF patients (p = 0.05) and XDP were similar (p = 0.59). However, TNF levels were significantly related to NK activity and to E/alpha activity in elderly men with heart failure but not controls. XDP were positively related to NK in heart failure patients but not controls. CONCLUSION: TNF and other measures of immune function and inflammation do not appear to be significantly elevated in elderly patients with heart failure of moderate severity. However, significant relationships exist between TNF, NK activity, XDP and E/alpha in the heart failure patients only, suggesting that immune activation and subclinical inflammation does exist in these patients.

Aged↗
PubMed1995

Studies of the effect of Pall leucocyte filters LG6 and AV6 in an in vitro simulated extracorporeal circulatory system.

Neutrophil activation is thought to play a major role in the inflammatory response seen in reperfusion injury and similar clinical situations, i.e. extracorporeal circulation. Impairment of neutrophil function or reduction of total numbers of neutrophils using a leucocyte filter may be beneficial in reducing the adverse clinical effects. In this study we have investigated the effect of the Pall LG6 and control AV6 filters during simulated in vitro cardiopulmonary bypass (CPB). Various parameters were evaluated including neutrophils, total leucocytes, monocytes, lymphocytes and platelets, expression of antigens on neutrophils using a panel of leucocyte-associated monoclonal antibodies CD13, 14, 15, 45Ro, 67, 11a, 11b and L selectin. The effects of leucocyte stimulation with phorbol myristate acetate (PMA) and a leucocyte bolus from a patient with chronic myeloid leukaemia (CML) were also investigated. We have demonstrated that the LG6 significantly reduces leucocytes, in particular neutrophils, with a modest reduction of lymphocytes, platelets and haematocrit, whereas the AV6 had no effect on leukocytes or neutrophils in the test system. In addition the LG6 was associated with a reduction in expression of all leucocyte antigens by approximately 20%; however there was no appreciable alteration of any of the antigens with AV6. Leucocyte stimulation with PMA resulted in a dramatic decrease of all cellular elements and an extra leucocyte load (using CML leucocytes) was not effectively filtered by the LG6 filter. These studies identify the capacity of the LG6 as compared with the AV6 to deplete activated neutrophils in an in vitro simulated cardiopulmonary bypass circuit.

Blood Component Removal↗
PubMed1995

Clinical audit of a specialist symptomatic breast clinic.

The efficient delivery of health care requires vigilant quality assurance. We describe the audit of our symptomatic breast clinic, which includes the option of a one-stop diagnostic service. A total of 134 new and 386 follow-up patients attended over four consecutive clinics. The majority of new referrals (68%) were seen by a consultant surgeon. Urgent referrals were seen significantly sooner than routine referrals (P < 0.001, chi 2-test), and the mean wait from designated appointment to seeing the surgeon was 37.6 (range-68 to 171) min. One-stop investigations were offered to 50 patients; of these, 36 women (72%) had a total wait of less than 2 h. For those not investigated at the same clinic, the mean time until investigations was 6.1 (range 0-36) days and mean recall was 2.7 (range 1-8) weeks. Patients undergoing definitive surgery for cancer (n = 5) were operated on average 14.2 (range 7-27) days after the decision was made in outpatients, while the mean waiting time for non-cancer operations was 49.7 (range 15-98) days. Objective audit on outpatient services is possible and can lead to improvement of services.

Adult↗
PubMed1994

Purification, characterization and analysis of rolipram inhibition of a human type-IVA cyclic AMP-specific phosphodiesterase expressed in yeast.

Analyses were done on a human type-IV cyclic AMP (cAMP) phosphodiesterase (hPDE-IVA-h6.1) expressed in an engineered strain of Saccharomyces cerevisiae. This strain (YMS6) expressed soluble PDE activity, together with an insoluble activity which was not released by re-homogenization, treatment with high-ionic-strength solutions or with the detergent Triton X-100. Pellet and soluble PDE activities were typical of type-IV PDE. They were cAMP-specific, insensitive to the addition of either cGMP (1 microM) or Ca2+/calmodulin, and inhibited by rolipram. Thermostability studies showed both activities to decay as single exponentials, indicating the presence of homogeneous PDE protein species in each fraction. Pellet PDE activity was more thermostable than the soluble enzyme. Mg2+ and Mn2+ dose-dependently increased PDE activity and reversed the inactivating effect of EDTA.h6.1 was engineered to express a C-terminal five-histidine motif (h6.1his5). This allowed purification of the PDE to apparent homogeneity in a simple two-step process involving a rolipram affinity column and a Ni2(+)-chelate column. A single monomeric protein of subunit molecular mass approximately 73 kDa and native molecular mass approximately 74 kDa resulted after a approximately 53000-fold purification. This exhibited a Km for cAMP of 8 microM, a true Vmax. of 0.8 mumol of cAMP hydrolysed/min per mg of PDE protein, a kcat. of 3702 s-1, and a value of the specificity constant kcat/Km of 4.6 x 10(8) M-1.s-1, the last implying a diffusion controlled reaction. Rolipram (Ki 0.4 soluble; 0.7 microM pellet) and 3-isobutyl-1-methylxanthine (Ki 15 soluble; 19 microM pellet) served as simple competitive inhibitors for both soluble and pellet forms of h6.1, respectively.

1-Methyl-3-isobutylxanthine↗
PubMed1994

Mouse very-low-density-lipoprotein receptor (VLDLR) cDNA cloning, tissue-specific expression and evolutionary relationship with the low-density-lipoprotein receptor.

The very-low-density-lipoprotein receptor (VLDLR) is a recently described lipoprotein receptor that shows considerable similarity to the low-density-lipoprotein receptor (LDLR). This receptor has been suggested to be important for the metabolism of apoprotein-E-containing triacylglycerol-rich lipoproteins, such as very-low-density-lipoprotein (VLDL), beta-migrating VLDL and intermediate-density lipoprotein. cDNA clones that code for the VLDLR were isolated from a mouse heart cDNA library. The deduced amino acid sequence predicts a mature protein of 846 amino acids preceded by a 27-residue signal peptide. Three mRNA species for the VLDLR with sizes of 3.9, 4.5 and 7.9 kilobases were present in high concentration in heart and muscle, which utilize triacylglycerols as an energy source. VLDLR mRNA is also detected in decreasing amounts in kidney, brain, ovary, testis, lung and adipose tissue. It is essentially absent in liver and small intestine. The amino acid sequence of the VLDLR is highly conserved among rabbit, human and mouse. VLDLR contains five structural domains very similar to those in LDLR, except that the ligand-binding domain in VLDLR has an eightfold repeat instead of a sevenfold repeat in LDLR. Sequence conservation among animal species is much higher for the VLDLR than the LDLR. Sequences of the VLDLR from three vertebrate species and the LDLR from five vertebrate species were aligned and a phylogenetic tree was reconstructed. Although both receptors contain five domains and share amino acid sequence similarity, our computations showed that they diverged before the divergence between mammals and amphibians. In addition, sequence comparison of both receptor sequences suggests that the rabbit is evolutionarily closer to man than to the mouse. These results are consistent with the hypothesis that the VLDLR and the LDLR have evolved from a common ancestral gene to play distinct roles in lipoprotein metabolism and that the metabolic handling of triacylglycerol by the body via the VLDLR is a highly conserved mechanism.

Amino Acid Sequence↗
PubMed1994

[Measuring quality of life. A new general and a new tumor specific formulary for evaluation and planning].

The generic measure, SF-36, was developed in the US. It covers both functioning and well-being and has proved suitable for clinical outcomes research, patient monitoring and health care planning. To protect the forms and scoring algorithms of the SF-36 and ensure comparability across studies and countries the copyright was placed with Medical Outcomes Trust, a non-profit making organization. Researchers are granted permission through a user agreement procedure. An international team of investigators is developing authorized translations of the SF-36 through the International Quality of Life Assessment (IQOLA) Project, sponsored by Glaxo Research Institute, Research Triangle Park, North Carolina, USA, and Schering-Plough Corporation, Kenilworth, New Jersey, USA. The Swedish test version is currently available on a case-by-case basis at the Health Care Research Unit. The tumor-specific measure, QLQ-C30, was developed and proved reliable in cross-cultural field studies, created by the Quality of Life Study Group within the European Organization for Research and Treatment of Cancer (EORTC). It includes questions on functioning, symptom burden and global quality of life across tumors, supplemented by diagnosis--or therapy-specific additional modules. The instrument is copyrighted and all translations are placed with the Quality of Life Unit at the EORTC Data Center, Brussels. Requests for permission to use the instrument and scoring instructions should be sent to the Center.

Formularies as Topic↗
PubMed1994

Human very-low-density lipoprotein receptor complementary DNA and deduced amino acid sequence and localization of its gene (VLDLR) to chromosome band 9p24 by fluorescence in situ hybridization.

A complementary DNA for the very-low-density lipoprotein receptor (VLDLR) that codes for a protein of 873 amino acids was cloned from a human heart cDNA library. The mature protein of 846 amino acids, preceded by a 27-residue signal peptide, shares 97% amino acid sequence identity with the rabbit VLDLR. Like the low-density lipoprotein receptor, the VLDLR contains five different domains, all of which are highly conserved between human and rabbit. A tetrapeptide NPVY that potentially serves as a signal for clustering of the VLDLR on coated pits is present in the cytoplasmic domain, which is 100% conserved between human and rabbit. We localized the VLDLR gene to chromosome 9p24 by fluorescence in situ hybridization using the cloned cDNA as hybridization probe. The high amino acid sequence homology of the VLDLR between two mammalian species suggests that the receptor plays a fundamental role in lipoprotein metabolism and that energy metabolism mediated by triglyceride utilization may be an evolutionarily highly conserved mechanism.

Amino Acid Sequence↗
PubMed1994

Predictors and effects of long-term dieting on mental well-being and weight loss in obese women.

Sixty moderately obese women (mean BMI = 33, mean age = 43), randomized to a lactovegetarian or regular 1300-kcal weight-reducing diet were followed at 3, 8 and 24 months. Weight follow-up was 92%, while 47% complied with the program throughout with no differences between the two diets with respect to compliance rate, weight loss or behavioral test results. Over 24 months compliers lost a mean 3.9 kg compared to a gain of 1.8 kg in the non-compliers. Short-term improvements in mental well-being measured by the Mood Adjective Check List deteriorated after 2 years to lower levels than at entry. Self-assessed motivation to diet was inversely related to mental well-being at two years. Positive long-term changes of functional status (Sickness Impact Profile) were found. Though subjective prediction of success measured after 3 weeks on diet predicted short-term and maximum weight loss, it did not predict ultimate outcome. More difficulties in resisting emotional and social eating cues (high disinhibition score on the Three-Factor Eating Questionnaire) before and during the diet predicted weight gain. The more initial health-related dysfunction (SIP) the greater the weight regain. Psychological characteristics at baseline did not predict compliance or overall weight loss. The magnitude of weight loss after 24 months was related to amount and duration of maximum weight loss.

Adult↗
PubMed1994

Succinylcholine-induced cardiac arrest in children with undiagnosed myopathy.

Two paediatric cases are reported in which unexpected, life-threatening arrhythmias occurred. Routine induction of general anaesthesia with thiopentone, 5 mg.kg-1, in one and with halothane in the other, and succinylcholine 1.25-1.5 mg.kg-1 i.v. was followed by the development of wide complex tachyarrhythmia with hypotension in the first case and asystole in the second case despite pre-treatment with atropine in both cases. The first patient was resuscitated with tracheal intubation, 100% oxygen, manual ventilation and intravenous lidocaine and bicarbonate. The second patient required intubation, manual ventilation, 12 min of CPR and i.v. calcium, epinephrine and bicarbonate, as well as DC counter shock. Neither patient received dantrolene. Early recovery in both patients was uneventful with no neurological sequelae. Subsequent investigations revealed the presence of a dystrophin-deficient muscular dystrophy, Duchenne muscular dystrophy and Becker muscular dystrophy respectively, previously unsuspected, in both patients. The aetiology of the observed arrhythmias was presumably hyperkalaemia, secondary to succinylcholine-induced rhabdomyolysis. It is suggested that when faced with sudden, life-threatening arrhythmias following succinylcholine at induction of anaesthesia for paediatric patients, clinicians should include occult myopathy in the differential diagnosis, and thus consider the aggressive management of hyperkalaemia in addition to basic resuscitative efforts.

Anesthesia, Intravenous↗