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Biomedical subjects

M Walsh

Publications and source records attributed to M Walsh.

At least 127 records · Page 7Linked to original sources
PubMed1998

Early morning blood collections: A College of American Pathologists Q-Probes study of 657 institutions.

OBJECTIVE: To determine specimen collection and report times, and delivery, analytic, and total turnaround times (TAT) for routine early morning blood collections. DESIGN: The study was a 2-part College of American Pathologists Q-Probes study. In the first part, participants recorded specimen collection times, receipt in testing laboratory times, and test report times for all routine hemoglobin and potassium samples collected between the hours of 1 AM and 10:30 AM on one intensive care unit and one nonintensive care unit for a 1-week period. In the second part, participants provided information about their specimen collection, delivery, processing, analytic, and reporting practices in a questionnaire. SETTING: An intensive care unit and a nonintensive care unit in 657 institutions. MAIN OUTCOME MEASURES: Median collection time, delivery time, analytic time, total turnaround time, and report time. RESULTS: Median institutional collection times ranged from 3 AM to 9:20 AM, with the institution at the 50th percentile reporting a median collection time of 6 AM. Median institutional report times ranged from 3:45 AM to 12: 20 PM, with the institution at the 50th percentile reporting a median report time of 7:23 AM. Median delivery, analytic, and total turnaround times for the median institution were 25, 42, and 73 minutes, respectively. CONCLUSIONS: Factors shown to correlate with shorter total turnaround times were rural locations, a lower collections to full-time equivalent ratio, intensive care unit specimens, plasma for potassium measurements, the practice of delivering each specimen as it is collected, pneumatic tube delivery system, direct delivery route, and continuous versus batch testing.

Blood Specimen Collection↗
PubMed1997

Neurologic examination of sea turtles.

OBJECTIVE: To determine whether neurologic examination techniques established for use on dogs and cats could be adapted for use on sea turtles. DESIGN: Prospective controlled observational study. ANIMALS: 4 healthy Green Turtles (Chelonia mydas), 1 healthy Kemp's ridley sea turtle (Lepidochelys kempi), and 6 Green Turtles suspected to have neurologic abnormalities. PROCEDURE: Neurologic examinations were performed while sea turtles were in and out of the water and in ventral and dorsal recumbency. Mentation, general activity, head and body posture, movement and coordination, thoracic and pelvic limb movement, strength and muscle tone, and tail movement were observed. Thoracic and pelvic limb flexor reflexes and nociception, righting response, cranial nerve reflexes, clasp and cloacal reflexes, and neck, dorsal scute, cloacal and tail nociception were tested. RESULTS: Results of neurologic evaluations were consistent for healthy sea turtles. Sea turtles suspected to have neurologic abnormalities had abnormal results. CLINICAL IMPLICATIONS: Many of the neurologic examination techniques used to evaluate dogs and cats can be adapted and used to evaluate sea turtles. A standardized neurologic examination should result in an accurate assessment of neurologic function in impaired sea turtles and should help in evaluating effects of rehabilitation efforts and suitability for return to their natural environment.

Animals↗
PubMed1997

Will critical pathways replace the nursing process?

Individualised care is the essence of nursing and regard for the individual is the battle against the impersonal institution. Unfortunately, attempts to manage the process of individualised care have often ended in failure (Ford and Walsh 1994). Some observers maintain that the rigid behaviour which characterises the nursing process contradicts the intuitive nature and individualistic approaches which are fundamental to nursing practice (Benner 1984). This article reviews the concept of critical pathways, a new approach to managing patient care.

Cooperative Behavior↗
PubMed1997

Elevated levels of circulating soluble adhesion molecules in peripheral blood of patients with unstable angina.

We have demonstrated increased levels of the circulating soluble adhesion molecules (sCAMs), ICAM-1, VCAM-1, and E-selectin in patients with unstable angina compared with healthy controls. Our findings support the role of inflammation in clinically unstable coronary disease, and may indicate a potential role for measurement of peripheral sICAM levels as a marker for inflammatory activity in atherosclerotic plaque.

Adult↗
PubMed1997

Sp1 is required for the early response of alpha2(I) collagen to transforming growth factor-beta1.

It is currently debated whether AP1 or Sp1 is the factor that mediates transforming growth factor beta1 (TGF-beta) stimulation of the human alpha2(I) collagen (COL1A2) gene by binding to an upstream promoter element (TbRE). The present study was designed to resolve this controversy by correlating expression of COL1A2, AP1, and Sp1 in the same cell line and under different experimental conditions. The results strongly indicate that Sp1 is required for the immediate early response of COL1A2 to TGF-beta and AP1 is not. The Sp1 inhibitor mithramycin blocked stimulation of alpha2(I) collagen mRNA accumulation by TGF-beta, whereas the AP1 inhibitor curcumin had no effect. Furthermore, antibodies against Jun-B and c-Jun failed to identify immunologically related proteins in the TbRE-bound complex, irrespective of whether they were purified from untreated or TGF-beta-treated cells. AP1 did bind to the TbRE probe in vitro, but only in the absence of the upstream Sp1 recognition sequence. Based on this finding and DNA transfection results, we conclude that the AP1 sequence of the TbRE represents a cryptic site used under experimental conditions that either eliminate the more favorable Sp1 binding site or force the balance toward the less probable. Finally, a combination of cell transfections and DNA-binding assays excluded that COL1A2 transactivation involves the retinoblastoma gene product (pRb), an activator of Sp1, the pRb-related protein p107, an inhibitor of Sp1, or the Sp1-related repressor, Sp3.

Collagen↗
PubMed1997

Developing practice through networking.

Exhorted to provide evidence-based practice, be accountable practitioners, provide a value for money service and to expand the nursing role, nurses can be forgiven for wondering just how they can meet these laudable targets while coping with all the other stresses that are part and parcel of life in today's NHS This article reports on a network which offers appropriate support.

Clinical Competence↗
PubMed1997

How nurses perceive barriers to research implementation.

This article follows up a previous article on community nurses' perceived barriers to implementing research (Walsh 1997). Here the author examines the perceived barriers to research use among a sample of 63 hospital and 78 community nurses. The major barriers identified relate to the clinical setting and understanding research reports. The results have significant implications for managers of the service and educators who seek to promote research-based practice.

Attitude of Health Personnel↗
PubMed1997

Elevated levels of circulating soluble adhesion molecules in patients with nonrheumatic aortic stenosis.

Increased serum levels of soluble adhesion molecules are found in various disorders of inflammatory or immunologic etiology. We found elevated levels of the soluble adhesion molecules ICAM-1, VCAM-1, and E-selectin in patients with nonrheumatic aortic stenosis, suggesting that inflammation may be important in the pathogenesis of this condition, which is generally believed to be degenerative.

Aortic Valve Stenosis↗
PubMed1997

Accountability and intuition: justifying nursing practice.

This article examines how promoting individual accountability and justifying nursing practice using scientific evidence appears to contradict theories of intuitive nursing. The author considers the professional and legal implications raised by the contradiction and advocates that evidence-based practice must be the justification in law for nursing action.

Evidence-Based Medicine↗
PubMed1997

Perceptions of barriers to implementing research.

This article reports the findings of a study of community nurses to determine their perceptions of barriers to the implementation of research findings in practice. A questionnaire survey using a scale developed in the US (Funk and Champagne 1991) asked community nurse students to rank a series of perceived barriers in order of greatest to least obstruction. The results were also compared with those from Funk and Champagne's study (1991). The authors found that UK nurses considered lack of authority and the inaccessibility of research reports were major barriers to implementing research findings. The authors emphasise the need for collaboration between managers, academics and practitioners to overcome such barriers.

Community Health Nursing↗
PubMed1997

One-hour postload plasma glucose and risks of fatal coronary heart disease and stroke among nondiabetic men and women: the Chicago Heart Association Detection Project in Industry (CHA) Study.

Associations of baseline one-hour postload plasma glucose with 22-year coronary heart disease, stroke, cardiovascular diseases, and all cause mortality were assessed in five age-specific cohorts of nondiabetic men and women from the Chicago Heart Association Detection Project in Industry: 10,269 men ages 18-39 years; 7993 men ages 40-59 years; 1240 men ages 60-74 years; 6319 women ages 40-59 years; and 932 women ages 60-74 years. Plasma glucose was determined one hour after a 50-gram oral glucose load. Cox regression analyses were used to control for age and other covariates. Generally, higher glucose was significantly associated with mortality from coronary heart disease, stroke, cardiovascular diseases, and all cause mortality in men and women. This large longitudinal study provides evidence that one-hour postload plasma glucose in the absence of clinical diabetes at baseline apparently is an independent risk factor for fatal coronary heart disease and stroke in middle-aged and older nondiabetic men and women, and also for cardiovascular diseases and for all cause mortality.

Adolescent↗
PubMed1997

Managing risk in the city: the role of welfare professionals in managing risks arising from vulnerable individuals in cities.

Modern cities depend on individualism and the process of contracting. Contracts between individuals contribute to stability and order in cities. However, this is challenged by risks and uncertainties especially those relating to vulnerable individuals who are unable or unwilling to enter into contractual relations. This paper focuses on the role of caring professions and the impact of new strategies for managing risks related to vulnerable adults and children, especially the shift from managing risk in institutions to managing risk in the community. This paper is based on research funded through the ESRC Risk and Human Behaviour Programme.

Adult↗
PubMed1997

Cancer of the pyriform fossa: hyperfractionated radiotherapy as a primary treatment modality.

Carcinoma of the pyriform fossa carries one of the worst prognoses of all head and neck cancers. A prospective trial was set up to study the efficacy of hyperfractionated radiotherapy as a primary treatment modality in the management of these patients. Seventeen patients entered the trial and were followed for up to 3 years. Results for local control, regional control and survival compare favourably with patients treated primarily with surgery with or without radiotherapy. Hyperfractionated radiotherapy offers a logical and standardized approach to the management of this tumour and reduces the significant morbidity associated with the use of surgery as a primary treatment.

Carcinoma, Squamous Cell↗
PubMed1997

The effect of tonsillectomy on eustachian tube function.

A two-part study was designed to investigate the effect of tonsillectomy on eustachian tube function and to identify if any change is related to postoperative pain. Middle ear pressure was measured by tympanometry and results were classified as type A (+50 daPa to -99 daPa), type B (flat) or type C (-100 daPa to -350 daPa). Thirty-one patients with type A tympanograms, undergoing tonsillectomy enrolled in study A. Patients had tympanometry the next day and filled in a questionnaire incorporating visual analogue pain scores. In study B, 30 patients underwent a similar protocol and were followed up at 1 week tympanometry and a questionnaire. A control group of 26 patients undergoing appendicectomy was recruited. Follow-up was available on 23 patients from study B. Combining A and B, on the first postoperative day 39% of patients developed type C tympanograms. No member of the control group developed any change in middle ear pressure. There was no significant relationship between pain scores for throat pain or otalgia and the development of negative middle ear pressure. By day 7 all patients had type A tympanograms. Otalgia was a delayed symptom significantly associated with increased throat pain. Transient negative middle ear pressure commonly occurs following tonsillectomy.

Acoustic Impedance Tests↗
PubMed1997

An evaluation of patients comprehension of orthopaedic terminology: implications for informed consent.

We conducted a prospective study into patient comprehension of orthopaedic terminology that commonly appears on consent forms. The majority of patients questioned were unsure of the meaning of simple terms such as 'fracture reduction' or 'internal fixation'. All the patients questioned had signed consent forms recently for such procedures in an acute orthopaedic unit. We conclude that many patients willingly consent to procedures that they do not fully understand. This implies that there is an element of trust involved in the process of giving consent. We believe that this aspect of the doctor-patient relationship should be legally respected.

Adult↗