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Biomedical subjects

P Nolan

Publications and source records attributed to P Nolan.

At least 73 records · Page 4Linked to original sources
PubMed1995

Linguistic entrapment: medico-nursing biographies as fictions.

This paper argues that in their trainings health professionals are encouraged to use language naively as if it were a transparent medium of scientific communication. We contend that language use, particularly in the field of mental health care, should be studied in terms of its social functions and attention should be paid to the inevitably constructive nature of language in patients' records, in order that a 'fictional distance' opens up between patients and their records. Recent developments in literary theory and narrative analysis can be deployed as theoretical frameworks to understand this process, and we suggest that more attention to the use of language should be included in the educational programmes for health care professionals to counteract the risk of 'linguistic entrapment' or 'incarceration'.

Linguistics↗
PubMed1995

Survey of the social networks of people with severe mental health problems.

The social functioning of people with severe mental health problems is an indicator of general physical and emotional well-being. There exists a wealth of literature on the topic from the professional carer's perspective but relatively little from the perspective of the clients themselves. Thirty clients were interviewed in order to explore their understanding of the nature and value of the social networks in which they were currently involved. Despite having participated in a variety of rehabilitation interventions, these clients remained insecure and lacking in confidence. They had few friends beyond members of their immediate family and were generally leading lonely, friendless existences without the capacity to establish new relationships. Although this study suggests that clients often have grandiose plans for the future, mental health nurses may best meet their needs by helping to sustain existing relationships and using them at all levels of therapeutic intervention, rather than attempting to nurture new relationships for which clients are unready and the failure of which may result in a relapse in clients' mental health status.

Adult↗
PubMed1994

The influence of positivistic thought on nineteenth century asylum nursing.

The development of positivism, which had a considerable influence on the evolution of psychiatric thought and practice during the second half of the nineteenth century, is outlined. It was within this intellectual framework that figures such as Kraepelin, Bleuler and Schneider developed psychiatric nosologies and diagnostic criteria for certain mental illnesses. While there was little scientific evidence to support the claim that medical treatments had any beneficial effects on pyschiatric disorders, nevertheless psychiatric institutions were established in the mid-nineteenth century based on the medical model. Nurses were expected to observe, collect and report data on mental patients which were then presented to doctors for analysis. The intellectual climate of the asylums was such that nurses were not encouraged to question the scientific principles upon which the therapeutic regime was based, nor were they encouraged to seek a rationale for their daily observations and data collection. The specialized training for asylum nurses which was introduced towards the end of the nineteenth century did not give nurses their own professional identity, but rather reinforced the supremacy of medical knowledge in the care of the mentally ill. Trained nurses enhanced medical credibility, but did not progress care of the mentally ill because their training did not imply or encourage questioning of the positivistic basis of psychiatric treatment.

History, 19th Century↗
PubMed1994

The effects of oesophageal distension on diaphragm and laryngeal muscle activity in the anaesthetized cat.

The electromyographic (EMG) activities of diaphragm and laryngeal muscles were recorded during oesophageal distension in anesthetized cats. The responses to distension of the thoracic oesophagus differed from those evoked by distension of the cervical oesophagus. The crural component of the diaphragm (CD) was inhibited by distension of the thoracic oesophagus; distension of the cervical oesophagus did not affect CD EMG. Thyroarytenoid (TA) muscle EMG increased markedly and consistently in response to distension of the cervical oesophagus. Distension of the thoracic oesophagus only produced statistically significant increases in TA EMG with high distending volume (10 ml) at the level of the gastro-oesophageal junction. The main abductor of the vocal cords, the posterior cricoarytenoid (PCA) was either unchanged or decreased by oesophageal distension. The electrical activities of left paratendinous diaphragm, left costal diaphragm, internal intercostal and external intercostal muscles remained unchanged. The entire pattern would appear to constitute a means to aid passage of a bolus into the stomach, and simultaneously guard the respiratory tract from reflux or aspiration.

Anesthesia↗
PubMed1993

DiGeorge anomaly with renal agenesis in infants of mothers with diabetes.

We report on 2 infants with the DiGeorge anomaly born to diabetic mothers treated with insulin. Both infants had unilateral renal agenesis. One of the mothers has manifestations suggestive of velo-cardio-facial syndrome (VCFS). Cytogenetic studies on both patients and the mother with apparent VCFS were normal. Molecular studies utilizing probes from the DiGeorge critical region did not demonstrate a 22q11 microdeletion in either patient or the mother with apparent VCFS. We conclude that maternal diabetes is a pathogenetic factor in the DiGeorge anomaly, and infants of diabetic mothers who have this anomaly should also be screened for renal agenesis.

Adult↗
PubMed1993

Comparative mapping of 9 human chromosome 22q loci in the laboratory mouse.

We present a comparative map of genes on human chromosome 22q and homologous loci in the mouse genome. Gene order in humans was established using a panel of somatic cell hybrids. Genetic maps spanning homologous segments on three mouse chromosomes were generated using an interspecific backcross. The conserved linkage between human chromosome 22 and mouse chromosome 16 includes two closely linked loci, Comt and IgI-1. The second conserved linkage involves human chromosome 22 and mouse chromosome 11 and contains two genetically and physically linked loci, Lif and Nfh. Finally, conserved synteny involving mouse chromosome 15 and human chromosome 22 spans 30 cM and contains five loci (Acr, Bzrp, Dia-1, Il2rb and Pdgfb). Loci within this conserved synteny have been sublocalized to different portions of human chromosome 22. The order of genes on mouse chromosome 15 and human chromosome 22 provides further evidence for chromosomal rearrangements within the conserved synteny that have occurred since the divergence of lineages leading to mice and humans.

Animals↗
PubMed1993

Carbon dioxide-sensitive superior laryngeal nerve afferents in the anaesthetized cat.

The effects of CO2 on laryngeal receptors were studied in ten anaesthetized, paralysed, artificially ventilated cats using a preparation in which the upper airway was isolated in situ and artificially ventilated. This allowed CO2 to be confined to the upper airway and enabled responses to CO2 to be recorded whilst the larynx was being ventilated under physiological conditions. Single-unit afferent activity was recorded from the superior laryngeal nerve and the pressure and thermal sensitivity of receptors determined. Carbon dioxide responses were tested by switching from upper airway ventilation with room air to mixtures containing 5 and 9% CO2 with 21% O2 in N2. Fibres were classified into two broad groups, tonic and quiescent, depending on their level of activity when the larynx was not being ventilated. All tonic fibres responded to either positive or negative pressure. Quiescent fibres were either positive or negative pressure receptors, cold receptors or had no response to pressure or cold airflow. The majority of all categories of fibres were significantly affected by CO2 in a reversible and usually concentration-dependent manner. Tonic fibres were inhibited, regardless of pressure sensitivity. Quiescent negative and positive pressure receptors were excited and inhibited respectively whilst cold receptors and fibres with no response to occlusion were excited. Laryngeal hypoxia and systemic asphyxia and hypercapnia had no effect on receptor activity. We conclude that the majority of laryngeal receptors are sensitive to CO2 and that this receptivity may be important in the control of ventilation and upper airway muscle activity.

Afferent Pathways↗
PubMed1991

Nuclear transcription factors that bind to elements of the IL-2 promoter. Induction requirements in primary human T cells.

Prior studies have identified several elements that contribute to the activity of the IL-2 promoter in the stimulated T cell line, Jurkat. The sites and their corresponding nuclear binding factors include: NF-kappa B, AP-1, AP-3, OCT-1, and NF-AT. The latter "nuclear factor for activated T cells" likely contributes to the tissue specificity of IL-2 gene expression. Using electrophoretic mobility shift assays, we have studied these transcription factors in primary T cells from human blood to verify their presence in a physiologic setting and to identify the signals that stimulate factor activity. All factors are induced in the nuclei of T cells upon activation with mitogens but not with exogenous IL-2 growth factor. However, the signaling requirements and sensitivity to protein synthesis inhibitors differ considerably. Only the activities for NF-AT and AP-1 sites require two signals for optimal induction, i.e., PMA plus either lectin or antibody to the CD3 or CD28 surface molecules. Other factors are induced by lectin, antibody, and/or PMA alone. After appropriate stimulation, both NF-AT and AP-1 are peculiarly sensitive to the protein synthesis inhibitor anisomycin. Our data correlate the activity of NF-AT and AP-1 in gel shift assays with the two signals requirements for IL-2 gene expression.

Antibodies, Monoclonal↗
PubMed1991

Admission to child health surveillance lists: the views of FHSA general managers and general practitioners.

OBJECTIVES: To find out the sources of advice that were helpful to managers of family health services authorities in drawing up the criteria for admission of general practitioners to the child health surveillance lists; to determine the criteria used for admission of general practitioners to the family health services authorities' child health surveillance lists; to find out the changes general practitioners have made in child health surveillance in their practices; to determine the experiences of general practitioners relating to admission to the child health surveillance lists and to training in child health surveillance. DESIGN: Survey by postal questionnaire. SUBJECTS: General managers of all family health services authorities in England and Wales; all general practitioners in Yorkshire and Humberside. RESULTS: Managers of 80 of 93 family health services authorities replied (86%). A total of 62 (78%) found local community paediatricians helpful in compiling criteria for admission to child health surveillance lists, and 46 (57%) found national guidelines helpful. Fifty seven (71%) accepted general practitioners who had completed an approved course, and 45 (56%) accepted those with three or more years' experience of child health surveillance. Of the 1966 questionnaires sent to general practitioners, 1233 were satisfactorily completed (63%). Of the 919 respondents who had applied to be put on child health surveillance lists, 673 (73%) had been permanently accepted; of these, 441 (65%) had done an approved course and 375 (56%) had had three or more years' experience of child health surveillance. Of the 145 (16%) not accepted, 57 (39%) had done an approved course and 71 (49%) had three or more years' experience. Respondents reported variable quality and availability of courses in child health. CONCLUSIONS: Acceptance of general practitioners on to child surveillance lists has not been carried out consistently despite national guidelines setting out criteria for acceptance.

Child Health Services↗
PubMed1991

Osteoinductive potential of human demineralised bone and a bioceramic in abdominal musculature of the rat.

Human demineralised cortical bone chips ('bank' bone) and a particulate bioceramic (20% hydroxyapatite: 80% tricalcium phosphate) were implanted into muscle pouches in the rat abdominal wall. Combined implants of both bone and bioceramic were also made. The implants were examined histologically at thirty day intervals over a three month period. The results showed that the hydroxyapatite: tricalcium phosphate bioceramic was not resorbed and did not induce bone formation when implanted alone or in combination with human demineralised bone. In contrast the bank bone was osteogenic but, even at three months, bone formation was sparse. These results are in accord with recent findings that the use of xenogeneic model systems to evaluate the osteogenic potential of human bone is limited.

Abdominal Muscles↗
PubMed1991

Signs of cellular immunosuppression correlate with HLA-DR phenotypes in healthy HIV-negative homosexuals: preliminary findings.

Twelve healthy, anal-receptive, homosexual Caucasian males who were seronegative for HIV antibody were typed for HLA-DR antigens. Flow cytometry was used to immunophenotype peripheral blood lymphocytes bearing the CD4, CD8, LEU7, and combined CD8 and LEU7 antigens. These individuals had reported a large number of sexual partners within a five-year period preceding this study. Each individual was assigned a score based on the Hardy-Weinberg frequency of their HLA-DR phenotype in the Caucasian population. The larger the value of this score, the more common the HLA-DR phenotype, the smaller the score, the rarer the phenotype in the population at large. A significant inverse correlation was observed between this score and the proportion of lymphocytes with CD8 and LEU7 antigens. Lymphocytes bearing these two antigens have in vitro suppressor activity and are elevated in patients with human immunodeficiency virus (HIV) infection. The inverse association between CD8+/LEU7+ cells and frequency of HLA-DR phenotypes is consistent with the hypothesis that individuals with rarer phenotypes whose partners are drawn from the population at large are more likely to be challenged during anal insemination, which results in immunosuppression (alloantigenic challenge hypothesis). On the other hand, it is possible that an association exists between certain HLA-DR phenotypes and immune status. Although these observations were made in a very small sample, we believe that the strength of this association provides justification for further investigation into the possibility that alloantigenic challenge may increase the risk for infection, if exposed to HIV, and augment the immunosuppressive action of HIV once significant infection has occurred.

Antigens, Differentiation↗