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Biomedical subjects

R Fennell

Publications and source records attributed to R Fennell.

At least 19 recordsLinked to original sources

Reconciling pedagogy and health sciences to promote indigenous health.

OBJECTIVES: To increase knowledge and skills regarding Indigenous learning styles. To raise awareness within the tertiary education sector that Aboriginal students learn differently and that Indigenous cultures and pedagogy have validity and strength. To examine pedagogical strategies that assist both tertiary students capacity for learning and university lecturers' delivery and evaluation of teaching and learning strategies. METHODS: A qualitative, ethnographic framework using personal observations, field and classroom experience, interviews and review of literature in the fields of education, public health and Indigenous cultural perspectives. RESULTS: Aboriginal people are the receivers of services and programs that will be delivered, in the majority of cases, by university-educated, non-Aboriginal, professional health care providers. Indigenous students face specific challenges in obtaining an effective education for working in the Aboriginal and wider community in the field of public health; the challenges relate to culture, health paradigms and community. CONCLUSION: Lecturers in health and human science courses for Aboriginal students need to both examine and appreciate the cultural constraints on learning faced by their students within the context of mainstream curriculum, and to build on the large pool of knowledge and learning styles that Aboriginal society bequeaths to Aboriginal students. IMPLICATIONS: Academics can apply the cultural differences and knowledge base of the Indigenous community as a force to promote health through learning.

Anthropology, Cultural↗

Health behaviors of students attending historically black colleges and universities: results from the National College Health Risk Behavior Survey.

The National College Health Risk Behavior Survey was administered to a convenience sample of students at 8 historically Black colleges and universities in 7 states. Analyses showed major differences in the men's and women's responses. The men were significantly more likely than the women to be current smokers. Also, they more frequently reported heavy drinking, drinking and driving in the past days 30 days, and carrying a weapon. The women were significantly more likely to view themselves as overweight, and more than one third reported they were trying to lose weight. More than one third of the students had not exercised or participated in sports activities for more than 20 minutes in the past 7 days. Because historically Black colleges and universities educate the majority of undergraduate Black college students, multidimensional programs to promote disease prevention and health promotion for Black college students must be expanded and evaluated.

Adult↗

Atypical renal artery stenosis in a renal transplant: diagnosis by radionuclide techniques.

A case of a cadaveric kidney transplant recipient who developed progressively severe renal failure within 3 mo of transplantation secondary to renal artery stenosis is presented. The patient was primarily hypotensive and Doppler ultrasound showed normal flow. The problems in diagnosing this unusual case are reviewed. The findings on serial radionuclide studies eventually led to consideration of the correct diagnosis.

Adult↗

A review of evaluations of peer education programs.

Although peer education programs have existed on the college campus for many years, few evaluations of their effectiveness have been made. The author reviews the brief literature on process and outcome evaluations and offers suggestions to encourage evaluations that will yield more accurate and useful information. Such information is particularly important at a time when many universities face budgetary constraints that put these programs and those who administer them at risk when programs and services are curtailed.

Health Education↗

Using humor to teach responsible sexual health decision making and condom comfort.

Using a lively classroom activity and a sense of humor is helpful in conveying a serious message about responsible sexual behavior to college students. The activity described takes only 1 hour, requires simple and easily obtainable equipment, and generates animated discussions. Students learn to feel more comfortable about using condoms after demonstrations of the strength and flexibility of these increasingly available items.

Adolescent↗

AIDS/HIV articles published in selected professional health journals: 1981-1990.

Journals from five professional associations were reviewed to determine the response to AIDS/HIV in their journal: Association for the Advancement of Health Education (AAHE) and Journal of Health Education; American College Health Association (ACHA) and Journal of American College Health; American Public Health Association (APHA) and American Journal of Public Health; American School Health Association (ASHA) and Journal of School Health, and the Society for Public Health Education (SOPHE) and Health Education Quarterly. The project posed the following questions: 1) How many articles on AIDS/HIV were published in the selected journals during the 10-year period from 1981 through 1990?; 2) What types of articles were published during the period, such as editorials, recommendations, guidelines, and research?; and 3) What approaches were shown effective in changing knowledge, attitudes, and behavior? The first article appeared in 1984; 239 articles were published in the five journals reviewed. Each journal devoted at least one entire issue to AIDS/HIV. The articles were categorized as either applied (43.9%) or data-based (56.1%). Since most articles with a research focus did not include pretest and posttest measurements, it proved difficult to determine the most effective methods for changing knowledge, attitudes, and behavior. Evaluation methods that assess the effectiveness of interventions in changing knowledge, attitudes, and behavior are needed.

Acquired Immunodeficiency Syndrome↗

Peritonitis in children on chronic peritoneal dialysis: analysis at 10 years.

Peritoneal dialysis is the major form of renal replacement therapy for children awaiting renal transplantation. Peritonitis is the major associated morbidity. We retrospectively identified the pathogens, co-morbid factors and outcome of peritonitis in children on peritoneal dialysis from 1980-1989. Seventy-three children, mean age 12.4 years, received 1,234 patient months of chronic peritoneal dialysis. Twenty-four patients (33%) remained peritonitis free until their dialysis catheters were removed after transplantation. Forty-nine children (67%) developed 219 episodes of peritonitis. Peritoneal fluid cultures were positive in 169 episodes (77%). Of the pathogens identified, 73% were gram positive cocci, 22% gram negative rods, 3% were fungus, and 2% other organisms. The incidence of peritonitis was one episode per 5.6 months. Over a 10 year period: 1) 67% of children on peritoneal dialysis developed peritonitis; 2) gram positive cocci accounted for most episodes; 3) the incidence in children was higher than that reported for adults; 4) there were no deaths attributable to peritonitis.

Child↗

Selective modulation of band 4.1 binding to erythrocyte membranes by protein kinase C.

We have studied the effects of band 4.1 phosphorylation on its association with red cell inside-out vesicles stripped of all peripheral proteins. Band 4.1 bound to these vesicles in a saturable manner, and binding was characterized by a linear Scatchard plot with an apparent Kd of 1-2 x 10(-7) M. Phosphorylation of band 4.1 by purified protein kinase C reduced its ability to bind to membranes, resulting in a reduction in the apparent binding capacity of the membrane by 60-70% but little or no change in the apparent Kd of binding. By contrast, phosphorylation of band 4.1 by cAMP-dependent kinase had no effect on membrane binding. Digestion of the stripped inside-out vesicles with trypsin cleaved 100% of the cytoplasmic domain of band 3 but had little or no effect on glycophorin. Binding of band 4.1 to these digested vesicles was reduced by 70%. Phosphorylation of band 4.1 by protein kinase C had no effect on its binding to the digested vesicles, suggesting that the cytoplasmic domain of band 3 contained the phosphorylation-sensitive binding sites. This was confirmed by direct measurement of band 4.1 binding to the purified cytoplasmic domain of band 3. Phosphorylation of band 4.1 by protein kinase C reduced its binding to the purified 43-kDa domain by as much as 90%, while phosphorylation by cAMP-dependent kinase was without effect. These results show a selective effect of protein kinase C phosphorylation on the binding of band 4.1 to one of its membrane receptors, band 3, and suggest a mechanism whereby one of the key red cell-skeletal membrane associations may be modulated.

Cytoskeletal Proteins↗

Correlates of biopsy-studied nephropathy in young patients with insulin-dependent diabetes mellitus.

We have correlated pathologic findings in kidney biopsies from 12 adolescents with proteinuria or hypertension with severity of limited joint mobility (LJM) and retinopathy. We compared mean glucosylated hemoglobin (GHB) and clinical findings in these patients with those in patients without proteinuria or hypertension. Severity of LJM correlated with basement membrane thickening. Protein excretion correlated with degree of mesangial matrix increase and basement membrane changes. Retinal changes were related to basement membrane thickness and duplication. Despite treatment, blood pressures were significantly higher in patients with nephropathy than in the comparison group. Glycemic control status was generally poor and did not correlate with pathologic changes. The narrow spectrum of control did not permit assessment of possible effects of milder metabolic derangement. However, the similarity of GHB values in the groups with and without nephropathy implicates other factors. The group with clinical nephropathy had more LJM than did the comparison group, reaffirming LJM as a risk factor for early microvascular disease. Biopsy changes of nephropathy may begin relatively early in the course of diabetes (less than 7 years in three of our patients) and is already advanced when proteinuria appears.

Adolescent↗

Results of kidney retransplantation.

Sixty-two patients had a second renal transplant at the University of Florida, Gainesville , between Nov 30, 1966 and June 26, 1982. Two-year graft function for all 62 patients was 53.2%, and patient survival was 83.9%. The 51 recipients of cadaveric grafts had a two-year graft survival of 47%. Eleven patients who received second grafts from related donors had a two-year graft survival of 81.8%. Source of first grafts and length of survival of first grafts did not seem to be important in determining the outcome of second grafts. Recipients of cadaveric second kidneys had a significantly better two-year graft survival if they waited longer than six months between loss of the first kidney and retransplantation (52.9%) than if they waited less than six months (35.3%). We believe the results of kidney retransplantation justify second transplants in patients who lost their first grafts.

Adult↗

Comparative efficacy and safety of nalidixic acid versus trimethoprim/sulfamethoxazole in treatment of acute urinary tract infections in college-age women.

One hundred and thirty-five college-age women with acute urinary tract infections caused by gram-negative Enterobacteriaceae were treated by random allocation with either nalidixic acid (NA), 1 g every 6 h for 7 days, or trimethoprim/sulfamethoxazole (TMP/SMZ), 160/800 mg every 12 h for 10 days. The clinical and bacteriological cure rates were 98.0% in each group on the last day of therapy. At 1 and 4 week posttherapy, both the clinical and bacteriological cure rates for NA declined to 90.0 and 74.0% respectively; for TMP/SMZ, they declined to 93.0 and 72.0% respectively. By 4 weeks posttherapy, 96.0% of the TMP/SMZ group and 93.0% of the NA group had remained free of the initial urinary pathogens. Neither drug was associated with emergence of resistant bacterial mutants in urine. The antibody-coated bacteria tested (ACBT) localized 31.5% of the infections of the kidney and 67.7% to the bladder. Upper tract symptoms did not correlate with the presence of a positive ACBT. The response to therapy was similar for the two regimens regardless of ACBT results. After treatment, the emergence of resistant Enterobacteriaceae in fecal flora was 1.1% in the NA group and 2.3% in the TMP/SMZ group. The incidences of drug reactions were 7.0% with NA and 6.3% and TMP/SMZ.

Adult↗

Spectrum of multicystic renal dysplasia: diagnosis and management.

Multicystic renal dysplasia represents a spectrum of pathologic states, from unilateral multicystic kidney through segmental and focal multicystic dysplasia to bilateral multicystic kidney. Diagnosis can be established with low-risk procedures with reasonable accuracy. Treatment may be nonoperative in selected cases, but the physician must be responsible for long-term follow-up of the child until more is known about the natural history of this process.

Adolescent↗

Five-hour renal functional evaluation.

Children with urogenital disease frequently require evaluation of glomerular and tubular functions. Herein is presented a practical method of performing glomerular and tubular functional studies requiring short time periods and utilizing readily availabe laboratory techniques.

Adult↗