Search PubMed⌕ Search

Biomedical subjects

S Kenny

Publications and source records attributed to S Kenny.

16 recordsLinked to original sources
PubMed2004

Nutrition in the community--an exploratory study of oral nutritional supplements in a health board area in Ireland.

BACKGROUND: A review of the General Medical (Payments) Scheme data in the Midland Health Board (MHB) Ireland identified a spend of just over euro 0.5 million on enteral nutritional supplements (oral and tube feeds) in an 11-month period in 1998 [General Medical Services (Payments) Board, 1998, MHB Clinical Nutritional Products: January-December 1998, Dublin]. In 2000, a figure of euro5 million was reported as the annual spend (oral and tube feeds) [General Medical Services (Payments) Board, 2000, MHB Clinical Nutritional Products: January-December 2000, Dublin]. Research has shown that a high proportion of Oral Nutritional Supplements (ONS) are inappropriately prescribed by primary care practitioners (Gall et al., 2001). The role of General Practitioners (GPs) and Public Health Nurses (PHNs) in prescribing ONS to patients aged 65 years and older was examined, as they are directly involved in the delivery of primary health care. AIM: (i) Assess current trends, decision-making processes and monitoring procedures in the use of ONS for older patients in the community. (ii) Identify whether nutritional assessments and appropriate nutritional criteria are standard practice in determining selection of ONS. METHODS: A study was conducted among 99 GPs and 120 PHNs in the MHB. All GPs were selected to participate and 50% (60) of PHNs were randomly selected. A telephone questionnaire was administered to each subject over a 2-week period. RESULTS: Both GPs (78%) and PHNs (47%) reported that their prescription of/recommendations for ONS had increased in the last 4 years. None conducted a full nutritional assessment, but 25% of PHNs used a Nutrition Screening Tool when trying to ascertain whether a patient requires an ONS. Only 19.6% of GPs and 6.8% of PHNs surveyed were aware of the calorie content of a standard 200 mL ONS (sip-feed). In addition, a very significant proportion of both GPs and PHNs do not appear to give appropriate dietary advice to patients who may be at risk of malnutrition. Only 55% of GPs stated that they would specifically review a patient's ONS prescription. All GPs said that they would not conduct a full nutritional assessment at the review appointment. CONCLUSION: The results of this study raise concerns as to the appropriateness of current ONS prescription and monitoring in the community. They also highlight the need for further intervention in the primary care setting in order to ensure that elderly malnourished patients are detected, treated and monitored in an appropriate and cost-effective manner.

Administration, Oral↗
PubMed2004

Zinc ion release from novel hard tissue biomaterials.

Zinc polyalkenoate cements (ZPCs) and glass polyalkenoate cements (GPCs) are used routinely in dentistry, but have potential for orthopaedic applications as they set at body temperature without shrinkage or significant heat evolution. However, the materials have drawbacks; ZPCs are biocompatible in implant studies, but a fibrous collagen capsular layer forms adjacent to the cement. GPCs are bioactive in the bone environment as a result of the release of calcium, phosphate and fluoride ions, as well as the formation of a silicious gel phase, but research has shown that aluminum ions released result in defective bone mineralisation and as a consequence the ability of these cements to chemically bond to bone is lost. Two approaches have been developed to overcome these problems. The ZPC route considers a ZnO : hydroxyapatite (HA) : poly(acrylic acid) (PAA) mixture, the HA incorporated to improve bioactivity. The GPC route employs a calcium zinc silicate glass; the zinc taking the role that aluminum plays in conventional GPCs. This study has shown that cements can be formulated by an acid base reaction between PAA and both calcium zinc silicate glasses (GPCs) and a mixture of hydroxyapatite and zinc oxide (ZPCs). The moduli of these cements are comparable to both bone and conventional acrylic cements, highlighting their potential for biomedical applications. Unfortunately, both materials have previously been shown to be toxic by cell culture methods, as a result of high zinc ion release, and so it is necessary to study ion release profiles of the cements in order to determine the magnitude of this release. Considering the ZPCs, the modulus of the cement has an inversely proportional relationship to the zinc ion release. From the data presented it is clear that increases in polymer concentration results in lower amounts of zinc ions being released, whilst molar mass of the PAA has no influence. Therefore it would appear that polymer concentration has a significant influence over ion release. Generally, the amount of Zn(2+) released decreases with increasing HA content and/or decreasing ZnO content. Considering the GPCs, the materials are all seen to release large amounts of the active ion, when compared to the commercial versions. The extent of this release increases with temperature and agitation. The release could be minimised by an increased P : L mixing ratio, and an increased PAA concentration, which would produce a more cross-linked cement matrix. Minimising the release of the active ion should improve the in vitro bioactivity of both materials. However, for a full understanding of the clinical benefits of such materials, an in vivo study would be required.

Biocompatible Materials↗
PubMed2000

The influence of poly(acrylic acid) molar mass on the properties of polyalkenoate cements formed from zinc oxide/apatite mixtures.

The influence of poly(acrylic acid) molar mass was investigated on cements formed from zinc oxide-apatite mixtures at three aging times; one, seven and 28 days. Cements based on both hydroxyapatite and fluorapatite were investigated. The compressive strength, un-notched fracture strength and fracture toughness increased markedly with poly(acrylic acid) molar mass. The fracture toughness and un-notched fracture strength increased with aging time for the two highest molar mass cements, but decreased with time for the two lowest molar mass cements. The greater chain entanglement density present in the higher molar mass cements is thought to contribute significantly to the cement stability in addition to the crosslinking of the polyacrylate chains by calcium and zinc ions. Substitution of hydroxyapatite by fluorapatite had no significant influence on the mechanical properties of the cements at aging times longer than one day.

Journal Article↗
PubMed1995

Proteinuria and mortality in diabetes: the WHO Multinational Study of Vascular Disease in Diabetes.

The relation between proteinuria and mortality was investigated in 1188 patients with Type 1 diabetes and 3234 patients with Type 2 diabetes, aged 35-55 at baseline and followed up for a mean of 9.4 +/- 3.1 years in the WHO Multinational Study of Vascular Disease in Diabetes. Baseline prevalence of light or heavy proteinuria was the same (25%) in both types of diabetes after adjustment for differences in diabetes duration. Compared with patients with no proteinuria, all cause mortality ratios were 1.5 (95% confidence interval 1.1-2.0) and 2.9 (2.2-3.8) for Type 1 patients with light and heavy proteinuria, respectively, and 1.5 (1.2-1.8) and 2.8 (2.3-3.4) for Type 2 patients, after adjustment for age, duration of diabetes, blood pressure, cholesterol, and smoking. Proteinuria was associated with significantly increased mortality from renal failure, cardiovascular disease, and all other causes of death. In both types of diabetes, the association was strongest for renal deaths, and of similar magnitude for cardiovascular and all other causes of death. In conclusion, proteinuria is a common, important, and rather non-specific risk factor for increased morbidity and mortality in diabetes. The relation of proteinuria to mortality is similar for both types of diabetes. The benefits and risks of proteinuria reduction should be examined in large randomized trials with clinical endpoints.

Adult↗
PubMed1993

New home-delivered training prospects for people with disabilities.

The 'Home-Delivered Training Project' set out to test the viability of providing training in Information Technology to people with physical disabilities in their homes, using computers and modem links. The course included core modules on business applications software and optional modules on more specialist applications. The computer-based approach to instruction included computerized monitoring of student progress, the provision of on-line tutorial support as well as computerized test administration and marking. The 20 course participants, who lived in locations throughout Ireland, were unable to attend conventional training centres because of their limited mobility or other restrictions arising from their disabilities. They differed considerably in terms of disability type, educational qualifications and experience with computers. All but one of them completed the course successfully and were awarded certificates which are recognized in Ireland and the United Kingdom. Overall, they were very positive about the course, mainly because they could undertake it in their homes at a flexible pace to suit their learning patterns and the requirements of their disabilities. They recognized, however, that studying at home required a self-disciplined study routine which was not always easy to maintain. The fact that they were awarded an internationally recognized qualification on completion of the course was an important motivating factor, as it made the course relevant in terms of their employment aspirations.

Accreditation↗
PubMed1993

A follow-up study of diabetic Oklahoma Indians. Mortality and causes of death.

OBJECTIVE: To determine the mortality rates and causes of death for diabetic Oklahoma Indian adults by sex and age. RESEARCH DESIGN AND METHODS: This was a cohort follow-up study with baseline examination between 1972-1980 and the mortality follow-up between 1986 and 1989. Mean follow-up time was 10 +/- 4 yr. A quasi-random sample of 1012 (379 men and 633 women) NIDDM American Indians in Oklahoma was performed. Mean age was 52 yr and duration was 7 yr at baseline. Mean degree of Indian blood was 92% (77% full blood). At follow-up, 548 (54%) were alive, 452 (45%) were decreased, and 12 (1%) could not be traced. RESULTS: Death certificates were obtained and coded (ICD-9) for 439 (97%) of the deceased. Mean annual mortality rates were 4.99% for men and 4.17% for women, with an increasing trend with age for both sexes. Compared with the general population of Oklahoma, the observed/expected ratios for number of deaths were 2.92 for men and 4.09 for women (P < 0.0001). The three leading causes of death were circulatory disease (38%), diabetes (24%), and malignant neoplasms (12%). CONCLUSIONS: There is an excessively high mortality among diabetic Oklahoma Indians compared with the general population in the state and with diabetic patients in other populations.

Adult↗
PubMed1991

Effects of secretin and caerulein on enzymes of cultured pancreatic acinar cells.

We examined the effects of secretin (0 to 200 nM) and caerulein (0 to 100 nM) on rat pancreatic acinar cells cultured 0 to 48 h in serum-free medium. The effects of 100 nM secretin with 1 nM caerulein were also studied because secretin may potentiate the effects of caerulein. Cellular and media (secreted) lipase and amylase were analyzed as were cellular DNA and protein content. Cellular lipase and amylase activities significantly decreased (P less than 0.0001) over time in all treatment groups, whereas media amylase and lipase significantly increased (P less than 0.0001). Neither secretin nor caerulein affected cellular lipase or media amylase. However, secretin significantly increased (P less than 0.04) and caerulein tended to increase (P less than 0.08) media lipase in a dose-dependent manner. At 12 h, 10 nM secretin maximally increased media lipase (58%) suggesting that cultured acinar cells remain responsive to secretin in vitro. Caerulein, at all concentrations, significantly decreased (P less than 0.001) cellular amylase but exhibited a dose-dependent effect only at 24 h when 100 nM caerulein maximally decreased cellular amylase (34%). Secretin (100 nM) did not alter these effects of caerulein. These results support the proposed role of caerulein in the regulation of amylase but not a direct role of secretin in the regulation of lipase.

Amylases↗
PubMed1990

Localization by mutational analysis of transcription factor binding sequences in the U3 region of Rous sarcoma virus LTR.

The transcription factor binding sequences in the U3 region of Rous Sarcoma virus LTR have been determined by gel retardation assays using mutant synthetic oligonucleotides. The results indicate that the factor, E2BP, specifically binds to sequences TGCAATAC and TGCAACAT, which are localized between nucleotides -222 to -215 and -203 to -196, respectively. This factor is present at elevated levels in avian QT6 cells compared to mouse 3T3 and rat 2 tk- cells. E2BP binds to a sequence that is similar or identical to the sequence recognized by rat liver C/EBP. However, the two proteins are different as judged by three criteria: (i) the E2BP complex migrates slightly faster than the E2-C/EBP complex; (ii) antibodies against C/EBP neither inhibit binding of E2BP nor form a supercomplex which migrates slower than the complex formed with the factor alone; and (iii) E2BP is heat labile whereas C/EBP is heat stable. Another factor, E3BP, which binds to a sequence from -169 to -158, in the U3 region is also detected mainly in QT6 cells but not in mouse or rat cells. These results suggest that different cell-specific factors interact with different cis-acting regulatory sequences in the U3 region of RSV LTR.

Animals↗
PubMed1990

Telework as an employment option for people with disabilities.

This feasibility study, based on intensive casework, examined the potential of home-based teleworking arrangements for people with severe physical disabilities. Eleven teleworking arrangements, each involving a unique combination of work, working conditions and worker characteristics, were set up in different parts of Ireland and monitored over periods ranging from 6 to 18 months. Eight were still operational at the end of the project and, with one exception, were set to continue as longer-term arrangements. Outcomes from this action-research project suggest that teleworking is a feasible form of employment for such persons--provided care is taken over selection of workers, identification of work that is suited to the telework format and management of telework units by employers. They also suggest that teleworking arrangements can be quite flexible, ranging from examples in which work is performed mainly from home to those which combine home-based activity with varying degrees of conventional office-based activity. It is concluded that telework will create new opportunities for people with severe disabilities, as well as enabling others who become disabled during employment to retain their jobs. However, it is important that workers are appropriately trained in the use of computers and advanced telecommunications and, in many cases, home-delivered training is required.

Adult↗
PubMedDate not supplied

The influence of hydroxyapatite: zinc oxide ratio on the setting behavior and mechanical properties of polyalkenoate cements.

The influence of hydroxyapatite (HA) content on the setting behavior and mechanical properties of hydroxyapatite-zinc oxide-poly(acrylic acid) (HA-ZnO-PAA) composite cements were investigated as a function of HA content. The working time increased with HA content up to 45 wt % HA and then decreased whilst the setting time increased with increasing HA content. Mechanical properties were determined after storage in water at 37 degrees C for 1, 7 and 28 days. Young's moduli and compressive strength go through a maximum at approximately 30 and 45 wt % HA. Young's modulus increases with time, which is consistent with an ongoing crosslinking reaction.

Journal Article↗