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

Career destinations seven years on among doctors who qualified in the United Kingdom in 1988: postal questionnaire survey.

OBJECTIVE: To report the career choices and career destinations in 1995 of doctors who qualified in the United Kingdom in 1988. DESIGN: Postal questionnaire. SETTING: United Kingdom. SUBJECTS: All doctors who qualified in the United Kingdom in 1988. MAIN OUTCOME MEASURES: Current employment. RESULTS: Of the 3724 doctors who were sent questionnaires, eight had died and three declined to participate. Of the remaining 3713 doctors, 2885 (77.7%) replied. 16.9% (608/3593; 95% confidence interval 16.1% to 17.8%) of all 1988 qualifiers from medical schools in Great Britain were not working in the NHS in Great Britain in 1995 compared with 17.0% (624/3674; 16.1% to 17.9%) of the 1983 cohort in 1990. The proportion of doctors working in general practice was lower than in previous cohorts. The percentage of women in general practice (44.3% (528/1192)) substantially exceeded that of men (33.1% (443/1340)). 53% (276/522) of the women in general practice and 20% (98/490) of the women in hospital specialties worked part time. CONCLUSIONS: Concerns about recruitment difficulties in general practice are justified. Women are now entering general practice in greater numbers than men. There is no evidence of a greater exodus from the NHS from the 1988 qualifiers than from earlier cohorts.

Career Choice↗
PubMed2004

Destination therapy with ventricular assist devices.

Despite extensive research and great strides over the past 40 years, the ideal permanent mechanical assist device remains elusive. The incidence of heart failure is increasing, and the number of heart transplants has remained constant. The HeartMate and Novacor are two pulsatile, long-term ventricular assist devices (VADs) commonly used as a bridge to transplantation. Randomized Evaluation of Mechanical Assistance in the Treatment of Congestive Heart Failure is a randomized study of device therapy in heart failure with treatment either with device (HeartMate) therapy or maximal medical therapy which was recently completed and demonstrated a Kaplan-Meier survival rate at 1 year of 52% for the device group compared to 25% in the medical therapy group. The TCI HeartMate is the only device approved for destination therapy, while others such as the Novacor device are in the process of evaluation. Most of these devices are still plagued by mechanical problems, bleeding, thromboembolism and infection. Other promising new devices include smaller VADs using impeller pump technology, such as the Arrow LionHeart, Micromed Debakey pump and Jarvik 2000 pump. The CardioVAD is an interesting chronically implantable balloon pump inserted into the descending thoracic aorta. While experience with the newer implantable pumps is growing, most of them require some manipulation of the heart perioperatively, in addition to anticoagulation postoperatively and careful monitoring for complications and infection.

Cardiotonic Agents↗
PubMed1989

Destinations of stroke patients discharged from the Montreal area acute-care hospitals.

The destinations of stroke patients after discharge from acute-care hospitals were studied to ascertain the current use of health care resources. The 1984-1985 acute-care hospital discharge listings for the province of Quebec were consulted to identify 3,045 adults of the Montreal area who were discharged, deceased or alive, with a primary or secondary diagnosis of stroke. The relation between the length of stay (i.e., the time to death or discharge to long-term care, rehabilitation, or home) and the explanatory variables (age, sex, neighborhood socioeconomic status, type of stroke, and university affiliation of the discharging hospital) was assessed using Cox's proportional hazards models. Older patients and those with hemorrhagic strokes had the highest risk of death. However, patients with hemorrhagic strokes were more likely to survive if admitted to a university teaching hospital. Older patients, those with nonhemorrhagic strokes, and those admitted to university teaching hospitals were more likely to be discharged to long-term care. A greater proportion of patients discharged to rehabilitation centers were young, lived in a high-socioeconomic-status neighborhood, and had suffered a nonhemorrhagic stroke. Patients had a significantly higher probability of going home if they were young, had had a nonhemorrhagic stroke, had been admitted to a university teaching hospital, or were male.

Age Factors↗
PubMed2001

A model of destination-language acquisition: application to male immigrants in Canada.

We develop a model using human capital theory and an immigrant adjustment process to generate hypotheses on the acquisition of destination-language skills among immigrants. The model is tested for adult male immigrants in the 1991 Census of Canada. Use of English or French is greater, the younger the age at migration, the longer the duration of residence, the higher the educational attainment, the farther the country of origin from Canada, and the linguistically closer the mother tongue to English or French, and among those who are not refugees, those from a former British, French, or American colony, and those who live in an area where fewer people speak the respondent's mother tongue. The explanatory variables based on birthplace have behavioral interpretations and possess almost as much explanatory power as the birthplace dummy variables.

Adult↗
PubMed2001

Intestinal and blood parasites in Amazon parrots destined for relocation in Guatemala.

Approximately 350 Amazon parrots were destined for relocation in Peten province, northeastern Guatemala. In random sampling of the parrots, 95 blood and 75 fecal samples were examined individually for parasites. Coccidia were present in 6.0% (3/50) of Amazona autumnalis autumnalis, and they were the only parasites detected. There were no blood parasites observed in 64 A. a. autumnalis, four Amazona pionus senilis, 16 Amazona ferinosa guatemala, 10 Amazona albifronsus albifronsus, and one Amazona xantholora. No fecal parasites were observed in four A. p. senilis, 12 A. f. guatemala, eight A. a. albifronsus, and one A. xantholora.

Animals↗
PubMed2000

Detection of Cryptosporidium oocysts in bivalve molluscs destined for human consumption.

Clams (Dosinia exoleta, Ruditapes philippinarum, Venerupis pullastra, Venerupis rhomboideus, Venus verrucosa), mussels (Mytilus galloprovincialis), and oysters (Ostrea edulis) were tested for the presence of Cryptosporidium sp. oocysts using various stain techniques and a commercially available kit containing fluorescein isothiocyanate-conjugated monoclonal antibodies. All molluscs were harvested in northwest Spain (Galicia) except for R. philippinarum, which was from Italy, and 1 of the 6 oyster samples, which was from England. The results showed the presence of Cryptosporidium sp. oocysts in all of the molluscan species destined for human consumption.

Animals↗
PubMed2002

Is reduced first-phase insulin release the earliest detectable abnormality in individuals destined to develop type 2 diabetes?

Insulin is released from the pancreas in a biphasic manner in response to a square-wave increase in arterial glucose concentration. The first phase consists of a brief spike lasting approximately 10 min followed by the second phase, which reaches a plateau at 2-3 h. It is widely thought that diminution of first-phase insulin release is the earliest detectable defect of beta-cell function in individuals destined to develop type 2 diabetes and that this defect largely represents beta-cell exhaustion after years of compensation for antecedent insulin resistance. In this article, the origins of these concepts are reviewed and recent evidence is presented suggesting that reductions in both phases of insulin release are equally early, that they precede insulin resistance other than that simply due to obesity, and that they therefore may represent the primary genetic risk factor predisposing individuals to type 2 diabetes.

Diabetes Mellitus, Type 2↗
PubMed1987

Characterization of ovine follicles destined to form subfunctional corpora lutea.

A study was done to test whether ovulatory follicles destined to form subfunctional corpora lutea differed from normal ovulatory follicles in steroidogenic function. Twenty-five ewes were treated with prostaglandin F2 alpha on d 11 of the estrous cycle, then unilaterally ovariectomized before (n = 13) or after (n = 12) the surge of luteinizing hormone (LH) at the induced estrus to collect "control" follicles, which would have produced normal corpora lutea. In 15 ewes, the second ovary was removed 63 to 84 h later to collect "treated" follicles before (n = 7) or after (n = 8) the second expected surge of LH. Five ewes (control) were allowed to ovulate from the remaining ovary at first estrus and another five (treated) at the second estrus (3 to 4 d later). Treated ewes had lower serum progesterone than control ewes during the ensuing cycle (P less than .05). Treated follicles contained less estradiol in the theca (4.4 +/- .6 vs 10.0 +/- 2.5 ng; P less than .05), less androstenedione (.1 +/- .1 vs 1.0 +/- .2 ng) and estradiol (.5 +/- .1 vs 2.9 +/- 2.2 ng) in the granulosa (P less than .05) and less progesterone in the follicular fluid (.8 +/- .4 vs 3.3 +/- .8 ng; P less than .05) than control follicles, when removed before the surge of LH. Follicles removed after the surge of LH did not differ. In conclusion, ovulatory follicles with low steroidogenic function became corpora lutea that secreted lower-than-normal quantities of progesterone.

Androstenedione↗
PubMed1995

[Factors influencing users' destination upon discharge from a geriatric intermediate care facility in an urban area].

Geriatric Intermediate Care Facilities (GICF) have been established to help the hospitalized elderly return home. Users of the GICF are elderly persons who do not need hospitalization, but are mentally or physically impaired. To determine what factors influence users' destinations upon discharge from GICF, we analyzed various characteristics such as age, sex, place of residence before admission, length of stay, intellectual impairment, ability to perform activities of daily living (ADL) among users (N = 389) in a GICF in Chiba City. Multiple logistic regression analyses revealed that, compared with the users who were hospitalized, users who were male, admitted for home, stayed for long periods, and had a high ability to perform ADL were more likely to return home. The analyses also revealed that, compared with the users who were institutionalized, users who came from home, stayed for short periods, and had a high ability to perform ADL were more likely to return home. Evaluating a user's physical, mental, and socioeconomical conditions at an early stage of admission to a GICF may allow us to predict whether the user can be successfully discharged to his or her home or will have to remain at the GICF for an extended period.

Activities of Daily Living↗
PubMedDate not supplied

The destination and dependency of patients discharged from care of the elderly units in the West Midlands.

Between November 1988 and January 1989 a prospective survey was undertaken on patients aged 65 years and over who were discharged from the care of geriatricians in seven District General Hospitals. The survey aimed to provide a regional perspective on patient dependency by relating dependency at discharge to the discharge destination. The findings show that the majority of patients were relatively independent and most returned home. A significant number of the very dependent patients were discharged to the community with private residential and nursing homes making an important contribution to the placement of highly dependent patients.

Activities of Daily Living↗
PubMed2000

[Advice to HIV infected persons travelling to tropical or subtropical destinations].

Many HIV-infected persons travel from temperate zones to (sub)tropical destinations. HIV-specific immigration issues, medical resources abroad and problems regarding travel with multiple medication need to be anticipated. When prescribing immunisations and specific chemoprophylaxis, the stage of immunodeficiency as well as drug interactions with antiretrovirals must be taken into account. Live vaccines may be contraindicated. With good pretravel advice the risk of severe health problems is low for most HIV-infected travellers.

Anti-HIV Agents↗
PubMed2001

Migration, social support and perinatal health: an origin-destination analysis of Puerto Rican women.

Using pooled origin-destination data from the Puerto Rican Maternal and Infant Health Study, we investigate linkages between migration, social support, and perinatal health. We document differences in social support between three groups of Puerto Rican women: non-migrant women in Puerto Rico, first-generation migrants to the U.S. mainland, and mainland-born women. The role of social support in producing differences in perinatal health outcomes between the groups is assessed. The analysis shows striking differences in social support between island and mainland women, but little systematic variation among mainland women by generation of U.S. residence. The lower level of social support available to mainland women is not reflected in the health outcomes examined, which do not generally worsen with migration to the United States (with the exception of maternal smoking). Nonetheless, we show that social support has important implications for stress, which in turn increases the risk of poor health behavior and compromised infant health.

Family Health↗
PubMed2003

Ischemic insults derepress the gene silencer REST in neurons destined to die.

A subset of genes implicated in genetic and acquired neurological disorders encode proteins essential to neural patterning and neurogenesis. The gene silencing transcription factor neuronal repressor element-1 silencing transcription factor (REST)/neuron-restrictive silencer factor (NRSF) plays a critical role in elaboration of the neuronal phenotype. In neural progenitor and non-neural cells, REST acts by repression of a subset of neural genes important to synaptic plasticity and synaptic remodeling, including the AMPA receptor (AMPAR) subunit GluR2. Here we show that global ischemia triggers REST mRNA and protein expression. REST suppresses GluR2 promoter activity and gene expression in neurons destined to die. Because the GluR2 subunit governs AMPAR Ca2+ permeability, these changes are expected to have profound effects on neuronal survival. In keeping with this concept, acute knockdown of the REST gene by antisense administration prevents GluR2 suppression and rescues post-ischemic neurons from ischemia-induced cell death in an in vitro model. To our knowledge, our study represents the first example of ischemia-induced induction of a master transcriptional regulator gene and its protein expression critical to neural differentiation and patterning in adult neurons. Derepression of REST is likely to be an important mechanism of insult-induced neuronal death.

Animals↗
PubMed2004

[Length of hospital stay, mortality and destination after discharge of stroke patients].

Stroke remains an important cause of death, hospitalisation and chronic disability in developed populations. This study aimed to evaluate patients characteristics at admission that relate to length of hospital stay, mortality and destination of stroke patients. We studied 255 consecutive stroke patients admitted to internal medicine wards of Hospital São João, Porto. In-hospital mortality was 5.5%. In a multivariate analysis, we found male sex, paralysis in affected limb and intracerebral haemorrhage as significantly associated with longer hospitalisation. None of the studied characteristics was found to be independently associated with mortality. Previously living at an institution was significantly associated with discharge to an institution. This study showed that admission characteristics may provide relevant information to assess short term prognosis and to identify patients with special difficulties and needs.

Adult↗
PubMed1990

In vitro testing method of polymers candidate destined for contact with blood.

Research aiming at obtaining athromobogenic biomaterials destined for contact with blood have been the subject of interdisciplinary studies carried out since 1980. When testing candidate materials, it is advisable that preliminary classification as well as elimination of materials not conforming to the requirements of athromobogenesis should be performed. Practicable laboratory methods were selected facilitating in vitro evaluation of materials of modified surface and conforming to the definite requirements. The testing of candidate materials of athromobogenic properties comprises basic research methods enabling instantaneous classification. The applied experimental model comprises the following: scanning electron microscopy (SEM), thromboelastography (TEG), formula: [see text] examining clotting systems by determining calcium, cephalincalcium times as well as the amount of blood platelets, biochemical examination. Application of the above-mentioned methods enables objective preliminary evaluation of candidate materials that may be applied in obtaining implantation products and medical appliances for the contact with blood.

Blood↗
PubMed1985

A synthetic signal peptide blocks import of precursor proteins destined for the mitochondrial inner membrane or matrix.

A peptide corresponding to amino acids 1-27 of preornithine carbamyltransferase (pOCT) has been chemically synthesized. When added to energized mitochondria in vitro, 20 microM of the peptide, designated pO(1-27), resulted in a collapse of the electrochemical potential across the mitochondrial inner membrane. This effect on transmembrane potential was not observed, however, when pO(1-27) was added to energized mitochondria under conditions that support in vitro import of precursor proteins (i.e. in the presence of reticulocyte lysate). The latter finding, therefore, made possible an examination of the ability of pO(1-27) to block import of homologous and heterologous proteins into the organelle. At 5-10 microM, pO(1-27) prevented import of pOCT in vitro; inhibition was overcome by increasing the concentration of pOCT. In contrast, pO(16-27), a peptide corresponding to amino acids 16-27 of pOCT and exhibiting a charge:mass ratio similar to pO(1-27) had no such inhibitory effect. pO(1-27) blocked import of other unrelated precursor proteins destined either for the mitochondrial matrix (pre-malate dehydrogenase and a hybrid protein containing the signal sequence of pre-carbamyl phosphate synthetase) or for the mitochondrial inner membrane (pre-thermogenin).

Amino Acid Sequence↗
PubMed1982

Incorporation of 5-bromo-2'-deoxyuridine into mesenchymal limb-bud cells destined to die: relationship to polydactyly induction in rats.

The thymidine analogue, 5-bromo-2'-deoxyuridine (BUdR), given at the proper dose and time to pregnant rats produces preaxial hindlimb polydactyly in a high proportion of near term foetuses. The lack of physiological cell death in an area of preaxial mesenchyme known as the foyer primaire preaxial (fpp) is thought to be important in the pathogenesis of this defect. This study addresses the question of whether BUdR's well-known antidifferentiative effects, which are due in some way to drug incorporation into DNA, are operative in this in vivo system. The dose and temporal response of BUdR for the induction of preaxial polydactyly inversely parallels the frequency of embryonic hindlimbs with an fpp. Incorporation of BUdR into degenerative fragments within the fpp of these treated limbs is demonstrated with indirect immunofluorescence using an antibody to bromouridine. Hindlimbs exposed to a threshold dose of BUdR at the optimal time for producing polydactyly have incorporated the drug into degenerative fragments within the fpp. This suggests that a higher, teratogenic dose of BUdR might likewise be incorporated. The resulting higher level of incorporation presumably alters the normal course of terminal differentiation for these cells originally destined to die. Teratogenic doses of BUdR injected at later than the optimal time are also incorporated into dead cell fragments within the fpp, suggesting that presumptive dead cells have additional rounds of DNA synthesis which are BUdR-insensitive. Approximately 12 h prior to overt death presumptive fpp cells no longer incorporate the drug. Results reported support the hypothesis that incorporation of teratogenic levels of BUdR prevent cell death in the fpp. The extra cells are thought to contribute directly or indirectly to the added digit. Contrary to other views, it is suggested that BUdR-induced teratogenesis can be a result of the drug's antidifferentiative effects on specific, 'sensitive', populations of cells.

Abnormalities, Drug-Induced↗