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Biomedical subjects

C Carlisle

Publications and source records attributed to C Carlisle.

At least 19 recordsLinked to original sources
PubMed2003

Opportunistic screening for genital chlamydial infection. I: acceptability of urine testing in primary and secondary healthcare settings.

OBJECTIVES: To determine the acceptability of opportunistic screening for Chlamydia trachomatis in young people in a range of healthcare settings. DESIGN: An opportunistic screening programme (1 September 1999 to 31 August 2000) using urine samples tested by ligase chain reaction (LCR). Data on uptake and testing were collected and in-depth interviews were used for programme evaluation. SETTING: General practice, family planning, genitourinary medicine clinics, adolescent sexual health clinics, termination of pregnancy clinics, and women's services in hospitals (antenatal, colposcopy, gynaecology and infertility clinics) in two health authorities (Wirral and Portsmouth and South East Hampshire). Main participants: Sexually active women aged between 16 and 24 years attending healthcare settings for any reason. MAIN OUTCOME MEASURES: Uptake data: proportion of women accepting a test by area, healthcare setting, and age; overall population coverage achieved in 1 year. Evaluation data: participants' attitudes and views towards opportunistic screening and urine testing. RESULTS: Acceptance of testing by women (16-24 years) was 76% in Portsmouth and 84% in Wirral. Acceptance was lower in younger women (Portsmouth only) and varied by healthcare setting within each site. 50% of the target female population were screened in Portsmouth and 39% in Wirral. Both the opportunistic offer of screening and the method of screening were universally acceptable. Major factors influencing a decision to accept screening were the non-invasive nature of testing and treatment, desire to protect future fertility, and the experimental nature of the screening programme. CONCLUSIONS: An opportunistic model of urine screening for chlamydial infection is a practical, universally acceptable method of screening.

Adolescent↗
PubMed2003

Opportunistic screening for genital chlamydial infection. II: prevalence among healthcare attenders, outcome, and evaluation of positive cases.

OBJECTIVES: To determine the prevalence and treatment outcomes among young women screened opportunistically for genital Chlamydia trachomatis and to evaluate the impact of screening in those participating. DESIGN: An opportunistic screening programme (1 September 1999 to 31 August 2000) using urine samples, tested by ligase chain reaction (LCR). In-depth interviews were used for programme evaluation. SETTING: Screening was offered in two health authorities at general practice, family planning, genitourinary medicine (GUM), adolescent sexual health, termination of pregnancy clinics and women's services in hospitals (antenatal, colposcopy, gynaecology and infertility clinics). Main participants: Sexually active women (16-24 years) attending for any reason. MAIN OUTCOME MEASURES: Screening data: prevalence of infection by age and healthcare setting; proportion of positive patients attending for treatment. Evaluation data: participants' attitudes and views towards screening and follow up. RESULTS: In total, 16 930 women (16-24 years) were screened. Prevalence was higher in younger women (16-20) than those aged 21-24 years and was highly variable at different healthcare settings (range 3.4%-17.6%). Prevalence was approximately 9% in general practice. The role of the project health advisers in managing results and coordinating treatment of positive individuals was essential; the vast majority of all positives were known to be treated. Women felt that screening was beneficial. Improving awareness and education about sexually transmitted infections is required to alleviate negative reactions associated with testing positive for infection. CONCLUSIONS: Prevalence of infection outside GUM clinics is substantial and opportunistic screening using urine samples is an acceptable method of reaching individuals with infection who do not normally present at specialist clinics.

Adolescent↗
PubMed2001

Developing an evidence base for interdisciplinary learning: a systematic review.

AIM OF THE STUDY: The overall aim of the study was to explore the feasibility of introducing interdisciplinary education within undergraduate health professional programmes. This paper reports on the first stage of the study in which a systematic review was conducted to summarize the evidence for interdisciplinary education of undergraduate health professional students. METHODS: Systematic reviews integrate valid information providing a basis for rational decision making about health care which should be based on empirical and not anecdotal evidence. The accepted principles for systematic reviews were adapted in order to allow integration of the literature to produce recommendations for educational practice and guidelines for future research. FINDINGS: The literature on interdisciplinary education was found to be diverse, including relatively small amounts of research data and much larger amounts of evaluation literature. Methodological rating schemes were used to test for confounding influences in the research studies. The number of studies found was 141 but only 30 (21%) were included in the analysis because of lack of methodological rigour in the research and poorly developed outcome measures. CONCLUSIONS: Student health professionals were found to benefit from interdisciplinary education with outcome effects primarily relating to changes in knowledge, skills, attitudes and beliefs. Effects upon professional practice were not discernible and educational and psychological theories were rarely used to guide the development of the educational interventions.

Education, Professional↗
PubMed2000

Did Project 2000 nurse training change recruitment patterns or career expectations?

In the UK, Project 2000 nurse education, introduced over the last eight years, aimed to increase the professional status of nurses and enhance skills, focusing on wider community care. This paper reports some of the results from a research project conducted between 1994 and 1996, funded by the Department of Health (Project 2000 Fitness for Purpose 1996). It was hypothesized that the changes in Project 2000 training might attract those more academically qualified and lead to more rapid career progression. The results found in this study did not support either of these hypotheses and suggestions are made about the reasons for the negative findings.

Adult↗
PubMed2000

Choices and control: parental experiences in pediatric terminal home care.

During the past decade, palliative care at home has become an alternative option to hospital care for terminally ill children. This study describes the experience of caring for a dying child at home from a parent's perspective. A qualitative research design was used to conduct and analyze data. Nonstandardized, focused interviews were conducted with 10 families. Thematic content analysis assisted in deriving themes from the transcripts of the interviews. "Choice and control" was the major theme that linked all the other concepts, and it appeared to be fundamental to parental coping strategies. Most parents were willing to take responsibility for the nursing care of their child, including administration of intravenous medication. The patient's home was the overwhelming choice of parents for delivery of terminal care, with most parents perceiving it as their child's choice also.

Adaptation, Psychological↗
PubMed2000

The search for meaning in HIV and AIDS: the carers' experience.

This article explores informal carers' experiences in caregiving for people living with HIV and AIDS. The search for meaning encompasses the ways in which carers find meaning in caregiving. A grounded theory approach was taken. Data were collected by means of 43 in-depth interviews and participant observation. Caregivers felt that it was important to have control over the emphasis that HIV had within their lives and developed an attitude that put the virus in perspective. Getting involved in HIV and AIDS work outside of the immediate caregiving relationship was evident. The motivation for this was in part a reaction to prevailing societal views on HIV and in part altruistic in that it provided further meaning for the caregiving experience. This study suggests that finding meaning in caregiving is a powerful way to achieve a balance between the costs of caregiving and personal reward.

Caregivers↗
PubMed1999

Sex reversal caused by Mus musculus domesticus Y chromosomes linked to variant expression of the testis-determining gene Sry.

When the Y chromosomes from certain populations of Mus musculus domesticus are introduced into the mouse strain C57BL/6 (B6), testis determination can fail, resulting in gonads developing either as ovotestes (with both ovarian and testicular components) or as ovaries. Not all Y(DOM) chromosomes cause sex reversal. Y(DOM) chromosomes are divided into three classes based upon their ability to induce testes in B6. The molecular basis underlying the three Y(DOM) classes is an enigma. The simplest explanation is that they harbor different alleles of the testis-determining gene, Sry. Sequencing of Sry(DOM) genes has indeed identified polymorphisms. However, none were unequivocally linked to the sex-reversal trait. It was concluded that all SRY(DOM) proteins are functionally equivalent. Using a semiquantitative RT-PCR assay, we now show that representatives of the three Y(DOM) classes have variant Sry expression patterns, that severity of sex reversal correlates with Sry mRNA titers, and that genetic correction of the sex reversal results in the upregulation of Sry expression. We propose that the variant Sry expression patterns result from polymorphisms at the site of a putative Sry enhancer.

3' Untranslated Regions↗
PubMed1999

Skills competency in nurse education: nurse managers' perceptions of diploma level preparation.

This paper reports on part of a national study conducted between 1994 and 1996, the overall aim of which was to examine the 'fitness for purpose' of the Project 2000 nursing education reforms. The study used multiple methods of data collection, including an individual and group interview study of nurse managers (n = 132) and a national survey of Project 2000 diplomates and traditionally prepared registered nurses (n = 5417). Findings in relation to the managers' expectations and experiences of diplomates are presented. This includes views on the level of skills achievement and skills acquisition of diploma level education. The qualities of the diplomates are discussed and this includes those areas where the skills of the diplomates are felt to achieve what is required of the role. Also included is an exploration of those skills which the managers felt fell short of expectations. Managers raised the long-standing concerns of clinical skills and competencies and discussed these in relation to the changing health care environment and the relative roles of other health care workers. The conclusions highlight the need to identify what could be seen as the 'core skills' required of a registered nurse and the need to explore the environment in which the diplomate takes up first appointment.

Clinical Competence↗
PubMed1998

Ovotestes in B6-XXSxr sex-reversed mice.

The sex-reversed mutation Sxr results in XX males. In the absence of any other mutations, testis differentiation in XXSxr fetuses is essentially normal and only one report of an XXSxr fetus with ovotestes is in the literature. We report that 84% (21/25) of 13 days postcoitum XXSxr fetuses on the B6 inbred genomic background have ovotestes. Ovotestes were found in fetuses from both Sxra and Sxrb variants. Examination of fetuses older than 13 dpc suggests that the presence of ovotestes is transient in most fetuses. However, one overt hermaphrodite was identified after birth. The development of ovotestes is associated with the inbred background and is exacerbated by the dominant spotting oncogene allele KitW-42J. We propose that spreading of X-inactivation into the Sxr region resulting in loss of Sry expression is more extensive in B6-Sxr strains.

Animals↗
PubMed1997

The implications of Project 2000 and the formation of links with higher education for the professional and academic needs of nurse teachers in the United Kingdom.

A national study was conducted between 1991 and 1994 to explore and describe the changing role of the nurse teacher following the introduction of Project 2000 pre-registration nursing courses. Multiple methods were used to collect data from a wide variety of respondents (nurse teachers, midwife teachers, clinical nurses, health service managers and higher education lecturers). This paper presents the findings relating to the impact of Project 2000 and the move into higher education on the continuing educational needs of nurse teachers. Views on college strategies for staff development, the changing nature of teachers' academic and professional development needs and the problems of the conflicting demands experienced are reported. The research highlights the need for clinical credibility to be clearly defined in relation to nurse teachers and for educational institutions to place more emphasis on teachers' clinical development if the rhetoric of policy is to become a reality.

Attitude of Health Personnel↗
PubMed1997

The clinical role of nurse teachers within a Project 2000 course framework.

This paper reports on part of a national study that was conducted over a 3-year period (1991-1994). The overall aim of the study was to explore the changing role of the nurse teacher. Multiple methods of data collection were used, including a modified Delphi survey, a case study and telephone interviews. The sample included a wide variety of respondents (nurse teachers, midwife teachers, clinical nurses, health service managers and higher education lecturers). Findings in relation to the clinical role of the nurse teacher within a Project 2000 course framework are presented. This includes the nature of the clinical role, views on linking theory and practice, and potential barriers to the nurse teacher's clinical role. The future role of nurse teachers within the clinical area is discussed and this includes suggestions for the ways in which a nurse teacher's clinical commitment could be facilitated. Issues relating to the role of lecturer/practitioner are also highlighted.

Curriculum↗
PubMed1997

Effects of menopause and nasal occlusion on breathing during sleep.

Prevalence of sleep-disordered breathing (SDB) is reported to increase in menopausal women. We examined response to a nocturnal respiratory challenge (nasal occlusion) during overnight polysomnography in 31 women (45 to 55 yr). Thirteen were premenopausal, four perimenopausal, and 14 postmenopausal by history and hormonal assay. Nasal occlusion increased the apnea hypopnea index (AHI) (occlusion mean = 6.6 +/- 8.0 versus baseline mean = 1.6 +/- 2.6, p < 0.01) and arousal index (occlusion mean = 35.1 +/- 20.1 versus baseline mean = 20.7 +/- 11.6, p < 0.001), but did not change the oxygen saturation nadir in those with respiratory events (occlusion mean = 91.8 +/- 4.2 versus baseline mean = 92.0 +/- 11.6). Menopausal groups did not differ on AHI, arousal index, or oxygen saturation nadir in either condition. Key variables were compared between occlusion responders (n = 11) and nonresponders (n = 20). Responders and nonresponders were not distinguished by age, menopausal status, nor several cephalometric or anthropometric variables. Body mass index (31.1 +/- 8.5 versus 24.3 +/- 3.4, p < 0.003), neck circumference (34.0 +/- 2.5 versus 32.5 +/- 1.7 cm, p < 0.05), and mandibular-hyoid distance (18.5 +/- 3.8 versus 14.5 +/- 5.7 mm, p < 0.05) were greater in responders. These findings suggest hormonal factors may be less important than weight and facial morphology in midlife development of SDB in women.

Anthropometry↗
PubMed1996

Absence of correlation between Sry polymorphisms and XY sex reversal caused by the M. m. domesticus Y chromosome.

Mus musculus domesticus Y chromosomes (YDOM Chrs) vary in their ability to induce testes in the strain C57BL/6J. In severe cases, XY females develop (XYDOM sex reversal). To identify the molecular basis for the sex reversal, a 2.7-kb region of Sry, the testis-determining gene, was sequenced from YDOM Chrs linked to normal testis determination, transient sex reversal, and severe sex reversal. Four mutations were identified. However, no correlation exists between these mutations and severity of XYDOM sex reversal. RT-PCR identified Sry transcripts in XYDOM sex-reversed fetal gonads at 11 d.p.c., the age when Sry is hypothesized to function. In addition, no correlation exists between XYDOM sex reversal and copy numbers of pSx1, a Y-repetitive sequence whose deletion is linked to XY sex reversal. We conclude that SRY protein variants, blockade of Sry transcription, and deletion of pSx1 sequences are not the underlying causes of XYDOM sex reversal.

Animals↗
PubMed1996

The changes in the role of the nurse teacher following the formation of links with higher education.

A national study was conducted in England over a three-year period (1991-1994) to explore the changing role of the nurse teacher. The study used multiple methods of data collection, including a modified Delphi survey and a series of telephone interviews. A wide variety of respondents (nurse teachers, midwife teachers, clinical nurses, health service managers and higher education lecturers) were included in the sample. This paper presents findings relating to the changes in the role of the nurse teacher following the formation of links with higher education. Some of the issues discussed include the difficulties related to academic status and the relationships between nurse teachers and other lecturers in higher education, changes in teaching styles and the place of student nurses within higher education. The implications for nurse teachers which stem from a closer association with higher education are explored.

Burnout, Professional↗
PubMed1996

The changing academic role of the nurse teacher in the United Kingdom.

This paper presents findings from a national study conducted over a 3-year period (1991-94) which examined the changing role of the nurse teacher. The study used multiple methods to collect data from a wide variety of respondents (nurse teachers, midwife teachers, clinical nurses, health service managers and higher education lecturers). This paper presents the findings relating to the development of the nurse teacher's academic role following the introduction of Project 2000. The issues presented and discussed include specialization within the nurse teacher's role, the nature of this specialization and the development of academic credibility and scholarship. The implications of these changes in terms of the development of nursing as an academic subject area and the opportunity to contribute to the establishment of research based practice are explored.

Delphi Technique↗
PubMed1996

The dominant white spotting oncogene allele Kit(W-42J) exacerbates XY(DOM) sex reversal.

The Y chromosome from certain populations of M. m. domesticus is incapable of normal testis determination in the B6 inbred strain resulting in XY hermaphrodites or XY females (XY(DOM) sex reversal). B6 consomic strains have been developed with either transient (B6-Y(AKR)) or severe (B6-Y(TIR)) XY(DOM) sex reversal. We report that a point mutation, the dominant white spotting oncogene allele, Kit(W-42J), exacerbates XY(DOM) sex reversal. In B6-Y(AKR), penetrance of the trait is low; however, in B6-Y(TIR), Kit(W-42J) exacerbated sex reversal to such an extent that almost all XY progeny developed into females. The exacerbation of sex reversal was not linked to retardation of early fetal growth or reduction of testis size. Furthermore, semiquantitative RT-PCR for the testis-determining gene, Sry, suggests that exacerbation of sex reversal in B6-Y(TIR) is not due to blockade of Sry expression, a substantial delay in initiation of Sry expression, or exceptionally low levels of Sry mRNAs. We propose that Kit(W-42J) enhances sex reversal by adversely affecting a critical step in testis differentiation that is downstream of Sry.

Alleles↗