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Biomedical subjects

C Hicks

Publications and source records attributed to C Hicks.

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

Good researcher, poor midwife: an investigation into the impact of central trait descriptions on assumptions of professional competencies.

OBJECTIVE: in an attempt to explain the serious shortfall in published midwifery research an attempt was made to assess whether the way in which midwives construe their professional role acts as a deterrent to undertaking research. DESIGN: different subject experimental. SETTING: a college of nursing and midwifery in central England. PARTICIPANTS: 30 midwives attending postregistration continuing education courses. INTERVENTIONS: the midwives were divided into two groups and were asked to imagine that they were interviewing a candidate for a midwifery post following Asch's (1946) paradigm. The candidate had been described by her referee using six adjectives. Five of these were common to both groups of subjects, but the sixth descriptor for one group was 'good clinician', while for the other group it was 'good researcher'. MEASUREMENTS AND FINDINGS: the groups were asked to assess how much of each of 16 dimensional traits their candidate possessed. Analysis of the findings, using unrelated t-tests, suggested that if the candidate had been described as a poor researcher, it was also assumed that the candidate was more ambitious, a poorer communicator, less kind, stronger, more logical, less emotional, more confident, less popular, less compassionate, more rational, more organised and more analytical than the candidate described as a good clinician. IMPLICATIONS FOR PRACTICE: these findings suggest that if midwives are to become more research active they can only do so if they sacrifice their constructs of themselves as good midwives. If midwifery is to accept research as part of its responsibility it appears that there has to be a radical shift in predispositional assumptions to integrate the traits required for good clinical practice, sound research and femaleness?

Adult↗
PubMed1995

The shortfall in published research: a study of nurses' research and publication activities.

Although in recent years there has been increasing pressure on nurses to become more research minded, available evidence still suggests that there is a significant shortfall in published nursing research. To date, it has not been clear whether this lack of output is a function of nurses' failure either to conduct research in the first place or to get it published. It is self-evident that if patient care is to be enhanced through research, then the reasons for the low output must be investigated systematically in order to understand the precise nature of the problem. Therefore, a national survey of 230 nurses was undertaken in order to ascertain the reasons underpinning the low publication rate. A questionnaire, comprising sections on biographical information, research activities and attitudes to research was distributed to a random sample of nurses and the results were analysed using techniques of descriptive and inferential statistics. The results suggest that the observed shortfall in published research is not a product of nurses' failure to conduct research projects but rather of their reluctance to submit their findings for publication. This reluctance seemed for the majority of respondents to be the result of a pronounced lack of confidence. The findings from this survey are discussed with reference to future professional development programmes.

Adult↗
PubMed1995

A study of nurse managers' constructs of nurse researchers.

Recent fundamental changes in health care policy and provision have emphasized the need for a research culture within the National Health Service (NHS). The argument underpinning this revolves around the assumption that increasing the evidence-base of practice may have a significant impact on the quality of patient care. In consequence, members of the paramedical professions have been urged to become more research aware and research active. Despite these exhortations, however, there is mounting concern generally within the professions allied to medicine and, within nursing in particular, that the corpus of essential research evidence is not sufficient and that which exists is only partially effective in informing practice. While numerous explanations have been put forward to account for this, it is conceivable that the way in which the nurse's role is construed both by the nurse and by associated personnel is dysfunctional to the development of the nurse as researcher. To test this hypothesis, two groups of nurse managers were asked to consider how much of each of 15 bipolar dimensions was possessed by a nurse described either as 'a good clinician' or as 'a good researcher'. The results suggested that a nurse described as a good researcher was attributed with fewer of the characteristics assumed to be inherent to a good nurse. In this way, to be a good researcher appears to be fundamentally incompatible with being a good nurse. Moreover, a good researcher was also less likely to be employed. These results implicate the role of traditional attributions of nursing and are discussed in the context of the development of nursing research.

Adult↗
PubMed1994

Quantitation of platelet derived growth factor receptors on cells from human arterial segments.

The study of receptor expression in tissue containing multiple cell types presents a two-fold problem. Firstly, in situ studies are difficult to perform quantitatively and secondly, enzymatic disruption of the primary tissue results in the loss of cell surface receptors which may or may not be resynthesised. In vitro culture of cells following isolation may also alter receptor expression. To circumvent these problems, we have devised a reproducible non-enzymatic method for releasing endothelial and smooth muscle cells from human arterial segments and separating the mixture into constituent cell populations, in order to facilitate semi-quantitative receptor investigation by ELISA. The method involves the mechanical disruption of small artery segments and passage through progressively smaller sieves, resulting in a mixed population of single cells. Magnetic beads covalently attached to identifying lectins or antibodies are then used in a multistep procedure to give highly enriched cell populations. The dissociation/enrichment steps can be modified to select other cell types which may be present in the primary tissue, such as macrophages. We have used these preparations for locating and semi-quantitating PDGF and EGF receptors on the constituent cells of human umbilical artery preparations by ELISA using monoclonal receptor antibodies.

Antibodies, Monoclonal↗
PubMed1994

Bridging the gap between research and practice: an assessment of the value of a study day in developing critical research reading skills in midwives.

Despite increasing professional pressure on midwives to make their clinical practice research based, their remains a considerable amount of clinical activity which relies only on historical ritual rather than on rational scientific evidence. This apparent failure to integrate research into practice has generated a lot of debate regarding its cause. One widely accepted reason for midwives' non-use of empirical findings is simply that a large proportion of the workforce does not have the knowledge and training in the necessary skills to enable them to assess the value of published articles. Clearly the cost in time and human resources involved in providing a thorough training for the entire midwifery workforce in research skills would probably be unnecessary for the majority of midwives who simply want to be able to translate published research into their clinical practice. Consequently, a more pragmatic approach might be to assess the value of brief training days in developing midwives' competencies in reading research articles critically as a precursor to facilitating the integration of theory and practice. If the value of such courses could be demonstrated, then it is conceivable that study days of this type might be made more widely available for all midwifery personnel. This study investigated the effectiveness of one such study day in (a) modifying the participating midwives' evaluations of a published research article in accord with those of expert judges and (b) influencing the longer term use by the participants of published research. The day provided a brief introduction to basic research techniques both in theory and in practice, as well as a set of structured guidelines for evaluating research articles.(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Competence↗
PubMed1994

Lacrimal surgery in patients with congenital cranial or facial anomalies.

A series of 26 patients with lacrimal dysfunction due to congenital cranial or facial anomalies are reviewed. The underlying anatomical abnormalities responsible for symptoms and their influence on surgical management and outcome are discussed and illustrated with representative cases. It is shown that by adaptation of standard surgical techniques a high success rate can be achieved.

Abnormalities, Multiple↗
PubMed1994

Determinants for intracellular sorting of cytoplasmic and nuclear intermediate filaments.

The mechanism by which nuclear and cytoplasmic filaments are sorted in vivo was studied by examining which lamin sequences are required to target an otherwise cytoplasmic IF protein, the small neurofilament subunit (NF-L), to the nuclear lamina. By swapping corresponding domains between NF-L and lamin A, nuclear envelope targeting of NF-L was shown to require the presence of the "head" domain, a 42-amino acid sequence unique to lamin rod domains, a nuclear localization signal and the CAAX motif. Replacement of the entire COOH-terminal tail of lamin A with that of NF-L had no discernible effect on nuclear localization of lamin A, provided the substituted NF-L tail contained a NLS and a CAAX motif. This chimeric protein exhibited characteristics more typical of lamin B than that of the parental lamin A. With regard to cytoplasmic assembly properties, substitution of the head domain of lamin A for that of NF-L did not substantially affect the ability of NF-L to coassemble with vimentin in the cytoplasm. In contrast, insertion of a 42-amino acid sequence unique to lamin rod domains into NF-L profoundly affected NF-L coassembly with vimentin indicating that the 42-amino acid insertion in lamins may be important for sorting lamins from cytoplasmic IF proteins.

Amino Acid Sequence↗
PubMed1994

The role of the middle manager in health care research: some problems and perspectives.

There is mounting pressure on health care professionals to undertake research. However, despite national and local directives, relatively little research is published within the paramedical professions. One reason for this may relate to the fact that changes in basic training have located the bulk of the research skills amongst the most newly qualified but potentially least influential staff. This pilot study examined the impact of developing research competencies in a group of middle managers, on the assumption that they might then influence and facilitate research productivity among junior staff. The study was largely unsuccessful as a result of numerous practical and attitudinal problems. Some suggestions are put forward for overcoming some of these difficulties and thus for increasing research output amongst the paramedical professions.

Attitude of Health Personnel↗
PubMed1993

The risk of second-trimester amniocentesis in twin gestations: a case-control study.

OBJECTIVE: Pregnancy outcomes in patients with twin pregnancy undergoing second-trimester amniocentesis for fetal karyotype assessment were compared in a case-control study with twin pregnancies undergoing routine ultrasonographic studies at similar gestational ages. STUDY DESIGN: All spontaneous and induced twin gestations that underwent ultrasonographic examination between 14 and 20 weeks were compiled for the period January 1987 through January 1992. Patients having undergone multifetal reduction or chorionic villous sampling and those with fetal anatomic or chromosomal anomalies, discordant growth (> 20%), death, or a monoamniotic sac detected at ultrasonography were excluded. RESULTS: The mean (+/- SD) maternal age was significantly higher among the 101 cases than among the 108 controls (35.2 +/- 3.5 vs 30.4 +/- 5.3 years, respectively; p < 0.01). No differences were noted in gravidity, parity, number of prior spontaneous losses, or gestational age at ultrasonography between the two groups. The fetal loss rate was similar among cases and controls (seven of 202 [3.5%] vs seven of 216 [3.2%], relative risk 1.07, 95% confidence intervals 0.3 to 3.5). No losses occurred within 3 weeks of the procedure. Gestational age at delivery, birth weight, mean Apgar scores at 1 and 5 minutes, and length of neonatal stay were not significantly different between cases and controls. CONCLUSIONS: Second-trimester amniocentesis in twin pregnancies is apparently not associated with excess pregnancy loss.

Abortion, Spontaneous↗
PubMed1993

A survey of midwives' attitudes to, and involvement in, research: the first stage in identifying needs for a staff development programme.

Despite top-down directives in the UK to increase the research base of various of the paramedical professions, there is some evidence to suggest that there remains a serious shortfall in published research in these domains. Until this is increased, much clinical practice will continue to be founded on time-honoured tradition rather than on empirical evidence. Of special concern to the present study is the situation within midwifery. To investigate possible reasons for the limited research output in this area, a national questionnaire survey of 550 randomly selected midwives was undertaken. The questionnaire comprised sections on biographical/occupational details and research activities, together with a 13-item attitude-to research scale. The responses were analysed using techniques of descriptive and inferential statistics. The findings suggest that a major reason for the low overall publication rate was not a failure to undertake research in the first place, but instead, a reluctance to submit the findings for publication. This reluctance seemed to be a function of a prevailing diffidence amongst the majority of respondents. The findings are interpreted within a context of developing future staff training programmes.

Adult↗
PubMed1992

Research in midwifery: are midwives their own worst enemies?

This study investigated the hypothesis that midwives will undervalue research they believed to have been undertaken by a midwife as compared with that believed to have been undertaken by an obstetrician. Eighteen midwives were asked to assess two comparable research articles on 5 criteria. Half the sample were informed that the first article was written by a midwife and the second by an obstetrician. The order of authorship was reversed for the remainder of the sample. A related t-test was carried out to compare the midwife's paper with the obstetrician's on each of the 5 criteria. These suggested that no difference was perceived between the midwife's and obstetrician's clarity of expression or expertise on the topic in question, but significant differences were found on attributed grasp of research methodology, understanding of statistical analysis and contribution to current understanding, with the midwife emerging worse on all three (t = 1.99, p less than 0.05, t = 2.28, p less than 0.025, t = 1.8, p less than 0.05 respectively). Comparison of the overall scores also revealed that the general quality of the midwife's paper was also perceived to be poorer than the obstetrician's (t = 2.24, p less than 0.025). The findings are partially explained in terms of the gender influences that operate in midwifery.

Attitude of Health Personnel↗
PubMed1992

Of sex and status: a study of the effects of gender and occupation on nurses' evaluations of nursing research.

Despite wide recognition that nursing must increase its research base, there still appears not only to be a shortfall in published nursing research but also a marked failure to implement research findings into clinical practice. One possible explanation for these problems is that nursing research may not be valued by peer professionals. To investigate this possibility, a study was designed to test the hypothesis that nurses would underrate the quality of papers they believed to have been produced by a nurse as opposed to a doctor, even when the status of the authors was randomly assigned to the papers. Thirty-one nurses were asked to rate two comparable papers on a number of criteria. Half the sample was told that the first paper had been written by a nurse and the second by a doctor; for the remainder of the sample, the order of authorship was reversed. A series of related t-tests was performed on the sample's evaluations in order to ascertain whether the status of the author affected perceptions of quality. No difference was found in the sample's judgement of overall quality, clarity of expression, expertise on the topic in question or contribution to current knowledge. However, significant differences were found in attributed grasp of research design and statistical analysis, with the nurse being judged as inferior on both (t = 1.71, d.f. = 30, P < 0.05; t = 1.72, d.f. = 30, P < 0.05 respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Human arterial endothelial cell detachment in vitro: its promotion by homocysteine and cysteine.

We have explored earlier evidence that premature atherosclerosis in homocystinuria is triggered by homocysteine-induced loss of vascular endothelium. We used a reproducible sluicing assay to test in vitro detachment of human arterial endothelial cells. Cell detachment was induced by exposure of cultured endothelial cells to the sulphydryl-containing amino acids homocysteine and cysteine, whereas methionine, alanine, valine and isoleucine at comparable concentrations were ineffective. This cellular detachment was greatly diminished by growth of the endothelial cells on fibronectin coated- rather than plain tissue culture dishes. Considerably higher concentrations of homocysteine were required for in vitro effects than are associated with atherogenesis in homocystinuria, and despite the cysteine associated changes, cysteine itself is not known to be related to atherogenesis. These data suggested that in vitro detachment of cultured endothelial cells, induced by sulphydryl-containing amino acids, may have marginal relevance to mechanisms of atherogenesis in homocystinuria.

Amino Acids↗
PubMed1991

Linkworkers in antenatal care: facilitators of equal opportunities in health provision or salves for the management conscience?

A number of reports have highlighted non-English speaking Asian women as being at risk from limited health care provision (eg Whitehead, 1987). Of particular relevance to the present survey is their low uptake of antenatal care which may contribute to the above-average perinatal mortality rates for this group. In an attempt to ameliorate this problem, a Linkworker service was introduced in a number of multi-racial health districts. The survey reported here was an attempt to establish the efficacy of this service. From an initial sample of 30 health districts, 20 replies were obtained which provided some valuable insights on the current status of the Linkworker provision. In summary, the responses indicated that there is a worrying mis-match between client need and service planning, largely because relevant information about supply and demand is not collated. The net result is that many of the at-risk group are still denied the full and appropriate services of the Linkworker. It is concluded that if Linkworker provision is seen as a valuable commodity in enhancing equal opportunities in health care, then the service needs to be systematised. If it is perceived to be of little demonstrable value, then it should be scrapped. In either case, some clear policy decisions are required.

Asia↗
PubMed1991

Investigation of interleukin 2 receptors on human endothelial cells.

We have demonstrated that both recombinant and purified IL-2 exert a direct effect on quiescent human microvascular endothelial cells in vitro, causing the cells to enter the cell cycle and proliferate (Hicks et al., 1989). In this study we have identified IL-2 receptors (R) on both human umbilical vein (HUVEC) and neonatal foreskin (HCEC) endothelial cells. The techniques used to identify the receptors included proliferation studies, flow cytometry and immunofluorescence. Results indicate that both HUVEC and HCEC possess low numbers of receptors since both cell types proliferate in response to IL-2. The number of receptors on the cell surface vary according to passage number and culture conditions. Immunofluorescent studies show discrete areas of staining on the cell membrane. These combined results suggest that human vascular endothelial cells possess IL-2R.

Cell Division↗
PubMed1990

Monoclonal antibodies and arthritis.

Monoclonal antibodies to certain cell surface constituents on lymphocytes, monocytes and macrophages have been administered to Lewis rats with developing, established or adoptively transferred arthritis, to determine any immunomodulatory properties. Anti-CD4 antibodies against helper T-lymphocytes produced a dose related inhibition of developing arthritis; high dose levels completely suppressed all symptoms of arthritis and these rats were resistant to further attempts to induce arthritis. Anti-Ia (MHCII) antibodies also inhibited arthritis in a dose related manner; anti-pan T antibodies delayed the onset of arthritis, but antibodies against CD8 and IL-2 receptor positive cells were without effect. Development of type II collagen-induced arthritis was also inhibited by anti-CD4 treatment. Established arthritis could be temporarily inhibited by anti-CD4 antibodies, but rebound of arthritis invariably occurred after stopping treatment, as is the case with cyclosporin A. Similar results with anti-CD4 antibodies were obtained during treatment of arthritis adoptively transferred by arthritogenic T-lymphocytes. From these experiments it is clear that CD4 positive T-lymphocytes have a major role in the induction of adjuvant arthritis and that interaction between CD4 and Ia bearing cells is important. The rebound of arthritis that occurred after withdrawal of anti-CD4 treatment during established disease infers that cells in addition to helper T-lymphocytes are involved in the chronicity of arthritis, but these remain to be elucidated. These findings are discussed in relation to results with monoclonal antibodies in other models of arthritis and human rheumatoid arthritis; the prospects for human therapy are also discussed.

Animals↗