Biomedical subjects
C Jackson
Publications and source records attributed to C Jackson.
Behind the bare statistics.
The findings of the Mental Health Care stress survey will come as no surprise to nurses working on the front-line. But the statistics tell only half the story.
UK nurses have no right to feel complacent about the recent revelations that people with learning disabilities.
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A continuous striatal infusion of 6-hydroxydopamine produces a terminal axotomy and delayed behavioral effects.
Rat models of Parkinson's disease typically employ a rapid nigral injection of 6-hydroxydopamine (6-OHDA) to produce a near-complete loss of nigrostriatal dopamine neurons, and thus, model end stage disease. The present report describes the use of a continuous, low dose infusion of 6-OHDA into the striatum which produces a terminal axotomy of nigrostriatal dopamine neurons and protracted behavioral response. A solution of 6-OHDA in 0.4% ascorbate, delivered at 37 degrees C from osmotic minipumps, was stable for 8 days as determined by its retained toxicity to a dopaminergic neuroblastoma cell line. The continuous infusion of 0.2 mu g 6-OHDA per h did not affect the striatal uptake of [3H]%GABA, [3H]choline, or [3H]glutamate but reduced [3H]dopamine uptake by 55% within 1.5 days after the start of the infusion. The striatal infusion of 6-OHDA produced a dose-dependent reduction of striatal dopamine and DOPAC levels but did not alter HVA, 5-HT, or 5-HIAA. An increase in amphetamine-induced ipsiversive rotations occurred within 1.5 days after the acute striatal injection of 20 mu g or 30 mu g of 6-OHDA but required 4 days to develop with the continuous 6-OHDA infusion. The topography of the lesion mapped by [3H]mazindol binding showed that, beginning by 1.5 days, a diffuse depletion of terminals encompassed much of the striatum in the 30 mu g acute injection group, whereas in the continuously infused rats, the lesion was apparent only by 4 days and was restricted to a smaller and more completely lesioned area. Unlike acutely lesioned animals, continuously infused rats revealed no obvious loss of dopamine neurons in the pars compacta by 5 weeks after 6-OHDA. The continuous striatal infusion of 6-OHDA can produce a topographically limited terminal axotomy of dopamine neurons and a protracted behavioral impairment.
Humidification in the upper respiratory tract: a physiological overview.
Over the last 30 years, there has been a wealth of literature investigating the principles of humidification in the upper respiratory tract. Most of the nursing literature provides subjective information, whilst the medical profession presents concrete objective data based on sound clinical research. A great deal of information does not date; the physiological principles of humidification remain unchanged. As a clinical nurse adviser with previous experience of humidification trials (Jackson & Webb 1992), I was invited by the Trust Clinical Practice Group, which is responsible for practice development issues, to design humidification guidelines for use in the Trust. Such work is necessarily based on sound knowledge of normal physiology and hazards of artificial humidification. This article contains an outline of the concept of humidity, examination of the normal mechanism of humidification, and details of consequences of over- and under-humidification. Finally, the concept of optimal humidification is discussed, and the main mechanisms of viral and bacterial contamination of the upper airways are briefly detailed.
Demographic and clinical characteristics of patients with episodic migraine versus chronic daily headache.
We compared data from 243 patients with episodic migraine (EM) and 132 patients with chronic daily headache (CDH). We divided the latter group into those with tension-type headache only (CDH Type 1) and those with headaches having migrainous features (CDH Types 2 + 3) and compared each with the EM group and all three groups with one another. CDH Type 1 patients differed from those in the other groups by virtue of gender (more often male) and mean age at headache onset (older). The CDH Types 2 + 3 and EM groups differed only in that the former were more likely to have undergone a brain-imaging study. These data suggest that CDH Type 1 may represent a distinct headache syndrome, while CDH Types 2 + 3 closely resemble episodic migraine.
Atypical responses of rat ileum to pindolol, cyanopindolol and iodocyanopindolol.
1. Pindolol, cyanopindolol (CYP) and iodocyanopindolol (IodoCYP) have been reported to act either as antagonists, agonists or partial agonists at the beta 3-adrenoceptor in different preparations. A comprehensive investigation has not yet been described with these compounds tested in one tissue from one species. This study was conducted to delineate the pharmacological effects of pindolol, CYP and IodoCYP and to provide data on their affinities at the predominant beta-adrenoceptor in rat ileum. 2. The beta-adrenoceptors present in rat ileum were characterized in the presence of CGP 20712A and ICI 118 551, atropine and corticosterone, with (-)-isoprenaline used as an agonist. The role of the beta 1 and beta 2-adrenoceptors was determined by the omission of either CGP 20712A, ICI 118 551, or both, from the buffers. Conversely, the effectiveness of the beta 1- and beta 2-adrenoceptor blockade was examined by use of the beta 1-adrenoceptor-selective agonist, RO 363 and the beta 2-adrenoceptor-selective agonist, salbutamol. 3. There was no evidence for the presence of functional beta 1-adrenoceptors, and no strong evidence that beta 2-adrenoceptor stimulation contributed to the relaxant effects of (-)-isoprenaline. (-)-Phenylephrine did not produce relaxation of the tissue and 5-hydroxytryptamine produced contraction. 4. The beta 3-adrenoceptor-selective agonist, BRL 37344 and (-)-isoprenaline were potent full agonists (pD2 8.35 +/- 0.04 and 7.76 +/- 0.14 respectively), whereas ICI D7114 was less potent (pseudo pD2 6.92 +/- 0.15). These results indicate that the predominant functional beta-adrenoceptors in rat ileum are beta 3-adrenoceptors. 5. Partial agonist effects were produced by CYP (pD2 5.28 +/- 0.26) and IodoCYP (pD2 7.0 +/- 0.26), but not pindolol. All three compounds antagonized the effects of (-)-isoprenaline with pKb values of 6.68 +/- 0.10, 7.59 +/- 0.07 and 7.59 +/- 0.11 for pindolol, CYP and IodoCYP respectively. Likewise, CYP and IodoCYP antagonized the effects of BRL 37344 with pKb values of 7.20 +/- 0.22 and 7.21 +/- 0.14 respectively. This study provides the first functional data on the effects of IodoCYP, the ligand with the highest known affinity for the beta 3-adrenoceptor, at the characterized rat ileum beta 3-adrenoceptor. 6. In conclusion, whereas pKb values suggest that CYP and IodoCYP have a similar affinity for the beta 3-adrenoceptor in rat ileum, the higher potency of IodoCYP suggests that it promotes a greater coupling efficiency, or that its partial agonist effects are produced through a site other than the beta 3-adrenoceptor. The similar pKb values for CYP and IodoCYP at the beta 3-adrenoceptor contrast with their order of known affinities at the beta 1- and beta 2-adrenoceptors, where IodoCYP is far more potent than CYP. This provides evidence of further differences in the characteristics of the beta 3-adrenoceptors compared to the beta 1- and beta 2-adrenoceptors. Finally, the utility of IodoCYP as a beta 3-adrenoceptor antagonist would appear to be limited because of the greater magnitude of partial agonist effects that it produces.
Early intervention in psychosis: opportunities for secondary prevention.
A description of an emerging paradigm is presented which places emphasis upon secondary prevention in psychosis. It is argued that the first two or three years following a first episode of psychosis is a crucial period for high-quality psychosocial and biological interventions and a time slot which may influence recovery and long-term outcome. Factors contributing to long-term outcome as possible areas for secondary prevention are reviewed.
The impact of legislation to improve coordination of services to children with serious emotional disturbance.
OBJECTIVE: This study evaluated the impact of state legislation in Indiana mandating establishment of local coordinating committees to prevent inappropriate placement of children and youth with serious emotional disturbance out of the home and to facilitate the development of communitybased initiatives. METHODS: In the first stage of the study, a survey was sent to the directors of mental health, welfare, education, and probation agencies of each county to estimate the extent that the structure and processes mandated by law were in place. In the second stage, structured interviews were conducted with the directors of key agencies in seven representative counties. RESULTS: Stage 1 produced 310 completed surveys from all 92 counties; 73 counties had functioning committees. Improved coordination among providers was the most frequently cited reason for the committee's success; half of the respondents felt that the committee resulted in better services. More than half reported that too few service options were available. Other problems cited were rigid funding opportunities that limited options and lack of staff time to attend and prepare for meetings. Interviewees in the second stage noted that the committee too often formalized already-made decisions, that consideration of individual cases came too late in the process, and that in many cases less restrictive options had already been tried unsuccessfully. They also noted that the committee process had not achieved its major objective of pooling resources to address the needs of particular children. CONCLUSIONS: Adequate funding and a fiscal strategy to support coordination and staffing of local coordinating committees are critical to their successful implementation.
Assessing for glaucoma in general practice.
Examining patients appropriately for primary open angle glaucoma in the general practice setting has traditionally been extremely difficult. The authors review important issues in the early detection of primary open angle glaucoma and discuss new assessment tools to assist GPs in this area.
Initiation of cigarette smoking among children with and without learning disabilities.
The goals of this study were to determine if: (1) children with learning disabilities should be included in school-based smoking prevention programs and (2) existing prevention curricula are appropriate for children with learning disabilities. Initiation of cigarette smoking and several correlates of smoking, including personal attribute, peer influence, and parent influence variables, were measured in a sample of 1470 3rd and 5th grade children. The rates of smoking initiation were 17% and 15% for children with and without learning disabilities, respectively. In addition, several of the known correlates of smoking among youth, including low self-control, negative orientation toward school, and peer smoking, were also significantly associated with smoking by children with learning disabilities. Children with learning disabilities are as much in need of smoking prevention programs as children without learning disabilities. Although current smoking prevention curricula address issues relevant to children with learning disabilities, additional research is needed to identify the special needs of these children and to determine the type of smoking prevention program most likely to be effective with them.
Reducing anxiety in new dental patients by means of leaflets.
Fifty adults, consecutive attenders at a dentist who was new to them, were selected. They completed the Spielberger State Anxiety Inventory before and after they had read one of two different leaflets in the waiting room. One, the informative leaflet, included information about pain control and stop signals. A comparison leaflet did not include this information but acknowledged, sympathetically, that many people are nervous of dental treatment. The leaflet also provided some explanations for that fear. Both leaflets were designed, according to published evidence, to be easily read and understood. The layout drew attention to the most important points. State Anxiety decreased significantly only in the patients who read the informative leaflet (P < 0.01). This occurred before the patients met their new dentist. Those patients given the informative leaflet rated it as much more helpful than those given the comparison leaflet (P = 0.007).
Intussusception in a child presenting as lethargy.
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Complete nucleotide sequence of a gene prtR of Porphyromonas gingivalis W50 encoding a 132 kDa protein that contains an arginine-specific thiol endopeptidase domain and a haemagglutinin domain.
We have purified from Porphyromonas gingivalis W50 a 45 kDa arginine-specific, thiol-activated, EDTA-sensitive endopeptidase, designated prtR. Oligonucleotide probes based on the N-terminal amino acid sequence were used to isolate a genomic fragment containing an open reading frame (3654 bp) with the potential to encode a 132 kDa protein including the prtR N-terminus. Analysis of this prtR gene revealed that the predicted nascent product contains a protease domain followed by a haemagglutinin domain and is post-translationally processed by proteolytic (possibly autolytic) events to produce a 43-54 kDa arginine-specific, thiol protease and a 41-53 kDa haemagglutinin. Comparison of the prtR with the P. gingivalis prtH gene suggests that the prtH gene product also contains protease and haemagglutinin domains but in the reverse order to that in the prtR. An overlapping but shifted reading frame at the 3' end of the prtR encodes the 5' region of the prtH.
The theme of death in the French and German literature on eating disorders.
It is not widely appreciated in the English-speaking world that a number of articles written in French and German do address the role played by death preoccupations and concerns in the development and maintenance of eating disorders, particularly anorexia nervosa. In previous published articles these important "hidden" threads have been highlighted in examining in some detail, the writings of the German authors Binswanger, Von Weizsäcker, and Thomä. In this article, the writings of other German authors are also briefly reviewed as well as the French authors Bensoussan, Fouraste, Raimbault, and Thouzery-Loras. Implications and issues are posed for both the researchers and clinicians alike contributing to the literature in English on eating disorders, who do not necessarily embrace these themes in therapy and who may not reflect their significance to theory in the literature itself.
Effects of BDNF on dopaminergic, serotonergic, and GABAergic neurons in cultures of human fetal ventral mesencephalon.
The neurotrophin brain-derived neurotrophic factor (BDNF) was tested for its ability to promote the survival and regulation of expression of phenotypic markers of dopaminergic, serotonergic, and GABAergic neurons in free-floating roller tube cultures of human fetal ventral mesencephalon. This culture system contains neurons of the anlage of the substantia nigra as well as that of the rostral raphe nucleus. Dopaminergic neuron number and tyrosine hydroxylase (TH) fiber density was monitored by TH immunocytochemistry. Measurement of dopamine (DA) content, TH enzymatic activity, serotonin (5-HT) content, and glutamic acid decarboxylase (GAD) activity were used as indices of their respective neurotransmitter function. The presence of GABAergic and serotonergic neurons in this culture system was confirmed by GABA and 5-HT immunocytochemistry. In cultures maintained in the presence of BDNF (10 ng/ml), the density of TH-positive cells was increased by 2.5-fold (P F 0.05), and the TH-positive fiber density was increased by 3.5-fold (P F 0.01), relative to control cultures. Similarly, the relative increases in DA content and TH activity were 2.6- and 2.3-fold, respectively, in the BDNF-treated cultures (P F 0.01 and P F 0.01). On a per neuron basis, DA content and TH activity were not markedly changed by BDNF treatment, suggesting that the increases in DA content and TH activity are due to more DA neurons surviving. Relative elevations were also observed in serotonin content (2.0-fold, P F 0.01) and GAD enzymatic activity (1.4-fold, P F 0.01). Future studies will need to determine whether these changes result from the direct action of BDNF on these neurons or through some indirect mechanism. The results demonstrate that BDNF has beneficial effects on cultured human fetal tissue, which may be relevant in optimizing neuronal transplantation techniques, and that multiple systems are simultaneously influenced by BDNF.