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Biomedical subjects

C Kenney

Publications and source records attributed to C Kenney.

18 recordsLinked to original sources

Hemi-orolingual angioedema and ACE inhibition after alteplase treatment of stroke.

One hundred seventy-six consecutive patients treated with IV tissue plasminogen activator (tPA) for acute ischemic stroke were examined prospectively, and orolingual angioedema was found in nine (5.1%; 95% CI 2.3 to 9.5). The reaction was typically mild, transient, and contralateral to the ischemic hemisphere. Risk of angioedema was associated with angiotensin-converting enzyme inhibitors (relative risk [RR] 13.6; 95% CI 3.0 to 62.7) and signs on initial CT of ischemia in the insular and frontal cortex (RR 9.1; 95% CI 1.4 to 30.0).

Aged↗

Study to validate the outcome goal, competencies and educational objectives for use in intensive care orientation programs.

Intensive care orientation programs have become an accepted component of intensive care education. To date, however, there have been no Australian-based standards defining the appropriate level of competence to be attained upon completion of orientation. The aim of this study was to validate a set of aims, competencies and educational objectives that could form the basis of intensive care orientation and which would ensure an outcome standard of safe and effective practice. An initial document containing a statement of the desired outcome goal, six competency statements and 182 educational objectives was developed through a review of the orientation programs developed by the investigators. The Delphi technique was used to gain consensus among 13 nurses recognised for their expertise in intensive care education. The expert group rated the acceptability of each of the study items and provided suggestions for objectives to be included. An approval rating of 80 per cent was required to retain each of the study items, with the document refined through three Delphi rounds. The final document contains a validated statement of outcome goal, competencies and educational objectives for intensive care orientation programs.

Australia↗

The development of the Australian Basic Intensive Care Knowledge Test.

The Basic knowledge Assessment Tool (BKAT), a test developed in the United States, has been presented as a valid and reliable test of basic knowledge for critical care nursing. However, it was necessary to determine the BKAT's validity and reliability in the Australian intensive care (IC) context. The Delphi technique, utilising a panel of eleven experts, was used to determine the content validity of the BKAT. The Delphi process resulted in the development of a test with 105 questions. These questions consist of 49 original BKAT questions, 25 original BKAT questions slightly modified, 3 original BKAT questions with major modifications and 28 new questions. A criterion group design was used to establish the modified test's reliability and decision validity. Item analysis was undertaken using item difficulty and item discrimination indexes. The modified test was completed by 14 registered nurses with no IC experience, 18 registered nurses with intermediate IC experience and 25 registered nurses qualified as intensive care specialists. The mean score (and standard deviation) for the test for each of the respective groups was 41(9), 69(9) and 86(7). These results were significantly different (p < 0001). The reliability was established with a Cronbach Alpha coefficient of .96. The modified test is a reliable and valid measure of IC basic knowledge and can be used as a valuable adjunct in the assessment of IC orientation programs.

Australia↗

The effects of cage size and pair housing on exercise of beagle dogs.

One of the requirements of the 1985 amendments to the Animal Welfare Act is the establishment of an exercise program for dogs. Assumptions have been made by some that larger cages or the presence of a companion animal will motivate exercise. To examine how cage size, pair housing and human contact affect exercise, a study was conducted using a computerized video-data acquisition system that measured distance traveled and time spent moving in 1 x 1 m, (single only) and 1 x 2 m (single and paired) and 1 x 1.5 m cage (paired only) cages. Male beagle dogs (n = 6) housed singly in the 1 m2 cage traveled an average of 55 m/hr spending only 8% (57 min) of the 12 h photo period in motion. When the cage size was doubled, the average distance traveled decreased to 13 m/hr and the time spent moving increased to 11% (77 min/day). When dogs were pair housed in a regulation size cage, the average distance traveled decreased to 8.6 m/hr and they spent less than 6% of the day in exercising (42 min/12 hrs). The greatest amount of exercise was seen when dogs were housed as a pair in a cage less than recommended size (an average of 109 m/hr and 8.8 min/hr). Therefore, these data indicate that larger cages or pair housing in regulation size cages have little or no effect on the activity of purpose bred male beagle dogs. There was, however, a direct correlation between activity, time and distance, and the presence of humans in the animal room.(ABSTRACT TRUNCATED AT 250 WORDS)

Animal Welfare↗

Collagen crosslinking and cartilage glycosaminoglycan composition in normal and scoliotic chickens.

The amounts of lysine-derived crosslinks in collagens from tendon, cartilage, intervertebral disc, and bone and changes in the composition of sternal cartilage glycosaminoglycans were estimated in two lines of chickens, a control-isogenic line and a line that develops scoliosis. In the scoliotic line, scoliosis first appears at 3-4 weeks and progressively increases in severity and incidence so that 90% of the birds express the lesion by week 10. We have reported previously that cartilage, tendon, and bone collagens from scoliotic birds are more soluble than corresponding collagens from normal birds. Herein, collagen crosslinking and altered proteoglycan metabolism are examined as possible mechanisms for the differences in collagen solubility. At 1 week of age there were fewer reducible crosslinking amino acids (hydroxylysinonorleucine, dihydroxylysinonorleucine, and lysinonorleucine) in collagens from sternal cartilage and tendon in the scoliotic line than in the isogenic line. However, by week 3 and at weeks 5 or 7 values were similar in both groups. The amounts of hydroxypyridinium in vertebral bone and intervertebral disc collagen were also similar in both groups of birds. Consequently, differences in collagen crosslinking do not appear to be a persistent developmental defect underlying the expression of scoliosis in the model. However, differences were observed in cartilage proteoglycans and glycosaminoglycans from the scoliotic line that were not present in cartilage from the isogenic line. The average molecular weight of the uronide-containing glycosaminoglycans was 30% less in the scoliotic line than in the isogenic line, i.e., 12,000 compared to 18,000. The size distribution of cartilage proteoglycans from the scoliotic line also differed from that of proteoglycans from the isogenic line.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Scoliosis in chickens: responsiveness of severity and incidence to dietary copper.

The severity and incidence of spinal lesions were manipulated in a line of chickens susceptible to scoliosis by varying their dietary intake of copper. A decrease in expression of the lesion was related to increased intake of copper. The change in expression, however, appeared to be related only indirectly to the defects in collagen cross-linking, maturation, and deposition known to be associated with dietary copper deficiency. Thus, a dietary constituent in the range of normal intakes may act as an environmental factor in the expression of scoliosis.

Animals↗

Isolation and characterization of fibronectin from bovine aqueous humor.

Aqueous humor collected from freshly enucleated bovine eyes was passed over a gelatin affinity column, and bound material was eluted with 4M urea. When fractionated by sodium dodecyl sulfate electrophoresis, the eluted material co-migrated with human plasma fibronectin and protein standards of approximately 220,000 daltons. Amino acid analyses demonstrated a composition similar to that of human plasma fibronectin and fibronectin synthesized by cultured cells. The concentration of fibronectin in aqueous humor is approximately 100 times less than in human plasma.

Amino Acids↗

Attitudes of Australian nurses toward the implementation of a clinical information system.

A computerized clinical information system (CIS) used for the majority of patient charting and medical records was installed in six of 15 beds in the intensive care unit (ICU) of a large Australian hospital in November 1993. Staff acceptance was identified as integral to the success of the system. A survey was issued to all nursing staff of the ICU to identify factors that affected attitude toward computers in the critical care environment. Factors resulting in negative attitudes then could be targeted through training and support for users. The factors considered that potentially could influence attitudes were age, nursing experience, intensive care nursing experience, and education. The study showed that nursing experience had a statistically significant effect on motivation to use computers. A strong relation was evident between the concepts of beliefs, attitudes, and motivation. A less apparent association was present between knowledge and the other concepts. Orientation and in-service education programs should provide appropriate and applied information to optimize the motivation, beliefs, and computer literacy of nurses using CIS frameworks.

Adult↗

A comparison of nursing activities associated with manual and automated documentation in an Australian intensive care unit.

This article describes a comparative study that examined the frequencies of nursing activities, when using a clinical information system (CIS) and a paper-based documentation system in an Australian intensive care unit. The study unit had half the beds equipped with a CIS, and the remaining beds used paper documentation. Work sampling methodology was used to observe nurses working with both systems. Though there were differences for all activities between the environments and the directions of the differences were logical, none were statistically significant using a chi-square test (P = .11-0.65), probably because of the small sample size. This study established that work sampling methodology using a random timer is a valid and relatively easy method to capture work activity in the clinical area. Although this article does not provide definitive information regarding the benefits of a CIS over manual documentation, a number of important methodological issues are discussed, including the study design, procedure, use of dedicated observers, and the distinction between basic versus fully optioned systems. Future research should evaluate the efficiency, impact on patient outcomes and nursing practice, and cost effectiveness of fully optioned systems.

Australia↗