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Biomedical subjects

C Palmer

Publications and source records attributed to C Palmer.

At least 19 recordsLinked to original sources
PubMed2006

Epidemiology of infections caused by extended-spectrum beta-lactamase-producing Escherichia coli and Klebsiella spp.: a nested case-control study from a tertiary hospital in London.

Information on risk factors for acquisition of extended-spectrum ss-lactamase (ESBL)-producing organisms and their outcomes in patients with invasive infections is scant. The objectives of this study were to evaluate risk factors and all-cause mortality associated with infection due to ESBL-producing organisms using a nested case-control design, and to document transmission within a hospital employing molecular and conventional epidemiological methods. From December 2003 to April 2005, 50 patients with bloodstream infections (BSIs) due to ESBL-producing E. coli and Klebsiella spp. were recruited. Controls (N=50) were chosen, within the same period, from patients with non-ESBL-producing BSIs by simple random sampling; account was taken of potential confounding factors. Cases and controls were followed-up until November 2005, and outcomes were recorded as discharged or deceased. Molecular methods, supported by conventional epidemiology, were used to study the transmission of organisms. Logistic regression analyses showed prior ss-lactam antibiotics [odds ratio (OR) 11.57; 95% confidence intervals (CI) 2.31-51.15; P=0.003], hospital stay >15 days (OR 2.63; 95% CI 1.01-6.89; P=0.04) and prior admission to the intensive care unit (OR 13.98; 95% CI 1.88-19.15; P=0.006) to be independent risk factors for the acquisition of ESBL-producing organisms. In the first 15 days of follow-up, a significant proportion of patients with ESBL-producing organisms died; however, there was no difference in mortality between cases and controls at the end of the follow-up period. Molecular epidemiology identified five clusters amongst the ESBL-producing isolates. Conventional epidemiological analyses supported the evidence of transmission in three of these clusters.

Adolescent↗
PubMed2006

Laboratory diagnosis of bloodstream infections caused by extended-spectrum beta-lactamase-producing E. coli and Klebsiella species.

Extended-spectrum beta-lactamase (ESBL)-producing organisms are resistant to the third-generation cephalosporins commonly used as empirical therapy for a wide range of serious infections. It is therefore important for laboratories to offer reliable ESBL detection methods. This study compares two combination disc methods (Oxoid and Mast Diagnostics) containing cepodoxime with and without clavulanate with Vitek 2 for routine detection of ESBLs in Escherichia coli and Klebsiella spp. isolated from blood cultures. From December 2003 to April 2005, a total of 58 potential ESBL-producing isolates (resistant to cefotaxime and/or ceftazidime) by BSAC disc susceptibility were tested by the combination discs and Vitek 2. The Advanced Expert System, a feature of Vitek 2 reports possible mechanisms of resistance, based on interpretive reading of MICs. This study detected 7.4% more ESBL-producing isolates by Vitek 2 than by Oxoid disc testing (95% CI: 0.15-14.7%; P < 0.2) and 31.6% more ESBL-producing isolates were detected by Vitek 2 than by Mast disc testing, (95% CI: 16.2-46.96%; P < 0.001). Batch-to-batch variation was evident in disc performance for both disc types. Thus, use of appropriate controls is recommended when testing by the combination disc methods. Although no phenotypic test is 100% sensitive and specific, the Vitek 2 was a reliable system for ESBL detection; however, it is expensive and interpretation of results can be confusing to inexperienced users. Further studies to compare Vitek 2 with cefotaxime and ceftazidime combination discs may reveal disc methodology for ESBL detection to be a more reliable alternative than using cefpodoxime combination discs alone.

Anti-Bacterial Agents↗
PubMed2005

The detection of porcine circovirus in the Australian pig herd.

OBJECTIVE: To determine if porcine circovirus (PCV) type 1 (PCV1) or type 2 (PCV2) is present in the Australian pig herd, to conduct preliminary genetic characterisation of any viruses detected, and to determine if there is any obvious virological reason why post-weaning multisystemic wasting disease (PMWS), associated with PCV infection in other countries, has not been detected in Australia. DESIGN: Serum samples were collected from 14 randomly selected pig farms in Western Australia and used for detection of PCV antibody. Additional samples from one farm were obtained at 2-week intervals from pigs between 2 and 12 weeks of age to detect any age-associated variations in prevalence of infection. Veterinary practitioners from four Australian states submitted tissues of dead or unthrifty weaned pigs, and these were examined for evidence of PCV1 and PCV2 infection. PROCEDURE: Sera were tested for antibody to PCV using an indirect immunofluorescence assay (IFA). Tissues were tested for PCV1 and PCV2 genomic material using a multiplex PCR. RESULTS: PCV antibody was detected in approximately 30% of Western Australian pigs tested. PCV1 DNA was detected in tissue samples from Western Australia, South Australia and New South Wales and PCV2 DNA was detected in tissue samples from Western Australia, New South Wales and Queensland. Sequence analysis of the PCR products indicated the PCV1 and PCV2 present in Australia were very similar to strains in other countries where PMWS is endemic. CONCLUSION: Both PCV1 and PCV2 are present in Australia and the viruses present appear similar to those in countries with PMWS. The absence of PCV2-associated PMWS in Australia may be due to absence of essential secondary factors required for PCV2 to produce PMWS.

Age Factors↗
PubMed2002

Effects of delayed auditory feedback on timing of music performance.

Three experiments examined effects of delayed auditory feedback (DAF) on music performance as a function of the temporal location of feedback onsets within produced inter-onset intervals (IOIs). In Experiment 1, pianists performed isochronous melodies at two production rates with different amounts of DAF. Timing variability decreased for DAF amounts that caused feedback onsets to occur halfway through IOIs (binary subdivisions) in a 500-ms, but not 600-ms, IOI rate condition. In Experiment 2, pianists performed melodies with DAF delays and chose a preferred rate. Performers chose slower rates for larger delays; preferred rates approximated twice the amount of DAF. Experiment 3 tested the possibility that subjects deliberately conceptualized subdivisions in Experiments 1 and 2. Performers were given (1) no instructions, (2) instructions to mentally subdivide produced events in two, or (3) instructions to mentally subdivide produced events in three, in different blocks. Instructions to subdivide reduced timing variability for larger feedback delays. These experiments indicate that DAF disruption is reduced by subdividing instructions and sometimes by coincidences of feedback onsets with subdivisions of produced intervals. Such facilitation may reflect the use of hierarchical cognitive plans in production.

Auditory Perception↗
PubMed2002

Nutritional and immune status following spinal cord injury: a case controlled study.

STUDY DESIGN: Case controlled study. OBJECTIVE: To compare nutritional status and immune response in a group of spinal cord injured (SCI) patients with age and gender matched non SCI control subjects. METHOD: Thirty past patients of the Burwood Hospital Spinal Injuries Unit living locally were enrolled in the study. Age and gender matched non SCI control subjects were selected volunteers from hospital staff. Nutritional status was assessed by generating a Nutritional Risk Score (NRS, Appendix 1) and drawing blood for full blood count, iron studies, red blood cell folate, vitamin B12, ferritin, magnesium, and zinc. Immune status was assessed by vaccination response index (VRI) to Pneumovax 23 vaccine. RESULTS: Full blood count, iron studies, and testing for red blood cell folate, albumin, prealbumin, vitamin B12, ferritin, magnesium and zinc were normal range for both groups. The SCI group had significantly different median values than controls (P < 0.01) for haemoglobin concentration, white blood cell count, albumin, prealbumin, serum iron and % saturation. Body Mass Index (weight kg/(height cm(2)) was 22.2 (range 15-30) for the SCI group, significantly less than the paired control group index of 26 (range 20-32, P = 0.0004). Median NRS for SCI patients was 2 (range 0-6), compared to 0 (range 2-4) for paired controls (P < 0.0001). Scores ranged from 0 to 2 for each of the five NRS components for the SCI patients and 0 to 3 for the control group. There was no significant difference in the pre- and post-vaccination ratio for IgG, IgA, and IgM response to Pneumovax 23 vaccine. CONCLUSION: We have not identified any nutritional or immune status abnormality in SCI patients, however the SCI patients have a lower value for certain nutritional parameters and BMI. SCI patients however are at only slight risk of nutritional problems given their NRS and their lower normal values for certain nutritional factors.

Adult↗
PubMed2002

A survey of the delivery and uptake of influenza vaccine among health care workers.

During the 1990s, policies for immunizing fit health care workers against influenza varied between National Health Service (NHS) employers and the uptake of influenza vaccine by NHS staff was poor. In light of recent Department of Health recommendations to immunize key health care staff against influenza, we explored the possible reasons for poor uptake and assessed the impact of an intensive promotion campaign on vaccine acceptance. Among 290 doctors and nurses, the main perceived barriers to influenza immunization were difficulty with practical access to vaccine and lack of time to attend. Following intensive promotion and improved local access to influenza vaccine, the uptake among health care workers was approximately doubled. However, the overall proportion of staff immunized was low (5%) and the immunization rate among medical staff was particularly poor (2%). The practical implications for influenza immunization campaigns aimed at health care workers are discussed.

Attitude of Health Personnel↗
PubMed2001

Medical student debt at the Christchurch School of Medicine. The New Zealand Wellbeing, Intentions, Debt and Experiences (WIDE) survey of medical students pilot study. Results part I.

AIMS: To determine the level and sources of medical student debt at the Christchurch School of Medicine. METHODS: A questionnaire, The New Zealand Wellbeing, Intentions, Debt, and Experiences (WIDE) Survey of Medical Students, was developed and administered to all 204 medical students at the Christchurch School of Medicine and Health Sciences. Included were questions on student demographics, sources and levels of debt, parental financial support, and student perceptions of their debt. RESULTS: The response rate was 88%. International students, whose debt was with an overseas government, and students with mortgages were excluded from the data analysis. The combined total debt for the remaining 165 students was $7775000 with $6290000 (81%) owed to the Government Students Loans scheme. One quarter of 6th year medical students had a debt over $83250, 50% had a debt over $70000, and 75% had a debt over $50000. Student allowances were inaccessible to 64% of 4th and 5th year students and part-time employment during term-time was common. Lack of funds was reported to impair full participation in the medical course. CONCLUSION: The majority of medical students at the Christchurch School of Medicine accumulate high levels of debt, mainly dtrough the Government Student Loans scheme, during their medical training.

Education, Medical, Undergraduate↗
PubMed2001

Medical student career intentions at the Christchurch School of Medicine. The New Zealand Wellbeing, Intentions, Debt and Experiences (WIDE) survey of medical students pilot study. Results part II.

AIMS: To record career preferences for medical students at the Christchurch School of Medicine and Health Sciences and investigate factors, including student debt, that might influence career decisions. METHODS: A questionnaire, The New Zealand Wellbeing, Intentions, Debt, and Experiences (WIDE) Survey of Medical Students, was developed and administered to all 204 medical students at the Christchurch School of Medicine and Health Sciences. The survey included questions relating to preferred career intentions and factors influencing career decisions, including the decision to leave New Zealand to practise medicine. RESULTS: The response rate was 88%. 80% intend to practise medicine in New Zealand immediately after graduation, however 82% indicated that they would leave within two years of graduation. Financial opportunities overseas and level of debt were the strongest motivating factors to leave. Repayments towards student loans and increased salaries were factors that might retain people in New Zealand. Medical and surgical specialities were the most popular career choices. Personal interest was the strongest motivator for career choice. Practising in a rural community was not popular. CONCLUSION: Debt is one of a number of important factors influencing medical student career decisions including the decision to leave New Zealand. Initiatives addressing debt may be useful in retaining medical graduates in this country.

Adult↗
PubMed2001

Functional characterization of the C-terminus of the human ether-à-go-go-related gene K(+) channel (HERG).

1. In the present study the functional role of the C-terminus of the human ether-à-go-go-related gene K(+) channel HERG was investigated using a series of C-terminal deletion constructs expressed in Xenopus oocytes. 2. Constructs with deletions of 311 or more amino acid residues failed to form functional channels. Truncation by 215 amino acid residues or fewer had no discernable effects on channel activity. Truncation by 236 or 278 amino acid residues accelerated deactivation, and caused a faster recovery from inactivation. 3. In high extracellular K(+), channel deactivation of HERG results from the binding of the N-terminus to a site within the pore. This slows channel deactivation by a knock-off mechanism. Here, it was shown that C-terminal deletions also abolished this effect of high extracellular K(+). Mutants containing deletions in both the N- and C-termini deactivated with rates similar to those observed in individual deletion mutants. 4. In contrast, experiments with double-deletion constructs showed additive effects of the N- and C-termini on the voltage dependence of activation, and on the kinetics of inactivation and recovery from inactivation. The reduction of inactivation in these mutants contributed to an increase in peak current amplitude. 5. These results indicate that residues within the C-terminus of HERG play a role in channel expression as well as in most aspects of channel gating. The regulation of channel deactivation is likely to be mediated by an interaction with the N-terminus, but the regulation of the voltage dependence of activation, and of rate processes associated with inactivation, does not require the N-terminus.

Animals↗
PubMed2001

Hypoxic/ischemic insult alters ferritin expression and myelination in neonatal rat brains.

Ferritin is expressed very early in the development of oligodendrocytes. This protein makes iron available within cells while providing some protection from iron-induced oxidative damage. In the developing rat brain, ferritin is found initially in microglia followed by oligodendrocytes in a temporal and spatial pattern that coincides with the expression of myelin. In this study, we test the hypothesis that hypoxic/ischemic (H/I) insult will alter the expression of ferritin in microglia and oligodendrocytes, resulting in a delay in the appearance of myelin markers. Seven-day-old rat pups were exposed to H/I insult. Within 24 hours, after the insult, there is an increase in ferritin-positive amoeboid microglia and a decrease in immunohistochemical reaction for the myelin marker Rip in the brain. The oligodendrocyte marker 2'-3'-cyclic nucleotide 3'-phosphodiesterase is elevated in the H/I hemisphere relative to the hypoxia-only hemisphere between 8 and 15 days after insult. By 23 days after the insult, the subcortical white matter segregates into areas that contain ferritin-positive microglia and are devoid of Rip-positive oligodendrocytes or areas with Rip-positive cells and no ferritin-positive microglia. The H/I insult also affects the ratio of H-rich to L-rich ferritin expression at most of the time periods. These results demonstrate that the type of ferritin, its cellular distribution and the normal pattern of subcortical white matter myelination is affected by H/I. We propose that the absence of ferritin in oligodendrocytes prohibits them from storing sufficient iron to meet the synthetic and metabolic demands associated with myelination.

2',3'-Cyclic-Nucleotide Phosphodiesterases↗
PubMed2001

Magnetic resonance spectroscopic imaging in temporal lobe epilepsy: neuronal dysfunction or cell loss?

BACKGROUND: Magnetic resonance spectroscopy (MRS) has demonstrated consistent metabolic abnormalities in temporal lobe epilepsy. The reason for decreases in N-acetylated compounds are thought to be related to neuronal hippocampal cell loss as observed in hippocampal sclerosis. However, mounting evidence suggest that the N-acetylated compound decreases may be functional and reversible. OBJECTIVE: To establish whether the metabolic changes measured by MRS correlate to hippocampal cell loss in temporal lobe epilepsy. SUBJECTS AND METHODS: We prospectively performed quantitative hippocampal MR imaging volumetry and MRS imaging in 33 patients with intractable mesial temporal lobe epilepsy who were undergoing surgery. A neuronal-glial ratio of cornu ammonis and fascia dentata was obtained and correlated while validating the pathologic analysis by comparisons with specimens of age-matched autopsy control-case hippocampus (n = 14). RESULTS: The neuronal-glial ratio of the patient group was statistically significantly lower than in the control group for the cornu ammonis region (P<.001). Correlations of hippocampal volumes with cornu ammonis and neuronal-glial ratios revealed a significant interdependence (P<.01). However, correlations of the resected hippocampal creatine-N-acetylated compound ratio with the cornu ammonis or fascia dentata neuronal-glial ratios showed no significant interdependence (P>.8). CONCLUSIONS: Our findings support the concept that the metabolic dysfunction measured by MRS imaging and the hippocampal volume loss detected by MR imaging volumetry do not have the same neuropathologic basis. These findings suggest that the MRS imaging metabolic measures reflect neuronal and glial dysfunction rather than neuronal cell loss as previously assumed.

Adolescent↗
PubMed2001

The emancipation of nursing practice: applying anti-psychiatry to the therapeutic community.

This paper raises issues about the process and conduct of clinical relationships with people diagnosed as mentally ill who live in therapeutic communities. This clinical work is of particular importance in the late 1990s due to the changing socio-cultural climate of interaction with people living with mental illness. This climate has a focus of care on recovery in the community and not on long-term hospitalization. The paper takes the position of anti-psychiatry as a preferred model of intervention because it is person and not diagnosis oriented. The nature of the therapeutic community is explored in relation to its importance in the context of destigmatizing mental illness, its structure, and in its ability to empower the person from a philosophically driven and experiential perspective.

Attitude of Health Personnel↗
PubMed2001

Different accumulation of activated extracellular signal-regulated kinases (ERK 1/2) and role in cell-cycle alterations by epidermal growth factor, hydrogen peroxide, or asbestos in pulmonary epithelial cells.

The extracellular signal-regulated kinase (ERK) pathway is induced by cytokines and oxidative stress. In this study we examined the patterns of localization of phosphorylated ERK proteins in relationship to subsequent phenotypic responses by the mitogenic agent epidermal growth factor (EGF) (5 ng/ ml); hydrogen peroxide (H(2)O(2)) (100 to 300 microM), an inducer of apoptosis; and crocidolite asbestos (5 microg/cm(2) dish) in a nontransformed murine alveolar type II epithelial cell line (C10). Laser scanning cytometry and flow cytometry were used to determine: (1) whether expression of phosphorylated ERKs was cell cycle-related; and (2) whether cell-cycle alterations by agents could be modified after addition of the mitogen-activated protein kinase/ERK kinase (MEK) 1 inhibitor PD98059. In contrast to other stimuli which induced transient increases in phosphorylated ERKs, asbestos caused fiber-associated localization of phosphorylated ERKs that were elevated from 1 to 24 h (P < or = 0.05), and striking apoptosis followed by increased numbers of cells in the S phase at 72 h. In both control and asbestos-exposed cells, the percentage of phosphorylated ERK-positive cells was greatest in cells in the G(2)/M and S phases of the cell cycle. All stimuli caused increased proportions of cells in G(2)/M at 24 h that were inhibited by PD98059 (30 microM). Increases in G(2)/M cells by H(2)O(2) and asbestos also were decreased at 48 h by the MEK1 inhibitor. In addition, PD98059 abrogated elevations in S-phase cells by EGF and H(2)O(2) at 24 h and by asbestos at 72 h. Our results suggest that ERKs mediate cell-cycle alterations during the development of epithelial cell apoptosis or proliferation by diverse ERK stimuli.

Animals↗
PubMed2001

A disciplined approach to spiritual care giving for adults living with cystic fibrosis.

Adults living with cystic fibrosis are less likely than other pulmonary patients to describe themselves as religious, to attend worship services regularly, to use god language, to describe their spiritual life, and in general, to give any obvious, outward indications of their spiritual strength, concerns, and depth. And yet, they have consistently demonstrated in chaplain-patient encounters an awareness of the function and importance of their spirituality in relation to life choices, coping with illness, facing mortality, and expressing life meaning, beliefs, and values. A disciplined approach by chaplains is a key component to engaging these patients so that each person's unique spiritual story unfolds. Results from The Discipline demonstrate how adults with cystic fibrosis are different in their expression and approach to spirituality from other pulmonary patients.

Adult↗
PubMed2000

Preface.

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Journal Article↗
PubMed2000

The neuroprotective effect of deferoxamine in the hypoxic-ischemic immature mouse brain.

The iron chelator deferoxamine is efficacious in ameliorating hypoxic-ischemic brain injury in some models, perhaps by decreasing oxidative stress. Transgenic copper/zinc superoxide dismutase-1 (SOD1) overexpression in neonatal mice increases brain injury after hypoxia-ischemia compared to non-transgenic wildtype littermates because of increased oxidative stress. A neonatal mouse model of hypoxia-ischemia was used to examine histopathological damage, iron histochemistry and free iron concentration in the brains of SOD1 transgenic and non-transgenic littermates. Deferoxamine significantly decreased injury in non-transgenics compared to controls with a trend toward neuroprotection in the transgenics. There was no difference in free iron concentrations in the brains of SOD1 overexpressors or non-transgenics. Deferoxamine may protect the neonatal brain by a number of anti-oxidant mechanisms including iron chelation, enhancement of stress gene expression, or induction of other factors responsible for neuroprotection.

Animals↗
PubMed2000

Skill acquisition in music performance: relations between planning and temporal control.

We investigated the acquisition of music performance skills in novice and expert pianists. Temporal disruptions in novice performances coincided with constraints in planning capacities. Child and adult pianists ranging in age (9-26 years), training (3-15 years) and sight-reading ability learned to perform a novel musical piece in eleven practice trials. Computer-detected pitch and timing errors revealed: (1) gradual improvements in performance tempo and pitch accuracy with skill level and practice, generally fitting a power function; (2) a relative-timing/pitch accuracy trade-off and high incidence of simultaneous pitch/time errors; (3) improvements in relative timing (temporal continuity, underlying beat, metrical structure) with skill and practice; and (4) increased anticipatory behavior and a greater range of planning with skill and practice. A strong positive relationship between the mastery of temporal constraints and planning abilities within performance suggests that these two cognitive indicators are closely related and may arise from segmentation processes during performance. Examination of sequence timing may explicate planning abilities that underlie many complex skills.

Adolescent↗