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Biomedical subjects

D Roscoe

Publications and source records attributed to D Roscoe.

12 recordsLinked to original sources
PubMed2000

Regulation of 11beta-hydroxysteroid dehydrogenase enzymes by dietary sodium in the rat.

11Beta-hydroxysterold dehydrogenase enzymes (11beta-HSD1, 11beta-HSD2) regulate access of adrenocorticosteroids to receptors. 11Beta-HSD2 is a dehydrogenase that protects mineralocorticoid receptors from circulating glucocorticoid hormones, 11beta-HSD1 is a reductase that promotes formation of active hormone in glucocorticoid-sensitive tissues. Here we investigate whether low or high sodium diets affect 11beta-HSD enzyme activities and mRNA expression in liver and kidney tissues. 11Beta-HSD activity was measured as dehydrogenation of 3H-corticosterone by microsomes in the presence of NAD or NADP. In situ hybridisation techniques were used to assess expression of 11beta-HSD1 mRNA (liver and kidney) and 11beta-HSD2 mRNA (kidney). Dietary sodium did not affect 11beta-HSD2 mRNA expression in collecting tubules of the medulla: 11beta-HSD1 mRNA in proximal tubules of the inner cortex/outer medulla was lower after a high sodium diet. 11Beta-HSD1 mRNA in liver was unaffected by treatment. Renal enzyme activity with NAD (11beta-HSD2 cofactor) was lower following a high sodium diet (P < 0.05). In the presence of NADP (11beta-HSD1 co-factor), neither renal nor hepatic activities were affected. Dietary sodium restriction appears to increase 11beta-HSD activity by a non-genomic mechanism; this should enhance aldosterone specificity for mineralocorticoid receptors. 11Beta-HSD1 mRNA expression varies independent of enzyme activity and is not clearly related to altered glucocorticoid activity.

11-beta-Hydroxysteroid Dehydrogenases↗
PubMed1996

The impact of physician order entry on nursing roles.

This study examines the impact of physician order entry (POE) on nurses perceptions of work, quality of care, and nurse/physician communication. Four hospitals that have implemented a computerized order-entry system with POE were compared with four similar hospitals using the same computerized system with clerk order entry only. Three factors were extracted from the 29 item survey using principal component extraction with varimax rotation that accounted for 16.5%, 12.4% and 8.7% of the variance respectively. Three scales were constructed from these factors measuring perceptions of impact of the information system on the quality of care, job, control, and nurse/physician communication. Nurses working in the POE environment rated their computer system as having greater impact on the quality of care and lower ratings of perceived control than those working in non-POE environments. No differences were found between nurses working in POE environments and those working in POE in terms of their ratings of frequency of contact and ease of access to physicians.

Attitude of Health Personnel↗
PubMed1995

Successful implementation of an integrated physician order entry application: a systems perspective.

Direct physician order entry is required for effective implementation of an integrated electronic medical record. This effort involves multi-level changes in the whole system of care, from physicians attitudes to interdepartmental relations. This study reports the findings of a follow-up study that quantified dimensions associated with successful implementation identified in a previous study. Results identified several implementation strategies associated with success. These include an interdisciplinary implementation group, involvement of large numbers of regular staff, early and intensive training and support, and 24 hour available assistance as important to success. In addition, attitudes of physicians and their level of involvement were found to be associated with success.

Attitude of Health Personnel↗
PubMed1994

Dimensions associated with successful implementation of a hospital based integrated order entry system.

Implementation of an integrated electronic medical record requires direct physician order entry. This application involves multi-level changes in the whole system of care, from physicians attitudes to interdepartmental relations. This study reports the results of the first round of a modified Delphi, where a diverse group of individuals were asked to identify the most important facilitating and impeding factors associated with implementation of an order entry application. From a Q-sort of their responses, we identified 20 systemic, behavioral, and attitudinal dimensions perceived to be causal factors in successful implementation. We also explored how these dimensions may influence success by comparing successful with unsuccessful hospitals in terms of the frequency with which these dimensions were differently mentioned by respondents. We found that although available functionality was the most commonly mentioned factor by all participants, hardware availability, physician involvement, administration support, and medical administration involvement were more often mentioned by successful hospitals than by less successful hospitals. These results suggest that these factors were not present in the less successful hospitals. We also found that the frequency of responses within each category varied depending on the institutional role of the individuals responding. Those involved in support tended to see organizational variables as more important than those in clinical positions, whereas clinicians viewed administrative support and involvement of the chief as more important. These findings support the notion that the changes involved in instituting a physician order entry system are system wide and involve individual as well as organizational factors.

Attitude of Health Personnel↗
PubMed1988

Comparison of sleep staging by polygraph and color density spectral array.

Color Density Spectral Array (CDSA) is a new technique that uses the fast Fourier transform and color graphics to provide a display of frequency, power, and time. CDSA sleep records provide an overview of sleep architecture as well as quantitative+ EEG data. To validate this technique, overnight sleep records from five patients were independently staged from polygraph recordings and overnight CDSA records. Observed agreement between the two techniques was 85-92% for approximately 1,100 epochs per night.

Adult↗
PubMed1987

Representation of sleep stages by color density spectral array.

Multiple-channel color density spectral array (CDSA) was used to graphically represent sleep stages. This technique uses color coding of Fast Fourier Transforms to provide a compact display of frequency, power, and real time. Distinct CDSA patterns correlate to the awake, non-REM, and REM sleep states. The graphic compression of sleep data could considerably shorten the time required to stage overnight sleep recordings.

Color↗