Old age problem?
Explore the source record for details and available documents.
Attitude of Health Personnel↗
Biomedical subjects
David Pearson
Publications and source records attributed to David Pearson.
Interpolated potential energy surfaces and dynamics for atom exchange between H and H3(+), and D and H3(+).
Two ab initio interpolated potential energy surfaces have been constructed to study the dynamics of atomic hydrogen/deuterium exchange in collisions of H(3)(+) with H (D). One of the surfaces is based on energy calculations using quadratic configuration interaction with single and double excitations. The second includes a perturbative treatment of the triple excitations and an additive correction for basis set deficiency. Results from classical dynamics simulation of the exchange reaction on these surfaces are presented and discussed.
Journal Article↗
A convenient synthesis of chiral nonracemic vinyl aziridines.
[reaction: see text] The preparation of a range of alkyl and aryl chiral vinyl aziridines was achieved in high yield and stereoselectivity, and with excellent diastereoselectivity, by reaction of tert-butylsulfinylimines with the ylide derived from S-allyl tetrahydrothiophenium bromide.
Journal Article↗
Ultrasonic analysis of peptide- and antibody-targeted microbubble contrast agents for molecular imaging of alphavbeta3-expressing cells.
The goal of targeted ultrasound contrast agents is to significantly and selectively enhance the detection of a targeted vascular site. In this manuscript, three distinct contrast agents targeted to the alphavbeta3 integrin are examined. The alphavbeta3 integrin has been shown to be highly expressed on metastatic tumors and endothelial cells during neovascularization, and its expression has been shown to correlate with tumor grade. Specific adhesion of these contrast agents to alphavbeta3-expressing cell monolayers is demonstrated in vitro, and compared with that of nontargeted agents. Acoustic studies illustrate a backscatter amplitude increase from monolayers exposed to the targeted contrast agents of up to 13-fold (22 dB) relative to enhancement due to control bubbles. A linear dependence between the echo amplitude and bubble concentration was observed for bound agents. The decorrelation of the echo from adherent targeted agents is observed over successive pulses as a function of acoustic pressure and bubble density. Frequency-domain analysis demonstrates that adherent targeted bubbles exhibit high-amplitude narrowband echo components, in contrast to the primarily wideband response from free microbubbles. Results suggest that adherent targeted contrast agents are differentiable from free-floating microbubbles, that targeted contrast agents provide higher sensitivity in the detection of angiogenesis, and that conventional ultrasound imaging techniques such as signal subtraction or decorrelation detection can be used to detect integrin-expressing vasculature with sufficient signal-to-noise.
Antibodies↗
Doctors and managers. Out of the shadows.
Explore the source record for details and available documents.
Cooperative Behavior↗
Oculomotor control and the maintenance of spatially and temporally distributed events in visuo-spatial working memory.
Previous studies have demonstrated that working memory for spatial location can be significantly disrupted by concurrent eye or limb movement (Baddeley, 1986; Smyth, Pearson, & Pendleton, 1988). Shifts in attention alone can also interfere with spatial span (Smyth & Scholey, 1994), even with no corresponding movement of the eyes or limbs (Smyth, 1996). What is not clear from these studies is how comparable is the magnitude of effect caused by different forms of spatial disrupter. Recently, it has been demonstrated that limb movements produce as much interference with spatial span as do reflexive saccades (Lawrence, Myerson, Oonk, & Abrams, 2001). In turn this has led to the hypothesis that all spatially directed movement can produce similar effects in visuo-spatial working memory. This paper reports the results of five experiments that have contrasted the effect of concurrent eye movement, limb movement, and covert attention shifts on participants' working memory for sequences of locations. All conditions involving concurrent eye movement produced significantly greater reduction in span than equivalent limb movement or covert attention shifts with eyes fixated. It is argued that these results demonstrate a crucial role for oculomotor control processes during the rehearsal of location-specific representations in working memory.
Adult↗
Evaluating the California Wellness Foundation's Health Improvement Initiative: a logic model approach.
The difficulties of conducting randomized trials to evaluate community-based initiatives have led some researchers to argue in favor of a case study "logic model" approach to evaluation. This article describes a case study logic approach adopted for the evaluation of one community initiative, the Health Improvement Initiative (HII) funded by the California Wellness Foundation (TCWF). The HII is a comprehensive, community-based initiative designed to improve population health by implementing and sustaining community-level systems changes. Nine communities received funding to create broad-based community coalitions (Health Partnerships) that were charged with developing and implementing action plans around systems change. The HII is being evaluated using a case-study logic-model approach that uses quantitative and qualitative data to construct indicators of coalition functioning, systems changes, and population health. By examining the relationship between these indicators over time, it should be possible to determine if any changes in intermediate or long-term outcomes are associated with Health Partnership activities.
California↗
Illustrations from the Wellcome Library. Joseph Fenton and his books.
Explore the source record for details and available documents.
Books↗
Effects of brachytherapy on intimal hyperplasia in arteriovenous fistulas in a porcine model.
PURPOSE: The hypotheses of this investigation were that endovascular radiation would reduce intimal hyperplasia in arteriovenous fistulas (AVFs) and that this reduction would be associated with decreased expression of vascular endothelial growth factor (VEGF), platelet-derived growth factor (PDGF)-A, and tumor necrosis factor (TNF)-alpha. MATERIALS AND METHODS: Bilateral end jugular vein-to-side carotid artery fistulas were constructed in pigs. At 48 hours, one AVF was randomly selected for endovascular radiation with (192) Iridium. The contralateral fistula received no radiation and served as a control. Animals in group 1 (n = 7) received 14 Gy of radiation at a depth of 2 mm and tissue was harvested at 29 days; animals in group 2 received 7 Gy of radiation at a depth of 2 mm and tissue was harvested at 29 days (n = 8); and animals in group 3 received 7 Gy of radiation at a depth of 2 mm and tissue was harvested at 56 days (n = 8). The area and maximum thickness of intimal hyperplasia were then measured blindly. Immunohistochemical results for VEGF, PDGF-A, and TNFalpha were obtained and analyzed blindly by assigning a score of 0-3, with 0 indicating no staining and 3 indicating maximum staining. RESULTS: Irradiation with 14 Gy caused severe fibrosis in the media of the vein, with thrombosis of three of seven AVFs. Compared with the control group, the group that underwent irradiation with 7 Gy had significantly reduced intimal area at 56 days (9.9 mm(2) +/- 4.9 vs 2.1 mm(2) +/- 1.1; P =.001). This reduction correlated with significant reduction in the expression of VEGF (score of 2.2 +/- 0.1 vs 1.2 +/- 0.2; P =.001) and TNFalpha (1.3 +/- 0.1 vs 0.9 +/- 0.1; P =.04). CONCLUSION: Fourteen grays is an excessive radiation dose for veins, causing medial fibrosis and thrombosis of the AVF. Irradiation with 7 Gy effectively inhibited the formation of intimal hyperplasia in AVF. This inhibition correlated with decreased expression of VEGF and TNFalpha.
Animals↗
Barriers to developing the nurse practitioner role in primary care-the GP perspective.
BACKGROUND: Opportunities exist to develop an advanced nursing role in general practice and there is growing evidence that appropriately trained nurses can reduce cost and GP workload without compromising quality of care or patient satisfaction. Despite the shortfall of doctors entering British general practice and the difficulties doctors report in managing an increasing workload in primary care, few British practices have chosen to adopt this potential solution. An exploration of the barriers to the development of a nurse practitioner role is therefore timely. OBJECTIVE: To explore the views of British GPs regarding their attitudes towards developing an advanced nursing role in general practice. METHODS: A focus group study of GPs from four general practices in Yorkshire selected purposefully to represent a spectrum of experience in working with different nursing roles in general practice. Each focus group consisted of between 6 and 8 participants. A structured framework was used to elicit views, the group meetings were recorded and subjected to content analysis by two independent assessors. Inter-rater reliability was high (K = 0.921; 95% confidence limits 0.86-0.98). RESULTS: The study highlighted significant concerns by GPs with regard to the nurse practitioner role in general practice. Four themes were identified that may be impeding the development of advanced nursing roles in general practice. These are concerned with threats to GP status, including job and financial security, nursing capabilities, including training and scope of responsibility, and structural and organizational barriers. CONCLUSIONS: There is a need to acknowledge GP concerns and encourage a more widespread debate about the appropriate mix of skills required in primary care. Joint educational events and the development of GP preceptorship may help to develop a greater understanding of the potential value of advanced nursing roles in general practice.
England↗
The California wellness foundation's Health Improvement Initiative: evaluation findings and lessons learned.
PURPOSE: To evaluate the effect of the Health Improvement Initiative (HII), a 5-year grantmaking initiative funded by The California Wellness Foundation designed to identify the critical factors needed to bring about population health improvements through community-level systems change. DESIGN: The evaluation of the HII used a case-study, logic-model approach to make inferences about the effect of each community coalition (Health Partnership) on its target community. The primary outcome measure was the creation of significant and sustainable community-level systems change. SETTING: The HII included nine communities in California that received funding to create broad-based Health Partnerships. SUBJECTS: Primary data were collected from a variety of Initiative stakeholders by key informant interviews, closed-ended surveys, and participant observation. INTERVENTION: The HII provided funding over 5 years to nine Health Partnerships that were intended to be a driving force in implementing community-level systems change. The ultimate objective of the systems change process was to improve "population health, " broadly defined to include social economic, and cultural determinants of health, in addition to traditional health status indicators. MEASURES: Both qualitative and quantitative techniques were used to assess the effect of the HII on key community systems. The primary outcomes were qualitative descriptions of community-level changes. RESULTS: At the end of the 5 years of HII funding, six of the nine Partnerships had played a critical role in implementing sustainable systems changes that would likely have a significant effect in their target communities. CONCLUSION: The HII was successful in promoting community-level systems change in the majority of funded communities, although the evidence was mixed regarding the role of the Partnerships in bringing about these changes.
California↗
A training course for psychiatric nurses in Russia.
This article describes the impact on mental health services in Russia of a training course for psychiatric nurses in the management of aggression. This project, which is part of a seven-year international partnership between mental health professionals in the UK and Russia, demonstrates the importance of nurse training to effect change in healthcare organisations.
Aggression↗