Biomedical subjects
Publications and source records attributed to E Hopkins.
There is no consensus on the most appropriate treatment for lymphoedema. Patients are often confused--and may have been misinformed--about treatment options. The breast care specialist nurse should be able to offer a range of treatments, including sequential compression.
The notion of clinical leadership is significant in current nursing practice, particularly since recommendations made by the Department of Health in 'The Strategy for Nursing'. However, while it is a concept that many nurses aspire to implement, in reality the operationalizing of such a concept is fraught with difficulty. This paper aims to explore the issue of clinical leadership through a collegiate model developed in a particular practice area. The development of this collegiate relationship is articulated through the mediums of reflective practice and clinical supervision. A model of collegiality is offered as an approach to the integration of the spheres of clinical leadership. If reflective practice is to be a reality then it is essential that both clinical leaders and practitioners engage in such processes within a supportive culture.
Isolated gastric glands were used to study the mechanism of acid secretory inhibition by thiocyanate (SCN). It was found that SCN does not act as a competitive antagonist of histamine nor does SCN prevent the increase in cellular cAMP associated with histamine stimulation. SCN modifies but does not prevent the expansion of parietal cell canaliculi, indicating that this characteristic morphological transition does not require the actual formation of hydrochloric acid. Low doses (less than 5 mM) of SCN were found to inhibit aminopyrine accumulation, an index of acid formation, but do not inhibit either resting or stimulated respiration. Higher doses (greater than 10 mM) of SCN produce significant inhibition of stimulated but not resting respiration. These results indicate that SCN has two actions, i.e., inhibition of acid formation that requires low doses and inhibition of oxidative metabolism that requires higher doses. Incubation of glands in high-K+ (108 mM) medium leads to formation of an acid gradient in the absence of other secretagogues. The gradient was found to be transient, and its formation does not require oxidative metabolism, indicating that continued proton pumping is not required. Low doses of SCN were found to be more effective in dissipating the high-K+-induced gradient than a similar gradient induced by histamine stimulation. These results support the hypothesis that SCN inhibits acid secretion by increasing the rate of proton-gradient dissipation rather than interfering with a proton-pump mechanism.
Parents who use information from prenatal diagnosis in family planning may be faced with difficult decisions. For a variety of reasons, the communications and decision-making process may be substantially more complex and difficult if the parents are members of a minority group. Unless a number of special considerations are kept in mind when programs of prenatal diagnosis for minorities are developed, such programs may be more harmful than beneficial.
We investigated the performance of two groups of graduates of foreign medical schools on the 1975 and 1976 certification examinations of the American Board of Internal Medicine. Nearly all their postdoctoral residency training was obtained in the United States. The performance (most of those in this study were born in Asia and Southeast Asia) was much lower than that of graduates of United States medical schools. United States citizens who studied medicine abroad performed no better than alien graduates from foreign medical schools. Approximately half the foreign graduates born in the United States studied in Italy, and 10% in Switzerland, Mexico and Belgium. There were no significant differences in performance associated with the type of postdoctoral training (university, university-affiliated, community or other) undertaken in the United States. A significant inverse relation was observed between the interval from completion of training to first examination and the examination performance.
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