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Biomedical subjects

G Sloan

Publications and source records attributed to G Sloan.

15 recordsLinked to original sources
PubMed2001

Replicative response, immunophenotype, and functional activity of monocyte-derived versus CD34(+)-derived dendritic cells following exposure to various expansion and maturational stimuli.

Dendritic cells (DCs), generated ex vivo from blood mononuclear cells (PBMC) or CD34(+) stem cells, are being used to develop novel immunotherapies. To establish optimal DC generation, a direct comparison of the optimal cell source, culture conditions, and maturation stimuli was performed, utilizing phenotypic and functional assays as end points. Plastic adherent monocytes from PBMC were expanded in a serum-free medium (X-Vivo 10) for 7 days using GM-CSF/IL-4; CD34(+) cells were expanded for 14 days using GM-CSF/IL-4/ Flt3L, in either X-Vivo 10 alone or with albumin or autologous plasma. Expanded DC from both cell sources were matured for 7 days with CD40L or IFN-alpha/TNF-alpha. Starting from 2 x 10(7) monocytes, the optimal expansion/maturation process yielded 1.73 +/- 0.52 x 10(6) CD86(+) DC. Optimal expansion of CD34(+) cells (83.9 +/- 25.0-fold) was achieved using X-Vivo 10 with 5% plasma, matured with CD40L, and yielded 10.68 +/- 2.72 x 10(6) CD86(+) DC from 1 x 10(6) CD34(+) cells. Mature DC from PBMC or CD34(+) cells had similar enhanced expression of MHC class II HLA-DR, CD80, CD83, and CD86 and were potent stimulators of mixed lymphocyte reactions. Prior to maturation, all groups of DC actively phagocytosed apoptotic melanoma cells (approximately 50% of HLA-DR(+)). CD34(+) DC matured with CD40L or IFN-alpha/TNF-alpha had reduced phagocytic capability (34 and 31% of HLA-DR(+) DC, respectively). Similar expansion and functional activity was found using cryopreserved DC precursors, cultured in gas permeable bags. We conclude that both cell lineages produce potent mature DC, permitting exploration of the optimal clinical strategy to trigger anti-tumor immune responses in patients with malignancies.

Antigens, CD↗
PubMed2001

Illuminative evaluation: evaluating clinical supervision on its performance rather than the applause.

UNLABELLED: AIM(S) OF THE PAPER: This paper gives a description of illuminative evaluation and argues for its use in process-focused research investigating the reciprocal interpersonal interactions between clinical supervisors and their supervisees. Experiences from conducting an initial pilot study, which is a part of larger qualitative project concerned with individual clinical supervision in mental health nursing, are highlighted. BACKGROUND: Research investigating fundamental process issues in clinical supervision and their influence on outcomes for nursing is uncommon. Previous work in this area has stopped short of exploring the supervisory relationship and illuminating the importance of this interpersonal process in the delivery of gains. At the heart of the present project are questions about which supervisor interventions facilitate and constrain the supervisee's use of individual clinical supervision. METHOD: Data were collected using individual in-depth interviews, critical incident journals, session documents and audio recordings of supervision using illuminative evaluation and a case study approach. FINDINGS: Supervisor interventions included taking the lead, suggesting an option, exploring the supervisee's work, reflecting back, conveying an understanding of client issues, being supportive and giving information. Using Heron's framework, catalytic, prescriptive, informative and supportive interventions were identified. Interestingly, informative interventions related mainly to the sharing of team policy issues and were derived from the clinical supervisor's agenda. Although undoubtedly relevant to the supervisee's practice, such organizationally focused information giving may be at odds with progressing the therapeutic integrity and professional development of the supervisee. Degenerative interventions were also illuminated. CONCLUSIONS: Following the pilot study, it was concluded that the research approach known as illuminative evaluation using multiple case studies is an appropriate design to explore the supervisory process and the particular clinical supervisor and supervisee interactions which influence this. Potential outcomes from the supervisory experience will be contextualized with how mental health nurses engage in the supervisory process and the particular supervisor interventions delivered during supervision sessions.

Adult↗
PubMed2001

John Heron's six-category intervention analysis: towards understanding interpersonal relations and progressing the delivery of clinical supervision for mental health nursing in the United Kingdom.

AIMS: This paper provides a critique of how Heron's six-category intervention analysis framework has been adopted by nursing in the United Kingdom (UK) as a theoretical framework in nursing research and model for clinical supervision. From this, its merits as an analytic framework and model for clinical supervision in nursing are discussed. BACKGROUND: Heron's six-category intervention analysis has been acknowledged as a means by which nursing could develop its therapeutic integrity. It has also been used as a theoretical framework in nursing research focusing on nurses' perceptions of their interpersonal style. More recently descriptions of this framework have been proposed as a structure for clinical supervision. However, its use as a theoretical framework to underpin research investigating the interpersonal skills of nurses and as a model of clinical supervision must firstly be scrutinized. FINDINGS: Returning to Heron's original description and comparing this with its current adoption in the UK, misconceptions of this framework can be identified. Its value as an analytic tool investigating interpersonal relations in nursing has still to be evaluated. Furthermore, nursing's emphasis on certain intervention categories has undermined the potential potency of this framework and its contribution as a model for clinical supervision in nursing. CONCLUSION: We argue that Heron's six-category intervention analysis as a framework to investigate the interpersonal competence of nurses, particularly mental health nurses, requires investigation. This, in turn, would provide an opportunity to challenge the framework's theoretical standpoint. In addition to its value as an analytic tool, all six categories of Heron's framework have equal relevance to its contribution in nursing as a supervision model.

Authoritarianism↗
PubMed2000

Cognitive therapy supervision as a framework for clinical supervision in nursing: using structure to guide discovery.

Cognitive therapy supervision as a framework for clinical supervision in nursing: using structure to guide discovery Cognitive therapy has an undisputed evidence base upon which its clinical application flourishes. This approach is now a well-recognized and widely adopted method used in the treatment of a diversity of psychological problems. More recently, prominent innovators of this psychotherapy have devised a framework to guide the clinical supervision of cognitive therapists. In keeping with its therapeutic application, the cognitive therapy framework for supervision is focused, structured, educational and collaborative. It serves to enhance the therapeutic proficiency of the cognitive therapist. In contrast, the supervision models reported in the recent nursing literature are less precise in their mission and when evaluated their contribution to nursing is shown to be dubious. Following an overview of the supervision models commonly cited in the nursing literature, a more focused comment on the evaluative research concerning Proctor's three-function interactive model will be offered. It is suggested that the unconvincing research findings may be related to the conceptual muddle surrounding clinical supervision, and the expectation for clinical supervision to deliver more than an opportunity for the progression of our therapeutic integrity. From this, a cognitive therapy supervision framework is described and suggested by the authors as a structure from which supervisors can guide discovery.

Clinical Competence↗
PubMed1999

Good characteristics of a clinical supervisor: a community mental health nurse perspective.

A qualitative methodology was adopted using a questionnaire and focus group to identify characteristics of a good supervisor from a supervisee perspective (staff nurses working in a mental health setting). Findings from the questionnaire and focus group were used as a basis for the nominal group technique to establish a prioritization of those characteristics identified. Thematic content analysis of the focus group generated five major categories: who provides clinical supervision; what happens during supervision; factors affecting the choice of supervisor; characteristics of a good clinical supervisor; and limitations caused as a result of how supervision is conducted. The ability to form supportive relationships, having relevant knowledge/clinical skills, expressing a commitment to providing supervision, and having good listening skills were perceived by the staff nurses as important characteristics of their supervisor. Supervisees viewed their supervisor as a role model, someone who they felt inspired them, whom they looked up to and had a high regard for their clinical practice and knowledge base. Nonetheless, limitations to the supervisory process were identified. Having their clinical supervisor allocated to them, their supervisor also being their manager, and having supervision sessions documented and stored by this manager threatened the full utility of the clinical supervision. In this paper three categories will be discussed: what happens during clinical supervision; good qualities of a clinical supervisor; and limitations caused as a result of how clinical supervision is conducted. In light of the study's findings, recommendations are offered to develop the provision of clinical supervision.

Adult↗
PubMed1986

Is there a relationship between sexual abuse or incest and eating disorders?

The significance of sexual conflicts in many patients with eating disorders has been well documented. However, even when these have been considered to have some degree of etiological importance, the occurrence of actual sexual trauma or incest in the early lives of these patients has been generally neglected in the literature. At one point in time, it was noted that five of six patients on an inpatient unit for eating disorders revealed an early history of sexual abuse or incest. These five cases are described. A parallel is drawn between the psychological problems experienced by victims of childhood sexual abuse and by patients with anorexia nervosa and/or bulimia. Our suspicion that these experiences may not be atypical led to the present article, which has implications for the investigation and management of eating-disordered patients.

Adult↗
PubMedDate not supplied

CT appearance of appendicitis and its local complications.

During evaluation for occult fever or nonspecific abdominal pain CT will occasionally identify inflammatory disease of the appendix as the underlying cause. In these cases CT may also provide useful information about the presence of associated mesenteric inflammation, abscess, or perforation. Five cases are presented in which CT provided clinically useful information supplementing that gained from barium studies and clinical presentation. When a periappendiceal lesion is found, the extent and nature of inflammatory changes are shown directly rather than inferentially.

Abscess↗
PubMedDate not supplied

Understanding clinical supervision from a nursing perspective.

During the last 10 years there has been an increase in the amount of nursing literature dealing with clinical supervision. As a result, there has been a gradual growth in the use of clinical supervision to provide support, increase clinical competence and improve client care. Unfortunately, there has not been a comparable increase in research and as a result the amount of empirical knowledge is minimal. This article will discuss the key empirical studies that have focused on identifying the outcomes of supervision and isolating the characteristics that make a good clinical supervisor. Recommendations for practice and research will be suggested.

Clinical Competence↗
PubMedDate not supplied

Clinical supervision: characteristics of a good supervisor.

In this review of the literature, the author evaluates research into supervisor and supervisee perceptions of the attributes of good clinical supervisors. Nursing studies are reviewed but, because of the relative dearth of studies on the topic, the author draws on the counselling, psychology and psychotherapy literature to develop comparisons.

Clinical Competence↗
PubMedDate not supplied

Focus group interviews: defining clinical supervision.

In the companion article to a literature review published recently in Nursing Standard (Sloan 1998), the author demonstrates the use of focus groups as a data collection method. He details how the group discussion was analysed, and reproduces the findings relevant to the 'good characteristics' of a clinical supervisor from the supervisee's perspective.

Clinical Competence↗
PubMedDate not supplied

Anorexia nervosa: a cognitive-behavioural approach.

People with anorexia nervosa can be resistant to treatment because they do not feel the therapist is on their side. This article focuses on the need to establish a therapeutic relationship before interventions can begin. The author also outlines important factors in the onset and maintenance of anorexia nervosa.

Anorexia Nervosa↗