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Biomedical subjects

G Sullivan

Publications and source records attributed to G Sullivan.

At least 73 records · Page 4Linked to original sources
PubMed1993

The role of ethnic relations and education systems in migration from Southeast Asia to Australia.

"After a brief discussion of the geographical, cultural, and historical characteristics of Southeast Asia [and Hong Kong], a review is provided of the evolution of Australian immigration policy which, in our view, is a strong pull factor. This is followed by stock and flow analyses of Asian-born residents in Australia. The motivations for emigration in countries which exhibit substantial emigration rates are considered next and the article ends with the conclusion that demand factors and social networks play a decisive role in the decision to emigrate." Factors affecting migration significantly include political conditions and ethnic relations in countries of origin, and educational and career opportunities in the country of destination.

Asia↗
PubMed1992

Value of postprocedural chest radiographs in the adult intensive care unit.

OBJECTIVE: To evaluate the necessity for postprocedural chest radiographs after catheterization of central veins, insertion of pulmonary artery catheters, and placement of endotracheal tubes. DESIGN: Prospective, controlled study. SETTING: Two academic tertiary adult ICUs. PATIENTS: Consecutive patients (n = 316) requiring central vein cannulation or endotracheal intubation in the ICUs. INTERVENTION: After each invasive procedure, the physician was instructed to complete a detailed evaluation sheet. Criteria based on the details of the procedure and immediate postprocedural clinical evaluation of the patient were used to determine the likelihood of a radiologically detectable complication. Actual radiologic findings were subsequently compared against clinical predictions. MAIN OUTCOME MEASUREMENTS: Ability of housestaff to correctly predict the absence of radiologically detectable postprocedural complications (predictive negatives). RESULTS: Ability to predict the absence of complications after cordis catheter insertions via the subclavian vein or internal jugular vein was very high (151/152; p < .001). Unsuspected complications were more frequent with central vein multilumen catheter insertions (3/24; p < .001). Ability to predict uncomplicated pulmonary artery catheterization was also high (110/111; p < .001). Physicians were unable to predict the majority of complications associated with endotracheal intubations (28/32; p > .50). CONCLUSIONS: The use of a protocol that includes an evaluation of the characteristics of the procedure and postprocedural physical examination can greatly reduce the need for routine chest radiographs after subclavian and internal jugular vein cordis catheterizations and pulmonary artery catheter placement. Chest radiographs should be performed after endotracheal intubation and multilumen catheter insertion.

Catheterization, Central Venous↗
PubMed1992

Clinical factors associated with better quality of life in a seriously mentally ill population.

Improving the quality of life of persons with chronic mental illness is becoming an important treatment goal. In this study, 101 former acute care psychiatric inpatients with serious mental illness who were living in Mississippi communities were interviewed using portions of Lehman's Quality of Life Interview. A particular focus was whether clinical characteristics, such as medication compliance and social skills, that could be changed by interventions were associated with patients' ratings of their quality of life. Self-reports of better quality of life were associated with fewer depressive symptoms, fewer medication side effects, and better family interactions. Results indicate that clinical interventions to improve quality of life in this population should include family psychoeducational programs and better detection, evaluation, and treatment of both depressive symptoms and side effects of medication.

Adolescent↗
PubMed1992

Labour migration and policy formation in a newly industrialized country: a case study of illegal Thai workers in Singapore.

"Towards the end of 1988, the Singapore Government began to express concern about over-reliance of the economy on foreign workers and later about the presence of large numbers of illegal workers. This article examines the policies and legislation introduced to change these situations, and examines in detail the repatriation of 10,000 unauthorized Thai immigrants. In addition to economic policy and practice, the social and political aspects of migration and labour utilization are considered, as are the implications for international relations."

Asia↗
PubMed1992

Limb gangrene secondary to thromboembolic disease of the newborn.

Thromboembolic disease of the newborn is a well-known entity to neonatologists. When severe arterial compromise threatens limb survival, the orthopaedic surgeon may be called on to assist in the management of this disorder. A case of spontaneous postnatal ischemic gangrene of an upper extremity that resulted in amputation in a premature infant is presented; management options are discussed. Newborns are prone to thromboembolism due to a fibrinolytic capability that is significantly different from that of adults.

Arm↗
PubMed1991

The rapid infusion system: a superior method for the resuscitation of hypovolemic trauma patients.

The rapid infusion system (RIS), which can deliver fluids/blood products rapidly at precise rates and normothermic conditions, was compared with conventional fluid administration (CFA) in a randomized study of 36 hypovolemic trauma patients. Admission stratification criteria of the groups were similar relative to age, Glasgow Coma Score (GCS), Injury Severity Score (ISS) and plasma lactate. Despite the lack of difference in blood loss between the 24-h survivors of the two groups, the CFA group required greater total fluids (23.6/20.21), red blood cells (5.5/4.61), fresh frozen plasma (FFP) (2.8/1.91), platelets (523/204 ml), and crystalloids (12.9/10.61). Lactate levels were lower in the RIS group at virtually all times from hours 1 to 24 (4.3/5.3 mM/l, t-value = 3.3, DF = 279, P = 0.001). Post-admission hypothermia was greater in the CFA group at all times during the first 24 h (35.2/36.4 degrees C, t-value = 5.6, DF = 250, P = 0.001). The mean partial thromboplastin time was significantly higher in the CFA group (47.3/35.1 s, t-value = 3.1, DF = 279, P = 0.002). The PTT and PT were related to the degree of lactic acidosis (P = 0.0001) and hypothermia (P = 0.001) but not to the amount of FFP given (P = 0.14). The hospital costs, days in the ICU, and days on the ventilator were greater for the CFA group, as was the incidence of pneumonia (0/11 vs. 6/17; P = 0.03). Hypovolemic trauma patients resuscitated with the RIS needed fewer fluid/blood products and had less coagulopathy; more rapid resolution of hypoperfusion acidosis; better temperature preservation; and fewer hospital complications than those resuscitated with conventional methods of fluid/blood product administration.

Adult↗
PubMed1991

The impact of religion and cultural values on AIDS education programs in Malaysia and the Philippines.

This paper examines the impact of cultural values and government policies on the content of AIDS educational literature prepared by public health agencies in Malaysia and the Philippines. The literature from these countries, which has been distributed to the public and is intended to inform them of the danger of AIDS, how the HIV is and is not transmitted, and how to avoid infection, is analyzed and evaluated for effectiveness and congruence with the dominant religious tenets and cultural practices in each country, and attitudes to sexual behavior. The paper also describes the response of these countries to the AIDS pandemic, and concludes with suggestions about how this form of AIDS education can be improved.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Longitudinal change in HIV transmission risk behaviors by gay male physicians.

Gay male physicians were surveyed in 1984 and 1985 about their knowledge and attitudes regarding HIV transmission and AIDS and changes they had made in social, health-related, and sexual activities since the onset of the AIDS epidemic. Most of the 37 subjects who participated in both surveys progressively lessened their participation in HIV transmission risk behaviors over time. Health belief, AIDS knowledge, health coping, social support, mood state, and age factors all contributed to changes in sexual behavior. The modeling of sexual-behavior changes showed general stability over time. This study provides further evidence that multiple psychosocial factors are associated with changes in sexual behavior, even in gay male physicians.

Adult↗
PubMed1990

Social skills and relapse history in outpatient schizophrenics.

Persons with schizophrenia commonly have impaired social functioning (Wallace 1984). Those with greater impairments, particularly as measured by premorbid social attainment, have a poorer clinical prognosis (Strauss and Carpenter 1972). Interventions designed to improve social competence, such as social skills training, have yielded generalizable and durable effects and may have reduced relapse rates (Wallace and Liberman 1985; Liberman et al. 1986; Hogarty et al. 1986). Thus, a valid measure of social skills should be a useful clinical and research tool. This research explores the validity of a new instrument for measuring such skills, the Assessment of Interpersonal Problem Solving Skills (AIPSS) (Donahoe et al., this issue). The AIPSS differs from more conventional social functioning measures because it 1) utilizes observations of role-playing, rather than self-report or third-party report; 2) provides a rating of the patient's current rather than past functioning; 3) involves videotaped simulated "real life" situations that pose challenges to the patient's ability to solve socially relevant problems; 4) permits assessment of patient's social perception, processing of social information for action planning, and verbal and nonverbal social responses. In this study, we examined the relationship between these parameters of schizophrenic patients' social functioning and their recent relapse history.

Adult↗
PubMed1990

Sexual side effects of antipsychotic medication: evaluation and interventions.

Sexual side effects of antipsychotic medications, which include disturbances of erection and ejaculation, changes in libido, and priapism in men and decreased libido, orgasmic dysfunction, and menstrual irregularities in women, are estimated to occur in 30 to 60 percent of persons taking the drugs. The authors review side effects associated with specific drugs and present guidelines for assessing whether sexual dysfunction is related to medication. Pharmacological interventions that may reduce antipsychotic-induced sexual dysfunction include gradually reducing the dose or changing the type of medication and administering other medications such as bethanechol, neostigmine, cyproheptadine, and bromocriptine that are known to improve sexual dysfunction.

Adult↗
PubMed1990

New pharmacological studies with pentoxifylline.

Polymorphonuclear (PMN) overactivation plays a critical role in microcirculation as well as in conditions such as multiorgan failure (MOF). Pentoxifylline has been shown to prevent PMN activation by endotoxin and cytokines such as TNF alpha and IL-1. In addition, MOF induced by IL-2 in animals can be prevented by pentoxifylline. The present studies evaluated two aspects of PMN activation and pentoxifylline interaction. The first was the time sequence for pentoxifylline prevention of TNF alpha activation and the second was the activity of pentoxifylline on amphotericin B activation of PMNs. TNF alpha activation of PMNs is blocked by pentoxifylline when cells are exposed to pentoxifylline prior to TNF alpha or after TNF alpha. Amphotericin B activation of PMNs was demonstrated by a decreased chemotaxis, increased chemiluminescence, and increased PMN spreading. In all conditions, pentoxifylline decreased amphotericin B activation of PMNs. These results suggest that pentoxifylline can reverse cytokine activation of PMNs and that pentoxifylline may alter some of the toxic effects of amphotericin.

Amphotericin B↗
PubMed1989

Effect on ICU mortality of a full-time critical care specialist.

APACHE II scoring was obtained retrospectively on patients admitted to the ICU of a university hospital for two consecutive years. During the first year the patients were treated by their attending physician (group 1); during the second year, by a trained critical care specialist in cooperation with the attending physician (group 2). There were 223 patients in group 1 and 216 in group 2. The mean APACHE II scores were equivalent (group 1, 19.0 +/- 9.1 vs group 2, 18.3 +/- 8.2, p = NS). ICU mortality was reduced by 52 percent (group 1, 27.8 percent mortality vs group 2, 13.4 percent mortality p less than 0.01) and overall hospital mortality was reduced 31.0 percent (group 1, 35.5 percent vs group 2, 24.5 percent, p less than 0.01). No increased significance in ICU or hospital mortality reduction could be shown between subgroups of patients with APACHE II scores of 0 to 14, 15 to 24, and greater than 25. This retrospective analysis suggests that a full-time, trained critical care specialist may have made a significant impact on the management of critically ill patients at our institution.

Critical Care↗
PubMed1988

Group therapy for chronic medical illness: a multidiagnosis group.

Chronic medical illness, and the resulting feelings of alienation, dependency, and distress, represent significant psychiatric issues in the general hospital setting. This article presents the results of the first 3 years of a pilot psychotherapy group at UCLA. This group differed from the typical didactic or support groups offered within the hospital in that membership was not limited to any particular diagnostic group. It was hypothesized that such a multidiagnosis group would facilitate exploration of dynamic and interpersonal issues. Both the group process and the response of the membership supported this hypothesis. However, an interesting distinction emerged within the group between members who saw themselves as chronically medically ill and those who defined themselves as disabled. "Disabled" members were generally less satisfied with the group and tended to benefit less than other members. In light of the above findings, we offer recommendations for establishment of similar groups in other hospital settings.

Adaptation, Psychological↗
PubMed1988

Low-temperature stability of viruses in sludges.

Enteroviruses survived for up to 38 days without diminishing in numbers in extended-aeration sludges maintained at 5 degrees C. In oxidation ditch sludges similarly maintained, enteroviruses survived for up to 17 days without diminishing in numbers. The pHs of the sludges in this study were well inside the pH 6 to 8 corridor in which destruction of enteroviruses by the detergents and ammonia present in sludges reportedly does not occur. Unexplained, however, was the survival of large numbers of enteroviruses in sludges at pH 3.5, a pH at which some anionic detergents commonly present in sewage are rapidly virucidal. The long survival of enteroviruses in these sludges at 5 degrees C indicates that such sludges can probably be stored under refrigeration in the laboratory for extended periods while awaiting processing without suffering significant losses in enterovirus numbers.

Cold Temperature↗
PubMed1988

Optimum pH levels for eluting enteroviruses from sludge solids with beef extract.

This study demonstrates that elution of enteroviruses from a mixture of primary- and activated-sludge solids with beef extract at pH 9.2 +/- 0.2 may be less efficient than elution with beef extract at pH 7.2 +/- 0.2 and that elution of enteroviruses from extended-aeration-sludge solids with beef extract is at best no more efficient at pH 9.2 +/- 0.2 than at pH 7.2 +/- 0.2. Thus, the common practice of adjusting the pH of beef extract used for eluting enteroviruses from the natural neutral level of the elutant to alkaline levels is unnecessary and probably undesirable.

Animals↗
PubMed1988

Propranolol as a primary treatment of neuroleptic-induced akathisia.

We conducted a randomized, double-blind clinical trial of propranolol versus placebo as a single treatment of neuroleptic-induced akathisia in eleven schizophrenic patients. Neither propranolol nor placebo treated patients showed a significant improvement in akathisia. While propranolol may be useful as an adjunct to anticholinergic medication in the treatment of neuroleptic-induced akathisia, propranolol does not appear to be effective within 48 hours as a primary treatment in a select group of schizophrenic patients.

Adult↗
PubMed1988

Quality-of-care research in mental health: responding to the challenge.

Quality-of-care research in mental health is in the developmental stages, which affords an opportunity to take an integrative approach, building on principles from efficacy, effectiveness, quality assessment, and quality assurance research. We propose an analytic strategy for designing research on the quality of mental health services using an adaptation of the structure, process, and outcome classification scheme. As a concrete illustration of our approach, we discuss research on a particular target population-patients with chronic schizophrenia. Future research should focus on developing models of treatment, establishing criteria and standards for outcomes and processes, and gathering data on community practices.

Humans↗