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Biomedical subjects

J McIntosh

Publications and source records attributed to J McIntosh.

At least 37 records · Page 2Linked to original sources

Anxiogenic behavior in the light-dark paradigm follwoing intraventricular administration of cholecystokinin-8S, restraint stress, or uncontrollable footshock in the CD-1 mouse.

The influence of restraint stress (0, 15, 30, or 60 min), uncontrollable footshock (0, 15, 30, or 60 shocks), or intraventricular CCK-8S administration (0, 5, 25, or 50 ng delivered in a 1 microliter volume) were evaluated on transition frequency and cumulative time in light among CD-1 mice in the light-dark paradigm. Mice exposed to restraint stress of either 15 or 60 min were indistinguishable from nonrestrained animals, while the 30-min session of restraint decreased time in light and transition scores. The presentation of 15, 30, or 60 uncontrollable footshocks were equally effective in decreasing cumulative time in light but had no effect on transition scores. Intraventricular infusion of 25 and 50 ng doses of cholecystokinin-8S reduced cumulative time in light and transition frequency in CD-1 mice relative to vehicle or 5 ng CCK-8S-treated animals in the light-dark paradigm. The time in light and transition data secured among mice with repeated light-dark exposure and 30 min of restraint were comparable to the corresponding scores secured when performance was only evaluated on trial 1. Transition scores were reduced on trial 1 of mice exposed to 30 min of footshock, but time in light was reminiscent of the performance detected among mice with prior light-dark experience. Potential neurochemical correlates associated with the anxiogenic effects associated with stressor exposure and CCK-8S administration in the light-dark task are discussed.

Animals↗

The practice-based context of educational innovation: nurse and midwife preparation in Scotland.

The use of an illuminative approach to the national evaluation of the first 18 months of Project 2000 nurse and pre-registration midwifery education in Scotland has facilitated the generation of data about the contexts in which the new programmes function. The aim of this paper is to present some of the data generated from programme participants about the conditions students experience in practice-based learning experiences. The reported issues are direct or indirect effects of policy initiatives and service reforms. The current climate of change in health care provision has fostered a limited number of developments which are consistent with the aspirations of the new programmes and which offer highly valued learning experiences to students. More often however the reforms have served to frustrate the intent of the programmes to offer students experiences which are patient-centred, holistic-care and health oriented.

Community Health Nursing↗

Assessing need for district nursing: study findings.

To determine whether an appropriate level of nursing care is being provided in the community, this study aimed to explore whether patients' needs are being identified through the referral system and whether those needs are being met.

Health Services Needs and Demand↗

The question of knowledge in district nursing.

This paper focuses on the development of the experiential knowledge base in district nursing with reference to changes in professional preparation for district nurses and to a research study conducted by the author during the 1970s. The process of conducting the research showed that an exclusive focus on activity fails to capture the range and depth of nursing care in the home. Schön's concept of professional artistry is employed as an interpretive framework to consider some of the study findings and with reference to more recent research studies the author concludes that while it has always been central to skilled nursing, professional artistry has remained hidden. The problems confronting academics and practitioners in articulating such knowledge are explored together with the possible consequences of continued failure to address this issue. These difficulties are discussed in the context of the current changes in the National Health Service with particular reference to the introduction of grade mix in community nursing. The paper concludes by arguing that a better understanding of the district nurse's knowledge base must be vigorously pursued.

Community Health Nursing↗

Decision making in community nursing: an analysis of the stages of decision making as they relate to community nursing assessment practice.

This paper considers the nature of decisions made in the context of community nursing practice, in the light of the stages of decision making distilled by Carroll & Johnson from the work of various theorists, and explores the relevance of each stage to community nurses' decision making. Illustrative examples of specific theoretical perspectives are included throughout the paper. The discussion forms part of the literature review for research currently being undertaken by the authors into patient assessment by community nurses. As decision making is a key element of community nurses' assessment practice, the paper argues that decision making theory forms a useful conceptual framework for investigating this aspect of community nursing.

Community Health Nursing↗

The use of the Nominal Group Technique in research with community nurses.

The use of group-based techniques to generate ideas and offer solutions to problems is commonplace in many disciplines and for many purposes. What were originally useful adjuncts to market research have become valuable and illuminating tools in education, policy and research. This paper will describe the use of one such technique, the Nominal Group Technique, and its practical application in bridging the gap between researchers and practitioners in one particular study of community nursing.

Community Health Nursing↗

Bolus or infusion teicoplanin for intravascular catheter associated infections in immunocompromised patients?

An unexpected low efficacy of teicoplanin in the treatment of coagulase negative staphylococcal (CNS) infections on a regional Bone Marrow Transplant (BMT) Unit led to a retrospective study. CNS infections treated with gylcopeptides in BMT patients with in-dwelling central venous lines between May 1990 and May 1995 were reviewed. Efficacy rates of 50% for teicoplanin compared with 80% for vancomycin despite comparable antibiotic susceptibility. Glycopeptides have bactericidal action which is time dependent. Teicoplanin was administered by bolus injection during the study period and it is suggested that this observed difference in efficacy is caused by the short duration of exposure of luminal bacteria.

Adult↗

The Roy Adaptation Model: a consideration of its properties as a conceptual framework for an intervention study.

The underlying premise of this paper is the belief that one of the core values of nursing research is its ability to demonstrate that nursing interventions influence care outcomes. From this perspective the contribution offered by the Roy Adaptation Model for Nursing within an intervention study is evaluated. Although it was believed that the model enriched the study in several ways, its overall contribution was likened to a "conceptual stepping stone', used by the researcher en route back towards its underlying theories and classical intervention design methodologies.

Adaptation, Psychological↗

Susceptibility to astrocytoma and meningioma: influence of allelism at glutathione S-transferase (GSTT1 and GSTM1) and cytochrome P-450 (CYP2D6) loci.

We describe a case-control study to identify associations between polymorphism at the cytochrome P-450 (CYP2D6) and glutathione S-transferase (GSTT1 and GSTM1) loci and susceptibility to astrocytoma and meningioma. Accordingly, genotype frequencies in 112 astrocytoma and 50 meningioma patients were compared with frequencies in 577 controls. GSTM1 genotype frequencies in these groups were not different. Logistic regression analysis showed GSTT1 null and CYP2D6 poor metabolizer were risk factors in astrocytoma (odds ratio = 2.67 P = 0.0005 and odds ratio = 4.17 P = 0.0043, respectively) and meningioma (odds ratio = 4.52, P = 0.0001 and odds ratio = 4.90, P = 0.0132, respectively) when corrected for the other variables. No interactive effects between genotypes were identified. The data suggest polymorphism at loci encoding carcinogen-metabolizing enzymes influences susceptibility to astrocytoma and meningioma, possibly by determining effectiveness in the detoxification of environmental carcinogens.

Adult↗

A preliminary report on urinary BT-PABA/PAS excretion index, serum pancreatic isoamylase and faecal chymotrypsin tests of pancreatic dysfunction in Sowetan Africans.

The steady increase in chronic pancreatitis among black Africans at Soweto, RSA, in the past 40 years necessitates an objective and non-invasive test to detect the disease at an early stage. Given the biphasic nature of the disease--secretory hyperfunction with periodic active inflammatory episodes followed by steady exocrine impairment--we assessed three potential aids. Urinary BT-PABA/PAS excretion index (PEI), serum pancreatic isoamylase (PIA) and faecal chymotrypsin activity (FCA) were measured in the following groups: 16 outwardly healthy hospital workers, 16 consecutive patients with calcifying chronic pancreatitis and 19 with abdominal pain ascribed to other conditions (disease controls). (1) Healthy controls had lower PEI than those at Manchester, UK, or Madras, India, from subclinical acinar loss--as shown by lower PABA recovery whereas intestinal absorptive capacity was maintained, as shown by recovery of PAS. (2) Using the popular cut-off for PEI (0.75) only 9 of 14 patients with chronic pancreatitis were identified (sensitivity 64%, 2 tests unsatisfactory), while a value of less than 0.54, the mean -2 S.D. in local controls, yielded sensitivity of 50%. (3) If PEI of less than 0.75 or PIA outside the reference range was taken to indicate the disease, 5 of 9 disease controls would have been classed as chronic pancreatitis (among those with both tests satisfactory): retrospective ultrasound scans did not identify these. (4) Although FCA was less than the preselected cut-off, 5 units/g, in every patient with chronic pancreatitis (100% sensitivity) its poor predictive value was indicated by low specificity: subnormal levels in 4 of 14 and 6 of 16 healthy controls or disease controls, respectively, most of whom had near-normal values of PEI, PIA or both. (5) Collectively, these results suggest a high frequency of subclinical chronic pancreatitis at Soweto, but also that the combination of tests required to identify it may prove impractical--whether in field surveys or hospital practice.

4-Aminobenzoic Acid↗

Drug metabolizing enzymes of mussels as bioindicators of chemical pollution.

The GSTs of M. edulis provide an easily assayed activity which would be expected to respond to changes in pollution status. The main GST and a related GSH-binding protein have been purified and biochemically characterized. The former protein is most similar to the Pi class while the latter is a catalytically inactive monomer which appears to be related to the Mu class. This enzyme activity has been assessed as a potential indicator of exposure to chemical pollutants in both Cork Harbour and Venice Lagoon (using the closely related species, M. galloprovincialis). Controlled exposure studies with mussels in holding tanks have indicated that the herbicide aldicarb gives a slight but significant increase in GST activity consistent with the inducibility of these enzymes by xenobiotics in this bivalve. At present, we are studying samples which have been deliberately exposed to PAH and PCB compounds. Studies of this type are important in helping to understand the effects and fate of chemical pollutants released into estuarine environments.

Animals↗

Multiple nocardial brain abscesses: report of two patients.

Two patients presented with nocardial brain abscesses, one as secondary to overwhelming pulmonary infection following a thoracic empyema, the second as a primary abscess. Both patients had immunopression. Such an infection should be considered early in any patient who is immunocompromised.

Adult↗

Beyond discharge: telephone follow-up and aftercare.

1. Decreased length of stay, inadequate aftercare service, and insufficient attention on the part of professionals to the immediate difficulties of postdischarge adjustment have made the transition from psychiatric hospital back to the community more difficult. 2. Telephone follow-up and aftercare groups ease the patient's transition from hospital to community, help to prevent rapid readmission, and provide a feedback loop to the staff on discharge planning. 3. Little is known about the immediate postdischarge experience for patients and its effects on long-term adjustment. Extended contact with the discharged patient is an ideal way to begin to collect such data.

Adult↗

Differential expression of the epidermal growth factor receptor and its ligands in primary non-small cell lung cancers and adjacent benign lung.

The epidermal growth factor receptor (EGFR) and one of its ligands, transforming growth factor alpha (TGF-alpha), are thought to function as a potential autocrine loop in non-small cell lung cancer (NSCLC). However, the expression pattern of EGFR and the TGF-alpha-related ligands have not been fully characterized in primary NSCLC and adjacent benign lung tissue. For this reason, we comprehensively examined the coexpression and differential expression of EGFR and its ligands, TGF-alpha, epidermal growth factor (EGF), and amphiregulin (AR), by Northern analysis, in paired samples of primary tumors and uninvolved lung. For those RNA species overexpressed in malignant lung, single cell expression patterns were studied by immunohistochemistry. Specimens were obtained from 57 consecutive patients who underwent resection of carefully staged resectable NSCLC and were followed prospectively. Most (112 of 114) tissue samples yielded high-quality RNA. EGFR was expressed in 82 of 88 (93%) tissue samples, while TGF-alpha was expressed in 62 of 72 (86%) samples, and AR was expressed in 64 of 70 (92%) samples. EGF was unexpressed in total cellular RNA in both tumor and uninvolved lung. In a comparison of RNA expression patterns in tumors and uninvolved lung, overexpression of EGFR was found in 45% (22 of 44) of tumors, while overexpression of TGF-alpha was seen in 61% (22 of 36) of tumors, and decreased expression of AR was seen in 63% (22 of 35) of tumors. Cell type and stage did not influence differential expression, indicating that this is a frequent event in primary NSCLC. Simultaneous overexpression of EGFR and TGF-alpha was seen in only 38% of tumors. Simultaneous overexpression of EGFR and decreased expression of AR were seen in only 21% of tumors. Thus far, the differential expression of EGFR, TGF-alpha, and AR does not correlate with either disease-free or overall survival. These findings indicate that histologically dissimilar tumors can express similar components of autocrine or paracrine growth factor loops. Differential expression of EGFR and its ligands in tumor specimens compared to uninvolved lung is a common event in NSCLC and may participate in tumor growth without necessarily influencing tumor progression or histology.

Adenocarcinoma↗

Postpartum depression: women's help-seeking behaviour and perceptions of cause.

Research on postnatal depression has largely concentrated on investigating its possible causes. There have been few attempts to examine women's own perceptions and experiences of the condition or to explore the implications which these might have for help seeking and professional intervention. This paper reports on the experiences of depression of a sample of 60 first-time mothers. For the purposes of the study, depression was defined as the experience of depressed mood for a period of at least 2 weeks at some stage during the first 9 months postpartum. On this definition, depression was reported by a high proportion of the mothers (63%) and was found to be of early onset and lengthy duration. The majority of depressed mothers did not seek help from any source and only a quarter of them consulted a health professional. These low rates of consultation are explained in terms of mothers' perceptions of the cause of their depression, their ideas about appropriate solutions and their reluctance to admit to experiencing emotional difficulties. The implications of the study for intervention by health professionals are discussed.

Adult↗