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Biomedical subjects

J Parr

Publications and source records attributed to J Parr.

At least 19 recordsLinked to original sources
PubMed2006

Using the internet to deliver education on drug safety.

BACKGROUND: Medication administration errors (MAEs) occur in 3-8% of all non-intravenous drug doses given in UK hospitals; higher rates have been reported for intravenous drugs. Educational interventions are often advocated as one way of reducing these rates. However, group education sessions are often not practical. We developed internet-based educational modules on drug safety, and evaluated their effect on MAEs. METHODS: 11 modules were developed on different aspects of drug safety and delivered via commercially available software. All nursing staff on one ward were encouraged to participate. MAEs were identified using observation; the denominator used to calculate MAE rates was the number of opportunities for error. We aimed to observe 56 drug rounds before and after asking staff to complete the package. RESULTS: The 19 nurses who administered drugs on the study ward all agreed to participate. Of these, 12 (63%) nurses completed all 11 modules. Pre-education, 82 (6.9%) errors were identified in 1188 opportunities for error. Afterwards, 66 (5.0%) errors were identified in 1397 opportunities for error (95% confidence interval (CI) for the difference -3.8% to 0%). The MAE rate for non-intravenous drugs was 6.1% pre-education and 4.1% afterwards (95% CI for the difference -3.8% to -0.2%). Most errors with regard to intravenous doses were due to fast administration of bolus injections. CONCLUSIONS: An interactive educational package focusing on patient safety was developed, with a high rate of uptake among nursing staff on the study ward. A reduction in non-intravenous MAEs was observed after the use of the package, but no significant change was seen in the overall error rate.

Administration, Oral↗
PubMed2003

Screening of nine candidate genes for autism on chromosome 2q reveals rare nonsynonymous variants in the cAMP-GEFII gene.

The results from several genome scans indicate that chromosome 2q21-q33 is likely to contain an autism susceptibility locus. We studied the potential contribution of nine positional and functional candidate genes: TBR-1; GAD1; DLX1; DLX2; cAMP-GEFII; CHN1; ATF2; HOXD1 and NEUROD1. Screening these genes for DNA variants and association analysis using intragenic single nucleotide polymorphisms did not provide evidence for a major role in the aetiology of autism. Four rare nonsynonymous variants were identified, however, in the cAMP-GEFII gene. These variants were present in five families, where they segregate with the autistic phenotype, and were not observed in control individuals. The significance of these variants is unclear, as their low frequency in IMGSAC families does not account for the relatively strong linkage signal at the 2q locus. Further studies are needed to clarify the contribution of cAMP-GEFII gene variants to autism susceptibility.

Animals↗
PubMed2003

Primary pulmonary hypertension, Castleman's disease and human herpesvirus-8.

Primary pulmonary hypertension (PPH) and Castleman's disease (CD) are rare conditions infrequently encountered in clinical practice. In this paper, two patients diagnosed with both of these diseases are reported. The authors speculate that rather than being a chance occurrence, these conditions are linked by a common angio-proliferative mechanism. Therefore, an association between infection with the human herpesvirus-8 and the diseases of PPH and CD was sought. Evidence of human herpesvirus-8 infection was found in the lung tissue and, specifically, in the plexiform lesions from one of the patients.

Adult↗
PubMed2001

The inebri-actometer: a device for measuring the locomotor activity of Drosophila exposed to ethanol vapor.

Drosophila melanogaster can be used as a model organism for probing the genetic basis for alcohol sensitivity. In this paper, we describe a new device, the inebri-actometer, which measures the locomotor activity of up to 128 individual flies simultaneously. The device consists of 128 pairs of emitter/detector photodiodes connected in series through a computer interlink. A single fly is placed in each of the 128 chambers and humidified air or air containing variable amounts of ethanol vapor is pumped through the chambers. When a fly blocks the infrared signal transmitted by an emitter photodiode, the computer records one movement for that fly. We present preliminary results showing the effect of ethanol on the activity of wild-type Oregon R Drosophila. Five preliminary runs with 95% ethanol vapor revealed that this concentration induces an approximately 3- to 4-fold increase in locomotor activity which peaks at about 5 min after the addition of ethanol vapor. This is followed by a gradual decrease in activity leading to a nearly total cessation of movement after 30 min. Statistically significant dose-related activity increases were obtained for ethanol concentrations of 8, 19, 50, and 100% of maximum, assessed in two replications at each dose. Unlike the complete suppression of locomotion seen in the last 10 min of the session at maximum ethanol exposure, the initial stimulation effect at the 19% concentration was maintained across the 30-min session.

Alcoholism↗
PubMed2001

Validity and reliability of the FACT-G scale for use in the older person with cancer.

This project was designed to evaluate the Functional Assessment of Cancer Therapy General Scale (FACT-G) for use in the older patient with cancer. Subjects were administered the MOS Short Form Health Survey (SF-36) and the FACT-G scale. Subscale and total scores were compared using the Pearson product correlation test. FACT-G total and subscores were compared with the mixed aged cancer patient normative group of Cella et al. (1993). Good correlations were found between total and subscores of the SF-36 and the FACT-G in all areas except vitality. The mean total FACT-G score was 82.2 +/- 16.2 SD for the patients with cancer, and 92.3 +/- 11.8 SD for community-dwelling elderly (CDE). The FACT-G was able to discriminate between patients that received cancer care and CDE (p < 0.002). Subjects who scored higher on the FACT-G were found to have higher Eastern Cooperative Oncology Group Performance Status (PS). Subjects with a PS of 0 had a mean total FACT-G score of 87.9 +/- 14.4 SD. Subjects with a PS of 3 had a mean score of 59.0 +/- 23.2 SD. The FACT-G is a valid and reliable instrument for use in the older patient with cancer. The FACT-G is not an age-biased instrument.

Aged↗
PubMed2000

Diastereoselectivity an chiral ruthenium complexes of chiraphos monoxide ligands: epimerization, quasiracemates, and Lewis acid catalysis.

Heterobidentate chelating ligands comprising P,O-donor sets produce chiral metal centers when bound to arene-ruthenium complexes. The cymene complex [CyRu(eta2-chelate-P,O)Cl]+ cations are precursors to 16-electron dicationic strong Lewis acids which have potential use in asymmetric catalysis. Sixteen-electron complexes of this type, however, also provide a pathway with a low energy barrier to epimerization of the metal center in intermediates. With the chiral ligand (R,R)-chiraphos monoxide, the metal center in [CyRu(eta2)-(R,R)-Ph2PCHMeCHMe Ph2PO-P,O)Cl]+ epimerizes to minimize steric interactions in the two diastereomers yielding a 8. 2:1 dr in solution. Nevertheless, upon crystallization a new equilibrium is obtained in the solid and the crystals obtained have a 1:1 dr. These crystals are quasiracemates, which contain equal amounts of the (RRu) and (SRu)-CyRu-P-O-Cl stereocenters within the same crystal. The doubly charged Lewis acid, [CyRu(eta2-(R, R)-Ph2PCHMeCHMe Ph2PO-P,O)(solvate)]2+ derived from the chloro complex by chloride abstraction with AgSbF6 gave modest ee's (30%) in the Diels-Alder reaction of methacrolein with cyclopentadiene.

Acetonitriles↗
PubMed1998

Standards for psychological services in long-term care facilities.

Psychologists in Long-Term Care (PLTC), a national network established in 1983, has developed, with input from colleagues and consumers, standards for psychological practice in long-term care facilities. These standards address provider characteristics, methods of referral, assessment practices, treatment, and ethical issues. This article describes the document's development and offers suggestions for its use.

Geriatric Assessment↗
PubMed1998

Comorbidity and functional status are independent in older cancer patients.

PURPOSE: Comorbidity is a frequent and often therapeutically limiting problem in older cancer patients. However, to date, there is no standard measure of the comorbidity burden available for these patients. We tested the performance of two comorbidity scales and their relationship with functional status. PATIENTS AND METHODS: The Cumulative Illness Rating Scale-Geriatric (CIRS-G) was compared with the Charlson scale in 203 patients who received a comprehensive geriatric assessment (CGA) in our Senior Adult Oncology Program (SAOP). Study end points were variability, reliability, correlation with Eastern Cooperative Oncology Group (ECOG) performance status (PS), Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL). The relative weight of comorbidity versus tumor stage in the correlations with functional status was assessed. RESULTS: Median age was 75 years (range, 63 to 91). Sixty-four percent of patients scored 0 on the Charlson scale versus 6% on the CIRS-G. The correlation between the Charlson and CIRS-G was fair (p = 0.25 to 0.39). CIRS-G grade 3/4 had a fair correlation with ADL (p = 0.27). Otherwise, there was low or no correlation between comorbidity and functional status across the measures. Tumor stage was not correlated with functional status either. Correlation of ECOG PS with ADL (p = 0.51)c and IADL (p = 0.61) was moderate. Interrater and test-retest correlations were good or very good for both the Charlson and CIRS-G. CONCLUSION: Comorbidity needs to be assessed independently from functional status. Both the Charlson and CIRS-G scales are reliable tools for use in trials of older cancer patients. Both can be tested in further studies as predictors of outcomes such as toxicity of treatment, changes in functional status, or survival.

Activities of Daily Living↗
PubMed1997

Research methods for studying injecting drug users in a rural centre.

Targeted sampling, multiple data collection methods and peer interviewers have been used with success for studies of injecting drug users (IDUs) in main cities. This paper reports the success of a trial of these research methods with IDUs in a rural centre. Recruitment via outreach (for individual interviews and for focus groups), street intercept and service-based surveys (methadone clinic and prison based surveys) were found to be viable and to vary in their success in recruiting subgroups of IDUs. Their use in combination is recommended so that the largest possible range of IDUs can be recruited. The close involvement of peer interviewers and of an advisory group in planning and implementing these data collections was essential. Advertising was not found to be successful for recruiting to a phone-in, for focus groups nor to a community forum. Concerns about anonymity, 'paranoia' and a general lack of a cohesive IDU community were barriers to recruitment.

Journal Article↗
PubMed1996

Medicare malaise.

Explore the source record for details and available documents.

Bankruptcy↗
PubMed1995

Effects of hydroxyapatite tricalcium phosphate coating and intracancellous placement on bone ingrowth in titanium fibermetal implants.

The purpose of this study was to compare the host-bone response to hydroxyapatite/tricalcium phosphate (HA/TCP)-coated and noncoated titanium fibermetal implants placed in a load-sharing cancellous bone environment of the distal femurs of rabbits. The influence of implantation site was also investigated by comparing these intracancellous implants with intramedullary implants evaluated in a previous study. Three parameters were measured: percentage implant perimeter surface length in contact with new bone, percentage internal fibermetal surface length in contact with ingrown bone, and percentage of available pore space filled with bone. The HA/TCP coating significantly accelerated and increased bone ongrowth, new bone formation on the perimeter and internal surface of the implants. This effect was evident as early as 2 weeks after implantation. In contrast, there was no difference between HA/TCP-coated and noncoated implants in the bone ingrowth parameter, percentage of available pore space filled with bone, or pull-out strength. Scanning electron microscopy in the backscatter mode demonstrated that new bone formed directly onto the HA/TCP-coated fibers and did not usually form directly on noncoated fibers. Analysis of fluorochrome labeling revealed that bone formation in weeks 1 through 4 was primarily woven and thereafter lamellar. Compared with intramedullary placement, intracancellous placement significantly accelerated the apposition of bone to the perimeter and internal surface of HA/TCP-coated implants and both accelerated and increased bone ingrowth as a percentage of available pore volume. These data show that the host response to titanium fibermetal implants is influenced both by HA/TCP coating and by the implantation site.

Animals↗
PubMed1993

Histomorphometric assessment of the mechanisms for rapid ingrowth of bone to HA/TCP coated implants.

The purpose of this work is to use dynamic histomorphometry to evaluate the basic biological mechanisms by which hydroxyapatite/tricalcium phosphate (HA/TCP) implant coatings accelerate bone formation rates. Twenty-five rabbits had an HA/TCP coated cylindrical titanium fiber metal mesh implant surgically placed in the subchondral bone of the proximal tibia and a noncoated implant placed in the contralateral tibia. Twenty-two of these animals had HA/TCP coated cylindrical solid titanium implants placed in the distal femur and an uncoated implant placed in the contralateral femur. The animals were double labeled with vital stains, and sacrificed at 3, 6, 16, or 26 weeks after surgery. Histomorphometric analyses were done of the bone implant interfaces. Both static and dynamic histomorphometric parameters indicate that HA/TCP coatings stimulate faster bone ingrowth to coated fiber metal implants through the early production of woven bone and by subsequent rapid lamellar bone formation rates. Coated fiber metal implants demonstrated significantly more bone ingrowth than noncoated implants through 16 weeks postimplantation, but not by 26 weeks. In solid implants, the differences between coated and noncoated implants are less pronounced and not statistically significant, although there is a trend toward increased bone apposition to the surface of the implants over the first 16 weeks following implantation. The clinical significance of these results is that coated implants may allow earlier return to normal weightbearing.

Alloys↗
PubMed1992

Porous-coated uncemented components in experimental total hip arthroplasty in dogs. Effect of plasma-sprayed calcium phosphate coatings on bone ingrowth.

The effect of a thin plasma-sprayed, calcium phosphate ceramic coating on bone ingrowth into titanium fiber mesh porous-surfaced prostheses was examined in a controlled canine cementless total hip arthroplasty model. Bone ingrowth was quantified using backscattered scanning electron microscopy of undemineralized sections. When good contact between the bone and porous coating was present, the calcium phosphate-coated prostheses contained significantly higher amounts of bone ingrowth at three weeks postimplantation than the uncoated control prostheses. At six weeks, however, there was no significant difference in the amount of bone ingrowth between the coated prostheses and uncoated prostheses. The ingrown bone seemed to be more intimately associated with the calcium phosphate-coated porous surfaces than the uncoated porous surfaces. When gaps at the bone-porous coating interface occurred, the calcium phosphate coating did not enhance bone ingrowth across those gaps. Plasma-sprayed calcium phosphate coatings may be useful in enhancing the early ingrowth of bone into porous-surfaced joint replacement prostheses, but they may lack long-term effectiveness. The coatings were not effective in enhancing bone ingrowth across gaps between the porous surface and the bone bed prepared at surgery.

Acetabulum↗
PubMed1990

Insulin autoantibodies in Graves' disease--before and after carbimazole therapy.

Insulin autoantibodies (IAA) are well documented in patients with insulin-dependent diabetes (IDDM) prior to the administration of insulin and in patients with reactive hypoglycaemia--the insulin autoimmune syndrome (IAS). It has been suggested that IAA can be induced by the administration of drugs containing sulphydryl groups, such as carbimazole, and they have been frequently described in Graves' disease. An alternative explanation is the clustering of autoantibodies in autoimmune disease. We studied 39 patients (37 females, two males, age range 14 to 61 years; mean 33.8 years) with proven Graves' disease and no previous treatment with carbimazole. Fifteen of the 39 patients had a family history of other autoimmune diseases. IAA and thyroid autoantibodies were assayed at diagnosis and monthly thereafter while on treatment with carbimazole, for up to 6 months. IAA were measured using a direct-binding solid-phase ELISA and specificity was confirmed by absorption studies using insulin covalently coupled to Sepharose beads. At diagnosis 33 of the 39 patients (85%) were positive for thyroid microsomal antibodies, 13 (33%) were positive for thyroglobulin antibodies, and 4 (10%) were positive for IAA. All IAA-positive patients had microsomal antibodies at diagnosis, and two had thyroglobulin antibodies in addition. After 4 months on carbimazole, the frequency of thyroid microsomal autoantibodies was unchanged (83%), while that of anti-thyroglobulin antibodies had fallen (8.6%). All four IAA-positive patients remained positive, and studies of binding to human, porcine and bovine insulin demonstrated that one serum, initially human insulin specific, later became cross-reactive with all three. We conclude that low titres of IAA are found in Graves' disease, and are associated with the presence of autoimmunity rather than the carbimazole. Symptomatic hypoglycaemia, however, is rare in Caucasian patients.

Adolescent↗