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Biomedical subjects

J Scully

Publications and source records attributed to J Scully.

At least 19 recordsLinked to original sources
PubMed2004

The professional role of breast cancer nurses in multi-disciplinary breast cancer care teams.

Since the 1970s breast cancer services have witnessed considerable changes in the management of patients. One significant change was the introduction of specialist core personnel, including the breast care nurse (BCN). The role of the BCN has been gaining credence rapidly in the British NHS and this service is perhaps the paradigm of care for other services. With the lack of specific evidence of the role of specialist nurses in the breast care team, the current study aims to explore this area by in-depth interviews with core team members, and observations of 16 multi-disciplinary teams in England. The study explores the following themes: Nurses' unique informal management leadership role in ensuring the co-ordination, communication and planning of the team work; nurses' innovatory role in making the bureaucracy respond to patients and their relatives needs; nurses supportive role in the provision of expert advice and guidance to other members of the team; nurses confidence and humour in well-performing teams; and the limitations of the professional role of the breast cancer nurse. This study indicates that there is evidence that the BCN is practicing at an advanced level of practice. However, there is a severe lack of evidence-based description of that advanced practice. Cancer nurses including the BCNs should develop and participate in programmes of research in line with cancer legislation in order to build an evidence base that ultimately supports their unique role.

Attitude of Health Personnel↗
PubMed2003

Breast cancer teams: the impact of constitution, new cancer workload, and methods of operation on their effectiveness.

National guidance and clinical guidelines recommended multidisciplinary teams (MDTs) for cancer services in order to bring specialists in relevant disciplines together, ensure clinical decisions are fully informed, and to coordinate care effectively. However, the effectiveness of cancer teams was not previously evaluated systematically. A random sample of 72 breast cancer teams in England was studied (548 members in six core disciplines), stratified by region and caseload. Information about team constitution, processes, effectiveness, clinical performance, and members' mental well-being was gathered using appropriate instruments. Two input variables, team workload (P=0.009) and the proportion of breast care nurses (P=0.003), positively predicted overall clinical performance in multivariate analysis using a two-stage regression model. There were significant correlations between individual team inputs, team composition variables, and clinical performance. Some disciplines consistently perceived their team's effectiveness differently from the mean. Teams with shared leadership of their clinical decision-making were most effective. The mental well-being of team members appeared significantly better than in previous studies of cancer clinicians, the NHS, and the general population. This study established that team composition, working methods, and workloads are related to measures of effectiveness, including the quality of clinical care.

Adult↗
PubMed1999

Interagency collaboration: head start and a school of nursing.

Agency collaboration is gaining importance for schools of nursing as changes in health care systems focus on the community as a principal environment for health care delivery. Nursing faculty seeking settings in the community to prepare future nurses find Head Start especially interesting as a model of comprehensive care for low-income families. The skill required to develop successful collaboration between community agencies and schools of nursing is often underestimated. Polivka in a conceptual framework for community interageacy collaboration identifies factors to consider. Successful collaborative relationships require that goals be achieved, that relationships be satisfying, and that outcomes have value for all collaborators.

Child, Preschool↗
PubMed1996

How well does the psychiatry residency in-training examination predict performance on the American Board of Psychiatry and Neurology. Part I. Examination?

OBJECTIVE: Scores on the American College of Psychiatrists' Psychiatry Residency In-Training Examination (PRITE) were correlated with scores on the American Board of Psychiatry and Neurology (ABPN) Part I examination in psychiatry. METHOD: Pearson correlations between 1992 PRITE scores and 1994 ABPN Part I psychiatry scores were calculated. Analyses were based on 701 examinees. RESULTS: There was a moderate correlation between scores on the PRITE and ABPN Part I examination in psychiatry and a low correlation of neurology scores. CONCLUSIONS: These correlations were observed even though the two examinations differ in their purposes, content outlines, development, and administration.

Educational Measurement↗
PubMed1994

Backbone flexibility and stability of reverse turn conformation in a model system.

Molecular dynamics simulations have been used to study differences in propensity to form a disulfide-bridged turn conformation by peptides with sequence Ac-Cys-Pro-Xaa-Cys-NMe. The calculations were limited to three peptides, with Xaa = Aib, Gly and Val. The experimental differences in propensity (in terms of free energy differences delta delta G degree) were reproduced within 2 kJ/mol. The use of a reduced 1-4 non-bonded interaction potential was tested in this system, but was found to give slightly worse agreement with experiment. The stability of alternate conformations was determined systematically. Type I and II turn conformations of the Aib compound have similar free energy; the Val compound is most stable in a type I turn conformation (by 8 kJ/mol), while the Gly compound is most stable in a type II turn conformation (by 5 kJ/mol). Different backbone conformations were obtained for the valine compound in simulations in solution and in the crystal. It is concluded that turn conformations with psi i+2 near 0, as typically seen in proteins, are stabilized by intramolecular hydrogen bonding in the confined environment. However, when exposed to solvent, hydrogen bonds with water stabilize conformations with larger or smaller values of psi i+2 that are more similar to free energy minima in the isolated, terminally blocked, residue.

Amino Acid Sequence↗
PubMed1992

Training directors' opinions about the psychiatry resident in-training examination (PRITE).

OBJECTIVE: The American College of Psychiatrists conducted research to validate the content outline of the Psychiatry Resident In-Training Examination (PRITE) and to assess what residency training directors think about the examination. METHOD: A mail survey was sent to the 218 psychiatry residency training directors who subscribe to the PRITE. RESULTS: The survey response rate was 70%. A majority of the respondents indicated agreement with the relative emphasis given to each content area in the PRITE (range = 52%-80% agreement). Eighty-one percent of the respondents were strongly in favor of continuing the practice of releasing the examination and the correct responses each year after the examinations have been scored. The majority of the respondents use results on the PRITE for individual resident evaluation and program evaluation (90% and 94%, respectively). Very few respondents use the PRITE results as the sole measure for assessing residents' cognitive competence or use it for marketing their residency programs. CONCLUSIONS: The survey provided strong support for the content areas covered in the PRITE and their relative emphases. The current practice of releasing PRITE items and answers (a main difference between the PRITE and the certification examination of the American Board of Psychiatry and Neurology) was well supported by the survey results. The stated purpose of the PRITE, to provide educationally useful feedback for individuals and groups in the form of comparisons with peers in specific areas of knowledge, was supported by a large majority of the respondents.

Attitude of Health Personnel↗
PubMed1991

Health systems and policy in the USA and in the United Kingdom: an overseas programme.

An international programme, especially in a developed country, dramatically increases a student's understanding of health care systems. Students from a university programme in the USA learn about the development and structure of the British National Health Service through lectures and discussion in the US and England, and through 2 weeks of experience in England which include working with community health nurses in a district health authority. Related special experiences are planned which may include interviews with nurses involved in policy development, education, administration and specialty areas. Each student identifies an interest to pursue independently from the perspective of community care. As the student participates in the programme, alternative ways to give familiar care challenge formerly held beliefs. Health care emerges as a dynamic system, one that responds to issues, effects policy, and influences the role of health care providers.

Chicago↗
PubMed1991

The Program for Public Psychiatry: state-university collaboration in Colorado.

A major focus of state-university collaboration programs in psychiatry has been providing services and manpower from the university to the public mental health system, which in turns provides valuable educational experiences to the university. The Program for Public Psychiatry, a state-university collaboration program in Colorado, was founded on a 25-year relationship between the department of psychiatry at the University of Colorado Health Sciences Center and the Colorado Division of Mental Health. The program has enabled Colorado's two state hospitals and most of its urban community mental health centers to almost completely fill previously vacant psychiatric positions. The collaboration has expanded to include programs for forensic psychiatry and developmental disabilities, as well as to fund educational and research missions in developing the public psychiatric work force.

Academic Medical Centers↗
PubMed1987

Ratings of videotaped simulated patient interviews and four other methods of evaluating a psychiatry clerkship.

Ratings of videotaped interviews with simulated patients were compared with four other measures commonly used to evaluate medical students during their psychiatry clerkship. Intercorrelations among self-reported attitude change, written examination grade, and student rating of satisfaction with the clerkship suggest that each measures different processes. Low but significant correlations between preceptor ratings of interaction skills and data-gathering skills and process and content scores based on an end-of-course videotaped interview suggest that preceptor ratings and the videotaped interview method evaluated the same skills. The authors conclude that preceptor evaluations supplemented by objective ratings of videotaped interviews show promise for evaluating the development of interviewing skills.

Attitude↗
PubMed1986

Tripartite sequences within and 3' to the sea urchin H2A histone gene display properties associated with a transcriptional termination process.

We have defined a DNA sequence that behaves as an RNA polymerase II termination signal by using the human HeLa cell transient expression system. Surprisingly, this sequence is tripartite, including part of the coding region of the sea urchin H2A histone gene together with two separate sequences in the 3' flanking region of the gene. We demonstrate that this signal functions both in its normal gene environment and also when placed within the human alpha-globin gene. However, we have failed to detect a discrete 3' terminus. Rather, our data indicate the presence of an extremely heterogeneous series of nonpolyadenylated RNAs. These heterogeneous nonpolyadenylated RNAs are stable when transcribed from the intact histone gene but are highly unstable within the human alpha-globin gene. This provides evidence for the role of poly(A) in the stability of mRNA.

Animals↗
PubMed1985

The effect of spironolactone on hirsutism and female androgen metabolism.

An objective evaluation of the anti-androgen effects of spironolactone was performed in a consecutive series of 12 hirsute patients receiving a daily dose of 150 mg; nine completed the study. Using a computer assisted image analyser, hair diameter on two weekly shavings decreased significantly over a 12 month period in three of the patients, although growth rate and mean diameter did not change in the group as a whole. Plasma testosterone fell significantly to a mean of 53% of basal levels. The mean free testosterone (derived) fell significantly to 64% of basal by the sixth month (P = less than 0.005) and remained significantly depressed the remainder of the study. There was subjective benefit in hair growth and greasiness and a significant reduction in the semi-objective Ferriman-Gallwey index in nine of 10 subjects assessed for at least 9 months. We conclude that although spironolactone was not consistently successful, it may represent effective therapy for a sub group of patients with hirsutism.

Adolescent↗
PubMed1984

Oral spironolactone improves acne vulgaris and reduces sebum excretion.

In a consecutive series of thirty-six male and female patients referred with severe acne, the effect of 3 months' treatment with placebo or spironolactone (50-200 mg daily) on sebum excretion and clinical and endocrine status was evaluated double-blind. Twenty-six patients completed the study. Abnormal free androgen indices were found in 27% of the original nineteen female subjects. Spironolactone reduced sebum excretion in all female subjects, but there was no correlation between sebum response and androgen status. The clinical response was dose-dependent, with maximum subjective and objective benefit when spironolactone doses of 150-200 mg were used.

Acne Vulgaris↗