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Biomedical subjects

J Swan

Publications and source records attributed to J Swan.

36 records · Page 2Linked to original sources
PubMed1992

Limited value of the resting electrocardiogram in assessing patients with recent onset chest pain: lessons from a chest pain clinic.

OBJECTIVE: To evaluate a clinic set up specifically to assess patients with recent onset chest pain, particularly those presenting with a normal resting electrocardiogram. DESIGN: Retrospective review of case notes. SETTING: Cardiac department of a tertiary referral cardiothoracic centre. PATIENTS: 250 consecutive patients with recent onset chest pain seen within 24 hours of general practitioner referral. OUTCOME MEASURES: Clinical diagnosis and management. RESULTS: 40% of patients were seen within seven days of the onset of symptoms. Twenty seven per cent had non-cardiac symptoms and could be discharged while 60% were considered to have cardiac pain. Sixty six patients (26%) were admitted directly from the clinic and 48 of these underwent coronary angiography within three weeks. Seventy patients (28%) have so far undergone intervention (angioplasty or coronary artery surgery), 22 within one month of presentation. One hundred and nine patients (44%) presented with a normal resting electrocardiogram, 21 of whom were considered to have unstable angina. Forty one of these patients were investigated of whom 37 were found to have significant coronary disease and 26 have undergone intervention. CONCLUSIONS: This experience highlights the inadequacy of a routine electrocardiogram reporting service in patients with recent onset of chest pain. An alternative facility offering immediate and complete cardiac assessment produced patient benefit with early diagnosis and intervention. Investigation of these patients, however, accounted for 5% of cardiac catheterisation laboratory throughput; this was a significant additional and unscheduled workload.

Adult↗
PubMed1992

Implementation of the postdischarge follow-up call in the patient care units.

The Telephone Call Back System was implemented from October 1989 in the Inpatient and Ambulatory Care Units as a postdischarge follow-up and as an evaluation of the patients' hospital experience. Nurses called patients discharged from the Ambulatory Care Unit within 24 hours postdischarge and within 24-48 hours from the Inpatient Unit. Questions asked included present physical status, ocular discomfort, availability of assistance at home, and if there were any questions and concerns. For the year 1990, 77 percent of the patients discharged from the Ambulatory Care Unit were called and 71 percent were contacted. From the Inpatient Unit, 89 percent were called and 68 percent were contacted. Patient response required the following nursing interventions: review of discharge instructions, referral to an ophthalmologist and/or an internist, referral to a patient representative/social worker, reassurance on ocular signs and symptoms consistent with a normal postsurgical period, and patient teaching other than ophthalmic care. Patients discharged from the Inpatient Unit required more nursing intervention than patients discharged from the Ambulatory Care Unit. More than 99% of the patients discharged in both patient care units were satisfied with their hospital care. These results indicate the importance of postdischarge follow-up in the continuity of health care and in the transition from the health care institution to the home setting.

Aftercare↗
PubMed1991

Frontal bone advancement and compensatory craniofacial growth changes in rabbits with experimental coronal suture immobilization.

Recent clinical advances in the surgical correction of coronal suture synostosis involve the overcorrection of a frontal bone segment to allow for unrestricted expansion of the developing neurocapsular matrix. However, the effects of such large-scale calvarial repositioning on subsequent brain mass growth trajectories and compensatory cranio-facial growth changes is unclear. This study was designed to investigate this relationship in an experimental rabbit model of bilateral coronal suture synostosis. Amalgam markers were placed across the frontonasal, coronal, and anterior lambdoid sutures in thirty-one 1.5-week-old rabbits. Twenty-one animals underwent bilateral coronal suture immobilization using methyl-methacrylate. Ten animals were left untreated and served as sham controls. At 6 weeks of age, the coronal suture was released by frontal bone craniotomy or frontal bone craniotomy with a 6-mm frontal bone advancement. Lateral head radiographs were taken at 1.5, 6, 7, 9, 12, and 18 weeks of age. Results revealed that by 6 weeks of age, animals with coronal suture immobilization exhibited growth disturbances across the various sutures resulting in altered craniofacial and cranial vault shape compared to control animals. Following coronal suture release, animals that underwent craniotomy showed rapid restenosis, which resulted in significantly altered cranial vault shape and cranial orthocephalization by 18 weeks of age. Animals that underwent frontal bone advancement exhibited normal overall craniofacial growth by 18 weeks of age compared with control animals but did exhibit regional compensatory growth disturbances at the frontonasal and anterior lambdoid sutures, possibly related to neural tissue distension.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1991

Stability of school-age children's survey responses.

School-age children may have low levels of response stability on many questions asked in survey research. This article incorporates evidence from a three-wave panel study into a discussion of some possible causes of low stability. In general, children's responses to questions of fact were more stable than responses to questions of opinion. The findings suggest that when questionnaires are carefully developed, school-age children are reliable respondents.

Child↗
PubMed1990

Certificate of need and nursing home bed capacity in states.

Rapid expenditure increases raise concern with nursing home utilization, of which bed stock is an important determinant. This focuses attention on state policies to limit bed stock, particularly certificate-of-need (CON). This paper reports a cross-sectional/time-series analysis of 1981-1984 changes in state nursing home beds per aged population as functions of CON factors and of other state policy and market factors. Nursing home CON appears to constrain expansion of bed stock, older CON programs having stronger effects. Bed stock changes are positively related to dollar amounts of state CON approvals per aged population--interpreted to reflect the stringency of state CON programs.

Aged↗
PubMed1988

Manic depressive psychosis: an alternative therapeutic model of nursing.

Traditionally, the approach to affective disorders has focused upon the biophysical aetiology of the disorder. Given that a significant proportion of the so called 'recovered' manic depressive population experience a relapse, the adequacy of traditional treatment methods is questionable. The nursing literature represents the view that manic depressive patients have little, if any, control over their condition and the nursing management, therefore, is predominantly custodial, supportive and directive in character. Recent research suggests that life events, in particular the patient's perception and interpretation of such events, are potentially significant in the development of manic depressive symptomatology. This paper reports some aspects of an on-going nursing research project which is evaluating the efficacy of a multi-model nursing management package. The therapeutic model of nursing under study is briefly discussed and results of locus of control measurements are presented, which compare a random sample of recovered manic depressive women with existing norms. A description is also given of an attribution schedule developed by the authors for the research project. This schedule attempts to specifically assess the patient's attitudes towards her control of her illness.

Attitude of Health Personnel↗
PubMed1986

Identification, cloning and sequence determination of the genes specifying hexokinase A and B from yeast.

The hexokinase A (HKA) and hexokinase B (HKB) genes of Saccharomyces cerevisiae have been cloned from a library of yeast genomic DNA. Using an in vitro glucose phosphorylation assay, the HKB gene was located on a plasmid carrying a 13.6 kb fragment of yeast DNA. After subcloning the relevant restriction fragments, the nucleotide sequence of the HKB gene was determined. Using this information, we were able to locate the HKA gene on a plasmid carrying this gene, which we then sequenced. Approximately 43% of the amino acid sequence of HKB was determined directly from 24 tryptic peptides. The results are in complete agreement with those derived from the DNA sequence and are consistent with the results of x-ray crystallography. Comparison of the amino acid sequences of HKA and HKB show that 378 out of 485 residues are identical. The 5' flanking region of the A gene contains nucleotide sequences expected for genes that are expressed at relatively high levels in yeast. The 24 base pair hyphenated palindrome at the 3' end of the HKB gene may be a site for termination of transcription of this gene.

Amino Acid Sequence↗
PubMed1982

Physiological predisposition toward becoming a cigarette smoker: experimental evidence for a sex difference.

In two experiments, nonsmoking females whose urine was acidified were more willing after smoking one cigarette to volunteer to smoke additional cigarettes than were females whose urine was made alkaline. Males did not exhibit this effect. The results indicate that physiological factors that influence nicotine intake during the early smoking experiences of nonsmokers help determine who becomes a cigarette smoker, at least for females. These results may help us interpret recent increases in smoking among teenage females.

Female↗
PubMed1979

Physical structures of Tn10-promoted deletions and inversions: role of 1400 bp inverted repetitions.

We report here the physical structures of deletions and inversions promoted by the translocatable tetracycline-resistance element Tn10. DNA/DNA heteroduplex and restriction enzyme analyses of alterations in the genome of bacteriophage lambda suggest that both types of DNA alterations almost always originate at the internal termini of the 1400 bp terminal inverted repetitions of Tn10. Tn10-promoted deletions remove a single contiguous DNA segment beginning at one such terminus; Tn10-promoted inversions are more complex, and involve both an inversion and a specific deletion of Tn10 DNA.

Chromosome Deletion↗
PubMed1979

Nearly precise excision: a new type of DNA alteration associated with the translocatable element Tn10.

We describe an unusual DNA alteration, "nearly precise excision," which has been identified among tetracycline-sensitive deletion derivatives of lambda phages carrying the translocatable tetracycline-resistance element Tn10. DNA sequence analysis of two such derivatives demonstrates that each retains exactly 50 bp of Tn10 material. The original junctions between lambda and Tn10 sequences remain intact; however, an internal deletion has occurred within Tn10 which eliminates all but the last few base pairs at each end of the element. This deletion occurs within a short A + T-rich inverted repeat which is present near each end of Tn10. Nearly precise excisions occur at frequencies comparable to Tn10-promoted deletions, inversions and translocations, and, like these other events, are independent of phage and bacterial functions for homologous recombination (recA, recB, red). It is not yet clear, however, whether nearly precise excisions are specifically promoted by Tn10 or whether they arise during the course of normal DNA replication processes as a consequence of unusual symmetries present in the DNA sequence at the ends of Tn10.

Base Sequence↗
PubMedDate not supplied

Chronically ill children in self-care: issues for pediatric nurses.

The self-care (or latchkey) arrangement for children with a chronic illness is an important topic for pediatric nurses. This article reviews the impact of self-care for children's development, examines the effectiveness of teaching self-care skills to latchkey children, and provides assessment and intervention information to help pediatric nurses who are working with parents and children with chronic illness who are in self-care.

Child↗