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Biomedical subjects

K Galvin

Publications and source records attributed to K Galvin.

At least 19 recordsLinked to original sources

Psychological interventions for multiple sclerosis.

BACKGROUND: The unpredictable, variable nature of Multiple Sclerosis (MS), and the possibility of increasing disability, means that a diagnosis can have substantial psychological consequences. OBJECTIVES: To assess the effectiveness of psychological interventions for people with MS. SEARCH STRATEGY: We searched 19 databases up to December 2004; Cochrane MS Group Specialised Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, PsychINFO, CINAHL and 14 others. We searched reference lists of articles, wrote to corresponding authors of the 13 papers identified by June 2004, and searched for trials in progress using 3 research registers. SELECTION CRITERIA: Randomised controlled trials of interventions described as wholly or mostly based on psychological theory and practice, in people with MS. Primary outcome measures were disease specific and general quality of life, psychiatric symptoms, psychological functioning, disability, and cognitive outcomes. Secondary outcome measures were number of relapses, pain, fatigue, health care utilisation, changes in medication, and adherence to other therapies. DATA COLLECTION AND ANALYSIS: Pertinent studies were identified from abstracts by one author. Full papers were independently compared to selection criteria by four authors. Key details were extracted from relevant papers using a standard format, and studies scored on three dimensions of quality. The review is organised into four mini-reviews (MR) dependent on the intervention's target population; people with cognitive impairments (MR1), people with moderate to severe disability (MR2), people with MS (no other criteria) (MR3), and people with depression (MR4). MAIN RESULTS: Overall 16 studies were identified and included. MR1: three trials (n=145). Some evidence of effectiveness of cognitive rehabilitation on cognitive outcomes, although this was difficult to interpret because of the large number of outcome measures used. MR2: three trials (n=80). One small trial suggesting psychotherapy may help with depression. MR3: seven studies (n=688). Some evidence that cognitive behavioural therapy may help people adjust to, and cope with, having MS (three trials). The other trials were diverse in nature and some difficult to interpret because of multiple outcome measures. MR4: three trials (n=93). Two small studies of cognitive behavioural therapy showed significant improvements in depression. AUTHORS' CONCLUSIONS: The diversity of psychological interventions identified indicates the many ways in which they can potentially help people with MS. No definite conclusions can be made from this review. However there is reasonable evidence that cognitive behavioural approaches are beneficial in the treatment of depression, and in helping people adjust to, and cope with, having MS.

Adaptation, Psychological↗

Fatty acid profile, tocopherol, squalene and phytosterol content of walnuts, almonds, peanuts, hazelnuts and the macadamia nut.

Nuts are high in fat but have a fatty acid profile that may be beneficial in relation to risk of coronary heart disease. Nuts also contain other potentially cardioprotective constituents including phytosterols, tocopherols and squalene. In the present study, the total oil content, peroxide value, composition of fatty acids, tocopherols, phytosterols and squalene content were determined in the oil extracted from freshly ground walnuts, almonds, peanuts, hazelnuts and the macadamia nut. The total oil content of the nuts ranged from 37.9 to 59.2%, while the peroxide values ranged from 0.19 to 0.43 meq O2/kg oil. The main monounsaturated fatty acid was oleic acid (C18:1) with substantial levels of palmitoleic acid (C16:1) present in the macadamia nut. The main polyunsaturated fatty acids present were linoleic acid (C18:2) and linolenic acid (C18:3). alpha-Tocopherol was the most prevalent tocopherol except in walnuts. The levels of squalene detected ranged from 9.4 to 186.4 microg/g. beta-Sitosterol was the most abundant sterol, ranging in concentration from 991.2 to 2071.7 microg/g oil. Campesterol and stigmasterol were also present in significant concentrations. Our data indicate that all five nuts are a good source of monounsaturated fatty acid, tocopherols, squalene and phytosterols.

Arachis↗

Influence of concentrate composition and forage type on retail packaged beef quality.

The objective of this study was to determine the effect of type of conserved forage and concentrate composition on the quality of beef held in overwrapped (aerobic) or modified atmosphere packaging under simulated retail display for 17 d. Friesian steers (n = 45) were assigned randomly to one of five dietary treatments: 1) extensively fermented grass silage plus silage concentrate (EFS); 2) restricted fermented grass silage plus silage concentrate (RFS); 3) starch-based concentrate plus wheat straw (SC); 4) nonstarch-based concentrate plus wheat straw (NSC); or 5) zero-grazed perennial ryegrass plus grass concentrate (RYE). Meat quality was determined by measuring color, lipid oxidation (TBARS), alpha-tocopherol concentrations, and fatty acid composition. In aerobically packaged beef, there was a display x diet interactive effect (P < 0.001) on Hunter a* values, with steaks from the EFS group having higher (P < 0.05) a* values than all other dietary groups from d 6 through d 17. Moreover, during the last 12 d of display, beef from the EFS group had the lowest (P < 0.01) proportion of metmyoglobin (display day x diet; P < 0.001). Under aerobic packaging, the SC and NSC groups produced steaks with higher (P < 0.05) TBARS values than RFS, EFS, and RYE groups, which did not differ from each other (display day x diet; P < 0.01). The SC and NSC groups had higher (P < 0.05) oxidation levels than RFS, EFS, and RYE groups, which did not differ from each other. Beef from the EFS group had (P < 0.05) higher concentrations of alpha-tocopherol than from the SC, NSC, and RYE groups. Beef from EFS-fed steers had a higher (P < 0.05) proportion of saturated fatty acids than the SC and NSC groups. It was concluded that the method of grass conservation influenced beef color, whereas concentrate composition did not. Color of aerobically packaged beef was improved by feeding animals silage that had undergone extensive fermentation. Conversely, oxidative stability was decreased by feeding animals starch- and nonstarch-based concentrate diets.

Animal Feed↗

Grass silage versus maize silage effects on retail packaged beef quality.

The effects of three preslaughter diets on heifer beef quality were investigated. Heifers (n = 45) were divided into three groups and fed for ad libitum consumption either maize silage, grass silage, or a 50:50 mixture of maize silage and grass silage. Meat quality was determined by measuring color, lipid oxidation, alpha-tocopherol levels, and fatty acid composition. Beef from the maize silage group had poorest color stability (P < 0.05), whereas beef from the grass silage diet had best (P < 0.05) color stability. The visual panel least preferred the maize silage group after 2 or more days of display, and lipid oxidation was significantly (P < 0.001) higher in this group compared to the 50:50 maize:grass silage and grass silage groups. There was a significant (P < 0.001) difference in the alpha-tocopherol levels detected in the meat from the three dietary groups. Alpha-tocopherol levels increased in the order: maize silage < 50:50 maize:grass silage < grass silage, at levels of 2.08, 2.95, and 3.84 microg/g meat, respectively. Fatty acid analysis indicated 18:3 was significantly (P < 0.001) lower in the maize silage-fed group than in the maize:grass silage and grass silage groups. However, 18:3 was significantly (P < 0.001) higher in the grass silage group than in the other two groups. There were no significant differences in all other fatty acids among the three dietary groups. It was concluded that beef from grass silage-fed animals had better overall quality in terms of color, lipid oxidation, and alpha-tocopherol levels than beef from maize silage fed animals.

Animals↗

Assessing the impact of a nurse-led health education intervention for people with peripheral vascular disease who smoke: the use of physiological markers, nicotine dependence and withdrawal.

This study evaluated the impact of a nurse-led health education programme on the behaviour, nicotine dependence and nicotine withdrawal in patients who smoke and suffer from peripheral vascular disease, based in a large teaching hospital in the north of England. Smoking behaviour was measured by self report, end-expired carbon monoxide and urinary cotinine. Nicotine dependence and withdrawal were measured using a nicotine dependence scale and a nicotine withdrawal scale. The findings demonstrated that the programme did have some impact on behaviour. The study raised issues concerning the measurement of physiological markers for smoking as nursing outcomes. Issues about the measurement of nicotine dependence and withdrawal are highlighted.

Aged↗

Brain injury: the uncertainties of using complementary therapies.

The use of complementary therapies is fast growing in the UK, but their place within health care is still unclear. This study explored the views of families using a specific complementary therapy in the care of their brain-injured children, and of professionals involved in the care of the children. The findings revealed an interesting comparison of views about the use of complementary therapies and attitudes towards their use.

Adolescent↗

Interprofessional working and learning in a UK operating department.

This study explores the issues of working and training together for nurses and operating department assistants and practitioners (ODAs/ODPs), based on experiences in an operating department. Interviews and focus groups with nurses, ODAs/ODPs and medical staff were the means of collecting data.

Education, Nursing, Continuing↗

Exploring the expanded role of nurses in critical care.

This paper reports on a small research study that explored the perceptions of staff in an intensive/coronary/high-dependency care unit on the expanded role of nurses in critical care. The research was undertaken in two phases. In the first phase, focus groups and interviews of nursing and medical staff were used as methods to explore their perceptions. Data were analysed by thematic content analysis and generated four categories: specialized skills; maintaining competence; how far nurses can go; and training and education. Using verbatim examples from the participants, these categories are described. In summary, it was found that both doctors and nurses were in favour of nursing role developments, and for the nurses this was driven by their desire to meet the patients' needs. In a smaller second phase, a questionnaire was developed based on information gained in the first phase. It was utilized to seek the views of all the nursing staff on specific role-expansion activities. Findings revealed substantial support for developing the role of critical care nurses in a number of activities: cannulation; venepuncture; ordering blood tests and X-rays; performing physiotherapy; inserting arterial lines; performing elective cardioversion; thrombolysis treatment and intubation. This research study has yielded important information. However, it is recognized that, whilst these roles may be new to this particular critical care unit, there are many other units where they may already be common practice. Whenever new roles are developed, it is important to evaluate their effectiveness in measurable terms and regular audit is advisable. Further research is therefore recommended on both the development and evaluation of new roles in critical care.

Attitude of Health Personnel↗

Investigating and implementing change within the primary health care nursing team.

Primary care is developing rapidly with significant impacts on the nursing team. Such changes have brought inter-professional team-working into sharper focus, particularly community care and collaborative working. This paper: examines the nursing roles within a general practice; describes the perspectives of service users; identifies areas of change; clarifies core and specialist skills; defines new roles among the primary health care nursing team; proposes a new model of working; and identifies appropriate education. The project was set in a general practice in south-west England and used an action research methodology. The objectives were to create a change in practice and to develop and refine existing theory to underpin nursing roles. Throughout the research regular team meetings allowed reflection and discussion about research findings and progress. Data were collected from multiple sources, including team workshops, patient focus group interviews, and individual interviews with GPs, practice managers and area managers. Reflective diaries and a patient survey were also used. The analysis of the quantitative and qualitative data collected from patients formed a basis for practice development and facilitated the team's reflection on the areas of change. Overall high satisfaction with services and care was expressed in the patient interviews and the questionnaire. The themes from the data highlighted areas important for patients and helped in shaping the new roles and responsibilities for team members. Regarding the team perspective, the data indicated many areas that could be considered for development. The community nursing team decided to concentrate on three key areas: child health, leg ulcer management, and cardiovascular health. The research concludes that action research presents some problems and challenges but is a useful approach to developing team-working in primary health care.

Cardiovascular Diseases↗

Comparison of effects of dietary olive oil, tallow and vitamin E on the quality of broiler meat and meat products.

1. The effect of dietary fat and vitamin E supplementation on quality attributes (drip loss, oxidative stability, sensory quality) in chicken meat and meat products was investigated. Broiler chicks were fed on diets containing tallow (60 g/kg) or olive oil (60 g/kg) at a basal (30 mg/kg diet) or supplemental (200 mg/kg diet) concentration of alpha-tocopheryl acetate for 8 weeks. The alpha-tocopherol content and fatty acid composition of breast and thigh meat was determined. Drip loss was determined in breast fillets. Lipid oxidation (thiobarbituric acid-reacting substances/TBARS) and sensory quality (warmed-over flavour development/WOF) were assessed in minced thigh meat during storage. 2. Dietary olive oil increased the ratio of monounsaturated to saturated fatty acids (MUFA/SFA) in the diets. In breast and thigh, this resulted in approximately a two-fold increase in the MUFA/SFA ratio. Supplemental alpha-tocopherol increased the alpha-tocopherol content of muscles. 3. Dietary fat not influence drip loss in thawed breast fillets during refrigerated storage, but supplemental alpha-tocopherol reduced drip loss. 4. TBARS and WOF development in minced thigh meat patties were also reduced by supplemental alpha-tocopherol following frozen storage, or cooking and refrigerated storage. Storage stability was not adversely affected by dietary fat. 5. Overall, the results showed that increasing the monounsaturated profile of chicken meat lipids did not adversely affect quality characteristics. Dietary alpha-tocopherol supplementation was a more important factor in the determination of broiler meat quality.

Analysis of Variance↗

Efficacy of a high and accelerated dose of hepatitis B vaccine in alcoholic patients: a randomized clinical trial.

PURPOSE: A randomized, double-blind trial was conducted to compare the efficacy of a high-dose versus standard-dose hepatitis B vaccine in alcoholic patients. PATIENTS AND METHODS: One hundred ten alcoholic patients were randomized to either receive the standard dose (20 micrograms at 0.1, and 6 months) or a high dose (40 micrograms at 0, 1, 2, and 6 months) of recombinant hepatitis B vaccine (Engerix-B). Patients were monitored for relapse of drinking using self-report, serial serum carbohydrate deficient transferrin, and collateral verification. The final titer of antibody to hepatitis B surface antigen (anti-HBs) was obtained 12 months after the first vaccine dose; a seroconversion was defined as a titer greater than 10 mlU/ml. RESULTS: One hundred subjects completed the study; 10 of these had clinical or pathological evidence of cirrhosis. Thirty-six out of 48 (75%) of patients administered the high-dose regimen seroconverted compared with 24 of 52 (46%) in the standard dose group (P < 0.005). The mean anti-HBs titer of the high dose group was significantly greater than of the standard dose group (76.4 versus 39.4 mlU/ml, P < 0.01). Logistic regression demonstrated a significant effect on seroconversion for the vaccine dose (P < 0.005) and serum albumin (P = 0.05) but not for the other variables such as race, age, drinking during the study, serum creatinine, arm muscle circumference, and cirrhosis. CONCLUSIONS: A high- and accelerated-dose regimen of hepatitis B improves the serological response in alcoholic patients. This regimen (currently recommended for hemodialysis patients) should now also be considered for patients with a history of alcoholism.

Alcoholism↗

Influence of dietary vitamin E and oxidised sunflower oil on the storage stability of cooked chicken muscle.

1. The effects of oxidised dietary sunflower oil and dietary alpha-tocopheryl acetate supplementation on alpha-tocopherol concentrations in broiler muscle and on the storage stability of refrigerated, cooked, minced muscle were determined. Broiler chicks were fed on diets containing fresh sunflower oil and 30 (FS30) or 200 (FS200) mg alpha-tocopheryl acetate/kg, or oxidised sunflower oil and 0 (OS0), 30 (OS30) or 200 (OS200) mg alpha-tocopheryl acetate/kg. 2. Inclusion of oxidised sunflower oil significantly reduced dietary and hence, muscle alpha-tocopherol concentrations. 3. Oxidised oil increased oxidation in raw and cooked muscle, and reduced the oxidative stability of muscle during refrigerated and frozen storage. 4. Supplementation with alpha-tocopheryl acetate improved the stability of muscle, with stability increasing as muscle alpha-tocopherol concentrations increased, when fresh or oxidised oil was fed. Supplementation with 200 mg alpha-tocopheryl acetate/kg offset the effects of oxidised oil in breast, but not in thigh. 5. The results show that the prooxidising effects of oxidised oils in muscle foods can be overcome, but alpha-tocopherol content needs to be adequately adjusted to compensate for increased oxidative stress. Supplementation with 200 to 400 mg alpha-tocopheryl acetate/kg may be necessary to achieve an optimum muscle alpha-tocopherol concentration.

Animals↗

Suppression of grp78 core promoter element-mediated stress induction by the dbpA and dbpB (YB-1) cold shock domain proteins.

The highly conserved grp78 core promoter element plays an important role in the induction of grp78 under diverse stress signals. Previous studies have established a functional region in the 3' half of the core (stress-inducible change region [SICR]) which exhibits stress-inducible changes in stressed nuclei. The human transcription factor YY1 is shown to bind the SICR and transactivate the core element under stress conditions. Here we report that expression library screening with the core element has identified two new core binding proteins, YB-1 and dbpA. Both proteins belong to the Y-box family of proteins characterized by an evolutionarily conserved DNA binding motif, the cold shock domain (CSD). In contrast to YY1, which binds only double-stranded SICR, the Y-box/CSD proteins much prefer the lower strand of the SICR. The Y-box proteins can repress the inducibility of the grp78 core element mediated by treatment of cells with A23187, thapsigargin, and tunicamycin. In gel shift assays, YY1 binding to the core element is inhibited by either YB-1 or dbpA. A yeast interaction trap screen using LexA-YY1 as a bait and a HeLa cell cDNA-acid patch fusion library identified YB-1 as a YY1-interacting protein. In cotransfection experiments, the Y-box proteins antagonize the YY1-mediated enhancement of transcription directed by the grp78 core in stressed cells. Thus, the CSD proteins may be part of the stress signal transduction mechanism in the mammalian system.

Bacterial Proteins↗

Alcoholism is associated with hepatitis C but not hepatitis B in an urban population.

OBJECTIVES: Previous studies have suggested an association of viral hepatitis with alcoholism, although the role of confounding risk factors (e.g. i.v. drug use) has not been adequately excluded. We therefore compared the seroprevalences of hepatitis B and C in alcoholic patients to that of a nonalcoholic control group. METHODS: Hepatitis B surface antigen, hepatitis B core antibody, hepatitis B surface antibody, and hepatitis C virus antibody testing (second generation ELISA and a confirmatory recombinant immunoblot assay) was performed in 150 consecutive alcoholics admitted for detoxification and in 166 randomly selected patients attending a general medical clinic who were screened for alcoholism. RESULTS: Hepatitis B and C seropositivities in actively drinking alcoholics are 49.3 and 35.3%, respectively, and were significantly associated with a history of i.v. drug abuse. Out of 166 general medicine clinics patients, 93 were classified as nonalcoholic (by both self-report and collateral verification), 46 patients had a history of alcoholism , and 27 were indeterminate. In the subgroup of patients without known viral hepatitis risk factors, there was no significant difference in hepatitis B seropositivity among nonalcoholic general medicine clinic patients, alcoholic general medicine clinic patients, and alcoholic patients admitted for detoxification (22.1%, 30.3%, and 27.6%, respectively). In contrast, anti-HCV recombinant immunoblot assay seropositivity in alcohol patients admitted for detoxification without risk factors was significantly greater than in nonalcoholic general medicine patients without risk factors (10 vs 0%, p >0.01). Stepwise logistic regression analysis revealed that alcoholism requiring detoxification was a significant risk factor for hepatitis C but not for hepatitis B seropositivity. CONCLUSIONS: The increased seroprevalence of hepatitis C in actively drinking alcoholic patients without known risk factors suggests that alcoholism, in some way, is a predisposing factor for HCV infection.

Aged↗

Within-subject comparison of speech perception benefits for congenitally deaf adolescents with an electrotactile speech processor and a cochlear implant.

This study assessed speech perception benefits for three congenitally deaf adolescents who used an electrotactile speech processor (Tickle Talker(TM)) and subsequently went on to use a Nucleus Minisystem 22 cochlear implant. Both devices provided significant and comparable benefits for all children in the device plus lipreading condition. All children benefited from the additional information provided by either the Tickle Talker(TM) or the cochlear implant, and were able to perceive speech information with these devices that was not available through either aided residual hearing or lipreading. None of the three children were able to understand open-set words or sentences using either hearing aids alone or Tickle Talker(TM) alone, without the aid of lipreading. Two of the children showed significant open-set speech perception benefits while using their cochlear implant alone.

Adolescent↗

Utility of carbohydrate-deficient transferrin as a marker of relapse in alcoholic patients.

Carbohydrate-deficient transferrin (CDT) has been proposed as a marker of alcoholism. However, its role in monitoring alcoholic patients for relapse has not been extensively studied. We therefore performed sequential serum CDT measurements using a microcolumn/radioimmunoassay method (Kabi Pharmacia, Piscataway, NJ) in 86 male alcoholics participating in a hepatitis vaccination program who were monitored for relapse using self-report and collateral history (when available). The maximum serum CDT was significantly higher in patients who relapsed (n = 38) (33.1 +/- 3.1 mg/liter), as compared with abstinent subjects with collateral verification (n = 39) (18.8 +/- 1.3, p < 0.001) and abstinent patients without collateral verification (n = 9) (17.4 +/- 1.3, p < 0.01). Using the manufacturer's currently recommended threshold of 20 mg/liter for males, serum CDT was elevated in 29 of 38 patients who relapsed (sensitivity 76.3%). In 16 (42.1%) of the relapsed patients, a serum CDT above this threshold preceded the patient's self-report by at least 28 days. However, serum CDT exceeded 20 mg/liter in 10 of 48 patients who remained sober (specificity 79.2%); three of these patients had clinical and/or pathological evidence of cirrhosis. Using a threshold of 25 mg/liter, 21 of 38 patients who relapsed had an elevated serum CDT (sensitivity 55.3%); 12 (31.6%) of these patients had elevated serum CDT before self-report. Only 4 of 48 subjects who remained sober had serum CDT levels that exceeded 25 mg/liter (specificity 91.7%); three of these patients had clinical and/or pathological evidence of cirrhosis. In conclusion, serial serum CDT testing detects relapses before self-report in male subjects. Values between 20-25 mg/liter suggest relapse, but call for collateral verification, whereas CDT values above 25 mg/liter are usually diagnostic of relapse in the absence of cirrhosis.

Alcoholism↗

Hepatitis C virus antibody in alcoholic patients. Association with the presence of portal and/or lobular hepatitis.

OBJECTIVE: To evaluate the relationship between hepatitis C viral infection and alcoholic liver disease. DESIGN: Case-comparison study. SETTING: Bronx (NY) Veterans Affairs Medical Center. PARTICIPANTS: Forty-seven consecutive alcoholic patients undergoing diagnostic liver biopsy. MAIN OUTCOME MEASURES: Serum was obtained at the time of liver biopsy and assayed for antibodies to hepatitis C virus using enzyme-linked immunosorbent assay, recombinant immunoblot assay, and hepatitis C virus neutralization methods. RESULTS: Antibody to hepatitis C virus, as confirmed by the recombinant immunoblot assay, was strongly associated with the presence of portal and/or lobular inflammation (91% seropositivity) but was only present in 16% of patients without this histologic finding (P < .001). In patients without portal or lobular hepatitis, recombinant immunoblot assay seropositivity was seen in 27% of patients with cirrhosis and 20% of patients with alcoholic hepatitis and was absent in patients with steatosis and/or perivenular fibrosis. In the subgroup of alcoholic patients who were without known risk factors for hepatitis C virus infection (ie, no history of intravenous drug use or blood transfusions), antibody to hepatitis C virus was present in 78% of subjects with portal and/or lobular hepatitis but was absent in those with other types of alcoholic liver disease. Finally, anti-hepatitis C virus-seropositive patients had a significantly greater mean necroinflammatory score as compared with anti-hepatitis C virus-seronegative alcoholic patients (2.1 vs 1.2; P < .001). In contrast, there was no significant difference in the mean fibrosis score between the two groups. CONCLUSIONS: The presence of portal and/or lobular inflammation is strongly associated with antibodies to hepatitis C virus in alcoholic patients, even in the absence of known risk factors. This association indicates that hepatitis C virus is responsible, at least in part, for the portal and/or lobular hepatitis associated with alcoholic liver disease.

Adult↗