Biomedical subjects

Linda Scott

Publications and source records attributed to Linda Scott.

8 recordsLinked to original sources

PubMed2005

Shared governance and shared leadership: meeting the challenges of implementation.

New forms of leadership are required if staff are to be effectively engaged and involved in decision-making and promoting clinical effectiveness. One such mechanism is shared governance and shared leadership to ensure practice is both practitioner owned and organizationally supported. Empowering staff is a great challenge requiring effective planning, preparation and commitment. Establishing the process of shared governance requires effective leadership, implementation of a suitable framework, multidisciplinary working and examination of the organization's structure and culture. This paper discusses the challenges of implementation, preparation of staff, and alignment with the organizational agenda. It emphasizes that shared governance is an ongoing and fluid process, requiring continual assessment and re-evaluation in order to be flexible and responsive to an ever-changing environment. The Christie model provides a sustainable framework for moving practice forward and successful implementation has led to greater coordination of practice development and sharing of best practice.

Humans↗

PubMed2004

ERK1/2 and p38 cooperate to induce a p21CIP1-dependent G1 cell cycle arrest.

To study the mechanisms by which mitogen- and stress-activated protein kinases regulate cell cycle re-entry, we have used a panel of conditional kinases that stimulate defined MAPK or SAPK cascades. Activation of DeltaMEKK3:ER* during serum restimulation of quiescent cells causes a strong activation of JNK1 and p38alpha but only a modest potentiation of serum-stimulated ERK1/2 activity. In CCl39 cells this promoted a sustained G1 arrest that correlated with decreased expression of cyclin D1 and Cdc25A, increased expression of p21CIP1 and inhibition of CDK2 activity. In Rat-1 cells, in which p21(CIP1) expression is silenced by methylation, DeltaMEKK3:ER* activation caused only a transient delay in the S phase entry rather than a sustained G1 arrest. Furthermore, p21CIP1-/- 3T3 cells were defective for the DeltaMEKK3:ER*-induced G1 cell cycle arrest compared to their wild-type counterparts. These results suggest that activated DeltaMEKK3:ER* inhibits the G1 --> S progression by two kinetically distinct mechanisms, with expression of p21CIP1 being required to ensure a sustained G1 cell cycle arrest. The ERK1/2 and p38alphabeta pathways cooperated to induce p21CIP1 expression and inhibition of p38alphabeta caused a partial reversal of the cell cycle arrest. In contrast, selective activation of ERK1/2 by DeltaRaf-1:ER* did not inhibit serum stimulated cell cycle re-entry. Finally, selective activation of JNK by DeltaMEKK1:ER* failed to inhibit cell cycle re-entry, even in cells that retained wild-type p53, arguing against a major role for JNK alone in antagonizing the G1 --> S transition.

3T3 Cells↗

PubMed2002

Cost-effectiveness of screening for the factor V Leiden mutation in pregnant women.

The factor V Leiden (FVL) mutation is associated with vascular complications in pregnancy, and routine screening of all pregnant women has been suggested. We did a prospective, unselected study in 967 pregnant women to evaluate the cost-effectiveness of screening all women, or only those with a personal or family history of venous thrombosis (n=113). When anticoagulant prophylaxis was assumed to effect a 50% reduction in vascular complications, we recorded an additional management cost of 3768 pounds sterling with selective screening and 39,841 pounds sterling with universal screening. This additional cost would result in prevention of less than one and three vascular events,respectively. Our findings, therefore, suggest that screening of pregnant women for the FVL mutation is not cost-effective.

Cost-Benefit Analysis↗

PubMed2002

Vitamin C prevents hyperbaric oxygen-induced growth retardation and lipid peroxidation and attenuates the oxidation-induced up-regulation of glutathione in guinea pigs.

Hyperbaric oxygen therapy is used to treat various clinical conditions, but it also causes oxidative damage. The objectives of this study are to determine if increased vitamin C intake can prevent hyperbaric oxygen-induced damage and to determine interactions among vitamin C, glutathione and vitamin E in response to oxidative stress. The growth rates of unexposed guinea pigs fed 1.25 mg vitamin C/day were indistinguishable from that of guinea pigs fed 50 mg vitamin C/day. In contrast, hyperbaric oxygen exposure resulted in growth retardation in guinea pigs fed 1.25 mg vitamin C/day, but it had little effect on the growth rates of guinea pigs fed 50 mg vitamin C/day. Increased vitamin C intake also prevented hyperbaric oxygen-induced lipid peroxidation in the liver. In guinea pigs not exposed to hyperbaric oxygen, levels of vitamin C in tissues were closely related to vitamin C intake, but tissue levels of glutathione and vitamin E were not related to vitamin C intake. However, interactions between vitamin C and glutathione were observed upon chronic hyperbaric oxygen exposure. Chronic hyperbaric oxygen exposure resulted in >2-fold increases in the levels of glutathione in liver and lung of guinea pigs fed 1.25 mg vitamin C/day. In comparison, the oxidation-induced increases in glutathione were significantly attenuated in guinea pigs fed 50 mg vitamin C/day. These data show that increased intake of vitamin C can prevent or alleviate the hyperbaric oxygen-induced damage. The interactions between vitamin C and glutathione upon hyperbaric oxygen exposure indicate that there is a homeostatic regulation of antioxidant capacity in guinea pig tissues.

Journal Article↗

PubMed2002

Minimising the use of sedation/anaesthesia in young children receiving radiotherapy through an effective play preparation programme.

The delivery of radiotherapy to young children is a challenging process, yet little research has been undertaken to examine practice. Many centres routinely sedate or anaesthetise young children to overcome problems relating to non-adherence to treatment. This can lead to an increased risk of clinical complications, sub-optimal nutrition, sleep disruption and is time consuming and costly. This article describes how sedation can be minimised in young children through an effective play preparation programme. To examine the effectiveness of such a programme, which had been in progress for a number of years, an audit was undertaken on a paediatric oncology unit within a regional radiotherapy centre. This took place over a 5-year period (1994-1999), on all patients aged 2-5 years. Information was collated on age, tumour type, site, duration of radiotherapy, the need for involuntary immobilisation, days requiring sedation, and whether radiotherapy was given with curative or palliative intent. Outcome data presented on 63 children suggest sedation can be minimised in this age group through the implementation of an effective play preparation programme. Of 1030 treatment days, only 111 days required sedation (10.8%), over the whole age range. No general anaesthetics were given. Only 6 patients were sedated for the whole of their treatment (9.5%), with 52 patients requiring no sedation at all (82.5%).

Journal Article↗

PubMedDate not supplied

Child protection: the role of communication.

Communication can either inhibit effective practice or be a valuable linchpin for family support and child protection. This article considers the issues involved in working with vulnerable children and explains the vital role that written records and record-keeping play in multidisciplinary communications, which is central to their protection and care.

Child↗

PubMedDate not supplied

Patient group directions: training practitioners for competency.

Since the mid-1990s, three new initiatives have been introduced by the government to allow the prescribing of medicines by practitioners other than doctors: extended nurse prescribing, supplementary prescribing and patient group directions. Professional education and assessment is vital to ensure that these systems operate safely. After the implementation of patient group directions within a regional cancer centre, a training programme was developed, incorporating an assessment framework for competency development.

Clinical Competence↗

PubMedDate not supplied

An alternative to surgery in treating ectopic pregnancy.

In an ectopic pregnancy the fertilised egg becomes implanted outside the uterus. It affects around one in every hundred pregnancies. Traditionally the condition has been managed surgically. However, in recent years many women have been treated with methotrexate therapy.

Abortifacient Agents, Nonsteroidal↗