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Biomedical subjects

M Kerr

Publications and source records attributed to M Kerr.

At least 55 records · Page 3Linked to original sources
PubMed1994

Opportunities for communication in classrooms serving children with developmental disabilities.

Documented the number and types of opportunities for communication provided by teachers in seven classrooms for children with developmental disabilities and by teachers of nonhandicapped preschoolers in a day care center. In the special education settings, less than 14% of the more than 6,000 observation intervals contained an opportunity for communication. Most opportunities involved naming an object or event followed in frequency by opportunities to request, answer, and imitate. Similar results were obtained in the day care center. In the special education classrooms, a strong positive correlation was found between a child's existing communication skills and the number of opportunities received. Results suggest that these teachers did incorporate opportunities for communication into classroom activities.

Adolescent↗
PubMed1994

Phenotypic variability of familial adenomatous polyposis in 11 unrelated families with identical APC gene mutation.

BACKGROUND/AIMS: Familial adenomatous polyposis is caused by germline mutation of the adenomatous polyposis coli (APC) gene. Affected individuals develop hundreds of colorectal adenomas at young age and can have extracolonic lesions. METHODS: This study evaluated the phenotype of 74 patients with familial adenomatous polyposis from 11 unrelated families with an identical 5-base pair deletion at codon 1309 of the APC gene. RESULTS: Polyp density in the sigmoid colon of 16 patients from 9 families varied from 3.8 to 13.1/cm2, and mean polyp diameter ranged from 1.4 +/- 0.1 to 2.7 +/- 0.1 mm. The distribution of colonic adenomas also varied, with diffuse polyposis in 6 patients but relative polyp sparing in the more proximal colon in 6 others. Age at diagnosis of colorectal cancer ranged from 19 to 62 years, but the mean age did not differ among the 4 families with multiple cases. Colorectal cancers occurred predominantly in the rectosigmoid (80%) but also in the more proximal colon. The percentage of patients affected by various extracolonic lesions differed widely among and within the 11 families (range, 0%-100%). CONCLUSIONS: APC gene mutation at codon 1309 results in intrafamily and interfamily phenotypic variation in familial adenomatous polyposis. Environmental and/or other genetic factors must play roles in the expression of germline APC gene mutations.

Adenomatous Polyposis Coli↗
PubMed1994

A survey of aggressive behaviour among a population of persons with intellectual disability in Queensland.

A survey was conducted on aggressive behaviour within a population of 2412 persons with intellectual disability in Queensland, Australia. Two hundred and sixty-one individuals were identified who engaged in at least one form of aggressive behaviour, yielding an overall prevalence of 11%. The relative prevalence of aggressive behaviour was higher among institutionalized persons (35%) when compared to those living in group homes (17%) or other community-based facilities (3%). The aggressive behaviour sample included a higher percentage of males (64%). Most were described as functioning in the severe/profound (54%) or moderate (31%) range of intellectual disability with one-third having no intelligible speech. Two-thirds of the sample received medication for their challenging behaviour, while only one-third had behavioural programmes. Eighty per cent engaged in three or more forms of aggression. Many also displayed self-injury (34%) or property destruction (30%). Surveys of aggressive behaviour may prove useful for coordinating services.

Adolescent↗
PubMed1994

Case managers and physicians: communication and perceived problems.

OBJECTIVE: To describe case managers' perceptions of the physician-case manager relationship. DESIGN: A qualitative field study using in-depth open-ended interviews was used to elicit case managers' experiences and practices. A multidisciplinary team analyzed transcripts using an adaptation of the "grounded theory" approach of Glaser and Strauss. PARTICIPANTS/SETTING: Case managers were selected for interview using a maximum variation sampling strategy within an established state-wide case management agency. MAIN OUTCOME MEASURES: Transcript analysis allowed for the organization of observations into themes, which were merged across interviews to generate theses. RESULTS: Case managers report that: (1) The case manager role is poorly understood by physicians. (2) Physicians lack insight into the social and environmental aspects of home-bound elderly people. (3) Access to physician services is often difficult to obtain. (4) Power struggles occasionally surface in care planning. (5) Decisions by physicians and case managers regarding the care of frail elderly are often made from different agenda. CONCLUSIONS: From the perspective of case managers, gaps in interprofessional communication may hinder the optimal care of frail elderly individuals.

Aged↗
PubMed1994

"Stockless" cost reduction in the operating room.

St. Paul-Ramsey Medical Center in St. Paul, MN became one of the first hospitals in the United States to initiate a "stockless" par level inventory system. Successes with stockless led the hospital to look at implementing it in the OR to achieve a reduction of expense to revenue. Materiel Management and Surgical Services discussed a number of issues relevant to implementing a stockless program, including product flow, accuracy and cost of case carts and preference cards, item pricing, committed usage of items brought into the system and establishment of a steering committee. Specific OR issues and practices required evaluation and adjustment, such as the routine use of emergency direct ordering. Information systems support was brought in and a products committee established to do education and oversee the program. Savings for 1993-94 were $185,146.

Cost Savings↗
PubMed1993

Characterization of antinuclear autoantibodies present in the serum from nonobese diabetic (NOD) mice.

The nonobese diabetic (NOD) mouse develops insulin-dependent type 1 diabetes in response to autoantibodies and T-cell attack directed against pancreatic islet cell antigens. Sera obtained from nondiabetic and diabetic female mice demonstrated a 1.4-fold increase in IgG levels when compared to BALB/c control animals. Nondiabetic and diabetic male mice had a 2.1- and 3-fold increase, respectively, in serum IgG levels over that of control mice. Seven of 11 non-diabetic and 7/10 diabetic sera from female NOD mice contained antibody to cytoplasmic or nuclear components of HEp-2 cells. Cytoplasmic staining revealed reaction against cytoskeletal and midbody structures. Punctate nuclear staining patterns with HEp-2 cells showed antibody reaction to the centriole, mitotic chromosomes, and nuclear rim. On the other hand, sera from BALB/c mice were negative for antibody staining of HEp-2 cells. Confirmation of the autoantibody nature of the NOD sera was obtained by antibody staining of nuclear structures from the mouse 3T3 fibroblast cell line, and by staining of salivary gland tissue sections. The nuclear and cytoplasmic staining patterns of diabetic NOD sera were reminiscent of the autoantibody staining patterns observed in Sjögren's syndrome and other inflammatory autoimmune connective tissue diseases.

Animals↗
PubMed1993

Effect of temporal perspective on subjective confidence.

Four studies examined whether people tend to lose confidence in their prospects for success the closer they are to the "moment of truth." Study 1 found that students think they will do better on their midterm exams when asked on the 1st day of class than when asked on the day of the exam. Studies 2 and 4 replicated this finding under controlled conditions. Study 3 demonstrated that the same effect holds retrospectively: People are more confident that they would have performed well at a task long after the time to perform has passed. Data are presented indicating that these results stem from a tendency for people to feel more "accountable" for their assessments, and thus focus less on the causes of success and more on the causes of failure, as the time to perform approaches. Implications for the experience of regret are discussed.

Adult↗
PubMed1993

Abnormal plasma fibrinolysis in patients with rheumatoid arthritis and impaired endothelial fibrinolytic response in those complicated by vasculitis.

OBJECTIVES: (a) To assess plasma fibrinolytic parameters in patients with rheumatoid arthritis (RA) and to determine whether there are differences between patients with RA alone and those with RA complicated by vasculitis. (b) To determine if patients with RA respond differently to venous occlusion compared with normal subjects and to assess whether such a response differs in patients with RA alone and those with rheumatoid vasculitis. (c) To determine the extent of vascular damage in patients with rheumatoid vasculitis and if this correlates with the levels of plasma fibrinolytic parameters. METHODS: Sixty three patients with RA (38 had RA only and 25 had evidence of rheumatoid vasculitis) were recruited. Plasma levels of tissue plasminogen activator antigen (t-PA Ag), plasminogen activator inhibitor (PAI) activity, and factor VIII von Willebrand factor (vWF) were measured before and 10 minutes after venous occlusion. RESULTS: Patients with RA, with or without rheumatoid vasculitis, had higher baseline PAI levels than control subjects. The difference was statistically significant for patients with RA alone but was not statistically significant for patients with rheumatoid vasculitis. After venous occlusion, t-PA Ag levels increased significantly in normal subjects and patients with RA alone, but not in patients with rheumatoid vasculitis. Plasma levels of vWF were significantly higher in patients with rheumatoid vasculitis than in normal subjects and those with RA alone. In patients with RA alone, baseline vWF correlated positively with t-PA Ag levels, whereas a negative correlation was found between these two parameters in patients with rheumatoid vasculitis. A negative correlation between vWF and t-PA Ag levels after venous occlusion was also found in patients with rheumatoid vasculitis. CONCLUSIONS: Patients with rheumatoid vasculitis showed evidence of vascular damage with increased levels of vWF and impaired t-PA Ag release after venous occlusion, a useful measurement of endothelial reserve to remove fibrin. This may be of pathophysiological importance in the development of vasculitis in these patients.

Adult↗
PubMed1993

Inhibition of constitutive protein secretion from lactating mouse mammary epithelial cells by FIL (feedback inhibitor of lactation), a secreted milk protein.

The effect of a protein feedback inhibitor of lactation (FIL) on casein synthesis and secretion was examined using isolated acini from lactating mouse mammary gland. As previously found, FIL partially inhibited protein synthesis but produced an additional inhibition of constitutive casein secretion. The inhibition of synthesis and secretion showed similar dose-dependency and the inhibition was fully reversible. Constitutive secretion of pre-formed protein was inhibited by FIL in a pulse-chase protocol, indicating that the inhibitor regulated protein secretion by reducing protein movement through the secretory pathway independently of any initial inhibition of synthesis. Regulated exocytosis was not inhibited since casein release due to elevation of cytosolic Ca2+ concentration by the ionophore ionomycin was unaffected. Brefeldin A, which is known to block ER-to-Golgi transport, also inhibited both protein synthesis and secretion in mammary cells. The action of FIL on synthesis and secretion and previously described actions on casein degradation would be consistent with a block at an early stage in the secretory pathway. In support of this idea FIL treatment was found to result in vesiculation and swelling of the endoplasmic reticulum. These data provide evidence for a novel control of a constitutive secretory pathway by a physiological extracellular regulatory protein.

Animals↗
PubMed1992

Epidermal growth factor receptors in the oesophagus.

The quantity and distribution of epidermal growth factor receptors (EGF-R) in oesophageal mucosa was studied in the oesophagus in order to determine its role in oesophageal disease. Fifty five biopsies were taken from different levels of the oesophagus in 25 consecutive patients undergoing endoscopy. Another group of eight patients with histologically proven Barrett's oesophagitis had a biopsy taken from the area of columnar lined oesophagus. A peripheral, membranous pattern was seen predominantly confined to the basal and immediately suprabasal cells in all of the first group of patients. In the superficial cells a few granular cytoplasmic structures were positive. All patients with Barrett's oesophagitis showed EGF-R staining of the surface epithelium. A computerised planimeter was used to determine the proportion of stained areas of squamous cells which were expressed as a percentage of the total area of squamous cells. The difference in the area of cells stained for EGF-R between normal and inflamed oesophageal mucosa (29.5% and 43.1% respectively) was significant (p less than 0.001).

Adult↗
PubMed1991

Unraveling the mystique of power analysis.

Power analysis provides one method for assessing the efficacy of alternative research designs. The purpose of this article is to simplify the methods for calculating power analysis to determine an adequate sample size. Although attention to type I errors (alpha error) is prevalent among nurse researchers, there is less appreciation for research problems resulting from a type II error. Without the a priori examination of the power of the test of significance, there is no assurance that the sample is sufficient to discern significant differences. Formulas for calculating effect size are provided for t tests, correlations, chi-square, analysis of variance, and regression. Examples of calculating the effect size by using four different statistical tests based on research studies are presented: t tests with unequal variance between groups, chi-square, an analysis of variance, and regression. Power analysis is an additional procedure to ensure that the sample size is adequate for the research project about to be undertaken.

Nursing Research↗
PubMed1989

Mucocutaneous lymph node syndrome (Kawasaki disease).

Mucocutaneous lymph node syndrome has rarely been reported in the dental literature despite the orofacial features characteristic of the disease. A case is reported in which the cardinal signs were present: erythema of the oral mucosa, cervical lymphadenopathy, conjunctivitis, pyrexia, and desquamation of the skin of the hands and feet. In addition, hydrops of the gallbladder and cardiac disorder were also found. The patient may first seek treatment by the dental practitioner, by whom the diagnosis may be made. Attention is drawn to the possibility of cardiac abnormalities that may influence dental treatment.

Child↗