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Biomedical subjects

P M Mullen

Publications and source records attributed to P M Mullen.

9 recordsLinked to original sources

Strength of conjugate binding to plasmid DNA affects degradation rate and expression level in vivo.

In vitro assays have demonstrated the capability of poly-L-lysine to protect plasmid DNA from serum nucleases and cellular lysates. Our purpose was to evaluate the stability and potency of poly-L-lysine-DNA polyplexes after intravenous injection into mice. Polyplexes consisted of 32P-radiolabeled plasmid DNA complexed with poly-L-lysine at specified charge ratios. Variations in conjugate hydrophobicity and levels of modification with polyethylene glycol were investigated. Our results show that, in contrast to in vitro studies, the systemically administered polyplexes exhibited marked DNA degradation in the vascular compartment within 5 min. Substitution of poly-L-lysine epsilon-amino sites with polyethylene glycol or hydrocarbon chains resulted in faster degradation even when complexed at higher charge (+/-) ratios. Use of excess cationic charge in the polyplexes (+/- 2.5) diminished degradation rates only slightly. An analysis was made of the strength of the poly-L-lysine:DNA interaction by competition with poly-aspartic acid. Polyplexes with the strongest binding between conjugate and DNA in the competition assay were also the most stable in blood. However, tighter binding was not enough to fully protect the polyplex in vivo and polyplex DNA was substantially degraded within 10 min. Increased polyplex stability did not correlate with improved in vivo transfection efficiency.

Animals↗

Waiting lists in the post-review NHS.

Waiting lists for hospital inpatient treatment have existed since the foundation of the NHS. There have been many theories put forward to explain them and a wide range of proposals have been advanced to reduce or eliminate them. The effect of the recent changes in the NHS, coupled with the renewed political focus on waiting lists, is explored. It is concluded that access to waiting lists may be restricted, either by explicit rationing or as a result of contractual specifications. Further, the introduction of GP Fundholding, together with the purchaser-provider split, could result in a two-tier service, at least for non-urgent patients. These conclusions are illustrated by the findings from a simple simulation model.

Computer Simulation↗

Is there a future for planning teams?

Health care planning in the NHS is undergoing a revolution. The proposals in Working for Patients, which involve the separation of funding from the provision of services, and the proposals for community care in Caring for People have profound consequences for the planning and provision of services for the so-called priority groups. Planning teams, which were first established after the 1974 reorganisation, have been one of the main vehicles for planning coordinated care for such groups. The current study, which updates earlier findings, was carried out shortly before the publication of Working for Patients. It found an increased number of planning teams catering for a wider range of client groups, increasing unit involvement in care group planning and more emphasis on joint planning with local authorities. The implications of the findings for the post-review NHS are discussed, in particular the future of joint planning, the future of CHC involvement in planning and the future of planning teams themselves.

Community Health Services↗

Determining the training needs of planners.

Since the NHS Planning System was formally introduced in 1976 both it and the NHS itself have undergone a succession of changes and reorganisations. To facilitate the introduction of the Planning System an integrated programme in training for planning was established by the DHSS. Over the years since then, training in planning has developed in a less integrated manner and by the late 1980s it was felt that the situation should be reviewed to meet the challenges of the forthcoming round of strategic planning. Accordingly, the Health Services Management Centre was commissioned to carry out a study into the training needs of planners. Because of the restricted timescale a workshop approach was adopted and leading planners and managers from all tiers and all professions from different parts of England and Wales were invited to participate. The project had two main foci which are discussed here. Firstly, current and future changes in the NHS and its environment which might or will impact on health care planning and, secondly, the identification of the groups which require training in planning, the skills and competencies they require and possible methods of acquisition.

Health Planning Support↗