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Biomedical subjects

S Bond

Publications and source records attributed to S Bond.

At least 19 recordsLinked to original sources
PubMed1992

Measuring patients' satisfaction with nursing care.

Assessing patients' satisfaction with the care they receive is assuming greater importance and satisfaction with nursing is no exception. The kinds of study in which patient satisfaction has been used as an outcome are considered and show the range of conceptualizations and the general lack of rigour in its measurement. It is argued that research methods are often flawed by using inappropriate measures and greater care is warranted in their selection. Where appropriate measures do not exist, only then is the costly process of developing new assessments warranted. Some of the necessary steps in arriving at reliable and valid measures of patient satisfaction are discussed in the context of asking particular research questions.

Humans↗
PubMed1992

The contribution of charge to affinity at functional (M3) muscarinic receptors in guinea-pig ileum assessed from the effects of the carbon analogue of 4-DAMP methiodide.

1. 4-Diphenylacetoxy-1:1-dimethyl cyclohexane (carbo-4-DAMP) is the carbon analogue of 4-diphenylacetoxy-N-methylpiperidine (4-DAMP) methiodide. The compounds differ only in that the quaternary nitrogen atom in 4-DAMP methiodide is replaced by a quaternary carbon atom, which is uncharged. 2. Carbo-4-DAMP appears to act competitively at functional (M3) muscarinic receptors in guinea-pig ileum. Estimates of log affinity constant are 6.0 at 30 degrees C and 5.9 at 37 degrees C, i.e. the compound has 0.1% of the affinity of 4-DAMP methobromide. 3. The absence of charge makes little difference to the conformation as determined by X-ray crystallography. The bond lengths and angles are very similar, though the bonds in the cyclohexane ring of carbo-4-DAMP are consistently slightly longer than those in the piperidinium ring of 4-DAMP methiodide, and the presence of the charge slightly reduces the space between molecules. 4. The difference between the affinities of 4-DAMP methobromide and carbo-4-DAMP indicates that the contribution of coulombic forces to the binding between 4-DAMP methiodide and muscarinic (M3) receptors is at least 17 kJ mol-1 (4.1 kcal mol-1) at 37 degrees C. How much this is an underestimate depends upon how much hydrophobic binding is greater with the uncharged compound.

Animals↗
PubMed1992

Increased resting energy expenditure in childhood asthma: does this contribute towards growth failure?

In order to determine whether or not there was a relationship between disorders of growth in children suffering from asthma and either increased resting energy expenditure or inadequate energy intake, a group of 34 children suffering from perennial symptoms were studied. A control group matched with the asthmatic children for sex and fat free mass were similarly studied. The children kept seven day records of weighed food intake. Basal metabolic rate was measured on one occasion in the fasted state by means of indirect calorimetry using the ventilated hood technique. The asthmatic children kept a 28 day record of peak expiratory flow rates, asthma symptoms, and medication usage. The asthmatic children expended significantly more energy at rest than their matched controls in absolute terms (14%). There was no correlation between height or height SD score and any parameter of energy balance. The causes of these finding are as yet speculative.

Asthma↗
PubMed1992

Patients with suspected myocardial infarction: effect of mode of referral on admission time to a coronary care unit.

The aim of this prospective study was to determine the delay between the onset of symptoms and arrival in the coronary care unit of patients with suspected acute myocardial infarction, and the relative contribution to the total delay of patient delay, method of referral (self referral or general practitioner referral) and delay in the hospital before reaching the coronary care unit. All patients admitted with chest pain to the coronary care unit at Dudley Road Hospital, Birmingham, over the six month period April-September 1989 were included in the study. Ninety five patients were referred by their general practitioner and 107 patients attended the accident and emergency department directly or arrived by ambulance without contacting their general practitioner. The proportion of self referred and general practitioner referred patients with acute myocardial infarction, angina and non-cardiac chest pain were not significantly different. The total delay was significantly longer for patients who had been referred by their general practitioner (median 5.3 hours) than for self referrals (3.2 hours, P less than 0.001), with a significantly higher proportion of self referrals arriving at the coronary care unit within six hours of the onset of symptoms (77% versus 54%, P less than 0.01). Among general practitioner referrals, initial patient delay accounted for a median of 2.5 hours and the general practitioner's response time for a median of 1.1 hours. The delay in hospital was similar for both groups of patients. In inner city areas, self referral may result in considerably less delay than general practitioner referral allowing a greater proportion of patients to receive effective thrombolytic therapy.(ABSTRACT TRUNCATED AT 250 WORDS)

Coronary Care Units↗
PubMed1991

Nurses' assessment of elderly patients in hospital.

Nurses' assessment of patients' mobility in hospital provided the focus for an inductive qualitative study which examined how an everyday aspect of nursing practice was carried out. The study described assessment practices in both long-term care and acute care wards for elderly patients as a situated activity. Interviews with nurses, as well as observation of their activities and records, resulted in explanations of their behaviour as deriving from their conceptions of ward functions. These conceptions arose from their adoption of the values of cure and discharge and so, in the different types of ward, assessment held different meanings and was carried out in different ways. The findings have implications for nursing practice in different settings but also for the care of elderly and chronically ill patients, where cure is an inappropriate end goal of care. This example of developing explanatory theory inductively also has implications for the development of mid-range nursing theory and suggestions are made for its extension.

Geriatric Nursing↗
PubMed1991

Outcomes of nursing care: the case of primary nursing.

Using primary nursing as a 'case study', this paper reviews research literature which attempts to measure the effectiveness of a mode of nursing using outcome measures. Previous research, it is argued, is hampered by a lack of conceptualization of structure and process and inadequate research design, with consequent uncertain findings. A shift in emphasis is suggested from an evaluation of global concepts, such as primary nursing, to an identification of the features of structures and processes of nursing care which interrelate with patient and nurse outcomes. For this purpose, multivariate research design and investment in methodological research are recommended.

Humans↗
PubMed1991

Issues in measuring outcomes of nursing.

The upsurge in interest in measuring patient outcomes of nursing, it is argued, has been occasioned firstly by management changes and secondly by the professionalizing thrust of the nursing profession. Within this overall context, however, the objectives of individual patient outcome studies vary considerably. The current status of outcome measurement in nursing is outlined through a description of the use of different outcome measures to suit different purposes. Ascertaining whether nursing care makes a difference by using outcome measures raises methodological as well as professional issues, for example that of separating nursing from the inputs of other professional groups and incorporating individual patients' perspectives. While these challenges are complex and measuring the effectiveness of nursing in terms of patient outcomes is in its infancy, it is argued that, in this, nursing is no different from other professional groups. The paper goes on to suggest ways of moving forward in the measurement of outcomes of nursing for patients.

Humans↗
PubMed1990

HIV infection and community midwives: experience and practice.

To assess the effects of HIV infection on the work of community midwives, a postal survey of 1 in 5 in Scotland and England was carried out. The 907 respondents represent an 83% response rate. While only 1% of respondents had experience of patients with AIDS, 8% had been involved with known asymptomatic HIV infection and 32% had encountered those that they considered to be 'at high risk'. While the workload generated by HIV-infected patients for individual midwives at this time was small, almost all midwives themselves considered that they had a role to play in the prevention of HIV infection through health education and in counselling. While less than a quarter of those who had encountered HIV-positive patients had provided health education, more than half had done so to those worried about HIV infection and almost a quarter had counselled them. However, confidence to provide these aspects of practice was low, even among those who had received in-service education, although higher than among those who had not done so. A minority of community midwives had read policies or guidelines about aspects of practice and service provision, except for infection control where two thirds had read what they considered an adequate policy.

Community Health Nursing↗
PubMed1990

HIV infection and community midwives: knowledge and attitudes.

Findings from two sample surveys of community midwives in Scotland and England (N = 907) during 1988 reveal that there is limited knowledge about many aspects of HIV infection. Respondents were themselves concerned about their lack of experience and knowledge as well as the availability of resources for HIV infection. There were also substantial educational concerns. More than a quarter of respondents felt that they should have the right to refuse to care for HIV-infected patients and the majority felt that health professional who are most at risk of contact with HIV-infected materials should be informed of patients' HIV-antibody status without patient consent. Recommendations are made regarding ways of increasing community midwives' knowledge and confidence.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Outcomes of care within a multiple-case study in the evaluation of the experimental National Health Service nursing homes.

This paper reports outcome data from a multiple-case study of the three experimental NHS nursing homes and six hospital wards undertaken as part of the evaluation of the experimental NHS nursing homes. While all subjects were very frail, NHS nursing home residents were found to be less frail than those in hospital wards. Significant differences in favour of the NHS nursing homes were found in the proportion of subjects engaged in meaningful activity during the mornings and afternoons, in the amount of activity and contact with others during the hour preceding lunchtime, and in amount of verbal interactions over lunchtime, particularly when choices were offered. These outcome data support the findings of other studies carried out as part of the evaluation that there is no evidence to imply that continuing-care accommodation should not be provided in NHS nursing homes.

Aged↗
PubMed1990

HIV infection and AIDS in England: the experience, knowledge and intentions of community nursing staff.

A postal survey of 5243 community nursing staff throughout England sought information about their experience, education, knowledge, confidence and beliefs in relation to the human immunodeficiency virus (HIV) and the acquired immune deficiency syndrome (AIDS). A response rate of 74% was obtained. While experience of patients positive for HIV antibody or with AIDS was limited, one-third of community nursing staff had encountered patients worried about HIV infection. However, most lacked confidence to provide health education, counselling and terminal care. A quarter felt that they should have the right to refuse to care for patients with AIDS, while 85% were concerned about their lack of experience. In order to play an effective role in the prevention and management of HIV infection, community nursing staff need to be assisted in making links between knowledge they already possess and its application to HIV infection, and in developing and practising skills.

Community Health Nursing↗
PubMed1990

Towards defining the organization of nursing care in hospital wards: an empirical study.

The method of organizing nursing care known as 'primary nursing' is increasingly being introduced into hospital wards on the assumption that it will have beneficial effects for both patients and staff. Operational definitions of primary nursing, essential to provide replicable research into the organization of nursing care, are, however, lacking in available research literature. This study describes the development of a questionnaire intended to identify and discriminate between three methods of organizing nursing staff and nursing work: task allocation or functional nursing, team nursing and primary nursing. The questionnaire was distributed to 36 ward sisters on 27 acute and rehabilitation care of the elderly wards. Questionnaires were returned from 17 wards, a response rate of 63%. Findings indicate that few wards meet five or more criteria for classification as a particular method of nursing organization. The findings illustrate the difficulties in matching and discriminating between wards in order to conduct research in which organizational modality is an independent variable.

Attitude of Health Personnel↗
PubMed1990

HIV infection, AIDS and community nursing staff in Scotland.

Little is known about the effects of the 'AIDS epidemic' on the work of community nursing staff. In order to ascertain the extent and nature of their work related to HIV infection and AIDS, and to assess their knowledge and beliefs, a postal survey of one in five community nursing staff in Scotland was carried out. A response rate of 85% was achieved. While only 3% of respondents had encountered a patient with AIDS, 11% had been involved with HIV antibody positive patients and 30% had encountered professionally others worried about or at high risk of infection. Findings show that, although community nursing staff consider they have a role to play in health education, counselling and terminal care, they largely feel lacking in confidence and ill-prepared for this role. Recommendations are made for improvements in education, and in the provision of information and policy, geared specifically to the roles of different types of community nursing staff in their day-to-day work.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Replication of sialodacryoadenitis virus in mouse L-2 cells.

Sialodacryoadenitis (SDA) is a naturally-occurring infection of the laboratory rat raused by the coronavirus, sialodacryoadenitis virus (SDAV). The study of SDAV has been limited because there is no widely available continuous cell line for the propagation of high titers of the virus. The purpose of this study, therefore, was to compare the ability of SDAV to replicate in the permanent cell lines, LBC, of rat origin, and the mouse cell lines. L-929 and L-2. Following 2 to 6 repeated passages of SDAV in LBC cells, the virus could be readily propagated in LBC and L-2 cells, but not in L-929 cells. Similarly, SDAV adapted to replicate directly in L-2 cells could be readily propagated in LBC, but not L-929 cells. In LBC and L-2 cells, cytopathic effect (CPE), viral antigen, viral particles, and virus infectivity could be demonstrated. Titers of up to 10(8.0) infectious viral particles/0.25 ml of culture fluid were obtained at 48 hours in L-2 cells. Titers in LBC cells were one to two logs lower. When susceptible rats were inoculated with eighth passage L-2 cell-adapted virus, they developed typical lesions of SDA. Virus could be recovered from infected tissues and propagated in L-2 cells on first passage. The ability to propagate SDAV to high titers in the widely available L-2 cell line should promote the study of this virus and facilitate its comparison with other murine coronaviruses.

Animals↗
PubMed1989

A follow-up study of high-functioning autistic children.

It is well known that IQ is an important prognostic variable in the outcome of autistic children. There are, however, very few data available on the outcome of nonretarded autistic children as adults. We identified 16 such probands from records and followed them up between 11 and 27 years since discharge from a center specializing in the assessment of autistic children. There were 12 males and 4 females, average age was 26, and mean IQ was 92 (range 68-110). Although the majority were functioning poorly in terms of occupational-social outcome and psychiatric symptoms, a surprising number (4) had a very good outcome and might be considered recovered. The severity of early autistic behavior was a poor predictor of outcome, but neuropsychologic measures of nonverbal problem solving were highly correlated with outcomes. The results of the study indicate that a small percentage of nonretarded autistic children can be expected to recover to a substantial degree.

Adolescent↗
PubMed1989

In utero gene transfer and expression: a sheep transplantation model.

Retroviral-mediated gene transfer was used to insert a Neo R gene into fetal sheep hematopoietic cells obtained by exchange transfusion from lambs in utero. After gene transfer the cells were returned to the donor fetus. The lambs were examined after birth for the presence of a functioning Neo R gene. Of ten analyzable animals, six were positive for G418 resistant progenitor cells (CFU-Mix, CFU-C, BFU-E, CFU-E). Two animals were studied for extended periods of time: 8 and 24 months. Each has demonstrated a pattern wherein positive periods are interspersed with times when there were no detectable G418-resistant cells. We conclude that retroviral-mediated gene transfer can be used to insert genes into early progenitor cells of fetal sheep in utero and that the animals can continue to demonstrate blood cells expressing the gene for more than 2 years after birth. This is a US government work. There are no restrictions on its use.

Adenosine Deaminase↗