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Biomedical subjects

S Carlisle

Publications and source records attributed to S Carlisle.

10 recordsLinked to original sources
PubMed2001

Practice and professional development plans (PPDPs): results of a feasibility study.

BACKGROUND: Dissatisfaction with uniprofessional education structures as a means of improving the quality of healthcare has led to proposals to develop ways of integrating professional learning and organisational development. AIMS: Test the feasibility of introducing practice and professional development plans using a centrally sponsored project in Wales. DESIGN: Qualitative observational study. STUDY SAMPLE: All 541 practices in Wales were alerted to the project and invited to apply. A selection process was suggested to Health Authorities but not always efficiently conducted: 23 practices were selected and 18 participated in the process. METHOD: Central funding was made available to health authorities. The project framework was designed by an educational department and conceptualised as the development of personal portfolios linked to one key organisation change in each practice, facilitated by external consultants who would typically hold workshops or other events. An independent researcher using non-participant observation techniques at workshops and practices undertook documentary analysis and fieldwork in four health authorities. RESULTS: Difficulties were encountered with the process of implementing the project: marketing and practice selection inconsistencies delayed the work and it was difficult to recruit practices into the project. The lack of experienced individuals to do the work and practitioner suspicion about perceived 'management' agendas were significant problems. After initial hesitancies most practices appreciated the value of developing wider ownership and commitment to proposed practice changes. Organisations found it difficult to support individual completion of the personal portfolio component of the plans. The ability to develop systems for clinical services was dependent on having already established a culture of effective teamwork in the organisation. CONCLUSIONS: This work supports the view that organisational development has considerable potential for bringing about effective change, and individual contributions could form a valuable component of personal portfolios. We believe that the existing structures in education and management in the health service are not yet able to support these processes. Evidence from the fields of risk management and quality improvement all point to the need to develop effective organisational systems and the results of this feasibility study indicate that alternative models of sustaining organisational development need careful evaluation.

Education, Medical, Continuing↗
PubMed1998

'When the talking starts': a framework for analysing tutorials.

The drive towards learner-centred learning which will equip doctors for the next century has encouraged the exploration of alternative ways of learning. A fundamental assumption is that a new learning strategy will either fit into existing patterns or trigger changes in the way that teachers and learners talk together. Despite the use of videotaped tutorials within re-accreditation visits in parts of the UK, the literature reveals no currently existing frameworks to analyse these teaching/learning interactions in the general practice setting. In this qualitative study of tutorials in general practice vocational training, a new grounded theory was developed. This study was innovative in its use of audiotaped tutorials as opposed to espoused theories of interaction. The new theoretical framework of Trainer/GP Registrar interactions consists of five categories: 'gaps to be filled', 'listening in', 'quick fix', 'problem solving' and 'talk on'. Each category illustrates whose agenda was met, who triggers the learning issue, time factors, the educational philosophy and the degree of reflection encouraged. The key principle underpinning this framework is that for learning to be effective a range of educational transactions may need to occur. If educational transactions occur exclusively around one point on the framework, the quality of training and opportunities for critical reflection may suffer. This framework may have implications for the analysis by Trainers of their teaching dialogues in the same way that consultation analysis has informed the development of consultation styles in general practice.

Career Choice↗
PubMed1983

Schistosoma mansoni: morphologic changes induced by maintenance in vitro.

Adults of Schistosoma mansoni were incubated in several culture media at various time intervals ranging from 2 to 96 hr. The morphologic changes induced by the incubation were documented using both scanning and transmission electron microscopy. These included changes in the tegument, esophageal cells, and cecum. Variability was noted among worms within experimental groups and the surface changes on single worms were frequently observed to have patchy distribution. Based on morphologic changes observed, culture media were ranked as adequate, mediocre, or inadequate. RPMI-1640 + 50% fetal calf serum, Eagle's MEM with Earle's salts (no serum), and McCoy's 5A Medium + serum were judged adequate. Basal Eagle's Medium, Triple Eagle Medium, NCTC-135, and Earle's Balanced Salt Solution (all with or without serum) were judged mediocre. Hanks' Basal Salt Solution (with or without serum) was judged as severely inadequate. All media tested gave better results in the presence of serum. These factors point to the necessity for the use of carefully selected culture media, as well as adequate controls and sampling techniques in the interpretation of in vitro experiments with S. mansoni.

Animals↗
PubMed1983

Schistosoma mansoni: evaluation of selected preparative procedures for transmission and scanning electron microscopy.

Evaluation of numerous procedures for collection and preparation of Schistosoma mansoni for scanning (SEM) and transmission microscopy (TEM) revealed that some commonly used methods result in introduction of osmotic or mechanical damage. Modification and selection of appropriate procedures allowed elimination of these artifacts. Not eliminated by these procedures, however, were several kinds of spheres and blebs that were either external to the apical plasma membrane of the tegument or budding from it. After careful examination of all procedures, we concluded that these spheres appear to some extent on all schistosomes prepared for either SEM or TEM and may represent either a normal component of the schistosome surface, a constant host contaminant, or an artifact not eliminated by any of the multiple modifications of technique examined.

Anesthetics↗
PubMed1982

Fetal exposure to maternal hyperbilirubinemia. Neonatal course and outcome.

A case of prolonged fetal exposure to hyperbilirubinemia occurred in a mother with end-stage liver disease during the second and third trimester of pregnancy. At birth, the infant had elevated levels of both conjugated and unconjugated serum bilirubin that required multiple-exchange transfusions during the first three days of life. The infant exhibited abnormal neurologic findings at birth that resolved during the neonatal period. The results of subsequent developmental and neurologic evaluation were normal at 14 months of follow-up. Prolonged fetal exposure to elevated serum bilirubin levels may not necessarily result in developmental or neurologic handicap.

Adult↗
PubMed1981

Separation and detection of lipoproteins in human serum by use of size-exclusion liquid chromatography: a preliminary report.

Components of human serum can be separated on the basis of differences in relative molecular mass by using size-exclusion "high-performance" liquid chromatography. Lipoproteins in fractions of the eluate can be quantitated by conventional chemical and enzymatic methods. Alternatively, if lipoproteins in the serum are selectively prestained with diformazan dye, the column effluent can be monitored spectrophotometrically at 580 nm, so that only the lipoprotein components of serum are detected. Samples of purified low-density lipoproteins, so stained and analyzed, provide peak-area values that are proportional to their concentration as evaluated by chemical methods. With this technique, the various lipoprotein classes can be quickly separated and their concentration estimated. These techniques should prove useful in clinical and research laboratories.

Azo Compounds↗
PubMed1980

Evidence for two insulin receptor populations on human erythrocytes.

Human erythrocytes specifically bind 125I-insulin in a manner similar to cells in which insulin exerts a physiological response. In addition, erythrocytes are of practical value for correlating in vitro insulin binding with in vivo carbohydrate intolerance. The competitive binding of labelled and unlabelled insulin to erythrocyte receptor3 is typically curvilinear when plotted according to Scatchard. The curvilinear nature of the Scatchard plot describing insulin binding to membrane receptors, although originally attributed to heterogeneous sites, has been more recently interpreted as negative cooperativity between homogenous sites. Evidence reported here, however, suggests that there are two populations of insulin receptors on erythrocytes. Specific concentrations of concanavalin A (Con A), a lectin which mimics insulin activity, are shown here to inhibit one population of receptors leaving another population unaffected.

Binding, Competitive↗
PubMed1975

Effects of parasympathominetics on porcine stillbirth.

To study the effect of 2 parasympathomimetic drugs in reduction of incidence of stillborn pigs, 84 sows and gilts were randomly allotted to 3 treatment groups. Single 1-ml injections of isotonic saline solution, carbachol (2 mg/ml), or neostigmine bromide (5 mg/ml) were subcutaneously administered to pigs of groups A, B, and C, respectively. Injections were given midway through parturition in an attempt to hasten the delivery of the last pigs in the litter, where the corresponding incidence of stillbirth is greatest. The mean time of injection was after the birth of 3.5 pigs. Total stillbirths/litter for carbachol-treated (0.23) and neostigmine-treated (0.21) pies were significantly different (P greater than 0.0001) from those for control pigs (0.88). Before injection, stillbirths/litter for control pigs (0.23) were not significantly different from those for carbachol-treated (0.18) or neostigmine-treated (0.12) pigs. After treatment, stillbirths/litter for carbachol-treated (0.06) and neostigmine-treated (0.09) pigs were both significantly different (P greater than 0.0001) from those for saline solution-treated control pigs (0.65). When injected midway through parturition, carbachol and neostigmine reduced stillbirth rate by reducing stillbirths which occur late in farrowing.

Animals↗