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Biomedical subjects

S McNally

Publications and source records attributed to S McNally.

At least 19 recordsLinked to original sources
PubMed2006

Now, later or never? Challenges associated with hepatitis C treatment.

BACKGROUND AND AIMS: Of the 259,000 Australians estimated to have a hepatitis C virus infection, very few have received antiviral therapy. This study identifies personal, psychological and structural barriers associated with decisions to begin treatment and the challenges associated with adhering to a demanding treatment regimen. METHODS: Between August 2003 and May 2004, 224 people living in Victoria who were hepatitis C antibody positive completed a 78-item survey instrument. Participants were recruited from a variety of settings and included those who were on treatment for hepatitis C (n=45); previously on treatment (n=65); and people who had never experienced treatment (n=114). RESULTS: The average age of the participants was 43 years. Men (n=29) were more likely than women (n=15) to be receiving treatment. Participants diagnosed in the past five years (31%) were more likely to be receiving treatment compared with those diagnosed more than five years ago (14%). Participants rated the effectiveness of treatment as the most important factor in influencing their decision to begin treatment. Side effects were rated the biggest challenge to adhering to treatment and were also rated as the most important consideration for those who decided against treatment. CONCLUSIONS: This study has shown many decisions and challenges affect the uptake of, and adherence to, hepatitis C treatment. Dissemination and promotion of information about increased effectiveness of new treatments will greatly influence decisions to begin treatment. Careful management and minimisation of side effects are also essential to improve uptake and increase adherence to hepatitis C treatment.

Adolescent↗
PubMed2006

Inhibition of murine K-BALB and CT26 tumour growth using a Semliki Forest virus vector with enhanced expression of IL-18.

The enhanced Semliki Forest virus vector (SFV10-E), an RNA-based suicide expression vector system, expresses foreign genes at levels up to 10x higher than the original SFV10 vector. This vector has been used previously to express interleukin-12 for a tumour treatment study in a BALB/c murine model. Interleukin-18, an IFN-gamma-inducing cytokine, plays a key role in the early induction of T helper1 (Th1) cell-mediated immune responses in addition to anti-angiogenic activity. In this study, the murine IL-18 gene along with an Ig-kappa leader sequence was cloned into the SFV10-E vector. The pSFV10-E-IL-18 construct was characterised in vitro for levels of expression and secretion, and the production of biologically active IL-18 was confirmed. An in vivo tumour treatment study using high titre rSFV10-E-IL-18 virus-like particles to treat subcutaneous K-BALB and CT26 tumours in BALB/c mice demonstrated therapeutic efficacy including the disappearance of tumour cells in a minority of treated animals. Tumour regression was associated with induction of avascular and suppurative necrosis.

Animals↗
PubMed2003

The setting of standards for agricultural nitrogen emissions: a case study of the Delphi technique.

The Delphi technique is a means of aggregating the judgement of a panel of experts in order to improve the quality of decision-making. This paper provides a case study of the technique by undertaking a three-round Delphi study to determine a package of best available techniques to reduce nitrogen emissions from a poultry unit under the Integrated Pollution Prevention and Control Directive (IPPC). Forms of nitrogen addressed included ammonia (NH3), nitrous oxide (N2O) nitrogen oxides (NOx), dusts and nitrate (NO3-), with the study providing a means to prioritise the pollution concerns on different spatial scales. The priority pollutant issues were the contribution of NH3 to eutrophication, the global cooling effect of NH4+ aerosol, the role of NH4+ as a vector for atmospheric transport of NOx and SO2, the contribution of N2O to global warming, and NO3- leaching. Reduced nitrogen (NHx) was rated as a priority on all scales, while N2O and NO3- were rated as priorities only on global and local scales, respectively. The study indicated the need for abatement techniques at each stage of poultry rearing and waste management, with particular attention to reduce NH3 emissions, reflecting the priority pollutant concerns. Measures identified by the panel include maintenance of dry litter, low emission removal of litter from housing and storage of litter under cover. Once the litter has left the farm, this should either be used as a biofuel for electricity generation or rapidly incorporated into agricultural soils. The amounts and timing of manure application should be tuned to crop needs. Uncertainties in the Delphi technique limit its suitability as a stand-alone decision making tool. However, the Delphi technique proved useful in identifying priority pollutant issues, areas of agreement, disagreement and where information is lacking. This demonstrates its use when dealing with the complex issues of prioritising pollution issues and abatement approaches.

Air Pollutants↗
PubMed2002

A retrospective clinical and radiographic review of 173 hydroxyapatite-coated screw cups with 5- to 10-year follow-up, showing low revision rates for fixation failure.

We reviewed the midterm results of 173 hydroxyapatite-coated screw cups. The average follow-up was 6.5 years (range, 5-9 years). The follow-up rate was 93%. Patients were assessed using the Merle D'Aubigne-Postel clinical scoring scale and by radiographic review. Two patients had revision surgery for recurrent dislocation (1.2%), 3 patients were revised for aseptic loosening (1.7%), 1 patient underwent revision surgery because of deep prosthetic infection (0.6%), and 2 patients were revised for polyethylene wear without loosening (1.2%), which gave a total revision rate of 4.7%. The average postoperative Merle D'Aubigne-Postel scores were 5.7 for pain, 5.5 for range of motion, and 5.4 for function.

Aged↗
PubMed2001

Randomized clinical trial of diathermy versus scalpel incision in elective midline laparotomy.

BACKGROUND: Electrocautery is used increasingly for tissue dissection, although fears of excessive scarring and poor wound healing have curtailed its widespread use for skin incision. This study compared electrosurgical incision with traditional scalpel incision. METHODS: One hundred patients requiring elective midline laparotomy were randomized prospectively to either scalpel or diathermy incision. Parameters measured included incision time, wound size, wound blood loss, total intraoperative blood loss and postoperative wound pain. All wound complications were recorded. RESULTS: The two groups did not differ significantly in relation to patient or wound characteristics. Laparotomy incisions using diathermy were significantly quicker than scalpel incisions (mean(s. e.m.) 6.1(0.4) versus 7.5(0.5) s/cm2; P < 0.04). There was significantly less blood loss in the diathermy group compared with the scalpel group (0.8(0.1) versus 1.7(0.3) ml/cm2; P = 0.002). Postoperative pain scores were significantly lower in the diathermy group for the first 48 h after operation (P < 0.05). Morphine requirements were also significantly lower over the first 5 postoperative days in the diathermy incision group (P < 0.04). There was no difference between groups in wound complications before discharge and at the 1-month follow-up. CONCLUSION: Electrosurgical midline incision in elective surgery has significant advantages over scalpel use on the basis of incision time, blood loss, early postoperative pain and analgesia requirements.

Adolescent↗
PubMed1999

The effects of respite care on informal carers' well-being: a systematic review.

PURPOSE: The provision of respite care is a common method employed to reduce the burden on those who care for individuals with a chronic illness or disability. The aim of the present review was to examine research on respite provision with a view to establishing what effect it has on carers. METHOD: A literature search was conducted for studies examining the effect of respite provision on carers, 'Psyclit', 'Medline' and Social Science Citation Index computerized databases were utilized, followed by a search of the reference sections of relevant studies. RESULTS: The search yielded 29 studies, from which there was little evidence that respite intervention has either a consistent or enduring beneficial effect on carers' well-being. This may be due in part to the fact that the majority of the work conducted has been methodologically poor. Also significant, however, might be that the findings suggest respite care often fails to facilitate the maintenance of socially supportive relationships, which may moderate strain after respite has ended. CONCLUSIONS: A more 'carer-centred' approach is required in both the provision and evaluation of respite care intervention. This approach would address the experiences of both caregiver and care-recipient during the respite period.

Caregivers↗
PubMed1996

The triage role in emergency nursing: development of an educational programme.

This study explores the professional and educational development of emergency nurses and their beliefs regarding the appropriate content for a triage educational programme. A descriptive survey was conducted of emergency nurses employed by randomly selected teaching and non-teaching hospitals. Data analysis showed that emergency nurses used various methods to prepare and maintain their triage expertise. The survey found that the best method to prepare the novice emergency nurse for the triage role was to use a combination of a triage educational programme and clinical experience. Respondents indicated great interest in enrolling in an educational programme and, as a result of this survey, a comprehensive triage educational programme has been developed.

Clinical Competence↗
PubMed1991

Consistency and change in maternal child-rearing practices and values: a longitudinal study.

Although developmental psychologists frequently assume that parents change their child-rearing practices as their children develop, there is little research on this topic and virtually none involving parents of adolescents and a longitudinal, repeated-measures design. We examined changes in mothers' reported practices over time in regard to independence and control, expression of positive and negative affect, and disciplinary practices using items from the Child-Rearing Practices Report (CRPR). The CRPR was administered to the same mothers 5 times over an 8-year time period (from when their children were aged 7 or 8 years until they were 15-16 years old). A substantial degree of stability in behaviors and values was noted, even over the 8-year period. In addition, some practices increased or decreased with age, with most of the changes being consistent with prior theorizing and research, as well as commonsense notions related to child rearing.

Age Factors↗
PubMed1987

A rapid method to test for chloroplast DNA involvement in atrazine resistance.

A point mutation in the chloroplast psbA gene at codon 264 resulting in an animo acid substitution (ser-gly) manifests itself as atrazine resistance in all recognized weed species studied to date. The single base substitution overlaps a highly conserved Mae1 restriction site which is present in susceptible but not in resistant plants. This restriction enzyme, recently commercialized, has been used to show that it is now possible to discriminate rapidly between the two biotypes without the need for DNA sequencing.

Journal Article↗
PubMed1987

Atrazine Resistance in Chenopodium album: Low and High Levels of Resistance to the Herbicide Are Related to the Same Chloroplast PSBA Gene Mutation.

In Chenopodium album two different levels of atrazine resistance have been found according to following criteria: lethal dose and leaf fluorescence curve. The intermediate (I) phenotype is represented by a low level of resistance and a typical I fluorescence curve. It arose at high frequency, within one generation, after self-pollination of particular plants displaying a susceptible (S) phenotype. The resistance phenotype (Ri) has a high level of resistance and presents a typical resistant fluorescence curve. It appeared after self-pollination of chemically treated I plants. The I, Ri, and also R (resistant plants found in atrazine treated fields) phenotypes contain a serine to glycine mutation at amino acid position 264 in the chloroplast psbA gene product. The steady state level of the psbA gene transcript is not modified between S, I, Ri, and R phenotypes.

Journal Article↗
PubMed1986

Bladder drainage for caesarean section under epidural analgesia.

Fifty patients undergoing elective caesarean section under epidural analgesia were randomized prospectively to be catheterized with an 'in-out' or an indwelling urethral catheter. Of the patients who had catheterization for the time of surgery alone 44% subsequently required recatheterization, whereas all patients with indwelling catheters voided spontaneously on their removal. The frequency of significant bacteriuria was the same in both groups.

Adult↗
PubMedDate not supplied

Role of the lecturer practitioner in learning disability nursing.

The BA (Hons) Nursing course at Oxford Brookes University aims to develop reflective practitioners. The role of the lecturer practitioner has become established in order to bridge the theory-practice divide. Lecturer practitioners contribute to the common foundation programme in years 1-2 and to the specialist branch in years 3-4. Lecturer practitioners facilitate learning by working with students and mentors in practical and theoretical settings. Learning contracts containing evidence of achievement are used by students as a focus for reflection and demonstration of clinical competence. Lecturer practitioners have core responsibilities in their practice areas, e.g. practice input and formulation of policies, and in the School of Health Care Studies, e.g. module leadership and committee membership. In the field of learning disability, lecturer practitioners have contributed to the dissemination of ideas and developments locally and nationally. These include leadership of the Clinical Practice Development Unit and presentation of research papers and information about services in Oxfordshire at national conferences.

Humans↗