PubMed Health⌕ Search

Biomedical subjects

Sarah Mott

Publications and source records attributed to Sarah Mott.

6 recordsLinked to original sources
PubMed2005

Physical and chemical restraints in acute care: their potential impact on the rehabilitation of older people.

Agitation is a major problem for older people and is present in over half of the hospitalizations for people > 65 years of age. In a previous study by the authors, results indicated that nursing actions often did not meet best-practice standards in the care of older, agitated patients. This paper builds on these results by reviewing the literature pertaining to the use of restraints and contributes to the body of knowledge surrounding the impact of the acute-care experience on rehabilitation outcomes. Successful rehabilitation relies on the improvement of functional health outcomes and, for this to happen, physical and emotional well-being are important. The sequelae of restraint use in acute care have the potential to alter peoples' ability to participate fully in a rehabilitation programme, thereby placing their future placement at risk. This paper explores the outcomes of restraint use in the acute-care setting and presents the argument that their effects are likely to be detrimental to rehabilitation outcomes.

Acute Disease↗
PubMed2004

Probing domain mobility in a flavocytochrome.

The crystal structures of various different members of the family of fumarate reductases and succinate dehydrogenases have allowed the identification of a mobile clamp (or capping) domain [e.g., Taylor, P., Pealing, S. L., Reid, G. A., Chapman, S. K., and Walkinshaw, M. D. (1999) Nat. Struct. Biol. 6, 1108-1112], which has been proposed to be involved in regulating accessibility of the active site to substrate. To investigate this, we have constructed the A251C:S430C double mutant form of the soluble flavocytochrome c(3) fumarate reductase from Shewanella frigidimarina, to introduce an interdomain disulfide bond between the FAD-binding and clamp domains of the enzyme, thus restricting relative mobility between the two. Here, we describe the kinetic and crystallographic analysis of this double mutant enzyme. The 1.6 A resolution crystal structure of the A251C:S430C enzyme under oxidizing conditions reveals the formation of a disulfide bond, while Ellman analysis confirms its presence in the enzyme in solution. Kinetic analyses with the enzyme in both the nonbridged (free thiol) and the disulfide-bridged states indicate a slight decrease in the rate of fumarate reduction when the disulfide bridge is present, while solvent-kinetic-isotope studies indicate that in both wild-type and mutant enzymes the reaction is rate limited by proton and/or hydride transfer during catalysis. The limited effects of the inhibition of clamp domain mobility upon the catalytic reaction would indicate that such mobility is not essential for the regulation of substrate access or product release.

Binding Sites↗
PubMed2003

Royal Rehabilitation Centre Sydney: towards Clinical Development Units (Nursing).

Clinical Development Units (Nursing), also known as Practice Development Units and Nursing Development Units, are nursing units that continually strive for excellence in nursing practice. Nursing units endeavouring to attain, or having achieved, the standards required of a Clinical Development Unit (Nursing)--CDU(N)--provide a very motivating and stimulating environment for nursing professional development. This paper provides readers with an understanding of the underpinnings of a CDU(N) along with why and how a nursing unit would strive for this status. A priority of senior nurse management at a rehabilitation facility in Sydney, the Royal Rehabilitation Centre, has been working towards the upgrading of every nursing unit in their facility to the level of a CDU(N) over the past three years. By way of an innovative course, the Clinical Development and Leadership course developed by Professor Jennifer Greenwood in 1997, senior nurses are being provided with the knowledge and skills to enable them to work towards their goal of becoming part of a Clinical Development Unit (Nursing).

Credentialing↗
PubMed2003

Agitated older patients: nurses' perceptions and reality.

Management of agitation is an increasingly common duty in the nursing care of older patients. Agitation describes a range of behavioural symptoms including aggressiveness and hyperactivity, and can be a sign of severe illness. In a series of focus groups in a large teaching hospital, nurses' feelings and actions in regard to nursing agitated older people were recorded and analysed. The results demonstrated that agitation is not well understood and is often not well-managed. Despite recent efforts to provide more supportive staffing structures, nurses felt particularly stressed and unsupported in relation to this phenomenon. Recommendations are made for the instigation of enhanced education programmes as well as ongoing attention to improved workload initiatives.

Aged↗