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Biomedical subjects

Sue Jackson

Publications and source records attributed to Sue Jackson.

13 recordsLinked to original sources
PubMed2005

A modified grounded theory study of how psychiatric nurses work with suicidal people.

BACKGROUND: People with mental health problems continue to present a disproportionately high risk of suicide. Despite the relevance of suicide to psychiatric/mental health (P/MH) nurses, there is a documented paucity of research in this substantive area undertaken by or referring specifically to P/MH nurses; there is currently no extant theory to guide P/MH nursing care of the suicidal person. OBJECTIVES: Accordingly, this paper reports on a study undertaken to determine if P/MH nurses provide meaningful caring response to suicidal people, and if so how. DESIGN: The study used a modified grounded theory method and was conducted in keeping with the Glaserian tenets of Grounded Theory. SETTINGS: The study was conducted in two geographical locations within the United Kingdom, one in the North and the other in the Midlands; both locations contained large urban centres. PARTICIPANTS: A total of 20 participants were selected across the locations by means of theoretical sampling. All the participants were over 18 years old, had made a serious attempt on their lives or felt they were on the cusp of so doing and had received 'crisis' care from the 'emergency' psychiatric services. METHODS: The study adhered to the principle features of Glaserian grounded theory namely-(a) theory generation, not theory verification; (b) theoretical sampling, (c) the constant comparative method of data analysis; and (d) theoretical sensitivity (searching for/discovering the core variable, one which identified the key pychosocial process and contains temporal dimensions stages). Further, the authors ensured that the study was concerned with generating conceptual theory, not conceptual description. FINDINGS/CONCLUSION: The findings indicate that this key psychosocial problem is addressed through the core variable, 're-connecting the person with humanity'. This parsimonious theory describes and explains a three-stage healing process consisting of the sub-core variables: 'reflecting an image of humanity', 'guiding the individual back to humanity' and 'learning to live'.

Adaptation, Psychological↗
PubMed2005

Nectar xylose metabolism in a rodent pollinator (Aethomys namaquensis): defining the role of gastrointestinal microflora using 14C-labeled xylose.

The Namaqua rock mouse Aethomys namaquensis, a rodent pollinator of certain geoflorous Protea species, consumes nectar containing xylose. Xylose is not known to be efficiently utilized by mammals. However, it is fermented by certain bacteria, yeasts, and fungi, particularly gastrointestinal bacteria. The end products of microbial fermentation are utilized by the host in oxidative metabolism. Here we investigate the degree to which intestinal bacteria of A. namaquensis contribute to xylose metabolism. Mice were caught during Protea humiflora flowering and nonflowering seasons and given an oral dose of 14C-labeled xylose. Exhaled CO2 and excreted urine and feces were continuously collected for 30 h thereafter, and label recovery was determined. Each mouse was then treated with antibiotics to reduce gut microflora, and the experiment was repeated. With their natural gut flora population intact, mice caught during the flowering season exhaled significantly more 14CO2 than did mice caught during the nonflowering season. Also, during both seasons, mice exhaled significantly more 14CO2 before antibiotic treatment than after. Antibiotic treatment caused a significant increase in the proportion of 14C-labeled xylose that was excreted in the urine. The mouse diet likely influences the composition of the gastrointestinal community. Aethomys namaquensis relies on its gut microflora to ferment xylose, thereby converting it into end products that are used by the mice for metabolism.

Animals↗
PubMed2005

Acupuncture for irritable bowel syndrome: a blinded placebo-controlled trial.

AIM: Irritable bowel syndrome (IBS) is a common disorder and many patients fail to find adequate relief from conventional therapies for their symptoms. This study tests the claim that acupuncture is effective for a majority of these patients. METHODS: A prospective, blinded, sham acupuncture-controlled trial of traditional Chinese acupuncture was performed at a single postgraduate teaching hospital in Europe. Sixty patients with well-established IBS were recruited. The blinded comparator was sham acupuncture administered by the second of two acupuncturists who alone was aware of the randomization, and who otherwise followed the prescription of the first. The primary end-point was a defined fall in the symptom score at 13 wk (by intention to treat). The prior expectation was a 30% placebo response, and a response rate of 70% from acupuncture, for which the study was adequately powered. RESULTS: Patients in treated and sham groups improved significantly during the study-mean improvement in scores being equal (minus 1.9) and significant for both (P<0.05; one-tailed t test). There was a small numeric but non-significant difference between the response rate in patients receiving acupuncture (40.7%) and sham treatment (31.2%). Several secondary end-points marginally favored active treatment, but an improved symptom score of any degree of magnitude occurred more often with sham therapy (65.6% vs 59.2%). For no criterion was statistical significance approached. CONCLUSION: Traditional Chinese acupuncture is relatively ineffective in IBS in the European hospital setting, and the magnitude of any effect appears insufficient to warrant investment in acupuncture services.

Acupuncture Therapy↗
PubMed2005

The acute hypoxic ventilatory response: testing the adaptive significance in human populations.

The acute Hypoxic Ventilatory Response (HVR) is an important component of human hypoxia tolerance, hence presumably physiological adaptation to high altitude. We measured the isocapnic HVR (L min(-1) %(-1)) in two genetically divergent low altitude southern African populations. The HVR does not differ between African Xhosas (X) and Caucasians (C) (X:-0.34+/-0.36; C:-0.42+/-0.33; P > 0.34), but breathing patterns do. Among all Xhosa subjects, size-independent tidal volume was smaller (X: 0.75+/-0.20; C: 1.11+/-0.32 L; P < 0.01), breathing frequency higher (X: 22.2+/-5.7; C: 14.3+/-4.2 breaths min(-1); P < 0.01) and hypoxic oxygen saturation lower than among Caucasians (X: 78.4+/-4.7%; C: 81.7+/-4.7%; P < 0.05). The results remained significant if subjects from Xhosa and Caucasian groups were matched for gender, body mass index and menstrual cycle phase in the case of females. The latter also employed distinct breathing patterns between populations in normoxia. High repeatability (intra-class correlation coefficient) of the HVR in both populations (0.77-0.87) demonstrates that one of the prerequisites for natural selection, consistent between-individual variation, is met. Finally, we explore possible relationships between inter-population genetic distances and HVR differences among Xhosa, European, Aymara Amerindians, Tibetan and Chinese populations. Inter-population differences in the HVR are not attributable to genetic distance (Mantel Z-test, P = 0.59). The results of this study add novel support for the hypothesis that differences in the HVR, should they be found between other human populations, may reflect adaptation to hypoxia rather than genetic divergence through time.

Acclimatization↗
PubMed2004

Measurement reliability of highly variable physiological responses to experimentally-manipulated gas fractions.

Ventilatory and cardiac responses to changing inhaled gas fractions are notoriously variable within individuals. Such variation can confound clinical diagnoses and hypotheses about human adaptation. In this study we use a cardiac (HHR) and a ventilatory (HVR) measure of physiological sensitivity to an experimentally manipulated oxygen concentration (8% O2), to compare variation (a) within and between individuals, (b) within and between days and (c) within and between physiological parameters. To explore the sources of variation, we use the coefficient of variation (CV, %), repeatability (R, intraclass correlation coefficient, %) and repeated-measures analyses of variance. Both the HVR and the HHR are significantly repeatable (HVR: R = 0.76-0.92; HHR: R = 0.35-0.76) and equally variable within and between days. Its high R suggests that the HVR displays greater between-individual variation relative to within-individual variation than does the HHR. The HVR is thus a more reliable measure of physiological sensitivity to hypoxia than is the HHR. We suggest how these results may inform experimental design, and suggest how to avoid stochastic and experimental artefacts when investigating ventilatory and cardiac physiological responses to hypoxia.

Administration, Inhalation↗
PubMed2003

Patterns of respiration in diving penguins: is the last gasp an inspired tactic?

Humboldt penguins Spheniscus humboldti in captivity and free-living Magellanic penguins S. magellanicus were fitted with loggers to determine beak angles during breathing. The Humboldt penguins were also fitted with masks for determining rates of air flow during breathing. During periods of higher gas exchange requirement, Humboldt penguins opened their beaks during inspiration, where tidal volume was linearly correlated with both change in beak angle and maximum beak angle, closed them slightly during the final stages of inspiration and finally closed them during expiration. Substantial differences were apparent between individuals. Contrary to the condition proposed for most birds, our data suggest that expiration is passive during periods of high respiratory tidal volumes, and that the increased resistance of the respiratory pathway serves to slow air flow so as to maximize gas exchange in the lungs. During foraging, Magellanic penguins at the surface between dives showed similar breathing patterns but maximum beak angles were much higher and breath cycle time shorter, as would be expected for animals attempting to maximize gas exchange. Both maximum beak angle per breath and breath frequency changed systematically over the surface pause; both were initially high, then decreased to a low before rising again to a maximum just before diving. Based on known changes in tidal volume with beak angle derived from Humboldt penguins, a simple model is proposed to examine rates of gas exchange over the surface pause. This indicates that the observed patterns do not maximize the rate of transfer of oxygen over the whole of the surface pause but are rather concerned with an initial rapid accumulation of oxygen in the tissues followed by effective carbon dioxide release.

Animals↗
PubMed2002

A simple breathing circuit to maintain isocapnia during measurements of the hypoxic ventilatory response.

We report the development and testing of a simple breathing circuit that maintains isocapnia in human subjects during hypoxic hyperpnea. In addition, the circuit permits rapid switching between two gas mixtures with different partial pressures of oxygen. Eleven volunteers breathed repeated cycles of exposure to air (2 min of 21% O(2), balance N(2)) and hypoxia (2 min of 8.3+/-0.1% O(2), balance N(2)). Hypoxia induced significant increases in minute ventilation, breathing frequency and tidal volume (P < 0.05) that were consistent over repeated cycles of hypoxia (P > 0.1, one-way ANOVA). The system successfully maintained isocapnia in all subjects, with an average change in end-tidal CO(2) of only -0.2 mmHg during hyperventilation in hypoxia (range 0.4 to -0.8 mmHg). This system may be suitable for repeated tests of the hypoxic ventilatory response (HVR) and may prove useful for exploring intra- and inter-individual variability of HVR in humans.

Adult↗
PubMed2002

Xylose as a nectar sugar: from biochemistry to ecology.

Studies of nectar sugar composition in the Proteaceae, an ancient southern hemisphere plant family, have demonstrated that xylose comprises up to 39% of nectar sugar in two genera, Protea and Faurea, and may therefore represent a substantial fraction of the energy available to pollinators of these plants. Although insect and bird pollinators of Protea species are averse to xylose, mice (Aethomys namaquensis) will drink pure xylose, which is metabolized either by gut bacteria or by the mouse tissues. In the form of xylan polymers, the pentose sugar D-xylose is a structural component of plant cell walls, and there is considerable biotechnological interest in xylose fermentation. Bacteria and yeasts convert D-xylose to D-xylulose and thence via the pentose phosphate pathway to fructose-6-phosphate, which is either oxidized or fermented to ethanol. Gut symbionts of rodent pollinators may be analogous to ruminal xylose-metabolizing bacteria. The presence of xylose in Protea and Faurea nectar remains puzzling in view of pollinator aversions: even for rodent pollinators, it is the least preferred nectar sugar. In the generalized pollination systems of the Proteaceae, a coevolutionary explanation for nectar xylose as an attractant for mammalian pollinators is probably less likely than one involving plant physiology, with xylose in phloem sap being secreted passively into the nectar.

Animals↗
PubMed2002

Transforming a run down general practice into a leading edge primary care organisation with the help of the EFQM excellence model.

This article explains how a primary care team transformed a run down general practice into a leading edge healthcare organisation by adopting the principles of the EFQM excellence model. The decisions surrounding the choice of approach, challenges faced, benefits achieved and lessons learned are all described in such a way that the reader may appreciate the issues which faced the members of the 15-man team. In particular, the practice team found that describing indicators of quality and gathering evidence to test out assumptions regarding performance were vital elements in the pursuit of a continuous improvement culture that was to benefit patients, staff and key stakeholders alike. Whilst an increase in workload was experienced in the early days, the knowledge that this was associated with improved performance made the efforts worthwhile and the team eager to adopt a regular, never-ending cycle of self-assessment and improvement.

Benchmarking↗