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Bedi P, McHugh B, Davidson DJ, Rossi AG, Hill AT. S106 Peripheral blood neutrophils are primed and activated in bronchiectasis and are attenuated by the pro-resolving mediator lipoxin a4. Thorax 2016. [DOI: 10.1136/thoraxjnl-2016-209333.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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2
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Wilson JG, Minchin D, McHugh B, McGovern E, Tanner CJ, Giltrap M. Declines in TBT contamination in Irish coastal waters 1987-2011, using the dogwhelk (Nucella lapillus) as a biological indicator. Mar Pollut Bull 2015; 100:289-296. [PMID: 26443386 DOI: 10.1016/j.marpolbul.2015.08.038] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2015] [Revised: 08/19/2015] [Accepted: 08/23/2015] [Indexed: 06/05/2023]
Abstract
Using the vas deferens sequence index (VDSI) and relative penis size index (RPSI) in dogwhelks (Nucella lapillus), imposex levels were assessed at 63 sites within 11 sea inlets during 2010/2011 and compared these with levels gathered since 1987. Sterile females (VDS>5.0) were found at 14 of the 63 sites and 47 sites (75%) met the EcoQO (VDSI<2.0). The absence of imposex in 'control' areas on the west coast is due to the lack of vessel paint applications or net dips with TBT being used as an active anti-fouling ingredient. A significant decline was observed following 2005 when comparing VDSI levels which is consistent with the decline of TBT usage. Current levels are consistent with an overall improvement towards achieving Good Environmental Status according to the requirements under the Marine Strategy Framework Directive.
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Affiliation(s)
- J G Wilson
- Zoology Department, Trinity College Dublin, Dublin 2, Ireland
| | - D Minchin
- MOI, Marina Village, Ballina, Killaloe, Co. Clare, Ireland; Marine Science and Technology Center, Klaipeda University, 84 Manto, Klaipeda, Lithuania
| | - B McHugh
- Marine Institute, Rinville, Oranmore, Co. Galway, Ireland
| | - E McGovern
- Marine Institute, Rinville, Oranmore, Co. Galway, Ireland
| | - C J Tanner
- School of Natural Sciences, University of Nebraska, Lincoln, USA
| | - M Giltrap
- Zoology Department, Trinity College Dublin, Dublin 2, Ireland.
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3
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Wilson JG, McHugh B, Giltrap M. Biomarkers: are realism and control mutually exclusive in integrated pollution assessment? Mar Environ Res 2014; 102:11-17. [PMID: 25092022 DOI: 10.1016/j.marenvres.2014.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 07/05/2014] [Accepted: 07/09/2014] [Indexed: 06/03/2023]
Abstract
The conventional view of pollution monitoring is that any choice is a trade-off between realism and precision, as the control over confounding variables decreases with the increasing degree of organization of the test system. Dublin Bay is subject to considerable anthropogenic pressures and there have been many attempts to quantify the status of the system at organizational levels from DNA strand breaks (Comet) to the system itself (Ecological Network analysis, ENA). Using Dublin Bay as an example, the data show there was considerable variability at all levels of organization. At intracellular level, Lysosome Membrane Stability (LMS, assessed by Neutral Red Retention, NRR) varied almost 4-fold with season and individual condition, while the community level AZTI Marine biotic Index (AMBI) had a similar range within a single, supposedly homogeneous, site. Overall, there was no evidence that biomarkers of the lower levels of organisation reduced the variability of the measure, despite the extra control over influencing variables, nor was there any evidence that variability was additive at higher levels of organisation. This poses problems for management, especially given the fixed limits of Ecological Quality Standards (EQSs). Clearly while the integrated approach to pollution monitoring does offer the potential to link effects across the organizational range, it should also be possible to improve their capability by widening the database for reference values, particularly at the higher level of organization, and by process models, including the confounding variables found in the field, for those at lower level.
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Affiliation(s)
| | - B McHugh
- Marine Institute, Oranmore, Co. Galway, Ireland
| | - M Giltrap
- Zoology Dept., TCD, Dublin 2, Ireland
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White P, McHugh B, Poole R, McGovern E, White J, Behan P, Foley B, Covaci A. Application of congener based multi-matrix profiling techniques to identify potential PCDD/F sources in environmental samples from the Burrishoole Catchment in the West of Ireland. Environ Pollut 2014; 184:449-456. [PMID: 24121420 DOI: 10.1016/j.envpol.2013.09.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 09/16/2013] [Accepted: 09/18/2013] [Indexed: 06/02/2023]
Abstract
Homologue and congener profiles of PCDD/Fs in eels, passive sampler and sediment extracts from the Burrishoole, a rural upland catchment on the western Irish seaboard were compared with potential PCDD sources. ΣPCDD/F levels in eels ranged from 2.9 to 25.9 pg g(-1) wet weight, which are elevated compared to other Irish locations. The OCDD congener dominated the pattern of ΣPCDD/Fs in all matrices from Burrishoole. Passive samplers were successfully deployed to identify for the first time the presence in the water column of PCDD/Fs and dimethoxylated octachlorodiphenyl ether (diMeOoctaCDE), impurities found in pentachlorophenol (PCP) production. Principal component analysis (PCA) identified similarities between PCDD/F profiles in technical PCP mixtures and environmental samples from the Burrishoole region. Results strongly suggest residual PCDD contamination associated with historic local use of a dioxin contaminated product in the catchment area, with pentachlorophenol a strong candidate.
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Affiliation(s)
- P White
- Marine Institute, Rinville, Oranmore, Galway and Newport, Mayo, Ireland; School of Chemical and Pharmaceutical Sciences, Dublin Institute of Technology, Kevin St., Dublin 8, Ireland.
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Ryan C, McHugh B, Boyle B, McGovern E, Bérubé M, Lopez-Suárez P, Elfes CT, Boyd DT, Ylitalo GM, Van Blaricom GR, Clapham PJ, Robbins J, Palsbøll PJ, O’Connor I, Berrow SD. Levels of persistent organic pollutants in eastern North Atlantic humpback whales. ENDANGER SPECIES RES 2013. [DOI: 10.3354/esr00545] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Giltrap M, Ronan J, Hardenberg S, Parkes G, McHugh B, McGovern E, Wilson JG. Assessment of biomarkers in Mytilus edulis to determine good environmental status for implementation of MSFD in Ireland. Mar Pollut Bull 2013; 71:240-249. [PMID: 23664067 DOI: 10.1016/j.marpolbul.2013.02.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 02/07/2013] [Accepted: 02/09/2013] [Indexed: 06/02/2023]
Abstract
Candidate OSPAR/ICES recommended biomarkers at the level of the individual in Mytilus edulis for determination of good environmental status for MSFD were evaluated against contaminant levels at sites around Ireland. The sites chosen ranged from moderate to low pollution levels, but the actual ranking of the sites varied according to the contaminant levels present. At the most contaminated site, Cork, 4 out of 16 contaminants exceeded the EAC, while at Shannon, no EACs were exceeded. The SOS assay suggested that Cork was the healthiest site with a LT50 of 17.6 days, while SOS for Shannon was 15.6 days. Likewise, condition factors varied among sites and did not always correspond to contaminant-based status. There may be uncertainty in assigning status around the not good:good boundary. This raises potential difficulties not only in the biomarker/contaminant load relationship but also in the reliability of the biomarkers themselves and hence barriers meeting compliance levels.
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Affiliation(s)
- M Giltrap
- Zoology Department, Trinity College Dublin, Dublin 2, Ireland.
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Wang R, McHugh B, Ooi TL, He Z. Judgment of angular declination, but not of vertical angular size, is accurate. J Vis 2012. [DOI: 10.1167/12.9.906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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McHugh B, MacGinnitie A. Allergen Sensitization and the Risk of Asthma and Eczema in Children in the Pittsburgh Area. J Allergy Clin Immunol 2011. [DOI: 10.1016/j.jaci.2010.12.695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Besselink H, Nixon E, McHugh B, Rimkus G, Klungsøyr J, Leonards P, De Boer J, Brouwer A. Evaluation of tumour promoting potency of fish borne toxaphene residues, as compared to technical toxaphene and UV-irradiated toxaphene. Food Chem Toxicol 2008; 46:2629-38. [PMID: 18558458 DOI: 10.1016/j.fct.2008.04.039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2007] [Revised: 03/27/2008] [Accepted: 04/21/2008] [Indexed: 10/22/2022]
Abstract
In this study the potential impact of food chain-based biotransformation and physico-chemical weathering of toxaphene on its tumour promoting potential was investigated in vitro and in vivo. Human exposure to toxaphene is mainly through consumption of contaminated fish, therefore fish-borne residues of toxaphene (cod liver extract, CLE) were prepared by exposing cod to technical toxaphene (TT) for 63 days. UV-irradiated toxaphene (uvT) was included to represent a physico-chemical weathered toxaphene mixture. In vitro, TT, uvT and CLE all showed a dose- and time-dependent inhibition of gap junctional intercellular communication (GJIC) with a relative potency of CLE>TT=uvT. Tumour promoting potency was further studied in vivo in a medium term two-stage initiation/promotion bioassay in female Sprague-Dawley rats, using an increase in altered hepatic foci positive for glutathione-S-transferase-P (AHF-GST-P) as read out. No increase in AHF-GST-P occurred following exposure to either TT, uvT, or CLE, except for the positive control group (2,3,7,8-TCDD). Based on this study the no observed adverse effect level (NOAEL) for tumour promoting potency is at least 12.5mg/kg/week, or higher for CLE. Considering current human exposure levels in Europe it is doubtful that consumption of fish at current levels of toxaphene contamination give rise to human health risk.
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Affiliation(s)
- H Besselink
- BioDetection Systems BV, Kruislaan 406, 1098 SM, Amsterdam, The Netherlands.
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11
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Abstract
The TracerCAD system is one of the leading prosthetic CAD systems in the world and is increasingly used in clinics to replace traditional methods of residual limb shape capture. Accurate dimensional capture of the residuum is arguably the most important process in the production of a prosthetic socket. TracerCAD system accuracy has previously been tested on a cylindrical model but not a trans-tibial shape. Residual limbs are irregular in shape therefore it is important to assess if shape has an effect on the accuracy of data collected when using TracerCAD. The objective of this study is to investigate the accuracy of the TracerCAD system in measuring a model of a trans-tibial stump of known dimensions and volume. A model of a trans-tibial stump was produced and filled with plaster and measured using a data acquisition system with an accuracy of five micron (0.005 mm). The model was repeatedly traced using the TracerCAD system by an individual user. The mean value of measures taken by the dynamic indicator was calculated and compared to individual and mean values of TracerCAD measurement. Results showed that the TracerCAD measurement was not as consistent on the more complex trans-tibial model as for the cylindrical model.
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Affiliation(s)
- T McGarry
- National Centre for Training and Education in Prosthetics and Orthotics, University of Strathclyde, Glasgow, Scotland, UK.
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12
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Abstract
The objective of this study was to investigate the variation of measurements recorded when four different users of the TracerCAD system trace a model of known dimensions and volume. This complements a previous study where the accuracy and consistency of a single user was measured. Landmarks were added to indicate proximal, distal, anterior, medial and lateral regions of a specially manufactured cylindrical nylon 6.6 model. Four circumferential lines were added at regular intervals along the length of the cylinder with a view to calculating diameters and volumes relative to these landmarks. The model was measured using a comparator with guaranteed accuracy to one hundredth of a millimetre, and was traced using the TracerCAD system by four different users. The difference in mean volume between measured results and TracerCAD scans of differing users ranged to -3%. Individual trace volumes varied by up to -7.85%. In all volumes measured, 11 out of 12 maximum volume percentage differences measured greater than 2%, and of these, seven results showed maximum volume percentage difference to measure greater than 4%.
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Affiliation(s)
- T McGarry
- National Centre for Training and Education in Prosthetics and Orthotics, University of Strathclyde, Glasgow, Scotland, UK
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13
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Abstract
The objective of this study is to investigate the accuracy of the TracerCAD system in measuring a model of known dimensions and volumes. A cylindrical nylon 6.6 model was prepared. Landmarks were added to indicate proximal, distal, anterior, medial, and lateral. Four additional landmarks were added at regular intervals along the length of the cylinder with a view to calculating diameters and volumes relative to these landmarks. The model was measured using a comparator with a guaranteed accuracy of 0.01 mm and was traced using the TracerCAD system (Test 1). The test was repeated with the model rotated by 90 degrees (Test 2), to determine whether there were any effects related to the orientation of the model in relation to the transmitter. The difference in average volume between measured results and TracerCAD scans was between 0.20% and -1.96%. Individual trace volumes varied between -0.0085% and -4.50%. In all volumes measured in Tests 1 and 2, all maximum volume percentage differences measured greater than 3%.
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Affiliation(s)
- T McGarry
- National Centre for Training and Education in Prosthetics and Orthotics, University of Strathclyde, Glasgow, UK.
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14
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Abstract
Social stigmatization can disrupt the ability of individuals with genetic conditions to successfully adapt to their situation. We offer data on perceptions of stigma from a cross-sectional survey of 174 adults with Marfan syndrome by self-report. Fifty-six respondents (32%) reported feeling discriminated against or socially devalued because of having Marfan syndrome. Endorsement of discrimination was significantly correlated with having depressive symptoms, low self-esteem, the view Marfan syndrome has had significant negative consequences on one's life, striae, and perceptions of workplace discrimination. Nearly 30% of respondents reported withdrawing from social situations that they anticipated would lead to feeling stigmatized, and 25% reported electing to keep their condition secret in potentially stigmatizing situations. Over 50% of respondents reported educating others about Marfan syndrome as a means of coping with their feelings of stigma, and endorsement of education was correlated with viewing involvement in the National Marfan Foundation as important. Instances of workplace discrimination were perceived by 20% of respondents, and 23% reported that they remained in a dissatisfying job due to having Marfan syndrome. Genetics professionals should actively engage patients with Marfan syndrome in discussions about social stigmatization and encourage use of coping strategies aimed at enhancing quality of life.
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Affiliation(s)
- Kf Peters
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA 16802, USA.
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15
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Abstract
The quality of fit of a trans-tibial patellar-tendon-bearing (PTB) socket may be influenced by consistency in casting, rectification or alignment. This paper quantifies, for the first time, the variations in the rectified casts between two experienced prosthetists and the variation between the rectified casts of each individual prosthetist. Prosthetists A and B observed the hand casting of a typical trans-tibial amputee. Each prosthetist was supplied with 5 previously measured duplicated plaster models. The two prosthetists rectified the supplied plaster models based on their own interpretation of basic rectification guidelines. Both prosthetists operated in isolation. The re-measured rectified plaster model data was compared with the unrectified data. The extent of rectification at each of 1800 locations per plaster model was calculated. In zones of major rectification, the mean difference between prosthetists was quantified as 2mm and the standard deviation (SD) about that mean was +/- 1mm for each prosthetist. The co-ordinates of the apex of the fibular head for the 10 modified casts indicated that the maximum variation was in the axial direction with a SD of 4.3mm for prosthetist A and a SD of 2.8mm for prosthetist B. The lengths of the 5 plaster models rectified by prosthetist A indicated a SD of 0.2mm whereas the lengths of the 5 plaster models rectified by prosthetist B indicated a SD of 2.9mm.
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Affiliation(s)
- P Convery
- National Centre for Training and Education in Prosthetics and Orthotics, University of Strathclyde, Glasgow, Scotland, UK.
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Buis AWP, Blair A, Convery P, Sockalingam S, McHugh B. Pilot study: data-capturing consistency of two trans-tibial casting concepts, using a manikin stump model: a comparison between the hands-on PTB and hands-off ICECAST compact concepts. Prosthet Orthot Int 2003; 27:100-6. [PMID: 14571939 DOI: 10.1080/03093640308726665] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The quality of fit of a trans-tibial patellar tendon bearing (PTB) socket may be influenced by consistency in casting, rectification or alignment. For this study two distinctive different data-capturing concepts were tested in relation to prosthetist performance. The hands-on PTB and hands-off ICECAST compact concept were studied and compared for inter- and intra-prosthetist consistency using a specially designed manikin stump model. A purpose designed digitiser was used to scan a selected surface area of the produced models, 5 for each concept, 10 in total. The extent of casting consistency at each of 936 locations per plaster model was calculated and the level of consistency was quantified. This study has shown that by using the manikin model there is a clear indication that the investigated hands-off concept produces more consistent results than the hands-on concept.
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Affiliation(s)
- A W P Buis
- National Centre for Training and Education in Prosthetics and Orthotics, University of Strathclyde, Glasgow, Scotland, UK.
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Murphy M, McHugh B, Tighe O, Mayne P, O'Neill C, Naughten E, Croke DT. Genetic basis of transferase-deficient galactosaemia in Ireland and the population history of the Irish Travellers. Eur J Hum Genet 1999; 7:549-54. [PMID: 10439960 DOI: 10.1038/sj.ejhg.5200327] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Transferase-deficient galactosaemia, resulting from deficient activity of galactose-1-phosphate uridyltransferase (GALT), is relatively common among the Travellers, an endogamous group of commercial/industrial nomads within the Irish population. This study has estimated the incidence of classical transferase-deficient galactosaemia in Ireland and determined the underlying GALT mutation spectrum in the Irish population and in the Traveller group. Based upon a survey of newborn screening records, the incidence of classical transferase-deficient galactosaemia was estimated to be 1 in 480 and 1 in 30,000 among the Traveller and non-Traveller communities respectively. Fifty-six classical galactosaemic patients were screened for mutation in the GALT locus by standard molecular methods. Q188R was the sole mutant allele among the Travellers and the majority mutant allele among the non-Travellers (89.1%). Of the five non-Q188R mutant alleles in the non-Traveller group, one was R333G and one F194L with three remaining uncharacterized. Anonymous population screening has shown the Q188R carrier frequency to be 0.092 or 1 in 11 among the Travellers as compared with 0.009 or 1 in 107 among the non-Travellers. The Q188R mutation was shown to be in linkage disequilibrium with a Sac I RFLP flanking exon 6 of the GALT gene. This represents the first molecular genetic description of classical transferase-deficient galactosaemia in Ireland and raises intriguing questions concerning the genetic history of the Irish Travellers.
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Affiliation(s)
- M Murphy
- Department of Pathology, Children's Hospital, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland
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Abstract
An ankle-foot orthosis (AFO) is employed principally to treat musculoskeletal disorders of the ankle and/or subtalar joints although, occasionally, it may be prescribed to provide stance phase control of the knee. In order to function satisfactorily, an AFO must apply appropriate forces to the lower leg in a manner which does not cause local tissue damage or discomfort. Equally the leg will apply forces to the AFO which it must be capable of withstanding without breakage or loss of function. Thus it is useful to know where the body-device interface forces act during walking and to be able to estimate their magnitudes. This is not well understood and has not been satisfactorily documented. This paper explains the force actions between the AFO and the leg, in the sagittal plane, where there is absence of muscle power. Furthermore, it explores the possibility of estimating the magnitudes of these forces. It is found that the forces are greatest when orthotic assistance is needed to compensate for plantar flexor insufficiency in late stance phase. On the other hand, where the AFO is used to support the foot, in the absence of dorsiflexion power in swing phase, the forces are relatively small. Understanding these force levels is relevant to the design of the AFO in terms of choice and use of materials and components.
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Affiliation(s)
- B McHugh
- National Centre for Training and Education in Prosthetics and Orthotics, University of Strathclyde, Glasgow, Scotland, UK
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de Geus HJ, Besselink H, Brouwer A, Klungsøyr J, McHugh B, Nixon E, Rimkus GG, Wester PG, de Boer J. Environmental occurrence, analysis, and toxicology of toxaphene compounds. Environ Health Perspect 1999; 107 Suppl 1:115-44. [PMID: 10229713 PMCID: PMC1566367 DOI: 10.1289/ehp.99107s1115] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Toxaphene production, in quantities similar to those of polychlorinated biphenyls, has resulted in high toxaphene levels in fish from the Great Lakes and in Arctic marine mammals (up to 10 and 16 microg g-1 lipid). Because of the large variabiliity in total toxaphene data, few reliable conclusions can be drawn about trends or geographic differences in toxaphene concentrations. New developments in mass spectrometric detection using either negative chemical ionization or electron impact modes as well as in multidimensional gas chromatography recently have led researchers to suggest congener-specific approaches. Recently, several nomenclature systems have been developed for toxaphene compounds. Although all systems have specific advantages and limitations, it is suggested that an international body such as the International Union of Pure and Applied Chemistry make an attempt to obtain uniformity in the literature. Toxicologic information on individual chlorobornanes is scarce, but some reports have recently appeared. Neurotoxic effects of toxaphene exposure such as those on behavior and learning have been reported. Technical toxaphene and some individual congeners were found to be weakly estrogenic in in vitro test systems; no evidence for endocrine effects in vivo has been reported. In vitro studies show technical toxaphene and toxaphene congeners to be mutagenic. However, in vivo studies have not shown genotoxicity; therefore, a nongenotoxic mechanism is proposed. Nevertheless, toxaphene is believed to present a potential carcinogenic risk to humans. Until now, only Germany has established a legal tolerance level for toxaphene--0.1 mg kg-1 wet weight for fish.
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Affiliation(s)
- H J de Geus
- DLO-Netherlands Institute for Fisheries Research, IJmuiden, The Netherlands.
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20
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Bachrach SJ, Pidcock FS, Branca PA, Gilbert PL, Schneider A, Walko L, McHugh B. Early transfer to a rehabilitation hospital for infants with chronic bronchopulmonary dysplasia. Clin Pediatr (Phila) 1993; 32:535-41. [PMID: 8258206 DOI: 10.1177/000992289303200905] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Shortly after being weaned off the respirator, 43 infants with severe chronic bronchopulmonary dysplasia (BPD) were transferred from an intensive-care nursery at a teaching hospital to an affiliated children's rehabilitation hospital in a program that included special staff instruction. Morbidity, measured by rate of transfer back to the acute-care hospital, was lower than in a comparison group of 15 infants treated for severe BPD during the previous two years. Average length of stay was significantly shortened and an average of $60,000 per patient was saved. Using a rehabilitation hospital as a step-down unit shifts the emphasis from acute needs to chronic and developmental needs and from intensive monitoring and nursing care to care given at home by parents with nursing assistance.
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Affiliation(s)
- S J Bachrach
- Department of Pediatrics, Thomas Jefferson University Hospital, Philadelphia, PA
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21
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Peppard NR, McHugh B. Staff sense of ownership key to special needs unit success. Provider 1988; 14:30. [PMID: 10318068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Abstract
This paper describes the theory and structure of a day unit designed to intervene in the systems of families who present with severe or multiple problems to agencies attempting to help them, but who are difficult to engage in a therapeutic pact and unresponsive to attempts at outpatient therapy. An analysis of these families is offered in terms of the relations between internal and external boundaries and difficulties in making transitions in the daily contexts of life. The principles of the unit are described in terms of the creation of an artificial extended family, the intensification of sequence and patterns of interaction, and the making and traversing of boundaries. Particular attention is paid to the function of agency interventions in family patterns and to redefining the relationship between family and agencies.
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