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Van Hoye A, Regan C, Lane A, Vuillemin A, Woods C. Implementation of the GAA 'healthy clubs project' in Ireland: a qualitative study using the Consolidated Framework for Implementation Research. Health Promot Int 2024; 39:daad191. [PMID: 38243778 PMCID: PMC10799314 DOI: 10.1093/heapro/daad191] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2024] Open
Abstract
The sports clubs' role in promoting health has been acknowledged by policy makers and researchers, but there is little evidence on how sports clubs implement health-related interventions. The present article investigates the Gaelic Athletic Association Healthy Club Project (HCP) implementation process (mechanisms, barriers, leverages) over a 10-year timeframe. A case study design helped to produce and compare a data synthesis for five clubs involved since 2013. A qualitative iterative data collection, including document analysis was conducted through 20 focus groups with Healthy Club Officers, coaches, participants and members. The Consolidated Framework for Implementation Research was used in the deductive analysis process, conducted by the first author. Results have shown the success of the HCP in placing health promotion on the agenda of sports clubs leading to informal policy for health promotion, even if activities and recognition are directed toward and coming from the community. This study also underlines the virtuous cycle of the settings-based approach in enhancing membership and volunteer recognition through health promotion actions, and the importance of social good and corporate social activities for sports clubs. Nevertheless, the HCP still relies on limited human resources, is not recognized by competitive oriented adult playing members. and acknowledged as a resource by some coaches, limiting its rootedness in the core business of sports clubs. Future research should empower the HCP community to focus on organizational changes and develop outcomes for individuals, for the club as a whole as well as for the local community.
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Affiliation(s)
- A Van Hoye
- Physical Activity for Health Research Centre, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, V94T9PX Limerick, Ireland
- UMR 1319 INSPIIRE, Université de Lorraine, 54600 Vandoeuvre-les-Nancy, France
| | - C Regan
- Community and Health Department, Gaelic Athletic Association, D03 P6K7 Dublin, Ireland
| | - A Lane
- SHE Research Group, Technological University of the Shannon, N37HD68 Athlone, Ireland
| | - A Vuillemin
- LAHMESS, Université Côte d’Azur, 06200 Nice, France
| | - C Woods
- Physical Activity for Health Research Centre, Health Research Institute, Department of Physical Education and Sport Sciences, University of Limerick, V94T9PX Limerick, Ireland
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Van Hoye A, Regan C, Lane A, Cullen B, Vuillemin A, Woods C. Sport federation investment in health promotion: program implementation and viability. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Researchers have called for a better recognition of the potential of sports clubs for health promotion (HP), but less is known on the support provided by sports federation. The present study analyses the the implementation of the Gaelic Athletics Association (GAA) Healthy Club Project, to investigate its organization’s viability.
Methods
A single case study was realized, based on observation, document analysis and interviews, to document the viable system model.
Results
Results have identified a three-level structure, where 6 employees at national level support the work of 28 volunteer’s county health and well-being officers and 439 clubs implicated. Strengths of the organization are the identification of a single national referent for clubs or county, the learning process and openness to novelty, as well as the enhanced workforce through county implication as role model. Challenges are the financial and human resources provision, the ability to implicate county and club board and the training in HP of volunteers. Interlevel relationship are supported by the creation of a community of practice and the centralization of the project at national level, but hindered by a clear definition of county tasks. The strengths of the controlling system include a steering committee implicating partners completing each other and the proper use of evaluation to build evidence on the project, where challenges remains in wider collaboration within the GAA.
Conclusions
The present work has underlined key scaling up factors of the HCP implementation to support its viability, which could be learnt from other sports federation implementing HP interventions.
Key messages
• Sports federation have a key role to play to support sports clubs to promote health, by developing specific programs.
• Health Promotion development in sports clubs has similar scaling up implementation factor than other public health interventions.
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Affiliation(s)
- A Van Hoye
- Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
| | - C Regan
- Community and Health Department, Gaelic Athletic Association , Dublin, Ireland
| | - A Lane
- Technological University of the Shannon SHE Research Group, , Athlone, Ireland
| | - B Cullen
- Innovation and Research , Sport Ireland, Dublin, Ireland
| | - A Vuillemin
- Université Côte d'Azur LAHMESS, , France, France
| | - C Woods
- Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
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Garry N, Farooq I, Milne S, Lindow SW, Regan C. Trends in obstetric management of extreme preterm birth at 23 to 27 weeks' gestation in a tertiary obstetric unit: A 10-year retrospective review. Eur J Obstet Gynecol Reprod Biol 2020; 253:249-253. [PMID: 32892035 DOI: 10.1016/j.ejogrb.2020.08.034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Revised: 08/12/2020] [Accepted: 08/21/2020] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To evaluate maternal and perinatal outcomes in deliveries from 23 + 0 to 26 + 6 weeks gestation in a tertiary hospital. STUDY DESIGN A 10-year retrospective analysis was performed which included all women who delivered between 23 + 0 and 26 + 6 weeks gestation in a tertiary obstetric unit from 01/01/2007 to 31/12/2017 inclusive. Data were collected from electronic patient records and individual chart reviews using predetermined variables. RESULTS 340 women and 402 infants were included. 84 % (282/340) were singleton pregnancy and 17 % (59/340) had multiple pregnancies. 36.8 % (125/340) of women were delivered by Caesarean section, 11.2 % (14/125) had a classical caesarean section. The leading indications for delivery were preterm premature ruptured membranes (PPROM) 28.2 % (96/340), 8.5 % (29/340) severe pre-eclampsia (PET) and 5.6 % (19/340) were delivered for suspected placental abruption. Of all infants (N = 402), 18.9 % (76/402) were stillborn. 300 infants were admitted to the Neonatal Intensive Care Unit (NICU). The NICU survival to discharge rate was 83.7 % (251/300). The overall perinatal mortality rate (PNMR) was 328.4/1000 and a further late neonatal mortality of 47.3/1000 births. Notably, at the 23 week gestation NNDs are the major contributor to the PNMR and at later gestations stillbirths are the largest contributor. CONCLUSION Pregnant women delivering at extreme preterm gestations are at risk of maternal morbidity. Their infants have high rates of serious morbidity and mortality, with all survivors in this cohort affected by neonatal morbidity. Informed decision-making by providers and parents requires evidence based information on perceived outcomes, ideally individualized to the mother and pregnancy in question. Information from this retrospective cohort study can be used to counsel women and their families on potential morbidity and mortality and to manage expectations.
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Affiliation(s)
- N Garry
- Department of Obstetrics and Gynecology, Coombe Women and Infants University Hospital Dublin 8, Republic of Ireland.
| | - I Farooq
- Department of Obstetrics and Gynecology, Coombe Women and Infants University Hospital Dublin 8, Republic of Ireland
| | - S Milne
- Department of Obstetrics and Gynecology, Coombe Women and Infants University Hospital Dublin 8, Republic of Ireland
| | - S W Lindow
- Department of Obstetrics and Gynecology, Coombe Women and Infants University Hospital Dublin 8, Republic of Ireland
| | - C Regan
- Department of Obstetrics and Gynecology, Coombe Women and Infants University Hospital Dublin 8, Republic of Ireland
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Keane R, Manning C, Lynch C, Regan C, Byrne B. How Much Greater is Obstetric Intervention in Women with Medical Disorders in Pregnancy When Compared to the General Population? Ir Med J 2019; 112:1001. [PMID: 31651131] [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] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Introduction The purpose of this study was to compare obstetric and neonatal outcomes between women attending a specialised maternal medicine service and the general obstetric population. Methods Women attending from January 2011 to December 2016 were identified from the clinic database. Medical diagnosis, demographics, obstetric and neonatal outcomes were compared with data from hospital annual report 2014. Results 1873 women were compared with 8632 women who delivered at the hospital in 2014. Delivery before 34 weeks [82 (4.5%) vs 189 (2.2%)], induction of labour [761 (40.6%) vs 2664 (30.9%)] and delivery by Caesarean Section (CS) [664 (35%) vs 2479 (29%)] were higher p<0.001; but elective CS [334 (18%) vs 1425 (17%), p=0.18] did not differ between the two groups. Neonatal outcomes were similar. Conclusion Premature delivery, induction of labour and CS rates are higher in women with medical disorders in pregnancy. Encouragingly, 77% of women attempting vaginal birth in this group were successful.
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Affiliation(s)
- R Keane
- Medical student University College Dublin
| | - C Manning
- Maternal Medicine Service, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - C Lynch
- Maternal Medicine Service, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - C Regan
- Maternal Medicine Service, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - B Byrne
- Maternal Medicine Service, Coombe Women and Infants University Hospital, Dublin 8, Ireland
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Catzikiris N, Tapley A, Morgan S, Holliday EG, Ball J, Henderson K, Elliott T, Spike N, Regan C, Magin P. Maintaining capacity for in-practice teaching and supervision of students and general practice trainees: a cross-sectional study of early career general practitioners. AUST HEALTH REV 2019; 42:643-649. [PMID: 28793952 DOI: 10.1071/ah16285] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 06/18/2017] [Indexed: 11/23/2022]
Abstract
Objectives Expanding learner cohorts of medical students and general practitioner (GP) vocational trainees and the impending retirement of the 'baby boomer' GP cohort threaten the teaching and supervisory capacity of the Australian GP workforce. Engaging newly qualified GPs is essential to sustaining this workforce training capacity. The aim of the present study was to establish the prevalence and associations of in-practice clinical teaching and supervision in early career GPs. Methods The present study was a cross-sectional questionnaire-based study of recent (within 5 years) alumni of three of Australia's 17 regional general practice training programs. The outcome factor was whether the alumnus taught or supervised medical students, GP registrars or other learners in their current practice. Logistic regression analysis was used to establish associations of teaching and supervision with independent variables comprising alumnus demographics, current practice characteristics and vocational training experiences. Results In all, 230 alumni returned questionnaires (response rate 37.4%). Of currently practising alumni, 52.4% (95% confidence interval (CI) 45.6-59.0%) reported current teaching or supervisory activities. Factors significantly (P<0.05) associated with alumni currently undertaking in-practice clinical teaching and supervision were: Australian medical graduation (odds ratio (OR) for international graduates 0.36; 95% CI 0.14-0.92), working in a regional or remote area (OR 2.75; 95% CI 1.24-6.11) and currently undertaking nursing home visits, home visits or after-hours work (OR 2.01; CI 1.02-3.94). Conclusions Rural-urban and country-of-graduation differences in the engagement of early career GPs in practice-based apprenticeship-like teaching or training should inform strategies to maintain workforce training capacity. What is known about the topic? Projected changes in the demand for and supply of clinical teaching and supervision within Australian general practice will require greater uptake of teaching and supervision by recently qualified GPs to ensure sustainability of this teaching model. Although interest in and undertaking of teaching roles have been documented for GP or family medicine trainees, studies investigating the engagement in these clinical roles by GPs during their early post-training period are lacking. What does this paper add? This paper is the first to document the prevalence of teaching and supervision undertaken by early career GPs as part of their regular clinical practice. We also demonstrate associations of practice rurality, country of medical graduation and undertaking non-practice-based clinical roles with GPs' engagement in teaching and supervisory roles. What are the implications for practitioners? Establishing current teaching patterns of GPs enables appropriate targeting of new strategies to sustain an effective teaching and supervisory capacity within general practice. The findings of the present study suggest that exploring focused strategies to facilitate and support international medical graduates to engage in teaching during their vocational training, aided by focused supervisor support, may be of particular value.
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Affiliation(s)
- Nigel Catzikiris
- GP Synergy NSW and ACT Research and Evaluation Unit, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia. ;
| | - Amanda Tapley
- GP Synergy NSW and ACT Research and Evaluation Unit, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia. ;
| | - Simon Morgan
- GP Synergy NSW and ACT Research and Evaluation Unit, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia. ;
| | - Elizabeth G Holliday
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia. Email
| | - Jean Ball
- Public Health Research Program, Hunter Medical Research Institute, Locked Bag 1000, New Lambton, NSW 2305, Australia.
| | - Kim Henderson
- GP Synergy NSW and ACT Research and Evaluation Unit, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia. ;
| | - Taryn Elliott
- Discipline of General Practice, University of Adelaide, 183 Melbourne Street, North Adelaide, SA 5006, Australia. Email
| | - Neil Spike
- Eastern Victoria GP Training, 15 Cato Street, Hawthorn, Vic. 3122, Australia. Email
| | - Cathy Regan
- School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, NSW 2308, Australia. Email
| | - Parker Magin
- GP Synergy NSW and ACT Research and Evaluation Unit, 20 McIntosh Drive, Mayfield West, NSW 2304, Australia. ;
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Boyd SC, O'Connor AD, Horan MA, Dicker P, Manning C, Lynch C, Regan C, Ryan K, Tan T, Byrne BM. Analgesia, anaesthesia and obstetric outcome in women with inherited bleeding disorders. Eur J Obstet Gynecol Reprod Biol 2019; 239:60-63. [PMID: 31185377 DOI: 10.1016/j.ejogrb.2019.05.043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 05/28/2019] [Accepted: 05/30/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Vertebral canal haematoma (VCH) complicates 1 in 168,000 obstetric epidurals (Ruppen et al., 2006). This risk is increased in women with inherited bleeding disorders (IBD). The impact of a contraindication to regional anaesthesia on pain management and obstetric outcome in these women is unknown. The purpose of this study was to determine anaesthetic use and obstetric outcomes in a cohort of women with IBD. STUDY DESIGN 97 women with IBD that delivered 130 babies at the CWIUH from Jan 2011 to Dec 2016 were identified from a maternal medicine database. Multidisciplinary planning of peripartum care was communicated to labour ward staff using a simple checklist. The primary bleeding disorders were: Von Willebrands disease (VWD) Type 1 27 (27.8%); VWD Type 2A 3 (3.8%); Low VWF 3 (3.8%); Bleeding disorder of unknown aetiology (BDUA) 19 (19.6%); deficiency of Factors VII, VIII, IX, X, and XI 13 (13.4%); Carriers of Factor VIII, IX, X, XIII deficiency 17 (17.5%); 5 had combined deficiencies (5.2%) and there was one platelet function defect. 9 had a family history of a bleeding disorder (9.3%). Haemostatic support, analgesia, mode of delivery and maternal and fetal outcomes were compared between pregnancies where regional anaesthesia was permitted and those that were not using the Chi-squared test. RESULTS When pregnancies where regional anaesthesia was not recommended (49) were compared with pregnancies where regional anaesthesia was considered safe (81), the women were more likely to see an anaesthetist before labour 46 (94%) vs 46 (61%): p < 0.001; to require prophylactic haemostatic support for delivery 30 (61%) vs 1 (1%): p < 0.001; to use a remifentanil infusion 15 (31%) vs 0: p < 0.001, and have general anaesthesia for Caesarean Section (CS) 10 (20%) vs 1(1%): p < 0.001. Vaginal birth 35 (71%) vs 53(65%): p = 0.4 and CS rates 14 (29%) vs 26 (32%) p = 0.28 were similar. Postpartum haemorrhage (PPH) was more common 11 (24%) vs 9(12%) vs p = 0.07 but not statistically so. There were no cases of neonatal bleeding or VCH. CONCLUSION Contraindication to neuraxial blockade in labouring women with IBD does not influence mode of delivery. This information is reassuring to these women who may be anxious about delivery without regional anaesthesia.
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Affiliation(s)
- Sean C Boyd
- University College Dublin, Coombe Women and Infants University Hospital, Dublin 8, Ireland.
| | - Anna D O'Connor
- Maternal Medicine, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - Maebh A Horan
- Maternal Medicine, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - Pat Dicker
- Department of Epidemiology Royal College of Surgeons, Ireland
| | - Catherine Manning
- Maternal Medicine, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - C Lynch
- Maternal Medicine, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - C Regan
- Maternal Medicine, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - K Ryan
- Maternal Medicine, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - T Tan
- Perioperative Medicine Service, Coombe Women and Infants University Hospital, Dublin 8, Ireland
| | - B M Byrne
- Maternal Medicine, Coombe Women and Infants University Hospital, Dublin 8, Ireland
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Regan C, Sharma L, Villers KS. ORGANIZING SENIORS TO PROTECT THE HEALTH SAFETY NET: THE WAY FORWARD. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- C Regan
- Community Catalyst, Boston, Massachusetts, United States
| | - L Sharma
- Community Catalyst, Boston, MA, USA
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Goldsworthy S, Regan C, Pawley J, McGrail S, McCormack S, Varughese M. PO-1099: Lean method, live update - real-time librarian support for evidence based radiotherapy protocols. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31409-9] [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: 11/26/2022]
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Abbott JA, Guth E, Kim C, Regan C, Siu VM, Rupar CA, Demeler B, Francklyn CS, Robey-Bond SM. The Usher Syndrome Type IIIB Histidyl-tRNA Synthetase Mutation Confers Temperature Sensitivity. Biochemistry 2017. [PMID: 28632987 DOI: 10.1021/acs.biochem.7b00114] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Histidyl-tRNA synthetase (HARS) is a highly conserved translation factor that plays an essential role in protein synthesis. HARS has been implicated in the human syndromes Charcot-Marie-Tooth (CMT) Type 2W and Type IIIB Usher (USH3B). The USH3B mutation, which encodes a Y454S substitution in HARS, is inherited in an autosomal recessive fashion and associated with childhood deafness, blindness, and episodic hallucinations during acute illness. The biochemical basis of the pathophysiologies linked to USH3B is currently unknown. Here, we present a detailed functional comparison of wild-type (WT) and Y454S HARS enzymes. Kinetic parameters for enzymes and canonical substrates were determined using both steady state and rapid kinetics. Enzyme stability was examined using differential scanning fluorimetry. Finally, enzyme functionality in a primary cell culture was assessed. Our results demonstrate that the Y454S substitution leaves HARS amino acid activation, aminoacylation, and tRNAHis binding functions largely intact compared with those of WT HARS, and the mutant enzyme dimerizes like the wild type does. Interestingly, during our investigation, it was revealed that the kinetics of amino acid activation differs from that of the previously characterized bacterial HisRS. Despite the similar kinetics, differential scanning fluorimetry revealed that Y454S is less thermally stable than WT HARS, and cells from Y454S patients grown at elevated temperatures demonstrate diminished levels of protein synthesis compared to those of WT cells. The thermal sensitivity associated with the Y454S mutation represents a biochemical basis for understanding USH3B.
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Affiliation(s)
- Jamie A Abbott
- Department of Biochemistry, University of Vermont , Burlington, Vermont 05405, United States
| | - Ethan Guth
- Chemistry & Biochemistry Department, Norwich University , Northfield, Vermont 05663, United States
| | | | | | | | | | - Borries Demeler
- Department of Biochemistry, The University of Texas Health Science Center at San Antonio , San Antonio, Texas 78229, United States
| | - Christopher S Francklyn
- Department of Biochemistry, University of Vermont , Burlington, Vermont 05405, United States
| | - Susan M Robey-Bond
- Department of Biochemistry, University of Vermont , Burlington, Vermont 05405, United States
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Magin P, Catzikiris N, Tapley A, Morgan S, Holliday EG, Ball J, Henderson K, Elliott T, Regan C, Spike N. Home visits and nursing home visits by early-career GPs: a cross-sectional study. Fam Pract 2017; 34:77-82. [PMID: 27629569 DOI: 10.1093/fampra/cmw099] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Home visits (HVs) and nursing home visits (NHVs) are accepted as core elements of general practice. There is concern regarding declining rates of HVs and an increasing demand for NHVs together with a perceived decreased willingness of younger GPs to provide these services. OBJECTIVES To establish the prevalence and associations of recently vocationally qualified GPs ('graduates') performing HVs and NHVs. METHODS A cross-sectional questionnaire-based study of recent (within 5 years) graduates of 3 of Australia's 17 regional general practice training programs. Outcome factors were performing, as part of current practice, HVs and NHVs. Factors associated with each outcome were assessed by logistic regression with graduate and current practice characteristics and vocational training experiences as independent variables. RESULTS Of 230 responding graduates, 48.1% performed HVs and 40.6% performed NHVs in their current clinical GP role. Factors associated with both HVs and NHVs were participating in in-practice clinical teaching/supervision [odds ratios (ORs) 2.65 and 2.66], conducting HVs/NHVs during training (ORs 5.05 and 10.8) and working full-time (ORs for part-time work 0.20 and 0.29). Further associations with performing HVs were older GP age (compared to <36 years: ORs 3.65 for 36-40 and 2.53 for 41+), smaller practice size (OR 0.53 for larger practices), Australian undergraduate education (OR 0.31 for non-Australian) and greater number of years in their current practice as a qualified GP (OR 1.25 per year). CONCLUSIONS Our findings of graduates' modest engagement with HVs and NHVs reinforce concerns regarding Australian general practice's capacity to accommodate the needs of an aging population.
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Affiliation(s)
- Parker Magin
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia, .,GP Synergy, Newcastle, New South Wales, Australia
| | | | | | - Simon Morgan
- Elermore Vale General Practice, Newcastle, New South Wales, Australia
| | - Elizabeth G Holliday
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.,Public Health Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | - Jean Ball
- Public Health Research Program, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
| | | | - Taryn Elliott
- Department of General Practice, The University of Adelaide, Adelaide, South Australia, Australia
| | - Cathy Regan
- School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia.,GP Synergy, Newcastle, New South Wales, Australia
| | - Neil Spike
- Eastern Victoria GP Training, Melbourne, Victoria, Australia and.,Department of General Practice, The University of Melbourne, Melbourne, Victoria, Australia
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Bonney A, Morgan S, Tapley A, Henderson K, Holliday E, Davey A, van Driel M, Spike N, Regan C, Ball J, Magin P. Older patients' consultations in an apprenticeship model-based general practice training program: A cross-sectional study. Australas J Ageing 2016; 36:E1-E7. [DOI: 10.1111/ajag.12364] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Andrew Bonney
- School of Medicine; University of Wollongong; Wollongong New South Wales Australia
| | - Simon Morgan
- Elermore Vale General Practice; Newcastle New South Wales Australia
| | | | | | | | - Andrew Davey
- Discipline of General Practice; University of Newcastle; Newcastle New South Wales Australia
| | - Mieke van Driel
- Discipline of General Practice; University of Queensland; Brisbane Queensland Australia
| | - Neil Spike
- Department of General Practice; The University of Melbourne; Melbourne Victoria Australia
| | - Cathy Regan
- GPSynergy; Newcastle New South Wales Australia
| | - Jean Ball
- Hunter Medical Research Institute; Newcastle New South Wales Australia
| | - Parker Magin
- Discipline of General Practice; University of Newcastle; Newcastle New South Wales Australia
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Morissette P, Regan C, Fitzgerald K, Gerenser P, Travis J, Wang S, Fanelli P, Sannajust F. Shortening of the electromechanical window in the ketamine/xylazine-anesthetized guinea pig model to assess pro-arrhythmic risk in early drug development. J Pharmacol Toxicol Methods 2016; 81:171-82. [DOI: 10.1016/j.vascn.2016.06.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 05/23/2016] [Accepted: 06/04/2016] [Indexed: 11/26/2022]
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13
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Wearne SM, Morgan S, Magin P, Spike N, Tapley A, Regan C, McArthur L. Responding to registrars' in-consultation calls for assistance: Practical implications from the ReCeNT project. Aust Fam Physician 2016; 45:446-449. [PMID: 27622237] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND General practice registrars in Australia are expected to identify and address their knowledge or skills gaps during consultations. The content and frequency of registrars seeking assistance and the factors that influence this have been studied for 84,723 consultations. Term 1 registrars asked their supervisor for help in 11.0% of consultations, but by term 4 this reduced to 1.2% of consultations. Assistance was most often for skin or musculoskeletal conditions, and more often about management than diagnosis. OBJECTIVE This article discusses the implications of this information for Australian general practice training. DISCUSSION Registrars asked their supervisors for assistance despite having ready access to electronic information. Practices can anticipate supervisor interruptions approximately every tenth registrar consultation. The greater input required by registrars from supervisors earlier in training should be acknowledged by more flexible standards and payments to practices. A priority for general practice supervisor professional development is how to teach the management of complex patients, dermatology and musculoskeletal medicine.
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Affiliation(s)
- Susan M Wearne
- BM MMedSc FRACGP FACRRM DCH DRCOG DFFP GCTEd, Supervisor Research and Development Adviser, General Practice Education and Training, Canberra, ACT
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Sweeney NP, Regan C, Liu J, Galleu A, Dazzi F, Lindemann D, Rupar CA, McClure MO. Rapid and Efficient Stable Gene Transfer to Mesenchymal Stromal Cells Using a Modified Foamy Virus Vector. Mol Ther 2016; 24:1227-36. [PMID: 27133965 PMCID: PMC4982542 DOI: 10.1038/mt.2016.91] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Accepted: 04/19/2016] [Indexed: 12/13/2022] Open
Abstract
Mesenchymal stromal cells (MSCs) hold great promise for regenerative medicine. Stable ex vivo gene transfer to MSCs could improve the outcome and scope of MSC therapy, but current vectors require multiple rounds of transduction, involve genotoxic viral promoters and/or the addition of cytotoxic cationic polymers in order to achieve efficient transduction. We describe a self-inactivating foamy virus vector (FVV), incorporating the simian macaque foamy virus envelope and using physiological promoters, which efficiently transduces murine MSCs (mMSCs) in a single-round. High and sustained expression of the transgene, whether GFP or the lysosomal enzyme, arylsulphatase A (ARSA), was achieved. Defining MSC characteristics (surface marker expression and differentiation potential), as well as long-term engraftment and distribution in the murine brain following intracerebroventricular delivery, are unaffected by FVV transduction. Similarly, greater than 95% of human MSCs (hMSCs) were stably transduced using the same vector, facilitating human application. This work describes the best stable gene transfer vector available for mMSCs and hMSCs.
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Affiliation(s)
- Nathan Paul Sweeney
- Jefferiss Research Trust laboratories, Department of Medicine, Imperial College London, London, UK
| | - Cathy Regan
- Department of Pathology and Laboratory Medicine, Western University, Ontario, Canada.,Department of Biochemistry and Pediatrics, Western University, Ontario, Canada
| | - Jiahui Liu
- Department of Pathology and Laboratory Medicine, Western University, Ontario, Canada.,Department of Biochemistry and Pediatrics, Western University, Ontario, Canada
| | - Antonio Galleu
- Department of Haemato-Oncology, King's College London, London, UK
| | - Francesco Dazzi
- Department of Haemato-Oncology, King's College London, London, UK
| | - Dirk Lindemann
- Institute of Virology, Technische Universität Dresden, Dresden, Germany
| | - Charles Anthony Rupar
- Department of Pathology and Laboratory Medicine, Western University, Ontario, Canada.,Department of Biochemistry and Pediatrics, Western University, Ontario, Canada
| | - Myra Olga McClure
- Jefferiss Research Trust laboratories, Department of Medicine, Imperial College London, London, UK
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Meghan K, Ryan K, Regan C, Byrne B, Lynch C. P-051 Glanzmann's thrombasthenia in pregnancy – A case report. Thromb Res 2013. [DOI: 10.1016/s0049-3848(13)70097-5] [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: 11/29/2022]
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16
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Maher N, Paramanathan P, Ryan K, Lynch C, Byrne B, Regan C. P-053 IVC thrombosis preceding pregnancy – Two unusual cases. Thromb Res 2013. [DOI: 10.1016/s0049-3848(13)70099-9] [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: 10/27/2022]
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17
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Nicolaï P, Feugeas JL, Regan C, Olazabal-Loumé M, Breil J, Dubroca B, Morreeuw JP, Tikhonchuk V. Effect of the plasma-generated magnetic field on relativistic electron transport. Phys Rev E Stat Nonlin Soft Matter Phys 2011; 84:016402. [PMID: 21867317 DOI: 10.1103/physreve.84.016402] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2011] [Revised: 05/06/2011] [Indexed: 05/31/2023]
Abstract
In the fast-ignition scheme, relativistic electrons transport energy from the laser deposition zone to the dense part of the target where the fusion reactions can be ignited. The magnetic fields and electron collisions play an important role in the collimation or defocusing of this electron beam. Detailed description of these effects requires large-scale kinetic calculations and is limited to short time intervals. In this paper, a reduced kinetic model of fast electron transport coupled to the radiation hydrodynamic code is presented. It opens the possibility to carry on hybrid simulations in a time scale of tens of picoseconds or more. It is shown with this code that plasma-generated magnetic fields induced by noncollinear temperature and density gradients may strongly modify electron transport in a time scale of a few picoseconds. These fields tend to defocus the electron beam, reducing the coupling efficiency to the target. This effect, that was not seen before in shorter time simulations, has to be accounted for in any ignition design using electrons as a driver.
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Affiliation(s)
- Ph Nicolaï
- Centre Lasers Intenses et Applications, Université Bordeaux 1, Centre National de la Recherche Scientifique, Commissariat à l'Énergie Atomique et aux Énergies Alternatives, Talence, France.
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18
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Affiliation(s)
- Parker Magin
- General Practice Training Valley to Coast, Mayfield, NSW, Australia.
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Broughton C, Regan C, Gilchrist F, Pantin C, Lenney W. An audit of sexual health awareness in adult cystic fibrosis patients. J Cyst Fibros 2010. [DOI: 10.1016/s1569-1993(10)60398-0] [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: 10/19/2022]
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Abstract
OBJECTIVE To identify minimum criteria to assist the prediction of decline in physical health-related quality of life in the elderly. STUDY DESIGN AND SETTING Participants were women from the Australian Longitudinal Study on Women's Health, who responded to three separate Surveys conducted in 1996 (when they were aged 70-75 years), 1999 and 2002. Using data from these Surveys, three categories were generated which described current physical health-related quality of life and future physical decline as measured by the physical component summary score (PCS) of the MOS SF-36 quality of life survey. RESULTS Bivariate analyses reported a large number of variables significantly associated with physical decline (P < 0.001), including age, falls, number of diagnoses, symptoms, doctor visits and medications, days spent in hospital, body mass index, living arrangements and social support. Multivariate analyses, using decision tree analysis, identified three items which accurately predicted 76% of the women who would exhibit physical decline according to our definition. CONCLUSIONS This study identified a number of variables that may be useful in clinical screening for vulnerability to physical decline.
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Affiliation(s)
- David W Sibbritt
- Centre for Clinical Epidemiology & Biostatistics, Faculty of Health, The University of Newcastle, Newcastle, NSW 2300, Australia
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21
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Abstract
OBJECTIVE To test the hypothesis that patients with Alzheimer disease (AD) who have vascular risk factors have a worse prognosis over 18 months vs those without such risk factors. METHODS A sample of 224 people with AD and their caregivers were recruited purposively to be representative of people with dementia in terms of cognition, sex, and living situations in a longitudinal study of AD. Standardized instruments measuring cognition, functional status, and neuropsychiatric symptoms were used to collect data. Physical examination and relevant blood tests were performed. RESULT There was no difference in rate of deterioration between people with and without vascular risk factors, except in those who had a cerebrovascular accident (CVA) during the 18-month follow-up (p < 0.001). We considered possible confounders of outcome: sex, age, years of education, severity of dementia, depression, taking cholinesterase inhibitors (AChEIs), and whether those with vascular risk factors were more likely to die, but the results remained unchanged. Stopping AChEIs during the study was associated with cognitive and functional decline (p < 0.001). CONCLUSIONS Vascular risk factors as measured clinically and biochemically do not significantly increase deterioration at 18 months in people with Alzheimer disease who have a low burden of cerebrovascular risk factors. However, cerebrovascular events are associated with more rapid decline. Vascular risk factors may contribute to the expression of Alzheimer disease initially but are not part of the underlying etiologic process.
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Affiliation(s)
- C Regan
- Royal Free & University College Medical School, UCL, Department of Mental Health Sciences, Holborn Union Building, Archway Campus, Highgate Hill, London N19 5LW UK.
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Abstract
OBJECTIVE To conduct a systematic review of studies investigating the validity of administrative registers for use in psychiatric research. METHOD Studies were identified using MEDLINE (1966-2004) and EMBASE (1980-2004) databases using keywords 'validity' or 'reliability' combined with 'register' or 'database$'. Studies reviewed by two raters blind to each other and quality assessed using a data extraction form devised by the authors. A narrative description of the findings is presented. RESULTS Fourteen studies were identified, seven of which concerned Scandinavian registers. Ten studies were solely concerned with diagnostic validity and the most common single diagnosis studied was schizophrenia (five studies). Methods used and study quality varied widely. CONCLUSION Given the importance of the area, relatively little high-quality work exists into systematically measuring the diagnostic data validity of registers for research purposes.
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Affiliation(s)
- N Byrne
- Lambeth Adult Mental Health, Maudsley Hospital, South London and Maudsley NHS Trust, London, UK.
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Livingston G, Mahoney R, Regan C, Katona C. The Caregivers for Alzheimer's disease Problems Scale (CAPS): development of a new scale within the LASER-AD study. Age Ageing 2005; 34:287-90. [PMID: 15863413 DOI: 10.1093/ageing/afi103] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [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: 11/13/2022] Open
Abstract
BACKGROUND we developed the Caregivers for Alzheimer's disease Problems Scale (CAPS) comprising common risk factors for anxiety and depression for family carers of people with dementia. OBJECTIVE to calculate the sensitivity and specificity of the CAPS in order to measure its usefulness in identifying dementia caregivers at risk of anxiety and depression and therefore whether it identifies clinically relevant areas for intervention or highlights the need for support if the problem could not be changed. METHOD 153 family caregivers were interviewed as part of a larger epidemiologically representative study of people with Alzheimer's disease and their caregivers. Caregiver anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS). RESULTS the CAPS had high sensitivity and specificity in detecting caregivers with screen positive anxiety and depression. Five areas were indicated: neuropsychiatric symptoms and depression in the care-recipient, co-residence and relationships with the care-recipient, and physical health of the caregiver. CONCLUSIONS awareness of these problems can help clinicians identify those carers most likely to be anxious or depressed and indicate appropriate intervention and support. We recommend that this instrument be used as part of routine assessments of people with dementia and their families.
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Affiliation(s)
- G Livingston
- Department of Mental Health Sciences, University College London, Holborn Union Building, Archway Campus, Highgate Hill, London N19 5NL, UK.
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Abstract
The aim of the study was to document the role of laboratory investigations for unexpected stillbirths at term. It was a retrospective casenote review of 75 unexpected stillbirths at term from 1995 to 1999, at the National Maternity Hospital, Dublin, Republic of Ireland. Investigations performed included blood tests, chromosomal analysis, autopsy and placental histology. Perinatal autopsy was the most informative investigation with positive findings in 49% of cases. There were positive placental findings in 37% of cases. Six of the 26 cases showed abnormal karyotyping. Of the blood tests performed, the Kleihauer-Betke test was most informative, revealing a feto-maternal haemorrhage in 8% of cases and anticardiolipin antibodies were positive in 4% of cases. FBC, TORCH and glycosylated Hb were negative in all 75 patients. Despite thorough investigations 32 of cases (43%) remained unexplained.
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Affiliation(s)
- U Bohra
- National Maternity Hospital, Dublin, Republic of Ireland
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Murphy RP, Donoghue C, Nallen RJ, D'Mello M, Regan C, Whitehead AS, Fitzgerald DJ. Prospective evaluation of the risk conferred by factor V Leiden and thermolabile methylenetetrahydrofolate reductase polymorphisms in pregnancy. Arterioscler Thromb Vasc Biol 2000; 20:266-70. [PMID: 10634828 DOI: 10.1161/01.atv.20.1.266] [Citation(s) in RCA: 110] [Impact Index Per Article: 4.6] [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: 11/16/2022]
Abstract
Factor V (FV) Leiden and thermolabile methylenetetrahydrofolate reductase (MTHFR) are 2 common polymorphisms that have been implicated in vascular thrombosis. We determined whether these mutations predicted an adverse outcome in pregnancy. Second, we looked for an interaction between these 2 mutations in patients with recurrent fetal loss or thrombosis in pregnancy. Primigravid subjects at their booking visit to the National Maternity Hospital (Holles Street, Dublin, Ireland) were screened for the polymorphisms. Thermolabile MTHFR and FV Leiden genotypes were detected by either restriction fragment length polymorphism or heteroduplex capillary chromatography. The carrier frequency of FV Leiden in the screened primigravid population was 2.7% (allele frequency 1.36%), all being heterozygous for the mutation. This value was lower than expected from previous studies in European populations. Forty-nine percent of the screened population (289 of 584) were heterozygous for thermolabile MTHFR, and 10.6% were homozygous (62 of 584). The frequency of the 2 polymorphisms was no higher in those who subsequently developed preeclampsia (n=12) or intrauterine growth retardation (n=9), and none of the screened population developed thrombosis. However, the frequency of FV Leiden was higher in patients who subsequently miscarried after the first trimester of pregnancy (allele frequency of 5.5%, P=0.0356). Among those positive for FV Leiden, 3 of 27 miscarried, compared with 24 of 572 of FV Leiden-negative patients (11% versus 4.2%). No interaction was found between the 2 mutations in the control or patient populations. In patients with a prior history of venous thrombosis, the carrier rate of FV Leiden was increased (4 of 33, allele frequency of 7.6%, P=0. 0115). In contrast, the carrier frequency for thermolabile MTHFR was no higher, and there was no interaction between the 2 mutations. Neither mutation occurred at a significantly higher frequency in patients with a prior history of recurrent fetal loss. In conclusion, FV Leiden is a risk factor for thrombosis in pregnancy and possibly for second-trimester miscarriage independent of thermolabile MTHFR. However, prospective analysis suggests that the risk conferred by FV Leiden is low in a primigravid population. The thermolabile MTHFR genotype was not implicated in any adverse outcome.
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Affiliation(s)
- R P Murphy
- Department of Clinical Pharmacology, Royal College of Surgeons in Ireland
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26
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Zhao S, Totleben MJ, Freeman JP, Bacon CL, Fox GB, O'Driscoll E, Foley AG, Kelly J, Farrell U, Regan C, Mizsak SA, Szmuszkovicz J. Syntheses of benzoquinolizidine and benzoindolizidine derivatives as anti-amnesic agents. Bioorg Med Chem 1999; 7:1637-46. [PMID: 10482456 DOI: 10.1016/s0968-0896(99)00078-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [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: 11/22/2022]
Abstract
Tacrine, one of the drugs available for Alzheimer's disease based on the cholinergic approach, suffers from considerable toxicity. Many analogues of tacrine have been prepared which retain the pharmacologically rich aminopyridine or aminoquinoline motifs. The current research was undertaken to produce an acetylcholinesterase inhibitor by employing 11-aminobenzoquinolizidines (4) and 10-aminobenzoindolizidines (5) as templates. Thus, we aimed to achieve three goals relative to tacrine: eliminate the pyridine and quinoline moieties and render the molecule less flat. Overall, the compounds we prepared were poorer inhibitors of acetylcholinesterase compared to tacrine. The single exception was compound 6f which exhibited an effect comparable to that of tacrine, but only at a dose of the order of 10(-3) M. However, despite the poor acetylcholinesterase inhibition by 6b, this compound proved to be an effective anti-amnesic agent at 45 mg/kg dose.
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Affiliation(s)
- S Zhao
- Department of Chemistry and Biochemistry, University of Notre Dame, IN 46556, USA
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27
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Zhao S, Freeman JP, Bacon CL, Fox GB, O'Driscoll E, Foley AG, Kelly J, Farrell U, Regan C, Mizsak SA, Szmuszkovicz J. Syntheses of 1,2-diamino and 1,2-aminoalcohol derivatives in the piperidine and pyrrolidine series as anti-amnesic agents. Bioorg Med Chem 1999; 7:1647-54. [PMID: 10482457 DOI: 10.1016/s0968-0896(99)00079-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [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: 11/28/2022]
Abstract
Tacrine, one of the drugs available for Alzheimer's disease based on the cholinergic approach, suffers from considerable toxicity. Many analogues of tacrine has been prepared which retain the pharmacologically rich aminopyridine or aminoquinoline motifs. The current research is a continuation of our efforts in the area of 11-aminobenzoquinolizidines (4) and 10-aminobenzoindolizidines (5) (cf. ref9). A serendipitous discovery led us to the biologically active open chain analogue 9, and we proceeded to elaborate on this molecule. Overall, the compounds we prepared were poor inhibitors of acetylcholinesterase as compared to tacrine. The single exception was compound 20 which exhibited an effect comparable to that of tacrine, but only at a dose in the order of 10(-3) M. However, despite the poor acetylcholinesterase inhibition by 9, this compound was found to be an effective antiamnesic agent.
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Affiliation(s)
- S Zhao
- Department of Chemistry and Biochemistry, University of Notre Dame, IN 46556, USA
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28
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Affiliation(s)
- M Jackson
- Division of Maternal-Fetal Medicine, University of Pennsylvania School of Medicine, Philadelphia 19104-4283, USA
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Berezin V, Kawa A, Bojic U, Foley A, Nau H, Regan C, Edvardsen K, Bock E. Teratogenic potency of valproate analogues evaluated by quantitative estimation of cellular morphology in vitro. Toxicol In Vitro 1996; 10:585-94. [DOI: 10.1016/s0887-2333(96)00049-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/04/1996] [Indexed: 11/15/2022]
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Haimovich B, Regan C, DiFazio L, Ginalis E, Ji P, Purohit U, Rowley RB, Bolen J, Greco R. The FcgammaRII receptor triggers pp125FAK phosphorylation in platelets. J Biol Chem 1996; 271:16332-7. [PMID: 8663117 DOI: 10.1074/jbc.271.27.16332] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.6] [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: 02/01/2023] Open
Abstract
Platelets express a single low affinity receptor for immunoglobulin, FcgammaRII, that triggers multiple cellular responses upon interaction with multivalent immune complexes. In this study we show that immobilized IgG is also a potent stimulant of platelet activation triggering adhesion, aggregation, massive dense granule secretion, and thromboxane production. Platelet adhesion to IgG was blocked by the FcgammaRII receptor-specific monoclonal antibody, IV. 3. Pretreatment of the platelets with cytochalasin D to inhibit actin polymerization similarly prevented cell binding to IgG having no effect on platelet binding to fibrinogen. Platelet adhesion to IgG also led to the induction of tyrosine phosphorylation of multiple proteins including pp125(FAK) and p72(SYK). These proteins were also tyrosine-phosphorylated in alphaIIbbeta3-deficient IgG-adherent platelets from patients with Glanzmann's thrombasthenia. These data demonstrate that FcgammaRII mediates pp125(FAK) phosphorylation and platelet adhesion to IgG independent of the integrin alphaIIbbeta3. Treatment of the platelets with bisindolylmaleimide to inhibit protein kinase C prevented phosphorylation of pp125(FAK) as well as several other proteins, but not p72(SYK) phosphorylation. This study establishes that the FcgammaRII receptor mediates pp125(FAK) phosphorylation via protein kinase C.
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Affiliation(s)
- B Haimovich
- Department of Surgery, Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903, USA
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Abstract
Although the prevalence of overweight and obesity among US children is a concern for many health care professionals, incidence rates over time seem to be variable, depending on the assessment measurements used. It is difficult to determine the associated health implications of pediatric obesity or overweight, especially the type that might result in adult obesity or overweight. This review examines the various factors that contribute to the weight and fitness status of children, including anthropometric factors, nutrient intake, the level of physical activity, and nutrition knowledge. Nutrient intake data of the past decade show that the energy and fat intakes of children in the United States have been fairly constant. However, data also indicate that their physical activity has declined. The data strongly suggest that the apparent prevalence of pediatric overweight may not be so much a function of nutrient intake as of a decrease in physical activity leading to an imbalance of energy input and output.
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Regan C. CDF's (Children's Defense Fund) Carol Regan. Interview by Karen Gardner. Hosp Health Netw 1993; 67:41-2. [PMID: 8513370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- C Regan
- Children's Defense Fund, Washington, DC
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Regan C. An ounce of prevention ... saving lives and money with primary preventive care. Interview by Karen Gardner. Trustee 1993; 46:6-7, 31. [PMID: 10126356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Abstract
Attachment classifications in mothers and their 1-year-old infants were independently and concurrently assessed using the Adult Attachment Interview and the Strange Situation Procedure. Overall concordance was significant (k = 0.62), with strong links apparent between mothers classified dismissing and infants classified avoidant and between mothers classified autonomous and infants classified secure. Mothers' classified preoccupied were not more likely to have infants classified resistant. Mothers' perceptions and interpretations of the emotional distress of an infant observed in a 4-minute videotape were related to both infant and mother attachment classifications. These results are compatible with the suggestion that attachment classification reflect differences in internal working models of relationships. Other measures of maternal psychosocial adjustment were not related to infant attachment classifications.
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Affiliation(s)
- C H Zeanah
- Brown University School of Medicine, Providence, Rhode Island
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35
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Regan C. Nutrition awareness and the food service industry. Ann N Y Acad Sci 1991; 623:392-9. [PMID: 2042846 DOI: 10.1111/j.1749-6632.1991.tb43748.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Affiliation(s)
- C Regan
- National Restaurant Association, Washington, D.C. 20036-3097
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Elmore M, Smyth M, Cookman G, Regan C, O'Connor B, O'Cuinn G. Thyroliberin and luliberin degradation by enzymes in cultured cells of neural origin. Biochem Soc Trans 1991; 19:36S. [PMID: 1674702 DOI: 10.1042/bst019036s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- M Elmore
- Department of Biochemistry, University College, Galway, Ireland
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Regan C. The foodservice industry's responsibility toward the food-sensitive patient. Ann Allergy 1988; 61:88-90. [PMID: 3061326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- C Regan
- National Restaurant Association, Washington, DC 20001
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38
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Chenais-Popovics C, Corbett R, Hooker CJ, Key MH, Kiehn GP, Lewis CL, Pert GJ, Regan C, Rose SJ, Sadaat S, Smith R, Tomie T, Willi AO. Laser amplification at 18.2 nm in recombining plasma from a laser-irradiated carbon fiber. Phys Rev Lett 1987; 59:2161-2164. [PMID: 10035440 DOI: 10.1103/physrevlett.59.2161] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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Abstract
The expansion of United States for-profit hospital chains into the international arena is a new and important development. Experiences with contract management of middle eastern hospitals in the early 1970s gave the American firms impetus to pursue ownership of health facilities in other parts of the world. US companies now operate over 95 foreign hospitals. The reasons for this involvement include the political receptivity of the government of the host nation; the potential for rapid growth and profits; the lack of indigenous competition; and the ability to occupy a distinct niche within the extant health services organization. The political and ideological implications of the growth of private medicine, particularly in the United Kingdom, in terms of its effects on the National Health Service are discussed. Questions for future research are posed.
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Regan C. Promoting nutrition in commercial foodservice establishments: a realistic approach. J Am Diet Assoc 1987; 87:486-8. [PMID: 3559009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Americans are eating out an average of 3.7 times per week and are spending almost 40% of their food dollar doing so. A Gallup Survey shows about 39% of consumers claim to have improved their eating habits while eating out, but restaurant patrons are most concerned about nutrition when dining out on a routine visit or while in a family-style restaurant. Restaurant patrons are also now more likely to order lower sodium meals, small-size portions, and lower calorie entrées. Although the opportunity to promote nutrition in the foodservice setting exists, restaurant chefs and managers often lack the background to take advantage of it and could benefit from the services of qualified nutrition professionals. Dietitians could assist in identifying menu items appropriate for nutrition promotion, recipe development, and staff training. However, a realistic approach must be maintained, and the following facts should be kept in mind: Nutritious restaurant fare should blend with the theme of the menu and be promoted primarily on its sensory attributes. Nutrition in restaurants is best received when promoted generally and within the scope of health and wellness. Descriptive menu items should be carefully used. A restaurant consultant should be current on controversial food and nutrition trends. The wait staff should be properly trained.
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Lorig K, Feigenbaum P, Regan C, Ung E, Chastain RL, Holman HR. A comparison of lay-taught and professional-taught arthritis self-management courses. J Rheumatol 1986; 13:763-7. [PMID: 3772925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
One hundred subjects with arthritis were randomized into lay-taught, or professional-taught 12-h arthritis self-management courses, or a control group. Outcomes, knowledge, exercise, relaxation, disability, pain, and number of physician visits were measured aat baseline and 4 months. Professional-taught groups demonstrated greater knowledge gain while lay-taught groups had greater changes in relaxation (p less than .01) and a tendency toward less disability. Although it is impossible to draw definitive conclusions, this study suggests that lay leaders can teach arthritis self-management courses with results similar to those achieved by professionals.
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Abstract
The anticonvulsant drug, sodium valproate, enhanced total activity of glutamine synthetase in cortical and cerebellar homogenates of the rat at concentrations of 25-50 mM, without significantly altering substrate affinity. This effect was due to a selective increase in the Vmax and substrate affinity of the enzyme in the particulate fraction. At the same concentration the drug caused little change in the Vmax of the cytosolic enzyme, although the substrate affinity was reduced. These effects cannot be attributed to isozymes of glutamine synthetase as only one form could be demonstrated by ion-exchange chromatography or electroblotting with antibodies to glutamine synthetase. This selective stimulation of particulate glutamine synthetase is suggested to be due to increases in membrane fluidity induced by the drug. The contribution of these effects to the mechanistic action of sodium valproate is discussed.
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43
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Snapp D, Regan C. Organizing nursing homes. Health Med 1985; 2:28-9. [PMID: 10270158] [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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44
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Abstract
This article describes an empirical study of 28 alternative women's health organizations. These organizations were formed by women who rejected the existing institutions of health care, especially the nature and quality of reproductive health services. The study examined their philosophy of health care, the range of services provided and the characteristics of women who use them, their internal organization in terms of the distribution of power and authority, and the problems and challenges involved in their existence. Implications and impacts resulting from their continuing existence into the 1980s on the delivery of health care for women are addressed.
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45
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Beaver BL, Regan C, Fabri PJ. Use of the Hickman catheter for chronic venous access. Ohio State Med J 1983; 79:542-3. [PMID: 6634014] [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: 01/21/2023]
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46
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Abstract
Lactoperoxidase catalyzed 125I-iodination of 8-day-old rat cerebellar cultures enriched in interneurons, mainly granule cells, was studied during a period 1-8 days in vitro, when the mature appearance of the cultures develop. Autoradiography of the surface iodinated constituents after separation by SDS-polyacrylamide gel electrophoresis showed a limited number of heavily labeled bands, including polypeptides of apparent molecular weight (X 10(3] of 140, 88, 68, 58 and 53 daltons. Their relative proportion in terms of 125I-content changed during the development of the cultures. Initially, the labeled 140 kdaltons band (P140) was dominant. Using crossed immunoelectrophoresis with an antiserum raised against immature rat cerebellar plasma membrane preparations (anti-BPM serum) that primarily recognizes one neuronal surface antigen (D2)33, it was established that the P140 comprises the D2 protein. In contrast to the amount of D2, which increases during the 8-day culture period, the labeling of P140 decreased sharply after 2 DIV. This decline coincided with a developmental change in the molecular forms of D2 involving desialylation. Treatment of 2 DIV cultures with neuraminidase, which reproduces the D2 developmental change, prior to 125I-iodination resulted in a marked reduction in the labeling of P140, whereas the other major labeled group of polypeptides in the 50 kdalton range were little affected. Further experiments showed that the D2 protein is phosphorylated in the plasma membrane. It was found that some of the surface labeled proteins, including P140, are released into the culture medium, but apparently in a non-phosphorylated form. Thus it would appear that a significant part of the polypeptide chain of D2, which is an integral membrane constituent, is exposed on the cell surface, and that either D2 has an anchorage within the membrane that is phosphorylated but is not released or D2 is rapidly dephosphorylated when it is shed from the membrane.
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47
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Meier E, Regan C, Balázs R, Wilkin GP. Specific recognition of the neuronal cell surface by an antiserum raised plasma membrane preparations of immature rat cerebellum. Neurochem Res 1982; 7:1031-43. [PMID: 7177311 DOI: 10.1007/bf00964884] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
A brain specific antiserum was prepared by immunizing rabbits with a crude membrane fraction from 8-day old rat cerebella. In immunofluorescence studies the antiserum labeled the perikarya and processes of cultured cerebellar neurones. In contrast, other cell types, encountered in cerebellar cultures including astrocytes, endothelial cells and fibroblasts, were consistently unstained. The antiserum when used in crossed immunoelectrophoresis with Triton X-100 solubilized brain extracts reacted predominantly with one antigen that could be identified as the D2 protein.
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48
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Powell C, Regan C, Fabri PJ, Ruberg RL. Evaluation of Opsite catheter dressings for parenteral nutrition: a prospective, randomized study. JPEN J Parenter Enteral Nutr 1982; 6:43-6. [PMID: 6804654 DOI: 10.1177/014860718200600143] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
A prospective, randomized study compared the use of Opsite and standard gauze/tape dressings in 261 patients receiving parenteral nutrition. Eighty-four patients had a source of external drainage and were evaluated as a separate group. Catheter-related sepsis was assessed by blood culture, catheter tip culture, clinical sepsis, and clinical defervescence of fever after catheter removal. Although no statistically significant difference between Opsite and standard dressings could be identified, Opsite-treated patients consistently had increased parameters of catheter-related sepsis in all comparisons. As used here, Opsite is probably not a suitable catheter dressing system for parenteral nutrition.
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49
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Grant DA, Magee AI, Meeks D, Regan C, Bainbridge DR, Hermon-Taylor J. Identification of a defence mechanism in vivo against the leakage of enterokinase into the blood. Biochem J 1979; 184:619-26. [PMID: 395951 PMCID: PMC1161846 DOI: 10.1042/bj1840619] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
1. The serum proteinase inhibitors alpha 1-antitrypsin, alpha 2-macroglobulin, inter-alpha-trypsin inhibitor and C1-esterase inhibitor were found not to affect the catalytic activity of human enterokinase, whereas bovine trypsin activity was modified essentially as expected. Enterokinase was also not inhibited by Trasylol (trypsin inhibitor from bovine lung) or bovine pancreatic trypsin inhibitor. No other component in human or mouse serum complexing with enterokinase was identified. 2. Human enterokinase administered intravenously into mice was rapidly cleared from the circulation with a half-life of 2.5 min. This removal was not the result of the difference in species, since partially purified mouse enterokinase was cleared at the same rate as the human enzyme. Clearance was mediated by recognition of the carbohydrate portion of enterokinase and not through specific recognition of its catalytic site. Immunofluorescent staining showed that the enzyme accumulated in the liver. Attempts to block the clearance by the simultaneous infusion of competing glycoproteins suggested that enterokinase was taken up by hepatocytes. Of the glycoproteins tested only two, human lactoferrin (terminal fucosyl alpha 1 leads to 3 N-acetylglucosamine) and bovine asialo-fetuin (terminal galactosyl beta 1 leads to 4 N-acetylglucosamine) were weakly competitive. Two inhibitors of endocytosis, Intralipid and Triton WR1339, failed to delay the removal of enterokinase. It is proposed that enterokinase is cleared from the circulation by an as yet uncharacterized hepatocyte receptor.
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Kunz YW, Regan C. Histochemical investigations into the lipid nature of the oil-droplet in the retinal twincones of Lebistes reticulatus (Peters). REV SUISSE ZOOL 1973. [DOI: 10.5962/bhl.part.75970] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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