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McDonnell E, Corcoran L, Donnelly T. 196 AN AUDIT OF PROTON-PUMP INHIBITOR PRESCRIBING IN PATIENTS ATTENDING A RAPID ACCESS FRAILTY ASSESSMENT UNIT. Age Ageing 2022. [DOI: 10.1093/ageing/afac218.169] [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: 11/12/2022] Open
Abstract
Abstract
Background
Proton-Pump Inhibitor (PPI) usage has revolutionised gastroenterology practice with clinical indications for conditions such as Gastro-Oesophageal Reflux Disease (GORD), gastric and duodenal ulceration and Barrett's Oesophagus. However, these drugs are inappropriately prescribed, particularly among patients with an already heavy polypharmacy burden. PPI usage has been linked with electrolyte disturbances, most commonly hypomagnesaemia, resulting in higher rates of osteoporosis. It has also been shown to have adverse effects on renal function, an increased correlation with clostridium difficile and most recently, a deleterious impact on cognitive function. The purpose of this audit was to assess the appropriateness and clinical indication of PPI prescribing among patients attending Rapid Access Frailty Assessment Unit (RAFAU) in 2022.
Methods
A database of patients attending RAFAU in an Irish regional hospital was accessed. Records from years 2021-2022 were searched and documents citing patients’ medical history and clinical indication for prescribed medications included hospital discharge letters, outpatient clinic letters and GP referral letters. NICE guidelines from the UK NHS were used as comparison for prescribing guidelines.
Results
120 patients’ records were assessed. 63 (52.5%) patients were found to be prescribed a PPI among this cohort. Of those taking PPIs, only 15 (23.8%) patients were prescribed a PPI with a documented clinical indication in accordance with NICE Guidelines. Although several patients were taking gastro-erosive drugs including antiplatelets, anticoagulants and steroids, only one patient record mentioned PPIs being prescribed for iatrogenic gastritis. No records mentioned deprescribing or cessation of PPIs.
Conclusion
Most patients prescribed PPIs were without documented appropriate clinical indication and without clear duration of use. This is of particular importance among a frailty population where de-prescribing medications associated with significant co-morbidities should be prioritised.
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Affiliation(s)
- E McDonnell
- Midland Regional Hospital Tullamore , Tullamore, Ireland
| | - L Corcoran
- Midland Regional Hospital Tullamore , Tullamore, Ireland
| | - T Donnelly
- Midland Regional Hospital Tullamore , Tullamore, Ireland
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Courtney A, McDonnell E, Ng WL, Martin-Grace J, Tomkins M, Sherlock M, O'Connell P, Dunne H. Survey of Patient Knowledge and Awareness of "Sick Day Rules" in Rheumatology Patients on Long Term Glucocorticoid Therapy. Ir Med J 2022; 115:655. [PMID: 36306262] [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] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Aims Rheumatic disease (RMD) patients treated with long-term glucocorticoids (GC) are at risk of developing tertiary adrenal insufficiency. With this survey we aimed to assess the knowledge of RMD patients taking long-term glucocorticoid therapy regarding risk of adrenal insufficiency and understanding of the "steroid sick day rules". Methods RMD patients taking ≥2.5 mg prednisolone daily for ≥3 months were recruited from the Rheumatology outpatient department in Beaumont Hospital, Dublin. Patient knowledge and previous counselling of steroid sick day rules was determined using an 8-point questionnaire carried out face-to-face or via phone call. Results 51 RMD patients on GC therapy were recruited. 3/51 (5.9%) of patients reported that they had been counselled on the Sick Day Rules. 2/51 (3.9%) carried a steroid emergency card or MedicAlert bracelet. Few patients would increase their steroid dose appropriately in response to infection, vomiting or peri-procedure [14/51 (27.5%); 9/51 (17.7%) and 5/51 (7.2%), respectively]. Conclusion We demonstrate a significant deficit of patient knowledge around the precautions for long-term GC use in rheumatic diseases. We suspect that our results may be generalisable to many other RMD units. We are currently reviewing our procedures around healthcare professional and patient education, issuing of information leaflets, emergency cards or MedicAlert bracelets etc. to at risk patients.
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Affiliation(s)
- A Courtney
- Department of Endocrinology and Diabetes Mellitus, Beaumont Hospital/RCSI Medical School, Dublin
| | - E McDonnell
- Department of Rheumatology, Beaumont Hospital/RCSI Medical School, Dublin
| | - W L Ng
- Department of Rheumatology, Beaumont Hospital/RCSI Medical School, Dublin
| | - J Martin-Grace
- Department of Endocrinology and Diabetes Mellitus, Beaumont Hospital/RCSI Medical School, Dublin
| | - M Tomkins
- Department of Endocrinology and Diabetes Mellitus, Beaumont Hospital/RCSI Medical School, Dublin
| | - M Sherlock
- Department of Endocrinology and Diabetes Mellitus, Beaumont Hospital/RCSI Medical School, Dublin
| | - P O'Connell
- Department of Rheumatology, Beaumont Hospital/RCSI Medical School, Dublin
| | - H Dunne
- Department of Rheumatology, Beaumont Hospital/RCSI Medical School, Dublin
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Valenzano MC, Rybakovsky E, Chen V, Leroy K, Lander J, Richardson E, Yalamanchili S, McShane S, Mathew A, Mayilvaganan B, Connor L, Urbas R, Huntington W, Corcoran A, Trembeth S, McDonnell E, Wong P, Newman G, Mercogliano G, Zitin M, Etemad B, Thornton J, Daum G, Raines J, Kossenkov A, Fong LY, Mullin JM. Zinc Gluconate Induces Potentially Cancer Chemopreventive Activity in Barrett's Esophagus: A Phase 1 Pilot Study. Dig Dis Sci 2021; 66:1195-1211. [PMID: 32415564 PMCID: PMC7677901 DOI: 10.1007/s10620-020-06319-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 05/02/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Chemopreventive effects of zinc for esophageal cancer have been well documented in animal models. This prospective study explores if a similar, potentially chemopreventive action can be seen in Barrett's esophagus (BE) in humans. AIMS To determine if molecular evidence can be obtained potentially indicating zinc's chemopreventive action in Barrett's metaplasia. METHODS Patients with a prior BE diagnosis were placed on oral zinc gluconate (14 days of 26.4 mg zinc BID) or a sodium gluconate placebo, prior to their surveillance endoscopy procedure. Biopsies of Barrett's mucosa were then obtained for miRNA and mRNA microarrays, or protein analyses. RESULTS Zinc-induced mRNA changes were observed for a large number of transcripts. These included downregulation of transcripts encoding proinflammatory proteins (IL32, IL1β, IL15, IL7R, IL2R, IL15R, IL3R), upregulation of anti-inflammatory mediators (IL1RA), downregulation of transcripts mediating epithelial-to-mesenchymal transition (EMT) (LIF, MYB, LYN, MTA1, SRC, SNAIL1, and TWIST1), and upregulation of transcripts that oppose EMT (BMP7, MTSS1, TRIB3, GRHL1). miRNA arrays showed significant upregulation of seven miRs with tumor suppressor activity (-125b-5P, -132-3P, -548z, -551a, -504, -518, and -34a-5P). Of proteins analyzed by Western blot, increased expression of the pro-apoptotic protein, BAX, and the tight junctional protein, CLAUDIN-7, along with decreased expression of BCL-2 and VEGF-R2 were noteworthy. CONCLUSIONS When these mRNA, miRNA, and protein molecular data are considered collectively, a cancer chemopreventive action by zinc in Barrett's metaplasia may be possible for this precancerous esophageal tissue. These results and the extensive prior animal model studies argue for a future prospective clinical trial for this safe, easily-administered, and inexpensive micronutrient, that could determine if a chemopreventive action truly exists.
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Affiliation(s)
- M C Valenzano
- The Lankenau Institute for Medical Research, 100 Lancaster Avenue, Wynnewood, PA, 19096, USA
| | - E Rybakovsky
- The Lankenau Institute for Medical Research, 100 Lancaster Avenue, Wynnewood, PA, 19096, USA
| | - V Chen
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - K Leroy
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - J Lander
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - E Richardson
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - S Yalamanchili
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - S McShane
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - A Mathew
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - B Mayilvaganan
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - L Connor
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - R Urbas
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - W Huntington
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - A Corcoran
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - S Trembeth
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - E McDonnell
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - P Wong
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - G Newman
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - G Mercogliano
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - M Zitin
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - B Etemad
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - J Thornton
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA
| | - G Daum
- The Department of Pathology, Lankenau Medical Center, Wynnewood, USA
| | - J Raines
- The Lankenau Institute for Medical Research, 100 Lancaster Avenue, Wynnewood, PA, 19096, USA
| | | | - L Y Fong
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University, Philadelphia, PA, USA
| | - J M Mullin
- The Division of Gastroenterology, Lankenau Medical Center, Wynnewood, USA.
- The Lankenau Institute for Medical Research, 100 Lancaster Avenue, Wynnewood, PA, 19096, USA.
- Sidney Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA, USA.
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McDonnell E. Codeine Usage in Ireland- A Timely Discussion on an Imminent Epidemic. Ir Med J 2019; 112:899. [PMID: 31124348] [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: 06/09/2023]
Affiliation(s)
- E McDonnell
- Graduate Entry Medical School, University of Limerick
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Aguilar-Pontes MV, Brandl J, McDonnell E, Strasser K, Nguyen TTM, Riley R, Mondo S, Salamov A, Nybo JL, Vesth TC, Grigoriev IV, Andersen MR, Tsang A, de Vries RP. The gold-standard genome of Aspergillus niger NRRL 3 enables a detailed view of the diversity of sugar catabolism in fungi. Stud Mycol 2018; 91:61-78. [PMID: 30425417 PMCID: PMC6231085 DOI: 10.1016/j.simyco.2018.10.001] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
The fungal kingdom is too large to be discovered exclusively by classical genetics. The access to omics data opens a new opportunity to study the diversity within the fungal kingdom and how adaptation to new environments shapes fungal metabolism. Genomes are the foundation of modern science but their quality is crucial when analysing omics data. In this study, we demonstrate how one gold-standard genome can improve functional prediction across closely related species to be able to identify key enzymes, reactions and pathways with the focus on primary carbon metabolism. Based on this approach we identified alternative genes encoding various steps of the different sugar catabolic pathways, and as such provided leads for functional studies into this topic. We also revealed significant diversity with respect to genome content, although this did not always correlate to the ability of the species to use the corresponding sugar as a carbon source.
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Affiliation(s)
- M V Aguilar-Pontes
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands.,Fungal Molecular Physiology, Utrecht University, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands
| | - J Brandl
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Søltofts Plads 223, DK-2800, Kongens Lyngby, Denmark
| | - E McDonnell
- Centre for Structural and Functional Genomics, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada
| | - K Strasser
- Centre for Structural and Functional Genomics, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada
| | - T T M Nguyen
- Centre for Structural and Functional Genomics, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada
| | - R Riley
- US Department of Energy Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
| | - S Mondo
- US Department of Energy Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
| | - A Salamov
- US Department of Energy Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
| | - J L Nybo
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Søltofts Plads 223, DK-2800, Kongens Lyngby, Denmark
| | - T C Vesth
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Søltofts Plads 223, DK-2800, Kongens Lyngby, Denmark
| | - I V Grigoriev
- US Department of Energy Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
| | - M R Andersen
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Søltofts Plads 223, DK-2800, Kongens Lyngby, Denmark
| | - A Tsang
- Centre for Structural and Functional Genomics, Concordia University, 7141 Sherbrooke Street West, Montreal, QC, H4B 1R6, Canada
| | - R P de Vries
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands.,Fungal Molecular Physiology, Utrecht University, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands
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Mäkelä M, DiFalco M, McDonnell E, Nguyen T, Wiebenga A, Hildén K, Peng M, Grigoriev I, Tsang A, de Vries R. Genomic and exoproteomic diversity in plant biomass degradation approaches among Aspergilli. Stud Mycol 2018; 91:79-99. [PMID: 30487660 PMCID: PMC6249967 DOI: 10.1016/j.simyco.2018.09.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
We classified the genes encoding carbohydrate-active enzymes (CAZymes) in 17 sequenced genomes representing 16 evolutionarily diverse Aspergillus species. We performed a phylogenetic analysis of the encoding enzymes, along with experimentally characterized CAZymes, to assign molecular function to the Aspergilli CAZyme families and subfamilies. Genome content analysis revealed that the numbers of CAZy genes per CAZy family related to plant biomass degradation follow closely the taxonomic distance between the species. On the other hand, growth analysis showed almost no correlation between the number of CAZyme genes and the efficiency in polysaccharide utilization. The exception is A. clavatus where a reduced number of pectinolytic enzymes can be correlated with poor growth on pectin. To gain detailed information on the enzymes used by Aspergilli to breakdown complex biomass, we conducted exoproteome analysis by mass spectrometry. These results showed that Aspergilli produce many different enzymes mixtures in the presence of sugar beet pulp and wheat bran. Despite the diverse enzyme mixtures produced, species of section Nigri, A. aculeatus, A. nidulans and A. terreus, produce mixtures of enzymes with activities that are capable of digesting all the major polysaccharides in the available substrates, suggesting that they are capable of degrading all the polysaccharides present simultaneously. For the other Aspergilli, typically the enzymes produced are targeted to a subset of polysaccharides present, suggesting that they can digest only a subset of polysaccharides at a given time.
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Affiliation(s)
- M.R. Mäkelä
- Department of Microbiology, Faculty of Agriculture and Forestry, University of Helsinki, Viikinkaari 9, 00014, Helsinki, Finland
| | - M. DiFalco
- Centre for Structural and Functional Genomics, Concordia University, 7141 Sherbrooke Street West, Montréal, Québec, H4B1R6, Canada
| | - E. McDonnell
- Centre for Structural and Functional Genomics, Concordia University, 7141 Sherbrooke Street West, Montréal, Québec, H4B1R6, Canada
| | - T.T.M. Nguyen
- Centre for Structural and Functional Genomics, Concordia University, 7141 Sherbrooke Street West, Montréal, Québec, H4B1R6, Canada
| | - A. Wiebenga
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, the Netherlands
- Fungal Molecular Physiology, Utrecht University, Uppsalalaan 8, 3584 CT Utrecht, the Netherlands
| | - K. Hildén
- Department of Microbiology, Faculty of Agriculture and Forestry, University of Helsinki, Viikinkaari 9, 00014, Helsinki, Finland
| | - M. Peng
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, the Netherlands
- Fungal Molecular Physiology, Utrecht University, Uppsalalaan 8, 3584 CT Utrecht, the Netherlands
| | - I.V. Grigoriev
- US Department of Energy Joint Genome Institute, 2800 Mitchell Drive, Walnut Creek, CA, 94598, USA
- Department of Plant and Microbial Biology, University of California Berkeley, Berkeley, CA, 94598, USA
| | - A. Tsang
- Centre for Structural and Functional Genomics, Concordia University, 7141 Sherbrooke Street West, Montréal, Québec, H4B1R6, Canada
| | - R.P. de Vries
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, the Netherlands
- Fungal Molecular Physiology, Utrecht University, Uppsalalaan 8, 3584 CT Utrecht, the Netherlands
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Goemans N, Hauwe MV, Sajeev G, Yao Z, McDonnell E, Ward S, Signorovitch J. Validation of a prognostic score for changes in six-minute walk distance (6MWD) in patients with Duchenne muscular dystrophy (DMD). Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.494] [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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Mercuri E, Goemans N, Sajeev G, Yao Z, McDonnell E, Ward S, Signorovitch J. Consistency between natural history and clinical trial placebo arms for 48-week changes in six-minute walk distance (6MWD) in patients with Duchenne muscular dystrophy (DMD). Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.493] [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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McDonnell E, Lyons G, Chau S. Effects of storing blood in citrated silicone-coated glass tubes vs. citrated plastic tubes on thromboelastograph variables. Eur J Anaesthesiol 2007; 24:291-2. [PMID: 17087845 DOI: 10.1017/s0265021506001487] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2006] [Indexed: 11/06/2022]
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McDonnell E, Holohan M, Reilly MO, Warde L, Collins C, Geary M. Acceptability of routine enquiry regarding domestic violence in the antenatal clinic. Ir Med J 2006; 99:123-4. [PMID: 16972587] [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: 05/11/2023]
Abstract
Domestic Violence poses a significant health risk for the woman and her baby. We wished to determine the acceptability of routine questioning for domestic violence in the maternity hospital setting. A non-anonymised questionnaire was completed by 481 women attending for booking antenatal appointment in a maternity hospital antenatal clinic. The doctor asked four questions regarding experience of partner abuse, The acceptability of these questions was determined. 468 (99%) patients found the questions acceptable and said it would be helpful to ask all patients. Sixty-one (12.9%) women gave a history of at least one form of partner abuse. We concluded that routine enquiry about domestic violence during hospital antenatal visits is acceptable to women and perceived by them to be worthwhile.
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Affiliation(s)
- E McDonnell
- Medical Social Work Department, Rotunda Hospital, Dublin 1, Ireland.
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Ledikwe J, McDonnell E, Birkenshaw P, Probart C. School food service "Computer Exploration Kit". J Nutr Educ 2001; 33:171-2. [PMID: 11953234 DOI: 10.1016/s1499-4046(06)60188-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Abstract
OBJECTIVE Muscle imbalance and poor control of movement can have an impact on the daily occupational functioning of children with cerebral palsy. When one side of the body functions better than the other, children will often prefer to use the less-involved upper extremity for completion of play and self-care activities because they have learned that the other hand does not function as effectively. This study examined a method purported to overcome this learned nonuse of the affected upper extremity by directing the child's attention to this extremity and increasing his or her motivation to use it. The research hypothesis was that restriction of the less-involved hand with a resting splint would result in increased use of the more-involved hand in a child with spastic cerebral palsy. METHOD Initially, two children with cerebral palsy participated in this single-subject, ABA design study, but only one subject complied with the splint-wearing schedule and completed the study. This subject was a 2-year-old girl with greater involvement of the right side than the left. During the experimental phase, she wore a resting splint on her less-involved hand for most of the waking hours of the day to restrict its use. Data were collected over a 7-week period (2 weeks presplinting, 3 weeks splinting, 2 weeks postsplinting) and at a 6-month follow-up. Use of the more-involved extremity was measured through analysis of her performance during 15-min videotaped sessions of free play, administration of items from the Peabody Developmental Fine Motor Scales, and completion of a daily finger-feeding task. RESULTS An improvement in quality, quantity, and variety of use of the more-involved extremity after splinting, with some continuing improvement evident at follow-up, was found. The subject had increased voluntary control of her more-involved arm and hand and used them more spontaneously for completion of daily occupations. CONCLUSIONS Although the results of this single-case design are encouraging, further research with a randomized, controlled design is necessary to determine the effectiveness of the forced-use technique with a larger population.
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Abstract
Operating department nursing practice involves a diversity of skills in conjunction with a specialist and multidisciplinary knowledge base. This article explores the emergence of minimal access surgery (MAS) and what occurs during the perioperative period. The authors argue that perioperative care of the MAS patient requires not only technical competence but also a high order of interpersonal skill allied to specialist nursing knowledge.
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Abstract
The Food Guide Pyramid represents changes and challenges for nutrition educators. Nutrition educators will have to change the focus, content, and teaching expectations for lessons. Use of the Pyramid will also require changes in the way the concepts of good nutrition are related to different audiences. In contrast to previous food guides, which represented a foundation diet, the Food Guide Pyramid represents the total diet, addressing overnutrition as well as undernutrition. The Food Guide Pyramid is a graphic representation of the Dietary Guidelines for Americans, and illustrates the key concepts of variety, moderation, and proportionality. For practitioners, one challenge is to find ways to effectively use the Food Guide Pyramid to teach clients how to put the Dietary Guidelines into action. Another challenge involves designing materials that adapt the messages of the Food Guide Pyramid to a variety of audiences. Teaching materials and instructions should emphasize the key concepts of the Food Guide Pyramid and should be clear, consistent, motivational, and culturally sensitive. Few educational materials are available to help practitioners with these challenges. In this article we outline the key changes that the Food Guide Pyramid embodies, and provide ideas and suggestions for using the Pyramid in a practice setting.
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Affiliation(s)
- C Achterberg
- Penn State Nutrition Center, Pennsylvania State University, University Park 16802
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McDonnell E. Are we meeting their needs. Br J Theatre Nurs 1992; 2:S7-12. [PMID: 1627848] [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: 12/27/2022]
Abstract
The aim of this pilot study is to discover the student nurses' learning needs and perceptions during their operating department allocation and whether we are meeting those needs. Also, what influence their perceptions have had upon selecting perioperative nursing as a career. The study focuses upon semi-structured interviews with student nurses and their accounts of their experiences of being learners in the operating department. During their allocation, students are able to view surgery and to assist in the recovery of patients and to understand what a surgical patient experiences. They are exposed to the roles and responsibilities of operating department nurses. However, little is known about how students perceive these experiences. In this study two groups of students from the same year were interviewed to determine their perceptions and needs during the allocation and whether their learning needs had been met.
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Abstract
In brief: Ten recreational runners and squash players were monitored with telemetry to determine their heart rate response to the two activities. The authors found that even though squash is a discontinuous exercise, the mean heart rate intensity in the squash sessions was very similar to the mean heart rate intensity while running. Therefore, health professionals can indicate that squash play with a partner of equal ability and fitness level has aerobic benefits similar to running.
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Abstract
The present study reports the results of using the biopsy technique with members of the Canadian Wheelchair Internation Team. The results demonstrate that these athletes possess muscles with large fibre areas than seen in Olympic athletes.
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Akin JT, McDonnell E. Georgia hospital enthusiastic about its same-day center. Same Day Surg 1978; 2:4-6. [PMID: 10305737] [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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McDonnell E. Intra-Uterine Fractures. Atlanta Med Surg J 1860; 5:536-538. [PMID: 35824651 PMCID: PMC8843665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/30/2022]
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