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Beck E, Bleecker ER, Buhl R, FitzGerald M, Meltzer E, de la Hoz A, Sigmund R, Kerstjens HAM. Efficacy of once-daily tiotropium Respimat® in adults with asthma based on GINA steps 2 – 5. Pneumologie 2018. [DOI: 10.1055/s-0037-1619202] [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: 10/28/2022]
Affiliation(s)
- E Beck
- IFG Institut für Gesundheitsförderung, Rüdersdorf
| | - ER Bleecker
- Center for Genomics and Personalised Medicine Research Pulmonary, Critical Care, Allergy and Immunologic Medicine, Wake Forest School of Medicine, Winston Salem, USA
| | - R Buhl
- University Hospital Mainz
| | - M FitzGerald
- Centre for Heart and Lung Health, Vancouver, Canada
| | - E Meltzer
- Allergy & Asthma Medical Group & Research Center, San Diego, USA
| | - A de la Hoz
- Boehringer Ingelheim Pharma GmbH & Co KG, Biberach
| | - R Sigmund
- Boehringer Ingelheim Pharma GmbH & Co KG, Biberach
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2
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Kingston M, Radcliffe K, Daniels D, FitzGerald M, Lazaro N, McCarthy G, Sullivan A. British Association for Sexual Health and HIV: framework for guideline development and assessment. Int J STD AIDS 2010; 21:453-6. [PMID: 20852192 DOI: 10.1258/ijsa.2010.010162] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This article has been prepared by the Clinical Effectiveness Group (CEG) of the British Association for Sexual Health and HIV (BASHH) to specify the methodology BASHH requires for guideline development and the process of guideline evaluation by the CEG. This replaces the specifications for the development of UK guidelines on the management of sexually transmitted infections and closely related conditions previously published in this journal in 2004 and updated in 2005.
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Affiliation(s)
- M Kingston
- Manchester Centre for Sexual Health, The Hathersage Centre, Manchester
| | | | - D Daniels
- Sexual Health Clinic, West Middlesex University Hospitals NHS Trust, Isleworth
| | | | | | - G McCarthy
- Wolverton Centre for Sexual Health, Kingston Hospital NHS Trust, Kingston Upon Thames
| | - A Sullivan
- John Hunter Clinic, Chelsea and Westminster Healthcare NHS Trust, London, UK
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3
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Challenor R, FitzGerald M, Warwick Z. Developing quality indicators for sexually transmitted infection services with patient and public involvement. Int J STD AIDS 2010; 21:329-31. [DOI: 10.1258/ijsa.2009.009320] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The views of genitourinary (GU) medicine clinic populations in two locations (university teaching hospital and district general hospital) were sought regarding service quality measures. In Plymouth, patients were invited to participate in a qualitative interview. Twenty GU medicine patients (10 men, 10 women; age range 17–63 years) were interviewed and consistent themes emerged. In Taunton, patients were invited to complete a quantitative survey. Twenty patients (10 men, 10 women; age range 17–48 years) were asked to rank the importance of suggested quality measures. The qualitative and quantitative approaches produced different results but were complementary. Service quality indicators were finalized at a multidisciplinary team meeting with three public members. Quality indicators need to be challenging yet achievable and it is difficult to judge precisely where standards should be set. We hope other services may wish audit performance against these proposed local measures. If such data were to be pooled, it would provide valuable evidence for ‘SMART’ (Specific, Measurable, Attainable, Relevant, Time-based) service quality indicators that are challenging yet achievable for the majority of clinics. This paper demonstrates that it is possible to obtain GU medicine patient views despite problems with confidentiality and ‘one-stop’ clinic visits.
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Affiliation(s)
- R Challenor
- GUM Department, Derriford Hospital, Plymouth PL6 8DH
| | - M FitzGerald
- GUM Department, Musgrove Park Hospital, Taunton, UK
| | - Z Warwick
- GUM Department, Musgrove Park Hospital, Taunton, UK
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4
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Vrbova L, Stephen C, Kasman N, Boehnke R, Doyle-Waters M, Chablitt-Clark A, Gibson B, FitzGerald M, Patrick DM. Systematic review of surveillance systems for emerging zoonoses. Transbound Emerg Dis 2010; 57:154-61. [PMID: 20202176 DOI: 10.1111/j.1865-1682.2010.01100.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Evaluations of emerging zoonoses surveillance systems are rarely found in the published literature, making it difficult for decision-makers to choose the best surveillance initiatives.
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Affiliation(s)
- L Vrbova
- School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada.
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Abstract
These two papers discuss whether gonorrhoea screening of asymptomatic heterosexual men with no contact history should continue in UK genitourinary medicine clinics. Currently, most clinics routinely test all attenders. This requires an estimated 330,000 tests annually to detect 915 positives (1 in 361). The benefits to these patients are uncertain but the costs are huge and could fund currently unprovided services such as oral contraceptive provision or HIV testing before terminations of pregnancy. However stopping testing would deny individuals the reassurance they seek, prevent early detection of outbreaks and fail to detect carriers who go on to cause morbidity in their partners. On this view, the availability of non-invasive tests should be used to widen screening.
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Affiliation(s)
- R Pittrof
- Department of Reproductive & Sexual Health, Enfield Primary Care Trust, Enfield, UK
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6
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Rooney G, Daniels D, FitzGerald M, Ahmed-Jushuf I, Radcliffe K, Welch J. Specifications for the development of guidelines on the management of sexually transmitted infections and closely related conditions. Int J STD AIDS 2004; 15:299-305. [PMID: 15117496 DOI: 10.1177/095646240401500504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- G Rooney
- Clinical Effectiveness Group, British Association of Sexual Health and HIV, UK.
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Rooney G, Cluzeau FA, Daniels D, FitzGerald M, Ahmed-Jushuf I, Radcliffe K, Welch J. Getting the guidance right: optimizing the quality of the UK national guidelines on sexually transmitted infections and closely related conditions. Int J STD AIDS 2004; 15:297-8. [PMID: 15117495 DOI: 10.1177/095646240401500503] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- G Rooney
- Clinical Effectiveness Group of the British Association of Sexual Health and HIV, London, UK.
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Rooney G, Cluzeau FA, Daniels D, FitzGerald M, Ahmed-Jushuf I, Radcliffe K, Welch J. Getting the guidance right: optimizing the quality of the UK national guidelines on sexually transmitted infections and closely related conditions. Int J STD AIDS 2004. [DOI: 10.1258/095646204323012742] [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: 11/18/2022]
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9
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Rooney G, Daniels D, FitzGerald M, Ahmed-Jushuf I, Radcliffe K, Welch J. Specifications for the development of guidelines on the management of sexually transmitted infections and closely related conditions. Int J STD AIDS 2004. [DOI: 10.1258/095646204323012751] [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: 11/18/2022]
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Affiliation(s)
- M FitzGerald
- Centre for Clinical Epidemiology and Evaluation, Vancouver General Hospital, Vancouver, BC, Canada V5Z 1L8.
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Abstract
This paper concentrates on the specific impact that living in rural Australia has on the experience of chronic illness, and draws on data collected in a larger phenomenological study. Eighteen rural Australians in New South Wales described their experiences and referred particularly to issues that related to their rural context. A secondary analysis of the data revealed three sub-themes related to the concept of rural, choice of doctor, travelling and life style. The shortfalls in service identified by these participants deserves further investigation and could become fertile ground for an expanded nursing service.
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Affiliation(s)
- M FitzGerald
- Faculty of Nursing, University of Newcastle, Callaghan, New South Wales, Australia.
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12
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Pearson A, FitzGerald M. A survey of nurses' views on indicators for continuing competence in nursing. AUST J ADV NURS 2001; 19:20-6. [PMID: 11876348] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
The study, commissioned by the Australian Nursing Council Inc. (ANCI), sought to develop an approach to the maintenance of continuing competence in nursing broadly acceptable to nurses in all States and Territories and included the conduct of a postal survey of registered nurses (RNs) throughout Australia. An options booklet and accompanying questionnaire were posted to a random sample of 2 % of RNs from all Sates and the Northern Territory in Australia. The sample consisted of 4,133 RNs and 1,005 completed questionnaires were returned representing a 24.3% response rate. Data were analysed using SPSSX. The results suggest that respondents most favoured the introduction of a signed declaration of competence for all nurses seeking annual relicensing and the conduct of random competency audits by nursing regulatory authorities.
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Affiliation(s)
- A Pearson
- La Trobe University, Melbourne, Australia
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Yang W, Shen J, Wu M, Arsura M, FitzGerald M, Suldan Z, Kim DW, Hofmann CS, Pianetti S, Romieu-Mourez R, Freedman LP, Sonenshein GE. Repression of transcription of the p27(Kip1) cyclin-dependent kinase inhibitor gene by c-Myc. Oncogene 2001; 20:1688-702. [PMID: 11313917 DOI: 10.1038/sj.onc.1204245] [Citation(s) in RCA: 211] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2000] [Revised: 01/04/2001] [Accepted: 01/09/2001] [Indexed: 11/09/2022]
Abstract
Upon engagement of the B Cell Receptor (BCR) of WEHI 231 immature B cells, a drop in c-Myc expression is followed by activation of the cyclin-dependent kinase inhibitor (CKI) p27(Kip1), which induces growth arrest and apoptosis. Here, we report inverse patterns of p27 and c-Myc protein expression follow BCR engagement. We present evidence demonstrating, for the first time, that the p27(Kip1) gene is a target of transcriptional repression by c-Myc. Specifically, the changes in p27 protein levels correlated with changes in p27 mRNA levels, and gene transcription. Induction of p27 promoter activity followed BCR engagement of WEHI 231 cells, and this induction could be repressed upon co-transfection of a c-Myc expression vector. Inhibition of the TATA-less p27 promoter by c-Myc was also observed in Jurkat T cells, vascular smooth muscle, and Hs578T breast cancer cells, extending the observation beyond immune cells. Consistent with a putative Inr element CCAGACC (where +1 is underlined) at the start site of transcription in the p27 promoter, deletion of Myc homology box II reduced the extent of repression. Furthermore, enhanced repression was observed upon transfection of the c-Myc 'super-repressor', with mutation of Phe115 to Leu. The sequences mediating transcriptional activity and c-Myc repression were mapped to bp -20 to +20 of the p27 gene. Finally, binding of Max was shown to facilitate c-Myc binding and repression of p27 promoter activity. Overall, these studies identify the p27 CKI gene as a new target whereby c-Myc can control cell proliferation, survival and neoplastic transformation.
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Affiliation(s)
- W Yang
- Department of Biochemistry, Boston University Medical School, Boston, Maryland, MA 02118, USA
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Farzad E, Holton D, Long R, FitzGerald M, Laszlo A, Njoo H, Fanning A, Hershfield E, Hoeppner V, Allen E. Drug resistance study of Mycobacterium tuberculosis in Canada, February 1, 1993 to January 31, 1994. Can J Public Health 2000; 91:366-70. [PMID: 11089291 PMCID: PMC6980084] [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: 02/18/2023]
Abstract
OBJECTIVE To estimate the prevalence of resistance of Mycobacterium tuberculosis to first-line antituberculosis drugs in Canada. METHODS M. tuberculosis isolates from one third of all culture-positive tuberculosis (TB) cases diagnosed between February 1, 1993 to January 31, 1994 in Canada were collected prospectively. Proportion of drug-resistant isolates and the factors related to drug resistance were measured. RESULTS Of 458 study cases, 40 (8.7%) had resistance to at least one first-line antituberculosis drug, of which 5.9% had mono-resistance, 0.7% had multidrug-resistance(MDR-TB)--i.e., resistance to at least isoniazid and rifampin--and 2.2% had other patterns. The overall prevalence of resistance among the foreign-born cases was 10.6% with the highest level among those who resided in Canada for less than four years (15.5%). CONCLUSIONS Canada has a relatively low prevalence of antituberculosis drug resistance and a very low prevalence of MDR-TB. Some new immigrants to Canada may be at higher risk for drug resistance and their initial treatment needs to be tailored accordingly.
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Affiliation(s)
- E Farzad
- Division of Blood Borne Pathogens, LCDC, Ottawa.
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Abstract
Technological advances in health care have made it possible to restore and prolong life for patients who would have died in the past. Unfortunately, one consequence of this is that some patients linger in intensive care units (ICUs), dependent on the technologies but with no hope of recovery. Therefore, decisions regarding withdrawal of life-support treatment are increasingly being faced by the health-care team. This study aimed to explore the lived experience of critical care nurses who had cared for patients during withdrawal of life-support. The methodology employed was interpretive phenomenology. Interviews were conducted with seven critical care nurses, with the meanings of the experience of withdrawal of life-support treatment for these nurses extrapolated from the narratives and clustered into themes. The study highlighted the importance of honest communication during the processes of decision-making and withdrawal of treatment. It was important for these nurses to be sure that family members were well-informed regarding the process of withdrawal of life-support treatment and that they could provide support and ensure that the patient's comfort and dignity were maintained during the process. The need to debrief after the event became evident but formal debriefing processes were rarely undertaken.
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Affiliation(s)
- T Jones
- Department of Clinical Nursing, University of Adelaide/Royal Adelaide Hospital, South Australia
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Abstract
That nurses should base their practice on the best available knowledge is generally accepted by the profession. However, the operationalisation of this ideal if difficult for hard pressed clinicians. We believe that responsibility for assimilating current knowledge in a practical format belongs to all nurses working in an organisation. This paper describes a project where clinicians, administrators and academics have collaborated to rewrite standards of practice in a format that includes up to date evidence and practical measures for appraising outcomes. This work is a practical example of quality assurance activities serving to create opportunities for collaboration between nurses who have chosen to practice, teach, manage and/or research nursing.
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Affiliation(s)
- M FitzGerald
- Department of Clinical Nursing, University of Adelaide, Australia
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Affiliation(s)
- M FitzGerald
- Department of Psychiatry, New York State Psychiatric Institute, College of Physicians and Surgeons of Columbia University, New York, New York 10032, USA
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FitzGerald M, Malone KM, Li S, Harrison WM, McBride PA, Endicott J, Cooper T, Mann JJ. Blunted serotonin response to fenfluramine challenge in premenstrual dysphoric disorder. Am J Psychiatry 1997; 154:556-8. [PMID: 9090347 DOI: 10.1176/ajp.154.4.556] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE Indirect evidence suggests that abnormalities in serotonergic function may be involved in the pathogenesis of premenstrual dysphoric disorder. The goal of this study was to test the hypothesis of serotonergic deficiency in premenstrual dysphoric disorder by measuring the prolactin response to fenfluramine. METHOD The authors administered the serotonin-releasing drug dl-fenfluramine in a placebo-controlled protocol to nine women with premenstrual dysphoric disorder and 11 healthy female volunteers in the luteal phase of the menstrual cycle. RESULTS Compared to the normal subjects, the women with premenstrual dysphoric disorder had a significantly blunted prolactin response to fenfluramine. CONCLUSIONS Premenstrual dysphoric disorder appears to be associated with serotonergic deficiency.
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Affiliation(s)
- M FitzGerald
- Department of Psychiatry, College of Physicians and Surgeons, Columbia University, USA.
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21
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Ishioka C, Suzuki T, FitzGerald M, Krainer M, Shimodaira H, Shimada A, Nomizu T, Isselbacher KJ, Haber D, Kanamaru R. Detection of heterozygous truncating mutations in the BRCA1 and APC genes by using a rapid screening assay in yeast. Proc Natl Acad Sci U S A 1997; 94:2449-53. [PMID: 9122215 PMCID: PMC20108 DOI: 10.1073/pnas.94.6.2449] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
The detection of inactivating mutations in tumor suppressor genes is critical to their characterization, as well as to the development of diagnostic testing. Most approaches for mutational screening of germ-line specimens are complicated by the fact that mutations are heterozygous and that missense mutations are difficult to interpret in the absence of information about protein function. We describe a novel method using Saccharomyces cerevisiae for detecting protein-truncating mutations in any gene of interest. The PCR-amplified coding sequence is inserted by homologous recombination into a yeast URA3 fusion protein, and transformants are assayed for growth in the absence of uracil. The high efficiency of homologous recombination in yeast ensures that both alleles are represented among transformants and achieves separation of alleles, which facilitates subsequent nucleotide sequencing of the mutated transcript. The specificity of translational initiation of the URA3 gene leads to minimal enzymatic activity in transformants harboring an inserted stop codon, and hence to reliable distinction between specimens with wild-type alleles and those with a heterozygous truncating mutation. This yeast-based stop codon assay accurately detects heterozygous truncating mutations in the BRCA1 gene in patients with early onset of breast cancer and in the APC gene in patients with familial adenomatous polyposis. This approach offers a rapid and reliable method for genetic diagnosis in individuals at high risk for germ-line mutations in cancer susceptibility genes.
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Affiliation(s)
- C Ishioka
- Department of Clinical Oncology, Institute of Development, Aging and Cancer, Tohoku University, Aoba-ku, Sendai, Japan.
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FitzGerald M. Nursing and researching. Int J Nurs Pract 1997; 3:53-6. [PMID: 9274217] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
An example from an interpretive phenomenological study of the experience of chronic illness in rural Australia is used to describe aspects of the nursing researcher relationship with study participants and to draw some comparisons between this relationship and the nurse and client relationship. Nurses are bound to serve their clients; however, the researcher's principal purpose is to come to know and understand. These different principal purposes do not necessarily mean that the two relationships are completely different processes. There is a case for making the most of some overlapping skills and to see the results as positive 'by-products'. The question as to whether, or to what extent it is possible for the researcher to help participants intentionally is an issue worthy of discussion.
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Affiliation(s)
- M FitzGerald
- Department of Nursing, University of Adelaide, Australia
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Affiliation(s)
- M FitzGerald
- National Audit Development Project in Sexual Health, Taunton and Somerset Hospital, Musgrove Park, UK. Royal College of Physicians, National Audit Development Programme in Sexual Health
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FitzGerald M, Thirlby D, Bell G, Bedford C. National standards for contact tracing in gonorrhoea. Royal College of Physicians, National Audit Development Programme in Sexual Health. Int J STD AIDS 1996; 7:301. [PMID: 8876367 DOI: 10.1258/0956462961917870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- M FitzGerald
- National Audit Development Project in Sexual Health, Taunton, UK
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Abstract
Patti Lather writes of the convincing critique of traditional science that has amassed in the past 2 decades. The displacement of the assumptions of traditional science makes space for some interesting and exciting developments in the human sciences. However this theoretical rearrangement is not matched in practical spheres. While Lather is referring to education research I would include nursing when she writes, '...positivism retains its hegemony over practice'. There is ample evidence of the effects of this domination in nursing. Nurses work closely with the medical profession, which is still predominantly influenced by 'scientific' research, and health administrators who are in organizations which are bureaucratic and preoccupied with rationally. Medical practitioners control research ethics committees and funding bodies, which have relatively few nursing representatives and continue to judge proposals for qualitative projects by applying standard 'scientific' criteria. The administrators control budgetary matters and impose standards in the organizations. The dominance of traditional science needs to be challenged if nurses wish to make a place for different ways of knowing in their practice.
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Affiliation(s)
- M FitzGerald
- School of Health, University of New England, Armidale, New South Wales, Australia
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FitzGerald M. Physical assessment skills--use them. Contemp Nurse 1995; 4:97-9. [PMID: 8696038 DOI: 10.1080/10376178.1995.11001525] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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Altamirano M, Marostenmaki J, Wong A, FitzGerald M, Black WA, Smith JA. Mutations in the catalase-peroxidase gene from isoniazid-resistant Mycobacterium tuberculosis isolates. J Infect Dis 1994; 169:1162-5. [PMID: 8169415 DOI: 10.1093/infdis/169.5.1162] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Isoniazid resistance in Mycobacterium tuberculosis has been associated with total deletion of the katG gene, which codes for catalase-peroxidase production. To determine whether this is a common mechanism of drug resistance, 9 isolates of isoniazid-resistant and 1 of isoniazid-sensitive M. tuberculosis were analyzed by polymerase chain reaction amplification of a 237-bp sequence of the katG gene. Amplification was observed in the isoniazid-sensitive isolate and in 8 resistant isolates; in only 1 isoniazid-resistant isolate was there no amplification of the expected band, suggesting gene deletion. DNA sequencing showed that 8 of the 9 isolates had point mutations, deletions, or insertions of 1-3 bases. Evidence corroborating the presence of mutations in the katG gene was obtained by single-strand conformation polymorphism analysis in these 8 isolates. Thus, mutations as well as insertions and deletions in the katG gene can account for inactive catalase peroxidase, leading to isoniazid resistance; gene deletion occurs only infrequently, in approximately 11% of cases.
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Affiliation(s)
- M Altamirano
- Department of Pathology, University of British Columbia, Vancouver, Canada
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28
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Shen RN, Band B, Bingham JS, FitzGerald M, Johnson A, Pattman RS, Brown P, Barlow D. Genitourinary medicine and the Read Codes Clinical Terms Project--a medical language for the future. Genitourinary Medicine Specialty Working Group (GUM SWG). Int J STD AIDS 1994; 5:90-2. [PMID: 8031924 DOI: 10.1177/095646249400500202] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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McCombie WR, Martin-Gallardo A, Gocayne JD, FitzGerald M, Dubnick M, Kelley JM, Castilla L, Liu LI, Wallace S, Trapp S. Expressed genes, Alu repeats and polymorphisms in cosmids sequenced from chromosome 4p16.3. Nat Genet 1992; 1:348-53. [PMID: 1338771 DOI: 10.1038/ng0892-348] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.2] [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: 12/26/2022]
Abstract
The sequences of three cosmids (90 kilobases) from the Huntington's disease region in chromosome 4p16.3 have been determined. A 30,837 base overlap of DNA sequenced from two individuals was found to contain 72 DNA sequence polymorphisms, an average of 2.3 polymorphisms per kilobase (kb). The assembled 58 kb contig contains 62 Alu repeats, and eleven predicted exons representing at least three expressed genes that encode previously unidentified proteins. Each of these genes is associated with a CpG island. The structure of one of the new genes, hda1-1, has been determined by characterizing cDNAs from a placental library. This gene is expressed in a variety of tissues and may encode a novel housekeeping gene.
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Affiliation(s)
- W R McCombie
- Section of Receptor Biochemistry and Molecular Biology, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland 20892
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Abstract
Cystic fibrosis (CF) is the commonest, fatal, autosomal recessive disorder and is associated with lung sepsis, pancreatic failure and elevated sweat electrolytes. The CF gene on chromosome 7 encodes a protein identified as CF transmembrane conductance regulator (CFTR) which regulates chloride ion transport in epithelial cell membranes. Almost 100 mutations have been identified in this gene which cause defective chloride-channel control. Recently, this abnormality has been reversed in affected CF cells in vitro by retrovirus-mediated transfer of a normal gene. Fifty years ago, most cases died in childhood, but now up to 80% reach adulthood. Chronic lung sepsis is the principal cause of death, and intensive antibiotic therapy with chest physiotherapy is used to control this. Advanced lung disease can be successfully treated by heart-lung transplantation. Nebulised recombinant DNase and antineutrophil elastase agents such as alpha-1-antitrypsin and secretory leucoprotease inhibitor are potentially promising new therapies. Pancreatic insufficiency is managed by high-calorie diets and enteric coated enzyme supplements. Other prominent gastrointestinal complications include meconium ileus equivalent, biliary cirrhosis and cholelithiasis. Specially dedicated CF centres have led to improved survival rates and allow experienced staff to treat the many complications of CF while promoting research in this multisystem disorder.
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Affiliation(s)
- D Mulherin
- Adult Cystic Fibrosis Centre, University College Dublin, St. Vincent's Hospital, Ireland
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Mulherin D, Ward K, Coffey M, Keogan MT, FitzGerald M. Cystic fibrosis in adolescents and adults. Ir Med J 1991; 84:121-4. [PMID: 1817118] [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: 12/28/2022]
Abstract
A cystic fibrosis (CF) clinic for adults was established in 1977. We have reviewed the data on 164 patients who attended between 1977 and 1989. Twenty four patients had died, 11 being over 20 years of age at the time of death. Of the 140 patients still alive, 61% were male and 53% were aged over 20 years. Only 55% were diagnosed by one year and 88% by ten years. Almost all patients had respiratory symptoms and sputum culture yielded pseudomonas species in 69%. Other respiratory problems included major haemoptysis and pneumothorax, each in 10%. We found a wide range of respiratory impairment among older patients. Among 33 patients aged over 23 years, the mean (+/-S.D.) percent predicted FEV1 and FVC were 53.3% (+/- 18%) and 71.4 (+/- 20%) respectively. Mean weight in this group was 92.5% (+/- 14) of predicted. Malabsorption occurred in most patients and meconium ileus equivalent occurred in 34%. Other complications were clinical hepatomegaly (16%), diabetes mellitus (9%) and arthropathy (20%). Most patients were taking continuous antibiotics by mouth (89%) and by nebuliser (48%), beta-2 agonists by inhaler (57%) and oral steroids (29%). Almost all were taking multivitamins, pancreatic replacement therapy and multiple nutritional supplements. The number of CF "bed days" grew 12 fold since 1979 and the mean stay in hospital was double the hospital mean. The economic impact was such that over 1/4 of the annual hospital antibiotic budget was expended on CF patients.
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Affiliation(s)
- D Mulherin
- Adult Cystic Fibrosis Clinic, University College Dublin, St Vincent's Hospital, Elm Park
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FitzGerald M. Change in the ward. Making things happen. Nurs Times 1991; 87:24-7. [PMID: 1866278] [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: 12/29/2022]
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Abstract
The improved survival of cystic fibrosis (CF) patients is partly due to intensive treatment for their chronic infections. Treatment usually includes intravenous and nebulised aminoglycoside antibiotics and they receive a large cumulative dose of these antibiotics over their lifetime. There is little information in the literature on the prevalence of ototoxicity due to aminoglycoside in these patients. We performed pure tone audiometry on 43 CF patients aged 14-42 years. Seven (16%) had bilateral sensorineural hearing loss (SNHL) for high frequency sounds, consistent with aminoglycoside induced ototoxicity. However, only 2 of these patients had documented toxic serum levels in the past. The identification of bilateral SNHL in one in six adult CF patients is a cause for concern. It may be that the high cumulative dose of aminoglycosides received by these patients may be causing inner ear injury in the absence of specific episodes of toxic serum levels.
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Affiliation(s)
- D Mulherin
- Adult Cystic Fibrosis Centre, University College, Dublin, Ireland
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Maguire S, Moriarty P, Tempany E, FitzGerald M. Unusual clustering of allergic bronchopulmonary aspergillosis in children with cystic fibrosis. Pediatrics 1988; 82:835-9. [PMID: 3186372] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Allergic bronchopulmonary aspergillosis has been recognized in association with cystic fibrosis in children since 1965. Since then, however, there have been a paucity of reports of pediatric cystic fibrosis complicated by allergic bronchopulmonary aspergillosis, and, in most cases, these have been diagnosed retrospectively. A cluster of five acute cases seen during a 4-month period in a single cystic fibrosis center with a systemic illness and deterioration in respiratory status are described. In all five patients, reversible bronchoconstriction and infiltrative changes on x-ray films suggested the diagnosis. This was confirmed by the presence of (1) peripheral blood eosinophilia, (2) elevated total IgE and Aspergillus fumigatus-specific IgE, and (3) circulating serum precipitins against A fumigatus in all cases. All children tested had positive type 1 immediate hypersensitivity to skin tests for A fumigatus, in sputum eosinophilia, and Aspergillus cultured from sputum. Only three of five children were previously noted to be atopic and none had severe advanced suppurative lung disease. All children had previously received bronchodilator therapy and appropriate antibiotics. Following treatment with corticosteroids, acute symptoms and radiologic changes resolved for 1 to 5 months. To date, no children have had recurrence of their allergic bronchopulmonary aspergillosis while receiving alternate-day steroid treatment for 6 months.
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Affiliation(s)
- S Maguire
- Our Lady's Hospital for Sick Children, Crumlin, Dublin, Ireland
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Foley-Nolan D, Deegan R, Foley-Nolan A, Hone R, Barry C, Coughlan RJ, Quinlan W, Wong-Chung J, Doyle J, Mulpeter K, Quinn K, Casey E, Feighery C, Quinn C, Hassan J, Whelan A, Bresnihan B, Soden M, FitzGerald M, Gaine S, O’Laoide RM, Feeley J, McInerney DP, O’Brien M, Donohoe N, Comerford FR, Rooney M, O’Connor DP, Noones D, Weir D, Marron P, Keane C, McNicholl J, Glynes D, Hutchinson M, Murray A, Jackson J. Irish Association of Rheumatology and Rehabilitation Proceeding of Meeting held at St Vincent’s Hospital on Friday 30th October, 1987. Ir J Med Sci 1988. [DOI: 10.1007/bf02948318] [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: 10/21/2022]
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FitzGerald M. Tuberculosis: a continuing problem. Ir Med J 1987; 80:190-1. [PMID: 3429199] [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: 01/05/2023]
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Pembrey S, FitzGerald M. The ward sister. Developing the potential of sisters. Nurs Times 1987; 83:27. [PMID: 3646627] [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: 01/06/2023]
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FitzGerald M. Use of table-top projectors for histology classes. Med Biol Illus 1972; 22:100-2. [PMID: 5038498] [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: 01/13/2023]
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Fennelly JJ, Dunne J, McGeeney K, Chong L, FitzGerald M. The importance of varying molecular size, differential heat and urea inactivation of phosphatase in the identification of disease patterns. Ann N Y Acad Sci 1969; 166:794-810. [PMID: 5265245 DOI: 10.1111/j.1749-6632.1969.tb46435.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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Fennelly JJ, Dunne J, McGeeney K, Chong L, FitzGerald M. THE IMPORTANCE OF VARYING MOLECULAR SIZE, DIFFERENTIAL HEAT AND UREA INACTIVATION OF PHOSPHATASE IN THE IDENTIFICATION OF DISEASE PATTERNS. Ann N Y Acad Sci 1969. [DOI: 10.1111/j.1749-6632.1969.tb54317.x] [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: 11/28/2022]
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