Worldwide, the numbers of people living with chronic conditions are rapidly on the rise. Chronic illnesses are enduring and often cannot be cured, requiring a strategy for long term management and intervention to prevent further exacerbation. Globally, there has been an increase in interventions using telecommunications technologies to aid patients in their home setting to manage chronic illnesses. Such interventions have often been delivered by nurses. The purpose of this research was to assess whether a particular intervention that had been successfully implemented in the United Kingdom could also be implemented in Canterbury. In particular, this research assessed the perspectives of Canterbury based practice nurses and district nurses. The findings suggest that a majority of both district and practice nurses did not view the service as compatible with their current work situation. Existing workload and concerns over funding of the proposed service were identified as potential barriers. However, the service was perceived as potentially beneficial for some, with the elderly based in rural areas, or patients with chronic mental health needs identified as more likely to benefit than others. Practice nurses expressed strong views on who should deliver such services. Given that it was identified that practice nurses already have in-depth knowledge of their patients’ health, while valuing the strong relationships established with their communities, it was suggested that patients would most benefit from locally based nurses to deliver any community based health services in the future. It was also found that teletriaging is currently widely used by practice nurses across Canterbury to meet a range of health needs, including chronic mental health needs. This suggests that the scope of teletriaging in community health and its potential and full implications are currently not well understood in New Zealand. Significant events, such as the Christchurch earthquakes indicate the potential role of teletriaging in addressing mental health issues, thereby reducing the chronic health burden in the community.

Morphine is one of the most commonly prescribed medications for the relief of prolonged pain. Both basic science and clinical studies indicate that females require 2-3 times more morphine than males to achieve the same analgesic effect. To date, the mechanisms underlying sex differences in opiate responsiveness are unknown. Recent studies suggest that glial cells are potent modulators of morphine-based analgesia, and in particular, decrease the analgesic effect of opiates. Therefore, we tested the hypothesis that the sexually dimorphic effects of morphine were due to sex differences in glial cell activity. Our studies focused on the midbrain periaqueductal gray (PAG) as this region of the brain is critical for the analgesic effects of morphine. Adult male and female Sprague Dawley rats (250g- 400g) were procured from Charles River Laboratories, and were allowed 7 days to acclimate to the new facility. On the day of the experiment, animals received a subcutaneous injection of morphine (5mg/kg) or were handled in a similar manner. Thirty or 60 minutes after injections or handling, animals were perfused with a 4% paraformaldehyde and 2.5% acrolein tissue fixative solution. Brains were removed and stored in 20% sucrose until ready for sectioning. Brains were sectioned at 25mm using a freezing microtome, and immunohistochemical localization of markers for astrocyte glial cell activity was performed. Antibodies to glial fibrillary acidic protein (GFAP) were used to label activated astrocytes. If our hypothesis is correct, then females will have significantly greater density of the astrocyte cell activity marker GFAP as compared with males. Sex differences in PAG glial cell activity may provide the biological bases for the sexually dimorphic effect of morphine. This research may lead to better treatment for females experiencing prolonged chronic or neuropathic pain.

Johnston (1996) proposed that disability can be predicted by a model integrating biomedical and psychological variables; Johnston’s model has mainly been tested in chronic pain and most studies have found it to predict disability better than impairment alone. The first study replicated Dixon’s (2006) structural equation modelling study, which tested an updated variant of Johnston’s model with ICF constructs in orthopaedic patients on a waiting list for joint replacement surgery. The present study also extended these tests to post-surgery. Supportive results were found before surgery, as Dixon had also found, but also after surgery. However, few tests of the model at the within-person level had been conducted. Methodology of published experimental single-case studies targeting behaviour change was investigated in a large systematic review. Studies varied in quality and robustness of design, and few used statistical analyses. Johnston’s model was tested at the within-person level in a series of five correlational single-case studies; whether mood was predictive was also tested. Community participants with arthritis, chronic pain and activity limitations completed a daily dietary using a PDA of pain, activity level, mood and Johnston’s proposed variables, and wore an accelerometer to collect activity data. Differing from previous findings, pain (impairment) was not predictive, nor was self-efficiency, but motivational constructs (intention and goal-setting) did predict activity (limitations) in several cases. PBC predicted in the direction contrary to theory in two cases and was not predictive in the others. Mood was not predictive. Differences from previous findings suggest that the model may not predict the same way within individuals as between them, requiring further investigation.

Chronic renal failure (CRF) is associated with loss of lean body mass, a high incidence of malnutrition, and with insulin resistance. CRF is often complicated by metabolic acidosis. Metabolic acidosis is known to alter both protein and carbohydrate metabolism. A series of studies have been undertaken to investigate the effect of metabolic acidosis on protein metabolism in both normal and CRF human subjects, and to study whether metabolic acidosis in CRF affects insulin sensitivity. Protein turnover was studied using the technique of primed constant infusions of L-[1-¹³C]leucine. Normal subjects were studied before and after ammonium chloride induced metabolic acidosis. Acidosis was associated with increased protein turnover and amino acid oxidation. In CRF subjects, correction of acidosis with sodium bicarbonate decreased protein turnover and amino acid oxidation. The effect of acidosis in CRF on insulin mediated carbohydrate metabolism was studied using the technique of the hyperinsulinaemic euglycaemic clamp. Insulin sensitivity increased with correction of acidosis. By combining L-[1-¹³C]leucine infusions with hyperinsulinaemic euglycaemic clamps, the response of protein metabolism to hyperinsulinaemia was measured before and after correction of acidosis. The presence of acidosis did not impair the ability of insulin to modulate protein metabolism. There is therefore, dissociation between the effects of acidosis in CRF on insulin mediated carbohydrate metabolism and insulin mediated protein metabolism. In summary, metabolic acidosis increases protein catabolism in both normal and CRF man and may contribute to the loss of lean body mass characteristic of CRF. Insulin resistance in CRF improves with correction of acidosis. However the effects of acidosis on protein metabolism are not mediated via alterations in insulin sensitivity.

No description available.

No description available.

Alkylated polycyclic aromatic hydrocarbons (alkyl-PAHs) are major constituents of crude oil, and the 3-5 ringed alkyl-PAHs have been identified as the main components chronically toxic to fish. While chysene homologues have higher cytochrome P4501A (CYP1A) induction potencies than alkyl-phenanthrenes, there is little characterization of toxicity for 4-ringed alkyl PAHs. This study measured the chronic toxicity of chrysene, benz[α]anthracene, and some alkylated congeners to the embryos of Japanese medaka (Oryzias latipes) using the partition-controlled delivery method (PCD) of exposure. This exposure method relies on the partitioning of chemicals from polydimethylsiloxane (PDMS) films, loaded with various concentrations of test chemical, to embryo rearing solutions. The objectives of this thesis were: (1) to further characterize the PCD method with a series of 4-ringed PAHs; (2) to evaluate the effects of different chemical structures on the toxicity of test compounds; and (3) to extend structure toxicity relationships from alkyl-phenanthrenes. The PCD method generated a gradient of aqueous concentrations for test compounds, and these exposure concentrations were maintained constant for the 17-day period. Benz[α]anthracene showed higher toxicity than chrysene. Toxicity increased with the degree of alkylation on the ring structures, except that 2-methylbenz[α]anthracene was less toxic than the unsubstituted benz[α]anthracene. Substitutions at the middle region contributed to a higher toxicity than substitutions at the distal region. While actual mechanisms for these compounds to cause toxicity are unknown, the narcotic mode of action seems to be not involved due to the lack of mortality. Within the range of test concentrations, the chronic sublethal toxicity was limited by the low solubility of the test compounds. A structure toxicity relationship was illustrated by the regression between log EC50s and log Kow values. In addition to hydrophobicity represented by log Kow, structural dissimilarities between compounds and physical characteristics such as aqueous solubility limits should be taken into account in toxicity assessments with alkyl-PAHs. This research is the first toxicological assessment of alkyl-chrysenes and benz[α]anthracenes which is essential for a better understanding of structure toxicity relationships of alkyl-PAHs, and will contribute to more accurate ecological risk assessments of PAH contamination. / Thesis (Master, Biology) -- Queen's University, 2014-01-10 16:35:00.232

This thesis is submitted as a PhD by Portfolio of Publications. It represents an integrated examination of the BCR-ABL oncogene as a precise indicator of treatment response, drug resistance and relapse in patients with chronic myeloid leukaemia (CML). / Thesis (PhDBiomedicalScience)--University of South Australia, 2005.

Thesis (M.App.Sc. in Physiotherapy)--University of South Australia, 1996.

Diss. (sammanfattning) Stockholm : Karol. inst. / Härtill 6 uppsatser.