1,074 research outputs found
Monoclonal antibodies raised against membrane glycoproteins from mouse brain recognize N-linked oligomannosidic glycans
Monoclonal L3 and L4 antibodies have been shown to recognize carbohydrate epitopes on several neural cell adhesion molecules; these epitopes can be released by treatment with endoglycosidase H. In the present study, we have identified the oligosaccharides released by endoglycosidase H from the cell adhesion molecules AMOG and L1 by fast-atom bombardment mass spectrometry as being solely of the oligomannosidic type. Using neoglycolipids of oligomannosidc glycans, we also report that both antibodies show the highest reactivity with the α-manno-pentaose Manα1-3-[Manα1-6(Manα1-3)Manα1-6]-Man, but decreasing reactivity with the α-manno-hexaose, heptaose, octaose and nonaose glycans. Thus, to our knowledge, we describe here for the first time monoclonal antibodies recognizing N-glycosidically linked oligomannosidic glycan
An evidence-based approach to the routine use of optical coherence tomography
Optical coherence tomography is an imaging technology that has revolutionised the detection, assessment and management of ocular disease. It is now a mainstream technology in clinical practice and is performed by non-specialised personnel in some settings. This article provides a clinical perspective on the implications of that movement and describes best practice using multimodal imaging and an evidence-based approach. Practical, illustrative guides on the interpretation of optical coherence tomography are provided for three major diseases of the ocular fundus, in which optical coherence tomography is often crucial to management: age-related macular degeneration, diabetic retinopathy and glaucoma. Topics discussed include: cross-sectional and longitudinal signs in ocular disease, so-called ‘red-green’ disease whereby clinicians rely on machine/statistical comparisons for diagnosis in managing treatment-naïve patients, and the utility of optical coherence tomography angiography and machine learning
Professional Identity Differences in Novice Counselors
Many researchers have found that differences exist in counselors\u27 professional identity (PI) associated with gender, learning opportunities, and specialty area. However, researchers have not focused on the impact of counselors\u27 type of education program (online vs traditional) to PI. The purpose of this study was to address this gap and determine if differences exist in PI across program types for novice counselors. The framework for this study was built around the concept of PI, defined as including knowledge, expertise, professional roles, attitudes, behaviors, and interactions. The research question was designed to examine the differences in PIs across traditional and online education settings. A convenience sample of 140 new graduate participants was obtained for this cross-sectional survey study-113 from traditional programs and 27 from online programs. PI of participants was measured using the Professional Identity Scale in Counseling (PISC) and data were analyzed using an analysis of covariance with the covariates of gender and specialty area. The results did not show a significant difference in PI between program types, however, the means of the PISC showed that the group of online graduates scored slightly higher. While not statistically significant, the findings of the study contribute to positive social change by showing that no differences exist across the PI development of novice counselors based on program type. Therefore, counselor educators can continue to practice in ways that foster the development of students based on their education program type. Counselor education that fosters the development of student PI contributes to the community as a whole by producing individuals who are competent and knowledgeable for professional practice
Stretch for the treatment and prevention of contractures (Review)
Background Contractures are a common complication of neurological and non-neurological conditions, and are characterised by a reduction in joint mobility. Stretch is widely used for the treatment and prevention of contractures. However, it is not clear whether stretch is effective. This review is an update of the original 2010 version of this review. Objectives The aim of this review was to determine the effects of stretch on contractures in people with, or at risk of developing, contractures.The outcomes of interest were joint mobility, quality of life, pain, activity limitations, participation restrictions, spasticity and adverse events. Search methods In November 2015 we searched CENTRAL, DARE, HTA; MEDLINE; Embase; CINAHL; SCI-EXPANDED; PEDro and trials registries. Selection criteria We included randomised controlled trials and controlled clinical trials of stretch applied for the purpose of treating or preventing contractures. Data collection and analysis Two review authors independently selected trials, extracted data, and assessed risk of bias. The outcomes of interest were joint mobility, quality of life, pain, activity limitations, participation restrictions and adverse events. We evaluated outcomes in the short term (up to one week after the last stretch) and in the long term (more than one week). We expressed effects as mean differences (MD) or standardised mean differences (SMD) with 95% confidence intervals (CI). We conducted meta-analyses with a random-effects model. We assessed the quality of the body of evidence for the main outcomes using GRADE.Main results Forty-nine studies with 2135 participants met the inclusion criteria. No study performed stretch for more than seven months. Just over half the studies (51%) were at low risk of selection bias; all studies were at risk of detection bias for self reported outcomes such as pain and at risk of performance bias due to difficulty of blinding the intervention. However, most studies were at low risk of detection bias for objective outcomes including range of motion, and the majority of studies were free from attrition and selective reporting biases. The effect of these biases were unlikely to be important, given that there was little benefit with treatment. There was high-quality evidence that stretch did not have clinically important short-term effects on joint mobility in people with neurological conditions (MD 2°; 95% CI 0° to 3°; 26 studies with 699 participants) or non-neurological conditions (SMD 0.2, 95% CI 0 to 0.3, 19 studies with 925 participants). In people with neurological conditions, it was uncertain whether stretch had clinically important short-term effects on pain (SMD 0.2; 95% CI -0.1 to 0.5; 5 studies with 174 participants) or activity limitations (SMD 0.2; 95% CI -0.1 to 0.5; 8 studies with 247 participants). No trials examined the short-term effects of stretch on quality of life or participation restrictions in people with neurological conditions. Five studies involving 145 participants reported eight adverse events including skin breakdown, bruising, blisters and pain but it was not possible to statistically analyse these data. In people with non-neurological conditions, there was high-quality evidence that stretch did not have clinically important short-term effects on pain (SMD-0.2, 95%CI -0.4 to 0.1; 7 studies with 422 participants) and moderate-quality evidence that stretch did not have clinically important short-term effects on quality of life (SMD 0.3, 95% CI -0.1 to 0.7; 2 studies with 97 participants). The short-term effect of stretch on activity limitations (SMD 0.1; 95% CI -0.2 to 0.3; 5 studies with 356 participants) and participation restrictions were uncertain (SMD -0.2; 95% CI -0.6 to 0.1; 2 studies with 192 participants). Nine studies involving 635 participants reported 41 adverse events including numbness, pain, Raynauds’ phenomenon, venous thrombosis, need for manipulation under anaesthesia, wound infections, haematoma, flexion deficits and swelling but it was not possible to statistically analyse these data. Authors’ conclusions There was high-quality evidence that stretch did not have clinically important effects on joint mobility in people with or without neurological conditions if performed for less than seven months. Sensitivity analyses indicate results were robust in studies at risk of selection and detection biases in comparison to studies at low risk of bias. Sub-group analyses also suggest the effect of stretch is consistent in people with different types of neurological or non-neurological conditions. The effects of stretch performed for periods longer than sevenmonths have not been investigated. There was moderate- and high-quality evidence that stretch did not have clinically important short-term effects on quality of life or pain in people with non-neurological conditions, respectively. The short-term effects of stretch on quality of life and pain in people with neurological conditions, and the short-term effects of stretch on activity limitations and participation restrictions for people with and without neurological conditions are uncertain
quality of life outcomes of prostate cancer patients after radiotherapy or radical prostatectomy in a cohort study
Background This study describes and compares health-related quality of life
(HRQOL) of prostate cancer patients who received either radical prostatectomy
(nerve-sparing, nsRP, or non-nerve-sparing, nnsRP) or radiotherapy (external
RT, brachytherapy, or both combined) for treatment of localised prostate
cancer. Methods The prospective, multicenter cohort study included 529
patients. Questionnaires included the IIEF, QLQ-C30, and PORPUS-P. Data were
collected before (baseline), three, six, twelve, and twenty-four months after
treatment. Differences between groups’ baseline characteristics were assessed;
changes over time were analysed with generalised estimating equations (GEE).
Missing values were treated with multiple imputation. Further, scores at
baseline and end of follow-up were compared to German reference data. Results
The typical time trend was a decrease of average HRQOL three months after
treatment followed by (partial) recovery. RP patients experienced considerable
impairment in sexual functioning. The covariate-adjusted GEE identified a
significant - but not clinically relevant - treatment effect for diarrhoea (b
= 7.0 for RT, p = 0.006) and PORPUS-P (b = 2.3 for nsRP, b = 2.2 for RT, p =
0.045) compared to the reference nnsRP. Most of the HRQOL scores were
comparable to German norm values. Conclusions Findings from previous research
were reproduced in a specific setting of a patient cohort in the German health
care system. According to the principle of evidence-based medicine, this
strengthens the messages regarding treatment in prostate cancer and its
impacts on patients’ health-related quality of life. After adjustment for
baseline HRQOL and other covariates, RT patients reported increased symptoms
of diarrhoea, and nnsRP patients decreased prostate-specific HRQOL. RP
patients experienced considerable impairment in sexual functioning. These
differences should be taken into account by physicians when choosing the best
therapy for a patient
Evaluation of the initial implementation of a nationwide diabetic retinopathy screening programme in primary care: A multimethod study
Objectives The Australian Government funded a nationwide diabetic retinopathy screening programme to improve visual outcomes for people with diabetes. This study examined the benefits and barriers of the programme, image interpretation pathways and assessed the characteristics of people who had their fundus photos graded by a telereading service which was available as a part of the programme. Design Multimethod: survey and retrospective review of referral forms. Setting Twenty-two primary healthcare facilities from urban, regional, rural and remote areas of Australia, and one telereading service operated by a referral-only eye clinic in metropolitan Sydney, Australia. Participants Twenty-seven primary healthcare workers out of 110 contacted completed a survey, and 145 patient referrals were reviewed. Results Manifest qualitative content analysis showed that primary healthcare workers reported that the benefits of the screening programme included improved patient outcomes and increased awareness and knowledge of diabetic retinopathy. Barriers related to staffing issues and limited referral pathways. Image grading was performed by a variety of primary healthcare workers, with one responder indicating the utilisation of a diabetic retinopathy reading service. Of the people with fundus photos graded by the reading service, 26.2% were reported to have diabetes. Overall, 12.3% of eyes were diagnosed with diabetic retinopathy. Photo quality was rated as excellent in 46.2% of photos. Referral to an optometrist for diabetic retinopathy was recommended in 4.1% of cases, and to an ophthalmologist in 6.9% of cases. Conclusions This nationwide diabetic retinopathy screening programme was perceived to increase access to diabetic retinopathy screening in regional, rural and remote areas of Australia. The telereading service has diagnosed diabetic retinopathy and other ocular pathologies in images it has received. Key barriers, such as access to ophthalmologists and optometrists, must be overcome to improve visual outcomes
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