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Biomedical subjects

A Browne

Publications and source records attributed to A Browne.

At least 37 records · Page 2Linked to original sources
PubMed1996

Health, hygiene and maternal education: evidence from The Gambia.

The paper explores the ways in which women's education influences domestic hygiene practices and use of health care services in a traditional agricultural village in The Gambia. The "environment of health" is one of poverty, high morbidity and low levels of female literacy. A detailed household survey was undertaken in the rainy season when agricultural work is demanding of people's time and energy and morbidity rates are high. Mothers with and without formal education and with at least one child under 5 were included in the study. Small differences were found between the educated and uneducated group in the knowledge and practice of household hygiene. The healthcare services in the village were utilised by all women regardless of whether or not they had been to school, but educated mothers appeared to have a better understanding of health education messages. The case study illustrates the synergy between health, hygiene and maternal education and discusses the implications of the findings.

Adolescent↗
PubMed1995

Recovery characteristics following anaesthesia with sevoflurane or propofol in adults undergoing out-patient surgery.

The aim of the study was to compare recovery characteristics in adult patients following general anaesthesia either with the new investigational volatile agent sevoflurane or with propofol. Accordingly, two groups of 25 adults undergoing outpatient surgery were entered into a prospective, randomised study. Patients who received sevoflurane were extubated at an earlier stage than those receiving propofol (6.6 vs. 9.8 min), and the times to eye opening (7.2 vs. 12.6 min) and hand squeezing (8.2 vs 13.8 min) were also shorter. As measured by the digit-symbol substitution test, patients regained the pre-operative level of cognitive function significantly earlier after sevoflurane anaesthesia. Modified Aldrete scores were also higher in this group within the first hour after anaesthesia than in the propofol group. Sevoflurane appears to be a useful alternative to propofol in outpatient anaesthesia.

Adult↗
PubMed1995

Services for homeless pregnant women: lessons from the field.

Although a significant subset of homeless women are pregnant and at risk for adverse pregnancy outcomes, programmatic responses to their special needs are limited. Findings from the process evaluation of an innovative service demonstration program are explored, and recommendations for future service delivery efforts are offered.

Adult↗
PubMed1995

Bridging the professions: an integrated and interdisciplinary approach to teaching health care ethics.

In 1993, the authors introduced an interdisciplinary course in health care ethics at the University of British Columbia. They were motivated by two convictions: (1) an interdisciplinary approach to health care decision making is best; and (2) every significant health care decision has an ethical component. They wanted to encourage students from the various health care disciplines to participate in interdisciplinary decision making in their future practices by giving them an opportunity to study health care ethics together during their training. The authors give detailed descriptions of the objectives, format, curriculum, and evaluation of this innovative course in the hope that other educators who may want to develop similar courses can learn from their experience.

British Columbia↗
PubMed1994

Midazolam is metabolized by at least three different cytochrome P450 enzymes.

Distribution volumes and metabolism determine the pharmacokinetics of midazolam. Cytochrome P450 3A4 has been considered a significant enzyme in its metabolism. Using heterologously expressed cytochrome P450 enzymes, we have confirmed the additional involvement of cytochromes P450 3A3 and 3A5 in the hydroxylation of the midazolam. Whereas cytochrome P450 3A3 metabolized midazolam to the same extent as cytochrome P450 3A4, cytochrome P450 3A5 increased its metabolism by a factor of 2.7. The relationship of alpha- to 4-hydroxylation of midazolam was approximately 1.3 for cytochromes P450 3A3 and 3A4, and approximately 8.8 for 3A5. The primary location of cytochromes P450 3A3 and 3A4 is the liver in contrast with cytochrome P450 3A5, which occurs predominantly in the kidney. Therefore, further in vivo study is required to prove conclusively that enzymes in the kidney are involved in the metabolism of midazolam. Nitrendipine itself is metabolized by cytochrome P450 3A enzymes and this was shown to inhibit human liver microsomal hydroxylation of midazolam and preferentially alpha-hydroxylation by about 77%. 4-Hydroxylation was inhibited to 32% of control by nitrendipine. In contrast with inhibition of 4-hydroxylation, alpha-hydroxylation would appear to be competitively inhibited. These findings may be relevant to drug interactions in combined therapy.

Cytochrome P-450 CYP2E1↗
PubMed1993

ERCP in the management of patients having laparoscopic cholecystectomy: re-appraising current indications.

This study assessed the ability of biochemical tests and ultrasound to predict the presence of ductal calculi, and thereby refine the indications for ERCP, in patients before or after laparoscopic cholecystectomy. Thirteen of fifty-three patients investigated before laparoscopic cholecystectomy, and four of seventeen investigated after had stones confirmed at ERCP. The most sensitive indices for stones were raised serum alkaline phosphatase (0.76), aspartate transferase (0.75) and alanine transferase (0.76). The most specific indices were an abnormal ultrasound (0.92), raised serum amylase (0.78) and raised bilirubin (0.75). Serum bilirubin, amylase and ultrasound were all normal in twenty-seven patients and all of these had normal ERCPs. If patients with normal bilirubin, amylase and ultrasound were not referred for ERCP, no stones would have been overlooked and the number of ERCPs could have been reduced by 39%.

Adolescent↗
PubMed1993

Violence against women by male partners. Prevalence, outcomes, and policy implications.

Violence against women has only recently been addressed in national policy and legislation. Responses by most societal institutions to women assaulted by male partners are still based primarily on a lack of knowledge about the prevalence, severity, and outcomes of violence perpetrated by men against female intimates. Although well suited to make a vital contribution, psychologists still rarely involve themselves in proactive interventions with women victims. This article reviews empirical literature on the physical and sexual assault of women by their male intimates and discusses potential physical and psychological outcomes, with a focus on linking what is known about abused women's reactions with the rich literature on survivors' responses to trauma. Implications for research, treatment interventions, and policy are discussed.

Adult↗
PubMed1993

Family violence and homelessness: the relevance of trauma histories in the lives of homeless women.

Studies of homeless women reveal high lifetime rates of childhood physical and sexual abuse and of assault by intimate male partners. The extent of family violence in the lives of homeless women is examined, as are parallels between the long-term effects of childhood abuse and characteristics identified in homeless women. Implications for research and service provision are discussed.

Adult↗
PubMed1993

A conceptual clarification of respect.

The concept of respect, while frequently used in nursing literature, has not been extensively defined conceptually or empirically from a nursing perspective. This paper develops a conceptual definition of respect as a phenomenon in the domain of nursing action. Respect emerges as a primary nursing ethic that serves as the basis for our attitudinal, cognitive and behavioural orientation toward people. A comparison of respect to related nursing concepts reveals that respect is a component of and antecedent to caring, presence, confirmation and humanized care. A set of operational definitions of respect is proposed for use in research, education and practice. Potential methods for measuring respect as a nursing action or attitude are discussed. Several applications of respect for nursing are addressed, including the impact of lack of respect on patient-provider interactions, consideration of respect in a cultural context, and identification of client groups for which respect may have particularly significant implications. The paper concludes with recommendations for further research, with emphasis on the meaning and implications of respect for clients.

Attitude of Health Personnel↗
PubMed1993

The normal shoulder during the butterfly swim stroke. An electromyographic and cinematographic analysis of twelve muscles.

This study describes shoulder muscle activity during the butterfly stroke. Upon hand entry, the deltoids and rotator cuff muscles demonstrated activity as the humerus was abducted, extended, and externally rotated. The rhomboids and upper trapezius were also active, retracting and upwardly rotating the scapula, which positioned the glenoid for the humerus. During propulsion, the pectoralis major and latissimus dorsi generated power. The subscapularis and teres minor were active to control humeral rotation. The serratus anterior helped to pull the body over the arm by reversing its origin and insertion. The posterior deltoid completed humeral extension at the end of propulsion and began to lift the arm out of the water. Then, the middle and anterior deltoids fired with the supraspinatus and infraspinatus to abduct and externally rotate the arm. The scapular muscles were also active, retracting the proximal portion of the scapula while protracting and upwardly rotating the distal tip. The glenoid then provided a platform for the humerus. Overall, the serratus anterior and the subscapularis maintained a high level of activation throughout the stroke; thus, these muscles were highly susceptible to fatigue and vulnerable to injury.

Adult↗
PubMed1993

The painful shoulder during the butterfly stroke. An electromyographic and cinematographic analysis of twelve muscles.

This paper compares the muscle firing patterns of 12 shoulder girdle muscles in competitive butterfly swimmers with painful and normal shoulders. Seven of the 12 muscles revealed statistically significant differences between the two populations. The posterior deltoid demonstrated more activity in the painful shoulders during hand entry while the upper trapezius and serratus anterior exhibited less activity. This alteration in muscle firing patterns allowed for the humerus to be positioned for a wider hand entry, which decreased the pain of impingement of the supraspinatus on the coracoacromial arch. Correspondingly, there was significantly less activity in the supraspinatus. The teres minor and serratus anterior revealed significantly less muscle action throughout pulling as they respectively failed to balance the humeral rotation and did not reverse their origins and insertions to pull the body over the arm. Also, the subscapularis and infraspinatus displayed increased activity in the painful shoulders as they depressed the humeral head to avoid impingement. There were no significant differences between the two groups in the rhomboids, pectoralis major, latissimus dorsi, or the anterior and middle deltoids. From this information, accurate preventative and rehabilitative exercise programs for the competitive butterfly swimmer can be developed.

Adult↗
PubMed1991

Functional effects of N-linked oligosaccharides located on the external domain of murine class II molecules.

To evaluate the potential functional role of the alpha- and beta-chain N-linked oligosaccharides we used site-directed mutagenesis to construct class II Ak alpha and Ak beta genes that encode polypeptides with altered N-linked oligosaccharide acceptor sites in the N-terminal domain of both polypeptides. The alpha 1 domain acceptor site at positions 82 to 84 was eliminated by substituting Gln for Asn at position 82. The beta 1 domain acceptor site at positions 19 to 21 was deleted by substituting Gln for Asn at position 19 or Ala for Thr at position 21. The mutant genes (Ak alpha* or Ak beta*) were transfected either individually (mutants T.19, T.21, and T.82) or together (mutant T.82-21) into class II cell surface negative B lymphoma cell lines. Quantitative immunofluorescence with a panel of Ak beta- or Ak alpha- reactive mAb demonstrated that although the oligosaccharide-deleted Ak alpha Ak beta molecules were serologically wild type, the Ad alpha serologic epitope defined by mAb K24-199 was eliminated in both the T.19 and T.21 Ak beta* Ad alpha molecules. Cloned cell lines expressing the T.19 or T.21 Ak beta* Ak alpha molecules exhibited limited functional Ag presentation defects. Cells expressing the T.82 Ak alpha* Ak beta molecules exhibited defects in Ag presentation function to nine of the ten T hybridomas tested. Surprisingly, cells expressing the mutant T.82-21 class II molecule stimulated a response that was equal to the wild-type response from three of the nine T hybrids and a response that was significantly greater than that of wild-type cells from five of nine T hybridomas. These functional and serological analyses also indicate that some of the observed Ag presentation defects may be due to altered secondary structure caused by either deletion of the oligosaccharide or the amino acid substitution used to delete the N-linked oligosaccharide acceptor site.

Amino Acid Sequence↗
PubMed1990

Stabilizing mechanism of the glenohumeral ligaments.

By using the electromagnetic tracking system, the kinematics of the glenohumeral joint in the shoulder complex was studied. With the location of the glenohumeral ligament insertions digitized, the change of ligament length and direction could then be calculated throughout a given movement. This technique provided a useful method for in vitro assessment of the capsuloligamentous constraints of the shoulder joint.

Biomechanical Phenomena↗