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Biomedical subjects

A Robinson

Publications and source records attributed to A Robinson.

At least 199 records · Page 11Linked to original sources
PubMed1995

Overnight pulse oximetry in snoring and non-snoring children.

The effect of snoring on overnight pulse oximetry recordings in the paediatric community was investigated. A random sample of 222 children up to 10 years of age from the town of Frome, Somerset, UK, had overnight pulse oximetry performed in the home environment. The oximetry recordings obtained from 58 snoring and 164 non-snoring subjects were compared. No clinically relevant difference in oxygen saturation level could be detected between these two groups of children. In conclusion, snoring in children up to 10 years of age is common, 11% often snore. It is not associated with hypoxia as measured by overnight pulse oximetry. This would suggest that surgical intervention for the symptom of snoring alone is not indicated.

Child↗
PubMed1995

Advanced clinical roles: investigating dilemmas and changing practice through action research.

A new career structure for clinical nurses was implemented in 1987 in Victoria with the intention of providing clinical advancement and material rewards for nurses in clinical settings. This paper explains how participatory action research was used to explore some of the issues inherent in the role of the associate charge nurse. The clinical/management tension and the role expectations formed within the taken-for-granted rituals and routines of the ward and the hospital managerial structure are examined.

Health Services Research↗
PubMed1995

Transformative 'cultural shifts' in nursing: participatory action research and the 'project of possibility'.

For some time scholars have called for changes in nursing in order to address the subjugated position of nurses within health care. This paper argues that through an engagement with participatory action research, nurses open up a possibility to bring about transformative shifts in nursing culture. The motivation for nurses to engage with this research process arises out of an acknowledgement that they can no longer live with the sense of pain and crisis endemic in much of their nursing practice, and a desire to take action to bring about transformative change within their local ward cultures. However, their participation in critical reflective and collaborative processes that underpin action research exposes an array of minor scattered nursing practices which frustrate possibilities for transformative change. Drawing on empirical accounts from research conducted by the author, the paper argues that once made explicit, these minor practices and the regimes of truth that nurture and sustain them, can be reconstructed and the possibility of transformative cultural shifts in nursing will then emerge.

Clinical Nursing Research↗
PubMed1995

A new improved sub-unit vaccine for plague: the basis of protection.

In this study, we have determined the limit of protection achievable by immunisation with sub-units of Yersinia pestis against the development of plague in an experimental animal model. Co-immunisation with the purified culture-derived F1 and the recombinant V sub-units afforded a greater level of protection than with either sub-unit alone. The protection given by the combined sub-units was several orders of magnitude greater than that afforded by the whole cell killed (Cutter USP) vaccine and was equivalent to that achieved by vaccination with EV76, the live attenuated Y. pestis vaccine strain. However, the combined sub-unit vaccine has clear advantages over the live vaccine in terms of safety of use and absence of side-effects.

Animals↗
PubMed1995

Comparison of Crystal Enteric/Nonfermenter system, API 20E system, and Vitek AutoMicrobic system for identification of gram-negative bacilli.

A comparative evaluation of the Crystal Enteric/Nonfermenter system (Crystal; Becton Dickinson, Cockeysville, Md.), API 20E (API; bioMérieux Vitek, Inc., Hazelwood, Mo.), and the Vitek GNI card (Vitek; bioMérieux Vitek) was performed with 512 clinical isolates of gram-negative bacilli, including 381 members of the family Enterobacteriaceae and 131 nonenteric bacilli. With supplemental testing, API, Crystal, and Vitek correctly identified to the genus and species level 505 (98.6%), 489 (95.5%), and 494 (96.5%) of the 512 isolates, respectively. Supplemental testing, as specified by the manufacturer, was required to identify 119 (23.2%), 18 (3.5%), and 5 (1.0%) of the isolates with the three systems, respectively. Of the 381 isolates from the family Enterobacteriaceae, API and Crystal correctly identified 90.3 and 91.6% by 18 to 24 h without supplemental testing, respectively, and Vitek identified 92.4 and 96.1% following 10 and 18 h of incubation, respectively. Of the 131 nonenteric organisms, API and Crystal correctly identified 28.2 and 93.9% by 18 to 24 h without supplemental testing, respectively, and Vitek identified 84.0% by 10 h and 93.9% by 18 h. Errors in identification with each system were infrequent and appeared to be randomly distributed among the genera evaluated. The three systems were comparable in accuracy when either a weighted clinical laboratory profile of organisms or a group of selected isolates in a stress test sample was evaluated (P > 0.05). There were no significant differences between the three systems in their ability to identify either the isolates in the weighted group or those in the stress test (P > 0.05). Crystal compared favorably with API and Vitek, which have established track records in clinical laboratories, and is acceptable for the identification of members of the Enterobacteriaceae and nonenteric bacilli in a clinical microbiology laboratory.

Bacteriological Techniques↗
PubMed1995

Co-trimoxazole induced aseptic meningitis.

A 15 year old boy presented with two episodes of aseptic meningitis-like reactions after ingestion of co-trimoxazole. The diagnosis of co-trimoxazole induced aseptic meningitis was made. This syndrome should be considered in the differential diagnosis of aseptic meningitis.

Adolescent↗
PubMed1995

Sex chromosome tetrasomy and pentasomy.

Sex chromosome abnormalities occur in at least 1 in 400 births and include the well-described 47,XXX, 47,XXY, 47,XYY, and 45,X karyotypes. The addition of more than one extra X or Y chromosome occurs rarely, and little information is available in the medical literature. Individual case reports make up most of this body of knowledge, and all are based on subjects who identified themselves postnatally. Many were ascertained through screenings of institutions and hospitals; thus, there is no unbiased information on the natural history of poly X and Y karyotypes. A direct relationship between the number of additional sex chromosomes and the severity of the phenotype is generally assumed. The purpose of this article is to summarize what is known about these conditions and to present 10 additional cases. The karyotypes include, 48,XXXX, 49,XXXXX, 48,XXYY, 48,XXXY, 49,XXXXY, 49,XXXYY, 48,XYYY, 49,XYYYY, and 49,XXYYY.

Adolescent↗
PubMed1995

Psychosocial adaptation of 39 adolescents with sex chromosome abnormalities.

OBJECTIVES: Children with sex chromosome abnormalities (SCA) are known to be at increased risk for neuromotor, language, learning, and behavioral problems, but little is known of psychosocial adaptation of SCA adolescents. This study was conducted to evaluate psychologic characteristics of unselected SCA adolescents, including socialization, educational progress, separation from family, and incidence and severity of psychiatric disturbance. METHODS: Thirty-nine propositi identified through the screening of 40,000 consecutive Denver newborns, including boys with 47,XXY karyotypes and girls with 47,XXX, 45,X, and partial X monosomy, or SCA mosaic karyotypes, have been followed longitudinally into adolescence. Twenty-seven siblings served as controls. Between 12 and 19 years of age, all participated in blind psychiatric interviews and were administered standardized intelligence and achievement tests. RESULTS: SCA propositi demonstrated a mean IQ score 21 points lower than that of control subjects. In addition, lower mean scores were seen on achievement test results as well as lower overall psychosocial adaptation scores and increased incidence of psychiatric disturbance. Depression was the most frequent psychiatric diagnosis. Propositi were more likely to receive special education assistance in high school and were less likely to graduate from high school than were controls. Of the three nonmosaic propositi groups, the 47,XXX girls demonstrated the poorest overall psychosocial adaptation and highest degree of psychiatric disturbance. Mosaic girls were indistinguishable from control subjects. Marked variability was found among all three nonmosaic groups, with some individuals in each group demonstrating relatively strong psychosocial adaptation. CONCLUSIONS: The presence of nonmosaic sex chromosome abnormality increases the risk for impeded cognitive skills, learning abilities, and psychosocial adaptation in adolescence. The factors that allow for stronger adaptation in some of these adolescents include the presence of a stable and supportive family environment. The outlook for adaptation in unselected SCA adults remains uncertain.

Achievement↗