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Biomedical subjects

A Young

Publications and source records attributed to A Young.

At least 397 records · Page 22Linked to original sources
PubMedDate not supplied

Development of the NIST bone ash standard reference material for environmental radioactivity measurement.

The bone ash standard reference material (SRM), a blend of 4% contaminated human bone and 96% diluent bovine bone, has been developed for radiochemical method validation and quality control for radio-bone analysis. The massic activities of 90Sr, 226Ra, 230Th, 232Th, 234U, 235U, 238U, 238Pu, (239 + 240)Pu and (243 + 244)Cm were certified using a variety of radiochemical procedures and detection methods. Measurements confirmed undetectable radionuclide heterogeneity down to a sample size of 5 g. thereby implying adequate blending of particulate materials with dilution factors of up to 17,900. The results among most of the intercomparison laboratories and their methods were consistent. Disequilibrium was observed for decay chains: 234U(0.67 mBq/g)-230Th(0.47 mBq/g)-226Ra(15.1 mBq/g)-210Pb(23 mBq/g)-210Po(13 mBq/g) and 232Th(0.99 mBq/g)-228 Ra(6.1 mBq/g)-228Th(7.1 mBq/g). The disequilibria were the results of mixing occupationally contaminated human bone with natural bovine bone and the fractionation during internal biological processes. The massic activity of 210Pb, 228Th and 241Am were not certified because of insufficient 228Ra and 241Pu data and lack of knowledge in how 222Rn and its daughters will be fractionated in the SRM bottle over time.

Animals↗
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Pediatric home healthcare: a paradox.

Although parents may welcome having their ill child cared for at home, they are not prepared to compromise privacy and family rituals, nor share control of their child. The purpose of this article is to provide a snapshot of problems that parents have encountered with pediatric home healthcare. Home care parents offer suggestions for other parents and home healthcare nurses and agencies, encouraging them to be proactive in preventing potential problems.

Child↗
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Culture and somatization: clinical, epidemiological, and ethnographic perspectives.

OBJECTIVES: The cross-cultural prevalence of somatization and the limitations of current nosology and psychiatric theory for interpreting cultural variations in somatization are reviewed. METHOD: Selective review was conducted of recent research literature and research findings from an epidemiological survey and ethnographic study of help-seeking and health care utilization of a random sample of 2246 residents in a Canadian urban multicultural milieu. RESULTS: Somatization is common in all ethnocultural groups and societies studied to date. However, significant differences in somatization across ethnocultural groups persist even where there is relatively equitable access to health care services. Analysis of illness narratives collected from diverse ethnocultural groups suggests that somatic symptoms are located in multiple systems of meaning that serve diverse psychological and social functions. Depending on circumstances, these symptoms can be seen as an index of disease or disorder, an indication of psychopathology, a symbolic condensation of intrapsychic conflict, a culturally coded expression of distress, a medium for expressing social discontent, and a mechanism through which patients attempt to reposition themselves within their local worlds. CONCLUSION: Major sources of differences in somatization among ethnocultural groups include styles of expressing distress ("idioms of distress"), the ethnomedical belief systems in which these styles are rooted, and each group's relative familiarity with the health care system and pathways to care. Psychological theories of somatization focused on individual characteristics must be expanded to recognize the fundamental social meanings of bodily distress.

Affective Symptoms↗
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Substance use disorders in young adults with and without LD: predictive and concurrent relationships.

This article reports on young people with and without learning disabilities (LD) and substance use disorders (SUD). Participants were assessed for LD at ages 12 and 19 and for SUD and psychiatric disorders at age 19. Participants with LD at ages 12 and 19 were more likely to develop an SUD or a psychiatric disorder compared to participants without consistent LD. Participants with LD at age 19 were more likely to have a concurrent SUD or psychiatric disorder compared to those without LD at age 19, while participants with LD at age 12 showed only a trend toward increased rates of SUD at age 19 when compared to participants without LD at age 12. Participants with and without LD did not differ in substance use, consumption levels, or onset history. In a multivariate model, adolescent LD was associated with a three-fold increased risk for SUD after behavioral problems and family structure had entered the model. Although these results provide some support for the notion that adolescents with LD are at increased risk for SUD, LD also appears to confer a general risk for adverse outcomes.

Adolescent↗
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The role of chemoradiotherapy in maintaining quality of life for advanced esophageal cancer.

From May 1996 to July 1996, three male patients with advanced esophageal cancer with complete obstruction were treated with concurrent chemoradiotherapy. The first two courses of chemotherapy using 5-Fluorouracil (500 mg/m2) and Leucovorin (200 mg/m2) on day one through day five were given concurrently with radiotherapy. After completion of radiotherapy, four more courses of chemotherapy using the same regimen were given every four weeks. The total dose of irradiation using six MV linear accelerator given to the primary tumor was 5,000 cGy in 28 fractions. All three patients had relief of their obstruction with complete regression of the tumor after the completion of their treatment. All patients improved clinically and were able to remain symptom-free until the time of their death. The first patient survived for 12 months and died of respiratory failure because of his chronic obstructive pulmonary disease. The second patient also survived 12 months but died of liver metastasis. The third patient lived for 10 months and died of aspiration pneumonia.

Aged↗
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Intraperitoneal chemotherapy: a prolonged infusion of 5-fluorouracil using a novel carrier solution.

A novel carrier solution, icodextrin 20 (7.5%) has allowed exploration of prolonged intraperitoneal (IP) infusion of the cytotoxic drug, 5-fluorouracil. Eighteen patients with intraperitoneal carcinomatosis were entered into a feasibility and pharmacokinetic study of prolonged regional (IP) chemotherapy.. Specialist nurses trained the patients to self-administer their own treatment via a permanent i.p. catheter. A twin bag delivery system was used to perform one exchange daily. It proved possible to deliver continuous (5 days per week) i.p. 5-fluorouracil at doses of 200 mg/m2 and 300 mg/m2 for up to 12 weeks. The toxicities seen were infective peritonitis, nausea and vomiting, lethargy and anorexia. This was a nurse-led study and the home-based therapy holds promise for patients with malignant peritoneal disease.

Adult↗
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A third study on predicting NCLEX success with the HESI Exit Exam.

This was the third annual validity study designed to assess the accuracy of the HESI Exam (E2) in predicting NCLEX success for graduating registered and practical nursing students. As in year I (N = 2,725) and year II (N = 3,752), in year III (N = 6,277), the E2 was highly predictive of NCLEX success for associate degree nursing, bachelor of science nursing, diploma, and practical nursing students. Unlike previous years, in year III, monitoring was not a significant factor in the predictive accuracy of the E2. NCLEX success of low-scoring E2 students, first examined in year II, was also examined in year III. As in year II, low-scoring E2 students were significantly more (P = .001) likely to fail the licensure examination than high-scoring E2 students. In year III, unlike year II, there was no significant difference in the pass rate of low-scoring E2 students who participated in a remediation program and those who did not. The authors recommended that a more definitive definition of remediation be used in future studies and that such studies focus on E2 implementation strategies and their relationship to NCLEX success.

Education, Nursing, Associate↗
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Key issues to address with bottle-feeding.

Proper feeding during a baby's first year of life is crucial for a sound nutritional foundation. Because of this, there are several issues that must be addressed to ensure the child is fed properly. First, bottle-feeding moms should not be made to feel guilty about their feeding decision. It is also important to review feeding practices to avoid overfeeding and encourage positive nurturing techniques. Mothers should learn the key signals to watch for from their baby, such as sleep patterns and bowel movements. Also, it is crucial to teach parents the essential issues related to preparing bottles, such as cleaning the bottles and nipples and properly mixing the formula.

Bottle Feeding↗
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Understanding cultural differences when advising mothers about feeding choices.

Cultural teachings and practices greatly influence a mother's feeding decisions. It is important for all health care professionals to understand the cultures within their community and how various beliefs impact infant nutrition. For example, studies have shown the African American and Hispanic mothers are more likely to gain feeding information from family members. There are significant misconceptions being passed down through the generations which can lead to serious nutritional problems, such as overfeeding and the early introduction of cow's milk and food.

Cultural Characteristics↗
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Counseling at-risk mothers.

Special consideration should be given when counseling at-risk mothers. Although local health departments and offices for the Women, Infants, and Children Program (WIC) are teaching mothers about proper feeding practices, there is a large section of the population that does not qualify for government programs and does not have the financial resources to properly feed their children. Considering this group of parents, and the shrinking number of clinics, it is essential that health care professionals educate mothers in at-risk environments to watch for cues from the infant while determining feeding practices.

Breast Feeding↗
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Treating rheumatoid arthritis early with disease modifying drugs reduces joint damage: a randomised double blind trial of sulphasalazine vs diclofenac sodium.

BACKGROUND: Current disease management in rheumatoid arthritis (RA) has moved towards "inverting the therapeutic pyramid" by introducing disease-modifying anti-rheumatic drugs (DMARDs) early. Despite the logic of early DMARD therapy, there is a dearth of supportive evidence for this approach. We report a randomised controlled trial comparing sulphasalazine monotherapy with diclofenac monotherapy in early RA. The primary aim was to provide unequivocal evidence that early DMARDs prevent erosive damage. The secondary aim was to evaluate if sulphasalazine used alone has comparable symptomatic benefits to NSAIDs. METHODS: 117 patients with RA for under 12 months of diagnosis (mean 2 months) were randomised (62 sulphasalazine; 55 diclofenac). Sulphasalazine patients comprised 76% women, and 58% were rheumatoidfactor positive. Diclofenac patients comprised 74% women, and 54% were seropositive. 36% completed 12 months of therapy (16 sulphasalazine; 26 diclofenac); sulphasalazine was given for a mean period of 21 weeks and diclofenac for a mean period of 33 weeks. Results were analysed on an intention to treat basis. RESULTS: After 12 months the mean number of new erosions in patients randomised to receive sulphasalazine was 2.0 (95%CI 0.9, 3.1) and in patients randomised to receive diclofenac was 7.5 (95%CI 4.1, 10.9; p = 0.002 by Student's unpaired t-test). An analysis of valid compliant completers showed the mean number of new erosions in patients who received 12 months therapy with sulphasalazine was 2.3 (95%CI 0.6, 4.0) and in patients who received 12 months diclofenac was 10.5 (95%CI 5.0, 15.9; p = 0.018 by Student's unpaired t-test). The Ritchie articular index, swollen joint counts and pain scores decreased with both sulphasalazine and diclofenac, with mean falls in both groups of 15-20% at 2 weeks and 30-40% at 4 and 8 weeks. There were no differences between treatments. Disease activity scores showed similar highly significant mean decreases within both treatment groups (P < 0.001 in all cases) of 0.5 at 2 weeks and 1.0 at 4 weeks; at 12 and 26 weeks they were significantly lower with sulphasalazine (p = 0.036 and 0.045). 75% of the patients given sulphasalazine and 65% of those given diclofenac had one or more adverse events with no major differences between treatments. CONCLUSIONS: These results show that an accelerated dosing schedule of sulphasalazine has identical effects to diclofenac in reducing symptoms, indicating it is a rapidly effective DMARD. They also provide unequivocal evidence, analysed on an intention to treat basis, that early treatment with sulphasalazine significantly reduces the extent of radiological progression in active RA.

Anti-Inflammatory Agents, Non-Steroidal↗
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Does the tongue play a role in the initial development of vertical palatal shelf in hamster?

A study was undertaken to examine whether the tongue plays any role in determining the primordial development of palatal shelves in a vertical direction in mammals. Control and 6-mercaptopurine-treated embryos from Golden Syrian hamsters were examined by scanning electron microscopic and histological techniques for the spatio-temporal relationship of primordial development of the palate, tongue, and mandible. DNA synthesis, measured by 3H-thymidine incorporation, was used as an index of growth. The data indicated that in controls, vertical palate development began in the anterior half from the roof of the oronasal cavity, whereas the tongue bulges and the mandibular process developed in the posterior half of the oronasal cavity. A burst in DNA synthesis occurred in the palate and mandible, but not in the tongue. In 6-mercaptopurine-treated fetuses, although the chronological appearance of primordia of all three structures was normal, DNA synthesis was inhibited in all three structures. The recovery in DNA synthesis, albeit partial, was faster in the palate and mandible than in the tongue. On the basis of observations from the present study, along with those from other vertebrates, it is suggested that the developing tongue may not play any role in determining the direction of development of the palatal primordia.

Animals↗