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Biomedical subjects

B Saunders

Publications and source records attributed to B Saunders.

At least 55 records · Page 3Linked to original sources
PubMed1991

Preventing drug use problems: the university as a site for local action.

While the prevention of drug use problems comes well recommended, there is limited agreement on which preventive strategies are the most effective. Furthermore there is debate as to where activity most effectively occurs-should it be at the national or local level? In this study a university community was investigated with the aim of determining whether members of that community appreciated the need for prevention of drug use problems and which preventive strategies they deemed to be of value. The difficulties inherent in taking action within a tertiary environment are also considered and an agenda for action described.

Journal Article↗
PubMed1990

Alcohol and drug dependence: syndrome, strong attachment or everyday behaviour?

The concept of the dependence syndrome has largely replaced that of 'alcoholism' and 'addiction' in official classifications of alcohol- and drug-related disorders. However, the utility of the concept has been widely disputed by psychologists and other social scientists. The authors of this paper, both clinical psychologists, hold opposing positions on this issue. Following a brief statement of these positions and an outline of the dependence syndrome, the authors debate a range of disputed issues.

Journal Article↗
PubMed1990

Motivation and addiction behaviour: a psychological perspective.

In this paper traditional ideas about motivation and the addiction behaviours are critically considered. It is proposed that rather than viewing motivation as a static quality that clients either have or have not, motivation is more usefully perceived as the balance between the costs and benefits of undertaking any behaviour, juxtaposed with the costs and benefits of ceasing the behaviour. It is also proposed that confrontation approaches, rather than inducing motivation, actually increase the client's resistance. Motivational interventions therefore need to be based on a client-generated inventory of problems and concerns rather than a therapist-dictated one. A decision-making framework for motivational intervention is emphasized and the effectiveness of motivational strategies based on this paradigm is considered.

Journal Article↗
PubMed1989

Alcohol and other drugs: the prevention paradoxes.

This paper asks what prevents the prevention of alcohol and drug use problems. Five prevention paradoxes can be identified, all of which may well be interfering with our attempts to reduce the problems associated with drug use. Drug problem preventers should be aware of these paradoxes and, thus, be able to avoid becoming ensnared by them.

Adolescent↗
PubMed1989

Legislative and humanitarian impetus for development of alcohol and other drug policy at an Australian university.

The rationale for comprehensive alcohol and other drug policy at a tertiary institution is presented here as a health promotion strategy for educating University policy makers. Particular emphasis is placed on a discussion of humanitarian issues, that is, the right to a healthy environment, and the potential for legal liability in an environment where alcohol is readily available and other drugs are present. There is little attention paid to drug use related legal issues in the University, but at the same time drawing the attention of policy makers to the organisation's vulnerability to lawsuits has been reported to be a motivating force for adoption of drug use policy. Universities do experience problems related to alcohol and other drug use by staff and students. Problem reduction, and better management of problems, are the major goals of policy in this area. Local initiatives, for example at the organisational level, make important contributions to the overall drug prevention efforts of the nation. Well-developed policy and procedures and effective implementation constitute an important structural health promotion strategy. Such policy would comply with the immediate requirements of Occupational Health, Safety and Welfare legislation and provide some protection against wrongful dismissal claims and negligence lawsuits, as well as providing long-term educative effects. Situations for which policies are needed, range widely due to the University's unique environment and complex roles.

Adolescent↗
PubMed1988

Laterality defects in conjoined twins: implications for normal asymmetry in human embryogenesis.

We evaluated six pairs of conjoined twins: four pairs were dicephalus, and two were of the ischiopagus type. In three of the four dicephalus pairs, the right twin had an abnormality of laterality that included a right aortic arch, reversed great vessel orientation, bilateral right-sided isomerism of the lungs, asplenia, and situs inversus of the viscera. The left twin had normal great vessel orientation and situs solitus in each case. The finding that was unique in these three dicephalus twin pairs was their fused hearts, which were similar in orientation and configuration. The fourth dicephalus twin pair had one normally rotated heart, which was located in the midline and had normally placed chambers and great vessels. Each twin of this pair had normal visceral situs. In the two pairs of ischiopagus twins, each pair had two separate hearts, with normal cardiac structure and great vessel relationships. The viscera expressed normal laterality. Documentation of a defect in laterality in the right twin in three conjoined twin pairs with fusion of the hearts, combined with the presence of normal laterality in three pairs without cardiac fusion, has implications regarding the mechanisms leading to laterality of the human embryo. We suggest that rotation of the heart initiates the embryo's process of lateralization and that the laterality defects of the viscera seen in the right twin are a result of their abnormal cardiac rotation.

Abnormalities, Multiple↗
PubMed1988

Sudden infant apnea and insidious hydrocephalus.

Hydrocephalus secondary to intracranial-intraventricular hemorrhage is a common complication in the clinical course of the high-risk preterm newborn. Hydrocephalus in this population may be insidious without obvious intracranial hypertension. Apnea and respiratory arrest continue to cause concern following nursery discharge of the high-risk preterm newborn. We report a child who presented to the neonatology service with episodes compatible with serious sudden cardiorespiratory arrest. Insidious "non-hypertensive" hydrocephalus was documented as being responsible for these episodes, which resolved with treatment of the hydrocephalus. The perinatal neurosurgical consultant should be aware of this syndrome and instruct the parents and the pediatricians of these infants, who at the time of discharge are asymptomatic but have ventricular enlargement on neuro-imaging studies. The information presented here is of current importance, since most neonatologists are unaware of the syndrome of insidious hydrocephalus.

Apnea↗
PubMed1988

Washout of local anesthetic during arthroscopy.

The recommended dose of lidocaine is often insufficient to obtain adequate local anesthesia when performing knee arthroscopy, particularly in bilateral procedures. A prospective study was conducted to identify the quantity of anesthetic washed out of the knee by irrigation solution. Fourteen patients had knee arthroscopy performed with local anesthetic, either for diagnosis or reparative surgery. Anesthesia was obtained using 20 ml of 0.5% lidocaine injected intraarticularly at the beginning of each procedure, augmented in four cases by an additional 20 ml of 0.5% lidocaine during the procedure. Each of three portals was also infiltrated with bupivacaine 0.25% with epinephrine. Analysis of the normal saline effluent from knee irrigation during the procedure revealed that washout of lidocaine was 50% by weight (range, 42-66%). This percentage did not vary with age, operative time, or quantity of irrigation. We conclude that: (a) safe local anesthesia can be obtained in the average patient with less than the maximum dose of lidocaine, and (b) because of the 50% washout, the safe dose of lidocaine can be increased substantially if needed.

Adult↗
PubMed1986

Correlation of plasma hypoxanthine and catecholamine levels in the umbilical vein.

Hypoxanthine and the catecholamines, dopamine, norepinephrine and epinephrine were determined in umbilical venous cord plasma in 27 term babies delivered vaginally. When correlating hypoxanthine with log epinephrine a weak positive linear correlation was found (r = 0.45, p less than 0.05). The correlation between hypoxanthine and log dopamine showed a significant negative linear correlation (r = -0.65, p less than 0.01). There was also a significant correlation between log epinephrine and pH (r = 0.72, P less than 0.01) and base deficit (r = 0.46, P less than 0.05). In four babies who suffered intrauterine hypoxia, hypoxanthine was significantly elevated compared with non hypoxic babies (21.4 +/- 5.1 versus 6.3 +/- 6.6 mumol/l, P less than 0.01). In these babies norepinephrine (3710 +/- 3888 vs 789 +/- 718 Pg/ml, P less than 0.01) and epinephrine (298 +/- 229 vs 148 +/- 116 Pg/ml, P less than 0.05) were significantly elevated as well, in contrast to dopamine levels (188 +/- 94 vs 169 +/- 134 Pg/ml N. S.). This finding seems to indicate that dopamine synthesis goes down during hypoxia probably because the rate limiting enzyme in dopamine synthesis, tyrosine, hydroxylase, is inhibited in hypoxia.

Catecholamines↗
PubMed1985

Congenital hypernephronic nephromegaly with tubular dysgenesis: a distinctive inherited renal anomaly.

This paper describes a distinct, apparently inherited renal disorder we call congenital hypernephronic nephromegaly with tubular dysgenesis. The disorder is characterized by oligohydramnios, the Potter phenotype, and enlarged nonfunctional kidneys. Light microscopy demonstrates increased numbers of glomeruli, undifferentiated tubules, and interstitial fibrosis. Microdissection reveals short, immature nephrons that lack proximal convolutions, and abnormal vascularization of the glomerulus. Morphometric analysis demonstrates increased glomerular mass, primarily in the region of the corticomedullary junction, increased interstitial mass, and decreased tubular mass. The parameters that define this anomaly are presented, and the possible mechanisms of pathogenesis are discussed in relation to pathologic observations and current concepts concerning renal embryogenesis and differentiation. The recurrence of this anomaly in the male children of a consanguineous couple suggests an X-linked recessive mode of inheritance, although an autosomal-recessive mode of inheritance cannot be ruled out. This condition indicates that not all cases of the Potter phenotype can be considered to be sporadic.

Amniotic Fluid↗
PubMed1984

Muriel Driver Memorial Lecture 1984. Quality assurance--reflections on the wave.

This paper provides an overview of the evolution of quality assurance within the health care industry, with emphasis on the development of occupational therapy expertise. The current concept of quality assurance, focussed on ongoing monitoring and resolution of patient care problems, is discussed. The results of a national survey are presented, relating to the development of occupational therapy, quality assurance programs in the areas of: expertise in component activities, integration of facility and department programs, use of available resources, and extent of academic teaching. Predicted health care trends and their implications to occupational therapy are presented.

Canada↗
PubMed1984

Ventriculoperitoneal shunts in high risk newborns weighing under 2000 grams: a clinical report.

Fifty-three low birth weight high risk newborns who developed progressive hydrocephalus despite a trial period of intermittent lumbar punctures underwent cribside ventriculoperitoneal shunt placement. They all weighed less than 2000 g at the time of shunting (mean, 1308.6 g +/- 398.2 SD). The operative procedures were performed at a mean age of 31.5 days +/- 16.1 (SD). There were no deaths in this series. During the nursery stay, 14 patients required operative revisions for obstruction. The most common problem was infection, which occurred in 13 (24.5%) after the primary intervention and in another 5 of the 14 (35.7%) patients who required revision. The overall infection rate/patient was 26.9%. Shunt removal and intensive antibiotic therapy cured the infection in all but 1 patient. Premature, low birth weight newborns may undergo ventriculoperitoneal shunting, but close follow-up for complications such as infection and shunt obstruction is always required.

Anti-Bacterial Agents↗
PubMed1983

Neuroanaesthesia.

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Anesthesia↗