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Biomedical subjects

B Wilson

Publications and source records attributed to B Wilson.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

Important considerations in the development of public health advisories for arsenic and arsenic-containing compounds in drinking water.

Drinking water contamination by arsenic remains a major public health problem. Acute and chronic arsenic exposure via drinking water has been reported in many countries of the world; especially in Argentina, Bangladesh, India, Mexico, Thailand, and Taiwan, where a large proportion of drinking water (ground water) is contaminated with a high concentration of arsenic. Research has also pointed out significantly higher standardized mortality ratios and cumulative mortality rates for cancers of the bladder, kidney, skin, liver, and colon in many areas of arsenic pollution. General health effects that are associated with arsenic exposure include cardiovascular and peripheral vascular disease, developmental anomalies, neurologic and neurobehavioral disorders, diabetes, hearing loss, portal fibrosis of the liver, lung fibrosis, hematologic disorders (anemia, leukopenia, and eosinophilia), and carcinoma. Although, the clinical manifestations of arsenic poisoning appear similar, the toxicity of arsenic compounds depends largely u[on the chemical species and the form of arsenic involved. On the basis of its high degree of toxicity to humans, and the non-threshold dose-response assumption, a zero level exposure is recommended for arsenic, even though this level is practically non-attainable. In this review, we provide and discuss important information on the physical and chemical properties, production and use, fate and transport, toxicokinetics, systemic and carcinogenic health effects, regulatory and health guidelines, analytical methods, and treatment technologies that are applied to arsenic pollution. Such information is critical in assisting the federal, state and local officials who are responsible for protecting public health in dealing with the problem of drinking water contamination by arsenic and arsenic-containing compounds.

Arsenic↗
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Predicting severity of cognitive impairment after severe head injury.

It is often assumed that age is an important variable in determining cognitive outcome following severe head injury. The present study was carried out to determine whether age at time of injury predicted severity of cognitive impairment. Our hypothesis was that the older the patient at time of head injury the worse should be the cognitive impairment. Cognitive impairment was assessed by scores on nine standardized tests. Scores were obtained from 144 consecutive referrals to a clinical psychologist; all subjects had sustained a severe head injury. Of these, 115 had suffered a closed head injury. Ages ranged from 13 to 65 years. Apart from Unusual Views and Verbal Fluency no significant correlations were found between age and test performance. Thus there was little evidence that age predicted performance on cognitive tests. A number of significant correlations were found between length of coma and cognitive performance. The findings would seem to confirm that cognitive outcome after severe head injury is predicted by length of coma (which reflects severity of brain damage) whilst age at time of injury does not appear to be a good predictor of outcome.

Activities of Daily Living↗
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A short screening test for visual neglect in stroke patients.

OBJECTIVE: to extend a preliminary study of the internal structure of six measures comprising the 'conventional' subtests of the Behavioural Inattention Test (BIT) in order to develop a short screening test for visual neglect. DESIGN: discriminant function analysis of the 15 tests constituting BIT. SETTING: rehabilitation centre. PATIENTS: 59 selected from consecutive stroke patients entering the centre. SELECTION CRITERIA: absent prior history of major CNS disorder, at least 1 week post-stroke, right-handed for writing, absent significant visual impairment other than visual field deficit, no psychiatric overlay or generalized intellectual deterioration, and ability to comprehend and respond to the visuomotor tasks administered. COMPARISON GROUP: 50 non-brain-damaged subjects (hospital employees, members of University subject panel, and local community volunteers). ASSESSMENTS: the 15 tests constituting the BIT. RESULTS: two subtests, letter cancellation and star cancellation, were the most sensitive measure, identifying 74% of neglect patients with no false positives. CONCLUSIONS: letter and star cancellation offer an adequate yet brief screening test for determining which patients might benefit from administration of the complete neglect test battery.

Cerebrovascular Disorders↗
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Evaluation of an HIV/AIDS continuing education program.

An HIV/AIDS education model was implemented for rural nurses as a demonstration project in Georgia. The overall goal of the project was to increase the quality of and access to HIV/AIDS-specific services in rural communities. Public health and community nurses were the focus of this effort due to their current roles in providing health care to rural and underserved populations and their potential for networking across health care and social services agencies to form an HIV/AIDS response network. One hundred and seventy-five nurses completed the program. Program evaluations revealed that, after completing the HIV/AIDS course, participants' professional preparedness, attitudes toward people with HIV/AIDS, and knowledge had improved. Consistently, participants' scores in each of these areas increased from the pretest to the posttest. Additionally, nurses participating in the program reported in a follow-up survey that they felt better prepared to care for people with HIV/AIDS. While there is a need for further HIV/AIDS education in rural communities, results of the program support its potential use as a model for other rural communities.

Adult↗
PubMedDate not supplied

Northern Initiative for Social Action: an occupation-based mental health program.

Northern Initiative for Social Action (NISA) is a consumer-run, occupation-based, nonprofit organization located in northeastern Ontario, Canada. The NISA organization has grown in response to research revealing few opportunities for participation in personally meaningful and socially valued occupation for persons with mental illness living in the community of study. This article describes a mixed-design research study conducted by the ParNorth Research Unit of NISA and an occupational therapist. The study purposes were to (a) better understand the emerging characteristics of the NISA program and identify which the participants found helpful; (b) evaluate whether participation in NISA improved members' quality of life; and (c) ascertain whether participation reduced members' need for more traditional and costly methods of care (e.g., hospitalization, crisis services). Focus groups, daily participant observation, a quality of life interview, a consumer member survey and objective review of hospitalization data were used for data collection. Qualitative results indicated that NISA helped to meet participants' being, belonging, and becoming needs. Quantitative data indicated that overall, NISA members perceive an improvement in their subjective quality of life and sense of well-being. Their perceptions are supported by minimal use of crisis services and hospitalization, improved socioeconomic status, and several members' success in obtaining paid employment either within or outside NISA. Future challenges include the need to clearly describe the evolving NISA model and to ensure that the growth of this new organization does not exceed secured human or fiscal resources.

Canada↗
PubMedDate not supplied

Governance models within multi-institutional systems.

The differences in governance models for multi-institutional systems are primarily related to the number of governing boards within a given system. This article presents those models with a corporate level governing board that maintains ultimate legal responsibility for the system. Although this is a complex issue, the needs of the patients and communities the affected organizations serve must be at the forefront of all discussions.

Canada↗
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Fast changing nursing.

Explore the source record for details and available documents.

Education, Nursing↗
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Pen oxygen concentration and pulmonary hypertension-induced right ventricular failure and ascites in meat-type chickens at low altitude.

Percentage O2 and CO2 were measured in the air in environmentally controlled commercial poultry pens (altitude approximately 300 m) containing broiler or roaster chickens 14 to 56 days of age. Outside air (mean of 10 samples) measured 20.85% O2 and 0.041% CO2. Air in the pens had significantly lower O2 and higher CO2 than outside air; however, air in 25 pens with a high incidence of ascites (mean 20.50% O2, 0.264% CO2) was not different from the air in 25 pens with a low incidence of ascites (mean 20.49% O2, 0.319% CO2). The lowest pen O2 was 20.20%, which would not cause reduced hemoglobin saturation (percent oxygen) of the arterial blood of normal chickens.

Air↗
PubMedDate not supplied

How five advanced practice nurses in nephrology spend their time.

The purpose of this paper is to report the results of a descriptive study undertaken to examine the scope of practice of five Masters-prepared nephrology nurse practitioner/clinical nurse specialists (NP/CNS) in a mid-size university teaching hospital program. Four of the NP/CNSs practised in three acute care sites, and one in the regional dialysis program. Impetus for the study came from two sources. First, a sixth person practising in the role was retiring and was not to be replaced. Second, the current three-site model for acute care was being transformed into a two-site model, thus creating opportunities to reduce variability in practice among the NP/CNSs. The study examined the activities of the NP/CNS role through the completion of a time documentation tool (TDT) by five nurse practitioners on each of 10 consecutive days of practice. The TDT was adapted from Ackerman's Model of Advanced Practice (1996). The model outlines five domains of practice for advanced practice nurses (APN): direct comprehensive care, support of systems, research, education, and publication and professional leadership. The NP/CNSs spent an average of 9.21 hours at work daily with a range of 8.6 to 10.3 hours. The TDT captured an average of 8.6 hours of working time with a range of 7.3 to 9.9 hours. An average of 72% of time was spent in clinical practice (range 64-83%). An average of 16% (range 11-20%) of time was spent in support of systems. Research (average 4%, range 3-7%), education (average 6%, range 3-16%), and publication and professional leadership (average 2%, range 0-6%) figured less prominently. The major activities performed within the clinical practice domain and the support of systems domain showed less variability across sites than was anticipated. The results of the study have helped the NP/CNSs and their management colleagues analyze and adapt the role to changing clinical requirements and economic realities.

Cooperative Behavior↗
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Flow cytometric and immunohistochemical analysis of p62c-myc oncoprotein in the bronchial epithelium of lung cancer patients.

The expression of p62c-myc in bronchial resection lines (BRLs) from lung cancer and control patients, has been examined by immunohistochemistry and parallel flow cytometry using antibodies directed against the p62c-myc oncoprotein. Both methods indicated a marked increase in nuclear p62c-myc levels in BRLs from tumour cases as compared to control BRLs. Immunohistochemistry also revealed greater cytoplasmic positivity in BRLs from cancer patients than from control cases. Flow cytometric quantitation of nuclear p62c-myc confirmed the immunohistochemical findings demonstrating that the median level of nuclear p62-myc fluorescence in BRLs from tumour cases was 1919 fluorescence units (FU) (range:216-7367 FU) and 144 FU (range:0-1365 FU) for non-tumour control BRLs. No consistent difference in p62c-myc fluorescence was observed between BRLs from smokers and non smokers. Both methods indicated that in lung tumour cases, nuclear p62c-myc was increased in histologically normal and abnormal BRLs, suggesting that hyperexpression of this protein is an early event preceding detectable morphological change. These results suggest that increased p62c-myc levels may be an early event in the pathogenesis of lung cancer.

Adult↗
PubMedDate not supplied

Informed patient consent: a historical perspective.

This article reviews the concept of informed patient consent by examining two long-term studies in which adequate consent was not obtained from study participants: the radiation experiments sponsored by the U.S. government beginning in the 1940s and the Tuskegee Syphilis Experiment conducted from 1932 to 1972. The article discusses how these experiments represent a violation of informed consent guidelines and research ethics. It also explores the ethical implications of the experiments to radiologic technologists today and discusses the technologist's role in obtaining patient consent in research and clinical practice settings.

Ethics, Medical↗