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Biomedical subjects

C A Burnett

Publications and source records attributed to C A Burnett.

At least 19 recordsLinked to original sources
PubMed2006

Parent satisfaction in a nurse led clinic compared with a paediatric gastroenterology clinic for the management of intractable, functional constipation.

AIMS: To assess parent satisfaction with a nurse led clinic for children with intractable, functional constipation compared with a paediatric gastroenterology outpatient clinic. METHODS: A validated questionnaire covering six separate domains in 48 statements (provision of information, empathy with the patient, technical quality and competence, attitude towards the patient, access to and continuity with the caregiver, and overall satisfaction) was employed. For all outcomes, the data were analysed on an intention-to-treat basis. RESULTS: 90/107 (84%) questionnaires were returned: 40/51 (78%) from the paediatric gastroenterology clinic and 50/56 (89%) from the nurse led clinic. Results indicated a high "total" satisfaction with the clinical care, but these were statistically significantly higher in the nurse led clinic compared with the paediatric gastroenterology clinic (median score 8.7 and 7.3 respectively, out of a maximum score of 10). This difference was consistent across all domains when the scores from those attending the nurse led clinic were compared with those attending the paediatric gastroenterology clinic (information median score 8.7 v 7.5; empathy 9.0 v 7.3; competence 9.1 v 8.0; attitude 8.7 v 7.3; access 8.2 v 6.7). All comparisons were highly statistically significant. CONCLUSION: These results provide firm evidence that parents of children with intractable constipation are satisfied with the care they receive in both the paediatric and nursing clinic setting. Parent satisfaction, however, was significantly higher in those attending the nurse led clinic. This study adds further support to the development of a nurse led service to manage intractable, functional constipation in children.

Adolescent↗
PubMed2004

Nurse management of intractable functional constipation: a randomised controlled trial.

AIMS: To evaluate the effectiveness of a nurse led clinic (NLC) compared with a consultant led paediatric gastroenterology clinic (PGC) in the management of chronic constipation. METHODS: Children (age 1-15 years) with functional constipation were randomised following a detailed medical assessment to follow up in either the NLC or PGC. An escalating algorithm of treatment was used as the basis of management in both the NLC and PGC. Main outcome measures were: time to cure at last visit or later confirmed by telephone; time to cure at last visit; and time to prematurely leaving the study. RESULTS: A total of 102 children were recruited, of whom 52 were randomly assigned to NLC and 50 to PGC. Outcome assessment showed that 34 children in the NLC and 25 children in the PGC were confirmed cured at their last visit or later confirmed by telephone. The median time to cure was 18.0 months in the NLC and 23.2 months in the PGC. The probability of being cured was estimated as 33% higher in the NLC compared to PGC (hazard ratio 1.33). Attending the NLC hastened time to cure by an estimated 18.4%. CONCLUSION: Children who attend an NLC are equally as, if not more likely to be cured of intractable constipation, than those attending a PGC and on average their cure will occur sooner. Results suggest that an NLC can significantly improve follow up for children with intractable constipation and highlight the important role for clinic nurse specialists in management of children with gastrointestinal disease.

Adolescent↗
PubMed2001

Migraine and masticatory muscle volume, bite force, and craniofacial morphology.

The purpose of this investigation was to compare the masticatory muscle volume, bite force, and craniofacial morphology of migrainous subjects with age- and sex-matched controls. Ten adult dentate migraineurs were matched with 10 dentate age- and sex-matched controls. The groups consisted of nine women and one man (mean age, 43 years; range, 29 to 51 years). Volumetric analysis of the masseter and medial pterygoid muscles was performed using magnetic resonance imaging. Craniofacial morphology was analyzed from standard cephalometric radiographs using 30 angular and linear variables. Recordings of bite force were made using a strain gauge transducer. There was a significant difference in the volume of both masseter and medial pterygoid muscles between the two subject groups (P<.0001), with the muscles of the migraineurs nearly 70% larger. The migraineurs recorded significantly higher maximal bite forces (P<.0001) than did the controls. No significant differences for any craniofacial morphological measurement were demonstrated between the two groups. It was concluded that the migraineurs had larger masseter and medial pterygoid muscle volumes, and greater bite forces than the controls, which could not be explained by any change in craniofacial morphology.

Adult↗
PubMed2001

Presentation, diagnosis and initial management of patients referred to a hospital tooth wear clinic.

Information on presenting complaints, diagnosis and initial management strategy was recorded on a proforma for 114 consecutive patients referred to a hospital tooth wear clinic over a two-year period. Over twice as many male patients were referred as females. Twenty percent of patients had no presenting complaint and the others shared the common complaints concerning appearance, sensitivity and their deteriorating dentitions. The assessment of aetiology identified attrition as the most common cause of tooth wear in the subject group studied. About half the group were prescribed preventative treatment only and the other half were deemed to require restorative dental treatment.

Adolescent↗
PubMed2000

Mortality rates and causes among U.S. physicians.

UNLABELLED: CONTENT/OBJECTIVES: No recent national studies have been published on age at death and causes of death for U.S. physicians, and previous studies have had sampling limitations. Physician morbidity and mortality are of interest for several reasons, including the fact that physicians' personal health habits may affect their patient counseling practices. METHODS: Data in this report are from the National Occupational Mortality Surveillance database and are derived from deaths occurring in 28 states between 1984 and 1995. Occupation is coded according to the U.S. Bureau of the Census classification system, and cause of death is coded according to the ninth revision of the International Classification of Diseases. RESULTS: Among both U.S. white and black men, physicians were, on average, older when they died, (73.0 years for white and 68.7 for black) than were lawyers (72.3 and 62.0), all examined professionals (70.9 and 65.3), and all men (70.3 and 63.6). The top ten causes of death for white male physicians were essentially the same as those of the general population, although they were more likely to die from cerebrovascular disease, accidents, and suicide, and less likely to die from chronic obstructive pulmonary disease, pneumonia/influenza, or liver disease than were other professional white men. CONCLUSIONS: These findings should help to erase the myth of the unhealthy doctor. At least for men, mortality outcomes suggest that physicians make healthy personal choices.

Aged↗
PubMed2000

Clinical rest and closest speech positions in the determination of occlusal vertical dimension.

Two subject groups had their mandibular positions determined, using an electrognathograph, at the clinical rest position (CRP) and at the closest speaking position (CSP). They were classified into a toothwear (largely of attritional origin) group (n=30) and a non-toothwear, or normal, group (n=60). The mean CRP deduced for the groups was similar in all three dimensions and found to be just less than 2 mm open from and 0.6 mm posterior to intercuspal position (IP) and approximately in the midline. The CSP, in two dimensions, of the toothwear group was significantly closer to IP than that of the normal group. The vertical component of CRP and CSP was similar for the normal group but CSP was significantly reduced in comparison to CRP for the toothwear group. The most forward component of CSP was significantly more anteriorly placed than was that of CRP. Although there was a pronounced inter-individual variation the results suggest toothwear, of long acting aetiology, has less affect on CRP than on CSP.

Adult↗
PubMed1999

Hernia: is it a work-related condition?

BACKGROUND: Development of hernias among active workers is a major occupational problem, however, the work-relatedness of hernias has not been well investigated. It is a difficult question for occupational and primary care physicians who must often address whether a worker with an inguinal hernia should be restricted from work requiring lifting of heavy objects. METHODS: To evaluate the possible work-relatedness of inguinal hernias, a cross-sectional study was performed. The goal of the study was to determine hernia incidence according to occupation with the Annual Survey of Occupational Injuries and Illnesses from the Bureau of Labor Statistics in 1994. Hernia incidence rates (per 10,000 workers) for industry and occupation categories were calculated with the estimates of the number of hernias in males and the employed male workers from the Current Population Survey. Rate ratios (RR) of hernia incidence rates were calculated. RESULTS: In 1994, an estimated 30, 791 work-related hernias in males were reported by US private establishments. The occupation groups with the highest RR were laborers and handlers (RR, 2.47; 95% confidence interval (CI), 2.14-2.80), machine operators (RR, 2.13; 95% CI, 1.81-2.44), and mechanics and repairers (RR, 1.72; 95% CI, 1.43-2.00). CONCLUSIONS: Rate ratios for hernias vary considerably within industries and occupations, with the highest ratios found in industries and occupations involving manual labor. This provides support for the hypothesis that the hernias are work-related, especially in work involving strenuous, heavy manual labor. Am. J. Ind. Med. 36:638-644, 1999. Published 1999 Wiley-Liss, Inc.

Adult↗
PubMed1999

Ischemic heart disease mortality and occupation among 16- to 60-year-old males.

Cardiovascular disease is the leading cause of death, and the role of occupation continues to generate interest. Using the National Occupational Mortality Surveillance system, proportionate mortality ratio (PMR) analyses were used to examine the association between occupation and ischemic heart disease among 16- to 60-year-old males. We used data from 1982-1992 from 27 states. Separate analyses were conducted for blue-collar and white-collar occupations. Among the blue-collar occupations with the highest PMRs for ischemic heart disease mortality were sheriffs, correctional institution officers, policemen, firefighters, and machine operators. Physicians (blacks only) and clergy (both races) were among the white-collar occupations with the highest PMRs for ischemic heart disease. Although more study is needed, consideration should be made for targeting high-PMR occupations, with improvement in work organization to reduce occupational stress and promotion of healthy lifestyles through cardiovascular disease prevention programs.

Adolescent↗
PubMed1998

Occupational dermatitis causing days away from work in U.S. private industry, 1993.

BACKGROUND: Occupational skin disease is an important cause of disability in the workplace. The aim of this report is to estimate the incidence of occupational dermatitis cases that causes days away from work and to characterize the cases. METHODS: The Annual Survey of Occupational Injuries and Illnesses from the Bureau of Labor Statistics collects employer reports on work-related dermatitis. Descriptive data are collected on a sample of the cases that result in days away from work. Estimates of the number of cases and days away from work were calculated by industry, occupation, and exposure source. RESULTS: In 1993, there were an estimated 8,835 cases of occupational dermatitis, a rate of 1.12/10,000 workers. The largest number of cases was in health services, while the highest rate was in agricultural crops. The occupation with the largest number of cases was non-construction laborers. Cleaning/polishing agents caused the largest number of cases. Calcium hydroxide and oxides caused a median of nine days away from work. DISCUSSION/CONCLUSIONS: The survey data show that the effect of occupational dermatitis is substantial in the lives of workers. These descriptive data should be used to target interventions.

Absenteeism↗
PubMed1998

Burning mouth in Parkinson's disease sufferers.

OBJECTIVE: The purpose of the study was to determine the prevalence of burning mouth (BM) in a population of Parkinson's Disease (PD) sufferers and also to assess the use of pain profiles in identifying the type of burning sensation experienced. DESIGN: Subjects were surveyed by means of a one shot postal questionnaire for which ethical approval had previously been granted. Anonymity was guaranteed and therefore no attempt was made to follow up non-respondents. MAIN OUTCOME: BM was reported by 24% of respondents. The pain profiles were completed by 17 BM sufferers. CONCLUSION: Burning mouth is reported to occur in 24% of PD sufferers which is 5 times greater than that of the general population. The reason for this is uncertain but the result has implications for the future care of PD patients and indicates the need for increased dental input at PD outpatient clinics.

Aged↗
PubMed1997

Gastrointestinal cancer mortality of workers in occupations with high asbestos exposures.

Asbestos, which is a well-known risk factor for lung cancer and malignant mesothelioma, has also been suggested as a gastrointestinal (GI) carcinogen. This study was conducted to assess the relationship between high asbestos exposure occupations and the occurrence of G1 cancer. Death certificate data were analyzed from 4,943,566 decedents with information on occupation and industry from 28 states from 1979 through 1990. Elevated proportionate mortality ratios (PMRs) for mesothelioma were used to identify occupations potentially having many workers exposed to asbestos. All PMRs were age-adjusted and sex- and race-specific. The PMRs for GI cancers in white males were then calculated for these occupations after excluding mesothelioma, lung cancer, and non-malignant respiratory disease from all deaths. We identified 15,524 cases of GI cancer in the 12 occupations with elevated PMRs for mesothelioma. When these occupations were combined, the PMRs for esophageal, gastric, and colorectal cancer were significantly elevated at 108 (95% confidence interval = 107-110), 110 (106-113), and 109 (107-110), respectively. Esophageal cancer was elevated in sheet metal workers and mechanical workers. Gastric cancer was elevated in supervisors in production and managers. Colorectal cancer was elevated in mechanical and electrical and electronic engineers. However, high exposure occupations like insulation, construction painter supervisors, plumbers, furnace operators, and construction electricians showed no elevations of GI cancers. In conclusion, this death certificate study supports an association between asbestos exposure and some GI cancer, however the magnitude of this effect is very small.

Asbestos↗
PubMed1997

Cancer mortality among laundry and dry cleaning workers.

A cancer mortality study of 8,163 deaths occurring among persons formerly employed as laundering and dry cleaning workers in 28 states is described. Age-adjusted sex-race cause-specific proportionate mortality ratios (PMRs) and proportionate cancer mortality ratios (PCMRs) were computed for 1979 through 1990, using the corresponding 28-state mortality as the comparison. For those aged 15-64 years, there were excesses in black men for total cancer mortality (PMR = 130, 95% confidence interval (CI) = 105-159) and cancer of the esophagus 1 (PMR = 215, 95% CI = 111-376), and in white men for cancer of the larynx (PMR = 318, 95% CI = 117-693). For those aged 65 years and over, there were statistically nonsignificant excesses for cancer of the trachea, bronchus, and lung in black women (PMR = 128, CI = 94-170) and for cancer of other and unspecified female genital organs in white women (PMR = 225, CI = 97-443). The results of this and other studies point to the need for the effective implementation of available control measures to protect laundry and dry cleaning workers.

Adolescent↗
PubMed1997

Industries and cancer.

Epidemiologic evidence on the relationship between selected industries and cancer is reviewed. This article will focus on several industries which have not been covered elsewhere in this volume, briefly describe current research on cancer in the agricultural and construction industries, and discuss surveillance data on cancer mortality in relation to industry listed on US death certificates. Employment in the rubber industry has been associated with bladder cancer, leukemia, stomach, and lung cancer and is considered by the International Agency for Research on Cancer (IARC) to have 'sufficient evidence of carcinogenicity in humans.' Studies of workers exposed to polychlorinated biphenyls (PCBs) have reported excess mortality from gastrointestinal neoplasms, hematologic neoplasms, and skin cancer (specifically malignant melanoma); IARC considers that the evidence for carcinogenicity in humans is 'limited.' Employment in the boot and shoe industry has been associated with nasal adenocarcinomas in England and Italy ('sufficient'). Hairdressers and barbers have been found to have excess bladder cancer and less consistent evidence for several other sites ('limited'). Workers exposed to wood dust have excess mortality from cancer of the nasal sinuses and paranasal cavities; there is less consistent evidence for excess laryngeal cancer ('sufficient'). Workers employed in the petroleum industry have limited evidence for excess leukemia and other lymphatic and hematopoietic neoplasms, and skin cancer (particularly malignant melanoma) ('limited').

Adenocarcinoma↗
PubMed1996

Neurodegenerative diseases: occupational occurrence and potential risk factors, 1982 through 1991.

OBJECTIVES: To identify potential occupational risk factors, this study examined the occupational occurrence of various neurodegenerative diseases. METHODS: Death certificates from 27 states in the National Occupational Mortality Surveillance System were evaluated for 1982 to 1991. Proportionate mortality ratios were calculated by occupation for presenile dementia, Alzheimer's disease, Parkinson's disease, and motor neuron disease. RESULTS: Excess mortality was observed for all four categories in the following occupational categories: teachers; medical personnel; machinists and machine operators; scientists; writers/designers/entertainers; and support and clerical workers. Clusters of three neurodegenerative diseases were also found in occupations involving pesticides, solvents, and electromagnetic fields and in legal, library, social, and religious work. Early death from motor neuron disease was found for firefighters, janitors, military personnel, teachers, excavation machine operators, and veterinarians, among others. CONCLUSIONS: Neurodegenerative disease occurs more frequently in some occupations than in others, and this distribution, which may indicate occupational risk factors, should be further investigated.

Black or African American↗
PubMed1995

Effects of alpha-cyano-4-hydroxycinnamic acid on fatigue and recovery of isolated mouse muscle.

Fatigue and recovery of mouse soleus and extensor digitorum longus muscles were investigated in standard saline and in saline containing the lactate + hydrogen ion transport blocker, alpha-cyano-4-hydroxycinnamic acid (cinnamate). The fatigue protocol was a series of brief isometric tetani which reduced isometric force by about 25%. Recovery was monitored by test tetani during recovery. Both muscles recovered completely in standard saline. Soleus muscle also recovered completely in the presence of cinnamate, whereas extensor digitorum longus hardly recovered at all. Force during fatigue and recovery can be described in a mathematical simulation in which force depends on intracellular inorganic phosphate and pH, and the only effect of cinnamate is to block lactate + hydrogen ion transport. The results of the simulation suggest that during the fatiguing series of tetani pH changes are small and have a negligible effect on force, but pH is a major determinant of the timecourse of recovery in extensor digitorum longus.

Animals↗
PubMed1995

The practice of Consultants in Restorative Dentistry (UK) in routine infection control for impressions and laboratory work.

This investigation aimed to examine the practice of the members of The Consultants in Restorative Dentistry Group (UK) in relation to routine cross-infection control when handling impressions and items of prosthetic laboratory work. A questionnaire was sent to one hundred and twenty six members of the Group. A response rate of 63% was recorded. Seventy percent of respondents routinely rinsed and disinfected dental impressions. Twenty four percent routinely rinsed items of laboratory work and 44% routinely disinfected items of laboratory work. The results of this study demonstrate a lack of uniformity in the practice of members of the group in routine infection control for impressions and laboratory work.

Dental Impression Technique↗