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Biomedical subjects

C Roberts

Publications and source records attributed to C Roberts.

At least 469 records · Page 26Linked to original sources
PubMedDate not supplied

Universal precautions: improving the knowledge of trained nurses.

Universal precautions relate to the management of blood-borne viruses such as human immunodeficiency virus (HIV) and hepatitis B and C. Advice on the transmission of blood-borne viruses and the precautionary measures used to reduce or eliminate cross-infection have been addressed by national and professional bodies. There is a significant amount of research which assesses trained nurses' knowledge of universal precautions and includes understanding of the transmission routes of blood-borne viruses and the measures required to prevent cross-infection. However, the majority of the literature indicates an incomplete knowledge among trained nurses of the principles and application of universal precautions. The ability of the trained nurse to fulfil his/her role as health educator, teacher and therefore effective infection control practitioner is questioned by the literature. This article discusses the role of education in improving the knowledge of trained nurses and considers the implementation of in-service training and preregistration education.

Body Fluids↗
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A comparison of topical EMLA cream and Prilocaine injection for anaesthesia of the tympanic membrane in adults.

To date there is no ideal method of painlessly achieving anaesthesia of the ear drum for myringotomy and grommet insertion. In this double blind, placebo controlled prospective study we have assessed a new topical anaesthetic agent (EMLA Cream) for use on keratinised squamous epithelium. A comparison has been made with the anaesthesia achieved by an injected agent. Twenty individuals were randomly allocated to receive placebo or EMLA cream. Their relative discomfort was measured on a visual analogue scale. Ten individuals received injected anaesthetic prior to myringotomy and grommet insertion and the discomfort of injection and of the procedure were similarly measured. We found EMLA cream to be an equally effective method of anaesthetising the ear drum as an injected agent. In addition there was minimal discomfort in the achievement of this anaesthesia. The discomfort of injecting the ear canal is shown to be similar to that of performing myringotomy and grommet insertion without anaesthesia.

Administration, Topical↗
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Solubilisation of a novel anticonvulsant binding site from pig cortical membranes.

The present study describes the solubilisation of the novel anticonvulsant, SB-204269, binding site from pig cortical membranes. Throughout the study the binding of a close analogue of this compound, [125I]-SB-217644 (trans 6- Acetyl-4S-(3-iodobenzoylamino)-3,4-dihydro-2,2-dimethyl-2H-benzo[b ]pyran-3R-ol) was used to monitor the success of the solubilisation procedure. [125I]-SB-217644 was an ideal mechanistic tool for quantifying the binding to this novel anticonvulsant site, with a high specific activity and affinity (K(D) of 3 nmol/l). Optimum conditions for the solubilisation of this anticonvulsant binding site were investigated using a multifactorial experimental design to assess a large number of variables. Detergent type, detergent-protein ratio, absence of Mg2+ and temperature were deemed to be important factors. However, the increases observed in binding site specific activity were minimal compared with those achieved for yields. Maximum percentage yields of binding activity (25%) were achieved with a low concentration of the zwitterionic detergent, CHAPS, in the presence of a low protein concentration. This yield was further enhanced on combining mixtures of detergents. The highest recovery (37%) was achieved with a 50:50 (v:v; 1.5 x critical micelle concentration) mixture of the ionic detergent, sodium cholate, and the non-ionic detergent, MEGA-10. In summary, we report the successful solubilisation of a novel anticonvulsant binding site, identified by its selective affinity for SB-204269 and its analogues. The recovery of nearly 40% of the target binding sites from the starting material should provide a good starting point for the purification of this protein.

Animals↗
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Invasive Haemophilus influenzae type b disease in elderly nursing home residents: two related cases.

We investigated two fatal cases of invasive Haemophilus influenzae type b (Hib) infection in a community nursing home in western Sydney, Australia. Two elderly women had lived in the same room, and the onset of their illness was 5 days apart. Hib isolates from blood cultures showed identical profiles by pulsed field gel electrophoresis. These findings suggest that Hib infection was transmitted within this nursing home. Serious Hib disease may be underrecognized in this setting. Continued surveillance and serotyping of invasive H. influenzae disease is essential for identifying groups at increasing risk that may benefit from immunization against Hib.

Aged↗
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Don't go 'way, it's time to play ... the safety game!

In an attempt to decrease the amount of time and dollars spent while increasing positive staff response, Emanual Hospital in Portland, Oregon, developed a game format to review required safety information. The game was piloted, then presented to the hospital's safety committee where it was approved as part of the hospital's education program. The game has significantly increased the percentage of staff participation in required classes. At the same time, cost of presenting the classes has decreased significantly.

Education, Nursing, Continuing↗
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Effect of acute biomechanical changes on corneal curvature after photokeratectomy.

PURPOSE: Unintended hyperopic shift is a common yet poorly understood complication of phototherapeutic keratectomy (PTK) that raises fundamental questions about the etiology of corneal curvature change in PRK and LASIK. We investigated the relative contributions of ablation profile and peripheral stromal thickening to intraoperative PTK-induced central flattening, and propose a biomechanical model of the acute corneal response to central ablation. METHODS: Fourteen de-epithelialized eye bank globes from seven donors underwent either broadbeam ablation (approximately 100-microm depth, no programmed dioptric change) or sham photoablation in paired-control fashion. Peripheral stromal thickness changes and the pattern of thickness loss across each ablation zone were evaluated by optical section image analysis as predictors of acute corneal flattening. RESULTS: Relative to sham ablation, keratectomy caused significant anterior corneal flattening (-6.3+/-3.2 D, P = .002). Concomitant peripheral stromal thickening (+57+/-43 microm, P = .01) was a significant predictor of acute hyperopic shift (r = 0.68, P = .047). Ablation pattern bias did not consistently favor hyperopia and was a poor lone predictor of hyperopic shift. CONCLUSIONS: Unintended keratectomy-induced hyperopic shift is replicable in a human donor model and is associated with significant thickening of the unablated peripheral stroma. This biomechanical response may have a considerable impact on early refractive outcomes in PTK, PRK, and LASIK.

Acute Disease↗
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Improving nursing records with audit.

This article describes the efforts of one unit to introduce an audit tool to measure the effectiveness of nursing documentation. After two years of use, the authors have been able to show that the quality of documentation is significantly better and patients have benefited from the improved communication that has resulted.

Documentation↗
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A new joint training programme in infectious diseases and medical microbiology.

The increasing overlap between the disciplines of medical microbiology and infectious diseases prompted the Joint Royal Colleges Committee on Infection and Tropical Medicine to set up a working party to examine how trainees could obtain certification in both subjects. Following widespread consultations, a scheme was developed that entails six years of training and leads to the award of CCSTs in both microbiology and infectious diseases. Both Royal Colleges and the Specialist Training Authority have approved the scheme. Joint training will be demanding and will not be suitable for everyone; it represents an alternative approach to training in the infection disciplines that will run alongside the existing monospecialty training programmes.

Certification↗
PubMedDate not supplied

Clinical evaluation of and parental satisfaction with resin-faced stainless steel crowns.

PURPOSE: This study evaluated the clinical success and parental acceptance of anterior primary dentition caries treatment with prefabricated resin-faced stainless steel crowns. METHODS: A retrospective analysis of maxillary anterior primary dentition caries treatment using Whiter Biter II Crowns was performed. Each crown was evaluated for retention, fracture, interface failure, color match, marginal integrity, and surface texture. Parental satisfaction regarding the esthetics of the crowns was evaluated by survey. RESULTS: Thirty-eight crowns were evaluated in 12 children. The average crown age at time of examination was 20.7 months. Three teeth were lost to trauma with all other crowns remaining intact. Twelve crowns (32%) showed loss of at least some facial resin. Nine crowns (24%) had complete loss of the resin facing. Overall parental satisfaction with the treatment was excellent, however, satisfaction with crown esthetics received the lowest rating. CONCLUSIONS: While parental satisfaction with treatment of anterior primary dentition caries with prefabricated resin-faced stainless steel crowns is excellent, the high failure rate of the resin facings is problematic.

Child↗