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Biomedical subjects

G Walker

Publications and source records attributed to G Walker.

215 records · Page 12Linked to original sources
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Dibekacin intrarenal distribution characteristics and renal cortical elution kinetics. Comparison with gentamicin and tobramycin.

Dibekacin (3',4-dideoxykanamycin B) is a new semisynthetic aminoglycoside developed in Japan and one which has found wide clinical acceptance in that country. The antibacterial activity of this compound indicates that it is relatively similar to gentamicin. Since it appears that the intrarenal distributional characteristics and renal cortical kinetics of aminoglycosides provide some predictive information concerning the clinical incidence of nephrotoxicity, we designed a series of pharmacokinetic studies in healthy mongrel dogs which would define such kinetic information for dibekacin and would contrast the results with similar studies for gentamicin and tobramycin. The renal cortical kinetics of dibekacin, as developed in these studies, show that in a canine model the behavior of dibekacin is similar to that of gentamicin and significantly different from tobramycin. Dibekacin and gentamicin show reproducibly higher renal cortical tissue concentrations than tobramycin in both the acute infusion studies and multiple dosing studies. The results suggest that dibekacin may possess the same inherent nephrotoxic potential as that of gentamicin. In order to show any difference in clinical toxicity between gentamicin and dibekacin, a very extensive randomized, double-blind, prospective clinical trial of efficacy and toxicity will be needed.

Animals↗
PubMedDate not supplied

To report or not to report: emergency services response to elder abuse.

PURPOSE: Prehospital emergency medical services (EMS) personnel, as initial responders to calls for assistance, are in an ideal position to identify abused or neglected elderly. A survey of prehospital personnel in Michigan was conducted to determine the scope of this problem, levels of awareness, and willingness to report cases of elder abuse. METHODS: The study population was a random sample of 500 prehospital personnel throughout one state. A blinded, self-administered survey was completed by emergency medical technicians (EMTs) and paramedics outlining their practice characteristics, prevalence of abuse in their community, and training available specific to elder abuse. Attitudes concerning the understanding and reporting of geriatric abuse were measured using a Likert-type scale. RESULTS: A total of 156 surveys (31%) was completed; 68% of the respondents were paramedics. Respondents had an average of 8.7 years (range: 9 months-30 years) of prehospital emergency-care experience, and evaluated an average of 11 patients (range: 1-59) older than 65 years of age each week. Seventy-eight percent had seen a suspected case of elder abuse or negligence during their careers; 68% had seen a case during the past 12 months (mean: 2.3 cases/yr; range: 0-24 cases/yr). However, surveyed personnel reported only 27% of suspected cases to authorities last year (mean: 0.62 cases/yr). Reasons for not reporting included 1) unsure which authorities take reports; 2) unclear definitions; 3) unaware of mandatory reporting laws; and 4) lack of anonymity. Ninety-five percent of respondents stated that training related to elder abuse was not available through their EMS agency. CONCLUSION: Paramedics and EMTs lack complete understanding of their role in the identification and reporting of elder abuse. This information should be emphasized during EMS training and reinforced through continuing education.

Aged↗
PubMedDate not supplied

Distributed situation awareness in dynamic systems: theoretical development and application of an ergonomics methodology.

The purpose of this paper is to propose foundations for a theory of situation awareness based on the analysis of interactions between agents (i.e. both human and non-human) in subsystems. This approach may help to promote a better understanding of technology-mediated interaction in systems, as well as helping in the formulation of hypotheses and predictions concerning distributed situation awareness. It is proposed that agents within a system each hold their own situation awareness, which may be very different from (although compatible with) that of other agents. It is argued that we should not always hope for, or indeed want, sharing of this awareness, as different system agents have different purposes. This view marks situation awareness as a dynamic and collaborative process binding agents together on tasks on a moment-by-moment basis. Implications of this viewpoint for the development of a new theory of, and accompanying methodology for, distributed situation awareness are offered.

Awareness↗
PubMedDate not supplied

Sound field audiometry: recommended stimuli and procedures.

Comprehensive recommendations are presented for conducting sound field audiometry with frequency specific stimuli. These recommendations are primarily based on a series of investigations by the authors. The rationale for each recommendation is presented, together with a brief overview of the supporting research. The preferred stimuli are frequency modulation tones, triangularly or sinusoidally modulated at a rate of about 20 Hz, or suitably generated narrow bands of noise. The optimal bandwidths of the stimuli, expressed in percentages of the center frequency, vary with frequency. Stimuli suitable for most purposes have bandwidths ranging from about 30% at 0.25 kHz to about 10% at 4 kHz. Stimuli having narrower or broader bandwidths are desirable for some special purposes. The test room should be as nonreverberant as possible and the subject should be seated on an adjustable height chair with headrest. The control microphone method of calibration is preferred but a method is also presented for carrying out the traditional precalibration procedure. The SPL of the complex stimulus should be taken as the peak deflections on a sound level meter set to "RMS-FAST." A conversion table is presented which allows thresholds obtained in the sound field to be expressed as dB HTL. With the materials and methods described here it is possible to achieve the same reliability for sound field testing as for audiometry under earphones.

Acoustic Stimulation↗
PubMedDate not supplied

Acid resistance of enamel subsurface lesions remineralized by a sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate.

The aim of this clinical study was to investigate the acid resistance of enamel lesions remineralized in situ by a sugar-free chewing gum containing casein phosphopeptide-amorphous calcium phosphate nanocomplexes (CPP-ACP: Recaldent). The study utilized a double-blind, randomized, crossover design with two treatments: (i) sugar-free gum containing 18.8 mg of CPP-ACP, and (ii) sugar-free gum not containing CPP-ACP as control. Subjects wore removable palatal appliances with insets of human enamel containing demineralized subsurface lesions and chewed the gum for 20 min 4 times per day for 14 days. After each treatment the enamel slabs were removed and half of each lesion challenged with acid in vitro for 8 or 16 h. The level of remineralization was determined using microradiography. The gum containing CPP-ACP produced approximately twice the level of remineralization as the control sugar-free gum. The 8- and 16-hour acid challenge of the lesions remineralized with the control gum resulted in 65.4 and 88.0% reductions, respectively, of deposited mineral, while for the CPP-ACP-remineralized lesions the corresponding reductions were 30.5 and 41.8%. The acid challenge after in situ remineralization for both control and CPP-ACP-treated lesions resulted in demineralization underneath the remineralized zone, indicating that the remineralized mineral was more resistant to subsequent acid challenge. The results show that sugar-free gum containing CPP-ACP is superior to an equivalent gum not containing CPP-ACP in remineralization of enamel subsurface lesions in situ with mineral that is more resistant to subsequent acid challenge.

Acetic Acid↗
PubMedDate not supplied

The evolution of a distance education initiative into a major telehealth project.

After a five-year collaboration in distance learning, the University of Texas Medical Branch in Galveston School of Nursing and the Lamar University Department of Nursing in Beaumont, Texas, opened discussions during the mid-1990s about working together to establish a cutting-edge telehealth clinic. Other participants in this dialogue were the UTMB Division of Pediatric Special Services (DPSS) and the East Texas Area Health Education Center (ETAHEC). DPSS hoped to provide telehealth services for children who had to commute routinely to receive comprehensive health care. ETAHEC, which specializes in building community-academic partnerships to improve the health of populations in its service region, had already worked with members of the team, providing support for the distance education collaboration between UTMB and LU. Several meetings between representatives from the two universities and ETAHEC resulted in the decision by LU to establish an infrastructure for distance learning that could also support telehealth activities. UTMB, which offered family nurse practitioner education at LU through the earlier distance learning initiative, had extensive experience in both distance education and telehealth. It provided the expertise to ensure that the two types of technology could be provided on the LU campus. Eventually, a third university came on board, and the program expanded to provide services in six public schools. A single telehealth clinic, in operation for two years with over 112 client visits, has grown into a major telehealth initiative linking an academic health science center, universities, and school districts in Texas.

Child Health Services↗
PubMedDate not supplied

In the line of fire.

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Bosnia and Herzegovina↗