Biomedical subjects
Publications and source records attributed to J Miller.
In California, legislation that would give respiratory therapists legal credentialing has a 50-50 chance of enactment, say proponents. Therapists in Michigan are pinning their hopes on title licensure. In Utah a licensing bill for RTs is being rewritten. Arguments by both sides of the issue are presented here.
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Choosing the right audiovisual media for a health education program involves a variety of considerations, not the least of which is budget. The following article offers tips on making an informed, intelligent selection of media programs.
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Immunosuppression, although necessary to enable the graft to escape the consequence of immune surveillance carries some risks for the patients. There is an associated increase in neoplasm, opportunistic infections, and end-organ toxicity. In addition, even with excellent patient compliance, rejection (acute and chronic) remain a major limitation that contributes to the loss or decrease in the function of the allograft. New drugs have been added to the armamentarium of immunosuppressive agents to suppress allograft rejection and to rescue graft from cyclosporine-resistant. Most of the immunosuppressive agents in use today are direct at the T lymphocyte, non-specifically inhibiting T-cell activation and proliferation. The authors described here an update of these new immunosuppressive agents and new strategies used in solid organ transplantation.
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The effects of new aryl-sydnones: 3-[4-X-3-nitrophenyl]-1,2,3-oxadiazolium-5-olates, where X = Cl (SYD-1); pyrrolidino (SYD-2); piperidino (SYD-3) and morpholino (SYD-4) on the survival of mice bearing Sarcoma 180, Ehrlich carcinoma, B10MCII (Fibrous histiocytoma) and L1210 leukemia ascitic tumours, on the proliferation of cultured tumour cells and on the synthesis of DNA in L1210 leukemia were determined. SYD-1 and SYD-2 in vivo significantly enhanced the survival of S180, Ehrilich and B10MCII tumour-bearing mice. Furthermore, SYD-2 showed significant activity against L1210. SYD-3 and SYD-4 did not show antitumour activity. SYD-1, in vitro was the most cytotoxic against all the above tumour cells. All of the drugs tested inhibited thymidine uptake by L1210 cells, SYD-4 being the least active.
Children with terminal heart disease experience a dramatic improvement in functional status after heart transplantation but may be at increased risk for problems in psychosocial adaptation. Selected psychosocial outcomes were assessed in 49 pediatric heart transplant recipients and their families from five heart transplantation centers. Heart transplant recipients did not appear significantly different from their peers on self-report measures of self-concept and anxiety, but they showed significantly less social competence and more behavior problems than a normative population. Behavior problems observed were most frequently suggestive of depression and were significantly associated with greater family stress and diminished family resources for managing stress. The study findings further suggest that the heart transplant recipients' ability to verbalize or ventilate their feelings and concerns to others seems to facilitate psychosocial adaptation. Assessment of stress, resources, and coping is imperative to enable health professionals to promote the psychosocial adaptation of pediatric heart transplant recipients and their families.
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A 64 ml (effective stroke volume) in vitro electrohydraulic ventricular assist device (VAD) prototype has been built. The energy converter is an axial flow pump driven by a brushless direct current (DC) motor. Systole begins as silicone oil is pumped from the volume displacement chamber (VDC) into the ventricle, displacing the flexing diaphragm separating the oil and the blood. In diastole, the motor reverses, providing active filling by pumping oil from the ventricle into the VDC. The surface mount electronic internal controller provides motor commutator, energy management, telemetry, and physiologic control functions. Energy is supplied externally by either a 12 V DC power supply or a 12 V DC rechargeable battery and is transmitted through the skin by a transcutaneous energy transformer (TET). Energy can also be supplied by a 12 V DC rechargeable internal battery. Bidirectional infrared telemetry is used to transmit information between the internal and external controllers.
The overwhelming obstacles to effective CPS intervention created by increasing reports of abuse and neglect, funding shortfalls, and the lack of qualified workers have prompted national efforts to reform the public child welfare system in the United States. Organizations such as the American Public Welfare Association, the Children's Defense Fund, the Child Welfare League of America, and the National Association of Social Workers are currently working closely with other national organizations to develop legislative proposals that will enable child welfare agencies to be more responsive to the needs of children and families. A critical component of this reform is the need to recruit, train, and retain qualified and competent CPS workers. The four training programs described in this article are examples of innovative programs seeking to enhance service delivery by enhancing the knowledge and skills of their staff members. Although the four programs were developed in very different political and social climates and within diverse organizational structures, they all provide useful lessons in how to develop efficient and effective training for workers delivering protective services for children. Any national, state, or local efforts to design and develop new CPS training programs should take into account the significant strides made by these agencies.
This article presents findings from a survey conducted in Kenya in 1985 of the reproductive health knowledge, attitudes, and practices among more than 3,000 unmarried Kenyan youth, students and nonstudents, between the ages of 12 and 19. The survey was designed to elicit information that would be useful in gauging the kinds of problems Kenyan adolescents face in order to design programs that meet their needs. The study shows that although a solid majority of adolescents appear to have received information on reproductive health, the quality of the information is generally low. Fewer than 8 percent could correctly identify the fertile period in a woman's menstrual cycle. A substantial proportion of the population surveyed, more than 50 percent, is sexually active, having initiated intercourse some time between 13 and 14 years of age, on average. In spite of a general disapproval of premarital sex (but approval of the use of contraceptives among the sexually active), most of the sexually active population--89 percent--have never used contraceptives. The many contradictions between attitudes and practices pose serious questions and demonstrate the need to reexamine the programs (and policies) that provide access to reproductive health services to adolescents in Kenya.
Neuropathologic changes in the temporal lobe, including focal atrophy of the subiculum and entorhinal cortex, have been described in association with Alzheimer disease. We studied the usefulness of detecting temporal-lobe structural changes on CT in making the diagnosis of Alzheimer disease. The dementia imaging protocol we use includes thin-section (5 mm) cuts of the temporal lobe oriented 20 degrees negative (caudal) to the plane of the canthomeatal line. Thirty-four patients with suspected Alzheimer disease and 20 normal elderly control subjects, all between 65 and 80 years old, were studied with a standard protocol that also included neurologic and medical examinations and detailed psychometric testing. All the temporal-lobe evaluations of the five variables measured were significantly associated with the presence or absence of Alzheimer disease. Almost all Alzheimer patients showed evidence of mild or greater severity of overall temporal-lobe atrophy. The absence of temporal-lobe atrophy, seen in approximately one half the normal cases, identified normal individuals with a high degree of specificity (95%). The presence of characteristic hippocampal lucency, apparently due to enlargement of the choroid and hippocampal fissures, showed the highest sensitivity and classification accuracy of all the variables tested (82 and 80% respectively; p less than .001), correctly identifying 82% of Alzheimer patients and 80% of Alzheimer patients and control subjects. These results indicate that CT detection of structural changes in the temporal lobe and hippocampus strongly support the diagnosis of Alzheimer disease. A temporal-lobe imaging protocol for CT, and by extension for MR, is suggested for the evaluation of patients with the clinical diagnosis of a dementing disorder.
BACKGROUND: The aim was to determine the influence of the socioeconomic status of the family and the hygienic practices in the home on the prevalence of head lice infestation in children. METHODS: The study was carried out by analyzing the answers to a standardized epidemiological questionnaire given to parents of school children aged 4-17 in Bet Shemesh, a medium-sized urban town 25 km from Jerusalem. RESULTS: Of 3,000 questionnaires distributed, 958 (31.9%) were completed and returned. The majority of the children (72.4%) had been previously infested with lice. Half of them had other family members, mainly brothers and sisters, who had been infested in the past with lice. In 97.5% of the families the mother was responsible for examining the children for lice, and for carrying out treatment when infestation was present. An association was found between presence of lice infestation and mother's education, age of child, and frequency of shampooing, combing, and examination for lice. There was no association between infestation rates and mother's country of origin, crowding in the home, and the sharing of combs, brushes, hats, scarves, towels, and clothes. CONCLUSIONS: There is evidence that the incidence of lice infestation depends on the hygienic practices in the home rather than on the socioeconomic status of the family or sharing of personal articles among family members.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.