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Biomedical subjects

J Tanner

Publications and source records attributed to J Tanner.

At least 19 recordsLinked to original sources
PubMed2002

Double gloving to reduce surgical cross-infection.

BACKGROUND: The invasive nature of surgery, with its increased exposure to blood, means that during surgery there is a high risk of transfer of pathogens. Pathogens can be transferred through contact between surgical patients and the surgical team, resulting in post-operative or blood borne infections in patients or blood borne infections in the surgical team. Both patients and the surgical team need to be protected from this risk. This risk can be reduced by implementing protective barriers such as wearing surgical gloves. Wearing two pairs of surgical gloves, as opposed to one pair, is considered to provide an additional barrier and further reduce the risk of contamination. OBJECTIVES: The primary objective of this review was to determine if double gloving (wearing two pairs of gloves), rather than single gloving, reduces the number of post-operative or blood borne infections in surgical patients or blood borne infections in the surgical team. The secondary objective of this review was to determine if double gloving, rather than single gloving, reduces the number of perforations to the innermost pair of surgical gloves. The innermost gloves (next to skin) compared with the outermost gloves are considered to be the last barrier between the patient and the surgical team. SEARCH STRATEGY: The reviewers searched the Cochrane Wounds Group Specialised Trials Register, MEDLINE, CINAHL, EMBASE and the Cochrane Controlled Trials Register. Glove manufacturing companies and professional organisations were also contacted. SELECTION CRITERIA: Randomised controlled trials involving: single gloving, double gloving, glove liners or coloured puncture indicator systems. DATA COLLECTION AND ANALYSIS: Both reviewers independently assessed the relevance and quality of each trial. Trials to be included were cross checked and authenticated by both reviewers. Data was extracted by one reviewer and cross checked for accuracy by the second reviewer. MAIN RESULTS: Two trials were found which addressed the primary outcome. A total of 18 randomised controlled trials which measured glove perforations were identified and included in the review. DOUBLE GLOVING (wearing two pairs of latex gloves). Nine trials compared single latex gloves versus double latex gloves. These found no difference in the number of perforations between the single latex gloves and the outermost pair of the double latex gloves, but the number of perforations to the double latex-innermost glove was significantly reduced when two pairs of latex gloves were worn. ORTHOPAEDIC GLOVES (thicker than standard latex gloves). One trial compared single latex orthopaedic gloves with double latex gloves. This showed there was no difference in the number of perforations to the innermost gloves when wearing double latex gloves compared with a single pair of latex orthopaedic gloves. INDICATOR GLOVES (coloured latex gloves worn underneath latex gloves). Three trials compared double latex gloves versus double latex indicator gloves. These trials showed similar numbers of perforations to both the innermost and the outermost gloves for both gloving groups. Perforations to the outermost gloves were detected more easily when double latex indicator gloves were worn. Wearing double latex indicator gloves did not increase the detection of perforations to the innermost gloves. GLOVE LINERS (an insert worn between two pairs of latex gloves). Two trials compared double latex gloves versus double latex gloves with liners. These trials showed a significant reduction in the number of perforations to the innermost glove when a glove liner was worn between two pairs of latex gloves. CLOTH GLOVES (cloth gloves worn on top of latex gloves). Two trials compared double latex gloves versus latex inner with cloth outer gloves. These trials showed that wearing a cloth outer glove significantly reduced the number of perforations to the innermost latex glove. STEEL WEAVE GLOVES (steel weave gloves worn on top of latex gloves). One trial compared double latex gloves versus latex inner with steel weave outer gloves. This trial showed no reduction in the number of perforations to the innermost glove when wearing a steel weave outer glove. REVIEWER'S CONCLUSIONS: Wearing two pairs of latex gloves significantly reduces the number of perforations to the innermost glove. This evidence comes from trials undertaken in 'low risk' surgical specialties, that is specialties which did not include orthopaedic joint surgery. Wearing two pairs of latex gloves does not cause the glove wearer to sustain more perforations to their outermost glove. Wearing double latex indicator gloves enables the glove wearer to detect perforations to the outermost glove more easily than when wearing double latex gloves. However wearing a double latex indicator system will not assist with the detection of perforations to the innermost glove, nor reduce the number of perforations to either the outermost or the innermost glove. Wearing a glove liner between two pairs of latex gloves to undertake joint replacement surgery significantly reduces the number of perforations to the innermost glove compared with double latex gloves only. Wearing cloth outer gloves to undertake joint replacement surgery significantly reduces the number of perforations to the innermost glove compared with wearing double latex gloves. Wearing steel weave outer gloves to undertake joint replacement surgery does not reduce the number of perforations to innermost gloves compared with double latex gloves.

Blood-Borne Pathogens↗
PubMed2002

The effects of supplementing Napier grass (Pennisetum purpureum) with rock phosphate and steamed bone meal compared with a commercial mineral mix on phosphorus absorption in cattle.

Twelve Boran steers with a mean live weight of 215.8 +/- 13.9 kg were used in an incomplete Latin Square experiment to compare the apparent phosphorus (P) absorption in cattle when Napier grass (Pennisetum purpureum) was supplemented with Busumbu rock phosphate (BRP), Minjingu rock phosphate (MRP), steamed bone meal (SBM) or a commercial mineral mix (CMM). The steers were housed individually and supplemented with P at 0, 4.5 or 17.5 g P/day. Dry matter intake (DMI) and dry matter digestibility (DMD) were not affected (p > 0.05) by the source of P. Live weight gains (LWG) were different (p < 0.05) across the sources of P. The coefficient for apparent P absorption from the supplement (CAPA), DMD and LWG decreased linearly (p < 0.05) with period. Dry matter intakes were not significantly different (p > 0.05) across periods. The level of P supplementation had no significant effect (p > 0.05) on DMI or LWG. However, increasing the level of P supplementation significantly increased (p < 0.05) the DMD of the basal diet. There was also a significant (p < 0.05) source x level interaction for CAPA. The CMM had the highest CAPA, which decreased from 106% to 74.7% with increasing level of P supplementation. For SBM, BRP and MRP, increasing P supplementation also increased CAPA. The CAPA for SBM and BRP and BRP and MRP were not significantly (p > 0.05) different from each other. These results suggest that BRP has potential as a source of P for ruminants.

Animal Nutritional Physiological Phenomena↗
PubMed2002

The ArtAssist Device in chronic lower limb ischemia. A pilot study.

BACKGROUND: Patients with chronic critical limb ischemia following a failed bypass graft or with non-reconstructable distal disease diagnosed angiographically, have a very poor prognosis. This is a prospective pilot study to assess the influence of the ArtAssist Device on pedal blood flow and amputation rate. METHODS: Thirty-three legs in 25 patients were evaluated. Ten legs presented with rest pain, and 23 legs with tissue loss. Nine legs had previously undergone bypass surgery. RESULTS: At a mean follow-up of 3 months, 14 (42%) legs were amputated, and 19 (58%) were saved. Eleven of the amputated legs were in patients with chronic renal failure, a known risk factor. The amputation rate, excluding this group, was 13.6% (3/22). Toe pressures measured initially and after 3 months on the pump showed a significant improvement (p=0.03). Forty percent of patients presenting with rest pain improved, while 26% of foot ulcers healed on the pump. Mortality rate was 12%. CONCLUSIONS: The results from this prospective study are encouraging but need to be validated in a larger prospective randomized study.

Aged↗
PubMed2001

Effect of water storage of E-glass fiber-reinforced composite on adhesion of Streptococcus mutans.

This study investigated the effect of water storage of fiber-reinforced composite on the adhesion of Streptococcus mutans (S. mutans) and its ability to stay adhered and multiply on the FRC. The materials (E-glass fibers and denture base polymer) were stored in water for 14 or 30 days or left dry. Water contact angles of the materials before and after water storage were determined. Test specimens, with or without parotid saliva or serum pellicle, were incubated in a suspension of S. mutans allowing initial adhesion to occur. Bacterial adhesion and multiplication was studied using scanning electron microscopy. Contact angles of both materials were significantly reduced after water storage indicating an increase in surface free energy. When studied without a surface pellicle, water storage significantly increased adhesion of S. mutans to both glass and polymer. Saliva coating of the materials resulted in higher degree of adhesion to glass fibers in comparison with polymer and after 14 days water storage glass bound over twice as much S. mutans cells than the polymer matrix. Bacterial growth and biofilm formation occurred equally on both materials. The results of this in vitro study suggest that in order to avoid the possible increase in S. mutans adhesion, the reinforcing glass fibers should be covered with the matrix polymer of the composite.

Bacterial Adhesion↗
PubMed2001

First assistant activities.

A discussion of some of the issues surrounding the first assistant role has been ongoing in perioperative journals since around 1995. The crux of this discussion is the concern that theatre nurses who take on first assistant duties will encounter problems with professional accountability and liability. It is also proposed that theatre nurses wishing to act as first assistants require additional training. However, much of this debate is influenced by an assumption that has been accepted, apparently unchallenged, by some theatre nurses. This assumption is that first assistant activities constitute an extended role.

Clinical Competence↗
PubMed2001

Staff rostering in the operating department.

The smooth running of the operating department is often facilitated by the goodwill of the staff who agree to stay behind when cases overrun, or work through lunch and coffee breaks. Many perioperative staff also cover on-calls and stand-bys, causing disruption to their social and family lives. These demands may make working in the operating department harder for some staff. With reference to current shortages of perioperative staff and staff retention, Judith Tanner and Gloria Bailey discuss some suggestions for being flexible with the off duty rota which may give staff more control and more choices over when they work.

Humans↗
PubMed2000

Adherence of Streptococcus mutans to an E-glass fiber-reinforced composite and conventional restorative materials used in prosthetic dentistry.

The adherence of Streptococcus mutans to E-glass used in fiber-reinforced composites, denture base polymer, and four other restoratives was investigated. The materials were studied with and without a parotid saliva and serum pellicle. Specimens of the studied materials (E-glass, denture base polymer, titanium, cobalt-chromium alloy, gold alloy, and grained feldspar ceramic) were incubated in a suspension of S. mutans, allowing initial adhesion to occur. The degree of bacterial adhesion was studied using scanning electron microscopy (SEM). The studied uncoated materials showed rather similar adhesion of S. mutans. Saliva coating resulted in a decrease of adherence to all materials except glass. With a saliva pellicle E-glass showed the strongest ability to bind S. mutans, and it differed significantly from the other studied materials. Serum coating markedly decreased adhesion to all materials, and only minor differences among the studied materials were observed. The results of this study suggest that the studied restoratives are rather similar with respect to S. mutans adhesion and that a saliva pellicle may promote adhesion of S. mutans to glass fibers.

Bacterial Adhesion↗
PubMed2000

Antihypertensive efficacy of the ACE-inhibitor perindopril in the elderly.

To assess the antihypertensive efficacy of the angiotensin-converting enzyme (ACE)-inhibitor, perindopril, in the elderly, patients >65 years of age with supine diastolic blood pressure (BP) > or =90 and < or =110 mm Hg at the end of a 4-week placebo washout period were treated with perindopril 4-8 mg/daily vs placebo using a multicentre, randomised, double-blind, parallel group design. Of the 191 patients entered, 183 completed 8 weeks of double-blind therapy. Average age was 72-73 years. Supine and standing BP at the end of the placebo run-in period were 173/96 vs 168/96 mm Hg. BPs were measured in the morning, 20-25 h after the previous day's dose (ie, at the end of the dosing interval). In the placebo group, supine and standing diastolic BP decreased by 3-4 mm Hg, and systolic BP by 6-7 mm Hg. In the perindopril-group, diastolic BP decreased by 6-7 mm Hg and systolic BP by 10-13 mm Hg (both P < 0.01 vs placebo). These data indicate a substantial placebo response of particularly systolic BP in older hypertensives and indicate the importance of a parallel placebo-group to assess the extent of the actual drug's effect. Perindopril caused additional decreases in diastolic BP by about 2 mm Hg, and in systolic BP by 4-5 mm Hg. The extent of this drug-effect may be less in older vs middle-aged hypertensives.

Aged↗
PubMed2000

A practice-based approach to the selection of course content.

In an attempt to reduce the theory-practice gap, institutions have tried to base the content of nursing courses on practice. When devising courses, groups or individuals decide the course content through discussion and debate. It is proposed that courses devised in this manner reflect the subjectivity of the individuals or the power relationships within the group rather than the reality of nursing practice. The author compared the content of a current theatre nursing course, devised by an individual, against content determined through researched observation of theatre nurse practice. While the author found that the observations confirmed the relevance of most of the current course content, some subjects were not addressed. The most surprising of these, and one which appeared to have an enormous influence on theatre nurse practice, was sociology.

Attitude of Health Personnel↗
PubMed2000

Backstage in the theatre.

Observations undertaken in the operating theatre suggested that the social environment, and certain forms of staff behaviour could be explained using the space analysis developed by Erving Goffman (1969) in The Presentation of Self in Everyday Life. In the study reported in this paper the theatre department was found to be a strongly 'backstage' area. However, it was also found that there were limits to this analysis, and these are explained within this article. Some practical suggestions as to how this analysis might be helpful in the management of health care institutions and the education of health care professionals are made.

Attitude of Health Personnel↗
PubMed1999

Physician characteristics and the physician-patient relationship. Impact of sex, year of graduation, and specialty.

OBJECTIVE: To examine the association of physician sex, medical specialty, and year of graduation from medical school with attitudes and behaviours that define physician-patient relationships. Hypotheses tested are that women physicians, family physicians, and recent graduates spend more time discussing lifestyle and general health issues during patients' first visits; are more likely to report behaviours that are empathetic and that encourage communication with patients; are less likely to view their role as directive and problem-oriented; and are more supportive of patients' rights to information and participation in decision making. DESIGN: A survey was mailed to a stratified random sample of physicians between February and June 1996. SETTING: Physician practices in Ontario. PARTICIPANTS: Of 714 practising Ontario physicians, 405 (57%) responded. MAIN OUTCOME MEASURES: Proportion of time and actual time spent discussing a patient's lifestyle during a first visit, communication style, attitudes regarding a directive approach to care, and attitudes regarding patients' rights. RESULTS: Women physicians and family physicians spent significantly more time discussing lifestyle during a first visit. Women, family physicians, and recent graduates were significantly more likely to report an empathetic communication style. Women and recent graduates were significantly less likely to have a directive, problem-oriented approach to care. Family physicians were significantly less supportive of patients' rights than medical and surgical specialists were. CONCLUSIONS: Physicians in this study reported empathetic communication styles and attitudes that support information sharing and patients' rights.

Adult↗
PubMed1999

Problem based learning: an opportunity for theatre nurse education.

In my experience theatre nurses are always saying that student nurses just don't know enough anatomy, even with compulsory regular teaching of the subject in pre-registration nurse education. Boud and Feletti (1997) say anatomy and other subjects are forgotten because when they are taught students do not perceive their relevance. Problem based learning (PBL) seeks to overcome this difficulty by integrating theory and practice. This article will describe problem based learning and give an example of a scenario used in this educational process. The benefits of a PBL theatre nursing course and the implications for theatre nurse education will be discussed.

Clinical Competence↗
PubMed1999

Women and men managers in pharmacy: gender issues.

This paper examines the backgrounds, behaviours, and attitudes of a representative sample of male and female pharmacy managers in Ontario, Canada. It shows that the female managers are younger than their male colleagues, and spend significantly more time on childcare activities. There were no differences between the male and female managers in terms of work commitment and job responsibilities, but the female managers spent more time in direct patient contact, an activity that the qualitative analysis indicated was important to them. Female managers were also more supportive of strategies that would encourage additional patient counseling. For faculty in health administration programs, the results suggest that the importance that females place on the psycho-social aspects of their jobs as managers needs to be recognized and supported in the development and delivery of courses of study.

Administrative Personnel↗