Search PubMed⌕ Search

Biomedical subjects

K Miller

Publications and source records attributed to K Miller.

At least 739 records · Page 41Linked to original sources
PubMedDate not supplied

Health professionals and the sex education of adolescents.

This paper is based on research assessing the provision of appropriate and effective sex education to pupils in the early years of their secondary schooling. It aimed to develop an awareness of their views about health professionals working in schools to help with sex education. The pupils had a range of responses to the work: they liked the openness with which medical personnel tackled the subject and welcomed their medical knowledge and the confidentiality they perceived that went along with that. There were also some profoundly negative reactions: gender had a bearing on the pupils' responses, and boys responded more negatively than girls. Differences in pupils' levels of development and sophistication had an impact on how they received the message. This is an edited version of a paper that will appear in a future issue of NTResearch.

Adolescent↗
PubMedDate not supplied

A fable.

Explore the source record for details and available documents.

Child Development↗
PubMedDate not supplied

Biomechanics of soft tissues.

Recent developments in Computer-Integrated and Robot-Aided Surgery (in particular, the emergence of automatic surgical tools and robots (as well as advances in Virtual Reality techniques, call for closer examination of the mechanical properties of very soft tissues (such as brain, liver, kidney, etc.). Moreover, internal organs are very susceptible to trauma. In order to protect them properly against car crash and other impact consequences we need to be able to predict the organ deformation. Such prediction can be achieved by proper mathematical modelling followed by a computer simulation. The ultimate goal of our research into the biomechanics of these tissues is development of corresponding, realistic mathematical models. This paper contains experimental results of in vitro, uniaxial, unconfined compression of swine brain tissue obtained by the author in Mechanical Engineering Laboratory, Japan, and discusses liver and kidney in vivo compression experiments conducted in Highway Safety Research Institute and the Medical Centre of The University of Michigan. The stress-strain curves for investigated tissues are concave upward for all compression rates containing no linear portion from which a meaningful elastic modulus might be determined. The tissue response stiffened as the loading speed increased, indicating a strong stress (strain rate dependence. As the step in the direction towards realistic computer simulation of injuries and surgical procedures, this paper presents two mathematical representations of brain, liver and kidney tissue stiffness. Biphasic and single-phase models are discussed. The biphasic model is shown to be inappropriate due to its inability to account for strong stress-strain relationship. Agreement between the proposed single-phase models and experiment is good for compression levels reaching 30% and for loading velocities varying over five orders of magnitude. Presented mathematical models can find applications in computer and robot assisted surgery, e.g. the realistic simulation of surgical procedures (including virtual reality), control systems of surgical robots, and non-rigid registration, as well as ergonomic design for injury prevention.

Animals↗
PubMedDate not supplied

Towards MRI guided surgical manipulator.

BACKGROUND: The advantages of surgical robots and manipulators are well recognized in the clinical and technical community. Precision, accuracy and the potential for telesurgery are the prime motivations in applying advanced robot technology in surgery. In this paper critical interactions between Magnetic Resonance Imaging equipment and mechatronic devices are discussed and a novel Magnetic Resonance compatible surgical robot is described. MATERIAL AND METHODS: Experimental results of the effects from several passive (metallic materials) and active (ultrasound motors) mechanical elements are demonstrated. The design principles for Magnetic Resonance compatible robots are established and the compatibility of the proposed robot is assessed by comparing images taken with and without the robot's presence within Signa SP/I GE Medical Systems scanner. RESULTS: The results showed that, in principle, it is possible to construct precision mechatronic devices intended to operate inside MR scanner. Use of such a device will not cause image shift or significant degradation of signal-to-noise-ratio. An MR compatible surgical assist robot was designed and constructed. The robot is not affected by the presence of strong magnetic fields and is able to manoeuvre during imaging without compromising the quality of images. A novel image-guided robot control scheme was proposed. As a part of the control scheme, biomechanics-based organ deformation model was constructed and validated by in-vivo experiment. It has been recognised that for robust control of an image guided surgical robot the precise knowledge of the mechanical properties of soft organs operated on must be known. As an illustration, results in mathematical modelling and computer simulation of brain deformation are given. CONCLUSION: The novel MR compatible robot was designed to position and direct an axisymmetric tool, such as a laser pointer or a biopsy catheter. New Robot control system based on the prediction of soft organ deformation was proposed.

Animals↗
PubMedDate not supplied

Essentials of finance for occupational physicians.

Comprehending the principles of finance is paramount to understanding the way an organization chooses to generate and use its financial resources. Financial principles may be employed in the same way a physician reviews fundamental systems to gauge a person s health. Just as basic anatomical and physiological components are used to assess the health of an individual, basic financial elements exist to ascertain the health of an organization. This chapter explains risk assessment, accounts receivable management, inventory, depreciation, capital formation, ratio analysis, and more.

Accounting↗
PubMedDate not supplied

Desmopressin acetate in children with severe primary nocturnal enuresis.

Desmopressin acetate, a synthetic antidiuretic drug, was evaluated in two US multicenter studies involving a total of 176 children with severe primary nocturnal enuresis. Patients who qualified during the screening period, entered a double-blind treatment phase during which they received 20 micrograms or 40 micrograms of desmopressin acetate or placebo at bedtime for four weeks. This phase was followed by a four-week open-label period, during which all patients received 20 or 40 micrograms of desmopressin acetate. In both studies, children given desmopressin acetate had significantly fewer wet nights after two and four weeks of therapy than did children given placebo. During the open-label period, patients crossed over from placebo to desmopressin acetate showed similar reductions in enuresis. Global evaluations by the patients, their parents, or the investigators further confirmed the good results with desmopressin acetate. No serious adverse experiences were reported. Thus the results of these studies corroborate previously published reports of the efficacy and safety of desmopressin acetate in the treatment of primary nocturnal enuresis.

Adolescent↗
PubMedDate not supplied

Relapsing malaria infection acquired in Kenya.

An American physician-traveler to East Africa presented with manifestations of cerebral malaria and was treated with intravenous quinidine for chloroquine-resistant falciparum malaria. He later relapsed with Plasmodium ovale infection, despite previous primaquine therapy. Treatment of chloroquine-resistant malaria is discussed. The difficulty in diagnosing P. ovale infections and the predominance of this malaria species over P. vivax in East Africa are reviewed.

Africa↗
PubMedDate not supplied

Advantages of a low-osmolality ionic contrast medium in intra-arterial applications.

Osmolality is recognized as a major contributing factor of contrast media related adverse reactions. The development of a new ionic contrast medium has made it possible to retain the ionic nature of contrast agents and have a lower osmolality than non-ionic and conventional ionic contrast media. Studies have indicated that low osmolality ionic contrast media is comparable to non-ionic agents and in some instances has proven to be superior to non-ionic contrast media.

Angiography↗
PubMedDate not supplied

A parent aide program: record keeping, outcomes, and costs.

As the use of parent aides grows, it is important that plans for developing and administering the services be carefully drawn to enhance the service. The record-keeping system described here evolved in direct response to program objectives and has helped maintain those objectives. It should be emphasized that although the procedures involved appear time consuming and perhaps troublesome, they play an important part in saving program time overall and making an effective service available to as many clients as possible. When the costs of parent aides are compared with those of other services, the results show that the time-limited, goal-oriented focus of this program allows effective services to be delivered economically.

Child↗
PubMedDate not supplied

Overcoming barriers to permanency planning.

The authors describe their success with a permanency planning project that emphasized interagency cooperation and worked from the thesis that every child is adoptable if return to the biological family is not possible.

Adoption↗
PubMedDate not supplied

The roles of the social worker in permanency planning.

The authors demonstrate how the theory of permanency planning becomes permanency planning practice. They outline the roles and tasks of the worker who is doing permanency planning, and illustrate them with a case example.

Child↗
PubMedDate not supplied

Transcatheter therapy in the angiographic suite.

To date, selective angiography is one of the best methods used to evaluate the presence and location of abdominal visceral arterial injury and hemorrhage. The rapid advancement of angiographic techniques and equipment has brought about the need for experienced and knowledgeable technologists. It is imperative that the technologist understand the underlying principles of the techniques and equipment so that he or she may perform with the utmost efficiency.

Aged↗
PubMedDate not supplied

A comparison of two modes of cervical exercise in adolescent male athletes.

OBJECTIVE: The Saturn-Ring is a new device that claims to increase cervical strength and flexibility. Therefore, the objective was to assess if use of the Saturn-Ring with conventional exercise would increase cervical strength, flexibility and circumference over conventional exercise alone. DESIGN: Subjects were randomly divided into two matched groups and a before/after design utilized. For pretest data, collection was done in a double-blind fashion. During the post-test, only the athlete knew the group in which he had participated. SETTING: The entire study was conducted in a high school field house. PARTICIPANTS: Fifty football players randomly chosen from a high school team served as subjects for the study. One subject was randomly selected from the pool of potential players and a matched subject was selected for the second group according to age, height and weight. This continued until both groups had 25 subjects. INTERVENTION: In addition to normal football exercises and practice, the experimental group used the Saturn-Ring five times a week over the 8-wk exercise program. MAIN OUTCOME MEASURES: Cervical strength and flexibility (flexion, extension, right lateral flexion and left lateral flexion) and girth size of the neck were measured before and after an 8-wk exercise program. RESULTS: Both groups showed significant gains in strength, flexibility and neck size. Further testing determined that the post-test results for the experimental group were significantly greater than the post-test results for the control group for neck sizes and all possible strength and flexibility measurements. CONCLUSIONS: The result of this study indicate that Saturn-Ring exercises in conjunction with conventional exercises will significantly increase cervical strength, flexibility and size over conventional exercises alone. There were several implications for further study: a) replicate the study to single out the effect of the Saturn-Ring alone, b) replicate the study with a broader spectrum of the population and include injured patients and c) research is needed to assess if the use of the Saturn-Ring can decrease the potential for cervical injury.

Adolescent↗
PubMedDate not supplied

A randomized single-blind evaluation of a discharge teaching book for pediatric patients with burns.

To evaluate the influence of a modular, multidisciplinary, pediatric burn discharge book on burn-care-related knowledge and satisfaction of caregivers, we studied children less than 17 years of age admitted with an acute thermal injury to the pediatric burn unit of a large, tertiary care hospital in Winnipeg, Canada over a 32 month period. Demographic characteristics of the population are similar to published profiles of other pediatric burn units with the exception that North American Indian (NAI) families were disproportionately admitted, with 59 out of the 123 (48%) admissions from a geographic area that has less than 15% NAIs. We randomly assigned the families to receive discharge instructions with the book (intervention group) or routine discharge teaching without the book (comparison group). Knowledge levels of burn care and satisfaction with discharge teaching of caregivers were evaluated with a questionnaire administered in single-blind fashion at the first outpatient follow-up visit. Sixty-two families received the book and 61 families received standard discharge teaching. Bivariate analysis showed greater knowledge in the intervention group, with an average score (range, 0.0 to 1.0) of 0.79 +/- 0.15 versus 0.73 +/- 0.15 in the comparison group (p < 0.05). We did not observe this positive effect of the book when we analyzed NAI families separately: 28 families instructed with the book scored 0.68 +/- 0.14 versus 0.63 +/- 0.13 in 31 families provided with routine teaching (p = 0.18). Stepwise multiple-regression analysis found that the influence of the book was limited to families with children who sustained scald burns (p < 0.05). Factors negatively related to the knowledge levels of caregivers (p < 0.05) were being of NAI origin and being NAI with no safety devices in the home. A positive correlation (p < 0.05) was found with having English as the first language, having a child with more extensive burns, having a younger age of the child with burns, and having fewer children in the home. In conclusion, we found that the discharge book improved the burn-care-related knowledge of caregivers. However, other factors, particularly ethnic and language background, were of greater influence.

Adolescent↗
PubMedDate not supplied

Circular stapling techniques for low anterior resection of rectal carcinoma.

BACKGROUND/AIMS: This report provides our experience in 103 patients with adenocarcinoma of the rectum along with a general overview of the use of circular stapler in rectal surgery. MATERIALS AND METHODS: Forty-two patients were randomized to a rectal anastomosis using either the single (SST) or double stapling technique (DST). RESULTS: From February 1991 to the present, 61 consecutive patients were treated to a rectal anastomosis using the DST. Perioperative mortality was 4.7 percent unrelated to the use of staplers. Statistically significant differences were noted: the mean distal resection margin measured 25.3 mm for SST and 35.0 mm for DST (p = 0.0274), without doughnut rings. Anastomotic stricture occurred in 3 patients (25%) using the 28-mm cartridge and in 1 (1.4%) using the 31-mm cartridge, respectively (p = 0.0082). To evaluate the different stapling techniques with bacterial contamination, the drain fluid was examined for lysozyme activity. When the SST was used, statistically significant enzyme activity increased as compared with the DST. Clinical leaks were noted in 9.5 percent (2/21) of the SST and in 2.4 percent (2/82) of the DST. The median follow-up of patients in the randomized study was 45 months (range, 32-62 months). Of the patients who underwent a potentially curative resection, seven (17.9 percent) developed a local recurrence, with no statistically significant differences in the stapling techniques of local recurrence and overall survival. CONCLUSIONS: Our experience, and that reported in literature, suggests that the double stapling technique is useful for restorative resection of rectal cancers.

Adenocarcinoma↗
PubMedDate not supplied

The reliability of the situation analysis observation guide.

The use of direct observation to assess the quality of family planning services is a central element of situation analysis studies. The interrater reliability of observational data from a study in Turkey was assessed using teams of multiple observers. Overall, the findings suggest a strong degree of reliability. Observers were more likely to agree when rating physical actions than verbal cues and when both observers were of similar backgrounds. The high degree of reliability in the situation analysis observation guide is considered to be due to a relatively low level of measurement and the use of crude indicators for several dimensions of quality. The guide's reliability makes this sort of study particularly valuable to family planning clinicians, program managers, and policymakers.

Family Planning Services↗