Biomedical subjects
Publications and source records attributed to M Harvey.
A 45-year-old man developed symptoms of pneumonia while on holiday in Spain. On his return home, a diagnosis of Legionnaires' disease was confirmed, complicated by acute renal failure, He was treated with dialysis and spontaneous recovery of renal function began on day 19.
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The hen egg-white lysozyme (HEL)-specific B cells which are activated in response to HEL share a cross-reactive idiotype as well as submolecular specificity. Helper T cells of two different specificities are implicated in their optimal activation, one recognizing the idiotype and the other, an epitope on the HEL molecule opposite to the one recognized by B cells. Thus, efficient T-B collaboration involves both idiotypic complementary and antigen bridging.
The problem of establishing criteria to be considered when selecting clinical areas for basic nurse training was investigated by the Teaching team from Bexley Hospital Nurse Education Centre, Kent. Establishments involved in training personnel in occupations other than nursing were examined and evaluated in order to see if comparisons could be made. Unfortunately the establishments chosen provided little information in respect of learner placement in nursing. Contributions to the nursing literature in respect of the subject being considered were sparse, but articles by Martin (1976), Roper (1976), Schröck (1973) and Strohmann (1977) were interesting and of considerable value. Whilst the project at Bexley involved examination of the more obvious criteria used in the selection of training areas, considerable attention was paid to the attitudes of clinical nursing personnel towards nurse education and training. Replies to an educational questionnaire devised by the team revealed many significant differences between the attitudes of those nurses involved in basic nurse training in the hospital's wards and departments when compared with those of other teaching and service personnel. A checklist of criteria was ultimately complied and it was suggested that a further comparative study emphasizing the attitude component of this project should be made in 12 months time.
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Maternal and fetal lymphocytes were tolerant of each other in the bidirectional mixed lymphocyte reaction. This seems to be the principal reason why the mother does not reject the fetal allograft. Tolerance between maternal and fetal cells must be largely due to a genetic mechanism, because the bidirectional mixed lymphocyte reaction between parents and older children was much reduced compared with that between randomly selected pairs of controls. This weak reaction disappeared when immunosuppressive agents were given to one member of the parent/child pair, whereas the mixed lymphocyte reaction between unrelated individuals was not abolished by similar immunosuppression. It is suggested that this genetic mechanism is distinct from the HLA system. Tolerance between maternal and fetal cells was not demonstrated in the unidirectional mixed lymphocyte reaction, suggesting that this tolerance requires the viability of the two cell populations.
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Evaluating the quality of medical care is a documented activity extending as far back as 1910, when William Flexner, MD, examined the nation's medical schools. Standards promulgated by the federal government and by voluntary accreditation agencies have been primarily responsible for driving the development and widespread use of monitoring activities over the past 20 years. A new wind is blowing, however. Momentum is increasing to incorporate the principles of industrial quality improvement into the healthcare arena. In this study, Michelle Harvey poses the following questions: Have hospitals made the transition from traditional quality assurance to continuous quality improvement? Is an individual hospital's transition affected by such variables as bed size, region, profit or nonprofit status, and system affiliation? This analysis suggests that opportunities to facilitate transition to the new paradigm abound.
Patients with right unilateral cerebral stroke, four of which showed acute hemispatial neglect, and healthy aged-matched controls were tested for their ability to grasp objects located in either right or left space at near or far distances. Reaches were performed either in free vision or without visual feedback from the hand or target object. It was found that the patient group showed normal grasp kinematics with respect to maximum grip aperture, grip orientation, and the time taken to reach the maximum grip aperture. Analysis of hand path curvature showed that control subjects produced straighter right hand reaches when vision was available compared to when it was not. The right hemisphere lesioned patients, however, showed similar levels of curvature in each of these conditions. No behavioural differences, though, could be found between right hemisphere lesioned patients with or without hemispatial neglect on either grasp parameters, path deviation or temporal kinematics.
As part of a study evaluating neonatal nurse practitioner programmes in England, data were collected on the experience of students from four separate English National Board (ENB, A19) programmes. A total of 123 nurses participated. Data were collected from 68 nurses using questionnaires at three points (the start, middle and end of the programme. The data show key concerns relating to the content and organization of course, the need for effective clinical supervision and teaching during the programmes, role transition issues and the value of informal and formal professional support. Senior and experienced nurses may find that their exposure to programmes of this kind is of interest and relevance to nurses facing similar challenges in other fields. It is also of vital importance in planning future skill mix and organizing critical care in specialties such as neonatal care.
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The purpose of this study was to evaluate the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) in pain reduction during cavity preparations in pediatric patients. Twenty patients, ages eight to fourteen years, were treated for Class I amalgam restorations in mandibular first permanent molars using TENS in a double blind protocol. Randomized assignments were made for ten experimental and ten control patients. Using the visual analogue scale, the ANOVA test indicated a significant decrease (p < 0.01) in patient ratings between the TENS experimental and the control group. It can be concluded there was a statistically significant decrease in the pain perceptions of pediatric patients during Class I amalgam cavity preparations in mandibular first permanent molars.