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Biomedical subjects

N Garrett

Publications and source records attributed to N Garrett.

At least 19 recordsLinked to original sources
PubMed2006

Interventions for the prevention and management of neck/upper extremity musculoskeletal conditions: a systematic review.

Considered from medical, social or economic perspectives, the cost of musculoskeletal injuries experienced in the workplace is substantial, and there is a need to identify the most efficacious interventions for their effective prevention, management and rehabilitation. Previous reviews have highlighted the limited number of studies that focus on upper extremity intervention programmes. The aim of this study was to evaluate the findings of primary, secondary and/or tertiary intervention studies for neck/upper extremity conditions undertaken between 1999 and 2004 and to compare these results with those of previous reviews. Relevant studies were retrieved through the use of a systematic approach to literature searching and evaluated using a standardised tool. Evidence was then classified according to a "pattern of evidence" approach. Studies were categorised into subgroups depending on the type of intervention: mechanical exposure interventions; production systems/organisational culture interventions and modifier interventions. 31 intervention studies met the inclusion criteria. The findings provided evidence to support the use of some mechanical and modifier interventions as approaches for preventing and managing neck/upper extremity musculoskeletal conditions and fibromyalgia. Evidence to support the benefits of production systems/organisational culture interventions was found to be lacking. This review identified no single-dimensional or multi-dimensional strategy for intervention that was considered effective across occupational settings. There is limited information to support the establishment of evidence-based guidelines applicable to a number of industrial sectors.

Cost-Benefit Analysis↗
PubMed2006

Pacific Islands families study: the prevalence of chronic middle ear disease in 2-year-old Pacific children living in New Zealand.

OBJECTIVE: The aim of this study was to determine the prevalence of chronic middle ear disease in 2-year-old Pacific children living in New Zealand. METHODS: The data were gathered as part of the Pacific Islands Families: First Two Years of Life (PIF) Study in which 1001 two year olds were screened using tympanometry to identify children at risk for otitis media with effusion (OME) and other otological disorders. Those failing the screening tests were referred to Manukau Superclinic where they had a further tympanometry test, and if they failed this test, were followed up with a comprehensive otological examination by an otolaryngologist using otomicroscopy and pneumatic otoscopy. RESULTS: Bilateral otitis media with effusion (OME) was the most common abnormality detected (N=102) with further cases of unilateral OME (N=8), and unilateral OME resolving (N=2). Other cases of OME were associated with acute otitis media (AOM), impacted wax (N=1), perforation (N=1), and mild retraction (N=2). Overall there were 118 children with unilateral or bilateral OME. AOM of any form was seen in nine cases. Retraction of the tympanic membrane was seen in 26 cases. The population prevalence among Pacific 2-year-old children was estimated as 25.4% for OME, 1.9% for AOM, and 26.9% for OME or AOM. CONCLUSIONS: These findings reveal that over 25% of Pacific Island 2-year-old were affected by OME and recommend the consideration of national screening for OME and other otological disorders at this earlier age.

Child, Preschool↗
PubMed2006

Influence of food platform width of mandibular removable partial denture on food mixing ability.

The aim of this study was to clarify the influence of food platform width on food mixing ability in patients with mandibular removable partial dentures (RPDs). Twelve subjects (six males and six females, mean age 56.8 years) with intact dentition except for unilaterally missing mandibular first and second molars participated in the study. The food platforms of their RPDs were made of light polymerized composite and three platform conditions were evaluated. A food platform (Control condition) had 7 mm width with a central focus on the top of the residual ridge. Narrowed platforms (5 mm) were created by trimming a lingual portion (Buccally oriented occlusion, Buccal condition) or a buccal portion (Lingually oriented occlusion, Lingual condition) from the control. Subjects chewed a standardized wax cube which provided an estimate of food mixing ability [Mixing Ability Index (MAI)] for each of the three platforms. A significant effect (P < 0.001) on the MAI was found for food platform type (repeated measures one-way analysis of variance). Tukey multiple comparisons found significant differences of MAI between Control condition (1.05 +/- 0.26) and Buccal condition (0.86 +/- 0.23) (P = 0.032), and between Control and Lingual condition (0.54 +/- 0.37) (P < 0.001). Furthermore, MAI with Lingual condition was significantly smaller than that with Buccal condition (P < 0.001). These results suggest that reduction in the width of the food platform may impair masticatory function and the buccal portion of mandibular food platform of RPD is more critical for food mixing than the lingual portion of the platform.

Composite Resins↗
PubMed2005

The occurrence of Campylobacter subtypes in environmental reservoirs and potential transmission routes.

AIM: To identify potential reservoirs and transmission routes of human pathogenic Campylobacter spp. METHODS AND RESULTS: An enrichment PCR method for the detection and identification of Campylobacter jejuni and/or Campylobacter coli in faecal, food and river water samples was applied to 1450 samples of 12 matrix types obtained from a defined geographical area. PCR-positive samples were cultured to yield isolates for typing, and the data for 616 C. jejuni isolates obtained. Serotyping and SmaI macrorestriction profiling using pulsed field gel electrophoresis revealed a high level of diversity within the isolates from each matrix. Campylobacter jejuni and C. coli subtypes indistinguishable from those obtained from human cases were detected in most of the matrices examined. No Campylobacter isolates were isolated from possum faeces. CONCLUSIONS: Ten of the 12 matrices examined may be involved in the transmission of human campylobacteriosis as they contained Campylobacter subtypes also isolated from clinical cases. SIGNIFICANCE AND IMPACT OF THE STUDY: Results indicate that, for this rural population, a range of potential transmission routes that could lead to campylobacteriosis exist. Their relative importance needs to be assessed from an exposure assessment standpoint.

Animals↗
PubMed2003

[Simulation of pigmented mucosa in complete dentures: development of an oral pigment index].

In the non-Caucasian population the skin and oral tissues show pigmentation to a variable degree, but much more than in Caucasian. When a person becomes edentulous, the tissues containing oral pigmentation disappear. The patient's ethnic background gives no information to predict the characteristics of individual oral pigmentation; other sources have to be found. The mucosal pigmentation of 106 non-Caucasian, dentate people in Amsterdam and Los Angeles was investigated; a classification-chart of oral pigmentation with six types was designed. This tool makes it possible to help patient, dentist and dental technician to choose an accurate simulation of the contour of oral pigmentation in a denture. It is recommended to document the individual pigmentation before extractions are performed.

Dentures↗
PubMed2003

Elucidation of potential transmission routes of Campylobacter in New Zealand.

Campylobacter is the most commonly reported notifiable disease in New Zealand. The cost of Campylobacter infections in the country during 1994 was estimated as dollar 61.7M although the true cost was probably higher. Investigation of the main environmental reservoirs and routes of transmission to humans is necessary to formulate the most appropriate intervention strategies. This project investigated the reservoirs of Campylobacter in a defined geographical area within New Zealand and compared strains isolated from humans and environmental sources within this area as a prelude to investigating the likely transmission routes to humans. Campylobacter jejuni was commonly found in faeces from dairy cows, beef cattle, sheep and ducks, chicken carcasses, sheep offal and surface waters and C. coli was commonly found in sheep faeces. Preliminary analysis of Penner types was suggestive of transmission to humans from dairy and beef cattle and possibly from sheep.

Animals↗
PubMed2002

Exposure of hospitality workers to environmental tobacco smoke.

OBJECTIVE: To determine quantitatively the extent of exposure of hospitality workers to environmental tobacco smoke (ETS) exposure during the course of a work shift, and to relate these results to the customer smoking policy of the workplace. SUBJECTS: Three categories of non-smoking workers were recruited: (1) staff from hospitality premises (bars and restaurants) that permitted smoking by customers; (2) staff from smokefree hospitality premises; and (3) government employees in smokefree workplaces. All participants met with a member of the study team before they began work, and again at the end of their shift or work day. At each meeting, participants answered questions from a standardised questionnaire and supplied a saliva sample. MAIN OUTCOME MEASURES: Saliva samples were analysed for cotinine. The difference between the first and second saliva sample cotinine concentrations indicated the degree of exposure to ETS over the course of the work shift. RESULTS: Hospitality workers in premises allowing smoking by customers had significantly greater increases in cotinine than workers in smokefree premises. Workers in hospitality premises with no restrictions on customer smoking were more highly exposed to ETS than workers in premises permitting smoking only in designated areas. CONCLUSIONS: Overall, there was a clear association between within-shift cotinine concentration change and smoking policy. Workers in premises permitting customer smoking reported a higher prevalence of respiratory and irritation symptoms than workers in smokefree workplaces. Concentrations of salivary cotinine found in exposed workers in this study have been associated with substantial involuntary risks for cancer and heart disease.

Adult↗
PubMed2002

A changing morphogen gradient is interpreted by continuous transduction flow.

In vertebrate development, most signalling factors behave as morphogens, eliciting divergent cell fates according to their concentration. We ask how cells interpret morphogen concentration as it changes during the establishment of a gradient. Using dissociated blastula cells of Xenopus exposed to activin for only 10 minutes, we have followed the phosphorylation of tagged Smad2, the principal activin transducer, from a cytoplasmic pool to the nucleus in real time. We show that a changing concentration of extracellular activin is rapidly and continuously transduced to provide a corresponding nuclear concentration of Smad2, even though gene response may be delayed for several hours. Nuclear Smad2 concentration changes up as the extracellular concentration of activin increases. We conclude that cells interpret a changing extracellular concentration by maintaining a continuous flow of activated transducer from a large cytoplasmic pool to the nucleus where it is degraded. The volume of this flow determines the steady state concentration of Smad2 in the nucleus and this is used by cells to interpret extracellular morphogen concentration.

Activins↗
PubMed2001

Treatment practices for chlamydial infection in New Zealand.

AIMS: To identify prescribing and treatment practices for chlamydial infection in New Zealand. METHODS: Postal survey to doctors and nurses at all sexual health, family planning, student and youth health centres, and randomly selected general practitioners. RESULTS: There was considerable variation in treatment regimes used for chlamydial infection with few respondents treating in accordance with international guidelines regarding dose, frequency, and duration of treatment. Doxycycline (88.4%) was most commonly used to treat uncomplicated chlamydial infection in non-pregnant patients. Most respondents (70.2%) stipulated doxycycline for longer durations than the seven day regimen international guidelines recommend, with doxycycline 100 mg twice a day for ten days most frequently specified. Among the 259 respondents who would treat pregnant women with erythromycin, 51 different treatment regimens were specified, and 51.7% recorded regimens less than that recommended by international guidelines. When treating a patient presumptively, the majority of respondents tested for chlamydial infection. In contrast to other respondents, sexual health clinic staff rarely provide patients with a prescription for a patient's partner without seeing the partner. CONCLUSIONS: Standardised treatment guidelines are required for patients diagnosed with chlamydial infection. Guidelines should include recommendations for the treatment of partners, and encourage the laboratory confirmation of diagnosis.

Anti-Bacterial Agents↗
PubMed2001

Screening and diagnostic practices for chlamydia infections in New Zealand.

AIMS: To identify screening and diagnostic practices for chlamydia infection in New Zealand. METHODS: Postal survey of doctors and nurses at all sexual health, family planning, youth and student clinics, and randomly selected general practitioners (GPs). RESULTS: Most respondents recognised chlamydia infection as a cause of pelvic inflammatory disease and infertility in females, and epididymitis and non-gonococcal urethritis in males. Ectopic pregnancy and conjunctivitis were less commonly recognised by GPs and student and youth centre doctors. Sterile pyuria and arthritis were well recognised only by sexual health doctors. Female doctors were significantly more likely to recognise signs and symptoms than male doctors. GPs were less likely than other respondents to screen for chlamydia infection. Sexual health doctors and nurses were more likely to remove cervical secretions prior to taking endocervical specimens. Contact tracing was regarded as very important by only a quarter of family planning respondents, compared with over 80% of other respondents. CONCLUSIONS: While respondents recognised most signs, symptoms, and sequelae of chlamydia infection, some important features were not well recognised. Screening practices varied, and many endocervical specimens were taken incorrectly. Given the long-term health consequences and cost of chlamydia infection sequelae, screening guidelines are urgently required.

Adolescent↗
PubMed2001

Surveillance of sexually transmitted infections in New Zealand, 1998.

AIMS: To describe the surveillance and epidemiology of sexually transmitted infections (STIs) in New Zealand. METHODS: Sexual health clinics submitted STI data to the Institute of Environmental Science and Research (ESR). Infection rates were calculated by dividing the number of diagnoses by the number of total clinic visits. Because the denominator used to calculate infection rates changed in 1998, STI rates in 1998 cannot be directly compared with previous years and case numbers were used to identify recent trends. RESULTS: In 1998, genital warts was the most commonly diagnosed STI (4.7%), followed by chlamydia (3.0%) and genital herpes (1.0%). Approximately two-thirds of gonorrhoea, chlamydia and genital warts diagnoses were in people aged less than 25 years. Chlamydia rates were 7.3% in Maori, 7.1% in Pacific Island people, and 2.1% in European. Gonorrhoea rates were 1.6% in Maori, 1.9% in Pacific Island people and 0.2% in European. The number of chlamydia and gonorrhoea cases increased between 1995 and 1998. CONCLUSIONS: The reporting of data by age, sex and ethnicity has allowed a more useful evaluation of the incidence of STIs. The majority of STIs were diagnosed among young New Zealanders, and disproportionately high chlamydia and gonorrhoea infection rates were found among Maori and Pacific Island people.

Adolescent↗
PubMed2001

Is testicular cancer an occupational disease of fire fighters?

BACKGROUND: A previous investigation showed an increased risk of testicular cancer among fire fighters in Wellington City, New Zealand, during the 1980s. Other studies of fire fighters had not identified testicular cancer as an occupational disease. METHODS: This was an historical cohort study of mortality and cancer incidence in all paid New Zealand fire fighters, from 1977 to 1995. RESULTS: The only cancer for which this study provided evidence of an increased risk was testicular cancer, even after excluding cases from the previous investigation. The standardized incidence ratio for 1990-96 was 3.0 (95% confidence interval: 1.3-5.90). There was no evidence that fire fighters were at increased risk from any particular cause of death. CONCLUSIONS: This study confirmed that New Zealand fire fighters are at increased risk of testicular cancer, although the reason is unknown. Other incidence studies of cancer in fire fighters are needed to confirm this finding.

Adult↗
PubMed2000

Estimated number of cases of foodborne infectious disease in New Zealand.

AIMS: To estimate the annual number of cases of infectious intestinal disease caused by foodborne pathogens in New Zealand and estimate the impact of these diseases in terms of days lost to illness. METHODS: Incidence of foodborne diseases were derived from data from infectious disease surveillance and hospital sources, and estimates of unreported illnesses using published population based studies. RESULTS: The estimated number of cases of foodborne infectious disease is approximately 119 000 per year, including 19 000 general practitioner visits, 400 hospital admissions, 22 cases of long term illness and two deaths. It is estimated that the number of cases of potentially foodborne infectious disease is approximately 199 000. Total number of cases of all infectious intestinal disease could be as high as 823 000. Days of lost production and leisure time activities lost to foodborne infectious disease are estimated as approximately 497 000. CONCLUSION: Foodborne infectious diseases represent a major public health burden in terms of the number of cases and days lost to illness.

Disease Outbreaks↗
PubMed2000

The Xenopus eomesodermin promoter and its concentration-dependent response to activin.

Eomesodermin is an essential early gene in Xenopus mesoderm formation and shows a morphogen-like response to activin. Here we define the regions of the Eomesodermin promoter required for mesodermal expression and for concentration-dependent response to activin. We find an activin response element (ARE) located between -5.6 and -5.0 kb which contains two critical FAST2 binding sites. The ARE alone is necessary and sufficient for concentration-dependent response to activin. A 5.6 kb promoter recapitulates Eomes expression in normal mesoderm cells. A repressor element extinguishes Eomes expression in the endoderm. We relate our results to mesoderm patterning in early Xenopus development and to a mechanism of morphogen gradient response.

Activins↗
PubMed2000

Household crowding a major risk factor for epidemic meningococcal disease in Auckland children.

BACKGROUND: New Zealand is in its ninth year of a serogroup B meningococcal disease epidemic with annual rates of up to 16.9 cases per 100,000. The highest incidence is in Maori and Pacific Island children in the Auckland region. We conducted a case-control study to identify potentially modifiable risk factors for this disease. METHODS: A case-control study of 202 cases of confirmed and probable meningococcal disease in Auckland children younger than 8 years of age recruited from May, 1997, to March, 1999, was undertaken. Controls (313) were recruited door-to-door by a cluster sampling method based on starting points randomly distributed in the Auckland region. They were frequency matched with the expected distribution of age and ethnicity in the meningococcal disease cases. RESULTS: With the use of a multivariate model and controlling for age, ethnicity, season and socioeconomic factors, risk of disease was strongly associated with overcrowding as measured by the number of adolescent and adult (10 years or older) household members per room [odds ratio (OR), 10.7; 95% confidence interval (CI), 3.9 to 29.5]. This would result in a doubling of risk with the addition of 2 adolescents or adults to a 6-room house. Risk of disease was also associated with analgesic use by the child, which was thought to be a marker of recent illness (OR 2.4, CI 1.5 to 4.0); number of days at substantial social gatherings (10 or more people for > 4 h; OR 1.8, CI 1.2 to 2.6); number of smokers in the household (OR 1.4, CI 1.0 to 1.8); sharing an item of food, drink or a pacifier (OR 1.6, CI 1.0 to 2.7); and preceding symptoms of a respiratory infection (cough, "cold or flu," runny nose, sneezing) in a household member (OR 1.5, CI 1.0 to 2.5). CONCLUSION: Some of these identified risk factors for meningococcal disease are modifiable. Measures to reduce overcrowding could have a marked effect on reducing the incidence of this disease in Auckland children.

Adolescent↗
PubMed2000

Basic science research in pain.

Pain is not simply a physiologic event, but a dynamic process that involves continuous interaction among complex systems. Nurses have the unique disciplinary background to envision the pain process within the context of the whole dynamic human being. Understanding the human condition in this holistic manner prepares nurses to develop clinically relevant research questions. Many of these research questions can best be answered initially through basic science research. Basic science research by a nurse will be distinct from other disciplines from the inception of the hypothesis through the conclusions drawn to the delineation of areas for further research. This article provides a few examples of basic science research in the area of pain by nurse researchers. The research includes both cellular and animal models and describes the relationship of the research to clinical practice. Patient care will ultimately benefit from clinically relevant research whether the methodology used is basic science or other methods.

Animals↗
PubMed1999

Differential expression of VegT and Antipodean protein isoforms in Xenopus.

The VegT/Antipodean (Apod) gene is important for germ layer formation in Xenopus. To investigate the role of this gene at the protein level, as opposed to the RNA level, we have generated affinity purified polyclonal antibodies to Apod, and for comparison, to the other early T-box proteins Xbrachyury and Eomesodermin. An anti-VegT/Apod antibody reveals that there are two protein isoforms in Xenopus, one that we refer to as VegT and a smaller molecular weight isoform that we refer to as Apod. These isoforms have different N-terminal domains resulting from developmentally regulated alternative splicing of a primary transcript arising from a single VegT/Apod gene. VegT is maternally expressed. Its translation is blocked during oogenesis but the protein is present from the egg until gastrulation in the presumptive endoderm. There is no evidence for zygotic expression of this isoform. Conversely, the Apod protein isoform is expressed only after the onset of zygotic transcription in the presumptive mesoderm and is inducible by activin. We conclude that the developmental role of VegT/Apod is mediated by two different proteins, with entirely different patterns of expression and response to growth factors.

Activins↗