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Biomedical subjects

P Tucker

Publications and source records attributed to P Tucker.

At least 55 records · Page 3Linked to original sources
PubMed1999

Localization of hyaluronan in pseudocapsule from total hip arthroplasty.

Hyaluronan is a large glycosaminoglycan present in normal synovial fluid imparting important viscoelastic properties for joint lubrication. In normal and noninflammatory conditions, hyaluronan has been localized to the lining layer of the synovial membrane, specifically synovial fibroblasts. Prosthetic joint fluid contains large amounts of hyaluronan, the source of which has not been determined. Pseudocapsules from patients who had total hip arthroplasty and were having revision surgery for nonloosened and nonseptic conditions were fixed in 10% acid formalin with 70% alcohol and stained for hyaluronic acid with biotinylated hyaluronic acid binding protein as a probe. Hyaluronan was localized strongly to the lining layer of the pseudocapsule, as in normal and osteoarthritic synovial membranes. The fibroblasts in the pseudocapsule of total hip arthroplasty may be responsible for the persistent production of hyaluronan in prosthetic joint fluid.

Adjuvants, Immunologic↗
PubMed1998

Light of domestic intensity produces phase shifts of the circadian oscillator in humans.

Twelve subjects have been studied in a chamber that isolated them from external noise and lighting. After several control days, one group (n = 6) was subjected to 18 x 27-h 'days' and the other to 11 x 30-h 'days'. Sleep was in the dark, and awake times were spent in normal domestic lighting (150-500 lux). Rectal temperature and wrist actimetry were measured throughout, and the phase of the circadian oscillator was inferred from that of the temperature data, purified to remove direct effects of activity. During the experimental 'days' the rhythms showed a mean period of 24.4 h. A detailed examination of the phase shifts from one day to the next showed that small advances and delays were superimposed upon this drift. Moreover, the mean size and direction of these shifts depended upon the time of exposure to lighting relative to the temperature minimum, as would be predicted from a phase-response curve.

Adult↗
PubMed1998

Oklahoma City: disaster challenges mental health and medical administrators.

Mental health and medical administrators responded to the Oklahoma City bombing with cooperative and overlapping efforts to meet community needs in the wake of terrorism. The major agencies assisted in the immediate rescue response, organized crisis hotlines, prepared mental health professionals to counsel bereaved families and victims, organized debriefing of rescuers, assessed mental health needs of local school children, planned for longer term treatment, and coordinated research efforts to learn from the disaster. Implications to mental health administrators responding to significant acts of terrorism are discussed.

Adult↗
PubMed1998

Industrial shift systems.

This technical report describes the identification of shift systems worked by industrial shiftworkers in England, Scotland and Wales. A diverse range of shift systems were reported to be in operation across 27 industrial sectors. Companies employed up to 14 different shift systems at a particular site. The numbers of shiftworkers on a given shift schedule ranged from 1 to 2977. Most systems employed fewer than 100 people. The majority of rotas were regular, rotating systems. The most common shift durations were 8 or 12 h. Compared to earlier surveys of shiftwork prevalence in certain industries there appeared to be a substantial increase over the past 3 decades in the proportion of the workforce who work shifts. Information about the average numbers of hours worked per week on major system types is given. In addition, data for the range of shifts per cycle, the distribution of shifts and distributions of their start and end times are presented.

Humans↗
PubMed1998

The impact of early and late shift changeovers on sleep, health, and well-being in 8- and 12-hour shift systems.

The effects on industrial shift workers of the timing of the changeover from the night to morning shift and of the length of the shift were examined. Two groups changed over at 6 a.m. and worked either 8-hr or 12-hr shift systems; the other 2 groups changed over at 7 a.m., working either 8- or 12-hr systems. Night sleeps between consecutive shifts that started at 6 a.m. were shorter and more disrupted than those starting at 7 a.m. Day sleeps following night shifts that finished at 6 a.m. were longer and less disrupted than those finishing at 7 a.m. Early starts were associated with poorer psychological and physical health. These effects of changeover time are considered in relation to the circadian rhythms in sleep duration and propensity. Although several measures favored 12-hr shifts, physical health indicators appeared to favor 8-hr systems, especially in combination with late changeovers. However, the observed effects of shift length on chronic outcome measures are somewhat inconsistent with previous research findings.

Adaptation, Psychological↗
PubMed1998

Time of day effects in, and the relationship between, sleep quality and movement.

The study aimed to measure the effects of a 27-h 'day' sleep-wake regime on actigraphic and subjective sleep variables, and to examine the relationships between these variables. Nine subjects spent 30 days and nights in the laboratory. After sleeping 8 h for each of 8 nights, the subjects had an imposed 27-h 'day', for 18 'days', remaining in bed for 9 h on each sleep period. Sleep periods therefore started 3 h later each day, although subjects' circadian rhythms stayed entrained to 24 h, because subjects were not isolated from the natural light-dark cycle. Time asleep, subjective sleep efficiency and subjective sleep quality, but not movement during sleep, were found to be significantly affected by time of going to bed. There were significant decreases in movement during recovery sleeps following each of two episodes of 26 h sleep deprivation. Over the study there were significant within-subject correlations between subjective sleep quality and subjective sleep efficiency (rav = 0.65), movement during sleep and subjective sleep efficiency (rav = -0.48), and movement during sleep and subjective sleep quality (rav = -0.26). We conclude that sleep movement, despite its low within- and between-subjects variability, is nevertheless a statistically reliable, but weak, indicator of subjective sleep efficiency and quality.

Adult↗
PubMed1998

Work shift duration: a review comparing eight hour and 12 hour shift systems.

OBJECTIVES: Shiftwork is now a major feature of working life across a broad range of industries. The features of the shift systems operated can impact on the wellbeing, performance, and sleep of shiftworkers. This paper reviews the current state of knowledge on one major characteristic of shift rotas-namely, shift duration. Evidence comparing the relative effects of eight hour and 12 hour shifts on fatigue and job performance, safety, sleep, and physical and psychological health are considered. At the organisational level, factors such as the mode of system implementation, attitudes towards shift rotas, sickness absence and turnover, overtime, and moonlighting are discussed. METHODS: Manual and electronic searches of the shiftwork research literature were conducted to obtain information on comparisons between eight hour and 12 hour shifts. RESULTS: The research findings are largely equivocal. The bulk of the evidence suggests few differences between eight and 12 hour shifts in the way they affect people. There may even be advantages to 12 hour shifts in terms of lower stress levels, better physical and psychological wellbeing, improved durations and quality of off duty sleep as well as improvements in family relations. On the negative side, the main concerns are fatigue and safety. It is noted that a 12 hour shift does not equate with being active for only 12 hours. CONCLUSIONS: There can be considerable extension of the person's time awake either side of the shift. However, the effects of longer term exposure to extended work days have been relatively uncharted in any systematic way. Longitudinal comparative research into the chronic impact of the compressed working week is needed.

Absenteeism↗
PubMed1998

Shift length as a determinant of retrospective on-shift alertness.

OBJECTIVES: This study examined the combined effects of shift length (8 versus 12 hours) and night-to-morning-shift changeover time (0600 versus 0700) on retrospective on-shift alertness ratings. METHODS: An abridged version of the Standard Shiftwork Index, which included retrospective alertness ratings, was completed by 4 groups of industrial shift workers. Two groups worked 8-hour shift systems and started their morning shifts at either 0600 or 0700; the other 2 groups worked 12-hour systems, starting their day shifts at either 0600 or 0700. RESULTS: The 8-hour workers reported considerably higher levels of alertness in the afternoon, while the 12-hour workers were more alert than the 8-hour workers in the morning and at 2200. Workers who started their shift around 0600 were less alert during the morning than those who started around 0700. The data suggested that the combined effects of working 8-hour shifts and starting the morning shift at around 0600 have particularly deleterious effects upon alertness. CONCLUSIONS: Effects on alertness can be explained in terms of differences in elapsed time on duty, sleep duration, sleep disruption, and chronic fatigue. The findings of this study appear to contradict previous research demonstrating that the major deleterious effects of extended shifts and delayed changeovers upon alertness occur at night. However, it is acknowledged that the absence of a difference in alertness at night may have been due to floor effects. Nevertheless, the implications of the alertness ratings for performance and safety, particularly during the afternoon, should not be ignored.

Adult↗
PubMed1998

Diurnal trends in mood and performance do not all parallel alertness.

OBJECTIVES: This study examined the hypothesis that alertness can be used to predict time-of-day effects on performance. METHODS: For 6 or 7 days the volunteers (24, highly practiced young women) were required to retire to bed at 0000 and were awakened at 0800. A battery of mood and performance tests was completed every 2 hours while the women were awake; the result was 9 equally spaced measures per day. Measures of mood, serial reaction time, and memory scanning were recorded. Rectal temperature was recorded continuously. RESULTS: After omitting the data from the first day to avoid any carry-over from the "first-night" effect on sleep, average time-of-day functions were calculated for each subject, for each variable, and were then z-transformed. Cross-correlations between the pooled time-of-day trends indicated that, while alertness was a reasonably good "predictor" of the simple perceptual-motor speed measures, it fared less well for some of the other measures. Two-way analyses of variance indicated that the time-of-day trend for all measures differed from that for alertness, although the magnitude of this difference varied substantially and, for some measures, was very largely due to the last reading of the day (0000). CONCLUSION: It is clear from these results that, while alertness may successfully "predict" variations in some measures of performance capability, and especially those of simple perceptual motor speed, care should be exercised in extrapolating to other performance measures.

Adolescent↗
PubMed1997

Paroxetine increases heart rate variability in panic disorder.

Panic patients have decreased heart rate variability, a risk factor for sudden cardiac death, and increased rates of cardiac death and stroke. Imipramine has been found to further reduce heart rate variability in panic. This study uses power spectral analysis to compare autonomic components of heart rate variability in 16 unmedicated control subjects and 17 panic patients before and after treatment with paroxetine at 20 mg/day for 4 weeks. Patients had higher predrug reclining and standing sympathetic activity than control subjects. After drug, patients' total sympathetic activity decreased. Predrug patients failed to increase sympathetic activity on orthostasis, lacking the normal baroreflex response found in control subjects. After drug, patients normalized this sympathetic component of the baroreflex response. Before drug, patients' parasympathetic reclining and standing activity did not differ from control subjects, and patients showed the normal orthostatic parasympathetic decrease. After drug, patients' total parasympathetic activity increased, whereas the baroreflex response was preserved. Nine medicated patients had more than a 50% reduction of panic attacks. In view of paroxetine's increase of heart rate variability, potential benefits of selective serotonin reuptake inhibitors in decreasing cardiac mortality in panic disorder are discussed.

Adult↗
PubMed1997

Traumatic reactions as predictors of posttraumatic stress six months after the Oklahoma City bombing.

OBJECTIVE: This study attempted to identify remembered reactions of Oklahoma City residents at the time of the April 1995 terrorist bombing that predicted later development of posttraumatic stress symptoms. METHODS: Eighty-six adults who sought help for distress related to the bombing six months after it occurred completed a survey about demographic characteristics, level of exposure to the event, symptoms of grief, retrospective reports of reactions at the time of the trauma, current posttraumatic stress symptoms, and coping strategies. To identify immediate bombing reactions predictive of later distress, retrospective reports of reactions to the trauma were correlated with current posttraumatic stress symptoms. Multiple regression analysis was used to determine which reactions predicted the emergence of posttraumatic stress symptoms. RESULTS: Reactions of being nervous and being upset by how other people acted when the bombing occurred accounted for about one-third of the total variation in posttraumatic stress symptom scores and thus were major predictors of posttraumatic stress. CONCLUSIONS: These results differ from those of other studies in which peritraumatic dissociation, or dissociation at the time of the event, was more predictive than anxiety for developing later distress. The results suggest that persons who experience significant anxiety at the time of the traumatic event may continue to experience distress. Those who are overly concerned about others' actions may be showing diminished interpersonal trust, evidence of terrorism's ability to erode social harmony.

Adult↗
PubMed1996

Adrenal lesions in a large kindred with multiple endocrine neoplasia type 1.

OBJECTIVE: To review the prevalence and natural history of adrenal lesions occurring in patients from a single kindred with multiple endocrine neoplasia type 1 (MEN-1). DESIGN: Case series. SETTING: Tertiary referral center. PATIENTS: Medical records of 33 patients from the Tasman 1 MEN-1 kindred who had undergone abdominal computed tomographic (CT) scanning were reviewed. In 30 patients, the results of abdominal ultrasonographic examinations were available for correlation with CT scan. Computed tomographic and ultrasound scans of 18 patients were reviewed by a radiologist blinded to the patients' clinical details. Three patients underwent adrenalectomy, and the histopathologic material was reviewed. MAIN OUTCOME MEASURES: Computed tomographic and ultrasound scans. RESULTS: Adrenal lesions were detected in 12 patients (36%) by CT scan examination. Ultrasound imaged 58% of these lesions. Pancreatic lesions were present in all cases of adrenal disease. Follow-up was available for 8 patients with adrenal disease. Over 5.5 years, 6 patients (75%) had stable disease, 1 patient had an adrenal lesion that enlarged by 5 mm, and 1 patient had a lesion that enlarged by 50 mm. Adrenal histopathologic material was available in 3 patients. Macronodular cortical hyperplasia was present in 2 patients and a cortical adenoma present in 1 patient. Another kindred had bilateral macronodular cortical hyperplasia at autopsy. CONCLUSIONS: Adrenal lesions are common in MEN-1 and occur in association with pancreatic disease. Abdominal CT scan is more sensitive than ultrasonographic examination in detecting adrenal disease. Primary hypersecretory syndromes of the adrenal glands appear to be rare, and the majority of lesions follow an indolent clinical course.

Adrenal Gland Neoplasms↗
PubMed1996

Comparison of eight and 12 hour shifts: impacts on health, wellbeing, and alertness during the shift.

OBJECTIVES: The generally agreed view is that there is no ideal shift system, and that most systems will have both advantages and disadvantages. As such, attention has been placed on trying to identify good and bad features of shift systems, with a view to minimising the possible ill health as a consequence of shiftwork. The present study focuses on the duration of the shift and looks at the implications for individual health, wellbeing, and alertness during the shift of extending the shift from the traditional eight hours to 12. METHODS: Two groups of chemical workers, one working 12 hour shifts and the other working eight hour shifts, took part. All completed a modified version of the standard shiftwork index (SSI), a set of self reported questionnaires related to health and wellbeing. RESULTS: The two groups did not differ on most outcome measures, although the differences that did exist suggested advantages for the 12 hour shift workers over the eight hour shift workers; with the notable exception of rated alertness at certain times of day. CONCLUSIONS: The results are explained in terms of the design of the 12 hour shift system and the specific sequencing of shifts that seem to minimise the potential for the build up of fatigue. Although the current data moderately favour 12 hour shifts, a cautionary note is sounded with regard to the implications of the alertness ratings for performance and safety.

Adult↗
PubMed1996

What is the psychiatrist's role in drugs and alcohol?

OBJECTIVE: This article describes a consensus view of the role of psychiatrists in respect of alcohol and other drug (AOD) problems, in response to the view expressed by Wodak [1]. METHOD: The data were selected on the basis of the knowledge and experience of the authors. RESULTS: Psychiatrists have made major contributions in the primary, secondary and tertiary prevention of AOD problems over many years in Australia and New Zealand. In recent years there has been an explosion of new knowledge in the AOD area and a shift from mental health to primary and public health care for these patients. Substance use disorders (SUD) are highly prevalent in all areas of psychiatric practice, requiring treatment in their own right as well as complicating the treatment of coexisting psychiatric illness. CONCLUSION: It is argued that psychiatrists have important roles in harm reduction, prevention and policy development; brief and early intervention in SUD in liaison and child psychiatry; and systematic treatment for those with dependence and other psychiatric comorbidity. A research and collaborative approach to AOD services and patients should be encouraged, rather than engaging in divisive debate over "ownership' of this area of clinical practice.

Adolescent↗
PubMed1996

The difference between activity when in bed and out of bed. II. Subjects on 27-hour "days".

Nine healthy subjects have been studied while exposed to the normal alternation of light and dark, but with their sleep and activity pattern adjusted to a 27-h "day" for 17 imposed "days." Rectal temperature showed clearly the competing influences of 27-h and 24-h components, and these were separated by the method of "purification." The method indicated that the endogenous component had a constant amplitude throughout the experiment and remained entrained to solar (24-h) time; by contrast, the exogenous component followed the imposed 27-h "day" and increased rectal temperature in proportion to the amount of subjects' activity. Wrist movement was used to assess activity while in bed (attempting sleep) and out of bed (when naps were forbidden). While these results confirmed adherence of the subjects to the imposed 27-h "days," they also showed that the dichotomy between "out of bed" activity and "in bed" inactivity depended on the phase relationship between endogenous (24h) and exogenous (27h) components. Thus, the dichotomy was highest and was equal to that during control days (with a conventional 24-h life-style) when the two components were in phase and lowest when the solar and imposed day were in antiphase. This was due to changes in activity, both during time spent in bed and out of bed. We confirm that this protocol can produce valuable information about the properties of the circadian system in humans and the value of the process of purification of temperature data. We have established also that the very simple and noninvasive measurement of wrist movement, coupled with its use to calculate dichotomy indices, provides valuable information that both confirms and extends the results obtained from the more conventional (but also more invasive) measurement of rectal temperature.

Bed Rest↗
PubMed1996

A preliminary investigation into individual differences in the circadian variation of meal tolerance: effects on mood and hunger.

A forced desynchrony methodology was used to assess postprandial blood glucose in 9 female volunteers during a 3-h period following a mixed meal presented at four times of day (08:00, 14:00, 20:00, 02:00). The influence of time of day on the postmeal glucose responses was evaluated by calculating the area under the curve, largest increase, time taken to reach peak, and fasting level. Circadian variations in meal tolerance were found for the area under the curve and largest increase, responses were greater (indicating poorer meal tolerance) in the evening than the morning. Fasting blood glucose exhibited diurnal variation although in the opposite direction to meal tolerance; levels were higher in the morning than the evening. Time taken to reach peak levels was not modulated by circadian rhythmicity. Estimates of the timing of poorest meal tolerance and the magnitude of this intolerance were computed for each subject. Individual differences in the magnitude of meal intolerance were found to influence hunger and self-reported calmness. Subjects with good tolerance had rhythms in both calmness and hunger, which were not found in those with poor tolerance. Subjects with good tolerance also tended to rate themselves as feeling more calm. These mood and hunger effects may result from differences in insulin resistance, which is hypothesized to underlie the circadian variations in meal tolerance.

Adult↗
PubMed1995

Crystal structure of a purple acid phosphatase containing a dinuclear Fe(III)-Zn(II) active site.

Kidney bean purple acid phosphatase (KBPAP) is an Fe(III)-Zn(II) metalloenzyme resembling the mammalian Fe(III)-Fe(II) purple acid phosphatases. The structure of the homodimeric 111-kilodalton KBPAP was determined at a resolution of 2.9 angstroms. The enzyme contains two domains in each subunit. The active site is located in the carboxyl-terminal domain at the carboxy end of two sandwiched beta alpha beta alpha beta motifs. The two metal ions are 3.1 angstroms apart and bridged monodentately by Asp164. The iron is further coordinated by Tyr167, His325, and Asp135, and the zinc by His286, His323, and Asn201. The active-site structure is consistent with previous proposals regarding the mechanism of phosphate ester hydrolysis involving nucleophilic attack on the phosphate group by an Fe(III)-coordinated hydroxide ion.

Acid Phosphatase↗