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Biomedical subjects

R Kennedy

Publications and source records attributed to R Kennedy.

141 records · Page 8Linked to original sources
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Patterns of flexibility, laxity, and strength in normal shoulders and shoulders with instability and impingement.

Imbalance of the internal and external rotator musculature of the shoulder, excess capsular laxity, and loss of capsular flexibility, have all been implicated as etiologic factors in glenohumeral instability and impingement syndrome; however, these assertions are based largely on qualitative clinical observations. In order to quantitatively define the requirements of adequate protective synergy of the internal and external rotator musculature, as well as the primary capsulolabral restraints, we prospectively evaluated 53 subjects: 15 asymptomatic volunteers, 28 patients with glenohumeral instability, and 10 patients with impingement syndrome. Range of motion was evaluated by goniometric technique in all patients with glenohumeral instability and impingement. Laxity assessment was performed and anterior, posterior, and inferior humeral head translation was graded on a scale of 0 to 3+. Isokinetic strength assessment was performed in a modified abducted position using the Biodex Clinical Data Station with test speeds of 90 and 180 deg/sec. Internal and external rotator ratios and internal and external rotator strength deficits were calculated for both peak torque and total work. Patients with impingement demonstrated marked limitation of shoulder motion and minimal laxity on drawer testing. Both anterior and multidirectional instability patients had excessive external rotation as well as increased capsular laxity in all directions. Sixty-eight percent of the patients with instability had significant impingement signs in addition to apprehension and capsular laxity. Isokinetic testing of asymptomatic subjects demonstrated a 30% greater internal rotator strength in the dominant shoulder. Comparison of all three experimental groups demonstrated a significant difference between internal and external rotator ratios for both peak torque and total work. Conclusions are that there appears to be a dominance tendency with regard to internal rotator strength in asymptomatic individuals. Impingement syndrome and anterior instability have significant differences in both strength patterns of the rotator muscles and flexibility and laxity of the shoulder. Isokinetic testing potentially may be helpful in diagnostically differentiating between these two groups in cases where there is clinical overlap of signs and symptoms.

Adult↗
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Fluorescence in situ hybridization studies on the sex chromosome constitution of human sperm.

More males are conceived than females and more males are born as a result of in vitro fertilization (IVF) and donor insemination procedures. All donor sperm samples are frozen for a minimum of 6 months before they are used. The ratio of more boys to girls has been consistently reported over the years. A similar finding has been noted in the Galway Fertility Unit at University College Hospital Galway, Ireland. Traditionally, it has been accepted that the reason for this excess is that a Y chromosome-bearing sperm swims faster than the X-bearing sperm because it contains less DNA and is therefore "lighter." To test this hypothesis, semen samples were collected at the Galway Fertility Unit from men presenting for routine semen assessments. Each sample was divided into a number of aliquots. The first aliquot was assessed as the "raw" ejaculate to measure the initial ratio of X to Y. The second aliquot was prepared using Percoll density gradients, which allows for greater recovery of sperm with higher motility and improved sperm function. The final aliquot was frozen. The frozen sample was later thawed and prepared using Percoll. The prepared sperm were kept for 48 h and sampled at the time of preparation and at 24 h and 48 h to establish if there was any differential survival over time. The X:Y ratio was analyzed using the technique of fluorescence in situ hybridization (FISH). This allowed the sex chromosomes to be specifically stained and identified simultaneously. No difference was found in the X:Y ratio of the sperm. Therefore, any selection for the Y sperm must take place at some later stage.

Humans↗
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Starting blocks.

Explore the source record for details and available documents.

Attitude of Health Personnel↗
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Arkansas experience: between the government & the private sector.

Officials in many communities, states and regions are trying to establish networks to electronically exchange administrative and clinical data. Today, however, few examples of truly operational healthcare information networks (HINs) exist. Because of governance, control and cost, efforts toward integrating clinical information have not progressed. These issues are most apparent in the struggle to establish community health information networks (CHINs).

Arkansas↗
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The Internet's impact on EDI.

Explosive growth of the Internet in a number of industries has created an information distribution channel that is likely to alter and leverage every aspect of electronic commerce. With the levels of IS integration and technological innovations in development in healthcare today, it is not unreasonable to predict that this industry soon will be similarly driven.

Commerce↗
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Small-group decision making can be effective management tool.

One of the key components of effective management is the ability to make decisions. To more effectively assist hospital supervisors and managers in dealing with and making appropriate judgments, educators need to examine carefully the processes involved in decision making and how they impact on both the individual and the group. The following discussion of structured small-group decision making is adapted from an independent study of the literature undertaken by this author to dissect these processes and how they impact on the decisions made.

Decision Making↗
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Case management in Australia: application of Moxley's scenarios.

In 1989 David Moxley produced a text for generic case management in the human services. He has revisited his initial work and argues that the case management concept has taken on diverse meaning as it has been applied more widely and for very different agendas. It may have emerged in community care, but is now being utilised as a tool of restructuring in all arenas of service provision. Moxley now suggests five distinct scenarios for the future of case management: community support and the organisation of support systems for people with disabilities; management of the economic costs of human services; the management of undesirables; the management of clinical pathways; recipient management services. His commentary is based on his U.S. experience. This article will examine the relevance of his predictions to the Australian context.

Australia↗