Atracurium associated with postoperative residual curarization.
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Adult↗
Biomedical subjects
R Mulder
Publications and source records attributed to R Mulder.
Medical student debt at the Christchurch School of Medicine. The New Zealand Wellbeing, Intentions, Debt and Experiences (WIDE) survey of medical students pilot study. Results part I.
AIMS: To determine the level and sources of medical student debt at the Christchurch School of Medicine. METHODS: A questionnaire, The New Zealand Wellbeing, Intentions, Debt, and Experiences (WIDE) Survey of Medical Students, was developed and administered to all 204 medical students at the Christchurch School of Medicine and Health Sciences. Included were questions on student demographics, sources and levels of debt, parental financial support, and student perceptions of their debt. RESULTS: The response rate was 88%. International students, whose debt was with an overseas government, and students with mortgages were excluded from the data analysis. The combined total debt for the remaining 165 students was $7775000 with $6290000 (81%) owed to the Government Students Loans scheme. One quarter of 6th year medical students had a debt over $83250, 50% had a debt over $70000, and 75% had a debt over $50000. Student allowances were inaccessible to 64% of 4th and 5th year students and part-time employment during term-time was common. Lack of funds was reported to impair full participation in the medical course. CONCLUSION: The majority of medical students at the Christchurch School of Medicine accumulate high levels of debt, mainly dtrough the Government Student Loans scheme, during their medical training.
Education, Medical, Undergraduate↗
Medical student career intentions at the Christchurch School of Medicine. The New Zealand Wellbeing, Intentions, Debt and Experiences (WIDE) survey of medical students pilot study. Results part II.
AIMS: To record career preferences for medical students at the Christchurch School of Medicine and Health Sciences and investigate factors, including student debt, that might influence career decisions. METHODS: A questionnaire, The New Zealand Wellbeing, Intentions, Debt, and Experiences (WIDE) Survey of Medical Students, was developed and administered to all 204 medical students at the Christchurch School of Medicine and Health Sciences. The survey included questions relating to preferred career intentions and factors influencing career decisions, including the decision to leave New Zealand to practise medicine. RESULTS: The response rate was 88%. 80% intend to practise medicine in New Zealand immediately after graduation, however 82% indicated that they would leave within two years of graduation. Financial opportunities overseas and level of debt were the strongest motivating factors to leave. Repayments towards student loans and increased salaries were factors that might retain people in New Zealand. Medical and surgical specialities were the most popular career choices. Personal interest was the strongest motivator for career choice. Practising in a rural community was not popular. CONCLUSION: Debt is one of a number of important factors influencing medical student career decisions including the decision to leave New Zealand. Initiatives addressing debt may be useful in retaining medical graduates in this country.
Adult↗
The use of the Hospital Anxiety and Depression Scale (HADS) in patients with chronic obstructive pulmonary disease: a pilot study.
AIMS: To investigate the use of the Hospital Anxiety and Depression Scale (HADS) with recuperating chronic obstructive pulmonary disease (COPD) patients. To study prevalence rates and changes in clinically relevant anxiety and depression during rehabilitation. METHODS: Consecutive patients admitted to a non acute respiratory ward over a twelve week period were asked to complete a HADS questionnaire on three occasions. Nurses recorded basic demographic information on admission. Additional demographic, medical and psychiatric data were obtained by retrospective review of medical records. RESULTS: Of 93 consecutive inpatients, 79 (85%) completed the admission HADS. 72 patients were eligible to complete the day three HADS and 60 the discharge HADS. Clinically relevant anxiety (HADS score of > or =8) was indicated in 39 patients (50%) and depression in 22 (28%). HADS anxiety (p=0.05) and total scores (anxiety+depression) (p=0.03) decreased between admission and discharge. A larger proportion of patients scored within the normal or mild psychopathology range by discharge. More severe COPD (FEV1% predicted) correlated with higher HADS anxiety scores (r=-0.39, p<0.001) and HADS depression scores (r=-0.34, p<0.005). Patients with a recorded history of anxiety (p<0.0001) and depression (p<0.02) had higher WADS scores. Females (n=37) when compared to males (n=42), recorded significantly higher HADS anxiety scores throughout (p<0.005). CONCLUSIONS: Clinically relevant anxiety, indicated by higher HADS scores, was more common in patients with severe COPD, a past history of anxiety or depression and females. Anxiety and total mood improved during inpatient rehabilitation. The use of this instrument with New Zealand COPD patients may improve identification and treatment of anxious and depressed patients.
Age Distribution↗
Future perspectives in bioreactor development.
The paper discusses conversion capacities of both anaerobic and aerobic wastewater treatment systems in relation to growth kinetics, hydrodynamics and biomass concentration. In the current modern anaerobic high-rate reactors the conversion potentials are optimally exploited. This is not yet true for aerobic systems since operation of aerobic systems under conditions of low biomass growth reduces the maximum applicable loading rates significantly. Both the concept of granulation and the introduction of fluidised bed systems have increased conversion capacities for both anaerobic and aerobic systems significantly. One of the latest development concerns the SBR with granular biomass. The grazing concept, in which ciliates convert aerobically grown dispersed cells, offers a possibility for significant improvement of aerobic systems. In the fields of psychrophilic and thermophilic anaerobic treatment, specific reactor development may contribute to further enhance volumetric conversion capacities. Due to reduced water usage, both COD and salt concentrations tend to increase for industrial effluents. As a consequence, there is a need for the development of anaerobic reactors retaining flocculant biomass. The membrane bioreactors offer a solution for certain niches in wastewater treatment. However the oxygen transfer economy is poor. There is a need for fundamental knowledge development to obtain a realistic image of this technology.
Bacteria, Aerobic↗
Harbinger. I: The development and evaluation of the first PACT replication.
While Assertive Community Treatment (originally known as the PACT program) is now recognized around the world as an effective model for rehabilitation of persons with severe mental illness, this was not the case 20 years ago. Harbinger of Grand Rapids, in Kent County, Michigan, was the first replication of the PACT model which sought fidelity and included an experimental design for assessing effectiveness. The design and results are presented from an initial 30-month and a follow-up 66-month evaluation of Harbinger. The 30-month evaluation showed significant differences favoring Harbinger vs, the control group on independent living, employment, and client functioning. At 66-months, there were fewer experimental-control group differences. The differences in results are analyzed in terms of design and data collection problems, changes in the treatment environment for the control group, and the longitudinal course of mental illness. The discussion focuses on next steps in ACT research, utilizing program theory to better establish the mechanisms for successful intervention models.
Activities of Daily Living↗
Development of an antimicrobial susceptibility testing method suitable for performance during space flight.
Very little is known regarding the effects of the microgravity environment of space flight upon the action of antimicrobial agents on bacterial pathogens. This study was undertaken to develop a simple method for conducting antibacterial susceptibility tests during a space shuttle mission. Specially prepared susceptibility test research cards (bioMérieux Vitek, Hazelwood, Mo.) were designed to include 6 to 11 serial twofold dilutions of 14 antimicrobial agents, including penicillins, cephalosporins, a beta-lactamase inhibitor, vancomycin, erythromycin, tetracycline, gentamicin, ciprofloxacin, and trimethoprim-sulfamethoxazole. MICs of the drugs were determined by visual reading of color end points in the Vitek research cards made possible by incorporation of a colorimetric growth indicator (alamarBlue; Accumed International, Westlake, Ohio). This study has demonstrated reproducible susceptibility results in the testing of isolates of Staphylococcus aureus, group A Streptococcus species, Enterococcus faecalis, Escherichia coli (beta-lactamase-positive and -negative strains), Klebsiella pneumoniae, Enterobacter cloacae, and Pseudomonas aeruginosa. In some instances, the MICs were comparable to those determined by a standard broth microdilution method, while in some cases the unique test media and format yielded slightly different values that were themselves reproducible. The proposed in-flight experiment will include inoculation of the Vitek cards on the ground prior to launch of the space shuttle, storage of inoculated cards at refrigeration temperature aboard the space shuttle until experiment initiation, and then incubation of the cards for 18 to 48 h prior to visual interpretation of MICs by the mission's astronauts. Ground-based studies have shown reproducible MICs following storage of inoculated cards for 7 days at 4 to 8 degrees C to accommodate the mission's time schedule and the astronaut's activities. For comparison, ground-based control (normal gravity) MIC values will be generated by simultaneous inoculation and incubation of a second set of test cards in a laboratory at the launch site. This procedure can provide for a safe and compact experiment that should yield new information on the effects of microgravity on the biological activities of various classes of antibiotics.
Aerospace Medicine↗
Detection of extended-spectrum-beta-lactamase-producing members of the family Enterobacteriaceae with Vitek ESBL test.
A three-phase analysis of the Vitek ESBL test and a double-disk (2 disk) test was performed to assess their ability to detect extended-spectrum beta-lactamases (ESBLs) in members of the family Enterobacteriaceae. In the first two phases involving detection of ESBLs in 157 stains processing well-characterized beta-lactamases, sensitivity and specificity were found to be 99.5 and 100%, respectively, for the Vitek ESBl test and 98.1 and 99.4%, respectively, for the 2-disk test. In the third phase, in which the ability of each test to detect ESBLs in 295 clinical isolates was assessed, there was only one false positive (Vitek ESBL test). Across all three phases, the Vitek ESBL test was found to be much easier to perform than the 2-disk test. The latter also involved subjective interpretation of results. There were a total of 176 Escherichia coli and 157 Klebsiella pneumoniae isolates and less than 40 isolates of each of 14 other species evaluated. In a supplemental study of Klebsiella oxytoca, an organism possessing a chromosomal beta-lactamase similar to an ESBL, the Vitek ESBL test was found to be capable of detecting hyperproduction of this enzyme in strains of this species as well. These data indicate that the Vitek ESBL test is reliable for the detection of ESBLs in E. coli and K. pneumoniae, the two species in which ESBLs are most common, and of hyperproduction of the K. oxytoca beta-lactamase, a situation which engenders a level of resistance to this species similar to that seen with ESBLs.
Cephalosporins↗
The biology of personality.
Historically, models of personality have generally postulated, or assumed, a link with biology. This century has witnessed a major revision of these ideas with both behavioural and psychoanalytic theorists emphasising life experiences as being largely responsible for behaviour as adults. Challenges to this assumption of the overwhelming importance of life experiences are reviewed. An extensive body of data now exists suggesting that biology contributes significantly to individual variability. This biological contribution occurs at a relatively low level in the central nervous system, best defined as temperament. Further research has suffered from the lack of a cohesive psychobiological model. Cloninger's tridimensional theory of personality is presented as a model which attempts to bridge the gap between theoretical temperamental traits, neurotransmitter function and clinical psychiatry. It is to be hoped that new theoretical models will be formulated which will focus on the importance of temperamental variables in psychiatric disorders.
Animals↗
Distribution and density of polygyne fire ants (Hymenoptera: Formicidae) in Texas.
Multiple-queen or "polygyne" Solenopsis invicta Buren colonies are a serious economic and environmental concern because they occur in much higher densities than the monogyne form. Polygyne colonies have been found at numerous locations in the United States; nevertheless, the frequency and distribution of this form are poorly known. Almost 700 roadside sites in 168 Texas counties were surveyed. Polygyny was discovered at 54% of the infested sites. Polygyne populations were scattered in a mosaic across Texas. The frequency of polygyny varied somewhat with geographic region, but the pattern was generally unrelated to habitat and environmental conditions. Polygyne sites averaged more than twice as many mounds per hectare as monogyne sites. Populations of monogyne and polygyne forms were slightly lower in cooler and drier portions of the state. Mounds of both forms were about the same size. Polygyny was correlated with lower rates of sexual production and reduced numbers of native ants. The high frequency of polygyny in Texas indicates that the fire ant problem in the state is much greater than previously realized.
Analysis of Variance↗
In vitro susceptibility studies of vancomycin-resistant Enterococcus faecalis.
Vancomycin resistance exhibited by Enterococcus faecalis isolates V583, V586, and V587 is described. The vancomycin MICs ranged from 32 to 64 micrograms/ml. Although resistant to vancomycin, the isolates were susceptible to teicoplanin (MIC, less than or equal to 0.5 micrograms/ml). Such a glycopeptide susceptibility profile has not been previously described for E. faecalis. Time kill studies showed that vancomycin resistance adversely affected the synergistic activity that vancomycin and aminoglycoside combinations usually demonstrate against enterococci. However, the ability to detect vancomycin resistance varied with the susceptibility testing method used. Whereas broth microdilution, broth macrodilution, and agar dilution methods detected resistance, disk-agar diffusion and the AutoMicrobic system Gram-Positive GPS-A susceptibility card (Vitek Systems Inc., Hazelwood, Mo.) did not. To detect vancomycin resistance reliably and establish the incidence of such E. faecalis isolates, adjustments in some susceptibility testing methods may be necessary.
Anti-Bacterial Agents↗
A crusading knight from Ivanhoe. Interview by Richard L Reece.
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Humans↗
A selective insecticide with a novel mode of action.
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Animals↗
Synthesis and laboratory evaluation of 1-(2,6-disubstituted benzoyl)-3-phenylureas, a new class of insecticides. I. 1-(2,6-Dichlorobenzoyl)-3-phenylureas.
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Aedes↗
Synthesis and laboratory evaluation of 1-(2,6-disubstituted benzoyl)-3-phenylureas, a new class of insecticides. II. Influence of the acyl moiety on insecticidal activity.
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Acylation↗