Biomedical subjects
R Walker
Publications and source records attributed to R Walker.
Diabetes nursing. A special function.
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Quality: dire care for diabetes.
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Care of people with diabetes in hospital.
Although most hospitals have protocols for the care of people with diabetes who are admitted as a result of their condition or other illness, deficiencies in the care offered are still regularly reported. This article explores reasons why the care of people with diabetes in hospital seems to be unsatisfactory, and proposes some solutions to the problems.
Diabetes care: dispelling the myths (continuing education credit).
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Diabetes care: dispelling the myths (continuing education credit).
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An evaluation of four light-curing units comparing soft and hard curing.
Composite resin shrinks during polymerization producing marginal gaps around composite restorations. While incremental placement of composite resin has been used to control shrinkage, this technique is time consuming. Curing lights have been developed with varying outputs and curing cycles to speed curing and reduce marginal gaps in composite restorations. This investigation measured the marginal openings of Class V resin restorations cured with four different light-curing units. High-intensity curing units provided rapid curing to composite resin increments, but the two-phase curing cycle afforded significantly better marginal integrity than the other units.
Chirodontics. A treatment paradigm for the new millennium.
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Disseminated mucormycosis in healthy adults.
Three patients of disseminated mucormycosis are described. None had predisposing factors. Two of them presented with nonspecific symptoms along with acute renal failure and peritonitis. Third patient had fulminating primary cutaneous mucormycosis which disseminated later. Development of acute renal failure with smooth enlargement of both kidneys in an apparently healthy individual or appearance of mould in a wound should raise the suspicion of mucormycosis. The hallmark of the infection was vascular invasion and thrombosis. Antemortem diagnosis could be made in one patient only. All patients had progressive downhill course despite supportive treatment, antibiotic and amphotericin in-B in one patient.
Restructuring public health in Ontario: implications for heart health promotion.
Community-based heart health promotion is viewed as an effective means of reducing cardiovascular disease risk. Although public health agencies have a central role in the implementation and dissemination of heart health programmes, their effectiveness is being challenged by major structural changes to Provincial public health systems across Canada, although the impacts of the changes have received relatively little attention in the research literature. As part of the Canadian Heart Health Initiative--Ontario Project (CHHIOP), this study used a qualitative approach to address the perceived implications of these changes to Ontario's public health system for heart health promotion. Interviews (n = 38) were conducted in eight public health units with staff most familiar with managing and/or delivering heart health activities. The results are mixed; that is, while many see the future of heart health promotion programming in Ontario as being at risk, others see recent changes as a step forward toward their institutionalization, particularly in light of recent funding decisions made by the Ministry of Health's Health Promotion Branch.
Partnering in and for heart health promotion: findings from a survey of community organizations.
This paper presents the results of a survey conducted with representatives (n = 283) of community health agencies linked to heart health activity in Ontario in order to: 1) describe their levels of involvement in heart health promotion, 2) describe the nature and extent of partnering undertaken in the context of community-based heart health promotion, and 3) assess the extent to which community development approaches vis-à-vis partnering are being employed in Ontario heart health promotion. The survey included a series of questions regarding level of agency involvement in heart health promotion activities organized around four areas: tobacco, nutrition, physical activity and general heart health. Respondents were also asked to report the nature and extent of partnering that took place. Results indicate that levels of involvement varied significantly across activity area and by organization, although every agency type reported some level of involvement in each of the four activity areas. Overall, agencies surveyed continue to employ traditional settings (i.e., schools and community) as well as strategies (i.e., public education) but report a substantial amount of partnering and collaboration when undertaking community-based heart health promotion activities.
Program helps HIV+ women in rural areas overcome barriers.
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Dural sinus thrombosis: verification with spin-echo techniques.
Although MR imaging is being used increasingly to detect dural sinus thrombosis, accurate evaluation of images has often been hindered by the presence of artifacts, especially flow-related enhancement, that may simulate intraluminal clot. We tried an approach with spin-echo techniques to eliminate flow-induced artifacts and, thus, facilitate the diagnosis of dural sinus thrombosis. In this investigation, a nonselective single-section spin-echo verification method was used as a prototype of this approach. Both patients and an experimental flow phantom were used to test the validity of this concept. Clinically, thrombosis was seen to persist as isointense or highly intense signal in the vascular lumina with the specialized sequence, while flow-related artifacts were replaced by hypointense signal, but not by signal void. These same changes were examined both quantitatively and qualitatively in the flow phantom by using varying velocities of flow. Although our clinical investigation concerns suspected dural sinus thrombosis, the principles of these specialized spin-echo techniques can be applied successfully throughout the head to eliminate certain flow-related artifacts.
The West Virginia Rural Cancer Prevention project.
The West Virginia Rural Cancer Prevention Demonstration Project was designed to improve the health of the residents of a rural county by preventing cancer or diagnosing it at an earlier stage. The initial phase of the project consisted of a random telephone survey of county households, a series of focus groups, and review of patient records at a local community health center. A committee composed of the project investigators, local citizens, and local health providers identified a series of interventions to be implemented in the target county. Interventions included community-based education, improvements in on-site mammography and colposcopy, augmenting current screening and educational programs for cancer of the breast and uterine cervix, a "cancer shepherd" program, and a program to improve patient compliance and tracking within the local community health center. Outcomes of this demonstration project generally support the concept of a broad-based program to increase utilization of services for the prevention and early diagnosis of cancer of the breast and cervix in a rural community. Local culture, geography, educational level, and economics for the target area are critical considerations.
Tissue inhibitor of the metalloproteinases and renal extracellular matrix accumulation.
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Urinary gonadotropin peptide (UGP) as a marker of gynecologic malignancies.
Urinary gonadotropin peptide (UGP) was measured in 866 urines from normal women and women with benign and malignant gynecologic disease using the Triton UGP enzyme immunoassay. The greatest level of overexpression of the marker was observed in patients with ovarian cancer. Using a cutoff of 4 fmol/mg creatinine, UGP was overexpressed in samples from 2% of normal premenopausal women, 15% of normal postmenopausal women, 5% of women with benign gynecologic disease, and 59% of women with ovarian cancer. UGP expression was independent of the histologic type of ovarian cancer. The expression of UGP and CA 125 were not correlated and use of the two markers in tandem increased the sensitivity of detection of disease by greater than 20% over that which was observed using each marker individually. UGP levels were correlated with clinical status, and doubled in value in 67% of patients with progressive disease, and were halved in 93% of patients who were in remission at the time of the study.