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Biomedical subjects

S Millar

Publications and source records attributed to S Millar.

At least 19 recordsLinked to original sources
PubMed2001

Patient education: designing a state-of-the-art consumer health information library.

Many patients believe that the education they receive about their health and their illnesses is inadequate or lacking. Nurse executives are in a key position to influence their patients' abilities to become more informed and to take greater responsibility for their healthcare decisions. In the article, the authors discuss Massachusetts General Hospital's state-of-the-art consumer health information library, including how the project was planned, organized, and implemented.

Boston↗
PubMed2001

Illusions in reading maps by touch: reducing distance errors.

The study reports systematic distance errors in reading raised-line maps by touch, and how they can be reduced. We show that T-shaped road junctions produce the typical error due to overestimating the length of the bisecting road compared to the bisected road. The error was not reduced when the target location was marked initially by a symbol. However, it was eliminated by instructions to use both hands concurrently to scan the route relative to an external square frame surrounding the map layout and to the body midline. Road junctions, which resemble 'Müller-Lyer' configurations, produced a significant overestimation of the length of a road that ended in diverging side roads relative to underestimating a road section with converging side roads. Spatial anchor cues from landmarks along the route, either alone or in conjunction with the spatial frame instructions, eliminated the illusion equally. We discuss theoretical implications, and the use of map frames and landmarks as spatial guides to improve map use by touch.

Adolescent↗
PubMed2001

A critical pathway for electronic medical record selection.

Electronic medical records (EMRs) are increasingly becoming a necessary tool in health care. Given their potential to influence every aspect of health care, there has been surprisingly little rigorous research applied to this important piece of emerging health technology. An initial phase of the COMPETE study, which is examining the impact of EMRs on efficiency, quality of care and privacy concerns, involved a rigorous "critical pathway" approach to EMR selection for the study. A multidisciplinary team with clinical, technical and research expertise led an 8-stage evaluation process with direct input from user physicians at each stage. An iterative sequence of review of EMR specifications and features, live product demonstrations, site visits, and negotiations with vendors led to a progressive narrowing of the field of eligible EMR systems. Final scoring was based on 3 main themes of clinical usability, data quality and support/vendor issues. We believe that a rigorous, multidisciplinary process such as this is required to maximize success of any EMR implementation project.

Humans↗
PubMed2000

The active phase-related increase in corticosterone and aggression are linked.

Recently we demonstrated that corticosterone exerts an acute facilitatory effect on aggression in male rats. Corticosterone production reaches a maximum at the onset of the dark period, while male rats are more aggressive in the dark. Here we present evidence demonstrating that the corticosterone increase at the beginning of the dark period is causally linked to the increase in aggressiveness. We measured plasma corticosterone and quantified aggressive behaviour of male territorial rats at various time points of the day-night transition. Low aggression levels were observed in the full light period when plasma concentrations of corticosterone were low. An increase in plasma corticosterone occurred just prior to the dark phase, when aggressive responding was the highest. Aggressive behaviour remained high in the early dark period when corticosterone was still high. We found that blocking the high affinity mineralocorticoid receptor (MR) with spironolactone (5 or 10 mg/kg) during the early dark period dramatically and specifically reduced territorial aggression.

Aggression↗
PubMed2000

Vertical and bisection bias in active touch.

We investigated the conditions that underlie the vertical and bisection illusion in touch, in order to understand the basis of their similarity to visual illusions, and the means of reducing the biases in length perception by active touch. Movement, speed, and spatial reference cues were tested. Movements in scanning L-shapes in ipsilateral and contralateral (across the body midline) table-top space produced significant underestimation of the vertical line with the right hand, but not with the left hand. Right-handed scanning of L-shapes showed no significant bias when the vertical line in the figure was aligned to the body midline, suggesting that spatial cues were involved. The vertical line was overestimated in inverted T-shapes, but underestimated in rotated T-shapes, implicating line bisection. Holding scanning latencies constant reduced the vertical error for inverted T-shapes, but could not explain the bisection bias. Sectioning biases were predicted by the location of junctions on sectioned lines, showing that junction points act as misleading anchor cues for movement extents. The illusion was significantly reduced when reference information was added by instructing subjects to relate two-handed scanning of the figure to an external frame and to body-centred cues. It is argued that disparities in spatial reference (anchor) cues for movement extents are involved in vertical and bisection biases in active touch. The hypothesis that length illusions depend on disparities in spatial reference information can also account for the similarity of the tactile to the visual horizontal-vertical illusion.

Adolescent↗
PubMed1999

Veering re-visited: noise and posture cues in walking without sight.

Effects of sound and posture cues on veering from the straight-ahead were tested with young blind children in an unfamiliar space that lacked orienting cues. In a pre-test with a previously heard target sound, all subjects walked straight to the target. A recording device, which sampled the locomotor trajectories automatically, showed that, without prior cues from target locations, subjects tended to veer more to the side from which they heard a brief, irrelevant noise. Carrying a load on one side produced more veering to the opposite side. The detailed samples showed that, underlying the main trajectories, were alternating concave and convex (left and right) movements, suggesting stepwise changes in body position. It is argued that the same external and body-centred cues that contribute to reference-frame orientation for locomotion when they converge and concur, influence the direction of veering when the cues occur in isolation in environments that lack converging reference information.

Auditory Perception↗
PubMed1998

Mineralocorticoid receptor blockade inhibits aggressive behaviour in male rats.

Previous experiments have demonstrated that aggressive behaviour of male rats in a territorial setting is facilitated by corticosterone. Moreover, the inhibition of the endogenous corticosterone response prevents agonistic behaviour. The aim of the present paper was to investigate the effect of mineralocorticoid receptor (MR) blockade on the expression of aggressive behaviour at the beginning of the dark phase, when MRs are mostly occupied due to the diurnal peak of corticosterone secretion. High levels of aggressive behaviour were induced in male Wistar rats cohabiting with females by exposing them 3 times to an intruder male rat of smaller size. Intruder males were introduced at the beginning of the active period on every second day for 20 minutes, while the female was temporarily removed. A gradual increase in the number of biting attacks was noticed, the rats performing 6.7 +/- 2.0 attacks per 20 min on the last day (n=8). One hour before the fourth encounter rats were injected with the MR blocker spironolactone (10 mg/kg). Attacking behaviour was almost totally abolished (0.87 +/- .35 attacks per 20 min; n=8). Vehicle injections were ineffective (9.3 +/- 2.1 attacks per 20 min; n=8). Offensive threats underwent similar changes while other behaviours showed non-significant variation, with the exception of resting which increased towards the end of the observation period. The time course of these effects showed that the primary action was on offensive aggressive behaviour. This report is the first to show that the almost total MR occupancy at the beginning of the dark (active) period of the day is a prerequisite for the expression of aggressiveness in response to a social challenge.

Aggression↗
PubMed1998

Symmetry in haptic and in visual shape perception.

Four experiments tested the hypothesis that bilateral symmetry is an incidental encoding property in vision, but can also be elicited as an incidental effect in touch, provided that sufficient spatial reference information is available initially for haptic inputs to be organized spatially. Experiment 1 showed that symmetry facilitated processing in vision, even though the task required judgments of stimulus closure rather than the detection of symmetry. The same task and stimuli failed to show symmetry effects in tactual scanning by one finger (Experiment 2). Experiment 3 found facilitating effects for vertically symmetric open stimuli, although not for closed patterns, in two-forefinger exploration when the forefingers had previously been aligned to the body midaxis to provide body-centered spatial reference. The one-finger exploration condition again failed to show symmetry effects. Experiment 4 replicated the facilitating effects of symmetry for open symmetric shapes in tactual exploration by the two (previously aligned) forefingers. Closed shapes again showed no effect. Spatial-reference information, finger movements, and stimulus factors in shape perception by touch are discussed.

Form Perception↗
PubMed1997

Cytokines in human breast milk.

In early life humans derive all their nutrients from milk. Human milk provides the neonate with not only a food source but also a source of biologically active molecules such as hormones, growth factors and cytokines. Cytokines are multifunctional glycoproteins involved in cell communication and immune system activation. Two of these cytokines, granulocyte-colony stimulating factor (G-CSF) and interleukin-6 (IL-6), are present in variable concentrations in human milk. We measured G-CSF and IL-6 concentrations in healthy nursing mothers. The 30 milk samples assayed contained G-CSF levels from 14 pg/mL to > 2500 pg/mL. Of the 28 milk samples assayed for IL-6, 24 contained levels from 0.81 pg/mL to 306 pg/ mL. The remainder had levels below the detection limit of the assay. These biologically active molecules may play a role in neonatal growth and development, and may also protect the infant against infection.

Granulocyte Colony-Stimulating Factor↗
PubMed1994

Human milk contains granulocyte colony stimulating factor.

Human milk provides the neonate with a variety of balanced nutrients and contains biologically active molecules such as hormones and growth factors. We have utilized a sensitive enzyme immunoassay to detect the granulocyte stimulator, granulocyte colony-stimulating factor (G-CSF) in human milk samples. The 12 milk samples tested contained G-CSF ranging from 45 to 1551 pg/ml.

Adult↗
PubMed1993

EGF abrogation-induced fusilli-form dysmorphogenesis of Meckel's cartilage during embryonic mouse mandibular morphogenesis in vitro.

Mutations associated with genes of the EGF superfamily are implicated in facial malformations arising from abnormal development of the first branchial arch. EGF and EGF receptor (EGFr) transcripts are expressed in the mouse embryonic first branchial arch and derivatives from E9 through E15. EGF transcripts are localized to ectomesenchymal cells associated with precartilage, cartilage, bone and tooth-forming cells. EGF and EGFr proteins co-localize to the same cells suggesting an autocrine regulation. To test whether EGF effects the timing and positional information required for Meckel's cartilage (MC) and tooth development, we cultured E10 mandibular explants in serumless, chemically defined medium with either antisense or sense EGF oligodeoxynucleotides. Antisense inhibition of EGF expression produces bilaterally symmetrical Fusilli-form dysmorphogenesis of MC and decreases tooth bud size; these effects are reversed by the addition of exogenous EGF to the culture medium. Tyrphostin RG 50864, which inhibits EGF receptor kinase activity, inhibits EGF stimulation of tyrosine phosphorylation in a concentration-dependent manner and severely retards mandibular development yet increases tooth size. These findings support the hypothesis that endogenous EGF and EGF-like proteins provide signalling to regulate the size and shape both of cartilage and tooth formation during craniofacial morphogenesis.

Animals↗
PubMed1991

Predicting elderly cardiac patients at risk for readmission.

Elder patients with cardiac disease are at high risk for physical deterioration during post hospital recovery and suffer frequent early readmission. It is important to identify such patients who frequently need help with discharge planning from social workers during their first admission. This study utilized computerized data on 628 patients, 238 of whom were readmissions. Question was raised as to what factors (functional, psychological, social and environmental), differentiated patients who were readmitted from those who were not. Using logistic regression, three variables: marital status, presence of coping difficulty and age of patients were identified as predictors of readmission within three months. Those who were married were less likely to be readmitted. Those with coping difficulties and older individuals were more likely to be readmitted. The accuracy of prediction, using these three factors, was 61 percent. Of those patients predicted as not being readmitted, sixty-nine percent were correctly predicted, while 39 percent were readmitted. Of patients predicted as readmissions, 49 percent were correctly predicted, while 51 percent were not. The major limitation of this study was that key physiological determinants of readmission were not collected. It is imperative that a valid screening device for predicting who is at risk for readmission should include physiological preconditions as well as functional and psychosocial data.

Adaptation, Psychological↗
PubMed1990

Screening elder cardiac patients to identify need for social work services.

Present screening methods to identify older patients in need of posthospital care planning are overly sensitive and lack specificity, with the rate of false-positive screenings reaching 65 percent. Research was undertaken to develop a computerized screening mechanism to identify elderly cardiac patients at high risk for posthospital care needs. Using the data from the Medicus Nursing Productivity and Quality of Patient Care Classification System (NPAQ) as potential predictive factors, the false-positive screening rate was reduced to 26 percent. Early and accurate identification of these patients may prove beneficial to patients and their families and to social workers and hospital administrators. It can improve social worker efficiency in developing and implementing an adequate posthospital care plan, thus enhancing patient recovery.

Aftercare↗