Infection control in dentistry.
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Dentistry↗
Biomedical subjects
S Porter
Publications and source records attributed to S Porter.
Attitudes of dentists to HIV-positive patients.
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Adult↗
Class I and II HLA antigens in British patients with oral lichen planus.
The frequencies of human leukocyte antigens--HLA-A, HLA-B, HLA-C, HLA-DR, and HLA-DQ1--were determined in a group of 40 white British patients with oral lichen planus and compared with those of healthy controls. Alterations in the frequencies of several HLA antigens were noted. In particular, an increase in HLA-Bw57 and a decrease in the frequency of HLA-DQ1 were seen in the group with lichen planus. When different clinical subgroups of lichen planus were compared with the control group, significant changes were also noted in the frequencies of HLA antigens. This suggests that lichen planus may represent a heterogeneity of diseases and that HLA-Bw57 may predispose a person to lichen planus whereas HLA-DQ1 may be associated with resistance to it.
Adult↗
HIV-salivary gland disease. Salivary scintiscanning with technetium pertechnetate.
The salivary disease in two patients with human immunodeficiency virus infection was investigated by technetium pertechnetate scintiscanning. Although there was good histologic evidence of benign lymphoepithelial disease, scintiscanning failed to delineate any salivary lesions. Technetium pertechnetate scintiscanning seems to be of little value in the detailed investigation of salivary disease in human immunodeficiency virus infection, though gallium scanning can help. Fine needle aspiration or biopsy remain the main diagnostic tools.
AIDS-Related Opportunistic Infections↗
Genomic imprinting: a proposed explanation for the different behaviours of testicular and ovarian germ cell tumors.
Gonadal germ cell tumors in males are malignant in greater than 98% of cases while their ovarian counterparts are benign in 97% of cases. It has recently become clear that the maternal and paternal genomic contributions to the fertilized egg, provided by the haploid germ cells, have different and, to some extent, complementary effects on the developing embryo. This phenomenon, termed genomic imprinting, is a result of epigenetic modification of the genomes of male and female germ cells that has occurred in a sex-specific way during gametogenesis. There is a balance between the paternal and maternal effects in a normal embryo; results to date suggest that the paternal imprint promotes growth while the maternal imprint acts to limit potentially harmful overgrowth. It is proposed that differences in clinical behaviour between ovarian and testicular germ cell tumors can be explained by differences in the normal pattern of genomic imprinting of female and male germ cells.
Chromosome Deletion↗
Nursing research conventions: objectivity or obfuscation?
This paper is a critique of naïve realism, the philosophy which animates much nursing research, and which leads researchers to assume that the attainment of objective knowledge is possible. The nature of naïve realism, and its relationship to objectivity, is discussed. Central to this outlook is the belief that the values and interests of the researcher can and should be divorced from the prosecution of research. This is reflected in the literary convention of referring to the researcher in the third person. Contrary to this position, I argue that the interpretations, values and interests of the researcher are central to the research process. Moreover, nursing research may be affected by the interests of managers, educationalists, and those who wish to see nursing attain professional status. Nursing researchers should accept that they are part of the social situations which they study. They should therefore become reflexive in their outlook. This entails recognizing and attempting to understand the effects of the researcher, rather than trying to eliminate or ignore them.
Attitude↗
The determinants of psychiatric nursing practice: a comparison of sociological perspectives.
This paper commences by observing that psychiatric nurses tend not to interact with their clients in a therapeutic fashion. It is not clear, however, whether this is due to the nature of psychiatric institutions or to the attitudes of individual nurses. Contrasting social theories which posit either the importance of social structures, or of individual interpretations as determinants of behaviour, are outlined. These are then applied to the problem of psychiatric nursing practice. It is argued that while there are strengths in both theoretical positions, neither on their own can adequately characterize the complexity of the problem. Rather than attempting to explain influences upon psychiatric nursing practice in terms of either structure or action, we should appreciate the importance of, and relationship between, both factors. Given the rapid changes occurring in mental health nursing, research into factors influencing practice will become increasingly important. In order to explain developments adequately, researchers will need to take account of the duality of structure and action.
Attitude of Health Personnel↗
Liver function in UK patients with oral lichen planus.
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Adult↗
Family treatment of spouses and children of patients with multiple personality disorder.
Although there is a large body of literature on the individual treatment of patients with multiple personality disorder (MPD), there are few accounts of the treatment of the spouses and children of these patients. After reviewing some of the existing literature, the authors present case examples of family work with patients, spouses, and children on two inpatient units and in the partial hospitalization program at Menninger. Techniques for the beginning, middle, and later phases of family treatment are illustrated.
Adult↗
Spontaneous malignant transformation of melanocytes explanted from Wf/Wf mice with a Kit kinase-domain mutation.
The W/Kit mouse locus, affecting proliferation and survival of pigment cells, blood cells, and germ cells, is known to encode a tyrosine kinase growth factor receptor and is considered a protooncogene; yet it has not heretofore been causally implicated in any malignancies of those cells. The Wf/Wf mutant mouse coat comprises viable and inviable melanoblast clones, seen ultimately as pigmented and white transverse stripes--the latter more prominent. Judging from the pattern, all clones initially expand, and the inviable ones then undergo programmed cell death prenatally. To observe skin melanocytes of the viable clones during extended proliferation, the cells were explanted from individual young mice. An unusually large number of primary explants failed to survive--a result consistent with a growth handicap. In 3 of the 10 surviving cell lines, many cells spontaneously underwent a series of striking changes with the classic features of transformation. The two transformed lines that have been tested by grafting to immunosuppressed hosts formed undifferentiated invasive tumors compatible with malignant amelanotic melanoma. None of our 52 other melanocyte lines of the coisogenic wild-type strain and 13 other natural genotypes have become transformed under the same culture conditions. Molecular analysis of the Wf gene revealed a single change from wild-type: a point mutation affecting the catalytic region in the kinase domain of the Kit protein. The apparent growth disadvantage due to the mutation may allow selection for melanocytes mobilizing more efficient pathways, thus leading to neoplasia. Production of both viable and inviable melanoblast clones is unlikely to be due only to the kinase mutation; possibly the degree, duration, and consistency of expression of this locus may be controlled by cis elements outside the coding region.
Animals↗
Effect of rapid thoracic compression on the cerebral blood flow-velocity patterns of small infants.
We measured the middle cerebral artery (MCA) flow-velocities of 12 small infants (mean weight, 2,882 +/- 602 g) before, during, and after the rapid thoracic compression (RTC) maneuvers of partial forced expiratory flow-volume studies. Cerebral flow-velocities were measured using transcranial Doppler ultrasonography. RTC increased MCA end diastolic flow-velocities and Pourcelot indices of all infants (P less than 0.001). These values returned to baseline immediately after the release of chest compression. We also measured the MCA flow-velocities of several preterm infants during their normal daily activities. The changes in flow-velocity patterns observed during normal daily life were similar to those observed during RTC. These findings demonstrate that RTC produces real, but likely not pathologic, changes in cerebral blood flow-velocities.
Blood Flow Velocity↗
Institutional restraints upon education reforms: the case of mental health nursing.
The purpose of this paper is to temper over-optimistic expectations about the degree to which Project 2000 training will improve the quality of psychiatric nursing care. The paper commences by citing evidence that, to date, psychiatric nurses have tended not to adopt therapeutic approaches towards their patients. Curricular innovations aimed at encouraging them to do so have had little effect. It is argued that the effects of the latest education reforms may be similarly compromised. The reasons for mental health nurses not engaging in therapeutic care are as much to do with the institutions they work in as with the training that they receive. As long as nurses feel that it is part of their role to maintain institutional order, their therapeutic role will be compromised; while the latter requires social proximity, the former demands social distance. Moreover, because it is informal, rather than formal, therapeutic interactions that patients value in their dealings with nurses, it is not clear that the sort of knowledge that Project 2000 curricula are designed to impart will be therapeutically effective.
Attitude of Health Personnel↗
Sodium monochloroacetate poisoning of greenfinches.
A large number of passerine birds, mainly greenfinches, were found dead or dying in a hedgerow close to a field of onions recently sprayed with sodium monochloroacetate (SMCA). An analytical method is described for isolating monochloroacetic acid from bird tissues, as its potassium salt, by ion exchange chromatography. The ion exchange eluate is evaporated to dryness, acidified, extracted with ether and the ethereal extract methylated with diazomethane. The concentration of the methyl ester of monochloroacetic acid is determined using the Mass Selective Detector in the selected ion mode. Chemical analysis confirmed the exposure of the birds to SMCA. It is calculated that 50 microliter of spray contained the lethal dose of SMCA for a greenfinch.
Acetates↗
Surveillance of nosocomial infection in private psychiatric hospitals: an exploratory study.
BACKGROUND: The vast majority of work published about infection control programs, procedures, and practices addresses general acute care facilities. Consequently, infection-control coordinators at psychiatric hospitals have few established norms or models to use in adapting available standards to the unique needs of psychiatric hospitals and their patients. This descriptive study explored practices for the surveillance of nosocomial infections in private psychiatric hospitals. METHODS: A survey was mailed to the infection control coordinator of the 284 hospitals belonging to the National Association of Private Psychiatric Hospitals. Questionnaire data were collected anonymously. Surveys were returned by 103 (36%) of the hospitals. RESULTS: The most frequent criteria used to define the presence of nosocomial infections were the Center for Disease Control guidelines and clinical judgment, used by 38% and 39% of the respondents, respectively. Most (64%) of the respondents indicated that they did calculate a nosocomial infection rate. The most frequent method used to calculate infection rates was based on patient discharges. Sixty-five hospitals (63%) reported their most recent yearly infection rate, which ranged from 0.00 to 0.35, with a median rate of 0.05 (mean, 0.06; SD, 0.07). CONCLUSIONS: Overall, the findings reflected much variability in respondents' practices in defining nosocomial infections and calculating infection rates. We therefore suggest that both the method used to calculate the rate and facilities' definitions of nosocomial infection be considered when comparing infection rates across facilities.
Cross Infection↗
Purification, Characterization, and Cloning of Cinnamyl Alcohol Dehydrogenase in Loblolly Pine (Pinus taeda L.).
Cinnamyl alcohol dehydrogenase (CAD, EC 1.1.1. 195) has been purified to homogeneity from differentiating xylem tissue and developing seeds of loblolly pine (Pinus taeda L.). The enzyme is a dimer with a native molecular weight of 82,000 and a subunit molecular weight of 44,000, and is the only form of CAD involved in lignification in differentiating xylem. High levels of loblolly pine CAD enzyme were found in nonlignifying seed tissue. Characterization of the enzyme from both seeds and xylem demonstrated that the enzyme is the same in both tissues. The enzyme has a high affinity for coniferaldehyde (K(m) = 1.7 micromolar) compared with sinapaldehyde (K(m) in excess of 100 micromolar). Kinetic data strongly suggest that coniferin is a noncompetitive inhibitor of CAD enzyme activity. Protein sequences were obtained for the N-terminus (28 amino acids) and for two other peptides. Degenerate oligonucleotide primers based on the protein sequences were used to amplify by polymerase chain reaction a 1050 base pair DNA fragment from xylem cDNA. Nucleotide sequence from the cloned DNA fragment coded for the N-terminal protein sequence and an internal peptide of CAD. The N-terminal protein sequence has little similarity with the lambdaCAD4 clone isolated from bean (MH Walter, J Grima-Pettenati, C Grand, AM Boudet, CJ Lamb [1988] Proc Natl Acad Sci USA 86:5546-5550), which has homology with malic enzyme.
Journal Article↗
The poverty of professionalization: a critical analysis of strategies for the occupational advancement of nursing.
The purpose of this paper is to evaluate critically the strategies of occupational advancement used by nurses. It is noted that these are frequently framed within the paradigm of professionalization. However, despite the ubiquity of its use, it is argued that this model is inappropriate. Specific strategies are examined. Attempts to appropriate the title of profession by demonstrating that nursing possesses the relevant attributes are dismissed as rhetorical exercises. The rise of managerialism, despite being cloaked in the guise of professionalism, is seen as anti-professional because it restricts the autonomy of individual practitioners. Clinical 'professionalization' is also regarded as problematic because it does not fit with the definition of a professional as an autonomous practitioner. Examination of patient advocacy, and of attempts to validate nursing diagnosis, demonstrate that the occupational advancement of clinical nurses is increasingly dependent upon the co-operation of health care consumers. This dependence is incompatible with the prescriptive powers and exclusive knowledge that are claimed by traditional professions. It is concluded that nurses should abandon the ideology of professionalization and concentrate on the more pertinent issue of maximizing the efficacy of the occupation.
Career Mobility↗
Project School Care: integrating children assisted by medical technology into educational settings.
The increasing number of children assisted by medical technology in the U.S. has led to a need for systematic planning for the children's care in community settings such as schools. Project School Care in Massachusetts provides consultation to school systems as schools respond to the challenge of integrating children assisted by medical technology into educational settings. The model of practice described includes the step-wise planning process and the ensuing training, enrollment, and monitoring procedures. Implications are explored with particular emphasis on upgrading of skills at all medical and educational levels. More input from school health personnel in administrative decision-making around enrollment of children with special health care needs is recommended. For these children, a health care plan should be incorporated into their Individualized Education Plans and into their school records.
Boston↗
Working conditions of British resident hospital oral and maxillofacial surgeons.
The aim of this study was to determine the opinions of on-call senior house officers in British oral and maxillo-facial surgery, or related units, about aspects of their working conditions. Despite concern about the conditions of service of junior hospital staff in other clinical specialties, the results suggest that most senior house officers in this discipline are satisfied with their present posts. However, regular review of their conditions of service is still indicated.
Attitude of Health Personnel↗