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PubMed2005

Tumour size distribution in mammography screening.

Many mammography screening programmes have not been able to show higher percentages of small invasive cancers detected at subsequent screens than at initial screens. This has been a matter of serious concern as it contradicts the very theory of screening. Based on data from the county of Fyn, Denmark we evaluated the distribution based on point estimates, as well as on the entire tumour size distribution. The programme changed the amount of tumours less than 15 or 20 mm, but did not change the amount of tumours less than 10 mm. We evaluated the entire tumour size distribution and found that screen number was the only significant factor, implying that the number of screens changed the tumour size distribution. We recommend that the entire tumour size distribution is used to evaluate the ability of a programme to detect small breast cancers, instead of only point estimates as has previously been the practice.

Aged↗
PubMed2005

Acid aspiration prophylaxis in labour: a survey of UK obstetric units.

BACKGROUND: The risk of acid aspiration is still a major concern in pregnant patients. In view of the increasing numbers of drugs available to decrease gastric acid production, it seemed timely to reassess acid aspiration prophylaxis policies in the UK. METHOD: An OAA-approved postal survey of 250 UK lead consultant obstetric anaesthetists was conducted in 2004 in order to establish the current practice of acid aspiration prophylaxis in labour. If acid aspiration prophylaxis was used, further questions were asked relating to subgroups of patients, category, dose and route of administration of drugs used and whether there was an anticipated change in practice. RESULTS: A response rate of 83% was achieved. There had been a decrease in the routine use of acid aspiration prophylaxis to 32% of units, an increase in the use of acid aspiration prophylaxis in "at risk" groups to 61% and a decrease in the number of units never using prophylaxis to 7%. Oral ranitidine administered six-hourly is the most common practice. There is little use of proton pump inhibitors. CONCLUSION: Compared to previous surveys of UK practice there has been an overall increase in the use of acid aspiration prophylaxis.

Antacids↗
PubMed2005

SIH--a novel lipophilic iron chelator--protects H9c2 cardiomyoblasts from oxidative stress-induced mitochondrial injury and cell death.

Recent evidence suggests that oxidative stress is a common denominator in many aspects of cardiovascular pathogenesis. Free cellular iron plays a crucial catalytic role in the formation of highly toxic hydroxyl radicals, and thereby it may aggravate the contribution of oxidative stress to cardiovascular disease. Therefore, iron chelation may be an effective therapeutic approach, but the progress in this area is hindered by the lack of effective agents. In this study, using the rat heart myoblast-derived cell line H9c2, we aimed to investigate whether the novel lipophilic iron chelator salicylaldehyde isonicotinoyl hydrazone (SIH) protects the cells against hydrogen peroxide (H2O2)-induced cytotoxicity. Exposure of cells to 100 micromol/l H2O2 has within 4 h induced a complete dissipation of their mitochondrial membrane potential (DeltaPsim). Co-treatment with SIH dose-dependently reduced (EC50=0.8 micromol/l) or even completely abolished (3 micromol/l) this collapse. Furthermore, the latter SIH concentration was capable to fully prevent alterations in cell morphology, and inhibited both apoptosis (annexin-V staining, nuclear chromatin shrinkage, TUNEL positivity) and necrosis (propidium iodide staining), even 24 h after the H2O2 exposure. In comparison, deferoxamin (a commercially available hydrophilic iron chelator used in clinical practice and most previous studies) was cytoprotective only at three-order higher and clinically unachievable concentrations (EC50=1300 micromol/l). Thus, in this study, we present iron chelation as a very powerful tool by which oxidative stress-induced myocardial damage can be prevented.

Aldehydes↗
PubMed2000

Cognitive strategies for reporting portion sizes using dietary recall procedures.

OBJECTIVES: To examine recall strategies used by interview respondents when making judgments about portion size and to better understand how respondents use various portion-size aids. DESIGN: Study participants were separated into groups, each using a different set of portion-size estimation aids: (a) 2-dimensional paper aids presented in stacks, (b) 2-dimensional aids, cut out and presented on rings, (c) household-type aids, and (d) a combination of 2- and 3-dimensional aids, many of which are used in national government surveys. Respondents gave a "quick list" of foods consumed the previous day and practiced cognitive thinking skills. Then the interviewer selected at least 2 solid, 2 liquid, and 2 amorphous foods for probing. Respondents were asked to think aloud as they reported how much they ate of each food. Types and frequencies of cognitive strategies used for portion-size estimation were determined. SUBJECTS: Interviews of 1 to 1 1/2 hours were conducted with 76 adults aged 18 to 65 years. Participants were recruited to obtain a mix of races, ages, educational levels, and genders. RESULTS: The most frequently used strategy was visualization and comparison to aids. Others strategies were known amounts, estimations based on known amounts, visualization of volume or a container, and actions such as pouring or moving hands to the mouth. Respondents preferred aids that were similar in size and shape to actual portions consumed for liquid or amorphous food and preferred the ruler for solid foods. APPLICATIONS: To obtain the best data from dietary recalls, expect answers that are possible for respondents to give, supply respondents with aids that help them recall amounts consumed, and guide respondents to appropriate aids that help them formulate focused responses.

Adolescent↗
PubMed2000

Nurses' participation and utilization of research in the Republic of China.

A survey was done to improve understanding of nurses' participation in research activities and their utilization of research for practice in one developing country, the Republic of China. The sample for this 1996-1997 study was 382 staff nurses and nurse managers. Using two instruments designed for the project it was found that although research participation was low overall, 64% participated in some research activities with data collection and presentation at national conferences the most frequent activities. Nearly half the nurses had utilized research to change practice in the previous three years. The main barriers to utilization were lack of time and lack of staff. Role models, consultation and guidance to locate useful research were the main types of needed assistance. The findings provide direction for future training, education and managerial policy, especially for nurses in developing countries, which account for 84% of the world's population and 93% of the worldwide burden of disease.

Adult↗
PubMed2006

Urinary metabolic evaluations in normal and stone forming children.

PURPOSE: Urinary stone disease is relatively rare in children and urinary metabolic evaluations have been the standard in our practice. We have previously reported a high rate of urinary metabolic abnormalities in stone forming children. We compared urinary chemistry values in normal and stone forming children. MATERIAL AND METHODS: A prospective study was performed to assess urinary metabolic profiles in children with no history or a family history of urinary calculi. The 24-hour urine collections were performed and evaluated at an outside central laboratory. Urine chemistry studies were adjusted for creatinine. The data were compared to those on a historical cohort of calcium stone forming children. RESULTS: A total of 58 samples from normal children and 142 from stone forming children were evaluated. Mean age was 10 years in normal children and 12 years in stone forming children. of the normal and stone forming children 45% and 51%, respectively, were female. Supersaturation levels of calcium oxalate as well as calcium to creatinine levels were significantly higher in children with stones. No data confounding by age or sex was identified by stratification. CONCLUSIONS: There are significant differences in urinary metabolic evaluations between normal and stone forming children. This may allow more precise treatment to prevent recurrent stone episodes. We continue to perform metabolic evaluations in all children with documented urolithiasis.

Adolescent↗
PubMed1997

Adult outcome of children reared for long-term periods in foster families.

OBJECTIVE: To study the long term impact of adverse childhood experiences resulting from family breakdowns combined with a stable care environment. Another aim was to determine predictive factors for maladjusted psycho-social integration in adulthood. METHOD: Sixty-three children from severely psychosocially dysfunctioning families selected from among those having been in care in an institutional setting: All had been reared for at least 5 years by foster families, had been out of care for more than 5 years and were at least 23 years old at the time of the survey. Semi-structured interviews were used in a follow-up study to assess adult outcome, essentially in terms of professional status, social, and family relationships. RESULTS: Data was obtained for 94% of the study population (n = 59), 71% via direct interviews (n = 45). The majority had managed to overcome their childhood adversities: 56% were well-integrated socially, 12% had average integration results, 20% were partially integrated and 10% were in situations of failure. These difficulties were linked to multiple family disturbances and repeated traumatic experiences during childhood (p < .05). Multiple regression analyses indicated that these risk factors accounted for 28% of the variance in the social integration score (p < .0001). Severe emotional deprivation over a prolonged period was a contributing factor to clinical disorders. CONCLUSION: At the study period, intergenerational repetition of "child placement" behaviors, significant in the previous generation, had practically disappeared. The results also highlighted the substantial psychotherapeutic and child-rearing assistance provided by the staff of the foster care agency.

Adolescent↗
PubMed1997

A three-dimensional multivariate model of passive human joint torques and articular boundaries.

OBJECTIVE: The development of a novel three-dimensional mathematical model of passive human joint torques that is of practical use, takes into account the complex non-linear interactions that exist between the moments generated by the various passive structures spanning the joint in question, and is applicable to all types of articular joints. DESIGN: Mathematical model validated by practical implementation. BACKGROUND: Previous models of passive human joint torques were predominantly one-dimensional and did not take into account the interactions of the various structural components. METHODS: Mathematical modelling is used in conjunction with repeated passive torque experiments on the right elbow joint of a healthy 29-year-old male. On the basis of the experimentally observed torque-angle data, the full set of articular model parameters characterizing the two-dimensional passive elastic torque function of the subject's right elbow joint could be determined. RESULTS: In addition to the passive elastic torque functions, the two-dimensional contour of the elbow joint's articular boundaries was also obtained. CONCLUSIONS: The present model is especially useful for assessing certain pathological conditions in any body joint investigated, and in addition is best suited for the inclusion in large-scale dynamic simulation models of the human neuromusculoskeletal system.

Journal Article↗
PubMed2003

Health technology assessment in its local contexts: studies of telehealthcare.

Health technology assessment (HTA) is one of the major research enterprises of late modernity, reaching into fields of previously autonomous professional practice, and critically interrogating the organisation and delivery of health care. The 'evaluation' of new health technologies within the field of HTA is increasingly a normative political expectation, as discourses of 'evidence-based' practice run through health policy in the UK and elsewhere. Despite its importance in governing the direction of innovation in health care delivery, there are hardly any empirical studies of HTA in practice. In this paper, we draw on two ethnographic studies of telehealthcare implementation and evaluation in the UK to explore the practical conduct of HTA, and we focus specifically on the social organisation and conduct of randomised controlled trials of these new technologies. The paper examines how evaluation forms a mediating set of practices that make the embedding or normalisation of a new technology possible; and present a simple model of the social and technical contingencies within the evaluation process.

Anthropology, Cultural↗
PubMed1985

Gas chromatographic-mass spectrometric analysis of methylphenidate and p-hydroxymethylphenidate using deuterated internal standards.

A gas chromatography-mass spectrometry assay is described for the simultaneous determination of threo-dl-methylphenidate and threo-dl-p-hydroxymethylphenidate in plasma and urine using selected ion monitoring of electron impact generated fragments of their pentafluoropropionyl derivatives. The use of recently available deuterated analogues as internal standards improves overall performance relative to previous methods. The practical limit of quantifiable detection of the assay is 0.5 ng/ml for both methylphenidate and p-hydroxymethylphenidate. p-Hydroxymethylphenidate appears to be a significant urinary metabolite of methylphenidate in rats but not in humans.

Adult↗
PubMed2002

Making the transition from enrolled to registered nurse.

Each year among the university graduates who become eligible to register as nurses for the first time, there are a number of people who have previously trained and practiced as enrolled nurses. There is little research that examines the experiences and needs of this unique group of simultaneously experienced and novice nurses. In this paper, a phenomenological approach was used to examine the lived experience of nine former enrolled nurses making the transition from nursing student to graduate nurse. Data from extensive interviews with these nine nurses was examined using van Manen's (1990) steps of thematic analysis. The grouping of concepts into subthemes led to the identification of three main themes that described the nurses' experiences of transition: responsibility and accountability, change, and job satisfaction. Excerpts from interview transcripts are used as exemplars in discussion of the meaning and importance of these findings. The findings of this study will inform nurse education and graduate transition support services.

Career Mobility↗
PubMed2002

A case study to detect the leakage of underground pressureless cement sewage water pipe using GPR, electrical, and chemical data.

The exploration and determination of leakage of underground pressureless nonmetallic pipes is difficult to deal with. A comprehensive method combining Ground Penetrating Rader (GPR), electric potential survey and geochemical survey is introduced in the leakage detection of an underground pressureless nonmetallic sewage pipe in this paper. Theoretically, in the influencing scope of a leakage spot, the obvious changes of the electromagnetic properties and the physical-chemical properties of the underground media will be reflected as anomalies in GPR and electrical survey plots. The advantages of GPR and electrical survey are fast and accurate in detection of anomaly scope. In-situ analysis of the geophysical surveys can guide the geochemical survey. Then water and soil sampling and analyzing can be the evidence for judging the anomaly is caused by pipe leakage or not. On the basis of previous tests and practical surveys, the GPR waveforms, electric potential curves, contour maps, and chemical survey results are all classified into three types according to the extent or indexes of anomalies in orderto find out the leakage spots. When three survey methods all show their anomalies as type I in an anomalous spot, this spot is suspected as the most possible leakage location. Otherwise, it will be down grade suspected point. The suspect leakage spots should be confirmed by referring the site conditions because some anomalies are caused other factors. The excavation afterward proved that the method for determining the suspected location by anomaly type is effective and economic. Comprehensive method of GRP, electric potential survey, and geochemical survey is one of the effective methods in the leakage detection of underground nonmetallic pressureless pipe with its advantages of being fast and accurate.

Data Collection↗
PubMed2007

Second generation catalytic asymmetric synthesis of Tamiflu: allylic substitution route.

Catalytic asymmetric synthesis of Tamiflu, an important antiinfluenza drug, was achieved. After the catalytic enantioselective desymmetrization of meso-aziridine 3 with TMSN3, using a Y catalyst (1 mol %) derived from ligand 2, an allylic oxygen function and C1 unit on the C=C double bond were introduced through cyanophosphorylation of enone and allylic substitution with an oxygen nucleophile. This second generation route of Tamiflu is more practical than our previously reported route. [reaction: see text].

Catalysis↗
PubMed2001

Failure of ondansetron in treating cerebellar tremor in MS patients--an open-label pilot study.

Cerebellar tremor is a frequent and disabling symptom in multiple sclerosis (MS) patients. Supportive pharmacological treatment with different drugs showed only minor effects in a few studies and in clinical practice. Encouraged by previous studies with ondansetron, a 5HT3-antagonist, we conducted a small open-label, prospective and controlled study with 14 MS patients suffering predominantly from cerebellar tremor of the upper extremities. Principal outcome measure to evaluate a functional improvement of the single intravenous administered ondansetron injection was the subject performance in the 9-hole-peg-test (9HPT) and 3 blind assessed upper extremity writing and copying tasks. We neither found significant improvement in the upper extremity tests nor in the subjective response of the patients. In conclusion we could not confirm a beneficial effect of ondansetron on cerebellar tremor of MS patients.

Adult↗
PubMed1999

The work-family research agenda in changing contexts.

This article argues that research on the work-family interface has evolved against a backdrop of dramatic and ongoing social and workplace change and must continue to reflect current and future context. The article overviews current trends that have implications for work and family and considers some possible future scenarios. It identifies a number of research areas and questions that build on previous theoretical and practical developments in the work-family field and reflect current trends. It is argued that questions about the well-being and sustainability of workplace human resources, of families in their diverse forms, and of communities are of overriding significance for the work-family research agenda, particularly if current trends continue unabated.

Family Relations↗
PubMed2003

Using auditory streaming to reduce disruption to serial memory by extraneous auditory warnings.

Three experiments were conducted to examine the effects of extraneous speech warnings (i.e., low-priority warnings initiated during high-priority tasks) on cognitive performance and whether organizing the auditory warnings into streams can attenuate any disruption. Experiment 1 demonstrated that a variety of speech warnings can be separated into perceptually distinct streams by allocating them to discrete spatial locations. Experiment 2 showed that increasing the rate of presentation of the warnings to promote streaming decreased clarity ratings but increased perceived urgency ratings. Experiment 3 demonstrated that the disruption to serial memory for navigational information by extraneous speech warnings could be attenuated by streaming. Results are interpreted in light of previous research, and practical implications for auditory warning design are discussed.

Adult↗
PubMed1994

Metabolism of cytochrome P4503A substrates in vivo administered by the same route: lack of correlation between alfentanil clearance and erythromycin breath test.

Because there is considerable interindividual variation in both microsomal CYP3A4 activity and CYP3A4 substrate disposition, an established probe of in vivo CYP3A4 activity would represent an important advance in clinical practice. In a previous study, no correlation was found between the 14C-erythromycin breath test and urinary dapsone recovery ratio. However these drugs were administered by different routes, with the orally administered dapsone being exposed to presystemic metabolism by the gut and renal metabolism before the measurement of the urinary ratio. To overcome the variable of route of administration, the aim of this study was to determine whether the elimination of two intravenously administered CYP3A4 substrates (alfentanil and erythromycin) correlate. We compared the metabolism of alfentanil to its CYP3A4-dependent metabolite, noralfentanil, with the erythromycin breath test in 14 young healthy white men. No significant correlation was found between alfentanil metabolism and the erythromycin breath test: alfentanil clearance versus erythromycin breath test, r = 0.45, p = 0.1; partial metabolic clearance to noralfentanil versus erythromycin breath test, r = 0.35, p = 0.23. Because these two CYP3A4 substrates were administered by the same (intravenous) route, we conclude that differences in the route of administration do not explain the lack of correlation between the erythromycin breath test and other probes of CYP3A4 metabolism.

Adult↗
PubMed2003

Miniaturized gas ionization sensors using carbon nanotubes.

Gas sensors operate by a variety of fundamentally different mechanisms. Ionization sensors work by fingerprinting the ionization characteristics of distinct gases, but they are limited by their huge, bulky architecture, high power consumption and risky high-voltage operation. Here we report the fabrication and successful testing of ionization microsensors featuring the electrical breakdown of a range of gases and gas mixtures at carbon nanotube tips. The sharp tips of nanotubes generate very high electric fields at relatively low voltages, lowering breakdown voltages several-fold in comparison to traditional electrodes, and thereby enabling compact, battery-powered and safe operation of such sensors. The sensors show good sensitivity and selectivity, and are unaffected by extraneous factors such as temperature, humidity, and gas flow. As such, the devices offer several practical advantages over previously reported nanotube sensor systems. The simple, low-cost, sensors described here could be deployed for a variety of applications, such as environmental monitoring, sensing in chemical processing plants, and gas detection for counter-terrorism.

Air↗