Digital Commons Network^™

Screening For Parkinson's Disease With Response Time Batteries: A Pilot Study, Andrew Johnson, Philip Vernon, Quincy Almeida, Linda Grantier, Rene Singarayer, Mandar Jog

Andrew M. Johnson

Background: Although significant response time deficits (both reaction time and movement time) have been identified in numerous studies of patients with Parkinson's disease (PD), few attempts have been made to evaluate the use of these measures in screening for PD. Methods: Receiver operator characteristic curves were used to identify cutoff scores for a unit-weighted composite of two choice response tasks in a sample of 40 patients and 40 healthy participants. These scores were then cross-validated in an independent sample of 20 patients and 20 healthy participants. Results: The unit-weighted movement time composite demonstrated high sensitivity (90%) and specificity (90%) in …

Cleaning Ability Of Disinfectants For Dental Steel Burs, Noor Hayaty Abu Kasim Abu Kasim N.H.

Noor Hayaty Abu Kasim Abu Kasim N.H.

Dental burs are a source of bacterial contamination due to its direct contact with carious teeth, saliva and blood. Objective: The aim of this study was to evaluate the disinfecting and cleaning ability of selected commercially available disinfectants on dental burs. Method: Size 5 round stainless steel burs were used to excavate caries from freshly extracted human molars. The burs were then immediately immersed in Grotanat Drill Bath (Shülke & Mayr, Germany), Micro 10 (Unident, Swizerland), Gigasept FF (Shülke & Mayr, Germany), Lysetol AF (Shülke & Mayr, Germany) and 70% Isopropyl alcohol (J.Y. Baker, USA) according to the manufacturer's instructions. …

Survival Of Patients With Metastatic Breast Cancer: Twenty-Year Data From Two Seer Registries, Patricia Tai, Edward Yu, Vincent Vinh-Hung, Gábor Cserni, Georges Vlastos

Edward Yu

Background: Many researchers are interested to know if there are any improvements in recent treatment results for metastatic breast cancer in the community, especially for 10- or 15-year survival. Methods: Between 1981 and 1985, 782 and 580 female patients with metastatic breast cancer were extracted respectively from the Connecticut and San Francisco-Oakland registries of the Surveillance, Epidemiology, and End Results (SEER) database. The lognormal statistical method to estimate survival was retrospectively validated since the 15-year cause-specific survival rates could be calculated using the standard life-table actuarial method. Estimated rates were compared to the actuarial data available in 2000. Between 1991 …

Waiver Of Consent For Emergency Research, Andrew Mcrae, Charles Weijer

Charles Weijer

No abstract provided.

The Methylentetrahydrofolate Reductase Gene Variant (C677t) As A Risk Factor For Essential Hypertension In Caucasians, S. Heux, F. Morin, R. Lea, M. Ovcaric, L. Tajouri, L. Griffiths

Lotti Tajouri

Essential hypertension (EH) is a common, multifactorial disorder likely to be influenced by multiple genes of modest effect. The methylenetetrahydrofolate reductase (MTHFR) gene C677T mutation is functionally important, being strongly associated with reduced enzyme activity and increased plasma levels of homocysteine. Mild hyperhomocysteinemia is a known risk factor for cardiovascular disease (CVD) and hypothesised also to be involved in hypertension pathophysiology. The present study was performed to determine the prevalence of the 677T mutation in Australian Caucasian patients diagnosed with EH and to test whether the C677T variant is associated with the disorder. A case-control cohort, consisting of 250 EH …

Retraining Balance Using Task-Focussed Work-Stations, Nancy Low Choy

Nancy Low Choy

Extract:

This chapter aims to:
Present a task-oriented approach to retraining balance and mobility using workstations as an effective mode of delivering tailored interventions to individual or small groups of residents or community-based elders who are: frail aged; elders who ambulate with supervision within residential care facilities; or elders who are independently ambulant in the community.

Provide an outline of workstations that illustrate varying levels of challenge but address the multiple aspects of balance and mobility that need to be considered while retraining balance and mobility in elders.

© Copyright Elsevier Limited, 2004

Embedding Evidence-Based Practice In A Nursing Curriculum: A Benchmarking Project, Wendy Chaboyer, Ania Willman, Patricia Johnson, Lynette Stockhausen

Patricia Johnson

The development of a new nursing curriculum in one Australian university provided the opportunity for academic staff to consider the best ways to integrate the requirements of evidence-based practice (EBP) into nursing education and culminated in the development and conduct of a specific benchmarking project. Data collection for the project included the use of university documents, observations and informal discussions with staff. An analysis of this information resulted in the emergence of five categories that were grouped into two major categories, namely infrastructure and processes. Within the major category of infrastructure, two minor categories, namely evidence-based nursing (EBN) Unit and …

A Theoretical Framework For The Assessment And Treatment Of Balance And Mobility Deficits, Nancy Low Choy

Nancy Low Choy

Extract:

This chapter aims to:
Review the theoretical elements that contribute to balance and mobility as a basis for assessing balance and mobility in the elderly, and presenting a tailored but multidimensional approach to assessing and retraining balance and mobility deficits in the elderly.

Describe a process of assessing balance and mobility in the elderly that uses observational and problem-solving skills while analysing balance and mobility tasks, identifies and measures impairments, and monitors progress and outcomes for elders of varying functional motor ability.

© Copyright Elsevier Limited, 2004

Managing Unmanageable Physicians: Leadership, Stewardship, And Disruptive Behavior, Tim Keogh, William Martin

William Marty Martin

Physician and health care leaders are seeking guidance and support on how to address disruptive behavior that has an impact on safety, quality, and performance. This article equips leaders with a model and process to prevent and address disruptive behavior.

A Spiroplasma Associated With Tremor Disease In The Chinese Mitten Crab (Eriocheir Sinensis), Wen Wang, Bohai Wen, Gail E. Gasparich, Ningning Zhu, Liwen Rong, Jianxiu Chen, Zaikuan Xu

Gail Gasparich

Framingham Score For Cardiovascular Diseases Among Civil Servantes,Sao Paulo, 1998.[Portuguese], Paulo A. Lotufo

Paulo A Lotufo

Lecture presented the first meeting for a cohort study addressing cardiovascular diseases in Brazil. Hospital Universitario/ Universidade de Sao Paulo, August, 2004.

Planning Evaluation Of Radiotherapy For Complex Lung Cancer Cases Using Helical Tomotherapy, Tomas Kron, Grigor Grigorov, Edward Yu, Slav Yartsev, Jeff Chen, Eugene Wong, George Rodrigues, Kris Trenka, Terry Coad, Glenn Bauman, Jake Van Dyk

Edward Yu

Lung cancer treatment is one of the most challenging fields in radiotherapy. The aim of the present study was to investigate what role helical tomotherapy (HT), a novel approach to the delivery of highly conformal dose distributions using intensity-modulated radiation fan beams, can play in difficult cases with large target volumes typical for many of these patients. Tomotherapy plans were developed for 15 patients with stage III inoperable non-small-cell lung cancer. While not necessarily clinically indicated, elective nodal irradiation was included for all cases to create the most challenging scenarios with large target volumes. A 2 cm margin was used …

Effects Of Des-Aspartate-Angiotensin I On The Actions Of Angiotensin Iii In The Renal And Mesenteric Vasculature Of Normo-And Hypertensive Rats, Mohd Rais Mustafa, Murugan Dharmani, Kunheen N.K, Meng-Kwoon Sim

Mohd Rais Mustafa

An earlier study showed that des-aspartate-angiotensin I (DAA-I) attenuated the pressor action of angiotensin III in aortic rings of the spontaneously hypertensive rat (SHR) but not the normotensive Wistar Kyoto (WKY) rat. The present study investigated similar properties of DAA-I in isolated perfused kidneys and mesenteric beds of WKY and SHR. In the renal vasculature, angiotensin III induced a dosedependent pressor response, which was more marked in the SHR than WKY in terms of significant greater magnitude of response and lower threshold. DAA-I attenuated the pressor action of angiotensin III in both the WKY and SHR. The attenuation in SHR …

Cara Menghilangkan Gatal Di Kemaluan Pria, Obatgataldi Selangkanganpaha

obatgataldi selangkanganpaha

Towards An Integrated Model For Breast Cancer Etiology: The Lifelong Interplay Of Genes, Lifestyle, And Hormones, Susan E. Hankinson, Graham A. Colditz, Walter C. Willett

Graham Andrew Colditz

While the association of a number of risk factors, such as family history and reproductive patterns, with breast cancer has been well established for many years, work in the past 10–15 years also has added substantially to our understanding of disease etiology. Contributions of particular note include the delineation of the role of endogenous and exogenous estrogens to breast cancer risk, and the discovery and quantification of risk associated with several gene mutations (e.g. BRCA1). Although it is difficult to integrate all epidemiologic data into a single biologic model, it is clear that several important components or pathways exist. Early …

Towards An Integrated Model For Breast Cancer Etiology: The Lifelong Interplay Of Genes, Lifestyle, And Hormones, Susan E. Hankinson, Graham A. Colditz, Walter C. Willett

Susan E. Hankinson

While the association of a number of risk factors, such as family history and reproductive patterns, with breast cancer has been well established for many years, work in the past 10–15 years also has added substantially to our understanding of disease etiology. Contributions of particular note include the delineation of the role of endogenous and exogenous estrogens to breast cancer risk, and the discovery and quantification of risk associated with several gene mutations (e.g. BRCA1). Although it is difficult to integrate all epidemiologic data into a single biologic model, it is clear that several important components or pathways exist. Early …

Impact And Influences On Caregiver Outcomes At One Year Post-Stroke, Lorraine N. Smith, John Norrie, Susan M. Kerr, Maggie Lawrence, Peter Langhorne, Kennedy R. Lees

Dr. Maggie Lawrence

Four outcome measures of carer stress and coping at one year post-stroke were identified: carer general health, anxiety, depression and perception of stress. Each outcome was assessed using valid and reliable instruments. In addition, we collected demographic data from both carers and patients which could reasonably be expected to influence carer stress and coping (e.g. age, deprivation levels) as well as information specific to the caring role. Results: Carers were found to be more anxious than previously reported. Neither satisfaction with caring nor the adoption of helpful coping strategies were associated with positive carer outcomes but, nevertheless, carers were not …

Reclaiming The Everyday World: How Long-Term Ventilated Patients In Critical Care Seek To Gain Aspects Of Power And Control Over Their Environment, Patricia Johnson

Patricia Johnson

Critical care nurses are increasingly seeking to base patient care on evidence derived from research studies. The purpose of this study was to explore the meanings former patients attributed to being on long-term mechanical ventilation in a critical care unit (CCU) in Australia. Using Heideggerian phenomenology, unstructured interviews were undertaken with nine participants. Data were analysed thematically using the method developed by van Manen. Thematic analysis revealed four major themes. This article presents the findings from the theme titled: Reclaiming the everyday world, which describes how the study participants gained comfort from the presence of nurses and their families, sought …

The Role Of Adenosine-Related Genes Variants In Susceptibility To Essential Hypertension, Kirsty Wright, Lotti Tajouri, Rod Lea, Micky Ovcaric, Stephanie Heux, Fabien Morin, Wallid Bey, John Headrick, Lyn Griffiths

Lotti Tajouri

Objective: To test markers within adenosine-related genes: A1 and A2a receptors (ADORA1, ADORA2a) and adenosine deaminase (ADA) for potential involvement in essential hypertension (EH).

Design: Case-control association study investigating gene variants for the ADORA1, ADORA2a and ADA genes.

Participants: The study used a cohort of 249 unrelated hypertensive individuals who were diagnosed with hypertension, and an age, sex and ethnically matched group of 249 normotensive controls.

Results: The association analysis indicated that both allele and genotype frequencies did not differ significantly between the case and control groups (P > 0.05) for any of the markers tested.

Conclusion: The adenosine-related gene variants …

Normal Values Of Balance Tests In Women Aged 20 - 80, Rosemary Isles, Nancy Low Choy, Marie Steers, Jennifer Nitz

Nancy Low Choy

Objectives:
To determine normal values for four commonly used clinical functional balance tests from community-dwelling women aged 20 to 80 and to identify any significant decline due to aging.

Design:
A cross-sectional study was undertaken to provide normative values for four clinical balance tests across 6 decade cohorts.

Setting:
The Betty Byrne-Henderson Center for Women and Aging, Royal Womens' Hospital, Brisbane, Australia.

Participants:
Four hundred fifty-six community-dwelling, independently ambulant women with no obvious neurological or musculoskeletal-related disability, aged 20 to 80, were randomly recruited from a large metropolitan region.

Measurements:
The clinical balance measures/tests were the Timed Up and Go …

Temporal Coherence Of Criteria For Four Personality Disorders, Leslie C. Morey, Andrew E. Skodol, Carlos M. Grilo, Charles A. Sanislow, Mary C. Zanarini, M. Tracie Shea, John G. Gunderson, Thomas H. Mcglashan

Charles A. Sanislow, Ph.D.

This study sought to investigate the coherence of changes observed in diagnostic criteria for borderline, schizotypal, obsessive-compulsive, and avoidant personality disorders. Five hundred, forty-nine patients were independently evaluated 2 years apart, and correlations of observed changes in each diagnostic criterion with changes in other criteria were examined to determine if there was within-syndrome consistency in these changes. The observed changes in criteria were consistent within syndrome (median alpha = 0.72 across 4 disorders), and reasonably specific to that syndrome relative to the other disorders. The results support the validity of these criterion sets as representing coherent syndromes.

Living Donor Liver Transplantation: Surgical Techniques And Innovations, Vivian C. Mcalister

Vivian C. McAlister

A colleague and I attended a talk about a set of liver transplant experiments in mice, which the speaker had designed to undermine a commonly held immunological belief. My companion (who should have known better) afterward asked me rhetorically, "What's next? Heart transplantation in a tadpole?"

When does the awe-inspiring give way to the commonplace? Technically wonderful surgery is considered ordinary not because it is commonly done but because the holder of this opinion has no image of the technique.

Not long ago, resectional hepatic surgery was followed by the development of orthotopic liver transplantation. Although both techniques have matured …

Investigation Of An Inducible Nitric Oxide Synthase Gene (Nos2a) Polymorphism In A Multiple Sclerosis Population, Lotti Tajouri, Virginie Martin, Micky Ovcaric, Rob Curtain, Rod Lea, Peter Csurhes, Michael Pender, Lyn Griffiths

Lotti Tajouri

Multiple sclerosis (MS) is a chronic inflammatory disease of the central nervous system (CNS) affecting most commonly the Caucasian population. Nitric oxide (NO) is a biological signaling and effector molecule and is especially important during inflammation. Inducible nitric oxide synthase (iNOS) is one of the three enzymes responsible for generating NO. It has been reported that there is an excessive production of NO in MS concordant with an increased expression of iNOS in MS lesions. This study investigated the role of a bi-allelic tetranucleotide polymorphism located in the promoter region of the human iNOS (NOS2A) gene in MS susceptibility. A …

Health Care In Canada: Provinces Versus The Federal Government, Vivian C. Mcalister

Vivian C. McAlister

Ako Ako: A Progress Report On A Collaborative Peer Mentoring Pilot Programme, Chrissy Joyce-Erueti, Rhona Poutu-Shaw, Khurshid Mitchell

Chrissy Erueti

We present a progress report on a pilot peer-mentoring programme for staff at a tertiary institution. Ako Ako is a Maori methodology of learning that acknowledges that both partners share the power base of teaching and learning. Peer mentoring replicates this methodology and requires a paradigm shift from traditional mentoring where one is deemed to have higher levels of knowledge and skills. In this process the group engages in an exchange of knowledge and skills to enhance professional practice. Although mentoring was occurring within the institute, no formal structure was in place. A need was established and a framework to …

Sex Differences In Copd And Lung Cancer Mortality Trends—United States, 1968–1999, Neely Kazerouni, C. J. Alverson, Stephen C. Redd, Joshua A. Mott, David M. Mannino

David M. Mannino

Purpose: Cigarette smoking by U.S. women in the 1940s and 1950s caused large increases in smoking-related lung disease among women. To determine the magnitude of these increases, we compared the mortality trends for males and females in the United States for chronic obstructive pulmonary disease (COPD) and lung cancer for 1968-1999.

Methods: We used the national mortality data files compiled by the National Center for Health Statistics of the CDC and U.S. census data to calculate age-adjusted (2000) death rates for COPD, lung cancer, and all causes.

Results: COPD death rate for females increased by 382% from 1968 through 1999, …

Report On The Introduction And Evaluation Of An Assistant Practitioner, Susan Nancarrow, Hazel Mackey

Susan Nancarrow

No abstract provided.

The Neurobiology Of Antiepileptic Drugs For The Treatment Of Nonepileptic Conditions, Michael A. Rogawski, Wolfgang Löscher

Michael A. Rogawski

Antiepileptic drugs (AEDs) are commonly prescribed for nonepileptic conditions, including migraine headache, chronicneuropathic pain, mood disorders, schizophrenia and various neuromuscular syndromes. In many of these conditions, as in epilepsy, the drugs act by modifying the excitability of nerve (or muscle) through effects on voltage-gated sodium and calciumchannels or by promoting inhibition mediated by γ-aminobutyric acid (GABA) A receptors. In neuropathic pain, chronic nerveinjury is associated with the redistribution and altered subunit compositions of sodium and calcium channels that predisposeneurons in sensory pathways to fire spontaneously or at inappropriately high frequencies, often from ectopic sites. AEDs maycounteract this abnormal activity by …

A Systematic Review Of Brachytherapy. Is It An Effective And Safe Treatment For Localised Prostate Cancer?, Jenny Doust, Emma Miller, Gillian Duchesne, Michael Kitchener, David Weller

Jenny Doust

BACKGROUND Brachytherapy is a promising treatment for prostate cancer as it may have reduced rates of impotence and incontinence. OBJECTIVE General practitioners can influence the treatment patients receive by their referral patterns, so it is important they understand the effectiveness and safety of treatment. We reviewed the primary literature on brachytherapy as sole therapy for localised prostate cancer. DISCUSSION Although there have been many studies on the safety and effectiveness of brachytherapy, there have been no trials of brachytherapy versus other treatments that would control for factors such as tumour stage, grade, or initial prostate specific antigen levels. Brachytherapy for …

The Neurobiology Of Antiepileptic Drugs, Michael Rogawski, Wolfgang Löscher

Michael A. Rogawski

Antiepileptic drugs (AEDs) provide satisfactory control of seizures for most patients with epilepsy. The drugs have the remarkable ability to protect against seizures while permitting normal functioning of the nervous system. AEDs act on diverse molecular targets to selectively modify the excitability of neurons so that seizure-related firing is blocked without disturbing non-epileptic activity. This occurs largely through effects on voltage-gated sodium and calcium channels, or by promoting inhibition mediated by GABA-A (γ-aminobutyric acid, type A) receptors. The subtle biophysical modifications inchannel behaviour that are induced by AEDs are often functionally opposite to defects in channel properties that are caused …