Medicine and Health Sciences Commons^™

Muc4/Muc4 Functions And Regulation In Cancer., Goldi Kozloski

Goldi A Kozloski

Living In A Material World: How Visual Cues To Material Properties Affect The Way That We Lift Objects And Perceive Their Weight, Gavin Buckingham, Jonathan Cant, Melvyn Goodale

Gavin Buckingham

The visual properties of an object provide many cues as to the tensile strength, compliance, and density of the material from which it is made. However, it is not well understood how these implicit associations affect our perceptions of these properties and how they determine the initial forces that are applied when an object is picked up. Here we examine the effects of these cues on such forces by using the classic "material-weight illusion" (MWI). Grip and load forces were measured in three experiments as participants lifted cubes made from metal, wood, and expanded polystyrene. These cubes were adjusted to …

Uptake Of A Team Briefing In The Operating Theatre: A Burkean Dramatistic Analysis, Sarah Whyte, Carrie Cartmill, Fauzia Gardezi, Richard Reznick, Beverley Orser, Diane Doran, Lorelei Lingard

Lorelei Lingard

Communication among healthcare professionals is a focus for research and policy interventions designed to improve patient safety, but the challenges of changing interprofessional communication patterns are rarely described. We present an analysis of 756 preoperative briefings conducted by general surgery teams (anesthesiologists, nurses, and surgeons) at four urban Canadian hospitals in the context of two research studies conducted between August 2004 and December 2007. We ask the questions: how and why did briefings succeed, how and why did they fail, and what did they mean for different participants? Ethnographic fieldnotes documenting the coordination and performance of team briefings were analyzed …

Plantar Cutaneous Sensory Stimulation Improves Single-Limb Support Time, And Emg Activation Patterns Among Individuals With Parkinson's Disease, M. Jenkins, Q. Almeida, S. Spaulding, R. Van Oostveen, J. Holmes, Andrew Johnson, S. Perry

Andrew M. Johnson

Parkinson's disease is a chronic neurological disorder that results in gait and posture impairment. There is increasing evidence that these motor impairments may be partially due to deficits within the sensory system. In this study, the effects of a facilitatory insole that provides increased plantar sensory stimulation, was evaluated during gait, in a group of individuals with Parkinson's disease in comparison with healthy age-matched controls. Spatial-temporal parameters of gait were evaluated using an instrumented carpet, and muscle activation patterns were evaluated using surface EMG. All participants were tested with both a facilitatory (ribbed) insole and a conventional (flat) insole while …

Effect Of Interval To Definitive Breast Surgery On Clinical Presentation And Survival In Early-Stage Invasive Breast Cancer, Olga Vujovic, Edward Yu, Anil Cherian, Francisco Perera, A. Dar, Larry Stitt, A. Hammond

Edward Yu

Purpose: To examine the effect of clinical presentation and interval to breast surgery on local recurrence and survival in early-stage breast cancer. Methods and materials: The data from 397 patients with Stage T1-T2N0 breast carcinoma treated with conservative surgery and breast radiotherapy between 1985 and 1992 were reviewed at the London Regional Cancer Program. The clinical presentation consisted of a mammogram finding or a palpable lump. The intervals from clinical presentation to definitive breast surgery used for analysis were 0-4, >4-12, and >12 weeks. The Kaplan-Meier estimates of the time to local recurrence, disease-free survival, and cause-specific survival were determined …

Learner-Centred Medical Education: Improved Learning Or Increased Stress?, Michelle Mclean, T Gibbs

Michelle McLean

Context: Globally, as medical education undergoes significant reform towards more "learner-centred" approaches, specific implications arise for medical educators and learners. Although this learner-centredness is grounded in educational theory, a point of discussion would be whether the application and practice of these new curricula alleviate or exacerbate student difficulties and levels of stress. Objectives: This commentary will argue that while this reform in medical education is laudable, with positive implications for learning, medical educators may not have understood or perhaps not embraced "learner-centredness" in its entirety. Discussion: During their training, medical students are expected to be "patient-centred". They are asked to …

Role Of Non-Group A Streptococci In Acute Pharyngitis, Jeffrey Tiemstra, R L. Miranda

Jeffrey Tiemstra, MD, FAAFP

Accelerated Fractionation In Inoperable Non-Small Cell Lung Cancer. A Phase I/Ii Study, Edward Yu, Luis Souhami, Julio Guerra, Brenda Clark, Carole Gingras, Palma Fava

Edward Yu

Background: A prospective, single-treatment-arm, Phase I/II trial was performed to determine the tumor response to an accelerated regimen and assess the feasibility and toxic effects of this approach in patients with inoperable non-small cell lung cancer (NSCLC). Methods: Thirty-seven previously untreated patients with inoperable NSCLC who had no evidence of metastatic disease entered the study. All patients were able to walk and had disease that was measurable or assessable. Patients with palpable supraclavicular disease and weight loss were also eligible. Radiation therapy consisted of an altered fractionation regimen with a concomitant boost technique. The original lung volume received a dose …

Decarboxylation Of L-Dopa And 5-Hydroxytryptophan In Dispersed Rat Pancreas Acinar Cells, E. Yu, L. Stern, A. Tenenhouse

Edward Yu

Amino acid decarboxylation activity in dispersed rat pancreas acinar cells and fractions derived by differential centrifugation of homogenate of these cells was studied. The rate of decarboxylation was measured by determining the rate of production of the [3H]-amine from [3H]-amino acid or the rate of production of 14CO2 from the [14C]-carboxy-labelled amino acid. Only the hydroxylated amino acids L-dopa and 5-hydroxytryptophan are decarboxylated by intact dispersed pancreas acinar cells or cell homogenates at all pH values and amino acid concentrations tested. The decarboxylase activity is located exclusively in the cell cytosol. Each substrate competitively inhibits the decarboxylation of the other …

Circulatory Arrest In A Brain-Dead Organ Donor: Is The Use Of Cardiac Compression Permissible?, Michael Moreland

Michael P. Moreland

No abstract provided.

Is The Risk Syndrome For Psychosis Risky Business?, Amresh Shrivastava

Amresh Srivastava

No abstract provided.

Ethical Challenges In Icu Research, Charles Weijer

Charles Weijer

No abstract provided.

Current Practice In Physical Child Abuse Forensic Reports: A Preliminary Exploration, Marcellina Mian, Catherine Schryer, Marlee Spafford, Jan Joosten, Lorelei Lingard

Lorelei Lingard

No abstract provided.

What Factors Predict Outcome At Relapse After Previous Esophagectomy And Adjuvant Therapy In High-Risk Esophageal Cancer?, Edward Yu, Patricia Tai, Richard Malthaner, Larry Stitt, George Rodrigues, Rashid Dar, Brian Yaremko, Jawaid Younus, Michael Sanatani, Mark Vincent, Brian Dingle, Dalilah Fortin, Richard Inculet

Edward Yu

Management of patients who have disease relapse after completion of surgery and adjuvant chemo-radiation (CRT) is controversial. Some oncologists would advocate intensive therapeutic intervention due to promising experience on treatment for recurrence disease while others would recommend palliative support due to the concerns for poor patient outcome post disease recurrence. In Addition, it is not clear if patient outcome is improved post adjuvant CRT when patients at risk have resection margin involvement and if time interval to recurrence can affect patient survival post relapse. The present study was conducted to determine what factors will affect patient outcome at relapse after …

When Can Physicians Say “No” To Families And Patients?, Charles Weijer

Charles Weijer

No abstract provided.

Medical Device Patents, Lawrence Sung

Lawrence M. Sung

This product addresses the unique aspects of U.S. medical device patents, specifically durable medical equipment, and examines their grant and enforcement. Coverage includes information on prosecution, transfer, and litigation, including settlement. Patents for specific types of devices are addressed. The comprehensive treatment of patents in the medical specialties of orthopedics, cardiovascular disease, dentistry, ophthalmology, radiology, and surgery, among others, is a useful resource for readers, whether they seek competitive business insight or are curious about the history of medical technology development.

Decision-Making By Adolescents And Parents Of Children With Cancer Regarding Health Research Participation, Kate Read, Conrad Fernandez, Jun Gao, Caron Strahlendorf, Albert Moghrabi, Rebecca Pentz, Raymond Barfield, Justin Baker, Darcy Santor, Charles Weijer, Eric Kodish

Charles Weijer

Background: Low rates of participation of adolescents and young adults (AYAs) in clinical oncology trials may contribute to poorer outcomes. Factors that influence the decision of AYAs to participate in health research and whether these factors are different from those that affect the participation of parents of children with cancer.

Methods: This is a secondary analysis of data from validated questionnaires provided to adolescents (>12 years old) diagnosed with cancer and parents of children with cancer at 3 sites in Canada (Halifax, Vancouver, and Montreal) and 2 in the United States (Atlanta, GA, and Memphis, TN). Respondents reported their …

Pillows For Pain, Michael Lock

Michael Lock

No abstract provided.

Natural Killer Cell Activity Following 6 Weeks Of Strength Training In Healthy Young Males With/Without Testosterone Enanthate Administration, Sonya Marshall-Gradisnik, Robert Weatherby, Glen Deakin, Rosanne Coutts, Rudi Meir, Paul Connellan, Lesley Stevenson, Shane Rogerson, Shi Zhou

Sonya Marshall-Gradisnik

There is limited information on the acute immune response to resistance-training programs in combination with short-term administration of the anabolic androgenic steroid, testosterone enanthate (TE), in healthy young males. Eighteen healthy young men were match-paired and randomly assigned in a double-blind manner to either a TE or a placebo (PG) group. All subjects performed a structured resistance-training program while receiving injection of either TE at the dosage of 3.5 mg per kilogram body mass, or saline as placebo, once weekly for 6 weeks. A 10-second all-out cycle sprint test was conducted at the beginning (Week 0) and end (Week 6) …

Treatment Resistant Depression, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Switching And Selecting Atypical Antipsychotic Drugs: Paliperidone, Amresh Srivastava

Amresh Srivastava

No abstract provided.

Hdl-Cholesterol-Raising Effect Of Orange Juice In Subjects With Hypercholesterolemia, Elzbieta Kurowska, J. Spence, John Jordan, Stephen Wetmore, David Freeman, Leonard Piché, Paula Serratore

Leonard Piché

Background: Orange juice-a rich source of vitamin C, folate, and flavonoids such as hesperidin-induces hypocholesterolemic responses in animals. Objective: We determined whether orange juice beneficially altered blood lipids in subjects with moderate hypercholesterolemia. Design: The sample consisted of 16 healthy men and 9 healthy women with elevated plasma total and LDL-cholesterol and normal plasma triacylglycerol concentrations. Participants incorporated 1, 2, or 3 cups (250 mL each) of orange juice sequentially into their diets, each dose over a period of 4 wk. This was followed by a 5-wk washout period. Plasma lipid, folate, homocyst(e)ine, and vitamin C (a compliance marker) concentrations …

Understanding Screen-Related Sedentary Behavior And Its Contributing Factors Among School-Aged Children: A Social-Ecologic Exploration, Meizi He, Stewart Harris, Leonard Piché, Charlene Beynon

Leonard Piché

Purpose: To explore the factors that contribute to children's screen-related sedentary (S-RS) behaviors. Settings: Elementary schools. Subjects: A random sample of children in grades five and six and their parents. Measures: The outcome measure was children's S-RS activity level measured by a self-administered questionnaire. A full spectrum of potential contributing factors for children's S-RS behaviors was obtained through surveys. Multilevel linear regression methods were used to determine the associations between these factors and children's screen time (hours per day) and results were expressed as regression coefficients (g). Results: Of 955 child-parent pairs in 14 participating schools, 508 pairs (53%) completed …

Factors Impacting On The Lives Of Terminally Ill Older People, And Requests For Euthanasia, Phd Thesis, University Of Queensland, Colleen Cartwright

Professor Colleen M Cartwright

No abstract provided.

A Proposed Ethical Framework For Vaccine Mandates: Competing Values And The Case Of Hpv, Robert Field, Arthur Caplan

Robert I. Field

Debates over vaccine mandates raise intense emotions, as reflected in the current controversy over whether to mandate the vaccine against human papilloma virus (HPV), the virus that can cause cervical cancer. Public health ethics so far has failed to facilitate meaningful dialogue between the opposing sides. When stripped of its emotional charge, the debate can be framed as a contest between competing ethical values. This framework can be conceptualized graphically as a conflict between autonomy on the one hand, which militates against government intrusion, and beneficence, utilitarianism, justice, and nonmaleficence on the other, which may lend support to intervention. When …

Evaluating Diagnostic Tests—Should The Same Methods Apply?, Jenny Doust, Jonathon Craig

Jenny Doust

It is now accepted wisdom by regulators, purchasers, journal editors, and clinicians that the true effects of health care interventions can only be evaluated by well-designed randomized controlled trials. The study by Rutten et al,¹ reports the results of a randomized controlled trial of N-terminal pro-brain natriuretic peptide in an emergency department in the Netherlands. Given that this is the third randomized controlled trial assessing the effectiveness and cost effectiveness of a natriuretic peptide in an emergency department setting,²,³ it is important to ask whether diagnostic tests should always be evaluated by randomized controlled trials or are other study types …

Contractile Properties Of The Pig Bladder Mucosa In Response To Neurokinin A: A Role For Myofibroblasts?, P Sadananda, Russ Chess-Williams, E Burcher

Russ Chess-Williams

Background and purpose: The bladder urothelium is now known to have active properties. Our aim was to investigate the contractile properties of the urinary mucosa in response to the tachykinin neurokinin A (NKA) and carbachol. Experimental approach: Discrete concentration–response curves for carbachol and NKA were obtained in matched strips of porcine detrusor, mucosa and intact bladder, suspended in organ baths. The effects of inhibitors and tachykinin receptor antagonists were studied on NKA-mediated contractions in mucosal strips. Intact sections of bladder and experimental strips were processed for histology and immunohistochemistry. Key results: All types of strips contracted to both carbachol and …

Turning Simulation Into Reality: Increasing Student Competence And Confidence, Debra Wagner, Mary Bear, Jane Sander

Debra L Wagner

Clinical experiences are an essential part of nursing education as students learn technical skills, build on critical thinking skills, and hone skills in patient teaching. To build competence and confidence in each of these skill areas, an innovative clinical experience for senior students enrolled in women’s health nursing was developed to provide nursing care and independent discharge teaching for postpartum mothers. Faculty facilitated this clinical experience by designing a simulation laboratory for students to practice their maternal self-care teaching and infant care skills prior to beginning their clinical rotation. In the hospital, students spent a day independently prioritizing new mothers’ …

The Sum Of The Parts Detracts From The Intended Whole: Competencies And In-Training Assessments, Elaine Zibrowski, S. Singh, Mark Goldszmidt, Christopher Watling, Cynthia Kenyon, Valerie Schulz, Heather Maddocks, Lorelei Lingard

Lorelei Lingard

OBJECTIVES: Despite the fact that Canadian residency programmes are required to assess trainees' performance within the context of the CanMEDS Roles Framework, there has been no inquiry into the potential relationship between residents' perceptions of the framework and their in-training assessments (ITA). Using data collected during the study of ITA, we explored residents' perceptions of these competencies.

METHODS: From May 2006-07, a purposive sample of 20 resident doctors from internal medicine, paediatrics, and surgery were interviewed about their ITA experiences. Data collection and analysis proceeded in an iterative fashion consistent with grounded theory. In April 2008, a summary of recurrent …

Ethical And Policy Issues In Cluster Randomized Trials: Rationale And Design Of A Mixed Methods Research Study, Monica Taljaard, Charles Weijer, Jeremy Grimshaw, Judith Brown, Ariella Binik, Robert Boruch, Jamie Brehaut, Shazia Chaudhry, Martin Eccles, Andrew Mcrae, Raphael Saginur, Merrick Zwarenstein, Allan Donner

Charles Weijer

Background: Cluster randomized trials are an increasingly important methodological tool in health research. In cluster randomized trials, intact social units or groups of individuals, such as medical practices, schools, or entire communities--rather than individual themselves--are randomly allocated to intervention or control conditions, while outcomes are then observed on individual cluster members. The substantial methodological differences between cluster randomized trials and conventional randomized trials pose serious challenges to the current conceptual framework for research ethics. The ethical implications of randomizing groups rather than individuals are not addressed in current research ethics guidelines, nor have they even been thoroughly explored. The main …